Patent EP0614647A2 successfully refreshed from Google Patents.
EP0614647A2
Expired / Lapsed
EP
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Instruments for performing arthroscopic spinal surgery
Assignee: Smith and Nephew Inc
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Filing: 1994-03-08
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Granted: —
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Expires: 2014-03-08
Abstract
Abstract A method and apparatus for performing an arthroscopic spinal laminectomy or similar surgical procedure includes a plurality of cannulas which are individually inserted, in a predetermined sequence, into predetermined areas of a patient's spinal column. The first inserted cannula (78) has a tissue manipulating surface (20) thereon which is used to create a working space adjacent a predetermined area of the patient's spinal column. A viewing device is inserted through this cannula and the fluid used in association therewith is used to maintain the working space. The second and third cannulas (88) are larger in size and are working cannulas in that they provide passageways for instruments used in the surgical procedure. The second and third cannulas are utilised by the surgeon to sequentially remove a portion of the ligaments flavum necessary to expose the desired area of the patient's spinal bone and, if necessary, to remove any portion of bone necessary to expose the nerve and disc area. The nerves are then moved and the sequestered portion of the disc is removed, all utilising the cannulas as passageways to perform the surgical procedure. In addition to a cannula which has a tissue manipulating surface thereon, the invention includes a rongeur having a cross section shaped to pass through a cannula and with a suction connection therefor so that whatever body tissue and/or bone fragments are cut by the rongeur may be removed by suction through the passageways created by the cannula.
Inventors
- 👤 David E. Shapiro
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-27 09:17
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/16; A61B17/1604; A61B17/1606; A61B17/1608; A61B17/1611; A61B17/1662; A61B17/1671; A61B17/1684; A61B17/34; A61B17/3417; A61B17/3421; A61B17/1675; A61B17/00234; A61B2017/00238; A61B2017/00261; A61B17/28; A61B17/29; A61B17/2909; A61B2017/2912; A61B2017/2919; A61B2017/292; A61B17/32; A61B17/320068; A61B2017/320072; A61B2017/320078; A61F; A61F2/00; A61F2/02; A61F2/30; A61F2/32; A61F2/36; A61F2/3662
Claims Analysis
Total Claims: 22
Claim 1
Independent Claim
55 words
A cannula for performing an arthroscopic spinal surgical procedure comprising a tubular body member having an interior instrument passage and a tissue manipulating surface at the end thereof which will be inserted into a patient's body to an area adjacent the spinal column, said tissue manipulating surface extending radially outwardly from said tubular body member.
Claim 2
Dependent Claim
19 words
A cannula according to claim 1 further characterised in that said tissue manipulating surface has an arcuate sharp end.
Claim 3
Dependent Claim
26 words
A cannula according to claim 2 further characterised in that said arcuate sharp end has exterior portions extending outwardly from opposite sides of said tubular body.
Claim 4
Dependent Claim
33 words
A cannula according to claim 2 further characterised in that said arcuate sharp end is at the termination of a gradually outwardly curved portion which extends radially outwardly from said tubular body member.
Claim 5
Dependent Claim
21 words
A cannula according to claim 4 further characterised in that said tubular body member terminates rearwardly of said arcuate sharp end.
Claim 6
Dependent Claim
147 words
An instrument for use in an arthroscopic spinal surgical procedure to both sever and remove pieces of tissue and/or bone by suction, including a body having a suction connection at one end thereof, a handle member attached to said body proximate said suction connection, said body having a rongeur cutting element at the opposite end thereof, and a suction passage between said suction connection and said rongeur cutting element, a sleeve coaxially mounted on said body for axial movement relative at one end thereof which cooperates with said body rongeur cutting element, a second handle member connected to said sleeve and pivotally connected to said first handle member for causing movement of said sleeve, the exterior of said sleeve through a major portion of its length having a size and shape to pass through a cannula for positioning within a working space adjacent a patient's spinal column.
Claim 7
Dependent Claim
30 words
An instrument according to claim 6 further characterised in that said first handle member has a platform thereon, with said body member being attached to and supported by said platform.
