Surgical Access System and Related Methods
First Claim
1. A system for accessing a surgical target site, comprising:
- an initial distraction system for creating an initial distraction corridor, wherein said initial distraction assembly includes a K-wire and at least one dilator capable of being slidably passed over said K-wire to perform said initial distraction;
an assembly capable of being guided to said targeted surgical site along said at least one dilator of said initial distraction assembly and distracting from said initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from said secondary distraction corridor to thereby create an operative corridor to said surgical target site;
wherein at least one of said initial distraction system and one of said retractor blades includes at least one stimulation electrode; and
a control unit capable of electrically stimulating said at least one stimulation electrode, sensing a response of a nerve depolarized by said stimulation, determining at least one of nerve proximity and nerve direction from at least one of said initial distraction system and one of said retractor blades to the nerve based upon the sensed response, and communicating at least one of visual indicia and audio communications to a user representing at least one of said nerve proximity and said nerve direction.
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Accused Products
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.
187 Citations
18 Claims
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1. A system for accessing a surgical target site, comprising:
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an initial distraction system for creating an initial distraction corridor, wherein said initial distraction assembly includes a K-wire and at least one dilator capable of being slidably passed over said K-wire to perform said initial distraction; an assembly capable of being guided to said targeted surgical site along said at least one dilator of said initial distraction assembly and distracting from said initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from said secondary distraction corridor to thereby create an operative corridor to said surgical target site; wherein at least one of said initial distraction system and one of said retractor blades includes at least one stimulation electrode; and a control unit capable of electrically stimulating said at least one stimulation electrode, sensing a response of a nerve depolarized by said stimulation, determining at least one of nerve proximity and nerve direction from at least one of said initial distraction system and one of said retractor blades to the nerve based upon the sensed response, and communicating at least one of visual indicia and audio communications to a user representing at least one of said nerve proximity and said nerve direction. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system for accessing a surgical target site, comprising:
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a distraction assembly to create a tissue distraction corridor in a lateral, trans-psoas path to a targeted spinal site, wherein said distraction assembly includes an initial assembly including an elongate inner element and first and second dilators, the elongate inner element being positionable in a lumen of the first dilator and at least one of elongate inner element and the first dilator includes at least one stimulation electrode, and the second dilator being advanceable to over the first dilator to the targeted spinal site; a retraction assembly to retract tissue from said tissue distraction corridor to thereby form an operative corridor in the lateral, trans-psoas path to a targeted spinal site, the retraction assembly being guidable along at least one dilator of the distraction assembly to said targeted spinal site, wherein the retraction assembly includes a plurality of retractor blades for engaging the tissue to maintain the operative corridor in the lateral, trans-psoas path to a targeted spinal site; and a control unit to transmit an electrical stimulation signal to said at least one stimulation electrode and to receive an electromyographic (EMG) sensor signal of a neuromuscular response of a nerve depolarized by said stimulation signal, the control unit including a display device with a graphical user interface that displays information indicative of at least one of nerve proximity and nerve direction in response to the EMG sensor signal. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18)
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Specification