Patent Publication Number: US-11653934-B2

Title: Surgical instrument and method

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation of U.S. patent application Ser. No. 16/038,742, which is a division of U.S. patent application Ser. No. 14/640,189, filed on Mar. 6, 2015, now U.S. Pat. No. 10,080,571. These applications are hereby incorporated herein by reference, in their entireties. 
    
    
     TECHNICAL FIELD 
     The present disclosure generally relates to medical devices for the treatment of musculoskeletal disorders, and more particularly to a surgical system for preparation of a surgical site and a method for treating a spine. 
     BACKGROUND 
     Spinal disorders such as degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumor, and fracture may result from factors including trauma, disease and degenerative conditions caused by injury and aging. Spinal disorders typically result in symptoms including pain, nerve damage, and partial or complete loss of mobility. 
     Non-surgical treatments, such as medication, rehabilitation and exercise can be effective, however, may fail to relieve the symptoms associated with these disorders. Surgical treatment of these spinal disorders includes fusion, fixation, corpectomy, discectomy, laminectomy and implantable prosthetics. In procedures, such as, for example, corpectomy and discectomy, fusion and fixation treatments may be performed that employ implants to restore the mechanical support function of vertebrae. Surgical instruments are employed, for example, to prepare tissue surfaces for disposal of the implants. Surgical instruments are also employed to engage implants for disposal with the tissue surfaces at a surgical site. This disclosure describes an improvement over these prior art technologies. 
     SUMMARY 
     In one embodiment, a surgical instrument is provided. The surgical instrument includes a first member defining an axis and including a cutting surface. A second member includes a cutting surface that is rotatable relative to the first member. A third member includes an outer surface. The cutting surface of the second member is rotatable relative to the outer surface to transfer the cut tissue along the axis. Systems and methods of use are disclosed. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present disclosure will become more readily apparent from the specific description accompanied by the following drawings, in which: 
         FIG.  1    is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure; 
         FIG.  2    is a side view of the components shown in  FIG.  1   ; 
         FIG.  3    is a cross section view taken along lines A-A shown in  FIG.  2   ; 
         FIG.  4    is a side view of components of the system shown in  FIG.  1   ; 
         FIG.  5    is an end view of components of the system shown in  FIG.  1   ; 
         FIG.  6    is an end view of components of the system shown in  FIG.  1   ; 
         FIG.  7    is a cross section view taken along lines B-B shown in  FIG.  4   ; 
         FIG.  8    is a cross section view taken along lines C-C shown in  FIG.  5   ; 
         FIG.  9    is a perspective view of components of the system shown in  FIG.  1   ; 
         FIG.  10    is a side view of components of the system shown in  FIG.  1   ; 
         FIG.  11    is an end view of the components shown in  FIG.  10   ; 
         FIG.  12    is an end view of the components shown in  FIG.  10   ; 
         FIG.  13    is a cross section view of components of the system shown in  FIG.  1   ; 
         FIG.  14    is a cross section view taken along lines G-G shown in  FIG.  13   ; 
         FIG.  15    is a cross section view taken along lines E-E shown in  FIG.  10   ; 
         FIG.  16    is a side view of components of the system shown in  FIG.  1   ; 
         FIG.  17    is an end view of the components shown in  FIG.  16   ; 
         FIG.  18    is a cross section view of components of the system shown in  FIG.  1   ; 
         FIG.  19    is a cross section view taken along lines H-H shown in  FIG.  18   ; 
         FIG.  20    is a perspective view of components of the system shown in  FIG.  1   ; 
         FIG.  21    is a side view of the components shown in  FIG.  20   ; 
         FIG.  22    is an end view of the components shown in  FIG.  20   ; 
         FIG.  23    is an end view of the components shown in  FIG.  20   ; 
         FIG.  24    is a cross section view taken along lines I-I shown in  FIG.  21   ; 
         FIG.  25    is a cross section view taken along lines J-J shown in  FIG.  21   ; 
         FIG.  26    is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure disposed with vertebrae; 
         FIG.  27    is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure; 
         FIG.  28    is a side view of the components shown in  FIG.  27   ; 
         FIG.  29    is an end view of the components shown in  FIG.  27   ; 
         FIG.  30    is an end view of the components shown in  FIG.  27   ; 
         FIG.  31    is a cross section view taken along lines K-K of  FIG.  28   ; 
         FIG.  32    is a cross section view taken along lines L-L of  FIG.  28   ; 
         FIG.  33    is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure; 
         FIG.  34    is an end view of the components shown in  FIG.  33   ; 
         FIG.  35    is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure; 
         FIG.  36    is an end view of the components shown in  FIG.  35   ; 
         FIG.  37    is a cross section view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure; 
         FIG.  38    is a cross section view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure; 
         FIG.  39    is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present disclosure with parts separated; 
         FIG.  40    is a perspective view of components of the system shown in  FIG.  39   ; 
         FIG.  41    is a cross section view of components of the system shown in  FIG.  39   ; and 
         FIG.  42    is a cross section view of components of the system shown in  FIG.  39   . 
     
    
    
     DETAILED DESCRIPTION 
     The exemplary embodiments of the surgical system and related methods of use disclosed are discussed in terms of medical devices for the treatment of musculoskeletal disorders and more particularly, in terms of a surgical system for preparation of a surgical site and a method for treating a spine. 
