Navigated access chisel

Abstract

A navigated access chisel may include a first geometry configured to locate the access chisel to a first portion of a navigation system instrument. The access chisel may include a second geometry' configured to locate the access chisel to a second portion of the navigation system instrument. The first geometry' may be a shaft geometry of the access chisel. The second geometry may be a hub geometry of the access chisel. The hub and shaft geometries may mimic the geometry of the navigation system instrument for engagement of the navigation system instrument to the access chisel. A system may include the access chisel, a guide tube, and a strike plate. The system may include the navigation system instrument, which may be a third-party tracker array'. Additional systems and associated methods are also provided.

Description

NAVIGATED ACCESS CHISELCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 638,745, filed April 25, 2024, which is incorporated by reference in its entirety for all purposes.TECHNICAL FIELD

[0002] This disclosure is directed to medical devices, systems and methods. More specifically, this disclosure is directed to devices, systems and methods related to a navigated access chisel.BACKGROUND

[0003] Some surgical devices provide a means to access the posterior facet j oint in either an open or minimally invasive procedure for posterior facet fusion. In a minimally invasive surgical technique, fluoroscopy can be used to provide X-ray guidance to navigate an instrument to the facet joint. In instances where poor anatomical anatomy or preexisting hardware (e.g., implants) obstructs anatomical features that are used as landmarks, it can become difficult to accurately access the facet joint.

[0004] In addition, there are many existing technologies that provide navigable instruments to access parts of the spinal anatomy, including the pedicle and disc space. However, there are no known navigable instrument designs that specifically access the facet joint.

[0005] Accordingly, a need exists for new systems and methods related to a navigated access chisel.SUMMARY

[0006] In accordance with embodiments of the present disclosure, an access chisel may include a first geometry configured to locate the access chisel to a first portion of a navigation system instrument. The access chisel may include a second geometry configured to locate the access chisel to a second portion of the navigation system instrument.

[0007] The first geometry may be configured to interface the access chisel to a bore of the navigation system instrument. The bore may be defined at least partially by a rim ofthe navigation system instrument, and wherein the second geometry is configured to interface the access chisel to the rim. The access chisel may include a hub defining a hub geometry. The access chisel may include a shaft defining a shaft geometry. The hub geometry and the shaft geometry may mimic the geometry of the navigation system instrument for engagement of the navigation system instrument to the access chisel. In examples, a system may include the access chisel and the navigation system instrument.

[0008] In accordance with embodiments of the present disclosure, an access chisel for interfacing with a navigation system instrument may include a hub including a hub geometry. The access chisel may include a shaft including a shaft geometry' proximate the hub. The hub geometry and the shaft geometry may mimic a geometry of the navigation system instrument for engagement.

[0009] A system may include the access chisel and one or more accessory instruments configured for attachment to the access chisel. The one or more accessory instruments may include a guide tube. The system may include a clip releasably coupling the guide tube to the access chisel. The one or more accessory instruments may include a handle. The one or more accessory instruments may include a strike plate. The strike plate may be configured to attach to the guide tube and comprises a mallet surface. The navigation system instrument may be a third-party7tracker array.

[0010] In accordance with embodiments of the present disclosure, a system may include a navigation system instrument, and an access chisel configured to interface with the navigation system instrument at a first geometry and a second geometry to locate the access chisel to the navigation system instrument.

[0011] The navigation system instrument may include an axis. The first geometry may align the access chisel to the axis. The first geometry may include a shaft geometry of the access chisel that mimics a bore geometry of the navigation system instrument. The access chisel may be positionable within the navigation system instrument to align the shaft geometry7with the bore geometry. The second geometry may include a hub geometry7of the access chisel that mimics a rim geometry of the navigation system instrument. An engagement of the hub geometry with the rim geometry may limit a rotation of the access chisel relative to the navigation system instrument about the axis. The system may include a guide tube configured to receive at least a portion of the access chisel. The system may include a clip releasably coupling the access chisel to the guide tube. The system may be configured for use in the lumbar spine.

[0012] In addition to the exemplar}' aspects and embodiments described above, further aspects and embodiments will become apparent by reference to the drawings and by study of the following descriptionBRIEF DESCRIPTION OF THE DRAWINGS

[0013] FIG. 1 illustrates a navigated access chisel system in accordance with embodiments of the present disclosure.

