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WO2025227017A1 - Ciseau d'accès à navigation - Google Patents

Ciseau d'accès à navigation

Info

Publication number
WO2025227017A1
WO2025227017A1 PCT/US2025/026337 US2025026337W WO2025227017A1 WO 2025227017 A1 WO2025227017 A1 WO 2025227017A1 US 2025026337 W US2025026337 W US 2025026337W WO 2025227017 A1 WO2025227017 A1 WO 2025227017A1
Authority
WO
WIPO (PCT)
Prior art keywords
geometry
access chisel
navigation system
access
chisel
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/US2025/026337
Other languages
English (en)
Inventor
Christopher U. Phan
Rachid OUIDJA
Nicole HOPPE
Geoff TOON
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Providence Medical Technology Inc
Original Assignee
Providence Medical Technology Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Providence Medical Technology Inc filed Critical Providence Medical Technology Inc
Publication of WO2025227017A1 publication Critical patent/WO2025227017A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
    • A61B90/13—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints guided by light, e.g. laser pointers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints

Definitions

  • This disclosure is directed to medical devices, systems and methods. More specifically, this disclosure is directed to devices, systems and methods related to a navigated access chisel.
  • Some surgical devices provide a means to access the posterior facet j oint in either an open or minimally invasive procedure for posterior facet fusion.
  • fluoroscopy can be used to provide X-ray guidance to navigate an instrument to the facet joint.
  • poor anatomical anatomy or preexisting hardware e.g., implants
  • an access chisel may include a first geometry configured to locate the access chisel to a first portion of a navigation system instrument.
  • the access chisel may include a second geometry configured to locate the access chisel to a second portion of the navigation system instrument.
  • the first geometry may be configured to interface the access chisel to a bore of the navigation system instrument.
  • the bore may be defined at least partially by a rim of the navigation system instrument, and wherein the second geometry is configured to interface the access chisel to the rim.
  • the access chisel may include a hub defining a hub geometry.
  • the access chisel may include a shaft defining a shaft geometry.
  • the hub geometry and the shaft geometry may mimic the geometry of the navigation system instrument for engagement of the navigation system instrument to the access chisel.
  • a system may include the access chisel and the navigation system instrument.
  • an access chisel for interfacing with a navigation system instrument may include a hub including a hub geometry.
  • the access chisel may include a shaft including a shaft geometry' proximate the hub.
  • the hub geometry and the shaft geometry may mimic a geometry of the navigation system instrument for engagement.
  • a system may include the access chisel and one or more accessory instruments configured for attachment to the access chisel.
  • the one or more accessory instruments may include a guide tube.
  • the system may include a clip releasably coupling the guide tube to the access chisel.
  • the one or more accessory instruments may include a handle.
  • the one or more accessory instruments may include a strike plate.
  • the strike plate may be configured to attach to the guide tube and comprises a mallet surface.
  • the navigation system instrument may be a third-party 7 tracker array.
  • a system may include a navigation system instrument, and an access chisel configured to interface with the navigation system instrument at a first geometry and a second geometry to locate the access chisel to the navigation system instrument.
  • the navigation system instrument may include an axis.
  • the first geometry may align the access chisel to the axis.
  • the first geometry may include a shaft geometry of the access chisel that mimics a bore geometry of the navigation system instrument.
  • the access chisel may be positionable within the navigation system instrument to align the shaft geometry 7 with the bore geometry.
  • the second geometry may include a hub geometry 7 of the access chisel that mimics a rim geometry of the navigation system instrument. An engagement of the hub geometry with the rim geometry may limit a rotation of the access chisel relative to the navigation system instrument about the axis.
  • the system may include a guide tube configured to receive at least a portion of the access chisel.
  • the system may include a clip releasably coupling the access chisel to the guide tube.
  • the system may be configured for use in the lumbar spine.
  • FIG. 1 illustrates a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIG. 2 illustrates an exploded view of a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIGS. 3-4 illustrate a navigated access chisel system including at least one accessory instrument in accordance with embodiments of the present disclosure.
  • FIG. 5 illustrates a use of a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIGS. 5A-5D illustrate example axial and lateral views of tracking a navigated access chisel system through tissue to an entrance of a facet joint in accordance with embodiments of the present disclosure.
