Device and method for operating a tool relative to bone tissue and detecting ...

US008092455B2

(12) UIllt€d States Patent (10) Patent No.: US 8,092,455 B2 Neubardt et al. (45) Date of Patent: Jan. 10, 2012 (54) DEVICE AND METHOD FOR OPERATING A 4,207,897 A 6/1980 Lloyd et al. TOOL RELATIVE TO BONE TISSUE AND A 3/ Isieett et alt 31 , , owson e . DETECTING NEURAL ELEMENTS 4,285,347 A 8/1981 Hess (75) Inventors: Seth L. Neubardt, White Plains, NY (Continued) (US); William Keith Adcox, Memphis, TN (U S); Sharonda Felton, Cordova, FOREIGN PATENT DOCUMENTS TN (US) FR 2 865 920 B1 2/2004 _ (Continued) (73) Ass1gnee: Warsaw Orthopedic, Inc., Warsaw, IN (US) OTHER PUBLICATIONS ( >l< ) Notice, Subject to any disclaimer, the term ofthis H.L. Journee et al., System for Intra-Operative Monitoring of the patent is extended Or adjusted under 35 Cortical Integrety of the Pedicle During Pedicle Screw Placement in USC_ 1540:’) by 2102 days Low-Back Surgery: Design and Clinical Results, 18th Annual International Conference of the IEEE Engineering in Medicine and Biol(21) App1_ NQ_; 11/052,641 ogy Society, Amsterdam 1996, p. 144-145, 0-7803-381 1-1/97, Copyright IEEE. (22) Filed: Feb. 7, 2005 Primary Examiner A Thomas C. Barrett (65) Prior Publication Data Assistant Examiner A Christopher Beccia US 2006/0178593 A1 Aug. 10, 2006 (57) ABSTRACT (51) Int. C]. An apparatus for providing medical treatment includes a tool A61B 5/05 (2006.01) portion configured to operate relative to bone tissue, a handle (52) U.S. Cl. ........................................ .. 606/79; 600/547 Portion te Operate the teel portion, and a nerve menitenhg (58) Field of Classification Search .................. .. 606/79, Systemto detectneurai e1ementS- The-tool POItiOI1iI1C111<1eS an 606/96, 80’ 86’ 98’ 104; 600/554’ 546; 173/2 insulated shaft comprised of an electrically conductive memSee application file for Complete Search history ber and a non-insulated tip. The shaft carries an electrical signal to the non-insulated tip. The handle portion, which is (56) References Cited removably and operably connected to the tool portion, incor

