Ultrasonic cutting device
View Patent ↗An ultrasonic surgical cutting method and apparatus is provided wherein the method and apparatus allows for the cutting of bone from within a hollow pathway such that a cutter associated with the ultrasonic method and apparatus remains sufficiently cool to prevent necrosis of the bone being cut. Furthermore the ultrasonic device and method can be employed in the cutting of soft tissue, wherein a cooled cutter is used to prevent the sticking of soft tissue to the cutting blade of the device during use.
1. A method for cutting the pedicle region of a vertebra during spinal surgery with an ultrasonic cutting tool, comprising:
providing a pathway into the pedicle of vertebrae to be cut;
locating an ultrasonic cutting tool into said pathway at a fixed distance, wherein said tool contains
an ultrasonic transducer element for producing an ultrasonic output;
a rotatable handpiece sized and oriented to contain the ultrasonic transducer;
a lateral cutting tip associated with the ultrasonic transducer element, wherein the lateral cutting tip oriented perpendicular to the ultrasonic transducer; and
a geared mechanism for rotating said lateral cutting mechanism in response to rotation of the rotatable handpiece relative to the ultrasonic cutting tool;
a convective cooling pathway associated with the lateral cutting tip;
rotating said lateral cutting tip in a circumferential manner about an eccentric axis of the ultrasonic cutting tool by rotating the rotatable handpiece to engage the geared mechanism to extend said lateral cutting tip from within said pathway to a predetermined position, the eccentric axis being a center of rotation of the lateral cutting tip and parallel to a longitudinal axis of the ultrasonic cutting tool; and
at the predetermined position, rotating said lateral cutting tip about the longitudinal axis of the ultrasonic cutting tool by rotating the rotatable handpiece and thus rotating the ultrasonic cutting tool with the lateral cutting tip extended to form a circumferential groove in the surrounding pedicle of the pathway, wherein heat generated by the lateral cutting tip is removed using the convective cooling pathway.
2. The method of claim 1 , wherein said cutting tip is constructed of a biocompatible material.
3. The method of claim 1 , wherein said ultrasonic cutting tool operates in the frequency range between about 22 Khz and about 45 Khz.
4. The method of claim 1 , wherein said ultrasonic cutting tool operates in the amplitude range between about 50 to about 100 microns.
5. The method of claim 1 , further comprising the providing of a guide tube, wherein said guide tube is sized and oriented to fit within the hollow pathway into the vertebrae.
6. The method of claim 5 , further comprising the providing of an adjustable stop, wherein said adjustable stop is associated with the guide tube such that the distance that the guide tube is inserted into the hollow pathway is predefined.
7. A method of performing a surgical procedure comprising:
delivering a lateral cutting tip of an ultrasonic cutting tool to proximate a vertebra, wherein the lateral cutting tip is oriented perpendicular to the ultrasonic cutting tool;
cutting a portion of the vertebra with the lateral cutting tip of the ultrasonic cutting tool, the step of cutting comprising rotating the lateral cutting tip about an eccentric axis of the ultrasonic cutting tool by rotating a rotatable handpiece relative to the ultrasonic cutting tool to engage a geared mechanism in the ultrasonic cutting tool to extend said lateral cutting tip to a predetermined position, the eccentric axis being a center of rotation of the lateral cutting tip and parallel to a longitudinal axis of the ultrasonic cutting tool, and at the predetermined position, rotating said lateral cutting tip about the longitudinal axis of the ultrasonic cutting tool by rotating the rotatable handpiece and thus rotating the ultrasonic cutting tool with the lateral cutting tip extended to form a circumferential groove in the vertebrae; and
cooling the cutting tip to temperature sufficient to inhibit necrosis of tissue proximate the cutting tip using a convection cooling system coupled to the ultrasonic cutting tool.
8. The method of 7 , wherein the cutting tip is cooled to a temperature less than approximately 50° C.
9. The method of 7 , wherein the cutting tip is cooled to a temperature less than approximately 45° C.
10. The method of 7 , wherein the cutting tip is cooled to a temperature less than approximately 40° C.
11. The method of 7 , wherein the cutting tip is cooled to a temperature approximate to body temperature.