Percutaneous bone graft delivery system and method

Abstract

A bone graft delivery system includes a bone graft injector and an access portal. The access portal may include a handle having a first arm pivotably connected to, and biased away from, a second arm. A ratchet including a pawl may extend from the second arm. A delivery tube may be configured to mate with the first arm and be configured to store a bone graft material therein. A plunger including a shaft and a plunger tip at the distal end thereof may be configured to move through the delivery tube. At least a portion of the shaft may include teeth, the pawl of the ratchet being configured to iteratively contact the teeth. A user may hold the access portal with a first hand and the bone graft injector with a second hand, iteratively squeezing the handle to iteratively eject amounts of bone graft material into a patient.

1 . A bone graft injection system comprising:
 a body;   a handle assembly operatively coupled to the body;   a cannula coupled to and extending from the body;   a tube configured to be positioned at least partially within the body and at least partially within the cannula; and   a plunger configured to be positioned at least partially within the tube and operably coupled to the handle assembly so that actuation of the handle assembly advances the plunger within the tube.   
     
     
         2 . The bone graft injection system of  claim 1 , further comprising a trocar configured to fit at least partially within the cannula. 
     
     
         3 . The bone graft injection system of  claim 2 , wherein the trocar has a handle, a shaft extending from the handle, and tip at one end of the shaft. 
     
     
         4 . The bone graft injection system of  claim 3 , wherein the tip has at least one cutting surface. 
     
     
         5 . The bone graft injection system of  claim 4 , wherein the tip has at least one non-cutting surface. 
     
     
         6 . The bone graft injection system of  claim 3 , wherein the tip is ramped such that a distalmost end of the tip has a height that is smaller than a proximalmost end of the tip. 
     
     
         7 . The bone graft injection system of  claim 1 , further comprising:
 a distractor configured to be positioned at least partially within the cannula; and   a space holder configured to be positioned over at least a portion of the cannula.   
     
     
         8 . The bone graft injection system of  claim 7 , wherein the distractor has a distal tip having two opposing substantially planar surfaces. 
     
     
         9 . The bone graft injection system of  claim 7 , wherein the distractor has a distal tip with a height and a width, the height being smaller than the width. 
     
     
         10 . The bone graft injection system of  claim 9 , wherein the width of the distal tip is about 8 mm. 
     
     
         11 . The bone graft injection system of  claim 7 , wherein the space holder is configured to be translated along a longitudinal axis of the cannula and rotated about the longitudinal axis of the cannula. 
     
     
         12 . The bone graft injection system of  claim 11 , wherein the space holder has a distal tip having two prongs extending from diametrically opposed portions of the space holder. 
     
     
         13 . A method for delivering a bone graft material to a surgical site in a patient comprising:
 providing access through skin of a patient with an access portal;   inserting a trocar into a cannula extending from a bone graft injection device so that a distal tip of the trocar extends beyond a distal end of the cannula, the distal tip of the trocar having at least one cutting surface;   advancing the bone graft injection device through the access portal to the surgical site;   removing the trocar from the bone graft injection device;   inserting a delivery tube assembly loaded with the bone graft material into the cannula of the bone graft injection device; and   expelling the bone graft material from the delivery tube assembly to the surgical site.   
     
     
         14 . The method of  claim 13 , wherein the step of advancing the bone graft injection device to the surgical site includes cutting tissue of the patient with the at least one cutting surface of the trocar. 
     
     
         15 . The method of  claim 13 , wherein the step of expelling the bone graft material includes iteratively actuating the bone graft injection device, such that each actuation advances at least some of the bone graft material through the delivery tube subassembly. 
     
     
         16 . A method for delivering a bone graft material to a space between adjacent vertebrae in a patient comprising:
 providing access through skin of a patient with an access portal;   inserting a distractor into a cannula extending from a bone graft injection device so that a distal tip of the distractor extends beyond a distal end of the cannula;   positioning a space holder over the cannula so that a distal end of the space holder is positioned proximally of the distal tip of the distractor;   advancing the bone graft injection device through the access portal until the distal tip of the distractor is positioned within the intervertebral space;   rotating the distractor to distract the adjacent vertebrae;   advancing the space holder so that the distal end of the space holder is positioned within the intervertebral space;   removing the distractor from the bone graft injection device;   inserting a delivery tube assembly loaded with the bone graft material into the cannula of the bone graft injection device; and   expelling the bone graft material from the delivery tube assembly to the surgical site.