Surgical Access System and Related Methods
First Claim
1. A method for accessing a spinal disc of a lumbar spine through an operative corridor, comprising:
- inserting an initial guidewire along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, the guidewire having a rigidity such that the guidewire is advanceable through the bodily tissue to the targeted intervertebral disc of the lumbar spine;
sequentially introducing a plurality of dilators of increasing diameters to create a tissue distraction corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the plurality of dilators comprising;
an initial dilator that slidably advances over an exterior of the guidewire and engages the lumbar spine, and at least a second dilator that slidably advances over an exterior of the initial dilator and engages the lumbar spine, wherein at least one dilator of the plurality of dilators includes markings indicative of a depth distance between a distal end of the at least one dilator and a skin location; and
selecting a set of retractor blades from a plurality of sets of retractors blades, each of the plurality of sets of retractor blades having a different retractor blade length;
advancing the selected set of retractor blades toward the lumbar spine to enlarge the tissue distraction corridor and thereby form an operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the selected set of retractor blades being releasably locked to a blade holder device using a locking assembly for each respective retractor blade of the selected set of retractor blades, wherein the operative corridor is so dimensioned as to receive an implant through the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine;
releasably engaging a first shim member with a passageway of a first retractor blade of the selected set of retractor blades so that a distal portion of the first shim member extends distally from the first retractor blade, wherein at least a portion of the passageway of the first retractor blade is defined along an inner face of the first retractor blade;
releasably engaging a second shim member with a passageway of a second retractor blade of the selected set of retractor blades so that a distal portion of the second shim member extends distally from the second retractor blade, wherein at least a portion of the passageway of the second retractor blade is defined along an inner face of the second retractor blade;
releasably engaging one or more strands of fiber optic cable with one or more retractor blades of the selected set of retractor blades such that light is emitted into the operative corridor; and
after the operative corridor is formed, passing the implant between the selected set of retractor blades through the operative corridor along the lateral, trans-psoas path to the lumbar spine.
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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.
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Citations
19 Claims
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1. A method for accessing a spinal disc of a lumbar spine through an operative corridor, comprising:
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inserting an initial guidewire along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, the guidewire having a rigidity such that the guidewire is advanceable through the bodily tissue to the targeted intervertebral disc of the lumbar spine; sequentially introducing a plurality of dilators of increasing diameters to create a tissue distraction corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the plurality of dilators comprising;
an initial dilator that slidably advances over an exterior of the guidewire and engages the lumbar spine, and at least a second dilator that slidably advances over an exterior of the initial dilator and engages the lumbar spine, wherein at least one dilator of the plurality of dilators includes markings indicative of a depth distance between a distal end of the at least one dilator and a skin location; andselecting a set of retractor blades from a plurality of sets of retractors blades, each of the plurality of sets of retractor blades having a different retractor blade length; advancing the selected set of retractor blades toward the lumbar spine to enlarge the tissue distraction corridor and thereby form an operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the selected set of retractor blades being releasably locked to a blade holder device using a locking assembly for each respective retractor blade of the selected set of retractor blades, wherein the operative corridor is so dimensioned as to receive an implant through the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine; releasably engaging a first shim member with a passageway of a first retractor blade of the selected set of retractor blades so that a distal portion of the first shim member extends distally from the first retractor blade, wherein at least a portion of the passageway of the first retractor blade is defined along an inner face of the first retractor blade; releasably engaging a second shim member with a passageway of a second retractor blade of the selected set of retractor blades so that a distal portion of the second shim member extends distally from the second retractor blade, wherein at least a portion of the passageway of the second retractor blade is defined along an inner face of the second retractor blade; releasably engaging one or more strands of fiber optic cable with one or more retractor blades of the selected set of retractor blades such that light is emitted into the operative corridor; and after the operative corridor is formed, passing the implant between the selected set of retractor blades through the operative corridor along the lateral, trans-psoas path to the lumbar spine. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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Specification