     In one embodiment, the surgical system includes a surgical instrument, such as, for example, a disc preparation instrument. In some embodiments, the surgical instrument includes a manual cutter housing disposed about an internal rotating cutter. In some embodiments, the surgical system includes a disc preparation device with a combination of an outer paddle scraper structure having two or more blades or openings between the blades and an internal rotating auger and/or suction mechanism for conveying disc debris into the instrument and away from the surgical site. 
     In some embodiments, the surgical system includes a surgical instrument including a rotating cutter housing that provides a rigid protective cover configured to cover the rotating cutter blade. In some embodiments, the cutter housing includes at least two openings with four sharp edges to facilitate cutting of peripheral material when rotated. In some embodiments, the peripheral material is processed via the internal cutting and grinding mechanism. In some embodiments, the surgical instrument includes a housing configured to incorporate one, two, and/or multiple openings to facilitate accessibility to the internal cutting and grinding mechanism. In some embodiments, the surgical instrument includes a rotating cutter mechanism disposed with the rotating cutter housing for cutting and/or macerating disc material. In some embodiments, the surgical instrument includes suction to facilitate material removal. In one embodiment, the surgical instrument includes a navigation device to facilitate positioning and/or tracking of components of the surgical system. 
     In some embodiments, the surgical instrument is configured to be surgically inserted into a space between vertebral bodies to facilitate cutting and removing tissue and bone to create a space or pathway for fusion or motion implants. In some embodiments, the surgical instrument includes a rotating cutter housing, a rotating cutter, a stationary auger, a rotating grinder, and an irrigation and/or debris removal tube. 
     In one embodiment, the surgical instrument includes a rotating cutter having a circumferential helical cutting geometry that is configured to create shear against an inside portion of the housing. In some embodiments, the helical shape can be either a right hand or left hand cutter feature. In some embodiments, the surgical instrument includes a cannulated rotatable cutter to facilitate mating with a stationary auger. In some embodiments, the surgical instrument includes a rotor/stator combination to facilitate high shear to process cut material into a smaller particle size. In some embodiments, the helical shape causes cut debris to channel inside the stationary auger and is forced towards a rotating grinder. In some embodiments, the surgical instrument includes a rotating cutter having an end configured with a cutting geometry to facilitate insertion. In some embodiments, the surgical instrument includes irrigation surfaces that facilitate irrigation to enter the auger channels to mix with debris to provide a transfer mixture, and create a hydraulic bearing surface between moving parts of the cutter. 
     In one embodiment, the surgical instrument includes a stationary auger member that includes a rotational pitch opposite of the cutter to create a force along auger channels to transfer cut material towards a rotating grinder. In some embodiments, the auger is cannulated to facilitate irrigation to transfer to a tip of the rotating cutter. In some embodiments, the surgical instrument includes a rotating cutter having irrigation and/or a hydraulic bearing surface and irrigation holes. 
     In one embodiment, the surgical instrument includes a rotating grinder that includes pathways to facilitate irrigation around a peripheral surface of the rotating cutter to transfer to the cannulated stationary auger member. In one embodiment, the rotating grinder includes a grinding surface and a debris portal. In one embodiment, the rotating grinder includes an irrigation channel and debris removal oriented in a selected direction. In some embodiments, the surgical instrument includes a grinding surface configured to cause a high shear with the stationary auger member as material is forced into debris portals. 
     In one embodiment, the surgical instrument includes debris irrigation and suction. In one embodiment, the surgical instrument includes a manual blade with a spinning cutter having an internal stationary auger. In some embodiments, the surgical instrument includes an irrigation port disposed in a handle and a suction connection in the handle. In one embodiment, the manual blade includes a pair of cutting elements. In one embodiment, the manual blade includes four cutting elements oriented in a cruciate configuration. In one embodiment, the surgical instrument includes scrape blades and rotating blades. In one embodiment, the surgical instrument is employed with a method such that a surgeon cuts away disc and endplate tissue with the manual blade by manually rotating and/or scraping the tissue. In some embodiments, the method includes the step of moving tissue debris into ports between the manual blades. 
     In some embodiments, the surgical instrument includes an auger having a central cannula configured for disposal of a piston. In some embodiments, the piston is disposed with the central cannula and within a rotating blade disposed thereabout. In some embodiments, the piston translates relative to the auger in a first axial direction and/or in a second axial direction to move tissue debris. In some embodiments, the piston comprises a compactor to engage and move tissue debris for removal of the tissue debris from the auger and/or to facilitate grinding and cutting of tissue. 
     In some embodiments, components of the surgical instrument have a central cannula configured for disposal of an illumination device. In some embodiments, the illumination device includes a fiber-optic light cable. In some embodiments, components of the surgical instrument include a fiber-optic light and a camera mounted with an outer housing and/or a stationary shaft, as described herein. In some embodiments, the camera includes a miniature camera. 
     In some embodiments, the surgical instrument includes an auger comprising two or more counter rotating internal blades. In some embodiments, the blades are co-axially disposed and comprise alternate diameters, increasing or decreasing. In some embodiments, the blades are separate and disposed in a serial configuration. In some embodiments, the blades may rotate in the same or different directions. 
     In some embodiments, the surgical instrument includes a manual cutter housing that collects tissue debris, as described herein, and arrests movement of the components of the surgical system to close and seal the surgical instrument. In some embodiments, this configuration increases a suction force to facilitate removal of tissue debris from the cutters and/or blades. In some embodiments, the components of the surgical instrument can be heated and/or cooled to facilitate processing of tissue, as described herein. In some embodiments the surgical instrument includes an inner blade, such as, for example, the stationary shaft, having a heating or cooling element that heats or freezes tissue, such as, for example, intervertebral disc tissue and an outer blade, such as, for example, the rotatable cutter, having an insulating element disposed about the inner blade. The heating or cooling element can be electrically connected to a power source. 
