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公开(公告)号：US20070156020A1
公开(公告)日：2007-07-05
申请号：US11714578
申请日：2007-03-06
申请人： Kevin Foley , Maurice Smith , John Clayton , Joseph Moctezuma
发明人： Kevin Foley , Maurice Smith , John Clayton , Joseph Moctezuma
IPC分类号： A61B1/00
CPC分类号： A61M29/02 , A61B17/02 , A61B17/1671 , A61B17/3417 , A61B17/3421 , A61B90/50 , A61B2017/00261 , A61B2017/00296 , A61B2017/0046 , A61B2017/00469 , A61B2017/0262 , A61B2017/3445 , A61B2017/347 , A61B2090/306 , A61B2090/3614 , A61B2090/373 , A61M29/00
摘要： A method for accessing the spine includes making an incision in the skin of a patient. The skin and tissue can be dilated, and a cannula inserted through the dilated skin and tissue. The cannula includes a distal end positioned adjacent a first working space that includes paraspinous tissue. The cannula can be repositioned through the incision to a second working space adjacent the distal end of the cannula.
摘要翻译： 用于访问脊柱的方法包括在患者的皮肤中进行切口。 皮肤和组织可以扩张，插管穿过扩张的皮肤和组织。 套管包括邻近包括棘突状组织的第一工作空间定位的远端。 套管可以通过切口重新定位到邻近套管远端的第二工作空间。
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公开(公告)号：US20060025677A1
公开(公告)日：2006-02-02
申请号：US11179044
申请日：2005-07-11
申请人： Laurent Verard , Joel Hughes , Steven Hartmann , John Kappus , Joseph Moctezuma , Matthew DiCorleto , Bradley Jascob , John Clayton
发明人： Laurent Verard , Joel Hughes , Steven Hartmann , John Kappus , Joseph Moctezuma , Matthew DiCorleto , Bradley Jascob , John Clayton
IPC分类号： A61B5/05
CPC分类号： A61B90/39 , A61B5/062 , A61B5/4504 , A61B5/4528 , A61B5/7285 , A61B6/12 , A61B6/4405 , A61B6/4423 , A61B6/4441 , A61B6/541 , A61B8/4245 , A61B8/543 , A61B17/3421 , A61B34/20 , A61B90/36 , A61B2034/107 , A61B2034/2051 , A61B2034/2068 , A61B2034/207 , A61B2034/2072 , A61B2034/256 , A61B2090/365 , A61B2090/367 , A61B2090/376 , A61B2090/378 , A61B2090/3954 , A61B2090/3983 , H01F2005/027
摘要： A surgical navigation system for navigating a region of a patient that may include a non-invasive dynamic reference frame and/or fiducial marker, sensor tipped instruments, and isolator circuits. The dynamic reference frame may be placed on the patient in a precise location for guiding the instruments. The dynamic reference frames may be fixedly placed on the patient. Also the dynamic reference frames may be placed to allow generally natural movements of soft tissue relative to the dynamic reference frames. Also methods are provided to determine positions of the dynamic reference frames. Anatomical landmarks may be determined intra-operatively and without access to the anatomical structure.
