Granted Patent B2

US 7,651,496 · App. 11/184,568 · Granted Jan 26, 2010

Abstract

Claims (59)

1. A method for treating the spine, comprising:

first, advancing a guidewire through the skin of a patient along a percutaneous path to a target location of a vertebra;

second, advancing an implant over the guidewire to the target location of the vertebra, and coupling the implant with the vertebra at the target location;

third, after coupling the implant with the vertebra, advancing an elongate body having a proximal end and a distal end until the distal end is adjacent the target location, the elongate body having an inner surface defining a passage extending therethrough, wherein a cross-sectional area of the passage at a first location is greater than a cross-sectional area of the passage at a second location, wherein the first location is distal to the second location; and

fourth, performing a procedure at the target location.

2. The method of claim 1 , wherein the implant comprises a marker.

3. The method of claim 2 , further comprising:

removing the marker; and

advancing a fastener into the vertebra at the target location.

4. The method of claim 3 , wherein the fastener is advanced over a guidewire.

5. The method of claim 3 , wherein the fastener is advanced through the passage of the elongate body.

6. The method of claim 5 , wherein the fastener is advanced over a guidewire.

7. The method of claim 2 , further comprising:

removing the guidewire before advancing the elongate body;

inserting a guidewire through the marker after advancing the elongate body.

8. The method of claim 7 , further comprising:

removing the marker through the passage of the elongate body over the guidewire; and advancing a fastener to the target location over the guidewire.

9. The method of claim 2 , further comprising:

advancing a second marker over a second guidewire to a second target location on a second vertebra;

coupling the second marker with the second vertebra; and

positioning the elongate body such that the passage therethrough provides access to both the first and second target locations.

10. The method of claim 1 , wherein the implant comprises an elongate portion of a fastener.

11. The method of claim 10 , further comprising:

advancing a housing portion of the fastener through the passage; and

coupling the housing portion with the elongate portion of the fastener after the elongate body has been inserted into the patient.

12. The method of claim 11 , wherein the fastener comprises a first fastener and the vertebra comprises a first vertebra and further comprising:

advancing a second fastener to a second vertebra;

coupling the second fastener with the second vertebra; and

coupling a spanning member with the first fastener and with the second fastener.

13. The method of claim 12 , further comprising:

advancing a third fastener to a third vertebra;

coupling the third fastener with the third vertebra; and

coupling a spanning member with the second fastener and with the third fastener.

14. The method of claim 12 , wherein the second fastener comprises an elongate portion and a housing portion and wherein the method of advancing the second fastener to the second vertebra comprises:

advancing the elongate portion of the second fastener to a second vertebra;

advancing the housing portion of the second fastener to the elongate portion of the second fastener; and

coupling the housing portion of the second fastener to the elongate portion of the second fastener.

15. The method of claim 12 , wherein the spanning member comprises a fixation element.

16. The method of claim 12 , wherein the spanning member comprises a flexible element.

17. The method of claim 1 , wherein performing a procedure comprises moving one vertebra relative to an adjacent vertebra in a cephalad-caudal direction.

18. The method of claim 1 , wherein performing a procedure comprises moving one vertebra relative to an adjacent vertebra in an anterior-posterior direction.

19. The method of claim 1 , wherein performing a procedure comprises debriding tissue.

20. The method of claim 1 , wherein performing a procedure comprises performing an inter-body fusion.

21. The method of claim 1 , wherein performing a procedure comprises delivering bone graft material.

22. A method for treating the spine, comprising:

first, advancing a guidewire through the skin of a patient along a percutaneous path to a target location of a vertebra;

second, advancing a cannulated implant over the guidewire to the target location of the vertebra;

third, coupling the cannulated implant with the vertebra at the target location;

fourth, removing the guidewire;

fifth, advancing an elongate body having a proximal end and a distal end until the distal end is substantially adjacent the target location, the elongate body having an inner surface at least partially defining a passage extending therethrough, wherein a first transverse dimension of the elongate body at a first location is greater than a second transverse dimension the elongate body at a second location, the first location being distal to the second location; and

sixth, performing a procedure at the target location through the passage of the elongate body.

23. A method for treating the spine, comprising:

first, percutaneously performing a first procedure at one or more target locations on the spine of a patient at least in part with the aid of a guidewire;

second, advancing a marking device over the guidewire to indicate the position of the target location;

third, advancing an elongate body until the distal end is adjacent the one or more target locations, the elongate body having an inner surface defining a passage extending therethrough, wherein a cross-sectional area of the passage at a first location is greater than a cross-sectional area of the passage at a second location, wherein the first location is distal to the second location; and

fourth, performing a second procedure at the one or more target locations through the passage of the elongate body.

24. The method of claim 23 , wherein the second procedure comprises a fixation procedure.

25. The method of claim 24 , wherein the first procedure comprises preparing one or more target locations for the fixation procedure.

26. The method of claim 23 , wherein the target location comprises an inter-body space, the first procedure comprises preparing the target location for insertion of a prosthetic disk, and the second procedure comprises inserting a prosthetic disk.

Assignments (8)