     In some embodiments, the cutting surfaces or blades of the components of the surgical instrument, as described herein, can include, such as, for example, diamonds, spikes and/or sandpaper. In some embodiments, the surgical system includes a diverting filter connected to the surgical instrument and configured to bifurcate tissue debris into a plurality of portions of the filter. In some embodiments, the filter includes at least one portion that facilitates trapping and collecting bone. 
     In some embodiments, the surgical system includes a device configured to inject a bio-material, such as, for example, a polymer, cement, or stiffener into intervertebral disc tissue. In some embodiments, the bio-material is injected with tissue to quick set at the time of surgery or prepared and introduced before the surgery. In some embodiments, the surgical system includes a bio-material, such as, for example, a discogram injection to stiffen intervertebral disc tissue and increase cutting efficiency. In some embodiments, the surgical system is employed with a method such that intervertebral disc tissue is heated and/or bio-frozen prior to cutting to alter the disc material characteristics and to facilitate cutting. 
     In one embodiment, one or all of the components of the surgical system are disposable, peel-pack, pre-packed sterile devices that can be used with an implant. One or all of the components of the surgical system may be reusable. The surgical system may be configured as a kit with multiple sized and configured components. 
     In some embodiments, the present disclosure may be employed to treat spinal disorders such as, for example, degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumor and fractures. In some embodiments, the present disclosure may be employed with other osteal and bone related applications, including those associated with diagnostics and therapeutics. In some embodiments, the disclosed surgical system and methods may be alternatively employed in a surgical treatment with a patient in a prone or supine position, and/or employ various surgical approaches to the spine, including anterior, posterior, posterior mid-line, direct lateral, postero-lateral, and/or antero-lateral approaches, and in other body regions. The present disclosure may also be alternatively employed with procedures for treating the lumbar, cervical, thoracic and pelvic regions of a spinal column. The system and methods of the present disclosure may also be used on animals, bone models and other non-living substrates, such as, for example, in training, testing and demonstration. 
     The present disclosure may be understood more readily by reference to the following detailed description of the disclosure taken in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this disclosure is not limited to the specific devices, methods, conditions or parameters described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed disclosure. Also, in some embodiments, as used in the specification and including the appended claims, the singular forms “a,” “an,” and “the” include the plural, and reference to a particular numerical value includes at least that particular value, unless the context dearly dictates otherwise. Ranges may be expressed herein as from “about” or “approximately” one particular value and/or to “about” or “approximately” another particular value. When such a range is expressed, another embodiment includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment. It is also understood that all spatial references, such as, for example, horizontal, vertical, top, upper, lower, bottom, left and right, are for illustrative purposes only and can be varied within the scope of the disclosure. For example, the references “upper” and “lower” are relative and used only in the context to the other, and are not necessarily “superior” and “inferior”. 
     As used in the specification and including the appended claims, “treating” or “treatment” of a disease or condition refers to performing a procedure that may include administering one or more drugs to a patient (human, normal or otherwise or other mammal), in an effort to alleviate signs or symptoms of the disease or condition. Alleviation can occur prior to signs or symptoms of the disease or condition appearing, as well as after their appearance. Thus, treating or treatment includes preventing or prevention of disease or undesirable condition (e.g., preventing the disease from occurring in a patient, who may be predisposed to the disease but has not yet been diagnosed as having it). In addition, treating or treatment does not require complete alleviation of signs or symptoms, does not require a cure, and specifically includes procedures that have only a marginal effect on the patient. Treatment can include inhibiting the disease, e.g., arresting its development, or relieving the disease, e.g., causing regression of the disease. For example, treatment can include reducing acute or chronic inflammation; alleviating pain and mitigating and inducing re-growth of new ligament, bone and other tissues; as an adjunct in surgery; and/or any repair procedure. Also, as used in the specification and including the appended claims, the term “tissue” includes soft tissue, ligaments, tendons, cartilage and/or bone unless specifically referred to otherwise. 
     The following discussion includes a description of a surgical system and related methods of employing the surgical system in accordance with the principles of the present disclosure. Alternate embodiments are also disclosed. Reference is made in detail to the exemplary embodiments of the present disclosure, which are illustrated in the accompanying figures. Turning to  FIGS.  1 - 25   , there are illustrated components of a surgical system  10  including a surgical instrument  12 . 
     The components of surgical system  10  can be fabricated from biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and/or their composites. For example, the components of surgical system  10 , individually or collectively, can be fabricated from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, Grade 5 titanium, super-elastic titanium alloys, cobalt-chrome alloys, stainless steel alloys, superelastic metallic alloys (e.g., Nitinol, super elasto-plastic metals, such as GUM METAL® manufactured by Toyota Material Incorporated of Japan), ceramics and composites thereof such as calcium phosphate (e.g., SKELITE™ manufactured by Biologix Inc.), thermoplastics such as polyaryletherketone (PAEK) including polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO 4  polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers, elastomeric composites, rigid polymers including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy, partially resorbable materials, such as, for example, composites of metals and calcium-based ceramics, composites of PEEK and calcium based ceramics, composites of PEEK with resorbable polymers, totally resorbable materials, such as, for example, calcium based ceramics such as calcium phosphate, tri-calcium phosphate (TCP), calcium sulfate, or other resorbable polymers such as polyaetide, polyglycolide, polytyrosine carbonate, polycaroplaetohe and their combinations. 