  • FIG. 6 illustrates another use of a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIGS. 6A-6B illustrate example axial and lateral views of advancing a navigated access chisel system into a facet joint in accordance with embodiments of the present disclosure.
  • FIG. 7 illustrates another use of a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIG. 8 illustrates another use of a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIG. 9 illustrates a flow diagram of a process of using a navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIGS. 10-11 illustrate first and second exploded views of another navigated access chisel system in accordance with embodiments of the present disclosure.
  • FIG. 12 illustrates the navigated access chisel system of FIG. 10 in a first configuration in accordance w ith embodiments of the present disclosure.
  • FIG. 13 illustrates the navigated access chisel system of FIG. 10 in a second configuration in accordance with embodiments of the present disclosure.
  • distal and proximal are used to refer to a position or direction relative to the treating clinician, such as a surgeon. “Distal” and “distally” refer to a position that is distant from, or in a direction away from, the treating clinician. “Proximal” and “proximally” refer to a position that is near, or in a direction toward, the treating clinician. The terms “posterior” and “anterior” refer to the back and front, respectively, of the body of a subject.
  • cortication refers to the process by which an outer surface of a bone is roughened or removed and the underlying cancellous bone exposed. Relative to the outer bone surface, the cancellous bone more effectively retains deposited graft material, thereby promoting healing and bone growth after surgery.
  • the term “about” can include numbers that are rounded to the nearest significant figure.
  • the recitation of numerical ranges by endpoints includes all numbers and subranges within and bounding that range (e.g., 1 to 4 includes 1, 1.5, 1.75, 2, 2.3, 2.6, 2.9, etc. and 1 to 1.5. 1 to 2, 1 to 3, 2 to 3.5, 2 to 4, 3 to 4. etc ).
  • Navigation technologies provide a means to precisely track the location of surgical instruments throughout a procedure.
  • “live” views may show the position of the surgical instruments relative to anatomical landmarks, such as in axial, lateral, and A-P perspective.
  • One or more surgical instruments may be compatible with the navigation technologies, such as facilitating tracker arrays, or other tracking devices, to be attached onto the surgical instrument(s) for navigation purposes.
  • examples of the present disclosure may combine access to the facet joint and the ability for subsequent instruments to access the facet joint, such as into a one-step method or process.
  • the facet joint may be any facet joint in the spine, including the lumbar spine, the thoracic spine, and the cervical spine, without intent to limit.
  • FIG. 1 illustrates a navigated access chisel system 100 (hereinafter “system” for sake of convenience without intent to limit) in accordance with embodiments of the present disclosure.
  • the system 100 includes various features to track the location of one or more surgical instruments, such as using proprietary' or third-party 7 tracking systems (e.g., a navigation system instrument).
  • the system 100 may interface (e.g., couple, attach, lock, etc.) with the navigation system instrument, such that the position, orientation, etc. of a surgical instrument may be determined (e.g., via a tracker array coupled to the surgical instrument).
  • the navigation system instrument By interfacing the navigation system instrument with the surgical instrument, the surgical instrument may be navigated to a desired position, with such navigation allowing for “live” tracking of the surgical instrument (e.g., via fluoroscopy).
  • the system 100 may include a navigation system instrument 104 and an access chisel 108, such as for interfacing with the navigation system instrument 104.
  • the navigation system instrument 104 may facilitate a determination of its position.
  • the navigation system instrument 104 may be configured to determine, or provide data for the determination of, its position in space (e.g., absolute position, relative position, in two-dimensional space, in three-dimensional space, etc.).
  • the navigation system instrument 104 may include a tracker array 1 12 (e.g., an array of tracker elements).
  • the navigation system instrument 104 may be a third-party tracker array, such as a tracker array 112 provided by a third-party supplier independent or separate from the access chisel 108.
  • the navigation system instrument 104 may include a sleeve 116.
  • the tracker array 112 may be coupled to the sleeve 116. such as via a post 120, although other configurations are contemplated.
  • the access chisel 108 may be configured for insertion into or through tissue, such as towards a target site (e.g.. a target joint).
  • a target site e.g.. a target joint
  • the access chisel 108 may be advanced through tissue to a target facet joint, such as for a facet fusion procedure of any portion of the spine (e.g., the lumbar spine, the cervical spine, etc.), although other configurations are contemplated.
