Procedure for spinal pedicle screw insertion

Details Procedure for spinal pedicle screw insertion Procedure for spinal pedicle screw insertion

1992-04-30

1993-03-23

Hafer, Robert A.

Surgery

Instruments

Orthopedic instrumentation

606 72, A61B 1756

Patent

active

051960150

ABSTRACT:
Pedicle screws are inserted in spinal vertebrae in a manner to reduce the likelihood of nerve damage caused by improper screw placement. A screw opening is started in part of a skeletal region, e.g., a pedicle of a lumbar vertebra and an electric potential of a certain magnitude is applied to the inner surface of the opening while the patient is observed for nervous reactions such as leg twitching. The opening continues to be formed while the electric potential is applied until a desired hole depth is obtained in the absence of nervous reaction to the potential. The direction in which the screw opening is being formed is changed to a direction other than the last direction, after observing patient reactions to the electric potential when the screw opening was being formed in the last direction. A tool for carrying out the procedure includes a handle and a probe tip extending from the handle for forming an opening in bone tissue. Stimulator circuitry arranged inside the handle produces an electric potential of a predetermined level, and the potential is applied to the probe tip while the tool handle is manipulated to urge the probe tip into the bone tissue.

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"The Adult Spine-Principles and Practice", vol. 2, Raven Press (1991), pp. 1928, 1935-1937, & 2035-2036.
H. N. Herkowitz, et al., "Instrumentation of the Lumbar Spine for Degenerative Disorders, Operative Techniques in Orthopaedics" (Jan. 1991), at 91-96.
"Anatomic Consideration for Sacral Screw Placement", S. Mirkovic, et al., Spine, 1991 supplement, at S289-S294.
"Surgical Anatomy of the Sacrum", S. I. Esses, et al., Spine, 1991 supplement, at S283 to S288.
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"Results of Spinal Arthrodesis with Pedical Screw-Plate Fixation", J. L. West, III, et al., Journal of Bone and Joint Surgery, Sep. 1991, at 1179-84.
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Instruction manual for the DUPACO Nerve Stimulator, model 5410 (Nov. 1983).

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