摘要翻译： 一种用于导航患者区域的手术导航系统，其可以包括非侵入性动态参考框架和/或基准标记器，传感器尖端器械和隔离器电路。 动态参考框架可以在用于引导仪器的精确位置放置在患者身上。 动态参考框架可以固定地放置在患者身上。 此外，动态参考框架可以被放置成允许软组织相对于动态参考框架的大体自然移动。 还提供了用于确定动态参考帧的位置的方法。 可以在手术中确定解剖标志，而不需要解剖结构。
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公开(公告)号：US06206822B1
公开(公告)日：2001-03-27
申请号：US09347200
申请日：1999-07-02
IPC分类号： A61B104
CPC分类号： A61M29/02 , A61B17/02 , A61B17/1671 , A61B17/3417 , A61B17/3421 , A61B90/50 , A61B2017/00261 , A61B2017/00296 , A61B2017/0046 , A61B2017/00469 , A61B2017/0262 , A61B2017/3445 , A61B2017/347 , A61B2090/306 , A61B2090/3614 , A61B2090/373 , A61M29/00
摘要： Devices and methods for performing percutaneous spinal surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (DI) and an outer diameter (DO) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D2) equal to the diameter (DI) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30). The fixture (30) includes a housing (31) attachable to the proximal end (22) of the cannula (20) that defines a working channel opening (35) which is in communication with the working channel (25). The housing (31) also defines an optics bore (60) adjacent the working channel opening (35). In certain embodiments, the fixture (30) supports the viewing element (50) for translation and/or rotation within the optics bore (60) along the longitudinal axis of the bore, and for rotation of the housing (31) relative to the cannula (20) so that the longitudinal axis of the optics bore (60) will rotate about the longitudinal axis of the working channel (25). Methods are also provided for performing spinal surgeries percutaneously with direct visualization and without the requirement for a fluid-maintained workspace.
摘要翻译： 示出了在直接可视化下和通过单个插管进行经皮脊柱手术的装置和方法。 提供了一种装置（10），其包括具有第一内径（DI）和外径（DO）的细长套管（20），所述第一内径（DI）和外径（DO）的尺寸用于经皮引入患者体内。 套管（20）在其端部（21,22）之间限定工作通道（25），该工作通道具有等于套管的直径（DI）的第二直径（D2），该直径（DI）的尺寸用于容纳穿过其中的工具。 细长的观察元件（50）可以优选地通过夹具（30）与靠近工作通道（25）的套管（20）接合。 固定装置（30）包括可连接到套管（20）的近端（22）的壳体（31），该壳体限定与工作通道（25）连通的工作通道开口（35）。 壳体（31）还限定邻近工作通道开口（35）的光学孔（60）。 在某些实施例中，固定装置（30）支撑观察元件（50），用于沿着孔的纵向轴线在光学孔眼（60）内平移和/或旋转，并且用于壳体（31）相对于插管 （20），使得光学孔（60）的纵向轴线将围绕工作通道（25）的纵向轴线旋转。 还提供了用于通过直接可视化经皮肤执行脊柱手术并且不需要流体维持的工作空间的方法。
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公开(公告)号：US6152871A
公开(公告)日：2000-11-28
申请号：US160882
申请日：1998-09-25
IPC分类号： A61B17/32 , A61B1/00 , A61B17/00 , A61B17/16 , A61B17/28 , A61B17/34 , A61B19/00 , A61M29/00 , A61M39/00
CPC分类号： A61B17/3417 , A61B17/3421 , A61M29/00 , A61M29/02 , A61B17/1671 , A61B2017/00261 , A61B2017/00296 , A61B2017/0046 , A61B2017/00469 , A61B2017/00477 , A61B2017/3445 , A61B2017/347 , A61B2090/062 , A61B2090/306 , A61B2090/3614 , A61B2090/373 , A61B90/361 , A61B90/50 , A61M25/0662
摘要： Devices and methods for performing percutaneous surgery under direct visualization through a single cannula are shown. A device includes an elongated cannula sized for percutaneous introduction that defines a working channel between its ends. The working channel is sized to receive one or more surgical tools therethrough. A clamp assembly is engaged to the outer surface of the cannula. The clamp assembly includes a viewing element receiving portion and a viewing element includes a clamp assembly engaging portion for removably engaging the viewing element to the clamp assembly. In one embodiment, the receiving portion defines a receptacle for receiving a dovetail included on the engaging portion of the viewing element. The receiving portion may also include a pivotable clip for removably engaging a protuberance of the engaging portion. The clamp includes a mechanism that allows translation, rotation, and removal of the clamp assembly and the viewing element with respect to the cannula. The cannula may also be engaged to a flexible arm that is securely mounted in order to stabilize the position of the cannula at the surgical site.