  • the access chisel 108 may be inserted or wedged in a facet, such as to guide and anchor the system 100 at the target site.
  • the access chisel 108 may include a first tip 124.
  • the first tip 124 may include a roughened surface or formed features, such as to aid in anchoring or docking the access chisel 108 in the facet joint, for roughening or decorticating the facet joint, etc.
  • the system 100 may include a guide tube 130.
  • the guide tube 130 may be configured to receive at least a portion of the access chisel 108.
  • the guide tube 130 may include a hollow shaft 134 or pipe through which the access chisel 108 is inserted.
  • the hollow shaft 134 may be configured to allow for slidable insertion of the access chisel 108 therein.
  • the guide tube 130 may include a second tip 138 (e.g., a pair of tips) with roughened surfaces or features, such as to aid in anchoring or docking the guide tube 130 (e.g., at the target site, facet joint, etc.).
  • FIG. 2 illustrates an exploded view of the system 100 in accordance with embodiments of the present disclosure.
  • the navigation system instrument 104 may include a bore 202.
  • the bore 202 may be defined through the sleeve 116.
  • the bore 202 may be defined at least partially by a nm 206 of the sleeve 116.
  • the rim 206 may define an opening to the bore 202.
  • a slot 210 may extend across the rim 206 (e.g., across the end face of the rim 206), such as across the bore 202 to opposing lateral sides of the sleeve 116.
  • the access chisel 108 may be an elongated instrument including a shaft 214 having a proximal end 218 and a distal end 222.
  • the first tip 124 may be defined on the distal end 222.
  • the proximal end 218 may be shaped for engagement, such as including a shaped end 226 and a groove 230.
  • the shaped end 226 may have one or more faces or surfaces, such as opposing parallel surfaces, for engagement.
  • the proximal end 218 may be shaped to engage a handle 234.
  • the handle 234 may engage both the shaped end 226 and the groove 230 to secure the handle 234 to the access chisel 108.
  • the handle 234 may include internal dimensions complementary to the shaped end 226 and a detent that selectively engages the groove 230.
  • the detent may be selectively moved into and out of position with the groove 230 via a secondary handle 238.
  • the access chisel 108 may be configured to interface with the navigation system instrument 104.
  • the access chisel 108 may include a first geometry configured to locate the access chisel 108 to a first portion of the navigation system instrument 104.
  • the first geometry may be configured to interface the access chisel 108 to the bore 202.
  • the shaft 214 may define a shaft geometry, such that the shaft geometry mimics the geometry of the bore 202 (e.g., a bore geometry with a diameter, shape, and/or other configuration similar to the shaft geometry ).
  • the navigation system instrument 104 may include an axis 242, such as defined by the bore 202.
  • the first geometry may align the access chisel 108 to the axis 242.
  • the access chisel 108 may be positionable within the navigation system instrument 104 (e.g., within the bore 202) to align the shaft geometry 7 with the bore geometry 7 .
  • the access chisel 108 may include a second geometry configured to locate the access chisel 108 to a second portion of the navigation system instrument 104.
  • the second geometry may be configured to interface the access chisel 108 to the rim 206.
  • the access chisel 108 may include a hub 246, such as along the shaft 214 between the proximal end 218 and the distal end 222.
  • the hub 246 may include or define a hub geometry.
  • the shaft geometry may be proximate the hub 246.
  • the hub geometry may mimic the geometry of the rim 206 for engagement (e.g., a rim geometry with a shape or configuration complementary to the hub geometry ).
  • the hub 246 may include a flange 250 and one or more tabs 254 extending from the flange 250.
  • the flange 250 may extend radially from the shaft 214.
  • the one or more tabs 254 may extend from the flange 250 along an axial length of the shaft 214, such as from the flange 250 towards the proximal end 218.
  • the flange 250 and tab(s) 254 may engage the navigation system instrument 104 (e.g., sleeve 116), such as the flange 250 engaging the end face of the rim 206, and the tab(s) 254 received in the slot 210.
  • engagement of the hub geometry with the rim geometry may limit a rotation of the access chisel 108 relative to the navigation system instrument 104 about the axis 242.
  • engagement of the hub geometry with the rim geometry may limit rotation of the access chisel 108 within the bore 202.
  • the access chisel 108 may be configured to interface with the navigation system instrument 104 at the first geometry and the second geometry to locate the access chisel 108 to the navigation system instrument 104.
  • FIGS. 3-4 illustrate at least one accessory instrument in accordance with embodiments of the present disclosure.
  • the system 100 may include one or more accessory instruments 300 for attachment to the access chisel 108.
  • the one or more accessory instruments 300 may facilitate use (e.g., surgical use) of the access chisel 108 and/or system 100 in general.
  • the one or more accessory instruments 300 may include the guide tube 130.
