초록 ▼

Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In general, the method involves advancing a spinal fixation element in a first, lengthwise orientation along a pathway extending from a minimally invasive

Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In general, the method involves advancing a spinal fixation element in a first, lengthwise orientation along a pathway extending from a minimally invasive percutaneous incision to a spinal anchor site. As the spinal fixation element approaches the spinal anchor site, the fixation element can be manipulated to extend in a second orientation, which is preferably substantially transverse to the first orientation, to position the fixation element in relation to one or more spinal anchors.

대표청구항 ▼

1. A minimally invasive method for delivering a spinal fixation element comprising: positioning a distal end of a percutaneous access device proximate to a spinal anchor implanted in a vertebra such that an inner lumen extending through the percutaneous access device forms a pathway extending from a

1. A minimally invasive method for delivering a spinal fixation element comprising: positioning a distal end of a percutaneous access device proximate to a spinal anchor implanted in a vertebra such that an inner lumen extending through the percutaneous access device forms a pathway extending from a skin surface, through tissue, to the spinal anchor;advancing a leading end of a spinal fixation element into an opening in a proximal-most end of the percutaneous access device, and advancing the spinal fixation element through the inner lumen toward the spinal anchor;after advancing, manipulating the spinal fixation element to pass the leading end of the spinal fixation element through a slot formed in a sidewall of the percutaneous access device, and to thereby position a trailing end of the spinal fixation element within the spinal anchor implanted in the vertebra. 2. The method of claim 1, wherein the percutaneous access device has a maximum outer diameter that is substantially the same as a maximum outer diameter of the spinal anchor. 3. The method of claim 1, wherein the percutaneous access has a maximum inner diameter that is substantially the same as a maximum outer diameter of the spinal anchor. 4. The method of claim 3, wherein, when the leading end of the spinal fixation element is passed through the slot, the spinal fixation element is rotated to a second orientation substantially parallel to a vertebral column. 5. The method of claim 1, wherein, when the spinal fixation element is advanced through the inner lumen, the spinal fixation element is in a first orientation substantially parallel with a longitudinal axis of the percutaneous access device. 6. The method of claim 1, wherein the positioning step includes coupling the percutaneous access device to the spinal anchor. 7. The method of claim 1, further comprising coupling the percutaneous access device to the anchor prior to insertion of the anchor, and advancing the anchor and percutaneous access device through an incision. 8. The method of claim 7, wherein the incision is approximately the same size as a maximum diameter of the anchor. 9. The method of claim 1, wherein the spinal anchor is selected from the group consisting of spinal screws, hooks, bolts, and wires. 10. The method of claim 1, further comprising coupling the spinal fixation element to the spinal anchor with one or more of a set screw, band clamp, slotted connector or offset connector. 11. A minimally invasive method for delivering a spinal fixation element comprising: inserting a distal end of a percutaneous access device through an incision to position the distal end of the percutaneous access device subcutaneously at a spinal implant site;passing a leading end of a spinal fixation element lengthwise into an opening in a proximal-most end of the percutaneous access device;subcutaneously reorienting the spinal fixation element by advancing the leading end of the spinal fixation element from a distal portion of the percutaneous access device to position the spinal fixation element proximate to a second spinal implant site, thereby positioning the spinal fixation element proximate to both spinal implant sites. 12. The method of claim 11, wherein the reorienting step comprises bringing the leading end of the spinal fixation element into contact with a protrusion in an inner wall of the percutaneous access device, the protrusion causing the leading end of the spinal fixation element to pass outside of a distal end of the percutaneous access device. 13. The method of claim 11, further comprising a spinal implant coupled to the distal end of the percutaneous access device. 14. The method of claim 13, wherein the spinal implant is coupled to the percutaneous access device by a sleeve slidably disposed therearound. 15. The method of claim 11, wherein the passing and reorienting steps include using a manipulator coupled to a proximal end of the spinal fixation element and slidably disposed within the percutaneous access device to deliver the spinal fixation element to the spinal implant site. 16. A minimally invasive method for delivering a spinal fixation element comprising: inserting a distal end of a percutaneous access device through an incision to position the distal end of the percutaneous access device subcutaneously at a spinal implant site;passing a spinal fixation element lengthwise into an opening in a proximal-most end of the percutaneous access device;subcutaneously reorienting the spinal fixation element by advancing a leading end of the spinal fixation element into contact with a protrusion in an inner wall of the percutaneous access device, the protrusion causing the leading end of the spinal fixation element to pass outside of a distal end of the percutaneous access device to position the spinal fixation element proximate to a second spinal implant site, thereby positioning the spinal fixation element proximate to both spinal implant sites.