SURGICAL ACCESS SYSTEM AND RELATED METHODS

• US 20120238822A1
• Filed: 06/01/2012
• Published: 09/20/2012
• Est. Priority Date: 10/08/2002
• Status: Active Grant

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Nuvasive Incorporated
• Inventors: Miles, Patrick, Martinelli, Scot, Finley, Eric, Gharib, James, Farquhar, Allen, Kaula, Norbert, Blewett, Jeffrey, Medeiros, Goretti
• Granted Patent: US 8,512,235 B2
• Time in Patent Office: Days
• US Class Current: 600/202
• 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 17/0218 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 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00261 Discectomy
• 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 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/395 Details of stimulation, e.g. nerve stimulation to elicit EMG response
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

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 system for accessing a spinal disc of a lumbar spine through an operative corridor, comprising:

an initial dilating cannula configured 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 exposed along a tapered outer surface that is angled relative to a longitudinal axis of said initial dilating cannula such that the stimulation electrode is configured to deliver electrical stimulation away from the distal tip region for nerve monitoring when the initial dilating cannula is positioned in the lateral, trans-psoas path,

a secondary distraction assembly comprising a plurality of dilators of sequentially larger diameter deliverable to the spinal disc along the lateral, trans-psoas path; and

a retraction assembly comprising a blade holder apparatus and a plurality of retractor blades releasably attachable to said blade holder apparatus, wherein said retraction assembly is configured to maintain 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 the retraction assembly further comprises a fixation element that is releasably attachable to a first retractor blade of the plurality of retractor blades such that a distal portion of said fixation element extends distally of a distal end of the said first retractor blade and is configured to penetrate into the lumbar spine for affixing the first retractor blade to the lumbar spine, said fixation element including a proximal portion having a width that is greater than a maximum width of said distal portion of said fixation element, wherein a second retractor blade of the plurality of retractor blades is movable away from the first retractor blade for establishing said operative corridor to the lumbar spine between said first and second retractor blades,

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.