Patent Description:
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. From <CIT> a surgical instrument according to the preamble of claim <NUM> is known. A further surgical instrument is known from <CIT>.

This disclosure has the object to reduce the problems encountered in the prior art and to describe an improvement over these prior art technologies. This is achieved by a surgical instrument according to claim <NUM>. Further embodiments are subject of the dependent claims.

The surgical instrument according to the invention includes a first member defining an axis and having a scraping surface configured to scrape tissue, a second member including a cutting surface that is rotatable relative to the first member, wherein the second member has a maximum length defined by opposite end surfaces of the second member, the end surfaces each being disposed within the first member, and a third member including an outer surface defining at least a portion of a passageway configured for disposal of the scraped tissue, wherein the third member is fixed with the first member, wherein the cutting surface is rotatable relative to the third member to transfer the scraped tissue along the axis, wherein the third member includes a threaded surface that directly engages a threaded surface of the second member such that the second member translates relative to the third member along the axis as the second member rotates relative to the first member.

The surgical instrument can include a housing defining a longitudinal axis and having an inner surface that defines a cavity. The housing further can include a plurality of teeth disposed along a wall that extends transverse to the longitudinal axis, the teeth being configured to scrape tissue. An auger can comprise a rotatable cutter having a maximum length defined by opposite end surfaces, the end surfaces each being disposed within the cavity. The rotatable cutter can be rotatable relative to the housing. The rotatable cutter can define an interior cavity. The auger further can comprise a stationary member disposed within the interior cavity and fixed with the housing. The stationary member can include a helical outer surface such that the rotatable cutter rotates about the helical outer surface to transfer the scraped tissue in a first direction along the axis.

The exemplary embodiments of the surgical instrument disclosed are discussed in terms of medical devices for the treatment of musculoskeletal disorders. Furthermore, methods of use of the inventive surgical instrument and more particularly, use of the inventive surgical instrument in terms or as part of a surgical system for preparation of a surgical site and a method for treating a spine are described to further explain aspects and advantages of the inventive surgical instrument.

The inventive surgical instrument can be a part of a surgical system that includes the surgical instrument, such as, for example, a disc preparation instrument. In some embodiments, the surgical instrument includes a scraper tube disposed about a rotating helical blade. A stationary auger is positioned within the rotating helical blade. The rotating helical blade defines an irrigation pathway therein. Tissue that is scraped by the scraper tube is pulled into the rotating helical blade. The stationary auger transfers the scraped tissue under the rotating helical blade, which cuts the scraped tissue into a smaller size. A suction pathway between the irrigation tube and the scraper tube transfers the cut tissue to a remote container. In some embodiments, the instrument includes various aspects, which influence the capturing of tissue. For example, in a first aspect, tissue is captured mechanically between the helical blades relative to the scraper tube. In a second aspect, the rotation of the helical blade with respect to the inner auger and outer tube causes a pumping action, which creates a different pressure across the blade and induces a negative pressure (vacuum) at the opening of the tube, which can draw tissue into the cutter. In a third aspect, there is a direct passageway from the opening of the tube through the channels of the cutter/auger to the suction container, which will draw tissue effluent through the system.

In one embodiment, the surgical instrument is configured for efficient grinding and removal of the tissue via the cutting mechanism described herein. A grinder end of the rotating shaft allows better tissue removal. Further, when the tissue enters into the auger it has only been through one cut. A ring band in the surgical instrument cuts the tissue a second time as it exits the rotating shaft, which makes it easier to liquefy with the irrigation. In one embodiment, the surgical instrument includes a channel/pocket on the side allows the device to be more aggressive and grab the tissue and pull it into the disposal.

The inventive surgical instrument can be part of a surgical system that includes the surgical instrument that includes a manual cutter housing disposed about an internal rotating cutter. In some embodiments, the surgical instrument includes a disc preparation device with a combination of an outer paddle scraper structure having teeth and an intemal rotating auger and/or suction mechanism for conveying disc debris into the instrument and away from the surgical site.

The inventive surgical instrument can be part of a surgical system that includes the surgical instrument including a scraper housing that provides a rigid protective cover configured to cover the rotating cutter blade. In some embodiments, the scraper housing includes teeth to facilitate scraping of peripheral material. In some embodiments, the surgical instrument includes a housing configured to incorporate one, two, and/or multiple walls or surfaces with teeth to facilitate scraping of the peripheral material. In some embodiments, the surgical instrument includes a rotating cutter mechanism disposed with the scraping 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 scraping and removing tissue and bone to create a space or pathway for fusion or motion implants. In some embodiments, the surgical instrument includes a scraper housing, a rotating cutter, a stationary auger 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 scraped debris to channel inside the stationary auger. In some embodiments, the surgical instrument includes a rotating cutter having an end configured with a cutting geometry. 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 debris irrigation and suction. In one embodiment, the surgical instrument includes a manual scraper with a spinning cutter having an intemal 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 cutting/scraping elements. In one embodiment, the manual scraper includes teeth to facilitate scraping of tissue. In one embodiment, the surgical instrument includes scraper teeth or blades and rotating blades. The surgical instrument can be employed with a method such that a surgeon scrapes away disc and endplate tissue with the manual scraper. The method can include the step of moving tissue debris into ports.

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 altemate 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 scraper 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 scraper 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, teeth, spikes and/or sandpaper. The surgical system can include a diverting filter connected to the surgical instrument and configured to bifurcate tissue debris into a plurality of portions of the filter. The filter can include at least one portion that facilitates trapping and collecting bone.

The surgical system can include a device configured to inject a bio-material, such as, for example, a polymer, cement, or stiffener into intervertebral disc tissue. The bio-material can be injected with tissue to quick set at the time of surgery or prepared and introduced before the surgery. The surgical system can include a bio-material, such as, for example, a discogram injection to stiffen intervertebral disc tissue and increase cutting efficiency. The surgical system can be 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.

One or all of the components of the surgical system can be 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. The 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 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, 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 scope of the 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 clearly dictates otherwise. Ranges may be expressed herein as from "about" or "approximately" one particular value and/or to "about" or "approximately" another 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 an inventive surgical instrument being part of a surgical system and related methods of employing the inventive surgical instrument as part of 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 <FIG>, there are illustrated components of an inventive surgical instrument <NUM> being part of a surgical system <NUM> that includes the surgical instrument <NUM>.

The components of surgical system <NUM> 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 <NUM>, individually or collectively, can be fabricated from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, Grade <NUM> 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<NUM> 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. One or more components of surgical system <NUM> may be fabricated from piezoelectric materials.

The components of surgical system <NUM> including surgical instrument <NUM> 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. Surgical system <NUM> 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 <NUM> includes a member, such as, for example, a scraper tube <NUM> that extends between an end <NUM> and an end <NUM>. Tube <NUM> defines an axis X1. Surgical instrument <NUM> includes a handle <NUM> coupled to tube <NUM> such that handle <NUM> is fixed relative to tube <NUM>. That is, tube <NUM> and handle <NUM> are coupled to one another such that translation and/or rotation of tube <NUM> relative to handle <NUM> is prevented. As such, rotation of handle <NUM> also rotates tube <NUM> and translation of handle <NUM> also translates tube <NUM>. This allows handle <NUM> to be gripped by a medical practitioner and manipulated to scrape and/or distract tissue using end <NUM> of tube <NUM>, as discussed herein. In some embodiments, handle <NUM> is removably coupled to tube <NUM> such that handle <NUM> may be removed from tube <NUM> without breaking handle <NUM> or tube <NUM>. In some embodiments, handle <NUM> is permanently coupled to tube <NUM> such that handle <NUM> cannot be removed from tube <NUM> without breaking handle <NUM> and/or tube <NUM>. In some embodiments, handle <NUM> is integrally and/or monolithically formed tube <NUM>. In some embodiments, tube <NUM> and/or handle <NUM> 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. In some embodiments, tube <NUM> is a bayonet style tube that is configured to position handle <NUM> out of the line of site of tube <NUM>.