[0014] FIG. 2 illustrates an exploded view of a navigated access chisel system in accordance with embodiments of the present disclosure.

[0015] FIGS. 3-4 illustrate a navigated access chisel system including at least one accessory instrument in accordance with embodiments of the present disclosure.

[0016] FIG. 5 illustrates a use of a navigated access chisel system in accordance with embodiments of the present disclosure.

[0017] FIGS. 5A-5D illustrate example axial and lateral views of tracking a navigated access chisel system through tissue to an entrance of a facet joint in accordance with embodiments of the present disclosure.

[0018] FIG. 6 illustrates another use of a navigated access chisel system in accordance with embodiments of the present disclosure.

[0019] FIGS. 6A-6B illustrate example axial and lateral views of advancing a navigated access chisel system into a facet joint in accordance with embodiments of the present disclosure.

[0020] FIG. 7 illustrates another use of a navigated access chisel system in accordance with embodiments of the present disclosure.

[0021] FIG. 8 illustrates another use of a navigated access chisel system in accordance with embodiments of the present disclosure.

[0022] FIG. 9 illustrates a flow diagram of a process of using a navigated access chisel system in accordance with embodiments of the present disclosure.

[0023] FIGS. 10-11 illustrate first and second exploded views of another navigated access chisel system in accordance with embodiments of the present disclosure.

[0024] FIG. 12 illustrates the navigated access chisel system of FIG. 10 in a first configuration in accordance w ith embodiments of the present disclosure.

[0025] FIG. 13 illustrates the navigated access chisel system of FIG. 10 in a second configuration in accordance with embodiments of the present disclosure.DETAILED DESCRIPTION

[0026] The following description of certain embodiments is merely exemplary in nature and is in no way intended to limit the invention or its applications or uses. In the following detailed description of embodiments of the present systems and methods, reference is made to the accompanying drawings which form a part hereof, and which are shown by way of illustration specific embodiments in which the described systems and methods may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice presently disclosed systems and methods, and it is to be understood that other embodiments may be utilized and that structural and logical changes may be made without departing from the spirit and scope of the present system. Moreover, for the purpose of clarity, detailed descriptions of certain features will not be discussed when they would be apparent to those with skill in the art so as not to obscure the description of the present system. The following detailed description is therefore not to be taken in a limiting sense, and the scope of the present system is defined only by the appended claims.

[0027] The terms “distal” and “proximal” are used to refer to a position or direction relative to the treating clinician, such as a surgeon. “Distal” and “distally” refer to a position that is distant from, or in a direction away from, the treating clinician. “Proximal” and “proximally” refer to a position that is near, or in a direction toward, the treating clinician. The terms “posterior” and “anterior” refer to the back and front, respectively, of the body of a subject.

[0028] As used herein, “decortication” refers to the process by which an outer surface of a bone is roughened or removed and the underlying cancellous bone exposed. Relative to the outer bone surface, the cancellous bone more effectively retains deposited graft material, thereby promoting healing and bone growth after surgery.

[0029] The terms “device” and “instrument” may be used interchangeably herein. The terms “component,” “member” and “tool” may also be used interchangeably.

[0030] For the following defined terms, certain definitions shall be applied unless a different definition is given elsewhere in this disclosure. The terms “a.” “an.” and “the” are used to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” The term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B.” All numeric values are assumed to be modified by the term “about.” whether or not explicitly indicated. Theterm “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (e.g., having the same function or result). In many instances, the term “about” can include numbers that are rounded to the nearest significant figure. The recitation of numerical ranges by endpoints includes all numbers and subranges within and bounding that range (e.g., 1 to 4 includes 1, 1.5, 1.75, 2, 2.3, 2.6, 2.9, etc. and 1 to 1.5. 1 to 2, 1 to 3, 2 to 3.5, 2 to 4, 3 to 4. etc ).

[0031] Turning now to the figures, a minimally invasive means to access a facet joint through use of navigation technologies is provided. Navigation technologies provide a means to precisely track the location of surgical instruments throughout a procedure. For example, “live” views may show the position of the surgical instruments relative to anatomical landmarks, such as in axial, lateral, and A-P perspective. One or more surgical instruments may be compatible with the navigation technologies, such as facilitating tracker arrays, or other tracking devices, to be attached onto the surgical instrument(s) for navigation purposes. In addition, examples of the present disclosure may combine access to the facet joint and the ability for subsequent instruments to access the facet joint, such as into a one-step method or process. As described herein, the facet joint may be any facet joint in the spine, including the lumbar spine, the thoracic spine, and the cervical spine, without intent to limit.