摘要翻译： 示出了通过单个插管在直接可视化下进行经皮手术的装置和方法。 一种装置包括尺寸适于经皮引入的细长套管，其在其端部之间限定工作通道。 工作通道的尺寸适于接收一个或多个外科手术工具。 夹具组件接合到套管的外表面。 夹具组件包括观察元件接收部分，并且观察元件包括用于将观察元件可移除地接合到夹具组件的夹具组合接合部分。 在一个实施例中，接收部分限定用于接收包括在观察元件的接合部分上的燕尾榫的插座。 接收部分还可以包括用于可移除地接合接合部分的突起的可枢转夹子。 夹具包括允许夹具组件和观察元件相对于插管的平移，旋转和移除的机构。 套管还可以接合到柔性臂，该柔性臂被牢固地安装以便稳定插管在手术部位的位置。
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公开(公告)号：US09265589B2
公开(公告)日：2016-02-23
申请号：US11935793
申请日：2007-11-06
CPC分类号： A61B34/20 , A61B17/1703 , A61B17/1707 , A61B90/11 , A61B90/36 , A61B2034/2051 , A61B2034/2055 , A61B2090/034 , A61B2090/062 , A61B2090/3983
摘要： A system for tracking a navigated instrument. The system can include a first elongated instrument and a second elongated instrument. The first elongated instrument can have a first proximal end and a first distal end. The first elongated instrument can be adapted to be positioned relative to an anatomy. The second elongated instrument can move adjacent to the first elongated instrument. The second elongated instrument can have a second proximal end and a second distal end. The system can also include at least one tracking device coupled to the second elongated instrument. When the second elongated instrument is in a first position, the at least one tracking device tracks the first distal end of the first elongated instrument, and when the second elongated instrument is in a second position, the at least one tracking device tracks the second distal end of the second elongated instrument.
摘要翻译： 跟踪导航仪器的系统。 该系统可以包括第一细长器械和第二细长器械。 第一细长器械可以具有第一近端和第一远端。 第一细长器械可适于相对于解剖结构定位。 第二细长仪器可以移动到第一细长仪器附近。 第二细长器械可以具有第二近端和第二远端。 该系统还可以包括耦合到第二细长仪器的至少一个跟踪装置。 当所述第二细长器械处于第一位置时，所述至少一个跟踪装置跟踪所述第一细长器械的第一远端，并且当所述第二细长器械处于第二位置时，所述至少一个跟踪装置跟踪所述第二远端 第二细长仪器的末端。
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公开(公告)号：US06217509B1
公开(公告)日：2001-04-17
申请号：US09233879
申请日：1999-01-20
IPC分类号： A61B100
CPC分类号： A61M29/00 , A61B17/1671 , A61B17/3417 , A61B17/3421 , A61B90/361 , A61B90/50 , A61B2017/00261 , A61B2017/00296 , A61B2017/0046 , A61B2017/00469 , A61B2017/00477 , A61B2017/3445 , A61B2017/347 , A61B2090/062 , A61B2090/306 , A61B2090/3614 , A61B2090/373
摘要： A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (DI) and an outer diameter (DO) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D2) equal to the diameter (DI) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30, 170). The fixture (30, 170) includes a housing/body (31, 171) attachable to the proximal end (22) of the cannula (20). The housing (31) defines an optics bore (60, 180) to support a viewing element (50) for translation and rotation relative to the cannula (20) so that the longitudinal axis of the optics bore (60, 180) will translate parallel to and rotate about the longitudinal axis of the working channel (25). Methods are also provided for performing surgeries percutaneously with direct visualization and without the requirement for a fluid-maintained workspace.