     Various components of surgical system  10  may have material composites, including the above materials, to achieve various desired characteristics such as strength, rigidity, elasticity, compliance, biomechanical performance, durability and radiolucency or imaging preference. The components of surgical system  10 , individually or collectively, may also be fabricated from a heterogeneous material such as a combination of two or more of the above-described materials. The components of surgical system  10  may be monolithically formed, integrally connected or include fastening elements and/or instruments, as described herein. 
     The components of surgical system  10  including surgical instrument  12  can be employed, for example, with mini-open and open surgical techniques to prepare a surgical site including tissue in connection with a surgical procedure for delivery and introduction of instrumentation and/or an implant, such as, for example, an intervertebral implant, at a surgical site within a body of a patient, for example, a section of a spine. In one embodiment, surgical system  10  may be employed with surgical procedures, such as, for example, corpectomy and discectomy, which include fusion and/or fixation treatments that employ implants. 
     Surgical instrument  12  includes a member, such as, for example, a body  14  that extends between an end  16  and an end  18 . Body defines an axis X 1  and includes a housing  20 . In some embodiments, housing  20  may have cross section configurations, such as, for example, oval, cylindrical, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. Housing  20  includes an inner surface  21  that defines a cavity, such as, for example, a channel  22 . Channel  22  is configured for disposal of a member, such as, for example, an auger  24 , as described herein. In some embodiments, channel  22  may have various cross section configurations, such as, for example, circular, cylindrical, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable, tubular and/or tapered. In some embodiments, housing  20  is configured to provide a rigid protective cover for auger  24 . 
     Housing  20  includes a wall  26  disposed about auger  24 . Wall  26  includes a thickness and a surface  30 . Surface  30  defines spaced openings  32  extending through the thickness of wall  26 . Wall  26  includes a cutting surface  34  that is disposed about openings  32 . Wall  26  has a tapered cross section configuration that extends to cutting surface  34 , which includes blades  36 . Blades  36  are configured to disrupt, scrape, cut and/or remove tissue from a surgical site. In some embodiments, housing  20  may include one or a plurality of spaced openings. 
     Manipulation including rotation, translation and/or angulation of housing  20  causes blades  36  to disrupt, scrape, cut and/or remove tissue at a surgical site and guide tissue into channel  22 . In some embodiments, blades  36  are configured for disposal between vertebral bodies to disrupt, scrape, cut and/or remove tissue, such as, for example, intervertebral disc tissue and/or vertebral endplate tissue to create a cavity, space and/or pathway at a surgical site including a targeted portion of an anatomy for delivery, introduction and/or implantation of a spinal implant. In some embodiments, cutting surface  34  is disposed at an angle α relative to an axis X 2  of housing  20  to direct cut tissue into channel  22 . In some embodiments, angle α is 45 degrees. In some embodiments, angle α may include an angle in a range of 0 through 180 degrees. In some embodiments, cutting surface  34  may be disposed at alternate orientations relative to housing  20 , such as, for example, transverse, perpendicular and/or other angular orientations such as acute or obtuse, co-axial and/or may be offset or staggered. 
     Auger  24  is configured for disposal in channel  22 . Auger  24  includes a member, such as, for example, a rotatable cutter  50  and a member, such as, for example, a stationary shaft  52 . Cutter  50  extends between an end  54  and an end  56 . Cutter  50  extends along axis X 1  when disposed in channel  22 . Cutter  50  is tubular in configuration. In some embodiments, cutter  50  may have cross section configurations, such as, for example, oval, cylindrical, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. 
     Cutter  50  includes a surface  58  that defines a plurality of spaced cutting flutes  60 . Cutting flutes  60  are spaced along cutter  50  and form helical blades  62  extending along a length of cutter  50 . Helical blades  62  are disposed at a rotational pitch R 1 . In some embodiments, surface  58  includes a scaffold and/or network of blades. In some embodiments, blades  62  may be disposed at alternate relative orientations, such as, for example, parallel, transverse and/or other angular orientations such as acute or obtuse, co-axial and/or may be offset or staggered. Blades  62  are configured for rotation within housing  20  and about shaft  52  to disrupt, scrape, cut, shear and/or macerate tissue and/or transfer and/or convey tissue along shaft  52 , as described herein. 
     Cutter  50  includes an inner surface  64  that defines an interior cavity  66 . Cavity  66  is configured for disposal of shaft  52  within housing  20 , as described herein. Cutter  50  is configured for rotation relative to shaft  52  to transfer tissue along a first direction, such as, for example, a direction D 1  along axis X 1 , as shown in  FIG.  3    and described herein. In some embodiments, blades  62  rotate relative to shaft  52  within housing  20  to disrupt, scrape, cut, shear and/or macerate cut tissue from blades  36  into a smaller particle size for removal a surgical site. In some embodiments, blades  62  rotate such that tissue disposed adjacent and/or between cutter  50  and shaft  52  is transferred and/or conveyed in direction D 1  due to fluid transfer forces created between the helical configurations of cutter  50  and shaft  52 . The tissue is transferred and/or conveyed towards a member, such as, for example, a grinder  100  for removal from a surgical site, as described herein. In some embodiments, auger  24  comprises two or more counter rotating internal blades, similar to cutter  50 . In some embodiments, the blades are co-axially disposed and comprise alternate diameters, increasing or decreasing. In some embodiments, the blades are separate and disposed in a serial configuration. In some embodiments, the blades may rotate in the same or different directions. 