[0032] FIG. 1 illustrates a navigated access chisel system 100 (hereinafter “system” for sake of convenience without intent to limit) in accordance with embodiments of the present disclosure. As described herein, the system 100 includes various features to track the location of one or more surgical instruments, such as using proprietary' or third-party7tracking systems (e.g., a navigation system instrument). The system 100 may interface (e.g., couple, attach, lock, etc.) with the navigation system instrument, such that the position, orientation, etc. of a surgical instrument may be determined (e.g., via a tracker array coupled to the surgical instrument). By interfacing the navigation system instrument with the surgical instrument, the surgical instrument may be navigated to a desired position, with such navigation allowing for “live” tracking of the surgical instrument (e.g., via fluoroscopy).

[0033] Referring to FIG. 1, the system 100 may include a navigation system instrument 104 and an access chisel 108, such as for interfacing with the navigation system instrument 104. The navigation system instrument 104 may facilitate a determination of its position. For example, the navigation system instrument 104 may be configured to determine, orprovide data for the determination of, its position in space (e.g., absolute position, relative position, in two-dimensional space, in three-dimensional space, etc.). In examples, the navigation system instrument 104 may include a tracker array 1 12 (e.g., an array of tracker elements). In examples, the navigation system instrument 104 may be a third-party tracker array, such as a tracker array 112 provided by a third-party supplier independent or separate from the access chisel 108. In some examples, the navigation system instrument 104 may include a sleeve 116. The tracker array 112 may be coupled to the sleeve 116. such as via a post 120, although other configurations are contemplated.

[0034] The access chisel 108 may be configured for insertion into or through tissue, such as towards a target site (e.g.. a target joint). For example, the access chisel 108 may be advanced through tissue to a target facet joint, such as for a facet fusion procedure of any portion of the spine (e.g., the lumbar spine, the cervical spine, etc.), although other configurations are contemplated. In such examples, the access chisel 108 may be inserted or wedged in a facet, such as to guide and anchor the system 100 at the target site. The access chisel 108 may include a first tip 124. The first tip 124 may include a roughened surface or formed features, such as to aid in anchoring or docking the access chisel 108 in the facet joint, for roughening or decorticating the facet joint, etc.

[0035] With continued reference to FIG. 1, the system 100 may include a guide tube 130. The guide tube 130 may be configured to receive at least a portion of the access chisel 108. For example, the guide tube 130 may include a hollow shaft 134 or pipe through which the access chisel 108 is inserted. Specifically, the hollow shaft 134 may be configured to allow for slidable insertion of the access chisel 108 therein. Like the access chisel 108, the guide tube 130 may include a second tip 138 (e.g., a pair of tips) with roughened surfaces or features, such as to aid in anchoring or docking the guide tube 130 (e.g., at the target site, facet joint, etc.).

[0036] FIG. 2 illustrates an exploded view of the system 100 in accordance with embodiments of the present disclosure. Referring to FIG. 2, the navigation system instrument 104 may include a bore 202. The bore 202 may be defined through the sleeve 116. In examples, the bore 202 may be defined at least partially by a nm 206 of the sleeve 116. For example, the rim 206 may define an opening to the bore 202. In some examples, a slot 210 may extend across the rim 206 (e.g., across the end face of the rim 206), such as across the bore 202 to opposing lateral sides of the sleeve 116.

[0037] The access chisel 108 may be an elongated instrument including a shaft 214 having a proximal end 218 and a distal end 222. The first tip 124 may be defined on the distal end 222. The proximal end 218 may be shaped for engagement, such as including a shaped end 226 and a groove 230. The shaped end 226 may have one or more faces or surfaces, such as opposing parallel surfaces, for engagement. For example, the proximal end 218 may be shaped to engage a handle 234. In such examples, the handle 234 may engage both the shaped end 226 and the groove 230 to secure the handle 234 to the access chisel 108. For instance, the handle 234 may include internal dimensions complementary to the shaped end 226 and a detent that selectively engages the groove 230. In examples, the detent may be selectively moved into and out of position with the groove 230 via a secondary handle 238.