  • the system 100 e.g., the access chisel 108) may include a clip 304, such as coupled to the hub 246 (e.g., the flange 250).
  • the clip 304 may releasably couple the guide tube 130 to the access chisel 108.
  • the clip 304 may releasably engage a complementary structure of the guide tube 130 (e.g. a ledge, groove, etc., such as of a handle 306 of the guide tube 130) to hold the guide tube 130 to the access chisel 108.
  • a complementary structure of the guide tube 130 e.g. a ledge, groove, etc., such as of a handle 306 of the guide tube 130
  • the one or more accessory instruments 300 may include the handle 234.
  • the handle 234 may releasably engage the proximal end 218 of the access chisel 108, such as for selective manipulation of the access chisel 108 via the handle 234.
  • the one or more accessory instruments 300 may include a strike plate 308.
  • the strike plate 308 may attach to the guide tube 130 to provide a mallet surface 312.
  • a user may mallet the strike plate 308 (e.g., mallet surface 312) to advance the guide tube 130 down the access chisel 108.
  • the strike plate 308 may extend laterally away from the access chisel 108, such as to a distance sufficient to provide clear access to the mallet surface 312.
  • striking (e.g., malleting) the strike plate 308 may release the engagement of the clip 304 with the guide tube 130.
  • the clip 304 may automatically release the guide tube 130 when a sufficient force is applied to the strike plate 308.
  • FIG. 5 illustrates a use of the system 100 in accordance with embodiments of the present disclosure.
  • the system 100 may be used with other portions of the spine, such as the cervical spine, etc.
  • the system 100 maybe advanced through tissue to a target site, such as to the entrance of a facet joint 502 in some examples.
  • the navigation system instrument 104 Through use of at least the navigation system instrument 104, the advancement of the system 100 may be tracked (e.g., the system 100 may be navigated to the facet joint 502).
  • FIGS. 5A-5D illustrate example axial and lateral views of tracking the system 100 through tissue to the facet joint 502 in accordance with embodiments of the present disclosure.
  • the patient may be scanned to provide a virtual reconstruction of the spine.
  • the scanned images may be used to track or otherwise determine the position of the system 100.
  • the position of the system 100 may be tracked using axial and lateral views.
  • the position of the system 100 may be tracked under fluoroscopy (e.g., in real time or ‘dive,’" or in near real time). In these and other examples, tracking the position of the system 100 may ensure proper positioning of the system 100 to the facet joint 502.
  • FIG. 6 illustrates another use of the system 100 in accordance with embodiments of the present disclosure.
  • the system 100 may be advanced into the facet joint 502. with the advancement into the facet joint 502 tracked via at least the navigation system instrument 104.
  • FIGS. 6A-6B illustrate example axial and lateral views of tracking the advancement of the system 100 into the facet joint 502 in accordance with embodiments of the present disclosure.
  • the position of the system 100 into the facet joint 502 may be tracked (e.g., in real time or ’‘live,” or in near real time), such as to ensure proper positioning of the system 100 into the facet joint 502.
  • the access chisel 108 e.g., the first tip 124 may be advanced into the facet joint 502. such as to anchor the system 100 at the target site.
  • FIG. 7 illustrates another use of the system 100 in accordance with embodiments of the present disclosure.
  • the guide tube 130 e.g., the second tip 138
  • the guide tube 130 may be advanced into the facet joint 502. such as to anchor the guide tube 130 at the target site.
  • the guide tube 130 may be advanced into the facet joint 502 by malleting the strike plate 308.
  • a user may mallet or otherwise strike the strike plate 308 to advance the guide tube 130 down the access chisel 108 and the second tip 138 into the facet joint 502.
  • advancement of the guide tube 130 into the facet joint 502 may be performed under fluoroscopy (e.g., using live axial and lateral view s).
  • FIG. 8 illustrates another use of the sy stem 100 in accordance with embodiments of the present disclosure.
  • the access chisel 108 may be removed from the guide tube 130, leaving the guide tube 130 anchored in the facet joint 502.
  • the access chisel 108 e g., with the navigation system instrument 104 and other accessory instruments 300
  • the access chisel 108 may be removed from the surgical site, leaving access to the facet joint 502 via the guide tube 130 (e.g., via the hollow shaft 134).
  • FIG. 9 illustrates a flow diagram of a method 900 of using a navigated access chisel system (e.g., the system 100 described above, the system 1000 described below) in accordance with embodiments of the present disclosure.
  • a navigated access chisel system e.g., the system 100 described above, the system 1000 described below
  • the method 900 is described herein with reference to FIGS. 1-8 and 10-13, although the method 900 is not limited to the embodiments illustrated therein. Note that one or more operations in FIG. 9 may be combined, omitted, and/or performed in a different order, as desired.
  • the method 900 includes receiving a virtual reconstruction of a patient’s spine.