     End  54  includes a portion  67  having a surface  68  and a surface  69 . Surface  68  defines an opening  70  configured for disposal of a portion of grinder  100 . Surface  69  includes a cavity, such as, for example, a groove  71 . Groove  71  is in communication with a fluid F supplied from an irrigation port, as described herein. Fluid F flows along groove  71  through openings, such as, for example, irrigation holes  72 . Holes  72  are configured to direct fluid F through grinder  100  and into shaft  52 , as described herein. In some embodiments, fluid F passes along groove  70  and provides a hydraulic bearing surface with grinder  100  to facilitate rotation of cutter  50  and prevent wear, overheating and/or damage during operation of the components of surgical instrument  12 . 
     Shaft  52  extends between an end  80  and an end  82  along axis X 1  when disposed in housing  20 . Shaft  52  is configured for disposal with cavity  66 . Shaft  52  is fixed with housing  20  by a protrusion, such as, for example, a flange  74 . Flange  74  is fixedly attached with shaft  52  to resist and/or prevent rotation. In some embodiments, shaft  52  may have cross section configurations, such as, for example, oval, cylindrical, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. 
     Shaft  52  includes a surface  84  that defines a helical surface  86 . Helical surface  86  is disposed in an alternate orientation relative to helical blades  62 . Helical surface  86  includes a rotational pitch R 2  that is alternative to rotational pitch R 1  to create a dynamic fluid transfer and/or shear force or pressure to transfer and/or convey tissue from a surgical site in direction D 1 . Helical blades  62  and helical surface  86  form a transfer channel  88  therebetween configured to direct cut tissue along axis X 1  towards grinder  100  in direction D 1 . The dynamic fluid transfer and/or shear force created by rotation of cutter  50  relative to shaft  52  and between helical blades  62  and helical surface  86  direct fluid flow and cut tissue within transfer channel  88 . In some embodiments, surface  58  and/or surface  84  may comprise alternate configurations, such as, for example, grooved, channeled, undulating, even, uniform, non-uniform, offset, staggered, textured and/or tapered to facilitate directional flow of fluid F. In one embodiment, as shown in  FIG.  37   , shaft  52  includes fiber-optic light cable  89  disposed and/or helically wound through a surface of shaft  52 . Light-cable  89  illuminates a surgical site. In some embodiments, an illumination device may be mounted with various components of surgical instrument  12 . In one embodiment, a miniature camera (not shown) can be mounted with various components of surgical instrument  12  to facilitate imaging of the surgical site. 
     Shaft  52  is cannulated to define a passageway  90  configured for transfer of fluid F in a direction, such as, for example, a direction D 2 . Passageway  90  is in communication with irrigation holes  72  via channels  118 ,  120 ,  122 , as described herein. Surface  84  at end  82  defines at least one opening  92  configured to direct fluid flow F out of passageway  90  into transfer channel  88 . The force of fluid flow F travelling through passageway  90  causes fluid flow F to exit passageway  90  through openings  92 . Fluid F is expelled from passageway  90  and is utilized to facilitate transfer of tissue along transfer channel  88  in direction D 1  to grinder  100 . Movement of fluid F through openings  92  creates a hydraulic bearing surface at ends  82 ,  56  between cutter  50  and shaft  52  to facilitate rotation of cutter  50  and prevent wear, overheating and/or damage during operation of the components of surgical instrument  12 . 
     Grinder  100  extends between an end  102  and an end  104 . End  104  is configured for disposal in portion  67  of cutter  50 . Grinder  100  includes a surface  106  that defines a cutting surface, such as, for example, a plurality of arcuate cutting blades  108  configured to cut, shear and/or macerate cut tissue from transfer channel  88  into a smaller particle size for removal from a surgical site. Cutting blades  108  form openings  110 . Grinder  100  includes a surface  112  that defines a debris reservoir  114 . Openings  110  are in communication with debris reservoir  114  such that the tissue that passes through openings  110  is transferred and/or conveyed into debris reservoir  114  for removal by a vacuum source attached with housing  20 . In some embodiments, the cutting surfaces described herein may include blades, serrations, tines, sharpened surfaces and/or edges. 
     Grinder  100  includes a surface  116  that defines a fluid flow pathway, such as, for example, a series of channels, such as, for example, channels  118 ,  120 ,  122 . Channels  118 ,  120 ,  122  communicate at junction  124  to facilitate the flow of fluid F through grinder  100  into passageway  90 . In some embodiments, channels  118 ,  120 ,  122  may be disposed at alternate relative orientations, such as, for example, transverse, perpendicular and/or other angular orientations such as acute or obtuse, co-axial and/or may be offset or staggered. 
     Channels  118 ,  120 ,  122  are each configured for alignment with holes  72  during rotation to receive fluid F. Junction  124  is oriented in communication with passageway  90 . Channels  118 ,  120 ,  122  are configured to receive fluid flow F from holes  72  and direct fluid flow F to junction  124  into passageway  90  of shaft  52 , as described herein, to direct fluid F in direction D 2  into passageway  90 . 
     Grinder  100  is configured for rotation relative to shaft  52  between an open, fluid communication position such that openings  110  are aligned with transfer channel  88  to facilitate passage of cut tissue from transfer channel  88  to debris reservoir  114  and a closed, non-communicating position such that surface  106  prevents passage of cut tissue from transfer channel  88  into debris reservoir  114 . As grinder  100  rotates between the open and closed positions of openings  110 , blades  108  shear tissue with shaft  52  to cut, shear and/or macerate cut tissue from transfer channel  88  into a smaller particle size for removal from a surgical site. Cut tissue is transferred and/or conveyed with fluid F in direction D 1 . In some embodiments, the open position of grinder  100  comprises a range of alignment of openings  110  with transfer channel  88  including a fully open position of openings  110  through gradual closing of openings  110  during rotation to a completely closed orientation such that surface  106  completely blocks openings  110 . 