[0038] The access chisel 108 may be configured to interface with the navigation system instrument 104. Along these lines, the access chisel 108 may include a first geometry configured to locate the access chisel 108 to a first portion of the navigation system instrument 104. For instance, the first geometry may be configured to interface the access chisel 108 to the bore 202. As one example, the shaft 214 may define a shaft geometry, such that the shaft geometry mimics the geometry of the bore 202 (e.g., a bore geometry with a diameter, shape, and / or other configuration similar to the shaft geometry ). In such examples, the navigation system instrument 104 may include an axis 242, such as defined by the bore 202. The first geometry may align the access chisel 108 to the axis 242. For instance, the access chisel 108 may be positionable within the navigation system instrument 104 (e.g., within the bore 202) to align the shaft geometry7with the bore geometry7.

[0039] In examples, the access chisel 108 may include a second geometry configured to locate the access chisel 108 to a second portion of the navigation system instrument 104. For instance, the second geometry may be configured to interface the access chisel 108 to the rim 206. Along these lines, the access chisel 108 may include a hub 246, such as along the shaft 214 between the proximal end 218 and the distal end 222. The hub 246 may include or define a hub geometry. The shaft geometry may be proximate the hub 246. The hub geometry may mimic the geometry of the rim 206 for engagement (e.g., a rim geometry with a shape or configuration complementary to the hub geometry ).

[0040] For instance, the hub 246 may include a flange 250 and one or more tabs 254 extending from the flange 250. The flange 250 may extend radially from the shaft 214.The one or more tabs 254 may extend from the flange 250 along an axial length of the shaft 214, such as from the flange 250 towards the proximal end 218. In such examples, the flange 250 and tab(s) 254 may engage the navigation system instrument 104 (e.g., sleeve 116), such as the flange 250 engaging the end face of the rim 206, and the tab(s) 254 received in the slot 210. As a result, engagement of the hub geometry with the rim geometry may limit a rotation of the access chisel 108 relative to the navigation system instrument 104 about the axis 242. For instance, engagement of the hub geometry with the rim geometry may limit rotation of the access chisel 108 within the bore 202. As a result, the access chisel 108 may be configured to interface with the navigation system instrument 104 at the first geometry and the second geometry to locate the access chisel 108 to the navigation system instrument 104.

[0041] FIGS. 3-4 illustrate at least one accessory instrument in accordance with embodiments of the present disclosure. Referring to FIGS. 1-4, the system 100 may include one or more accessory instruments 300 for attachment to the access chisel 108. The one or more accessory instruments 300 may facilitate use (e.g., surgical use) of the access chisel 108 and / or system 100 in general. In examples, the one or more accessory instruments 300 may include the guide tube 130. In such examples, the system 100 (e.g., the access chisel 108) may include a clip 304, such as coupled to the hub 246 (e.g., the flange 250). The clip 304 may releasably couple the guide tube 130 to the access chisel 108. For instance, the clip 304 may releasably engage a complementary structure of the guide tube 130 (e.g. a ledge, groove, etc., such as of a handle 306 of the guide tube 130) to hold the guide tube 130 to the access chisel 108.

[0042] In examples, the one or more accessory instruments 300 may include the handle 234. As noted above, the handle 234 may releasably engage the proximal end 218 of the access chisel 108, such as for selective manipulation of the access chisel 108 via the handle 234.

[0043] Referring to FIGS. 3-4, the one or more accessory instruments 300 may include a strike plate 308. The strike plate 308 may attach to the guide tube 130 to provide a mallet surface 312. For example, a user may mallet the strike plate 308 (e.g., mallet surface 312) to advance the guide tube 130 down the access chisel 108. The strike plate 308 may extend laterally away from the access chisel 108, such as to a distance sufficient to provide clear access to the mallet surface 312. In some examples, striking (e.g., malleting) the strike plate 308 may release the engagement of the clip 304 with the guide tube 130. For instance,the clip 304 may automatically release the guide tube 130 when a sufficient force is applied to the strike plate 308.

