Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
2000-03-02
2001-05-01
Reip, David O. (Department: 3731)
Surgery
Instruments
Orthopedic instrumentation
C606S079000, C606S099000
Reexamination Certificate
active
06224599
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to a device useful in the performance of spinal surgeries and the process for their use; and particularly relates to a system for distracting the intervertebral space to enable viewing of the spinal column and insertion of an appropriate spacing apparatus.
BACKGROUND OF THE INVENTION
The spine is a column of vertebrae divided into three sections (cervical, thoracic and lumbar). The vertebrae are separated by small cartilaginous cushions identified as intervertebral discs which contain a jelly-like substance called the nucleus pulposus. Additionally, each vertebrae contains several bony projections known as processes which attach to adjacent muscles. These processes interlock at areas termed facet joints and, in concert with the surrounding attached muscles, allow the spine to twist or bend.
When abnormalities such as disc herniation, spinal stenosis, spinal degeneration, cauda equina syndrome, or the like occur in an individual, nerves within or adjacent to the spinal column may become inflamed or impinged resulting in the individual experiencing various forms of pain, loss of flexibility, loss of motion, and possibly loss of bladder and/or bowel control. Additionally, these abnormalities may result in the development of spondylolisthesis, a condition in which one vertebrae slips forward over another.
Although conservative treatments are most often recommended, certain types of injuries, or conditions which result in intractable pain and the possibility of permanent loss of mobility often must be treated surgically.
Typical surgical procedures such as discectomy, laminectomy, and spinal fusion require the surgeon to first gain access to the interior of the spinal column and to the interior faces of the bony processes using either an anterior or posterior approach.
DESCRIPTION OF THE PRIOR ART
U.S. Pat. No. 5,306,309 discloses a spinal disk implant that is inserted by the use of a handle depicted in FIG. 14. The handle has a formed front end for engagement of the implant and may be struck by a hammer if necessary to urge the implant into position.
U.S. Pat. No. 5,425,772 discloses an implant device which employs an insertion tool, not shown, which couples to the implant and allows for placement between adjoining vertebrae.
U.S. Pat. No. 5,683,464 is similar to U.S. Pat. No. 5,306,309 and includes a new style of insertion tool as depicted in FIG.
15
. This implant tool includes a pair of flexible opposing arms and a means for securing the implant in place on the delivery tool until properly positioned.
U.S. Pat. No. 5,722,977 discloses a device for removal of vertebrae bone tissue by use of a mortising cutter for harvesting a bone plug from a donor and then inserting the plug into a prepared vertebrae recess.
U.S. Pat. No. 5,766,252 discloses a spinal implant having a wedge shape. The implant is inserted by a handle that couples to the implant.
U.S. Pat. No. 5,893,890 illustrates a vertebrae disk stabilizer. This invention includes a wedge shaped insertion mechanism that allows for the spreading of vertebrae and the insertion of a spinal implant. This invention requires the use of a key way formed integral to the insertion device.
The prior art fails to provide a device or process capable of accessing the internal regions of the spinal column and bony processes without damaging the end plates of adjacent vertebrae.
The present invention teaches a device and a process for its use which enables distraction of the disk space, and provides an enhanced view of the interior area subsequent to insertion without the need for excision of the vertebral end plates, thereby satisfying a long-felt need in the art.
SUMMARY OF THE INVENTION
The present invention describes a system comprised of a wedge and distractor channel constructed from titanium or a titanium alloy. The wedge is constructed and arranged to fit within the distractor channel, and is thus positioned prior to insertion. An appropriately sized combination of wedge and distractor channel are chosen dependent upon the particular anatomical results sought and an impactor handle is then attached to the wedge/distractor channel combination to facilitate insertion between two vertebrae, without trauma to their end plates. The wedge is then extracted, leaving the distractor channel defining means in place for maintenance of the desired degree of distraction and vertebral alignment, and for creation of an access port. The access port allows the surgeon easy ingress to the spinal column and associated anatomical structures. Discectomy is facilitated, as is the insertion of allografts or titanium cages for spinal fusion procedures. When it is desired, decortication means in the form of cutting edges may be incorporated in the wedge structure for abrading the bone adjacent the graft material to accelerate fusion.
Accordingly, it is an objective of the instant invention to teach a device which provides an enhanced view of the interior anatomy of the spine upon insertion.
It is also an objective of the instant invention to teach a retractor in communication with the access port for providing a clear field of view of the interior anatomy of the spine.
It is a further objective of the instant invention to teach a method and device for creation of an access port useful for retrieval of bony abnormalities and/or herneated disk fragments, or the like related spinal procedures which require access to the intervertebral area and surrounding anatomical structures.
It is yet another objective of the instant invention to teach a set of components which enables either an anterior or posterior approach for distraction of the spinous processes and access thereto.
It is a still further objective of the invention to teach a device for partial decortication of the end-plates upon insertion.
Other objectives and advantages of this invention will become apparent from the following description taken in conjunction with the accompanying drawings wherein are set forth, by way of illustration and example, certain embodiments of this invention. The drawings constitute a part of this specification and include exemplary embodiments of the present invention and illustrate various objects and features thereof.
REFERENCES:
patent: 5306309 (1994-04-01), Wagner et al.
patent: 5425772 (1995-06-01), Brantigan
patent: 5683464 (1997-11-01), Wagner et al.
patent: 5722977 (1998-03-01), Wilhelmy
patent: 5766252 (1998-06-01), Henry et al.
patent: 5797909 (1998-08-01), Michelson
patent: 5893890 (1999-04-01), Pisharodi
patent: 5968098 (1999-10-01), Winslow
patent: 6042582 (2000-03-01), Ray
patent: 6113602 (2000-09-01), Sand
Baynham G. Clay
Baynham Matthew G.
McHale & Slavin
Reip David O.
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