Devices and methods for minimally invasive spinal stabilization and instrumentation
View Patent ↗Described herein are devices and methods for fusion of adjacent vertebral bones using distractor platforms for exposure and resection of at least a portion of the facet joint, such as in performance of a TLiF procedure. In one embodiment, the distractor platform contains at least a first receptacle and/or extension adapted to couple to the implanted screw/bone marker and the method includes advancing a threaded segment of a bone fastener assembly into the identified first pedicle of the first vertebral bone, the first bone fastener assembly further comprises a second segment adapted to couple with a distraction platform adapted to concurrently attach onto at least one tissue retention blade and adapted to retain the tissue retention blade in the displaced position. Stabilization of a spinal segment is also provided by advancing a substantially concave orthopedic implant through an opening made in at posterior aspect of a disc space.
1. A method for stabilization of a spinal segment having a first vertebral bone, a second vertebral bone, and an intervening intervertebral disc space, comprising:
approaching a posterior aspect of said intervertebral disc space;
creating an opening in a posterior aspect of an annulus fibrosis of said intervertebral disc space;
advancing an anterior surface of an orthopedic implant through said opening in said annulus fibrosis; and
advancing a remainder of said orthopedic implant into said intervertebral disc space, said orthopedic implant following a circular trajectory that is centered at an axis of rotation positioned outside of said orthopedic implant;
wherein said orthopedic implant is configured to extend from said anterior surface to a posterior surface along an at least partially curvilinear axis, and comprises a first side surface and an opposing side surface, each configured to comprise a curvilinear segment that extends from said anterior to said posterior surfaces along a curvilinear trajectory and has a center of curvature positioned outside of said implant, said axis of rotation and said center of curvature of said implant being located on a same side of said implant.
2. The method of claim 1 , wherein said orthopedic implant is substantially concave with respect to said axis of rotation.
3. The method of claim 1 , further comprising identifying said posterior aspect of said intervertebral disc space with a radiographic imaging modality.
4. The method of claim 1 , further comprising utilizing at least a distraction platform to displace a tissue retractor member thereby creating an operative corridor.
5. The method of claim 4 , further comprising accessing a facet joint via said operative corridor and removing at least a portion thereof to expose said intervertebral disc space.
6. The method of claim 1 , further comprising implanting a bone forming material within said disc space.
7. A method for spinal segment stabilization of a subject, comprising:
creating an opening in a posterior aspect of an annulus fibrosis of an intervertebral disc space of said subject;
advancing a first portion of an orthopedic implant through said opening, said orthopedic implant configured to extend along an at least partially curvilinear axis, and comprising a center of curvature positioned outside of said orthopedic implant; and
advancing said orthopedic implant through a circular trajectory having a center that is outside of said orthopedic implant;
wherein said advancement of said curvilinear orthopedic implant causes said implant to be positioned within said intervertebral disc space of said subject; and
wherein said center of said circular trajectory and said center of curvature of said orthopedic implant are located on a same side of said implant.
8. The method of claim 7 , further comprising:
identifying a first pedicle of the first vertebral bone and an ipsilateral pedicle of the second vertebral bone with a radiographic imaging modality;
using at least a tissue retractor member and a distraction platform to form an operative corridor;
identifying a facet joint within said operative corridor; and
removing at least a segment of said facet joint to expose said intervertebral disc space.
9. The method of claim 7 , further comprising implanting a bone forming material within said intervertebral disc space.
10. The method of claim 7 , further comprising substantially immobilizing said orthopedic implant within said disc space using at least one of:
(i) a spinous process fastener;
(ii) a fusion mass; and
(iii) a fixation assembly.
11. The method of claim 7 , wherein said orthopedic implant is substantially concave with respect to said center of said circular trajectory.
12. The method of claim 7 , further comprising causing formation of a bony connection of a fusion mass on said ipsilateral side of said orthopedic implant and a fusion mass on an opposing contra-lateral side of said orthopedic implant via at least one cavity of said orthopedic implant.
13. The method of claim 7 , wherein said act of advancing said first portion of said curvilinear orthopedic implant through said opening occurs via at least one implantation instrument.
14. A method for spinal segment stabilization of a subject, comprising:
creating an opening in a posterior aspect of an annulus fibrosis of an intervertebral disc space of said subject;
advancing a first portion of a curvilinear orthopedic implant through said opening, said curvilinear orthopedic implant comprising a center of curvature positioned outside of said orthopedic implant; and
advancing a remainder of said curvilinear orthopedic implant into said intervertebral disc space via a circular trajectory having a center that is outside of said curvilinear orthopedic implant, said center of said circular trajectory and said center of curvature of said orthopedic implant being located on a same side of said implant.
15. The method of claim 14 , further comprising displacing a tissue retractor member utilizing at least a distraction platform and thereby creating an operative corridor.
16. The method of claim 15 , further comprising accessing a facet joint via said operative corridor and removing at least a portion thereof to expose said intervertebral disc space.
17. The method of claim 14 , further comprising implanting a bone forming material within said intervertebral disc space.
18. The method of claim 14 , further comprising substantially immobilizing said curvilinear orthopedic implant within said intervertebral disc space using at least one of:
(i) a spinous process fastener;
(ii) a fusion mass; and
(iii) a fixation assembly.