  • block 904 may include scanning the patient to provide the virtual reconstruction of the spine. The scanning may be performed by a third-party navigation system.
  • the method 900 includes attaching a navigation system instrument to an access chisel of the navigated access chisel system.
  • a tracking array may be attached to the shaft of the access chisel, such as in a manner as described herein.
  • the tracking array may be a third-party tracking array.
  • the method 900 includes attaching one or more accessory instruments to the access chisel.
  • one or more accessory instruments For example, at least one of a handle, a guide tube, or a strike plate may be attached to the access chisel, such as in a manner as described herein.
  • the method 900 includes associating an instrument to the access chisel.
  • block 916 may include selecting a third-party instrument in a navigation software database that is similar in geometry to the access chisel.
  • the method 900 includes registering the access chisel to the navigation system instrument.
  • the access chisel may be registered to the reference array (e.g., third-party referent array) that has been anchored to the patient’s anatomy (e.g.. a spinous process, etc.).
  • the reference array e.g., third-party referent array
  • the method 900 includes navigating the access chisel to a target site.
  • the access chisel may be navigated to a desired facet joint, such as in a manner as described herein.
  • navigation may allow for “live” tracking of the instrument relative to the patient’s anatomy (e.g., in the axial, lateral, and A-P view).
  • the method 900 includes navigating and advancing the access chisel into the facet joint, such as in a manner as described herein.
  • the method 900 includes advancing and attaching the guide tube into the facet joint, such as in a manner as described herein.
  • the guide tube may be advanced and attached into the facet joint by malleting or otherwise striking the strike plate.
  • the method 900 includes removing the access chisel and undesired accessories from the guide tube.
  • the access chisel and strike plate may be removed from the guide tube.
  • the method 900 includes proceeding with a posterior facet fusion procedure.
  • the guide tube may be used for facet fusion of the facet joint.
  • the access chisel may be reinserted into the guide tube, such as to confirm instrument position through the facet fusion procedure.
  • FIGS. 10-13 illustrate a navigated access chisel system 1000 (hereinafter “system” for sake of convenience without intent to limit) in accordance with embodiments of the present disclosure.
  • system may be similar to system 100. described above, with description of like features omitted for convenience (e.g., like features of the system 1000 including reference numbers incremented by 1000 compared to the system 100).
  • the system 1000 may include various features to track the location of one or more surgical instruments, such as using proprietary' or third-party tracking systems (e.g., a navigation system instrument), with the system 1000 interfacing (e.g., couple, atach, lock, etc.) with the navigation system instrument, such that the position, orientation, etc.
  • proprietary' or third-party tracking systems e.g., a navigation system instrument
  • a surgical instrument may be determined (e.g., via a tracker array coupled to the surgical instrument).
  • the navigation system instrument By interfacing the navigation system instrument with the surgical instrument, the surgical instrument may be navigated to a desired position, with such navigation allowing for ‘‘live’' tracking of the surgical instrument (e.g., via fluoroscopy).
  • the system 1000 may include a navigation system instrument 1004 and an access chisel 1008 that interfaces with the navigation system instrument 1004.
  • the system 1000 may include a guide tube 1030.
  • the navigation system instrument 1004 may be configured to determine, or provide data for the determination of, its position in space, with the navigation system instrument 1004 including a tracker array 1012 (e.g., a third- party’ tracker array) connected to or integrated with a sleeve 1016.
  • a bore 2002 may be defined through the sleeve 1016, and a slot 2010 may be defined at a terminal end of the sleeve 1016. for example, in an end face of a rim.
  • the navigation system instrument 1004 may include a handle 2034 for manipulation of the navigation system instrument 1004 and/or the system 1000 in general.
  • the navigation system instrument 1004 may include a buton 1006.
  • the buton 1006 may be positioned on a side of the sleeve 1016.
  • the button 1006 may be positioned on a side opposite the slot 2010, on a side opposite the tracker array 1012, or any combinations thereof.
  • the buton 1006 may be configured to selectively engage or release the access chisel 1008.
  • the button 1006 may operate a linkage, tab, or detent that selectively engages the access chisel 1008 to couple the navigation system instrument 1004 to the access chisel 1008, as described more fully below.
  • the access chisel 1008 may be similar to the access chisel 108, described above.
  • the access chisel 1008 may be configured for advancement through tissue, such as to a target facet joint.
