Percutaneous bone graft delivery system and method
A bone graft delivery system includes a bone graft injector and an access portal. The access portal may include a handle having a first arm pivotably connected to, and biased away from, a second arm. A ratchet including a pawl may extend from the second arm. A delivery tube may be configured to mate with the first arm and be configured to store a bone graft material therein. A plunger including a shaft and a plunger tip at the distal end thereof may be configured to move through the delivery tube. At least a portion of the shaft may include teeth, the pawl of the ratchet being configured to iteratively contact the teeth. A user may hold the access portal with a first hand and the bone graft injector with a second hand, iteratively squeezing the handle to iteratively eject amounts of bone graft material into a patient.
1. A method for delivering a bone graft material to a surgical site in a patient comprising:
creating an incision in a skin of the patient;
inserting an access portal through the incision in the skin of the patient;
gripping a bone graft injector assembly with a first hand of a user, the bone graft injector assembly including a handle, a ratchet assembly, a delivery tube assembly configured to store the bone graft material therein, and a plunger assembly operably coupled to the handle and the ratchet assembly and configured to move through the delivery tube assembly;
after inserting the access portal, advancing the bone graft injector assembly through the access portal toward the surgical site;
after advancing the bone graft injector assembly through the access portal, positioning a distal tip of a distractor between adjacent vertebrae;
rotating the distal tip of the distractor while the distal tip is between adjacent vertebrae to increase an amount of space between the adjacent vertebrae;
after rotating the distal tip of the distractor, advancing a space holder distally over the distal tip;
after advancing the space holder distally over the distal tip, removing the distractor from the bone graft injector assembly, such that the space holder maintains the increased spacing between the adjacent vertebrae;
expelling a first amount of the bone graft material from the delivery tube assembly using the first hand gripping the bone graft injector assembly; and
manipulating the access portal with a second hand of the user to change a position of the access portal while the first hand of the user is gripping the bone graft injector assembly, while the access portal is in the patient, and while the bone graft injector assembly is positioned within the access portal.
2. The method of claim 1 , further comprising dilating the incision after creating the incision and before inserting the access portal through the incision.
3. The method of claim 2 , wherein dilating the incision includes use of sequential dilators.
4. The method of claim 1 , further comprising loading the delivery tube assembly with the bone graft material prior to creating the incision in the skin of the patient.
5. The method of claim 1 , further comprising loading the delivery tube assembly with the bone graft material after creating the incision in the skin of the patient.
6. The method of claim 1 , wherein expelling the first amount of the bone graft material from the delivery tube assembly using the first hand gripping the bone graft injector assembly includes moving a first arm of the handle toward a second arm of the handle while the first hand of the user grips the handle.
7. The method of claim 6 , wherein moving the first arm of the handle toward the second arm of the handle drives plunger assembly distally through the delivery tube assembly.
8. The method of claim 7 , wherein moving the first arm of the handle toward the second arm of the handle drives the ratchet assembly, and the driving of the ratchet assembly causes the driving of the plunger assembly distally.
9. The method of claim 7 , wherein the plunger assembly includes a distal plunger tip that contacts the bone graft material as the plunger assembly is driven distally through the delivery tube assembly.
10. The method of claim 9 , wherein the distal plunger tip is formed of a first material, and a shaft of the plunger assembly is formed of a second material different than the first material.
11. The method of claim 1 , further comprising expelling a second amount of the bone graft material from the delivery tube assembly using the first hand gripping the bone graft injector assembly.
12. The method of claim 1 , further comprising removing the bone graft injector assembly from the access portal, inserting a tamping device into the access portal, and tamping the first amount of bone graft material.