Access assembly for anterior and lateral spinal procedures
View Patent ↗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 needle member ( 24 ) having a point end ( 28 ), a second end ( 88 ) and a central portion ( 90 ) and an outer diameter, said second end including a stop member extending outwardly from said outer diameter;
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 lumen sized so that said cannula slides over said needle member ( 24 ) and said second end ( 86 ) of said cannula is adjacent said stop member;
a handle assembly ( 14 ) for providing manipulating said needle assembly ( 12 ) during insertion thereof, said handle assembly ( 14 ) including a clamp portion ( 30 ), said clamp portion ( 30 ) cooperating with said adjacently positioned stop member and said second end of said cannula 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 handle assembly ( 14 ) is removable and re-securable to said needle assembly ( 12 ).
3. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 2 wherein 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 said clamp portion ( 30 ) of said handle assembly ( 14 ).
4. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 3 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.
5. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 4 wherein said clamp portion ( 30 ) of said handle assembly ( 14 ) includes a threaded engagement to provide controlled movement between a rod portion ( 44 ) and said clamp portion ( 30 ), said threaded engagement utilized to force a distal end of said rod portion ( 44 ) against said adjacently positioned clamp rings ( 32 ) ( 34 ).
6. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 4 wherein said second end ( 88 ) of said needle member ( 24 ) includes a gripping surface ( 56 ).
7. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 6 wherein said stop member is a portion of said gripping surface.
8. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 including 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 ( 73 ) of the center portion ( 80 ) of said cannula ( 26 ) extending through a central portion thereof.
9. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 8 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 ).
10. 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 ), second end ( 64 ) and a center portion ( 66 ), said center portion ( 66 ) sized to fit through said lumen ( 81 ) of said cannula ( 26 ).
11. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim 1 , wherein said handle assembly ( 14 ) is oriented at a predetermined angle with respect to said needle assembly ( 12 ) to provide the surgeon with an angular reference to the trajectory of said needle assembly ( 12 ).
12. 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 ).
13. 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 ).
14. 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 ).
15. The access assembly ( 10 ) for anterior, lateral and anterolateral spinal procedures of claim wherein said cannula ( 26 ) includes electrically conductive pathways for use with neurophysiological monitoring equipment ( 82 ).