[0044] FIG. 5 illustrates a use of the system 100 in accordance with embodiments of the present disclosure. Although the lumbar spine is shown in FIG. 5, the system 100 may be used with other portions of the spine, such as the cervical spine, etc. The system 100 maybe advanced through tissue to a target site, such as to the entrance of a facet joint 502 in some examples. Through use of at least the navigation system instrument 104, the advancement of the system 100 may be tracked (e.g., the system 100 may be navigated to the facet joint 502). Along these lines, FIGS. 5A-5D illustrate example axial and lateral views of tracking the system 100 through tissue to the facet joint 502 in accordance with embodiments of the present disclosure. For instance, the patient may be scanned to provide a virtual reconstruction of the spine. In such examples, the scanned images may be used to track or otherwise determine the position of the system 100. In examples, the position of the system 100 may be tracked using axial and lateral views. In some examples, the position of the system 100 may be tracked under fluoroscopy (e.g., in real time or ‘dive,’" or in near real time). In these and other examples, tracking the position of the system 100 may ensure proper positioning of the system 100 to the facet joint 502.

[0045] FIG. 6 illustrates another use of the system 100 in accordance with embodiments of the present disclosure. After initial insertion of the system 100 at the surgical site, the system 100 may be advanced into the facet joint 502. with the advancement into the facet joint 502 tracked via at least the navigation system instrument 104. Along these lines, FIGS. 6A-6B illustrate example axial and lateral views of tracking the advancement of the system 100 into the facet joint 502 in accordance with embodiments of the present disclosure. For instance, using scanned images (e.g., axial and lateral views of pre-scanned image, under fluoroscopy, etc.), the position of the system 100 into the facet joint 502 may be tracked (e.g., in real time or ’‘live,” or in near real time), such as to ensure proper positioning of the system 100 into the facet joint 502. In examples, the access chisel 108 (e.g., the first tip 124) may be advanced into the facet joint 502. such as to anchor the system 100 at the target site.

[0046] FIG. 7 illustrates another use of the system 100 in accordance with embodiments of the present disclosure. In examples, the guide tube 130 (e.g., the second tip 138) may be advanced into the facet joint 502. such as to anchor the guide tube 130 at the target site. The guide tube 130 may be advanced into the facet joint 502 by malleting the strike plate308. For instance, a user may mallet or otherwise strike the strike plate 308 to advance the guide tube 130 down the access chisel 108 and the second tip 138 into the facet joint 502. Although not illustrated, advancement of the guide tube 130 into the facet joint 502 may be performed under fluoroscopy (e.g., using live axial and lateral view s).

[0047] FIG. 8 illustrates another use of the sy stem 100 in accordance with embodiments of the present disclosure. In examples, the access chisel 108 may be removed from the guide tube 130, leaving the guide tube 130 anchored in the facet joint 502. For instance, once the guide tube 130 is sufficiently anchored, the access chisel 108 (e g., with the navigation system instrument 104 and other accessory instruments 300) may be removed from the surgical site, leaving access to the facet joint 502 via the guide tube 130 (e.g., via the hollow shaft 134). In such examples, the guide tube 130 may receive other surgical instruments through the hollow shaft 134 (e.g., decortication instruments, fusion instruments, implants, etc.), such as for a posterior facet fusion procedure via the guide tube 130 (e.g., through insertion of other surgical instruments through the guide tube 130).

[0048] FIG. 9 illustrates a flow diagram of a method 900 of using a navigated access chisel system (e.g., the system 100 described above, the system 1000 described below) in accordance with embodiments of the present disclosure. For explanatory purposes, the method 900 is described herein with reference to FIGS. 1-8 and 10-13, although the method 900 is not limited to the embodiments illustrated therein. Note that one or more operations in FIG. 9 may be combined, omitted, and / or performed in a different order, as desired.

[0049] At block 904, the method 900 includes receiving a virtual reconstruction of a patient’s spine. In examples, block 904 may include scanning the patient to provide the virtual reconstruction of the spine. The scanning may be performed by a third-party navigation system.

[0050] At block 908, the method 900 includes attaching a navigation system instrument to an access chisel of the navigated access chisel system. For example, a tracking array may be attached to the shaft of the access chisel, such as in a manner as described herein. In examples, the tracking array may be a third-party tracking array.

[0051] At block 912, the method 900 includes attaching one or more accessory instruments to the access chisel. For example, at least one of a handle, a guide tube, or a strike plate may be attached to the access chisel, such as in a manner as described herein.