Page2 U.S. PATENT DOCUMENTS 5,976,094 A 11/1999 Gozani 6,004,262 A 12/1999 Putz etal. 3421382 A gL1e1:1t1erd‘°£ta1~ 6,038,477 A 3/2000 Kayyali 445454374 A 10/1985 11° bu 6,050,992 A 4/2000 Nichols 445734448 A 3/1986 Ka°°bS.°n 6,081,741 A * 6/2000 1101110 ......................... .. 600/424 445924369 A 6/1986 Dan.‘ "131 6,104,960 A 8/2000 Duysensetal. 4 4 avlset ~ 6,132,386 A 10/2000 GOZ3.Il1 etal. 4,633,889 A 1/1987 Talallaetal. 6132 387 A 10/2000 G - H11 4650 375 A 3/1987 Millsap ........................... .. 408/6 ’ ’ °Zan!e ' 446584835 A 4/1987 P h d f 6,146,335 A 11/2000 Gozan1 4 4 O n °r 6,159,179 A 12/2000 SLIIIOIISOII 447594377 A 7/1988 DY.kStm 6161047 A 12/2000 King et 01. 4,803,976 A 2/1989 Fr1gg et 01. .................... .. 606/97 6’224’549 B1 5/2001 D 1 4807642 A 2/1989 BIOWII ’ ’ ronge en 4’823’79l A 4/1989 D,Am 1. 31 6,259,945 B1 7/2001 Epste1n etal. 448924105 A 1/1990 P eloet ~ 6,261,307 B1* 7/2001 Yoonetal. .................. .. 606/205 449264865 A 5/1990 Om“ 6,266,558 B1* 7/2001 Gozanietal. ............... .. 600/547 449624766 A 10/1990 Hm“ 6,277,094 B1 8/2001 Schendel 4,964,411 A 10/1990 JoerhrTS)(I)1n et 01. 6283960 B1,, 9/2001 Ashley 4,965,909 A 10/1990 McCullough et 01. 192/131R 6312392 B1 U/2001 Hem“ """""""""""" " 600/554 4974 595 A 12/1990 N d 6,391,005 B1 5/2002 Lumetal. 540074902 A 4/1991 W‘i’trtenStr°m 6,466,817 B1* 10/2002 Kaulaetal. ................. .. 600/546 4 4 6500128 B2 12/2002 Marino 5,058,602 A 10/1991 Brody 6315958 B1 1/2003 SW0 . , , yer et al. 24834222 A 5133; Belem 6,514,258 B1* 2/2003 Brown et 01. ................. .. 606/80 541274403 A 7/1992 Bee 1 6,535,759 B1* 3/2003 Epsteinetal. .............. .. 600/547 4 4 row“ ee 6,554,778 B1 4/2003 Fleming, 111 g4igé4(5)ig A @133; II\’IraSlS)etd‘:1~ 6,562,046 B2* 5/2003 S0000 ............................ .. 606/96 4 4 W M 6,564,078 B1 5/2003 M ' tal. 12413224233 3 3/133; (T:<>r1iieta1~ ~~~~~~~~~~~~~~~~ ~~ 318/5681 6,579,244 B2 6/2003 G(S1<r>lt11\;)1ii:1 , uver 6,582,441 B1 6/2003 He etal. 5,242,443 A 9/1993 Kambin 6,605,085 B1 8/2003 Edwards 5,255,691 A 10/1993 Otten 6,638,281 B2 10/2003 Gorek 5,282,468 A 2/1994 Klepinski 6,796,985 B2* 9/2004 Bolger et 01. ................. .. 606/80 5,284,153 A 2/1994 Raymond et 01. 7,050,848 B2* 5/2006 Hoey et 01. 600/547 5,284,154 A 2/1994 Raymond et 01. ........... .. 600/554 7,079,883 B2: 7/2006 Marine er 1411. 600/373 5,313,956 A 5/1994 1<h0tss0h et 01. 7,177,677 B2 22007 Kauaetw ~~~~~~~~~~~~~~~~~ 44 600 546 5,375,067 A 12/1994 Berchin 2002/0072686 A1 6/2002 Hoeyetal. 5,433,739 A 7/1995 Sluijteret 2002/0147485 A1 10/2002 M31110 etal. 5’480’440 A 1/1996 Kilnélirnt 2003/0045808 A1* 3/2003 Kaulaet 01. ................. .. 600/546 ’ ’ 2003/0083688 A1 5/2003 SIIIIOIISOII 544824038 A 1/1996 RBH 2003/0105503 A1 6/2003 M01100 545404235 A 71996 Wllson 2003/0181958 A1 9/2003 D0h01<,111 545604372 A 101996 Cory 2003/0187348 A1 10/2003 G00dWih 545664678 A 10/1996 Cadwell 2003/0195405 A1 10/2003 M01100 etal. 5579 781 A 12/1996 c k 4 4 0° 6 2004/0040727 A1* 3/2004 M'11 ............................. .. 173/2 545934429 A 1/1997 Rl_1ff _ 2004/0102783 A1* 5/2004 Sulttsrrlin et 01. .............. .. 606/80 5,630,813 A 5/1997 Klerurakls 2004/0122482 A1 6/2004 Tung etal. 5,671,752 A 9/1997 Sinderby et 01. 2004/0225228 A1 11/2004 Ferree 5,711,307 A 1/1998 Smits 2005/0075578 A1 4/2005 Gharib et 01. 5,775,331 A 7/1998 Raymond et 01. ........... .. 600/554 2005/0131415 A1* 6/2005 Hearn et 01. .................. .. 606/80 5,779,642 A 7/1998 Nightengale 2005/0149053 A1 7/2005 Varieur et 01. 5,797,854 A 8/1993 Hedgecock 2006/0173374 A1 8/2006 Neubardt etal. 5,807,275 A 9/1998 Jamshidi 2006/0173521 A1 8/2006 Pond, Jr. et al. 5,830,151 A 11/1998 Hadzic etal‘ 2006/0178594 Al 8/2006 Neubardtetal. 5,851,191 A 12/1998 Gozani 2006/0200023 A1 9/2006 Melkent etal. 5,876,405 A 3/1999 Del R10 et 01. 5,885,219 A 3/1999 Nightengale W0 W0 00/6621? 11/2000 5,888,196 A 3/1999 Bonutti wo wo 03/037170 A2 5/2003 5,902,105 A 5/1999 Uejimaetaj wo wo 2004/066850 A1 8/2004 5,928,158 A 7/1999 Aristides ..................... .. 600/547 * cited by examiner

.m_ wm_o_>m5 H iw~ ._.Dn_Z_ /% W mowwwoome ._<zw_w ._<:_o5 A Q>E 5 I Q 3 / >mo_>m__>_ /2 >E5oEo m_o<“Em;z_ oo._<z< mowwwooml §\E/ S 5 K I A : on ><._n_w_n_

S