Handle <NUM> includes an end <NUM> and an opposite end <NUM>. A motor <NUM> is coupled to end <NUM>. Motor <NUM> is configured to rotate a member, such as, for example, an auger or blade assembly <NUM> relative to tube <NUM> about axis X1, as discussed herein. End <NUM> includes a port <NUM> and a port <NUM> that is spaced apart from port <NUM>. A suction tube <NUM> is coupled to port <NUM>. Tube <NUM> is configured to create suction within a suction pathway of tube <NUM> to transfer scraped tissue within the suction pathway to a remote container, as discussed herein.

In some embodiments, tube <NUM> is in communication with a channel <NUM> of tube <NUM>. A suction cannister/pump system is connected with tube <NUM> such that the suction cannister/pump system provides suction within channel <NUM> to move material within channel <NUM> in the direction D1 in <FIG> out of channel <NUM> and the into suction cannister/pump system. An irrigation tube <NUM> is coupled to port <NUM>. Tube <NUM> is configured to provide a stream of water or other fluid within an irrigation pathway of blade assembly <NUM> that mixes with debris to provide a transfer mixture that is removed from instrument <NUM> via suction tube <NUM>, as discussed herein. In some embodiments, handle <NUM> includes a hub <NUM>. Port <NUM> and tube <NUM> extend through hub <NUM>, as shown in <FIG>, for example. Hub <NUM> includes a conduit <NUM> that is in communication with a channel <NUM> of port <NUM> and a cavity <NUM> that is in communication with conduit <NUM> and channel <NUM>. An adapter <NUM> and an end of tube <NUM> are positioned within cavity <NUM> such that a lumen <NUM> of adapter <NUM> is in communication with a passageway <NUM> and conduit <NUM> such that a fluid or other material can be introduced through channel <NUM>, conduit <NUM> and lumen <NUM> and into passageway <NUM> to direct the fluid to blade assembly <NUM>, as discussed herein. System <NUM> can include one or a plurality of irrigation seals <NUM> to direct the fluid into passageway <NUM>, as shown in <FIG>, for example.

Tube <NUM> includes an inner surface <NUM> that defines a cavity, such as, for example, channel <NUM>. Channel <NUM> is configured for disposal of a member, such as, for example, blade assembly <NUM>, as described herein. In some embodiments, channel <NUM> 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, tube <NUM> and/or handle <NUM> is/are configured to provide a rigid protective cover for blade assembly <NUM>. In some embodiments, tube <NUM> is removably coupled to handle <NUM> such that tube <NUM> can be removed from handle <NUM> without breaking handle <NUM> and/or tube <NUM>. In some embodiments, hub <NUM> includes an aperture <NUM> configured for disposal of tube <NUM> and a recess <NUM> that is in communication with aperture <NUM>, as shown in <FIG>, for example. A band, such as, for example, a ring <NUM> is positioned within recess <NUM> and a groove <NUM> of tube <NUM> to connect tube <NUM> with hub <NUM>. In some embodiments, tube <NUM> is integrally and/or monolithically formed with handle <NUM> such that tube <NUM> cannot be removed from handle without breaking handle <NUM> and/or tube <NUM>.

End <NUM> of tube <NUM> includes spaced apart side walls <NUM>, <NUM> that are connected by a transverse wall <NUM>, as best shown in <FIG>, <FIG> and <FIG>. That is, wall <NUM> extends from wall <NUM> to wall <NUM> to join wall <NUM> with wall <NUM>. In some embodiments, wall <NUM> is continuously curved. That is, wall <NUM> is continuously curved from wall <NUM> to wall <NUM> and/or has a continuous radius of curvature from wall <NUM> to wall <NUM>. At least a portion of each of walls <NUM>, <NUM>, <NUM> extends transverse to axis X1. That is, upper edges 42a, 44a, 46a of walls <NUM>, <NUM>, <NUM> each extends transverse to axis X1. In some embodiments, edges 42a, 44a, 46a define a cutting surface, such as, for example, a scraping surface configured to scrape tissue, such as, for example, bone, as discussed herein. Edge 42a extends parallel to edge 44a along the entire lengths of edges 42a, 44a. Edge 46a extends transverse to edges 42a, 44a. In some embodiments, edges 42a, 44a are each disposed at an angle α relative to axis X1, as shown in <FIG> to facilitate scraping and/or disrupting material, such as, for example, tissue and to dispose the material within tube <NUM>, as discussed herein. In some embodiments, angle α is an acute angle. In some embodiments, angle α may include an angle in a range of <NUM> through <NUM> degrees. In some embodiments, angle α may include an angle in a range of <NUM> through <NUM> degrees. In some embodiments, angle α may include an angle in a range of <NUM> through <NUM> degrees. In some embodiments, angle α may include an angle in a range of <NUM> through <NUM> degrees. In some embodiments, edge 46a is continuously curved. That is, edge 46a is continuously curved from edge 42a to edge 44a and/or has a continuous radius of curvature from edge 42a to edge 44a.

A plurality of teeth <NUM> are disposed along walls <NUM>, <NUM>, <NUM>. Teeth <NUM> are configured to disrupt, scrape and/or remove tissue from a surgical site, as discussed herein. In some embodiments, tips <NUM> of teeth <NUM> define edges 42a, 44a, 46a. In some embodiments, tips <NUM> are planar such that teeth <NUM> resemble truncated triangles. In some embodiments, tips <NUM> are pointed such that teeth <NUM> resemble isosceles triangles or equilateral triangles. Adjacent teeth <NUM> define gaps <NUM> therebetween. As such, edges 42a, 44a, 46a are interrupted by gaps <NUM> along the lengths of edges 42a, 44a, 46a. In some embodiments, teeth <NUM> are arranged uniformly along walls <NUM>, <NUM>, <NUM>, such that gaps <NUM> are uniformly spaced apart from one another along walls <NUM>, <NUM>, <NUM>. Inner surfaces of walls <NUM>, <NUM>, <NUM> define a cavity <NUM> configured for disposal of material, such as, for example, tissue that is scraped by teeth <NUM>, as discussed herein. Manipulation including translation and/or angulation of tube <NUM> causes teeth <NUM> to disrupt, scrape, cut and/or remove tissue at a surgical site and guide tissue into cavity <NUM>. In some embodiments, teeth <NUM> 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, wall <NUM> includes an inner surface 46a that extends transverse to axis X1. Surface 46a is angled to direct material in cavity <NUM> into an opening of tube <NUM>, as discussed herein. In some embodiments, walls <NUM>, <NUM>, <NUM> are free of teeth, such as, for example, teeth <NUM>. That is, adjoining surfaces of walls <NUM>, <NUM>, <NUM> are planar and continuous. In some embodiments, the disruption, scraping, cutting and/or removal of tissue provided by teeth <NUM> may, in combination with teeth <NUM> or alternatively, be provided by piezoelectric features or materials.

