Spinal access retractor

• US 10,278,686 B2
• Filed: 12/06/2016
• Issued: 05/07/2019
• Est. Priority Date: 09/20/2010
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Baudouin, Cyril, Fenn, Matthew, Hunziker, Markus, Saidha, Sean, White, Michael, Siddique, Khawar, Perri, Brian, Lindenmann, Philippe
• Primary Examiner(s): Philogene, Pedro
• Assistant Examiner(s): Comstock, David C
• Application Number:
  US15/370,201
• Publication Number:
  US 20170150956A1
• Time in Patent Office: 882 Days
• Field of Search: 600213, 600214, 600215, 600216, 600219, 600222, 600224
• 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 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00902 transparent or translucent
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0262 with a provision for protecting nerves

Abstract

A retractor includes a first arm, a second arm, and a translating member. The first arm comprises a proximal portion configured to retain a first retractor member and a distal portion configured to rotate relative to the proximal portion about a first axis. The second arm is configured to retain a second retractor member, such that rotation of the distal portion about the first axis causes the first retractor member to pivot toward or away from the second retractor member when the first retractor member and the second retractor member are coupled to the first arm and the second arm, respectively. The translating member is coupled between the proximal portion and the distal portion, and is configured to receive a drive force that causes the translating member to bias the distal portion to pivot relative to the proximal portion about the first axis.

Claims

1. A retractor configured to retract tissue, comprising:

a central member;

a first arm having a proximal portion and a distal portion spaced from the proximal portion, the distal portion of the first arm configured to carry a first retractor member;

a second arm having a proximal portion and a distal portion spaced from the proximal portion of the second arm, the distal portion of the second arm configured to carry a second retractor member, wherein the distal portions of the first and second arms are spaced from one another along a first direction, and each of the first and second arms is pivotably coupled to the central member;

a first retraction mechanism coupled to the central member and to the first and second arms, wherein the first retraction mechanism is configured to pivot the first and second arms in unison relative to the central member so as to increase a distance between the distal portions of the first and second arms in the first direction;

a second retraction mechanism coupled to the first arm, wherein the second retraction mechanism is configured to pivot the first arm relative to the central member independent of the second arm so as to increase the distance between the distal portions of the first and second arms in the first direction; and

a third retraction mechanism coupled to the second arm, wherein the third retraction mechanism is configured to pivot the second arm relative to the central member independent of the first arm so as to increase the distance between the distal portions of the first and second arms in the first direction.

2. The retractor of claim 1, wherein the first retraction mechanism includes:

a lead screw coupled to the central member, the lead screw defining a longitudinal axis that is perpendicular to the first direction; and

a follower carried by the lead screw and translatable along the lead screw in a second direction that is parallel with the longitudinal axis, wherein the follower is connected to the proximal portions of the first and second arms, such that translation of the follower along the lead screw in the second direction pivots the first and second arms in unison relative to the central member.

3. The retractor of claim 2, wherein the lead screw comprises a threaded portion, and the follower comprises a threaded bore configured to engage the threaded portion of the lead screw such that rotation of the lead screw about the longitudinal axis causes the follower to translate along the lead screw in the second direction.

4. The retractor of claim 2, further comprising:

a first connection bar coupling the proximal portion of the first arm to the follower; and

a second connection bar coupling the proximal portion of the second arm to the follower.

5. The retractor of claim 4, wherein the second retraction mechanism comprises:

the first connection bar, the first connection bar defining a longitudinal slot and an internal surface within the longitudinal slot, the internal surface defining a rack with teeth; and

a first pinion defining a first pinion central axis, the first pinion extending

     1) through an aperture defined in the proximal portion of the first arm and

     2) into the longitudinal slot, the first pinion having teeth configured to engage the teeth of the rack such that rotation of the first pinion about the first pinion central axis causes the first pinion to move along the rack so as to pivot the first arm relative to the central member independent of the second arm.

6. The retractor of claim 5, wherein the first connection bar defines a proximal end that is pivotably coupled to the follower via a first pin, the first pin defines a first pin central axis that is parallel with the first pinion central axis, and the first connection bar is configured to pivot relative to the follower about the first pin central axis.

7. The retractor of claim 5, wherein the third retraction mechanism comprises:

the second connection bar, the second connection bar defining a second longitudinal slot and a second internal surface within the second longitudinal slot, the second internal surface defining a second rack with teeth; and

a second pinion defining a second pinion central axis, the second pinion extending

     1) through an aperture defined in the proximal portion of the second arm and

     2) into the second longitudinal slot, the second pinion having teeth configured to engage the teeth of the second rack such that rotation of the second pinion about the second pinion central axis causes the second pinion to move along the second rack so as to pivot the second arm relative to the central member independent of the first arm.

