Patent ID: 7476240

Claim:
A method for introducing a spinal fixation element into a patient's spinal column, comprising: providing a first percutaneous access devices, the first percutaneous access device having a proximal end positioned outside a patient's body, a distal end adapted to couple to a spinal anchor, a lumen extending between the proximal and distal ends of the first percutaneous access device and defining a longitudinal axis, and first and second opposed sidewall openings extending from the distal end through at least a portion of the first percutaneous access device, the first and second opposed sidewall openings communicating with the lumen; providing a second percutaneous access devices, the second percutaneous access device having a proximal end positioned outside a patient's body, a distal end adapted to couple to a spinal anchor, a lumen extending between the proximal and distal ends of the second percutaneous access device and defining a longitudinal axis, and at least one sidewall opening extending from the distal end through at least a portion of the second percutaneous access device and communicating with the lumen; engaging a spinal fixation element to a shaft of a manipulator instrument; wherein the first percutaneous access device has a sleeve disposed therearound and effective to prevent removal of the first percutaneous device from the spinal anchor coupled thereto, the sleeve including at least one sidewall opening formed therein that is adapted to align with the first sidewall opening in the first percutaneous access device; positioning the shaft of the manipulator instrument through the first and second sidewall opening of the first percutaneous access device, through the at least one sidewall opening of the sleeve, and through the at least one sidewall opening of the second percutaneous access device with the spinal fixation element extends in an orientation substantially parallel to the longitudinal axis of each percutaneous access device; and rotating the manipulator instrument to change the orientation of the spinal fixation element to a substantially transverse orientation to seat the spinal fixation element in the two spinal anchors, the spinal fixation element rotating through the first sidewall opening of the first percutaneous access device into the lumen of the first percutaneous access device during rotation of the manipulator instrument.