Walls <NUM>, <NUM>, <NUM> each extend from a shaft <NUM> of tube <NUM>. Shaft <NUM> extends parallel to axis X1 along the entire length of shaft <NUM>. End <NUM> has a maximum height H1 that is greater than a maximum height H2 of shaft <NUM>, as shown in <FIG>. Shaft <NUM> includes an opening <NUM> that extends through a wall thickness of shaft <NUM>, the wall thickness of shaft <NUM> being defined by surface <NUM> and an opposite outer surface <NUM> of shaft <NUM>. Opening <NUM> is in communication with channel <NUM> and configured for disposal of material, such as, for example, tissue in cavity <NUM> that was scraped and/or cut by teeth <NUM> to move the material through opening <NUM> and into channel <NUM>. As discussed herein, surface 46a is angled to move material from cavity <NUM> through opening <NUM> and into channel <NUM>.

In some embodiments, opening <NUM> includes an inlet <NUM> positioned on one side of blade assembly <NUM>, as best shown in <FIG> and <FIG>. Inlet <NUM> is configured to allow blade assembly <NUM> to rotate within channel <NUM>. That is, when blade assembly <NUM> comprises a right-handed helical blade and is rotated in a first rotational direction, such as, for example, clockwise, at least a portion of the right-handed helical blade will occupy and rotate within inlet <NUM>. In some embodiments, blade assembly <NUM> comprises a left-handed helical blade and inlet <NUM> is positioned on an opposite side of blade assembly <NUM> such that rotation of the left-handed helical blade causes at least a portion of the left-handed helical blade to occupy and rotate within inlet <NUM>. Opening <NUM> includes only one inlet <NUM> positioned on one side of blade assembly <NUM> such that opening is asymmetrical. As stated above, the side of blade assembly <NUM> that inlet <NUM> is positioned on is dependent on whether blade assembly <NUM> comprises a right-handed helical blade or a left-handed helical blade. Significantly, including one inlet <NUM> positioned on one side of blade assembly <NUM> allows scraped and/or cut tissue to be suctioned toward a distal end of channel <NUM>, such as, for example, toward a rotating grinder that grinds the scraped and/or cut tissue. Indeed, it has been found that if opening <NUM> includes an inlet on both sides of blade assembly <NUM>, scraped and/or cut tissue is prevented from being suctioned toward the distal end of channel <NUM>. That is, if opening <NUM> includes an inlet on both sides of blade assembly <NUM>, scraped and/or cut tissue will become clogged within channel <NUM>, thus preventing the scraped and/or cut tissue from being ground by a grinder within channel <NUM>.

Blade assembly <NUM> is configured for disposal in channel <NUM> such that blade assembly <NUM> is visible through opening <NUM>. Blade assembly <NUM> includes a shaft <NUM> that is configured to be coupled to motor <NUM> to rotate shaft <NUM> relative to tube <NUM> about axis X1. In some embodiments, shaft <NUM> is removably coupled to motor <NUM> such that shaft <NUM> can be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. In some embodiments, shaft <NUM> is permanently fixed with motor <NUM> such that shaft <NUM> cannot be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with an output shaft of motor <NUM>. Shaft <NUM> extends along axis X1 when disposed in channel <NUM>. Blade assembly <NUM> includes a member, such as, for example, a rotatable cutter <NUM> that is coupled to shaft <NUM> and a member, such as, for example, a stationary auger <NUM>. In some embodiments, auger <NUM> is integrally and/or monolithically formed with tube <NUM> such that auger <NUM> is permanently affixed to tube <NUM>.

Cutter <NUM> is fixed relative to shaft <NUM> such that rotation of shaft <NUM> relative to tube <NUM> about axis X1 also rotates cutter <NUM> relative to tube <NUM> about axis X1. In some embodiments, shaft <NUM> is removably coupled to cutter <NUM> such that shaft <NUM> can be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. In some embodiments, shaft <NUM> is permanently fixed with cutter <NUM> such that shaft <NUM> cannot be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with cutter <NUM>. Shaft <NUM> includes an inner surface <NUM> defining a passageway <NUM>, as best shown in <FIG>. In some embodiments, an end <NUM> of cutter <NUM> is positioned within passageway <NUM> such that an outer surface of end <NUM> directly engages surface <NUM> to fix cutter <NUM> relative to shaft <NUM>. In some embodiments, cutter <NUM> can be variously connected with shaft <NUM>, such as, for example, monolithic, integral connection, frictional engagement, threaded engagement, mutual grooves, screws, adhesive, nails, barbs and/or raised element. Cutter <NUM> extends between end <NUM> and an opposite end <NUM>. Cutter <NUM> extends along axis X1 when disposed in channel <NUM>. Cutter <NUM> is tubular in configuration. In some embodiments, cutter <NUM> 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 <NUM> includes a surface <NUM> that defines a plurality of spaced cutting flutes <NUM>. Cutting flutes <NUM> are spaced along cutter <NUM> and form helical blades <NUM> extending along a length of cutter <NUM>. Helical blades <NUM> are disposed at a rotational pitch R1. In some embodiments, surface <NUM> includes a scaffold and/or network of blades. In some embodiments, blades <NUM> 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 <NUM> are configured for rotation within channel <NUM> and about auger <NUM> to disrupt, scrape, cut, shear and/or macerate tissue and/or transfer and/or convey tissue along auger <NUM>, as described herein. In some embodiments, cutter <NUM> includes a section, such as, for example, a solid ring section <NUM>, shown in <FIG>, for example. Section <NUM> is configured to force tissue under cutter <NUM> and through flutes of auger <NUM> defined by a helical surface <NUM> of auger <NUM>. This controls the tissue entering a discharge side of cutter <NUM> into a suction and/or vacuum pathway, as discussed herein.

Cutter <NUM> includes an inner surface <NUM> that defines an interior cavity <NUM>. Cavity <NUM> is in communication with passageway <NUM>. In some embodiments, cavity <NUM> is coaxial with passageway <NUM>. Cavity <NUM> is configured for disposal of auger <NUM> within channel <NUM>, as described herein. Cutter <NUM> is configured for rotation relative to tube <NUM> and auger <NUM> to transfer tissue along a first direction, such as, for example, a direction D1 (<FIG>) along axis X1, as described herein. In some embodiments, blades <NUM> rotate relative to tube <NUM> and auger <NUM> within channel <NUM> to move tissue in cavity <NUM> that was disrupted, scraped, cut, sheared and/or macerated by teeth <NUM> into a smaller particle size for removal from a surgical site. In some embodiments, blades <NUM> rotate such that tissue disposed adjacent and/or between cutter <NUM> and auger <NUM> is transferred and/or conveyed in direction D1 due to fluid transfer forces created between the helical configurations of cutter <NUM> and auger <NUM>. The tissue is transferred and/or conveyed for removal from a surgical site, as described herein. In some embodiments, auger <NUM> comprises two or more counter rotating intemal blades, similar to cutter <NUM>. In some embodiments, the blades are co-axially disposed and comprise altemate 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 <NUM> includes a surface <NUM> and a surface <NUM>. Surface <NUM> defines an opening <NUM> that is communication with passageway <NUM>. Blade assembly <NUM> is configured to have fluid flow through passageway <NUM> and opening <NUM> and into auger <NUM>, as described herein.

