Illuminated Endoscopic Pedicle Probe With Replaceable Tip

Abstract

An endoscopic pedicle probe for use during spinal surgery to form a hole in a pedicle for reception of a pedicle screw has an enlarged proximal end for cooperation with the hand of the surgeon and an elongate shaft terminating in a distal tip that may be pushed through the pedicle to form the hole. The tip may be detachable for replacement. An endoscope extends through the shaft and is connected with a monitor to enable the surgeon to visually observe the area being treated. In a preferred form a light means extends through the shaft to illuminate the area being treated, and in a further preferred form a conduit extends through the shaft to convey a fluid to flush the area being treated. In a further embodiment, two endoscopes are associated with the probe.

What is claimed is: 
     
         1 . A pedicle probe for forming a hole in the hard bony tissue of a vertebral pedicle to receive a pedicle screw, said pedicle probe comprising:
 an enlarged proximal end for cooperation with the hand of a surgeon using the probe to aid in controlling the probe;   an elongate shaft having a longitudinal axis and extending from the enlarged proximal end and terminating in a distal end; and   a detachable shaped tip on the distal end of the shaft, said tip having a reduced diameter relative to the shaft and a hardness and configuration adapted to be pushed through a pedicle to form a hole for reception of a pedicle screw, wherein said detachable tip enables a damaged or worn tip to be replaced, or a tip with different characteristics to be employed, without replacing the entire probe.   
     
     
         2 . A pedicle probe as claimed in  claim 1 , wherein:
 a bore extends longitudinally through the shaft and an endoscope extends through said bore, said endoscope including a camera having a lens positioned to provide a view of an area being treated and said endoscope being connected with an external monitor for conveying a visual image of the position of the tip relative to the area being treated during a surgical procedure, whereby a surgeon is provided with direct visual indication of the exact position of the probe during spinal surgery.   
     
     
         3 . A pedicle probe as claimed in  claim 2 , wherein:
 a second bore extends longitudinally through the shaft and a light is associated with said second bore to illuminate the area being treated.   
     
     
         4 . A pedicle probe as claimed in  claim 2 , wherein:
 the tip is fluted like a drill bit, and the lens and an opening for receipt of the lens is positioned in the base of a channel formed between the flutes.   
     
     
         5 . A pedicle probe as claimed in  claim 2 , wherein:
 the lens is positioned rearwardly of the distal point of the tip, whereby the lens is protected as the probe is inserted into hard bony material.   
     
     
         6 . A pedicle probe as claimed in  claim 2 , wherein:
 the lens is oriented to provide a view at 90° relative to the longitudinal axis of the shaft.   
     
     
         7 . A pedicle probe as claimed in  claim 2 , wherein:
 the lens is oriented to provide a forward view at 45° relative to the longitudinal axis of the shaft.   
     
     
         8 . A pedicle probe as claimed in  claim 2 , wherein:
 the lens is oriented to provide a straight-ahead forward view.   
     
     
         9 . A pedicle probe as claimed in  claim 3 , wherein:
 a third bore extends longitudinally through the shaft and a conduit for a fluid to flush the area being treated extends through said bore to flush body fluid and debris away from the area being treated.   
     
     
         10 . A pedicle probe for forming a hole in the hard bony tissue of a vertebral pedicle to receive a pedicle screw, said pedicle probe comprising:
 an enlarged proximal end for cooperation with the hand of a surgeon using the probe to aid in controlling the probe;   an elongate shaft having a longitudinal axis and extending from the enlarged proximal end to a distal end;   a reduced diameter tip on said distal end, said tip having a hardness and configuration adapted to be pushed through a pedicle to form a hole for reception of a pedicle screw;   a first bore extending longitudinally through said shaft and a first endoscope associated with said first bore, said first endoscope including a camera positioned at the distal end of said shaft and being connected with an endoscopic monitor to provide a surgeon with a direct view of the area being treated; and   a second bore extending longitudinally through the shaft and a light associated with said second bore to illuminate the area being treated.   
     
     
         11 . A pedicle probe as claimed in  claim 10 , wherein:
 a third bore extends longitudinally through said shaft and through said tip, and a second endoscope is associated with said third bore, said second endoscope including a camera positioned at the distal end of said tip and being connected with an endoscopic monitor to provide a surgeon with a direct view of the area being treated.   
     
     
         12 . A pedicle probe as claimed in  claim 11 , wherein:
 a fourth bore extends longitudinally through said shaft, and a conduit extends through said third bore for conveying a fluid to the area being treated to flush away from the area body fluid and debris that would otherwise obscure the area being treated.   
     
     
         13 . A pedicle probe as claimed in  claim 12 , wherein:
 said tip is detachable from said shaft, whereby said detachable tip enables a damaged or worn tip to be replaced, or a tip with different characteristics to be employed, without replacing the entire probe.   
     
     
         14 . A pedicle probe as claimed in  claim 13 , wherein:
 said detachable tip is threadably attached to said shaft.   
     
     
         15 . A pedicle probe as claimed in  claim 13 , wherein:
 said detachable tip has a base end received in an axial bore in the center of the distal end of the shaft, and a set screw extends through a side of said shaft into engagement with said tip base end to hold the tip in said axial bore.   
     
     
         16 . A pedicle probe as claimed in  claim 15 , wherein:
 a coaxial bore in said base end of said tip is in axial alignment with said first bore in said shaft, and said coaxial bore in said base end of said tip connects with an angularly extending diagonal bore opening through a side of said tip, said camera being positioned in said diagonal bore where it exits through the side of said tip.   
     
     
         17 . A pedicle probe as claimed in  claim 16 , wherein:
 said second and fourth bores open through the distal end of said shaft in rotationally spaced relationship to one another, said tip being rotationally oriented relative to said shaft so that said light is positioned on the same side of said probe as said diagonal bore and said camera.   
     
     
         18 . A pedicle probe as claimed in  claim 17 , wherein:
 a keyway is formed between the base end of said tip and said coaxial bore in said shaft to rotationally orient said tip when it is attached to said shaft so that said light is positioned on the same side of said probe as said diagonal bore and said camera.   
     
     
         19 . A pedicle probe for forming a hole in the hard bony tissue of a vertebral pedicle to receive a pedicle screw, said pedicle probe comprising:
 an enlarged proximal end forming a head for cooperation with the hand of a surgeon using the probe to aid in controlling the probe;   an elongate shaft having a longitudinal axis and extending from the enlarged proximal end and terminating in a distal end;   a reduced diameter tip on said distal end, said tip having a hardness and configuration adapted to be pushed through a pedicle to form a hole for reception of a pedicle screw;   at least one longitudinally extending channel formed in an outer surface of said shaft;   an endoscope extending through said head and through said at least one channel, said endoscope including a camera at the distal end of said shaft; and   a cylindrical sleeve telescoped over said shaft and over said at least one channel and endoscope positioned therein.   
     
     
         20 . A pedicle probe as claimed in  claim 19 , wherein:
 a second longitudinally extending channel is formed in the outer surface of said shaft, and a light means extends through said head and through said second channel to illuminate an area viewed by said endoscope.   
     
     
         21 . A pedicle probe as claimed in  claim 20 , wherein:
 a third longitudinally extending channel is formed in the outer surface of said shaft, and a conduit extends through said third channel for conveying a fluid to the area being treated to flush body fluid and debris away from the area.