SURGICAL ACCESS SYSTEM AND RELATED METHODS
First Claim
1. A system for accessing a spinal disc of a lumbar spine through an operative corridor, comprising:
- an initial dilating cannula to create a tissue distraction corridor to a lumbar spine, wherein said initial dilating cannula is deliverable to a spinal disc along a lateral, trans-psoas path to the lumbar spine, the distal tip region of the initial dilating cannula including a stimulation electrode situated at an angle relative to a longitudinal axis of said initial dilating cannula such that the stimulation electrode delivers electrical stimulation away from the distal tip region in a directed fashion for nerve monitoring during advancement of the initial dilating cannula along the lateral, trans-psoas path to the lumbar spine,a secondary distraction assembly comprising a plurality of dilators of sequentially larger diameter deliverable to the spinal disc along the lateral, trans-psoas path to the lumbar spine; and
a refraction assembly comprising a mounting structure and four refractor blades releasably attached to said mounting structure, wherein said retraction assembly maintains an operative corridor along the lateral, trans-psoas path to the lumbar spine that is enlarged from the tissue distraction corridor along the lateral, trans-psoas path to the lumbar spine, wherein, when the four retractor blades are delivered to the lumbar spine, a first of the four retractor blades is a posterior-most retractor blade, a second of the four retractor blades is an anterior-most retractor blade, a third of the four retractor blades is a caudal-most retractor blade, and a fourth of the four retractor blades is a cephalad-most retractor blade, wherein the angular orientation of said posterior-most retractor blade and said anterior-most retractor blade is independently adjustable relative to said mounting structure,wherein 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.
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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.
190 Citations
19 Claims
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1. A system for accessing a spinal disc of a lumbar spine through an operative corridor, comprising:
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an initial dilating cannula to create a tissue distraction corridor to a lumbar spine, wherein said initial dilating cannula is deliverable to a spinal disc along a lateral, trans-psoas path to the lumbar spine, the distal tip region of the initial dilating cannula including a stimulation electrode situated at an angle relative to a longitudinal axis of said initial dilating cannula such that the stimulation electrode delivers electrical stimulation away from the distal tip region in a directed fashion for nerve monitoring during advancement of the initial dilating cannula along the lateral, trans-psoas path to the lumbar spine, a secondary distraction assembly comprising a plurality of dilators of sequentially larger diameter deliverable to the spinal disc along the lateral, trans-psoas path to the lumbar spine; and a refraction assembly comprising a mounting structure and four refractor blades releasably attached to said mounting structure, wherein said retraction assembly maintains an operative corridor along the lateral, trans-psoas path to the lumbar spine that is enlarged from the tissue distraction corridor along the lateral, trans-psoas path to the lumbar spine, wherein, when the four retractor blades are delivered to the lumbar spine, a first of the four retractor blades is a posterior-most retractor blade, a second of the four retractor blades is an anterior-most retractor blade, a third of the four retractor blades is a caudal-most retractor blade, and a fourth of the four retractor blades is a cephalad-most retractor blade, wherein the angular orientation of said posterior-most retractor blade and said anterior-most retractor blade is independently adjustable relative to said mounting structure, wherein 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. - 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