Surgical access system and related methods

• US 10,251,633 B2
• Filed: 06/05/2014
• Issued: 04/09/2019
• Est. Priority Date: 06/26/2002
• Status: Active Grant

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Nuvasive Incorporated
• Inventors: Miles, Patrick, Martinelli, Scot, Finley, Eric, Gharib, James E., Farquhar, Allen, Kaula, Norbert F., Blewett, Jeffrey J.
• Primary Examiner(s): Woodall, Nicholas W
• Application Number:
  US14/297,369
• Publication Number:
  US 20140288374A1
• Time in Patent Office: 1,769 Days
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0262 with a provision for protecting nerves
• CPC Class Codes: A61B 5/296 for electromyography [EMG]
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence

Abstract

A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Claims

1. A pair of retractor blades for maintaining an operative corridor along a lateral, trans-psoas path to a lumbar spine, comprising:

a first retractor blade configured to be delivered toward a spinal disc along a lateral, trans-psoas path to the lumbar spine, the first retractor blade comprising;

at least one mounting arm configured to receive and lock with a blade holder apparatus, a distal blade portion extending perpendicular to the at least one mounting arm of the first retractor blade and including an interior face and an exterior face, an intermediate portion connecting between the distal blade portion and the at least one mounting arm of the first retractor blade, and one or more stimulation electrodes disposed along the exterior face of the distal blade portion and oriented oppositely away from the exterior face of the distal blade portion; and

a second retractor blade configured to be delivered toward the spinal disc along the lateral, trans-psoas path to the lumbar spine and positioned oppositely from the first retractor blade, the second retractor blade comprising;

at least one mounting arm configured to receive and lock with the blade holder apparatus, a distal blade portion having the same shape and size as the distal blade portion of the first retractor blade, extending perpendicular to the at least one mounting arm of the second retractor blade, and including an interior face and an exterior face, and an intermediate portion connecting between the distal blade portion and the at least one mounting arm of the second retractor blade,

wherein the first and second retractor blades are configured to maintain the operative corridor along the lateral, trans-psoas path to the lumbar spine so that the operative corridor is dimensioned so as to pass an implant through the operative corridor along the lateral, trans-psoas path to the lumbar spine.

2. The pair of retractor blades of claim 1, wherein the distal blade portion of the first retractor blade defines a single tubular passageway fixedly positioned relative to the at least one mounting arm of the first retractor blade and configured to slidably receive a first spine penetration member.

3. The pair of retractor blades of claim 2, wherein the single tubular passageway includes an upwardly facing opening, and a downwardly facing opening configured to face toward the lumbar spine when the first and second retractor blades maintain the operative corridor along the lateral, trans-psoas path to the lumbar spine.

4. The pair of retractor blades of claim 1, wherein the distal blade portion of the second retractor blade defines a single tubular passageway fixedly positioned relative to the at least one mounting arm of the first retractor blade and configured to slidably receive a first spine penetration member.

5. The pair of retractor blades of claim 1, wherein the one or more stimulation electrodes of the first retractor blade are positioned proximate to a distal most end of the distal blade portion of the first retractor blade.

6. The pair of retractor blades of claim 5, wherein the second retractor blade further comprises one or more stimulation electrodes disposed along the exterior face of the distal blade portion of the second retractor blade and oriented oppositely away from the exterior face of the distal blade portion of the second retractor blade.

7. The pair of retractor blades of claim 6, wherein the one or more stimulation electrodes of the first retractor blade are positioned proximate to a distal most end of the distal blade portion of the first retractor blade.

8. The pair of retractor blades of claim 1, wherein the mounting arm of the first retractor blade and the mounting arm of the second retractor blade are configured to mate with the same blade holder apparatus.

9. The pair of retractor blades of claim 8, wherein the mounting arm of the first retractor blade and the mounting arm of the second retractor blade are configured to be locked in relation to the said blade holder apparatus so as to maintain the operative corridor along the lateral, trans-psoas path to the lumbar spine.

10. The pair of retractor blades of claim 8, wherein the first retractor blade and the second retractor blade are adjustable relative to one another so that the first retractor blade is configured to be spaced apart from the second retractor blade.

11. The pair of retractor blades of claim 1, wherein at least a portion of the exterior face of the distal blade portion of the first retractor blade and at least a portion of the exterior face of the distal blade portion of the second retractor blade have a cylindrical surface region.

12. The pair of retractor blades of claim 1, wherein said at least one mounting arm of the first retractor blade comprises first and second mounting arms.

13. The pair of retractor blades of claim 1, wherein said at least one mounting arm of the second retractor blade comprises first and second mounting arms.