Auger <NUM> extends between an end <NUM> and an end <NUM> along axis X1 when disposed in channel <NUM>. Auger <NUM> is configured for disposal with cavity <NUM>. Auger <NUM> is fixed with end <NUM> of tube <NUM>. That is, auger <NUM> is coupled to tube <NUM> such that auger <NUM> is prevented from rotating and/or translating relative to tube <NUM>. In some embodiments, end <NUM> includes an engagement portion <NUM> configured for engagement with tube <NUM> to fix auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> may include a square, triangular, polygonal, star, torx, or hexalobe cross sectional configuration configured engage a correspondingly shaped portion of tube <NUM>, such as, for example, a surface <NUM> of tube. For example, in some embodiments, surface <NUM> defines an aperture <NUM> having a cross section that corresponds to the cross sectional configuration of portion <NUM> to resist and/or prevent rotation of auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> is positioned within aperture <NUM> such that an outer surface of portion <NUM> directly engages surface <NUM> to resist and/or prevent rotation of auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> extends through aperture <NUM> such that a section of portion <NUM> is positioned outside of tube <NUM>, as shown in <FIG>, for example.

Auger <NUM> includes a surface <NUM> that defines helical surface <NUM>. Helical surface <NUM> is disposed in an altemate orientation relative to helical blades <NUM>. Helical surface <NUM> includes a rotational pitch R2 that is alternative to rotational pitch R1 to create a dynamic fluid transfer and/or shear force or pressure to transfer and/or convey tissue from a surgical in direction D1. Helical blades <NUM> and helical surface <NUM> form a transfer channel <NUM> therebetween configured to direct cut tissue along axis X1 in direction D1. The dynamic fluid transfer and/or shear force created by rotation of cutter <NUM> relative to auger <NUM> and between helical blades <NUM> and helical surface <NUM> direct fluid flow and scraped or cut tissue within transfer channel <NUM>. In some embodiments, surface <NUM> and/or surface <NUM> may comprise altemate configurations, such as, for example, grooved, channeled, undulating, even, uniform, non-uniform, offset, staggered, textured and/or tapered to facilitate directional flow of fluid. In one embodiment, auger <NUM> includes fiber-optic light cable (not shown) disposed and/or helically wound through a surface of auger <NUM>. The light-cable illuminates a surgical site. In some embodiments, an illumination device may be mounted with various components of surgical instrument <NUM>. In one embodiment, a miniature camera (not shown) can be mounted with various components of surgical instrument <NUM> to facilitate imaging of the surgical site.

In some embodiments, auger <NUM> is cannulated and defines a passageway <NUM> configured for transfer of fluid in a direction, such as, for example, a direction D2 shown in <FIG>. Passageway <NUM> is in communication with passageway <NUM> via opening <NUM>, as described herein. Auger <NUM> defines at least one opening <NUM> configured to direct fluid flow out of passageway <NUM> into transfer channel <NUM>. The force of fluid flow travelling through passageway <NUM> causes the fluid flow to exit passageway <NUM> through opening <NUM>. Fluid is expelled from passageway <NUM> and is utilized to facilitate transfer of tissue along transfer channel <NUM> in direction D1. Movement of fluid through opening <NUM> creates a hydraulic bearing surface at ends <NUM>, <NUM> between cutter <NUM> and auger <NUM> to facilitate rotation of cutter <NUM> and prevent wear, overheating and/or damage during operation of the components of surgical instrument <NUM>. In some embodiments, auger <NUM> is cannulated, but not fenestrated. In some embodiments, auger <NUM> has a solid configuration and is not cannulated or fenestrated.

In assembly, operation and use, as shown in <FIG> and <FIG>, surgical system <NUM> 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 <NUM> including surgical instrument <NUM> are employed to augment a surgical treatment. Surgical instrument <NUM> can be delivered to a surgical site as a pre-assembled device or can be assembled in situ. Surgical system <NUM> may be may be completely or partially revised, removed or replaced.

Surgical system <NUM> 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 V1, V2, and diseased and/or damaged intervertebral discs and tissue are removed to create a vertebral space S.

Surgical instrument <NUM> is delivered to the surgical site including vertebrae V and inserted with space S. Handle <NUM> is manipulated to position end <NUM> of tube <NUM> with space S such that teeth <NUM> engage vertebral tissue, including but not limited to intervertebral tissue, endplate tissue and bone. For example, in one embodiment, handle <NUM> is manipulated to position end <NUM> of tube <NUM> within a disc annulus DA of vertebrae V within space S such that teeth <NUM> engage tissue of disc annulus DA, as shown in <FIG>. Tube <NUM> is pulled in direction D1 using handle <NUM> such that teeth <NUM> to disrupt, scrape and/or remove tissue from the surgical site. The tissue moves into cavity <NUM>, as discussed herein. In some embodiments, cavity <NUM> is angled toward opening <NUM> such that tissue that was scraped and/or removed by teeth <NUM> moves through opening <NUM> and into channel <NUM>. Motor <NUM> is actuated to cause rotation of cutter <NUM> relative to auger <NUM>.

Irrigation tube <NUM> is connected with port <NUM> and a source of fluid is connected to irrigation tube <NUM> to establish fluid flow in directions D1, D2, as described herein. Cutter <NUM> rotates relative to auger <NUM> such that blades <NUM> rotate to disrupt, scrape, cut, shear and/or macerate tissue that was scraped and/or removed by teeth <NUM> into a smaller particle size for removal the surgical site.

Blades <NUM> rotate such that tissue disposed adjacent and/or between cutter <NUM> and auger <NUM> is transferred and/or conveyed in direction D1 due to fluid transfer forces created between the helical configurations of cutter <NUM> and auger <NUM> and/or fluid exiting from opening <NUM>. The dynamic fluid transfer and/or shear force created by rotation of cutter <NUM> relative to auger <NUM> and between helical blades <NUM> and helical surface <NUM> direct fluid and scraped tissue within transfer channel <NUM>, to channel <NUM> as described herein.

Suction tube <NUM> is coupled to port <NUM> and a vacuum source such that the cut tissue and/or fluid is transferred and/or conveyed along channel <NUM> in the direction shown by arrow D1 for removal from the surgical site. The force of fluid and/or suction created by suction tube <NUM> directs the cut tissue and/or fluid through transfer channel <NUM> to channel <NUM>. Fluid and/or tissue is/are pulled into suction tube <NUM> to remove the fluid and tissue from the surgical site.

The surgical system <NUM> can include one or more further surgical instruments for use with the inventive surgical instrument <NUM>, 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.

The surgical system <NUM> can include an agent, which may be disposed, packed, coated or layered within, on or about the components and/or surfaces of surgical system <NUM>. 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 <NUM> with vertebrae V. 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 <NUM> are removed and the incision is closed. The components of surgical system <NUM> can be made of radiolucent materials such as polymers. Radiomarkers may be included for identification under x-ray, fluoroscopy, CT or other imaging techniques. 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 <NUM>. Surgical system <NUM> 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 <FIG>, the inventive surgical instrument <NUM> is part of a system <NUM>, similar to the systems and methods described herein, and hence the system <NUM> includes the inventive surgical instrument <NUM> having a scraper tube <NUM>, similar to scraper tube <NUM> described herein. Tube <NUM> is coupled to handle <NUM> in the same or a similar manner that tube <NUM> is connected with handle <NUM>. Tube <NUM> includes an inner surface <NUM> that defines a cavity, such as, for example, a channel <NUM>. Channel <NUM> is configured for disposal of blade assembly <NUM>. That is, tube <NUM>, cutter <NUM> and auger <NUM> are each positioned in channel <NUM>, as shown in <FIG>. In some embodiments, channel <NUM> 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.