     An irrigation port is configured to deliver fluid F into surgical instrument  12 , through holes  72 , through channels  118 ,  120 ,  122  and into passageway  90 . The force of fluid flow F directs cut tissue through transfer channel  88  to grinder  100 . Fluid F mixed with tissue is transferred into debris reservoir  114  for removal via the vacuum source connected with surgical instrument  12 . In some embodiments, surgical system  10  includes a diverting filter (not shown) connected to surgical instrument  12  and configured to bifurcate tissue debris into a plurality of portions of the filter. In some embodiments, the filter includes at least one portion that facilitates trapping and collecting bone. 
     In assembly, operation and use, as shown in  FIG.  26   , surgical system  10  is employed to treat an affected section of vertebrae V. A medical practitioner obtains access to a surgical site including vertebrae V in any appropriate manner, such as through incision and retraction of tissues. The components of surgical system  10  including surgical instrument  12  are employed to augment a surgical treatment. Surgical instrument  12  can be delivered to a surgical site as a pre-assembled device or can be assembled in situ. Surgical system  10  may be may be completely or partially revised, removed or replaced. 
     Surgical system  10  may be used with surgical methods or techniques including open surgery, mini-open surgery, minimally invasive surgery and percutaneous surgical implantation, whereby vertebrae V is accessed through a mini-incision, or sleeve that provides a protected passageway to the area. Once access to the surgical site is obtained, a surgical treatment, for example, corpectomy and/or discectomy, can be performed for treating a spine disorder. A diseased and/or damaged portion of vertebrae V between and/or including vertebra V 1 , V 2 , and diseased and/or damaged intervertebral discs and tissue are removed to create a vertebral space S. 
     Surgical instrument  12  is delivered to the surgical site including vertebrae V and inserted with space S. Housing  20  is manipulated including rotation, translation and/or angulation of housing  20  for engagement with vertebral tissue, including but not limited to intervertebral tissue, endplate tissue and bone, adjacent space S causing blades  36  to disrupt, scrape, cut and/or remove tissue from the surgical site and guide tissue into channel  22 , as described herein. An actuator, such as, for example, an electric motor is connected with surgical instrument  12  to actuate rotation of cutter  50  and grinder  100  relative to shaft  52 . 
     A source of fluid F is connected to the irrigation port of surgical instrument  12  to establish fluid flow in directions D 1 , D 2 , as described herein. Cutter  50  rotates relative to shaft  52  such that blades  62  rotate to disrupt, scrape, cut, shear and/or macerate cut tissue from blades  36  into a smaller particle size for removal the surgical site. 
     Blades  62  rotate such that tissue disposed adjacent and/or between cutter  50  and shaft  52  is transferred and/or conveyed in direction D 1  due to fluid transfer forces created between the helical configurations of cutter  50  and shaft  52 . The dynamic fluid transfer and/or shear force created by rotation of cutter  50  relative to shaft  52  and between helical blades  62  and helical surface  86  direct fluid F and cut tissue within transfer channel  88 , as described herein. 
     The tissue is transferred and/or conveyed to grinder  100  for removal from the surgical site. As grinder  100  rotates between the open and closed positions of openings  110 , as described herein, blades  108  shear tissue with shaft  52  to cut, shear and/or macerate cut tissue from transfer channel  88  into a smaller particle size for removal from the surgical site. Cut tissue is transferred and/or conveyed with fluid F in direction D 1 . The force of fluid F directs cut tissue through transfer channel  88  to grinder  100 . Fluid F mixed with tissue is transferred into debris reservoir  114  for removal via the vacuum source connected with surgical instrument  12 . 
     In some embodiments, surgical system  10  can include one or more surgical instruments for use with surgical instrument  12 , such as, for example, drivers, inserters, extenders, reducers, spreaders, distractors, blades, retractors, clamps, forceps, elevators and drills, which may be alternately sized and dimensioned, and arranged as a kit. 
     In one embodiment, surgical system  10  includes an agent, which may be disposed, packed, coated or layered within, on or about the components and/or surfaces of surgical system  10 . In some embodiments, the agent may include bone growth promoting material, such as, for example, bone graft to enhance fixation of the components and/or surfaces of surgical system  10  with vertebrae V. In some embodiments, the agent may include one or a plurality of therapeutic agents and/or pharmacological agents for release, including sustained release, to treat, for example, pain, inflammation and degeneration. 
     Upon completion of the procedure, the surgical instruments, assemblies and non-implanted components of surgical system  10  are removed and the incision is closed. The components of surgical system  10  can be made of radiolucent materials such as polymers. Radiomarkers may be included for identification under x-ray, fluoroscopy, CT or other imaging techniques. In some embodiments, the use of surgical navigation, microsurgical and image guided technologies may be employed to access, view and repair spinal deterioration or damage, with the aid of surgical system  10 . In some embodiments, surgical system  10  may include one or a plurality of plates, connectors and/or bone fasteners for use with a single vertebral level or a plurality of vertebral levels. 
