Endoscopic fusion system and method with neuromonitoring

Abstract

Systems, methods, and kits for performing endoscopic fusion with neuromonitoring. The endoscopic fusion may be performed, for example, through a cannula providing a portal to the disc space. Throughout various steps in the procedure, neuromonitoring may occur to minimize the possibility of injuring or contacting a nerve.

What is claimed is: 
     
         1 . A minimally invasive method for performing endoscopic fusion, comprising:
 determining an access target in a disc space and creating an incision;   inserting a k-wire through a needle cannula and into the disc space while stimulating the k-wire for neuro-monitoring;   removing the needle cannula after the k-wire is in position;   positioning a dilator over the k-wire and into the disc space while stimulating the dilator for neuro-monitoring;   positioning an implant cannula over the dilator and into the disc space and subsequently, removing the dilator; and   inserting an implant into the disc space through the implant cannula;   removing the implant cannula after the implant has been inserted.   
     
     
         2 . The method of  claim 1 , after determining an access target, further comprising inserting an assembled needle into the disc space through the incision, the assembled needle including a stylet disposed in an inner lumen of an insulated needle cannula while the stylet is being stimulated for neuromonitoring. 
     
     
         3 . The method of  claim 1 , after determining an access target, further comprising:
 inserting an assembled needle into the disc space through the incision, the assembled needle including a stylet disposed in an inner lumen of an insulated needle cannula while the stylet is being stimulated for neuromonitoring;   removing the stylet after the assembled needle has been inserted.   
     
     
         4 . The method of  claim 1 , after the step of inserting an implant, further comprising:
 expanding the inserted implant;   filling graft material into the expanded implant through an opening on the implant.   
     
     
         5 . The method of  claim 4 , wherein the step of filling graft material includes filling the graft material through a funnel. 
     
     
         6 . The method of  claim 1 , wherein positioning a dilator includes:
 inserting a transition dilator;   subsequently, inserting an implant dilator over the transition dilator; and   subsequently, removing the transition dilator.   
     
     
         7 . The method of  claim 1 , further comprising:
 performing discectomy before the implant is inserted; and   inserting graft material into the disc space before the implant is inserted, and   inserting an implant into the disc space.   
     
     
         8 . A minimally invasive method for performing endoscopic fusion, comprising:
 determining an access target in a disc space and creating an incision;   inserting an assembled needle into the disc space through the incision, the assembled needle including a stylet inserted through an inner lumen of an insulated needle cannula, wherein the needle cannula includes at least one channel extending along a longitudinal axis of the needle cannula, the needle cannula being configured to permit the stylet to enter and exit the cannula through the channel, the stylet being stimulated during insertion for neuromonitoring;   removing the stylet and inserting a k-wire through the needle cannula and into the disc space while the k-wire is being stimulated for neuromonitoring;   removing the needle cannula after the k-wire is in position;   positioning a dilator over the k-wire and into the disc space while the dilator is being stimulated for neuromonitoring;   positioning a working cannula over the dilator and into the disc space;   performing a spinal procedure within the disc space;   inserting a dilator through the working cannula and subsequently, removing the working cannula;   inserting an implant cannula over the dilator and subsequently, removing the dilator; and   inserting an implant through the implant cannula and positioning the implant within the disc space,   filling graft material into the implant after the implant is positioned in the disc space.   
     
     
         9 . The method of  claim 8 , wherein the implant is an expandable implant, and the expandable implant is inserted through the implant cannula in an unexpanded state and, after insertion, the implant is expanded to a desired height. 
     
     
         10 . The method of  claim 8 , further comprising, after inserting the implant through the implant cannula and positioning the implant within the disc space, packing graft material into the disc space through the implant cannula. 
     
     
         11 . The method of  claim 8 , further comprising, after inserting the implant through the implant cannula and positioning the implant within the disc space, removing the implant cannula and closing the incision.