  • the access chisel 1008 may include a first tip 1024 for anchoring or docking the access chisel 1008 in a facet j oint, for roughening or decorticating the facet joint, or the like.
  • the access chisel 1008 includes a flange 2050 and one or more tabs 2054 (e.g., a hub 2046).
  • the tab 2054 may engage the navigation system instrument 1004, such as the tab 2054 received in the slot 2010 defined in the sleeve 1016 when at least a portion of the access chisel 1008 (e.g., a proximal end 2018 of a shaft 2014) is inserted within the bore 2002.
  • the access chisel 1008 may be configured to interface with the navigation system instrument 1004 at a first geometry and a second geometry to locate the access chisel 1008 to the navigation system instrument 1004, such as in a manner similar to that described above.
  • the proximal end 2018 may be configured to engage the navigation system instrument 2004.
  • the proximal end 2018 may include a cutout or relief cut 2020.
  • the cutout or relief cut 2020 may be defined proximate to the tab 2054.
  • the cutout or relief cut 2020 may engage the button 1006 to couple the access chisel 1008 to the navigation system instrument 2004.
  • the button 1006 (or elements operatively connected to the button 1006) may seat within the cutout or relief cut 2020 to secure the access chisel 1008 to the navigation system instrument 2004.
  • the button 1006 may be depressed to clear the button 1006 or elements operatively connected to the button 1006 from the cutout or relief cut 2020.
  • the access chisel 1008 may include a clip 3004.
  • the clip 3004 may releasably engage a complementary structure of the guide tube 1030.
  • the clip 3004 may releasably engage the handle 1040, a ledge, groove, or other structure of the guide tube 1030 to hold the guide tube 1030 to the access chisel 1008, such as in a manner similar to that described above.
  • the guide tube 1030 may be configured to receive at least a portion of the access chisel 1008.
  • the guide tube 1030 may include a hollow shaft 1034 or pipe through which the access chisel 1 08 is inserted.
  • the hollow shaft 1034 may be configured to allow for slidable insertion of the access chisel 1008 therein.
  • the guide tube 1030 may include a second tip 1038 (e.g., a pair of tips) with roughened surfaces or features, such as to aid in anchoring or docking the guide tube 1030 (e.g.. at the target site, facet joint, etc.).
  • the guide tube 1030 includes a handle 1040 at its proximal end.
  • the system 1000 includes a strike plate 3008.
  • the strike plate 3008 may provide a mallet surface 3012 allowing a user to mallet the strike plate 3008 to advance the guide tube 1030 or system 1000 into a target facet joint, to advance the guide tube 1030 down the access chisel 1008, etc.
  • the strike plate 3008 may be selectively coupled to the guide tube 1030, such as via a set screw, corresponding engagement features, etc.
  • the strike plate 3008 may be coupled to the handle 1040.
  • FIG. 12 illustrates the system 1000 in a first configuration.
  • the first configuration may be defined by the access chisel 1008 coupled to the navigation system instrument 1004.
  • the proximal end 2018 of the shaft 2014 may be inserted into the bore 2002 of the sleeve 1016 with the geometry of the hub 2046 engaging the geometry' of the sleeve 1016.
  • the sleeve 1016 may be slid over the proximal end 2018 of the shaft 2014 until the tab 2054 is received in the slot 2010.
  • the proximal end 2018 of the shaft 2014 may engage the button 1006 to selectively secure the access chisel 1008 to the navigation system instrument 1004, for example, via the cutout or relief cut 2020.
  • the first configuration may be defined by the guide tube 1030 secured to the access chisel 1008.
  • the access chisel 1008 may be at least partially inserted into the guide tube 1030.
  • the shaft 2014 of the access chisel 1008 may be inserted through the hollow shaft 1034 of the guide tube 1030.
  • the first configuration may be defined by the clip 3004 engaging the guide tube 1030 (e.g., the handle 1040) to hold the guide tube 1030 to the access chisel 1008.
  • the guide tube 1030 may be retained by the access chisel 1008 via the clip 3004.
  • the system 1000 when fully connected, may be navigated to the facet j oint.
  • the access chisel 1008 may be docked into the facet joint, such as in a manner as described above.
  • FIG. 13 illustrates the system 1000 in a second configuration.
  • the second configuration may be defined by the guide tube 1030 released from the access chisel 1008.
  • the access chisel 1008 may be removed, at least partially, from the guide tube 1030. More particularly, once the access chisel 1008 docks into the facet joint, the user may mallet the strike plate 3008 to release the guide tube 1030 from the clip 3004 and advance the guide tube 1030 into the facet joint.
  • the access chisel 1008 with the navigation system instrument 1004 may be removed from the guide tube 1030.
  • the guide tube 1030 may be left behind, providing a portal for subsequent instruments to access the facet joint, such as in a manner as described above.
  • the navigation system instrument 1004 may be removed from the access chisel 1008.
  • depressing the button 1006 may disengage the access chisel 1008, allowing the navigation system instrument 1004 to be pulled or slid off the proximal end 2018 of the shaft 2014.

