Methods and devices for spinal fixation element placement
View Patent ↗Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spinal fixation element through at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in a lengthwise orientation that is substantially transverse to the longitudinal axis of each percutaneous access device. The spinal fixation element can then be advanced in the lengthwise orientation to seat the spinal fixation element in or adjacent to the receiver heads of at least two adjacent spinal anchors. A fastening element or other closure mechanism can then be applied to each spinal anchor to engage the spinal fixation element within the receiver heads of the adjacent anchors.
1. A method for introducing a spinal fixation element into a patient's spinal column, comprising:
providing at least two percutaneous access devices, each device having
a proximal end positioned outside a patient's body,
a distal end coupled to a spinal anchor,
a lumen extending between the proximal and distal ends of the percutaneous access device and defining a longitudinal axis, and
at least one sidewall opening extending from the distal end through at least a portion of the percutaneous access device;
positioning a spinal fixation element through the at least one sidewall opening and adjacent the proximal end of at least two percutaneous access devices such that the spinal fixation element extends in an orientation substantially transverse to the longitudinal axis of each percutaneous access device; and
advancing the spinal fixation element in a distal direction along the longitudinal axis in the substantially transverse orientation to seat the spinal fixation element in a receiver head of at least two adjacent spinal anchors.
2. The method of claim 1 , wherein each percutaneous access device includes first and second opposed sidewall openings.
3. The method of claim 1 , wherein the at least one sidewall opening extends from the distal end and terminates at a position distal to the proximal end.
4. The method of claim 1 , wherein each percutaneous access device includes a sleeve disposed therearound and effective to prevent removal of each percutaneous device from the spinal anchor coupled thereto, the sleeve including at least one sidewall opening formed therein that is adapted to align with the at least one sidewall opening in the percutaneous access device.
5. The method of claim 1 , wherein each percutaneous access device is threadably coupled to the receiver head of each spinal anchor.
6. The method of claim 1 , wherein each percutaneous access device and spinal anchor are mating together by a twist-lock closure mechanism.
7. The method of claim 1 , wherein each percutaneous access device is coupled to the receiver head of a spinal anchor, and the at least one opening in the percutaneous access device is adapted to align with a seating portion formed in each receiver head.
8. The method of claim 1 , further comprising providing a pusher mechanism adapted to advance the spinal fixation element into the receiver head of adjacent spinal anchors.
9. The method of claim 1 , further comprising providing a compression tool, and engaging at least two adjacent percutaneous access devices to compress the devices toward one another while maintaining relative spacing therebetween.
10. The method of claim 9 , wherein the compression tool comprises first and second opposed arms that are pivotally mated to one another.
11. The method of claim 1 , further comprising delivering a closure mechanism through each percutaneous access device and applying the closure mechanism to each spinal anchor to lock the spinal fixation element in the receiver heads of the anchors.
12. A method for introducing a spinal fixation element into a receiver head of adjacent spinal anchors, comprising:
positioning a spinal fixation element through openings formed in at least two adjacent percutaneous access devices such that the spinal fixation element extends between the at least two adjacent percutaneous access devices in a lengthwise orientation adjacent a proximal portion of the at least two percutaneous access devices;
advancing the spinal fixation element in a distal direction to seat the spinal fixation element in the receiver heads of the adjacent spinal anchors.
13. The method of claim 12 , wherein the spinal fixation element is advanced between muscles.
14. The method of claim 12 , wherein the each spinal anchor is coupled to a percutaneous access device.
15. The method of claim 12 , wherein each percutaneous access device includes opposed openings formed therethrough and extending along a length thereof.
16. The method of claim 15 , wherein the openings comprise slots that extend from a distal end and terminate at a position distal to the proximal end of each percutaneous access device.
17. The method of claim 12 , further comprising providing a pusher mechanism adapted to advance the spinal fixation element into the receiver head of adjacent spinal anchors.
18. The method of claim 12 , further comprising providing a compression tool, and engaging at least two adjacent percutaneous access devices to compress the devices toward one another.
19. The method of claim 18 , wherein the compression tool comprises first and second opposed arms that are pivotally mated to one another.
20. The method of claim 12 , further comprising providing and applying a closure mechanism to each spinal anchor to lock the spinal fixation element in the receiver heads of the anchors.