[0052] At block 916, the method 900 includes associating an instrument to the access chisel. For example, block 916 may include selecting a third-party instrument in a navigation software database that is similar in geometry to the access chisel.

[0053] At block 920, the method 900 includes registering the access chisel to the navigation system instrument. For instance, the access chisel may be registered to the reference array (e.g., third-party referent array) that has been anchored to the patient’s anatomy (e.g.. a spinous process, etc.).

[0054] At block 924, the method 900 includes navigating the access chisel to a target site. For instance, the access chisel may be navigated to a desired facet joint, such as in a manner as described herein. As noted above, navigation may allow for “live” tracking of the instrument relative to the patient’s anatomy (e.g., in the axial, lateral, and A-P view).

[0055] At block 928, the method 900 includes navigating and advancing the access chisel into the facet joint, such as in a manner as described herein.

[0056] At block 932, the method 900 includes advancing and attaching the guide tube into the facet joint, such as in a manner as described herein. For instance, the guide tube may be advanced and attached into the facet joint by malleting or otherwise striking the strike plate.

[0057] At block 936, the method 900 includes removing the access chisel and undesired accessories from the guide tube. For example, the access chisel and strike plate may be removed from the guide tube.

[0058] At block 940, the method 900 includes proceeding with a posterior facet fusion procedure. For example, with the access chisel and strike plate removed from the guide tube, the guide tube may be used for facet fusion of the facet joint. In examples, the access chisel may be reinserted into the guide tube, such as to confirm instrument position through the facet fusion procedure.

[0059] FIGS. 10-13 illustrate a navigated access chisel system 1000 (hereinafter “system” for sake of convenience without intent to limit) in accordance with embodiments of the present disclosure. Except as noted below, the system 1000 may be similar to system 100. described above, with description of like features omitted for convenience (e.g., like features of the system 1000 including reference numbers incremented by 1000 compared to the system 100). For example, the system 1000 may include various features to track the location of one or more surgical instruments, such as using proprietary' or third-party tracking systems (e.g., a navigation system instrument), with the system 1000 interfacing(e.g., couple, atach, lock, etc.) with the navigation system instrument, such that the position, orientation, etc. of a surgical instrument may be determined (e.g., via a tracker array coupled to the surgical instrument). By interfacing the navigation system instrument with the surgical instrument, the surgical instrument may be navigated to a desired position, with such navigation allowing for ‘‘live’' tracking of the surgical instrument (e.g., via fluoroscopy).

[0060] Referring to FIGS. 10-11, the system 1000 may include a navigation system instrument 1004 and an access chisel 1008 that interfaces with the navigation system instrument 1004. In some examples, the system 1000 may include a guide tube 1030. Like the navigation system instrument 104, the navigation system instrument 1004 may be configured to determine, or provide data for the determination of, its position in space, with the navigation system instrument 1004 including a tracker array 1012 (e.g., a third- party’ tracker array) connected to or integrated with a sleeve 1016. A bore 2002 may be defined through the sleeve 1016, and a slot 2010 may be defined at a terminal end of the sleeve 1016. for example, in an end face of a rim. The navigation system instrument 1004 may include a handle 2034 for manipulation of the navigation system instrument 1004 and / or the system 1000 in general. In some examples, the navigation system instrument 1004 may include a buton 1006. The buton 1006 may be positioned on a side of the sleeve 1016. For example, the button 1006 may be positioned on a side opposite the slot 2010, on a side opposite the tracker array 1012, or any combinations thereof. The buton 1006 may be configured to selectively engage or release the access chisel 1008. For example, the button 1006 may operate a linkage, tab, or detent that selectively engages the access chisel 1008 to couple the navigation system instrument 1004 to the access chisel 1008, as described more fully below.

[0061] The access chisel 1008 may be similar to the access chisel 108, described above. For example, the access chisel 1008 may be configured for advancement through tissue, such as to a target facet joint. The access chisel 1008 may include a first tip 1024 for anchoring or docking the access chisel 1008 in a facet j oint, for roughening or decorticating the facet joint, or the like. In some examples, the access chisel 1008 includes a flange 2050 and one or more tabs 2054 (e.g., a hub 2046). The tab 2054 may engage the navigation system instrument 1004, such as the tab 2054 received in the slot 2010 defined in the sleeve 1016 when at least a portion of the access chisel 1008 (e.g., a proximal end 2018 of a shaft 2014) is inserted within the bore 2002. As a result, the access chisel 1008may be configured to interface with the navigation system instrument 1004 at a first geometry and a second geometry to locate the access chisel 1008 to the navigation system instrument 1004, such as in a manner similar to that described above.