8. The retractor of claim 7, wherein the second connection bar defines a proximal end that is pivotably coupled to the follower via a second pin, and the second pin defines a second pin central axis that is parallel with the second pinion central axis, and the second connection bar is configured to pivot relative to the follower about the second pin central axis.

9. The retractor of claim 2, further comprising a third arm coupled to the central member and configured to carry a third retractor member.

10. The retractor of claim 9, further comprising a fourth retraction mechanism coupled to the central member and to the third arm, wherein the fourth retraction mechanism is configured to retract the third arm relative to the central member independent of the first and second arms in a direction parallel with the longitudinal axis.

11. The retractor of claim 10, wherein the lead screw defines a central bore, the fourth retraction mechanism includes a bar elongate along the longitudinal axis and received within the central bore, and the bar defines a threaded portion configured to engage a threaded portion of the third arm such that rotation of the bar about the longitudinal axis relative to the central member causes the retraction of the third arm.

12. The retractor of claim 11, wherein the bar defines a proximal end and a distal end spaced from the proximal end along the longitudinal axis, and the proximal end of the bar defines a shaped connecting feature configured to engage a driving tool for causing the rotation of the bar about the longitudinal axis relative to the central member.

13. The retractor of claim 9, wherein the third arm comprises a proximal portion and a distal portion spaced from the proximal portion in the second direction, and the distal portion is pivotable relative to the proximal portion about a third arm pivot axis that is parallel with the first direction.

14. The retractor of claim 2, wherein, when the lead screw defines a proximal end and a distal end spaced from the proximal end along the longitudinal axis, the distal end of the lead screw is coupled to the central member, the proximal end of the lead screw is remote from the central member, and translation of the follower along the lead screw in the second direction away from the distal end of the lead screw and toward the proximal and of the lead screw causes the pivoting of the first and second arms in unison relative to the central member.

15. The retractor of claim 1, wherein the distal portions of the first and second arms are each rotatable relative to the respective proximal portions of the first and second arms independent of operation of the first, second, and third retraction mechanisms.

16. A retractor configured to retract tissue, comprising:

a first arm having a proximal portion and a distal portion spaced from the proximal portion, the distal portion of the first arm configured to carry a first retractor member;

a second arm having a proximal portion and a distal portion spaced from the proximal portion of the second arm, the distal portion of the second arm configured to carry a second retractor member, the distal portions of the first and second arms spaced from one another along a first direction;

a central arm having a proximal portion and a distal portion spaced from the proximal portion of the central arm along a second direction that is different than the first direction, the distal portion of the central arm configured to carry a third retractor member, the proximal portion of the first arm rotatably coupled to the central arm about a first axis of rotation that is perpendicular to the first and second directions, the proximal portion of the second arm rotatably coupled to the central arm about a second axis of rotation that is perpendicular to the first and second directions; and

a rotating gear member having a first set of gear teeth,

wherein at least one of the first and second arms carries a second set of gear teeth configured to engage the first set of gear teeth such that the proximal portion of the at least one of the first and second arms is configured to pivot about the associated one of the first and second axes of rotation responsive to rotation of the rotating gear member so as to cause a distance between the distal portions of the first and second arms to increase along the first direction.

17. The retractor of claim 16, wherein the first and second axes of rotation are collinear with one another, the rotating gear member is a pinion coupled to the one of the first and second arms, the second set of gear teeth are formed on a connection bar carried by the one of the first and second arms, and rotation of the pinion causes rotation of the one of the first and second arms relative to and independent of the other of the first and second arms.

18. The retractor of claim 17, further comprising:

a lead screw coupled to the central arm, the lead screw defining a longitudinal axis that is perpendicular to the first direction; and

a follower carried by the lead screw and translatable along the lead screw in the second direction, wherein the second direction is parallel with the longitudinal axis, the connection bar is coupled to the follower, and the follower is connected to the proximal portion of the other of the first and second arms, such that translation of the follower along the lead screw in the second direction pivots the first and second arms in unison relative to the central arm so as to increase the distance between the distal portions of the first and second arms in the first direction.

19. The retractor of claim 16, wherein the first and second axes are parallel with one another.

20. The retractor of claim 19, wherein the first arm defines a third set of gear teeth configured to engage a fourth set of gear teeth defined by the second arm such that rotation of the rotating gear member causes the first and second arms to move relative to the central arm so as to increase the distance between the distal portions of the first and second arms along the first direction.