Access assembly for anterior and lateral spinal procedures
The present invention is directed to methods and instrumentation for performing surgery on the spine along its lateral aspect (side) and generally by a lateral, anterior or an anterolateral surgical approach, such that the instruments enter the body from an approach that is other than posterior and make contact with the spine along its lateral aspect. The present invention provides for the entire surgical procedure to be performed through a relatively small incision and may be performed in either the thoracic or lumbar spine.
1. An access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures comprising:
a needle assembly ( 12 ), including a cannula ( 26 ) and a needle member ( 24 ), said cannula ( 26 ) formed as a tubular member having a first end ( 84 ), a second end ( 86 ) and a central portion ( 80 ), a lumen ( 81 ) extending through said cannula ( 26 ), said needle member ( 24 ) having a point end ( 28 ), a second end ( 88 ) and a central portion ( 90 ) having an outer diameter sized to fit through said lumen ( 81 ), said second end ( 86 ) of said cannula ( 26 ) includes a first clamp ring ( 32 ), said second end ( 88 ) of said needle assembly ( 24 ) includes a second clamp ring ( 34 ), said first clamp ring ( 32 ) and said second clamp ring ( 34 ) constructed and arranged to be positioned adjacent with respect to each other and cooperating with a clamp portion ( 30 ) of a handle assembly ( 14 );
a handle assembly ( 14 ) for providing directional control of said needle assembly ( 12 ) during insertion thereof, said handle assembly ( 14 ) being removable and re-securable to said needle assembly ( 12 ), said handle assembly ( 14 ) includes a clamp portion ( 30 ) cooperating with said adjacently positioned first clamp ring ( 32 ) and said second clamp ring ( 34 ) for securing said handle assembly ( 14 ) to said needle assembly ( 12 ), said clamp portion ( 30 ) simultaneously securing said needle member ( 24 ) within said lumen ( 81 ) of said cannula ( 26 ) having said point ( 28 ) of said needle member ( 24 ) extending beyond an end point of said second end ( 86 ) of said cannula ( 26 ).
2. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 wherein said clamp portion ( 30 ) includes a groove ( 50 ) having a pair of generally flat opposing side surfaces ( 52 ) spaced a predetermined distance apart and extending along the length of the groove ( 50 ), said groove sized to span said first and said second clamp rings ( 32 ), ( 34 ) respectively.
3. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 2 wherein said clamp portion ( 30 ) of said handle assembly ( 14 ) includes a rod portion ( 44 ) which cooperates with said clamp portion ( 30 ) to secure said first and said second clamp rings ( 32 ), ( 34 ) within said clamp portion, a threaded engagement provides controlled movement between said rod portion ( 44 ) and clamp portion ( 30 ) by using said threads to force the distal end of said rod portion ( 44 ) against the groove ( 50 ) of said clamp portion ( 30 ).
4. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 2 wherein said second end ( 88 ) of said needle member ( 24 ) includes an anvil surface ( 56 ) suitable for striking with a mallet.
5. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 including a first dilator tube ( 68 ), said first dilator tube ( 68 ) is generally an elongated tubular member having a first end ( 70 ), a central portion ( 74 ) and a second end ( 72 ) having a central aperture ( 76 ) sized for cooperation with the outer surface ( 78 ) of the center portion ( 80 ) of the cannula ( 26 ) extending through a central portion thereof.
6. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 5 including a second dilator tube ( 16 ), said second dilator tube ( 16 ) is generally an elongated tubular member having a first end ( 36 ), a central portion ( 40 ) and a second end ( 38 ) having a central aperture ( 37 ) sized for cooperation with the outer surface of the central portion ( 74 ) of the first dilator tube ( 68 ) extending through a central portion ( 40 ) of said second dilator tube ( 16 ).
7. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , including a guide wire ( 18 ), said guide wire ( 18 ) including a first end ( 63 ), a second end ( 64 ) and a center portion ( 66 ), said center portion ( 66 ) sized to fit through said lumen ( 81 ) of said cannula ( 26 ).
8. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , wherein said handle assembly ( 14 ) is oriented at a right angle with respect to said needle assembly ( 12 ) to provide the surgeon with an angular reference to the trajectory of said needle assembly ( 12 ).
9. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , wherein said needle member ( 24 ) is constructed from electrically conductive materials for use with neurophysiological monitoring equipment ( 82 ).
10. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , wherein said needle member ( 24 ) includes electrically conductive pathways for use with neurophysiological monitoring equipment ( 82 ).
11. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , wherein said cannula ( 26 ) is constructed from electrically conductive materials for use with neurophysiological monitoring equipment ( 82 ).
12. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , wherein said cannula ( 26 ) includes electrically conductive pathways for use with neurophysiological monitoring equipment ( 82 ).