Non cannulated dilators

Abstract

A non-cannulated dilator that is designed with a rigid elongated solid body and with a judiciously configured tip is utilized as the first dilator of a series of dilators which are inserted into the body of a patient for minimally invasive spinal surgery and is made from a solid elongated body, that could be round, ovoid or other cross sectional configuration whose diameter is greater than one and a half (1½) millimeter, and that includes a tool engaging end portion at the proximal end is sufficiently rigid so as not to bend and has a pointed shaped insertion end portion at the distal end with the point of the pointed end being discreetly blunted and utilized in a surgical procedure as a replacement of the typical guide wire and is characterized as providing a “fee” to the surgeon as it penetrates through the tissue and muscle of the patient as it proceeds toward the target.

1 . A method of creating a working channel from a skin incision to proximate a vertebra, comprising: 
 making a skin incision,    inserting a distal end of a non cannulated dilator into the skin incision,    advancing the distal end of the dilator into proximity to a vertebra, the dilator extending from proximate the vertebra to external to the skin. incision,    inserting a cannula over the non cannulated dilator, and    removing the non cannulated dilator, a bore of the cannula defining a working channel from the skin incision to proximate the vertebra.    
   
   
       2 . The method of  claim 1 , wherein the distal end of the non cannulated dilator is advanced into contact with the vertebra.  
   
   
       3 . The method of  claim 2 , wherein a distal end of the cannula is advanced into contact with the vertebra.  
   
   
       4 . The method of  claim 1 , wherein the distal end of the non cannulated dilator is advanced into contact with the inferior edge of the superior lamina of the vertebra.  
   
   
       5 . The method of  claim 1 , further comprising selecting the size of the cannula based on the advancement of the non cannulated dilator into proximity to a vertebra.  
   
   
       6 . The method of  claim 5 , wherein the non cannulated dilator is graduated to facilitate sizing of the cannula.  
   
   
       7 . The method of  claim 1 , further comprising inserting a second cannula over the cannula, and inserting a third cannula over the second cannula.  
   
   
       8 . The method of  claim 1 , wherein the non cannulated dilator has a diameter greater than one and a half millimeters.  
   
   
       9 . The method of  claim 1 , wherein the non cannulated dilator is cylindrical in shape.  
   
   
       10 . The method of  claim 1 , wherein the non cannulated dilator is ovoid in shape.  
   
   
       11 . The method of  claim 1 , wherein the bore of the cannula has a circular cross-section.  
   
   
       12 . The method of  claim 1 , wherein the bore of the cannula has an ovoid cross-section.  
   
   
       13 . The method of  claim 1 , further comprising connecting a tool to a proximal end of the non cannulated dilator; and manipulating the tool to facilitate advancement of the non cannulated dilator into proximity to the vertebra.  
   
   
       14 . A kit comprising: 
 a non cannulated dilator having an elongated solid and generally rigid shaft having a proximal end spaced apart from a distal end, the shaft being sized to extend from a skin incision to proximate a vertebra, the shaft having a shaft diameter greater than one and a half millimeter, and    a plurality of cannulas, each cannula including a bore having a bore diameter and being sized to extend from a skin incision to proximate a vertebra, at least some of the cannulas each having a bore diameter greater than a bore diameter of another cannula.    
   
   
       15 . The kit of  claim 14 , wherein the plurality of cannulas comprises a first cannula having a first bore diameter greater than the shaft diameter, 
 a second cannula having a second bore diameter greater than the first bore diameter, and    a third cannula having a third bore diameter greater than the second bore diameter.    
   
   
       16 . The kit of  claim 14 , wherein the distal end of the shaft tapers to a blunt tip.  
   
   
       17 . The kit of  claim 14 , wherein the shaft includes indicia indicative of a graduated scale.  
   
   
       18 . The kit of  claim 14 , wherein the shaft on the non cannulated dilator is cylindrical in shape.  
   
   
       19 . The kit of  claim 14 , wherein the shaft of the non cannulated dilator is ovoid in shape.  
   
   
       20 . The kit of  claim 14 , wherein the bore of at least one of the cannulas has circular cross-section.  
   
   
       21 . The kit of  claim 14 , wherein the bore of at least one of the cannulas has an ovoid cross-section.  
   
   
       22 . A method of creating a working channel through tissue to proximate a vertebra, comprising: 
 inserting a blunt tip of a non cannulated dilator through tissue to position the tip of the non cannulated dilator adjacent a target site on a vertebra;    inserting at least one dilator over the non cannulated dilator;    inserting a cannula over the at least one dilator and the non cannulated dilator;    removing the at least one dilator and the non cannulated dilator such that the cannula defines a working channel extending therethrough.    
   
   
       23 . The method of  claim 22 , further comprising, prior to inserting the cannula, measuring a depth from a tissue surface to a target site on a vertebra.  
   
   
       24 . The method of  claim 23 , wherein the cannula has a size that is commensurate with the measured depth.  
   
   
       25 . The method of  claim 23 , wherein the depth of the pathway is measured using indicia formed on at least one of the non cannulated dilator and the at least one dilator.  
   
   
       26 . The method of  claim 22 , wherein a distal end of the cannula is advanced into contact with the vertebra.  
   
   
       27 . A method of creating a working channel through tissue to a surgical target, comprising: 
 inserting a non cannulated dilator through tissue to form a pathway to a surgical target;    inserting a series of cannulated dilators over the non cannulated dilator;    measuring a depth of the pathway;    inserting a cannula having a depth commensurate with the measured depth over the dilators;    removing the dilators such that a working channel extends through the cannula to the surgical target.    
   
   
       28 . The method of  claim 27 , wherein the depth of the pathway is measured using indicia formed on at least one of the non cannulated dilator and the series of cannulated dilators.  
   
   
       29 . The method of  claim 27 , wherein a distal end of the cannula is advanced into contact with the vertebra.