[0062] In some examples, the proximal end 2018 may be configured to engage the navigation system instrument 2004. For example, the proximal end 2018 may include a cutout or relief cut 2020. The cutout or relief cut 2020 may be defined proximate to the tab 2054. The cutout or relief cut 2020 may engage the button 1006 to couple the access chisel 1008 to the navigation system instrument 2004. For example, the button 1006 (or elements operatively connected to the button 1006) may seat within the cutout or relief cut 2020 to secure the access chisel 1008 to the navigation system instrument 2004. To release the navigation system instrument 2004 from the access chisel 1008. or vice-versa, the button 1006 may be depressed to clear the button 1006 or elements operatively connected to the button 1006 from the cutout or relief cut 2020.

[0063] In some examples, the access chisel 1008 may include a clip 3004. The clip 3004 may releasably engage a complementary structure of the guide tube 1030. For example, the clip 3004 may releasably engage the handle 1040, a ledge, groove, or other structure of the guide tube 1030 to hold the guide tube 1030 to the access chisel 1008, such as in a manner similar to that described above.

[0064] The guide tube 1030 may be configured to receive at least a portion of the access chisel 1008. For example, the guide tube 1030 may include a hollow shaft 1034 or pipe through which the access chisel 1 08 is inserted. Specifically, the hollow shaft 1034 may be configured to allow for slidable insertion of the access chisel 1008 therein. The guide tube 1030 may include a second tip 1038 (e.g., a pair of tips) with roughened surfaces or features, such as to aid in anchoring or docking the guide tube 1030 (e.g.. at the target site, facet joint, etc.). In some examples, the guide tube 1030 includes a handle 1040 at its proximal end.

[0065] In some examples, the system 1000 includes a strike plate 3008. Like the strike plate 308, the strike plate 3008 may provide a mallet surface 3012 allowing a user to mallet the strike plate 3008 to advance the guide tube 1030 or system 1000 into a target facet joint, to advance the guide tube 1030 down the access chisel 1008, etc. The strike plate 3008 may be selectively coupled to the guide tube 1030, such as via a set screw, corresponding engagement features, etc. In one example, the strike plate 3008 may be coupled to the handle 1040.

[0066] FIG. 12 illustrates the system 1000 in a first configuration. The first configuration may be defined by the access chisel 1008 coupled to the navigation system instrument 1004. For example, the proximal end 2018 of the shaft 2014 may be inserted into the bore 2002 of the sleeve 1016 with the geometry of the hub 2046 engaging the geometry' of the sleeve 1016. Stated differently, the sleeve 1016 may be slid over the proximal end 2018 of the shaft 2014 until the tab 2054 is received in the slot 2010. When inserted, the proximal end 2018 of the shaft 2014 may engage the button 1006 to selectively secure the access chisel 1008 to the navigation system instrument 1004, for example, via the cutout or relief cut 2020.

[0067] In some examples, the first configuration may be defined by the guide tube 1030 secured to the access chisel 1008. For example, the access chisel 1008 may be at least partially inserted into the guide tube 1030. In one example, the shaft 2014 of the access chisel 1008 may be inserted through the hollow shaft 1034 of the guide tube 1030. The first configuration may be defined by the clip 3004 engaging the guide tube 1030 (e.g., the handle 1040) to hold the guide tube 1030 to the access chisel 1008. In this manner, the guide tube 1030 may be retained by the access chisel 1008 via the clip 3004. In such configurations, the system 1000, when fully connected, may be navigated to the facet j oint. For example, the access chisel 1008 may be docked into the facet joint, such as in a manner as described above.