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  • Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
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  • Veterinary Medicine (AREA)
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  • Surgical Instruments (AREA)

Abstract

L'invention concerne un ciseau d'accès à navigation pouvant comporter une première géométrie conçue pour localiser le ciseau d'accès au niveau d'une première partie d'un instrument de système de navigation. Le ciseau d'accès peut comprendre une seconde géométrie conçue pour localiser le ciseau d'accès au niveau d'une seconde partie de l'instrument de système de navigation. La première géométrie peut être une géométrie d'arbre du ciseau d'accès. La seconde géométrie peut être une géométrie de moyeu du ciseau d'accès. Les géométries de moyeu et d'arbre peuvent imiter la géométrie de l'instrument de système de navigation pour la mise en prise de l'instrument de système de navigation avec le ciseau d'accès. Un système peut comprendre le ciseau d'accès, un tube de guidage et une plaque de frappe. Le système peut comprendre l'instrument de système de navigation, qui peut être un réseau de suivi tiers. L'invention concerne également d'autres systèmes et des procédés associés.
PCT/US2025/026337 2024-04-25 2025-04-25 Ciseau d'accès à navigation Pending WO2025227017A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202463638745P 2024-04-25 2024-04-25
US63/638,745 2024-04-25

Publications (1)

Publication Number Publication Date
WO2025227017A1 true WO2025227017A1 (fr) 2025-10-30

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2025/026337 Pending WO2025227017A1 (fr) 2024-04-25 2025-04-25 Ciseau d'accès à navigation

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WO (1) WO2025227017A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120029545A1 (en) * 2009-09-24 2012-02-02 Medicinelodge, Inc Dba Imds Co-Innovation Reciprocating surgical instrument
US8152814B2 (en) * 2005-09-30 2012-04-10 Depuy Products, Inc. Separator tool for a modular prosthesis
US20140336763A1 (en) * 2010-01-13 2014-11-13 Jcbd, Llc Systems for and methods of fusing a sacroiliac joint
US20210059833A1 (en) * 2018-01-04 2021-03-04 Providence Medical Technology, Inc. Facet screw and delivery device
US20210386434A1 (en) * 2018-09-21 2021-12-16 Providence Medical Technology, Inc. Vertebral joint access and decortication devices and methods of using

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8152814B2 (en) * 2005-09-30 2012-04-10 Depuy Products, Inc. Separator tool for a modular prosthesis
US20120029545A1 (en) * 2009-09-24 2012-02-02 Medicinelodge, Inc Dba Imds Co-Innovation Reciprocating surgical instrument
US20140336763A1 (en) * 2010-01-13 2014-11-13 Jcbd, Llc Systems for and methods of fusing a sacroiliac joint
US20210059833A1 (en) * 2018-01-04 2021-03-04 Providence Medical Technology, Inc. Facet screw and delivery device
US20210386434A1 (en) * 2018-09-21 2021-12-16 Providence Medical Technology, Inc. Vertebral joint access and decortication devices and methods of using

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