Surgical instrumentation and method for treatment of the spine

Abstract

Instrumentation for treatment of the spine, including an elongate member having a deformable distal end portion at least partially formed of a flexible and preferably elastic material. The distal end portion has an initial configuration for placement adjacent a vertebral body and a deformed configuration defining at least one outwardly extending projection for displacement of at least a portion of the vertebral body. The elongate member preferably comprises a rod member, a sleeve member and an actuator mechanism for imparting relative linear displacement between the rod and sleeve members to effect outward deformation of the distal end portion of the sleeve member. In one embodiment, the instrumentation is used to compact cancellous bone to form a cavity within a vertebral body. In another embodiment, the instrumentation is used to reduce a compression fracture. In yet another embodiment, the instrumentation is used to distract a disc space between adjacent vertebral bodies.

1 .- 79 . (canceled)  
     
     
         80 . A method for treatment of the spine, comprising: 
 providing an instrument including a deformable distal portion having an insertion configuration and a deformed configuration, the deformed configuration defining at least one transverse projection arranged along a single transverse axis;    positioning the deformable distal portion adjacent a spinal structure while in the insertion configuration; and    deforming the distal portion toward the deformed configuration to uniaxially displace at least a portion of the spinal structure along the transverse axis.    
     
     
         81 . The method of  claim 80 , wherein the deforming is directionally controlled.  
     
     
         82 . The method of  claim 80 , further comprising: 
 deforming the distal end portion back toward the insertion configuration; and    removing the distal end portion from the spinal structure.    
     
     
         83 . The method of  claim 80 , wherein the positioning comprises inserting the deformable distal portion through an outer wall of a vertebral body; and 
 wherein displacement of the at least a portion of the spinal structure comprises compacting cancellous bone to form a cavity within the vertebral body.    
     
     
         84 . The method of  claim 80 , wherein the positioning comprises inserting the deformable distal portion through an outer wall of a vertebral body; and 
 wherein displacement of the at least a portion of the spinal structure comprises at least partially reducing a compression fracture in the vertebral body.    
     
     
         85 . The method of  claim 80 , wherein the positioning comprises inserting the deformable distal portion into an intervertebral disc space between adjacent vertebral bodies; and 
 wherein displacement of the at least a portion of the spinal structure comprises exerting a force onto the adjacent vertebral bodies and distracting the intervertebral disc space.    
     
     
         86 . The method of  claim 80 , wherein the deforming of the distal portion toward the deformed configuration comprises selectively controlling the deforming to generate a controlled magnitude of force against the at least a portion of the spinal structure.  
     
     
         87 . The method of  claim 80 , wherein the instrument includes a first member and a second member engaged with the first member, the second member comprising the deformable distal portion, the deforming of the distal portion occurring in response to relative displacement between the first and second members, the relative displacement between the first and second members being regulated to generate a controlled magnitude of force against the at least a portion of the spinal structure.  
     
     
         88 . A method for treatment of the spine, comprising: 
 providing an instrument including a first member and a second member engaged with the first member, the second member including a deformable distal portion having an insertion configuration and a deformed configuration;    positioning the deformable distal portion adjacent a spinal structure while in the insertion configuration; and    deforming the distal portion toward the deformed configuration in response to relative displacement between the first and second members, the deformed configuration displacing at least a portion of the spinal structure.    
     
     
         89 . The method of  claim 88 , wherein the relative displacement between the first and second members is regulated to control the deforming and to generate a controlled magnitude of force against the at least a portion of the spinal structure.  
     
     
         90 . The method of  claim 88 , wherein the deforming is directionally controlled.  
     
     
         91 . The method of  claim 88 , wherein the deformed configuration of the distal portion defines at least one transverse projection arranged along a single transverse axis; and 
 wherein the deforming of the distal portion toward the deformed configuration uniaxially displaces at least a portion of the spinal structure along the transverse axis.    
     
     
         92 . The method of  claim 88 , further comprising: 
 inserting a cannula having a working channel through the skin and tissue of a patient;    positioning a distal end of the cannula adjacent a vertebral body; and    inserting the distal end portion of the instrument through the working channel to access the vertebral body.    
     
     
         93 . The method of  claim 92 , further comprising inserting a viewing element into a working channel of the cannula to provide visualization of the vertebral body.  
     
     
         94 . A method for treatment of the spine, comprising: 
 providing an instrument including a deformable distal end portion having an insertion configuration and a deformed configuration;    inserting a cannula having a working channel through the skin and tissue of a patient;    positioning a distal end of the cannula adjacent a spinal structure;    inserting the deformable distal end portion of the instrument through the working channel of the cannula;    positioning the deformable distal end portion proximately adjacent the spinal structure while in the insertion configuration; and    deforming the deformable distal end portion toward the deformed configuration to displace at least a portion of the spinal structure.    
     
     
         95 . The method of  claim 94 , wherein the deformed configuration of the deformable distal end portion defines at least one transverse projection arranged along a single transverse axis; and 
 wherein the deforming results in uniaxially displacing the at least a portion of the spinal structure along the single transverse axis.    
     
     
         96 . The method of  claim 94 , wherein the deforming is directionally controlled.  
     
     
         97 . The method of  claim 94 , wherein the positioning comprises inserting the deformable distal end portion through an outer wall of a vertebral body; and 
 wherein displacement of the at least a portion of the spinal structure comprises compacting cancellous bone to form a cavity within the vertebral body.    
     
     
         98 . The method of  claim 97 , wherein the compacting results in at least partially reducing a compression fracture in the vertebral body.  
     
     
         99 . The method of  claim 94 , wherein the deforming of the deformable distal end portion toward the deformed configuration comprises selectively controlling the deforming to generate a controlled magnitude of force against the at least a portion of the spinal structure.  
     
     
         100 . The method of  claim 94 , wherein the instrument includes a first member and a second member engaged with the first member, the second member comprising the deformable distal end portion, the deforming of the distal end portion occurring in response to relative displacement between the first and second members.  
     
     
         101 . The method of  claim 100 , wherein the relative displacement comprises linearly displacing the first member relative to the second member.  
     
     
         102 . The method of  claim 100 , further comprising mechanically regulating the relative displacement between the first and second members to generate a controlled magnitude of force against the at least a portion of the spinal structure.