Surgical instruments and method of using same
Certain preferred embodiments of the present invention relate to surgical instruments particularly suitable for preparing vertebral endplates during spinal interbody surgical procedures. Methods of using such instruments are also disclosed. In one embodiment, the surgical instrument includes a first portion which serves as a rasp, and a second portion serving as a device guide for a reaming device.
1 . A surgical instrument for use in spinal surgery comprising a first portion connected to a second portion; wherein
said first portion and second portion are longitudinally offset from each other;
said first portion is generally D-shaped in transverse cross-section and further comprises a top and bottom surface having rasp teeth;
said first portion further including at least one aperture that extends the entire transverse length of said first portion;
said second portion is generally rectangular shaped and further comprises an access port for guiding a reamer device; and
said second portion is adapted for removable attachment to a holder.
2 . The surgical instrument of claim 1 , wherein at least one of said first and second portion further comprises at least one contact member.
3 . The surgical instrument of claim 2 , wherein said at least one contact member is at least one of slidably and rotatably connected to said first portion, said second portion, or combinations thereof.
4 . The surgical instrument of claim 2 , wherein said at least one contact member is extendable from at least one of said first and second portion.
5 . The surgical instrument of claim 1 , wherein said at least one first portion further comprises at least one graded marking.
6 . The surgical instrument of claim 1 , wherein said at least one second portion further comprises at least one graded marking.
7 . The surgical instrument of claim 1 , wherein said second portion is integrally connected to a holder
8 . The surgical instrument of claim 1 , wherein said instrument is comprised of a durable material.
9 . The surgical instrument of claim 8 , wherein the durable material is at least one of a pure metal and metal alloy.
10 . The surgical instrument of claim 1 , wherein said access port is controllably extendable from said second portion.
11 . The surgical instrument of claim 10 , wherein said access port is telescoping.
12 . The surgical instrument of claim 1 , wherein said access port is threaded.
13 . A surgical instrument for use in spinal surgery comprising a first portion connected with a second portion; said first portion having top and bottom surfaces wherein at least one of said surfaces comprises rasp teeth; and said second portion including a device guide.
14 . The surgical instrument of claim 13 , wherein said first portion is removably connectable to said second portion.
15 . The surgical instrument of claim 13 , wherein said device guide is controllably extendable from said second portion.
16 . The surgical instrument of claim 15 , wherein said device guide is telescoping.
17 . The surgical instrument of claim 13 , wherein the device guide is an access port.
18 . The surgical instrument of claim 17 , wherein said access port is threaded.
19 . The surgical instrument of claim 13 , wherein the device guide is a frame.
20 . The surgical instrument of claim 13 , wherein the device guide is a track.
21 . The surgical instrument of claim 13 , wherein the first portion is generally D-shaped.
22 . The surgical instrument of claim 13 , further comprising at least one contact member connected to at least one of said first and second portion.
23 . The surgical instrument of claim 22 , wherein said at least one contact member is at least one of slidably and rotatably connected.
24 . The surgical instrument of claim 22 , wherein said at least one contact member is extendable from at least one of said first and second portion.
25 . The surgical instrument of claim 13 , wherein at least one of said first portion and second portion further comprise at least one graded marking.
26 . The surgical instrument of claim 13 , wherein said first portion is substantially planar.
27 . The surgical instrument of claim 13 , wherein said first portion is substantially cylindrical.
28 . The surgical instrument of claim 13 , wherein said first portion and said second portion are longitudinally offset from each other.
29 . The surgical instrument of claim 13 , wherein said second portion is removably connectable to a holder.
30 . The surgical instrument of claim 13 , wherein said second portion is integrally connected to a holder.
31 . The surgical instrument of claim 13 , wherein said first portion further includes at least one aperture that extends the entire transverse length of said first portion.
32 . A kit for performing spinal surgery comprising:
a surgical instrument comprising at least one first portion being connectable or connected with at least one second portion; the first portion comprising top and bottom surfaces wherein at least one of said surfaces has rasp teeth; and the second portion including a device guide.