An end <NUM> of tube <NUM> extends transverse to a longitudinal axis X2 of tube <NUM> and includes a wall <NUM> and a wall <NUM>. Wall <NUM> includes a cutting surface, such as, for example, a blade <NUM> configured to disrupt, scrape, cut and/or remove tissue from a surgical site. End <NUM> is angled such that blade <NUM> is positioned above a shaft <NUM> of tube <NUM>. That is, end <NUM> has a maximum height that is greater than a maximum height of shaft <NUM> such that blade <NUM> is positioned above a shaft <NUM> of tube <NUM>. Walls <NUM>, <NUM> define an aperture <NUM> configured to move tissue that is disrupted, scraped, cut and/or removed by blade <NUM> into channel <NUM>.

In all embodiments, auger <NUM> includes a threaded outer surface <NUM> that directly engages a threaded inner surface <NUM> of cutter <NUM> such that rotation of cutter <NUM> relative to auger <NUM> in a first rotational direction, such as, for example, clockwise causes cutter <NUM> to translate relative to auger <NUM> in direction D1 and rotation of cutter <NUM> relative to auger in an opposite second rotational direction, such as, for example, counterclockwise causes cutter <NUM> to translate relative to auger <NUM> in direction D2. In some embodiments, translation of cutter <NUM> relative to auger <NUM> in direction D1 facilitates movement of tissue and/or fluid from transfer channel <NUM> to channel <NUM> or <NUM>. That is, translating cutter <NUM> relative to auger <NUM> in direction D1 will move tissue in transfer channel <NUM> in direction D1 such that the material moves from transfer channel <NUM> to channel <NUM> or <NUM>.

In operation and use, surgical instrument <NUM> is delivered to the surgical site including vertebrae V and inserted with space S. Handle <NUM> is manipulated to position end <NUM> of tube <NUM> with space S such that blade <NUM> engages vertebral tissue, including but not limited to intervertebral tissue, endplate tissue and bone. For example, in one embodiment, handle <NUM> is manipulated to position <NUM> of tube <NUM> within disc annulus DA of vertebrae V within space S, as shown in <FIG>. Tube <NUM> is pushed in direction D3 using handle <NUM> such that blade <NUM> disrupts, scrapes and/or removes tissue from the surgical site. The tissue moves through aperture <NUM> and into transfer channel <NUM>.

Irrigation tube <NUM> is connected with port <NUM> and a source of fluid is connected to the irrigation tube <NUM> to establish fluid flow in directions D1, D2, as described herein. Cutter <NUM> rotates relative to auger <NUM> such that blades <NUM> rotate to disrupt, scrape, cut, shear and/or macerate tissue that was scraped and/or removed by blade <NUM> into a smaller particle size for removal the surgical site.

Blades <NUM> rotate such that tissue disposed adjacent and/or between cutter <NUM> and auger <NUM> is transferred and/or conveyed in direction D1 due to fluid transfer forces created between the helical configurations of cutter <NUM> and auger <NUM> and/or fluid exiting from opening <NUM>. The dynamic fluid transfer and/or shear force created by rotation and/or translation of cutter <NUM> relative to auger <NUM> and between helical blades <NUM> and helical surface <NUM> direct fluid and scraped tissue within transfer channel <NUM> into channel <NUM>, as described herein.

Suction tube <NUM> is coupled to port <NUM> and a vacuum source. Tissue and/or fluid is transferred and/or conveyed along channel <NUM> in the direction shown by arrow D1 for removal from the surgical site. The force of fluid and/or suction created by suction tube <NUM> directs scraped tissue through transfer channel <NUM> to channel <NUM>. Fluid mixed with tissue is pulled into suction tube <NUM> to remove the fluid and tissue from the surgical site.

In one embodiment, shown in <FIG>, surgical instrument <NUM> is similar to the embodiment of surgical instrument <NUM> shown in <FIG>, except that tube <NUM> has a blade assembly <NUM> positioned in channel <NUM> in place of blade assembly <NUM>. Blade assembly <NUM> is configured for disposal in channel <NUM> such that blade assembly <NUM> is visible through an opening <NUM> of tube <NUM>. Blade assembly <NUM> includes a shaft <NUM> that is configured to be coupled to motor <NUM> to rotate shaft <NUM> relative to tube <NUM> about axis X2. In some embodiments, shaft <NUM> is removably coupled to motor <NUM> such that shaft <NUM> can be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. In some embodiments, shaft <NUM> is permanently fixed with motor <NUM> such that shaft <NUM> cannot be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with an output shaft of motor <NUM>. Shaft <NUM> extends along axis X2 when disposed in channel <NUM>. Blade assembly <NUM> includes a member, such as, for example, a rotatable cutter <NUM> that is coupled to shaft <NUM> and a member, such as, for example, a stationary auger <NUM>. In some embodiments, auger <NUM> is integrally and/or monolithically formed with tube <NUM> such that auger <NUM> is permanently affixed to tube <NUM>.

Cutter <NUM> is fixed relative to shaft <NUM> such that rotation of shaft <NUM> relative to tube <NUM> about axis X2 also rotates cutter <NUM> relative to tube <NUM> about axis X2. In some embodiments, shaft <NUM> is removably coupled to cutter <NUM> such that shaft <NUM> can be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. In some embodiments, shaft <NUM> is permanently fixed with cutter <NUM> such that shaft <NUM> cannot be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with cutter <NUM>. Shaft <NUM> includes an inner surface <NUM> defining a passageway <NUM>, as best shown in <FIG>. In some embodiments, cutter <NUM> can be variously connected with shaft <NUM>, such as, for example, monolithic, integral connection, frictional engagement, threaded engagement, mutual grooves, screws, adhesive, nails, barbs and/or raised element. Cutter <NUM> extends along axis X2 when disposed in channel <NUM>. Cutter <NUM> is tubular in configuration. In some embodiments, cutter <NUM> 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 <NUM> includes a surface <NUM> defining a cutting flute <NUM> that forms a single helical blade <NUM> extending along a length of cutter <NUM>. Helical blade <NUM> is disposed at a rotational pitch R3. In some embodiments, surface <NUM> includes a scaffold and/or network of blades. In some embodiments, blade <NUM> may be disposed at altemate 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. Blade <NUM> is configured for rotation within channel <NUM> and about auger <NUM> to disrupt, scrape, cut, shear and/or macerate tissue and/or transfer and/or convey tissue along auger <NUM>, as described herein. In some embodiments, cutter <NUM> includes a section, such as, for example, a solid ring section <NUM>, shown in <FIG>, for example. In some embodiments, cutter <NUM> is configured to force tissue under cutter <NUM> and through flutes of auger <NUM> defined by a helical surface <NUM> of auger <NUM>. This controls the tissue entering a discharge side of cutter <NUM> into a suction and/or vacuum pathway, as discussed herein.

