Delivery systems for interspinous, interlaminar stabilization devices and methods of use
The present disclosure provides various surgical instruments and delivery systems to properly implant spinous stabilization devices, such as for example, interspinous, interlaminar stabilization devices, in a less invasive manner than what is currently performed. The delivery system may be a tubular delivery system through which instruments and devices can pass. Methods for using these surgical instruments and delivery systems are also provided.
1. A delivery system for delivering a spinal stabilization device to an implantation site external to adjacent vertebrae, the spinal stabilization device having superior and inferior bone-contacting sections and a midsection with a cavity defined therebetween, the spinal stabilization device having a lower profile when the spinal stabilization device is in a first orientation, and having a higher profile when the spinal stabilization device is in a second orientation, the delivery system comprising:
a hollow working sleeve having an instrument insertion end and a bone engagement end, the working sleeve having a profile that is smaller than the higher profile of the spinal stabilization device, the working sleeve further having an inner feature; and
an insertion instrument insertable into the instrument insertion end of the working sleeve, the insertion instrument having a movable arm insertable into the defined cavity of the spinal stabilization device and configured to releasably carry the spinal stabilization device through the working sleeve in the first orientation, the movable arm being configured, upon engagement by the inner feature of the working sleeve, to rotate the spinal stabilization device from the first orientation to the second orientation at the implantation site about a rotational axis extending transverse to the superior and inferior bone-contacting sections and through the defined cavity of the spinal stabilization device,
wherein the superior and inferior bone-contacting sections extend in a lateral direction relative to an axis defined along a direction of insertion and are intersected by the axis defined along the direction of insertion when the spinal stabilization device is in the first orientation, and
wherein the superior and inferior bone-contacting sections extend in a longitudinal direction relative to the axis defined along the direction of insertion when the spinal stabilization device is in the second orientation.
2. The system of claim 1 , wherein the spinal stabilization device comprises an interspinous or interlaminar stabilization device.
3. The system of claim 1 , wherein the implantation site is between respective adjacent spinous processes of the adjacent vertebrae.
4. The system of claim 1 , wherein the distal end of the working sleeve includes a plurality of finger projections.
5. The system of claim 4 , wherein the finger projections are expandable.
6. The system of claim 1 , wherein the distal end of the working sleeve includes movable flaps.
7. The system of claim 6 , wherein the movable flaps are hinged.
8. The system of claim 1 , wherein the working sleeve includes guide rails within the hollow elongate body.
9. The system of claim 8 , wherein the insertion instrument includes pins for engaging the guide rails of the working sleeve.
10. The system of claim 1 , wherein a plurality of lateral walls extend in a lateral direction from at least one section of the superior and inferior bone-contacting sections, wherein the spinal stabilization device rotates between a first, low profile configuration corresponding to the first orientation in which the lateral walls extend in the longitudinal direction and a second, upright configuration corresponding to the second orientation in which the lateral walls extend in the lateral direction, and wherein the second, upright configuration is angled up to about 90 degrees relative to the first, low profile configuration.
11. The system of claim 1 , further including a trocar configured for insertion into the working sleeve.
12. The system of claim 3 , further including a crimping plier configured for insertion into the working sleeve.
13. The system of claim 12 , wherein the crimping plier is configured to crimp the interspinous or interlaminar device onto a spinous process.
14. The system of claim 1 , further being configured for endoscopic surgery.
15. The system of claim 1 , further being configured for minimally invasive surgery.
16. The delivery system of claim 1 , wherein the inner feature of the working sleeve includes a spindle mechanism.
17. The delivery system of claim 1 , wherein when the spinal stabilization device is in the second orientation, the movable arm is lockable and the insertion instrument is capable of advancement relative to the working sleeve so as to urge the spinal stabilization device into the implantation site.
18. The delivery system of claim 1 , wherein, in the first orientation, the movable arm is positioned such that the superior and inferior bone-contacting sections of the spinal stabilization device extend substantially laterally within the working sleeve.
19. The delivery system of claim 1 , wherein, in the second orientation, the movable arm is rotated such that the superior and inferior bone-contacting sections of the spinal stabilization device is pivoted about 90 degrees relative to the first orientation.