33 . The kit of claim 32 , wherein said device guide is an access port.
34 . The kit of claim 32 , wherein said device guide is a frame.
35 . The kit of claim 32 wherein said device guide is a track.
36 . The kit of claim 32 , wherein the first portion is generally D-shaped.
37 . The kit of claim 32 , further comprising at least one contact member connected to at least one of said first and second portion.
38 . The kit of claim 37 , wherein said at least one contact member is extendable from at least one of said first and second portion.
39 . The kit of claim 37 , wherein said at least one contact member is slidably, rotatably, or combinations thereof, connected to at least one of said first and second portion.
40 . The kit of claim 32 , wherein said at least one first or second portion further includes at least one graded marking.
41 . The kit of claim 32 , wherein said at least one first portion is substantially planar.
42 . The kit of claim 32 , wherein said at least one first portion is substantially cylindrical.
43 . The kit of claim 32 , wherein said at least one first and second portion are longitudinally offset from each other.
44 . The kit of claim 32 , wherein said at least one second portion is integrally connected to a holder.
45 . The kit of claim 32 , wherein said at least one first portion further includes at least one aperture that extends the entire transverse length of said first portion.
46 . The kit of claim 32 , wherein said at least one second portion is removably connectable to a holder.
47 . A method of performing spinal surgery comprising the steps of:
providing a surgical instrument comprising a first portion being connected or connectable with a second portion; the first portion including top and bottom surfaces wherein at least one of said surfaces has rasp teeth; the second portion including a device guide;
exposing the spine and identifying the center of at least one target vertebral disc;
removing the anterior annulus of said at least one vertebral disk and performing at least a partial discectomy, thus creating at least one intervertebral cavity;
removing a sufficient amount of spinal endplate cartilage to expose underlying bone;
distracting at least one intervertebral cavity;
using the first portion of said surgical instrument to prepare at least one of the posterior-lateral and anterior-lateral regions of one or more spinal endplates;
providing a reamer through the device guide of the surgical instrument to further prepare said one or more spinal endplates.
48 . The method of claim 47 , wherein the step of exposing the spine comprises an anterior surgical approach.
49 . The method of claim 47 , wherein a complete discectomy is performed.
50 . The method of claim 47 further comprising the step of impacting at least one successively sized first-portion of the surgical instrument into the intervertebral cavity.
51 . The method of claim 47 , wherein the step of lateral preparation of one or more spinal endplates, comprises the step of contra-laterally rotating said surgical instrument.
52 . The method of claim 47 , wherein the step of providing a reamer comprises the steps of providing the reamer under fluoroscopic guidance.
53 . The method of claim 47 further comprising the step of placing an appropriately sized implant into the prepared intervertebral cavity.
54 . The method of claim 47 , wherein said device guide is an access port.
55 . The method of claim 47 , wherein said device guide is a frame.
56 . The method of claim 47 , wherein said device guide is a track.
57 . The method of claim 47 , wherein said first portion is generally D-shaped.
58 . The method of claim 47 , further comprising at least one contact member connected to at least one of said first and second portion.
59 . The method of claim 58 , wherein said contact members are at least one of slidably and rotatably connected.
60 . The method of claim 58 , wherein said at least one contact member is extendable from said at least one of first and second portion.
61 . The method of claim 47 , wherein said first portion is substantially planar.
62 . The method of claim 47 , wherein said first portion is substantially cylindrical.
63 . The method of claim 47 , wherein said second portion is removably connectable to a holder.
64 . The method of claim 47 , wherein said first portion further includes at least one aperture that extends the entire transverse length of said first portion.
65 . The method of claim 47 , wherein said device guide is controllably extendable from said second portion.
66 . The method of claim 54 , wherein said access port is telescoping.
67 . The method of claim 54 , wherein said access port is threaded.
68 . The method of claim 47 , wherein said reamer further comprises a collet.
69 . The method of claim 47 , wherein said reamer is operatively engaged with said device guide.