Cutter <NUM> includes an inner surface <NUM> that defines an interior cavity <NUM>. Cavity <NUM> is in communication with passageway <NUM>. In some embodiments, cavity <NUM> is coaxial with passageway <NUM>. Cavity <NUM> is configured for disposal of auger <NUM> within channel <NUM>, as described herein. Cutter <NUM> is configured for rotation relative to tube <NUM> and auger <NUM> to transfer tissue along a first direction, such as, for example, a direction D1 (<FIG>) along axis X2, as described herein. In some embodiments, blade <NUM> rotates relative to tube <NUM> and auger <NUM> within channel <NUM> to move tissue in aperture <NUM> that was disrupted, scraped, cut, sheared and/or macerated by blade <NUM> into a smaller particle size for removal from a surgical site. In some embodiments, blade <NUM> rotates such that tissue disposed adjacent and/or between cutter <NUM> and auger <NUM> is transferred and/or conveyed in direction D1 due to fluid transfer forces created between the helical configurations of cutter <NUM> and auger <NUM>. The tissue is transferred and/or conveyed for removal from a surgical site, as described herein. In some embodiments, auger <NUM> comprises two or more counter rotating intemal blades. In some embodiments, the blades are co-axially disposed and comprise altemate 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, shaft <NUM> includes a plurality of spaced apart openings <NUM> that each extend through a thickness of wall <NUM>. Openings <NUM> are defined by spaced apart ribs <NUM>. Openings <NUM> are disposed circumferentially about shaft <NUM> to define a grinder <NUM> configured to grind scraped tissue that was cut by cutter <NUM> and/or auger <NUM>. Grinder <NUM> can include one or a plurality of openings <NUM>. Grinder <NUM> is integrally and/or monolithically formed with shaft <NUM> and cutter <NUM>. As such, upon rotation of shaft <NUM> relative to tube <NUM> and auger <NUM>, blade <NUM> cuts tissue and causes tissue within cavity <NUM> to move in the direction shown by arrow D1 such that the tissue within cavity <NUM> moves into grinder <NUM>, where it is ground into smaller pieces. In some embodiments, edges of ribs <NUM> that define openings <NUM> are sharpened to form blades to facilitate the grinding of tissue when shaft <NUM> is rotated relative to tube <NUM> and auger <NUM>. In some embodiments, openings <NUM> are uniformly spaced apart from one another. For example, in one embodiment, shaft <NUM> includes three openings <NUM> that are each spaced apart <NUM> degrees from an adjacent opening <NUM>. In some embodiments, openings <NUM> are variously shaped, such as, for example, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered.

Auger <NUM> extends between an end <NUM> and an end <NUM> along axis X2 when disposed in channel <NUM>. Auger <NUM> is configured for disposal with cavity <NUM>. Auger <NUM> is fixed with end <NUM> of tube <NUM>. That is, auger <NUM> is coupled to tube <NUM> such that auger <NUM> is prevented from rotating and/or translating relative to tube <NUM>. In some embodiments, end <NUM> includes an engagement portion <NUM> configured for engagement with tube <NUM> to fix auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> may include a square, triangular, polygonal, star, torx, or hexalobe cross sectional configuration configured engage a correspondingly shaped portion of tube <NUM>, such as, for example, a surface <NUM> of tube <NUM>. For example, in some embodiments, surface <NUM> defines an aperture <NUM> having a cross section that corresponds to the cross sectional configuration of portion <NUM> to resist and/or prevent rotation of auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> is positioned within aperture <NUM> such that an outer surface of portion <NUM> directly engages surface <NUM> to resist and/or prevent rotation of auger <NUM> relative to tube <NUM>.

Auger <NUM> includes a surface <NUM> that defines helical surface <NUM>. Helical surface <NUM> is disposed in an altemate orientation relative to helical blade <NUM>. Helical surface <NUM> includes a rotational pitch R4 that is alternative to rotational pitch R3 to create a dynamic fluid transfer and/or shear force or pressure to transfer and/or convey tissue from a surgical in direction D1. Helical blade <NUM> and helical surface <NUM> form a transfer channel <NUM> therebetween configured to direct cut tissue along axis X2 in direction D1. The dynamic fluid transfer and/or shear force created by rotation of cutter <NUM> relative to auger <NUM> and between helical blade <NUM> and helical surface <NUM> direct fluid flow and scraped or cut tissue within transfer channel <NUM>. In some embodiments, surface <NUM> and/or surface <NUM> 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. In one embodiment, auger <NUM> includes fiber-optic light cable (not shown) disposed and/or helically wound through a surface of auger <NUM>. The light-cable illuminates a surgical site. In some embodiments, an illumination device may be mounted with various components of surgical instrument <NUM>. In one embodiment, a miniature camera (not shown) can be mounted with various components of surgical instrument <NUM> to facilitate imaging of the surgical site.

In some embodiments, auger <NUM> has a solid configuration and is free of any cannulas or passageways that are coaxial with a body of auger <NUM>. That is, auger <NUM> is not cannulated or fenestrated. End <NUM> includes a helical irrigation flute <NUM> configured to move irrigation fluid within passageway <NUM> to move in the direction shown by arrow D2 (<FIG>) such that the irrigation fluid exits passageway <NUM>. Suction within channel <NUM> then causes the irrigation fluid and/or any scraped or cut tissue within passageway <NUM> to move in the direction shown by arrow D1 for disposal thereof.

Irrigation tube <NUM> is connected with port <NUM> and a source of fluid is connected to the irrigation tube <NUM> to establish fluid flow in directions D1, D2, as described herein. Cutter <NUM> rotates relative to auger <NUM> such that blade <NUM> rotates to disrupt, scrape, cut, shear and/or macerate tissue that was scraped and/or removed by blade <NUM> into a smaller particle size for removal the surgical site.

Blade <NUM> rotates such that tissue disposed adjacent and/or between cutter <NUM> and auger <NUM> is transferred and/or conveyed in direction D1 due to fluid transfer forces created between the helical configurations of cutter <NUM> and auger <NUM>. The dynamic fluid transfer and/or shear force created by rotation and/or translation of cutter <NUM> relative to auger <NUM> and between helical blade <NUM> and helical surface <NUM> direct fluid and scraped tissue into channel <NUM>, as described herein.

Suction tube <NUM> is coupled to port <NUM> and a vacuum source. Tissue and/or fluid is transferred and/or conveyed along channel <NUM> in the direction shown by arrow D1 for removal from the surgical site. The force of fluid and/or suction created by suction tube <NUM> directs scraped tissue to channel <NUM>. Fluid mixed with tissue is pulled into suction tube <NUM> to remove the fluid and tissue from the surgical site.

In one embodiment, shown in <FIG>, surgical instrument <NUM> is similar to the embodiment of surgical instrument <NUM> shown in <FIG>, except that blade assembly <NUM> includes an auger <NUM> in place of auger <NUM>. Auger <NUM> extends between an end <NUM> and an end <NUM> along axis X2 when disposed in channel <NUM>. Auger <NUM> is configured for disposal with cavity <NUM>. Auger <NUM> is fixed with end <NUM> of tube <NUM>. That is, auger <NUM> is coupled to tube <NUM> such that auger <NUM> is prevented from rotating and/or translating relative to tube <NUM>. In some embodiments, end <NUM> includes an engagement portion <NUM> configured for engagement with tube <NUM> to fix auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> may include a square, triangular, polygonal, star, torx, or hexalobe cross sectional configuration configured engage a correspondingly shaped portion of tube <NUM>, such as, for example, surface <NUM> of tube <NUM>. For example, in some embodiments, aperture <NUM> has a cross section that corresponds to the cross sectional configuration of portion <NUM> to resist and/or prevent rotation of auger <NUM> relative to tube <NUM>. In some embodiments, portion <NUM> is positioned within aperture <NUM> such that an outer surface of portion <NUM> directly engages surface <NUM> to resist and/or prevent rotation of auger <NUM> relative to tube <NUM>.

