Methods and apparatus for performing procedures in the spine

Abstract

Disclosed are methods of accessing and treating the spine, while minimizing trauma to surrounding tissue. A device is introduced through tissue, to an access point on the spine. The device is thereafter advanced axially within the spine, from the access point across a treatment zone. In one application, the access point is on the anterior surface of the spine, and, in another application, the access point is on the posterior surface of the spine. The lumen created through the spine across the treatment zone may be either substantially linear, or curved.

1 . A method of treating the spine, comprising the steps of:
 identifying a site on the anterior surface of the sacrum;   forming a lumen from the site through the sacrum, through a disk and into at least one vertebrae; and   performing a therapeutic procedure.   
   
   
       2 . The method of treating the spine of  claim 1 , wherein the therapeutic procedure comprises delivering a bone growth facilitator. 
   
   
       3 . The method of treating the spine of  claim 1 , wherein the therapeutic procedure comprises inserting a prosthetic nucleus. 
   
   
       4 . The method of treating the spine of  claim 1 , wherein the therapeutic procedure comprises performing a partial discectomy. 
   
   
       5 . The method of treating the spine of  claim 1 , wherein the therapeutic procedure comprises performing a complete nucleectomy. 
   
   
       6 . The method of treating the spine of  claim 1 , wherein the lumen is nonlinear. 
   
   
       7 . The method of treating the spine of  claim 1 , wherein the lumen extends cephalad through any of the L3, L2, L1 or cephalad beyond in to one or more thoracic vertebrae. 
   
   
       8 . The method of treating the spine of  claim 1 , further comprising:
 identifying a site on the skin of a patient; and   using a minimally invasive puncture to create an access pathway from the site on the skin of a patient.   
   
   
       9 . The method of treating the spine of  claim 8 , the access pathway having a cross section in the range of about 0.35 cm to about 0.5 cm. 
   
   
       10 . The method of treating the spine of  claim 1 , further comprising:
 positioning an access device to the site on the anterior surface of the sacrum;   advancing the access device from the site on the anterior surface of the sacrum to a second site on the anterior surface of the sacrum; and   inserting the access device in the sacrum at the second site on the anterior surface of the sacrum.   
   
   
       11 . The method of treating the spine of  claim 10 , the step of positioning an access device to the site on the anterior surface of the sacrum further comprising introducing a blunt needle trocar to a presacral space. 
   
   
       12 . The method of treating the spine of  claim 10  the step of positioning an access device to the site on the anterior surface of the sacrum further comprising introducing a guide to a presacral space. 
   
   
       13 . The method of treating the spine of  claim 10 , the step of positioning an access device to the site on the anterior surface of the sacrum further comprising introducing a tubular sheath to a presacral space. 
   
   
       14 . An access device for treating the spine, comprising:
 a blunt needle trocar configured for accessing the spine through a presacral space;   a guide configured for accessing the spine through a presacral space; and   a tubular sheath configured for delivering a treatment to the spine through a presacral space.   
   
   
       15 . The access device for treating the spine of  claim 14 , wherein the treatment to the spine comprises a bone growth facilitator. 
   
   
       16 . The access device for treating the spine of  claim 14 , wherein the treatment to the spine comprises a prosthetic nucleus. 
   
   
       17 . The access device for treating the spine of  claim 14 , wherein the treatment to the spine comprises a discectomy device. 
   
   
       18 . The access device for treating the spine of  claim 14 , wherein the treatment to the spine comprises a complete nucleectomy device.