摘要翻译： 提供了一种装置（10），其包括具有第一内径（DI）和外径（DO）的细长套管（20），所述第一内径（DI）和外径（DO）的尺寸用于经皮引入患者体内。 套管（20）在其端部（21,22）之间限定工作通道（25），该工作通道具有等于套管的直径（DI）的第二直径（D2），该直径（DI）的尺寸用于容纳穿过其中的工具。 细长的观察元件（50）可以优选地通过固定装置（30,170）与邻近工作通道（25）的插管（20）接合。 固定器（30,170）包括可附接到套管（20）的近端（22）的壳体/主体（31,171）。 壳体（31）限定光学孔（60,180）以支撑观察元件（50），用于相对于套管（20）的平移和旋转，使得光学孔（60,180）的纵向轴线将平行平移 绕工作通道（25）的纵向轴线旋转并旋转。 还提供了用于通过直接可视化经皮进行手术并且不需要流体维持的工作空间的方法。
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公开(公告)号：US06176823B1
公开(公告)日：2001-01-23
申请号：US09200010
申请日：1998-11-25
IPC分类号： A61B100
CPC分类号： A61M29/00 , A61B17/1671 , A61B17/3417 , A61B17/3421 , A61B90/361 , A61B90/50 , A61B2017/00261 , A61B2017/00296 , A61B2017/0046 , A61B2017/00469 , A61B2017/00477 , A61B2017/3445 , A61B2017/347 , A61B2090/062 , A61B2090/306 , A61B2090/3614 , A61B2090/373
摘要： A fixture for performing percutaneous surgery under direct visualization and through a single cannula includes a housing/body attachable to the proximal end of the cannula by a ring. The ring encircles the cannula and is provided with a pair of opposing arms defining a slot therebetween. A mechanism connected to the arms is operable to compress and release the arms such that the fixture can grip the cannula at a plurality of locations along the cannula. The housing/body includes a support column extending between the housing/body and the ring and an optics bore for supporting a portion of a viewing element.
摘要翻译： 用于在直接可视化下和通过单个插管进行经皮手术的夹具包括通过环可附接到套管的近端的壳体/主体。 该环围绕套管并且设置有一对在其间限定狭槽的相对臂。 连接到臂的机构可操作以压缩和释放臂，使得夹具可以沿着套管沿着多个位置夹持套管。 壳体/主体包括在壳体/主体和环之间延伸的支撑柱和用于支撑观察元件的一部分的光学孔。
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公开(公告)号：US6007487A
公开(公告)日：1999-12-28
申请号：US920991
申请日：1997-08-29
CPC分类号： A61M29/02 , A61B17/02 , A61B17/3417 , A61M29/00 , A61B17/1671 , A61B17/3421 , A61B2017/00261 , A61B2017/00296 , A61B2017/0046 , A61B2017/00469 , A61B2017/0262 , A61B2017/3445 , A61B2017/347 , A61B2090/306 , A61B2090/3614 , A61B2090/373 , A61B90/50
摘要： Devices and methods for performing percutaneous spinal surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (D.sub.I) and an outer diameter (D.sub.O) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D.sub.2) equal to the diameter (D.sub.I) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30). The fixture (30) includes a housing (31) attachable to the proximal end (22) of the cannula (20) that defines a working channel opening (35) which is in communication with the working channel (25). The housing (31) also defines an optics bore (60) adjacent the working channel opening (35). In certain embodiments, the fixture (30) supports the viewing element (50) for translation and/or rotation within the optics bore (60) along the longitudinal axis of the bore, and for rotation of the housing (31) relative to the cannula (20) so that the longitudinal axis of the optics bore (60) will rotate about the longitudinal axis of the working channel (25). Methods are also provided for performing spinal surgeries percutaneously with direct visualization and without the requirement for a fluid-maintained workspace.