Claim 8
Dependent Claim
26 words
An instrument according to claim 6 further characterised in that said axially movable sleeve has an enlarged portion which is movably connected to said second handle.
Claim 9
Dependent Claim
17 words
An instrument according to claim 6 further characterised in that said sleeve has a circular cross section.
Claim 10
Dependent Claim
22 words
An instrument according to claim 6 further characterised in that said suction passage is radially offset from the axis of said body.
Claim 11
Dependent Claim
60 words
Apparatus for use in performing an arthroscopic spinal surgical procedure including a cannula having a body member with an internal generally cylindrical bore, a rongeur having a generally cylindrical cross section of a size to pass through said cannula, said rongeur having relatively movable cutting elements and a pair of pivotal handles for effecting relative movement of said cutting elements.
Claim 12
Dependent Claim
17 words
The apparatus according to claim 11 further characterised in that said cutting elements are relatively axially movable,
Claim 13
Dependent Claim
37 words
The apparatus according to claim 11 further characterised in that said rongeur includes a suction connection and a suction passage connecting said suction connection and said movable cutting elements for removal of tissue and/or bone severed thereby.
Claim 14
Independent Claim
148 words
A method for arthroscopically accessing a predetermined area of a patient's spinal column including the steps of: inserting a first cannula into a predetermined position relative to a patient's spine, inserting fluid utilising viewing means through said first cannula, moving muscle and/or tissue through manipulation of the first cannula to create a working space and utilising the fluid associated with the viewing means to maintain the working space, inserting a second cannula into a predetermined position relative to the first cannula, inserting a cutting instrument through the second cannula and into the working space to incise the ligamentum flavum adjacent the working space to expose bone in the predetermined area of the patient's spine, inserting a third cannula into a predetermined position relative to the first and second cannulas, and thereafter conducting a surgical procedure on the spinal column by manipulating instruments through said second and third cannulas.
Claim 15
Dependent Claim
21 words
A method according to claim 14 wherein said first cannula has an outwardly directed tissue moving surface at one end thereof.
Claim 16
Dependent Claim
23 words
A method according to claim 15 further characterised in that said cannula tissue moving surface extends radially from one end of said cannula.
Claim 17
Dependent Claim
23 words
A method according to claim 14 further characterised in that the predetermined area of the patient's spinal column is in the lumbar region.
Claim 18
Dependent Claim
24 words
A method according to claim 14 further characterised in that the surgical procedure performed through the use of the inserted cannulas is a laminectomy.
Claim 19
Independent Claim
215 words
A method of performing an arthroscopic laminectomy in a predetermined area of a patient's spinal column including the steps of: inserting a first cannula having a tissue manipulating surface thereon into a predetermined position relative to a patient's spine, inserting a fluid utilising viewing means through said first cannula, moving muscle and tissue through manipulation of the first cannula and its tissue manipulating surface to create a working space adjacent the spinal column and utilising the fluid associated with the viewing means to maintain the working space, inserting a second cannula into a predetermined position relative to the first cannula, inserting a cutting instrument through the second cannula and into the working space to incise the ligamentum flavum adjacent the working space, inserting a cutting/suction instrument through the second cannula and into the working space to remove a portion of the ligamentum flavum sufficient to expose the nerve and disc area of the spinal column, inserting a nerve moving instrument through the second cannula and into the working space to move sufficient nerves to expose the spinal column disc area, inserting a third cannula into a predetermined position relative to the first and second cannulas, and inserting a grasping instrument through the third cannula to grasp and remove a herniated portion of the spinal disc.
Claim 20
Dependent Claim
32 words
A method according to claim 19 further characterised in that the tissue manipulating surface on the first cannula is at the interior end thereof and extends radially outwardly from the first cannula.
Claim 21
Dependent Claim
41 words
A method according to claim 20 further characterised in that the first cannula tissue manipulating surface has a sharp curved end thereon which is wider than the body of the cannula and extends radially outwardly from the body of the cannula.
Claim 22
Dependent Claim
24 words
A method according to claim 19 further characterised in that the cutting/suction instrument inserted through the second cannula has a rongeur cutting means thereon.
References Cited (Backward Citations)
No citation records indexed.
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