     In one embodiment, as shown in  FIGS.  27 - 32   , system  10 , similar to the systems and methods described herein, includes surgical instrument  12  having a grinder  200 , similar to grinder  100  described herein. Grinder  200  extends between an end  202  and an end  204 . End  204  is configured for disposal in portion  67  of cutter  50  ( FIG.  9   ). Grinder  200  includes a surface  206  that defines arcuate cutting blades  208 , similar to blades  108  described herein, configured to cut, shear and/or macerate cut tissue from transfer channel  88  ( FIG.  3   ) into a smaller particle size for removal from a surgical site. Cutting blades  208  form opening  210 , similar to openings  110  described herein. Grinder  200  includes a debris reservoir  214 . Opening  210  is in communication with debris reservoir  214  such that the tissue that passes through opening  210  is transferred and/or conveyed into debris reservoir  214  for removal by a vacuum source attached with housing  20  ( FIG.  1   ). 
     Grinder  200  includes a channel  218 , similar to channels  118 ,  120 ,  122  described herein, which facilitates the flow of fluid F through grinder  200  into passageway  90 . Channel  218  is configured for alignment with holes  72  during rotation of cutter  50  to receive fluid F. Channel  218  is configured to receive fluid F from holes  72  and direct fluid F into passageway  90  of shaft  52 , as described herein, to direct fluid F in direction D 2  into passageway  90 . 
     Grinder  200  is configured for rotation relative to shaft  52  between an open, fluid communication position such that opening  210  is aligned with transfer channel  88  to facilitate passage of cut tissue from transfer channel  88  to debris reservoir  214  and a partially closed position such that surface  206  at least partially prevents passage of cut tissue from transfer channel  88  into debris reservoir  214 . As grinder  200  rotates between the open and closed positions of opening  210 , blades  208  cut, shear and/or macerate cut tissue from transfer channel  88  into a smaller particle size for removal from a surgical site. Cut tissue is transferred and/or conveyed with fluid F in direction D 1 . 
     The irrigation port is configured to deliver fluid F into surgical instrument  12 , through holes  72 , through channel  218  and into passageway  90 . The force of fluid F directs cut tissue through transfer channel  88  to grinder  200 . Fluid F mixed with tissue is transferred into debris reservoir  214  for removal via the vacuum source connected with surgical instrument  12 . 
     In one embodiment, as shown in  FIGS.  33  and  34   , system  10 , similar to the systems and methods described herein, includes surgical instrument  12  having a housing  320 , similar to housing  20  described herein. Housing  320  includes an inner surface  321  that defines a channel  322  configured for disposal of auger  24 , as described herein. 
     Housing  320  includes a wall  326  disposed about auger  24 . Wall  326  includes a thickness and a surface  330 . Surface  330  defines four spaced openings  332  extending through the thickness of wall  326 . Wall  326  includes four spaced sections that comprise a cruciate cross section configuration. The sections are spaced 90 degrees apart and extend linearly to cutting surfaces  334 , similar to surfaces  34  described herein, and are disposed about openings  332 . Cutting surfaces  334  include blades  336 , similar to blades  36  described herein. Blades  336  are configured to disrupt, scrape, cut and/or remove tissue from a surgical site. Manipulation including rotation, translation and/or angulation of housing  320  causes blades  336  to disrupt, scrape, cut and/or remove tissue at a surgical site and guide tissue into channel  322 , in the direction shown by arrows A in  FIG.  34   . 
     In one embodiment, as shown in  FIGS.  35  and  36   , system  10 , similar to the systems and methods described herein, includes surgical instrument  12  having a housing  420 , similar to housing  20  described herein. Housing  420  includes an inner surface  421  that defines a channel  422  configured for disposal of auger  24 , as described herein. 
     Housing  420  includes a wall  426  disposed about auger  24 . Wall  426  includes a thickness and a surface  430 . Surface  430  defines two spaced openings  432  extending through the thickness of wall  426 . Wall  426  includes two spaced sections that are disposed in alignment and/or co-axial along an axis transverse to axis X 1 . The sections are spaced 180 degrees apart and extend linearly to cutting surfaces  434 , similar to surfaces  34  described herein, and are disposed about openings  432 . Cutting surfaces  434  include blades  436 , similar to blades  36  described herein. Blades  436  are configured to disrupt, scrape, cut and/or remove tissue from a surgical site. Manipulation including rotation, translation and/or angulation of housing  420  causes blades  436  to disrupt, scrape, cut and/or remove tissue at a surgical site and guide tissue into channel  422 , in the direction shown by arrows B in  FIG.  36   . 
     In one embodiment, as shown in  FIG.  38   , system  10 , similar to the systems and methods described herein, includes surgical instrument  12  having a stationary shaft  552 , similar to stationary shaft  52  described herein. Shaft  552  is disposed within cavity  66  and has a reduced length such that cutter  50  and shaft  552  define a cavity portion  554  of cavity  66 . 
     A piston  556  is configured for disposal with cavity portion  554 . Piston  556  is configured for translation within cavity portion  554  along axis X 1 , in the directions shown by arrows E, to compact cut tissue, as described herein. In some embodiments, piston  556  includes a surface  558  that defines openings  560 . Openings  560  are configured to provide a passageway for fluid flow F into a passageway  590 , similar to passageway  90  described herein, and facilitate axial translation of piston  556  relative to cutter  50 . As fluid flow F passes through passageway  590  and openings  560 , piston  556  translates, in the directions shown by arrows E. Piston  556  translates relative to cutter  50  to move tissue debris, as described herein. In some embodiments, piston  556  comprises a compactor to engage and move tissue debris for removal of the tissue debris from auger  24 . The dynamic fluid transfer and/or shear force created by rotation of cutter  50 , similar to that described herein, directs fluid flow F and cut tissue into cavity  554  such that piston  556  compacts the cut tissue and directs the cut tissue into a grinder, similar to the grinders described herein, to facilitate grinding and cutting of tissue. 