摘要翻译： 示出了在直接可视化下和通过单个插管进行经皮脊柱手术的装置和方法。 提供了一种装置（10），其包括具有第一内径（DI）和外径（DO）的细长套管（20），所述第一内径（DI）和外径（DO）的尺寸用于经皮引入患者体内。 套管（20）在其端部（21,22）之间限定工作通道（25），该工作通道具有等于套管的直径（DI）的第二直径（D2），该直径（DI）的尺寸用于容纳穿过其中的工具。 细长的观察元件（50）可以优选地通过夹具（30）与靠近工作通道（25）的套管（20）接合。 固定装置（30）包括可连接到套管（20）的近端（22）的壳体（31），该壳体限定与工作通道（25）连通的工作通道开口（35）。 壳体（31）还限定邻近工作通道开口（35）的光学孔（60）。 在某些实施例中，固定装置（30）支撑观察元件（50），用于沿着孔的纵向轴线在光学孔眼（60）内平移和/或旋转，并且用于壳体（31）相对于插管 （20），使得光学孔（60）的纵向轴线将围绕工作通道（25）的纵向轴线旋转。 还提供了用于通过直接可视化经皮肤执行脊柱手术并且不需要流体维持的工作空间的方法。
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公开(公告)号：US5885292A
公开(公告)日：1999-03-23
申请号：US939796
申请日：1997-09-29
IPC分类号： A61B17/00 , A61B17/02 , A61B17/16 , A61B17/32 , A61B18/14 , A61F2/00 , A61F2/02 , A61F2/28 , A61F2/44 , A61F2/46 , A61B17/56
CPC分类号： A61F2/4611 , A61B17/02 , A61B17/0206 , A61B17/025 , A61B17/1604 , A61B17/1606 , A61B17/1608 , A61B17/1637 , A61F2/4455 , A61F2/4601 , A61B18/1442 , A61B2017/00261 , A61B2017/0042 , A61B2017/0256 , A61B2017/320044 , A61F2002/2835 , A61F2002/30062 , A61F2002/30153 , A61F2002/30261 , A61F2002/4623 , A61F2002/4635 , A61F2002/4649 , A61F2210/0004 , A61F2230/0019 , A61F2230/0082 , A61F2310/00293 , Y10S606/907
摘要： Minimally invasive spinal surgical techniques and tools are provided. The methods include separating the iliocostalis lumborum muscle from the anterior leaf of the thoracolumbar fascia to create a channel from the patient's skin to the intertransverse interval. In one embodiment, the method also includes delivering graft material through the channel to the intertransverse interval. A device according to one aspect of the present invention includes a retraction portion having a flattened plate configured to atraumatically retract tissue to create a working space within an endosurgical site and a curved shaft attached to the retraction portion. The shaft includes a bend having a radius of preferably 160 degrees. A gripping portion is attached to the shaft and is configured for manually gripping and manipulating the device.
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公开(公告)号：US20090118742A1
公开(公告)日：2009-05-07
申请号：US11935793
申请日：2007-11-06
IPC分类号： A61B19/00
CPC分类号： A61B34/20 , A61B17/1703 , A61B17/1707 , A61B90/11 , A61B90/36 , A61B2034/2051 , A61B2034/2055 , A61B2090/034 , A61B2090/062 , A61B2090/3983
摘要： A system for tracking a navigated instrument. The system can include a first elongated instrument and a second elongated instrument. The first elongated instrument can have a first proximal end and a first distal end. The first elongated instrument can be adapted to be positioned relative to an anatomy. The second elongated instrument can move adjacent to the first elongated instrument. The second elongated instrument can have a second proximal end and a second distal end. The system can also include at least one tracking device coupled to the second elongated instrument. When the second elongated instrument is in a first position, the at least one tracking device tracks the first distal end of the first elongated instrument, and when the second elongated instrument is in a second position, the at least one tracking device tracks the second distal end of the second elongated instrument.
摘要翻译： 跟踪导航仪器的系统。 该系统可以包括第一细长器械和第二细长器械。 第一细长器械可以具有第一近端和第一远端。 第一细长器械可适于相对于解剖结构定位。 第二细长仪器可以移动到第一细长仪器附近。 第二细长器械可以具有第二近端和第二远端。 该系统还可以包括耦合到第二细长仪器的至少一个跟踪装置。 当所述第二细长器械处于第一位置时，所述至少一个跟踪装置跟踪所述第一细长器械的第一远端，并且当所述第二细长器械处于第二位置时，所述至少一个跟踪装置跟踪所述第二远端 第二细长仪器的末端。
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