Auger <NUM> includes a surface <NUM> that defines helical surface <NUM>. Helical surface <NUM> is disposed in an altemate orientation relative to helical blade <NUM>. Helical surface <NUM> includes a rotational pitch R5 that is alternative to rotational pitch R3 to create a dynamic fluid transfer and/or shear force or pressure to transfer and/or convey tissue from a surgical in direction D1. Helical blade <NUM> and helical surface <NUM> form a transfer channel <NUM> therebetween configured to direct cut tissue along axis X2 in direction D1. The dynamic fluid transfer and/or shear force created by rotation of cutter <NUM> relative to auger <NUM> and between helical blade <NUM> and helical surface <NUM> direct fluid flow and scraped or cut tissue within transfer channel <NUM>. In some embodiments, surface <NUM> and/or surface <NUM> 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. In one embodiment, auger <NUM> includes fiber-optic light cable (not shown) disposed and/or helically wound through a surface of auger <NUM>. The light-cable illuminates a surgical site. In some embodiments, an illumination device may be mounted with various components of surgical instrument <NUM>. In one embodiment, a miniature camera (not shown) can be mounted with various components of surgical instrument <NUM> to facilitate imaging of the surgical site.

In some embodiments, auger <NUM> has a solid configuration and is free of any cannulas or passageways that are coaxial with a body of auger <NUM>. That is, auger <NUM> is not cannulated or fenestrated. End <NUM> includes one or a plurality of straight irrigation flutes <NUM> configured to move irrigation fluid within passageway <NUM> to move in the direction shown by arrow D2 (<FIG>) such that the irrigation fluid exits passageway <NUM>. Suction within channel <NUM> then causes the irrigation fluid and/or any scraped or cut tissue within passageway <NUM> to move in the direction shown by arrow D1 for disposal thereof. In some embodiments, flutes <NUM> are disposed evenly around the diameter of end <NUM>. For example, in one embodiment, auger <NUM> includes three flutes <NUM> disposed circumferentially about end <NUM> such that flues <NUM> are each spaced apart <NUM> degrees from an adjacent one of flutes <NUM>. In some embodiments, flutes <NUM> are concave grooves. In some embodiments, flutes <NUM> may be variously configured and dimensioned, such as, for example, planar, concave, polygonal, irregular, uniform, non-uniform, staggered, tapered, consistent or variable, depending on the requirements of a particular application.

In one embodiment, shown in <FIG>, surgical instrument <NUM> is similar to the embodiment of surgical instrument <NUM> shown in <FIG>, except that blade assembly <NUM> includes a shaft <NUM> in place of shaft <NUM>, a cutter <NUM> in place of cutter <NUM>, and a grinder <NUM> in place of grinder <NUM>. Cutter <NUM> is coupled to shaft <NUM>. Shaft <NUM> is configured to be coupled to motor <NUM> to rotate shaft <NUM> relative to tube <NUM> about axis X2. In some embodiments, shaft <NUM> is removably coupled to motor <NUM> such that shaft <NUM> can be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. In some embodiments, shaft <NUM> is permanently fixed with motor <NUM> such that shaft <NUM> cannot be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with an output shaft of motor <NUM>. Shaft <NUM> extends along axis X2 when disposed in channel <NUM>. Cutter <NUM> is fixed relative to shaft <NUM> such that rotation of shaft <NUM> relative to tube <NUM> about axis X2 also rotates cutter <NUM> relative to tube <NUM> about axis X2. In some embodiments, shaft <NUM> is removably coupled to cutter <NUM> such that shaft <NUM> can be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. In some embodiments, shaft <NUM> is permanently fixed with cutter <NUM> such that shaft <NUM> cannot be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with cutter <NUM>. Shaft <NUM> includes an inner surface defining a passageway. In some embodiments, cutter <NUM> can be variously connected with shaft <NUM>, such as, for example, monolithic, integral connection, frictional engagement, threaded engagement, mutual grooves, screws, adhesive, nails, barbs and/or raised element. Cutter <NUM> extends along axis X2 when disposed in channel <NUM>. Cutter <NUM> is tubular in configuration. In some embodiments, cutter <NUM> 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 <NUM> includes a cutting flute <NUM> and a cutting flute <NUM> that forms a double helical blade <NUM> extending along a length of cutter <NUM>. In some embodiments, flute <NUM> is joined with flute <NUM> at a circular ring <NUM> at a first end of cutter <NUM> and flute <NUM> is joined with flute <NUM> at a circular ring <NUM> at a second end of cutter <NUM>. In some embodiments, blade <NUM> may be disposed at altemate 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. Blade <NUM> is configured for rotation within channel <NUM> and about auger <NUM> to disrupt, scrape, cut, shear and/or macerate tissue and/or transfer and/or convey tissue along auger <NUM>, as described herein. In some embodiments, cutter <NUM> is configured to force tissue under cutter <NUM> and through flutes of auger <NUM> defined by helical surface <NUM> of auger <NUM>. This controls the tissue entering a discharge side of cutter <NUM> into a suction and/or vacuum pathway, as discussed herein.

Cutter <NUM> includes an inner surface <NUM> that defines an interior cavity <NUM>. Cavity <NUM> is in communication with the passageway of shaft <NUM>. In some embodiments, cavity <NUM> is coaxial with the passageway of shaft <NUM>. Cavity <NUM> is configured for disposal of auger <NUM> within channel <NUM>, as described herein. Cutter <NUM> is configured for rotation relative to tube <NUM> and auger <NUM> to transfer tissue along a first direction, such as, for example, a direction D1 along axis X2, as described herein. In some embodiments, blade <NUM> rotates relative to tube <NUM> and auger <NUM> within channel <NUM> to move tissue in aperture <NUM> that was disrupted, scraped, cut, sheared and/or macerated by blade <NUM> into a smaller particle size for removal from a surgical site. In some embodiments, blade <NUM> rotates such that tissue disposed adjacent and/or between cutter <NUM> and auger <NUM> is transferred and/or conveyed in direction D1 due to fluid transfer forces created between the helical configurations of cutter <NUM> and auger <NUM>. The tissue is transferred and/or conveyed for removal from a surgical site, as described herein.