     In one embodiment, as shown in  FIGS.  39 - 42   , system  10 , similar to the systems and methods described herein, includes a surgical instrument  612 , similar to surgical instrument  12  described herein. Surgical instrument  612  includes a member, such as, for example, a body  614 , similar to body  14  described herein, which defines an axis X 2  and includes a housing  620 , similar to housing  20  described herein. Housing  620  includes an inner surface  621  that defines a channel  622 . Channel  622  is configured for disposal of a member, such as, for example, an auger  624 , as described herein. 
     Housing  620  includes a wall  626  disposed about auger  624 . Wall  626  defines spaced openings  632  and includes blades  636 , similar to blades  36  described herein. Manipulation including rotation, translation and/or angulation of housing  620  causes blades  636  to disrupt, scrape, cut and/or remove tissue at a surgical site and guide tissue into channel  622 . 
     Auger  624 , similar to auger  24  described herein, is configured for disposal in channel  622 . Auger  624  includes a member, such as, for example, a rotatable cutter  650  and a member, such as, for example, a stationary shaft  652 . Shaft  652  extends between an end  680  and an end  682  along axis X 2  when disposed in housing  620 . Shaft  652  is tubular and configured for disposal with channel  622 . Shaft  652  is fixedly attached with housing  620  adjacent end  680  and/or end  682  to resist and/or prevent relative rotation therebetween. In some embodiments, shaft  652  may have cross section configurations, such as, for example, oval, cylindrical, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. Shaft  652  includes a wall surface that defines a channel  684  and a plurality of openings  686  that are circumferentially disposed about the wall surface. Openings  686  receive cut tissue, as described herein, adjacent openings  632  and facilitate, direct, transfer and/or convey the cut tissue to cutter  650 . 
     Cutter  650  extends between an end  654  and an end  656 . Cutter  650  extends along axis X 2  when disposed in channel  684 . Cutter  650  is tubular and configured for disposal within channel  684 . In some embodiments, cutter  650  is connected with housing  620  via a flange  674  that facilities rotation of cutter  650  relative to housing  620 . In some embodiments, cutter  650  may have cross section configurations, such as, for example, oval, cylindrical, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. 
     Cutter  650  includes a surface  658  that defines a plurality of spaced cutting flutes  660 . Cutting flutes  660  are spaced along cutter  650  and form helical blades  662 , similar to blades  62  described herein, extending along a length of cutter  650 . Blades  662  are configured for rotation within housing  620  and within shaft  652  to disrupt, scrape, cut, shear and/or macerate tissue and/or transfer and/or convey tissue along shaft  652 , as described herein. 
     Cutter  650  includes an inner surface  664  that defines an interior cavity  665 . Cutter  650  is configured for rotation relative to shaft  652  to transfer tissue in a direction D 3  along axis X 2 , as shown in  FIG.  41   . In some embodiments, blades  662  rotate relative to shaft  652  within housing  620  to disrupt, scrape, cut, shear and/or macerate cut tissue from blades  636  into a smaller particle size for removal a surgical site. In some embodiments, blades  662  rotate such that tissue disposed adjacent and/or between cutter  650  and shaft  652 , and/or within cavity  665 , is transferred and/or conveyed in direction D 3  due to fluid transfer forces created between the helical configuration and rotation of cutter  650  relative to shaft  652  and/or housing  620 . The tissue is transferred and/or conveyed towards a member, such as, for example, a cannula  700  for removal from a surgical site, similar to the systems and methods described herein. 
     Cannula  700  defines a transfer channel  702  that receives cut tissue from cavity  665  and directs the cut tissue in direction D 3  along axis X 2  for removal from a surgical site. In some embodiments, a vacuum source is connected to cannula  700  to direct fluid flow and cut tissue into transfer channel  702  and for removal from a surgical site. In some embodiments, a dynamic fluid transfer and/or shear force created by rotation of cutter  650  relative to shaft  652  directs fluid flow and cut tissue into transfer channel  702 . End  654  includes a wall surface  668  that defines an opening  670  configured for disposal of a portion of cannula  700 . 
     In some embodiments, fluid F flows through irrigation holes  672 , which are in communication with fluid F supplied from an irrigation port, as described herein, for transfer of fluid F in a direction D 4 , as shown in  FIG.  41   . In some embodiments, holes  672  are configured to direct fluid F into channel  622 , channel  684  and/or cavity  665 , similar to that described herein. In some embodiments, surface  668  includes one or more grooves  671 , which are in communication with a fluid F supplied from an irrigation port. In some embodiments, fluid F provides a hydraulic bearing surface between shaft  652 , cutter  650  and/or housing  620  to facilitate rotation of cutter  650  and prevent wear, overheating and/or damage during operation of the components of surgical instrument  612 . 
     An irrigation port is connected with components of surgical instrument  612  to deliver fluid F into surgical instrument  612 , through holes  672  and into cavity  665 , as described herein. In some embodiments, rotation of cutter  650  and the force of fluid flow F directs cut tissue through cavity  665  to transfer channel  702 . Fluid F mixed with tissue is transferred into transfer channel  702  for removal via the vacuum source connected with surgical instrument  612 . 
     It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplification of the various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.