[0068] FIG. 13 illustrates the system 1000 in a second configuration. The second configuration may be defined by the guide tube 1030 released from the access chisel 1008. For example, the access chisel 1008 may be removed, at least partially, from the guide tube 1030. More particularly, once the access chisel 1008 docks into the facet joint, the user may mallet the strike plate 3008 to release the guide tube 1030 from the clip 3004 and advance the guide tube 1030 into the facet joint. The access chisel 1008 with the navigation system instrument 1004 may be removed from the guide tube 1030. In such configurations, the guide tube 1030 may be left behind, providing a portal for subsequent instruments to access the facet joint, such as in a manner as described above. In one configuration, the navigation system instrument 1004 may be removed from the access chisel 1008. For example, depressing the button 1006 may disengage the access chisel 1008, allowing the navigation system instrument 1004 to be pulled or slid off the proximal end 2018 of the shaft 2014.

[0069] Of course, it is to be appreciated that any one of the examples, embodiments or processes described herein may be combined with one or more other examples, embodiments and / or processes or be separated and / or performed amongst separate devices or device portions in accordance with the present systems, devices and methods.

[0070] Finally, the above-discussion is intended to be merely illustrative of the present system and should not be construed as limiting the appended claims to any particular embodiment or group of embodiments. Thus, while the present system has been described in particular detail with reference to exemplary embodiments, it should also be appreciated that numerous modifications and alternative embodiments may be devised by those having ordinary skill in the art without departing from the broader and intended spirit and scope of the present system as set forth in the claims that follow. Accordingly, the specification and drawings are to be regarded in an illustrative manner and are not intended to limit the scope of the appended claims.

Claims

CLAIMSWhat is claimed is:

1. An access chisel comprising: a first geometry configured to locate the access chisel to a first portion of a navigation system instrument: and a second geometry configured to locate the access chisel to a second portion of the navigation system instrument.

2. The access chisel of claim 1, wherein the first geometry is configured to interface the access chisel to a bore of the navigation system instrument.

3. The access chisel of claim 2, wherein the bore is defined at least partially by a rim of the navigation system instrument, and wherein the second geometry is configured to interface the access chisel to the rim.

4. The access chisel of claim 3, wherein: the access chisel comprises a hub defining a hub geometry; the access chisel comprises a shaft defining a shaft geometry; and the hub geometry and the shaft geometry mimic the geometry of the navigation system instrument for engagement of the navigation system instrument to the access chisel.

5. A system comprising: the access chisel of any of claims 1-5; and the navigation system instrument.

6. An access chisel for interfacing with a navigation system instrument, the access chisel comprising: a hub comprising a hub geometry; and a shaft comprising a shaft geometry' proximate the hub, wherein the hub geometry and the shaft geometry mimic a geometry of the navigation system instrument for engagement.

7. A system comprising: the access chisel of claim 6; and one or more accessory instruments configured for attachment to the access chisel.

8. The system of claim 7, wherein the one or more accessory instruments comprise a guide tube.

9. The system of claim 8, further comprising a clip releasably coupling the guide tube to the access chisel.

10. The system of any of claims 7-9, wherein the one or more accessory instruments comprise a handle.

11. The system of any of claims 7-10. wherein the one or more accessory instruments comprise a strike plate.

12. The system of claim 11 , wherein the strike plate is configured to attach to the guide tube and comprises a mallet surface.

13. The access chisel of claim 6, wherein the navigation system instrument comprises a third-party7tracker array.

14. A system comprising: a navigation system instrument; and an access chisel configured to interface with the navigation system instrument at a first geometry and a second geometry to locate the access chisel to the navigation system instrument.

15. The system of claim 14, wherein the navigation system instrument comprises an axis, and wherein the first geometry7aligns the access chisel to the axis.

16. The system of claim 15, wherein the first geometry comprises a shaft geometry' of the access chisel that mimics a bore geometry of the navigation system instrument, the access chisel positionable within the navigation system instrument to align the shaft geometry with the bore geometry.

17. The system of claim 15 or 16, wherein the second geometry comprises a hub geometry of the access chisel that mimics a rim geometry of the navigation system instrument.

18. The system of claim 17, wherein an engagement of the hub geometry with the rim geometry limits a rotation of the access chisel relative to the navigation system instrument about the axis.

19. The system of any of claims 14-18, further comprising a guide tube configured to receive at least a portion of the access chisel.

20. The system of claim 19, further comprising a clip releasably coupling the access chisel to the guide tube.

21. The system of any of claims 14-20, wherein the system is configured for use in the lumbar spine.

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