In some embodiments, shaft <NUM> includes a plurality of spaced apart openings <NUM> that each extend through a thickness of shaft <NUM>. Openings <NUM> are defined by spaced apart ribs <NUM>. Openings <NUM> are disposed circumferentially about shaft <NUM> to define grinder <NUM>. Grinder <NUM> is configured to grind scraped tissue that was cut by cutter <NUM> and/or auger <NUM>. Grinder <NUM> can include one or a plurality of openings <NUM>. Grinder <NUM> is integrally and/or monolithically formed with shaft <NUM> and cutter <NUM>. As such, upon rotation of shaft <NUM> relative to tube <NUM> and auger <NUM>, blade <NUM> cuts tissue and causes tissue within cavity <NUM> to move in the direction shown by arrow D1 such that the tissue within cavity <NUM> moves into grinder <NUM>, where it is ground into smaller pieces. In some embodiments, edges of ribs <NUM> that define openings <NUM> are sharpened to form blades to facilitate the grinding of tissue when shaft <NUM> is rotated relative to tube <NUM> and auger <NUM>. In some embodiments, ribs <NUM> each extend parallel to one another such that ribs <NUM> each extend parallel to axis X2 when cutter <NUM> is positioned within channel <NUM>. In some embodiments, openings <NUM> are uniformly spaced apart from one another. For example, in one embodiment, shaft <NUM> includes three openings <NUM> that are each spaced apart <NUM> degrees from an adjacent opening <NUM>. In some embodiments, openings <NUM> are variously shaped, such as, for example, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered.

In one embodiment, shown in <FIG>, surgical instrument <NUM> is similar to the embodiment of surgical instrument <NUM> shown in <FIG>, except that blade assembly <NUM> includes a shaft <NUM> in place of shaft <NUM>, a cutter <NUM> in place of cutter <NUM>, and a grinder <NUM> in place of grinder <NUM>. Cutter <NUM> is coupled to shaft <NUM>. Shaft <NUM> is configured to be coupled to motor <NUM> to rotate shaft <NUM> relative to tube <NUM> about axis X2. In some embodiments, shaft <NUM> is removably coupled to motor <NUM> such that shaft <NUM> can be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. In some embodiments, shaft <NUM> is permanently fixed with motor <NUM> such that shaft <NUM> cannot be removed from motor <NUM> without breaking shaft <NUM> and/or motor <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with an output shaft of motor <NUM>. Shaft <NUM> extends along axis X2 when disposed in channel <NUM>. Cutter <NUM> is fixed relative to shaft <NUM> such that rotation of shaft <NUM> relative to tube <NUM> about axis X2 also rotates cutter <NUM> relative to tube <NUM> about axis X2. In some embodiments, shaft <NUM> is removably coupled to cutter <NUM> such that shaft <NUM> can be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. In some embodiments, shaft <NUM> is permanently fixed with cutter <NUM> such that shaft <NUM> cannot be removed from cutter <NUM> without breaking shaft <NUM> and/or cutter <NUM>. For example, in some embodiments, shaft <NUM> is integrally and/or monolithically formed with cutter <NUM>. Shaft <NUM> includes an inner surface <NUM> defining a passageway. In some embodiments, cutter <NUM> can be variously connected with shaft <NUM>, such as, for example, monolithic, integral connection, frictional engagement, threaded engagement, mutual grooves, screws, adhesive, nails, barbs and/or raised element. Cutter <NUM> extends along axis X2 when disposed in channel <NUM>. Cutter <NUM> is tubular in configuration. In some embodiments, cutter <NUM> 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 <NUM> includes a cutting flute <NUM> and a cutting flute <NUM> that forms a double helical blade <NUM> extending along a length of cutter <NUM>. In some embodiments, cutting flute <NUM> is joined with cutting flute <NUM> at a circular ring <NUM> at a first end of cutter <NUM> and cutting flute <NUM> is joined with cutting flute <NUM> at a circular ring <NUM> at a second end of cutter <NUM>. In some embodiments, blade <NUM> 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. Blade <NUM> is configured for rotation within channel <NUM> and about auger <NUM> to disrupt, scrape, cut, shear and/or macerate tissue and/or transfer and/or convey tissue along auger <NUM>, as described herein. In some embodiments, cutter <NUM> is configured to force tissue under cutter <NUM> and through flutes of auger <NUM> defined by helical surface <NUM> of auger <NUM>. This controls the tissue entering a discharge side of cutter <NUM> into a suction and/or vacuum pathway, as discussed herein.

In some embodiments, shaft <NUM> is connected to ring <NUM> by a plurality of spaced apart fingers <NUM>. Fingers <NUM> define openings <NUM> therebetween. Openings <NUM> define grinder <NUM>. Grinder <NUM> is configured to grind scraped tissue that was cut by cutter <NUM> and/or auger <NUM>. Grinder <NUM> can include one or a plurality of openings <NUM>. Grinder <NUM> is integrally and/or monolithically formed with shaft <NUM> and cutter <NUM>. As such, upon rotation of shaft <NUM> relative to tube <NUM> and auger <NUM>, blade <NUM> cuts tissue and causes tissue within cavity <NUM> to move in the direction shown by arrow D1 such that the tissue within cavity <NUM> moves into grinder <NUM>, where it is ground into smaller pieces. In some embodiments, fingers <NUM> each extend parallel to one another such that fingers <NUM> each extend parallel to axis X2 when cutter <NUM> is positioned within channel <NUM>. In some embodiments, edges of fingers <NUM> that define openings <NUM> are sharpened to form blades to facilitate the grinding of tissue when shaft <NUM> is rotated relative to tube <NUM> and auger <NUM>. In some embodiments, openings <NUM> are uniformly spaced apart from one another. For example, in one embodiment, grinder <NUM> includes three openings <NUM> that are each spaced apart <NUM> degrees from an adjacent opening <NUM>. In some embodiments, openings <NUM> are variously shaped, such as, for example, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered.

In some embodiments, shaft <NUM> is connected to ring <NUM> by a flute <NUM> and a flute <NUM>. Flutes <NUM>, <NUM> define one or a plurality of openings <NUM>. Openings <NUM> define grinder <NUM>. Grinder <NUM> is configured to grind scraped tissue that was cut by cutter <NUM> and/or auger <NUM>. Grinder <NUM> can include one or a plurality of openings <NUM>. Grinder <NUM> is integrally and/or monolithically formed with shaft <NUM> and cutter <NUM>. As such, upon rotation of shaft <NUM> relative to tube <NUM> and auger <NUM>, blade <NUM> cuts tissue and causes tissue within cavity <NUM> to move in the direction shown by arrow D1 such that the tissue within cavity <NUM> moves into grinder <NUM>, where it is ground into smaller pieces. In some embodiments, edges of flutes <NUM>, <NUM> that define openings <NUM> are sharpened to form blades to facilitate the grinding of tissue when shaft <NUM> is rotated relative to tube <NUM> and auger <NUM>.

Claim 1:
A surgical instrument (<NUM>) comprising:
a first member (<NUM>) defining an axis (X2) and including a scraping surface configured to scrape tissue;
a second member (<NUM>) including a cutting surface (<NUM>) being rotatable relative to the first member (<NUM>), the second member (<NUM>) having a maximum length defined by opposite end surfaces of the second member (<NUM>), the end surfaces each being disposed within the first member (<NUM>); and
a third member (<NUM>) including an outer surface defining at least a portion of a passageway (<NUM>) configured for disposal of scraped tissue, the third member (<NUM>) being fixed with the first member (<NUM>),
wherein the cutting surface (<NUM>) is rotatable relative to the third member (<NUM>) to transfer scraped tissue along the axis (X2),
characterized in that
the third member (<NUM>) includes a threaded surface (<NUM>) that directly engages a threaded surface (<NUM>) of the second member (<NUM>) such that the second member (<NUM>) translates relative to the third member (<NUM>) along the axis (X2) as the second member (<NUM>) rotates relative to the first member (<NUM>).