Surgical access system and related methods

• US 7,785,253 B1
• Filed: 01/31/2006
• Issued: 08/31/2010
• Est. Priority Date: 01/31/2005
• Status: Active Grant

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Nuvasive Incorporated
• Inventors: Martinelli, Scot, Finley, Eric, Arambula, Jared
• Primary Examiner(s): Rodriguez; Cris L
• Assistant Examiner(s): Mai; Hao D
• Application Number:
  US11/344,711
• Time in Patent Office: 1,673 Days
• Field of Search: 600/212, 600/213, 600/214, 600/219, 600/222, 600/223, 600/224, 600/227, 600231-237, 600/201
• US Class Current: 600/219
• 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

Abstract

A retractor-based access system for performing minimally invasive spine surgery via an anterior approach. The anterior access system and related methods of the present invention involve a plurality of retractor blades under the control of a single retractor handle apparatus.

Claims

1. A system for accessing a surgical target site, comprising:

a handle assembly including a first arm member hingedly coupled to a second arm member, said first arm member having a first recess formed within a distal end thereof, said second arm member having a second recess formed within a distal end thereof;

a first elongated extension member removably coupled to said first arm member, said first elongated extension member having a post extending from a proximal end of said first elongated extension member, said post being received within said first recess to removably couple said first elongated extension member and said first arm member;

a second elongated extension member removably coupled to said second arm member, said second elongated extension member having a post extending from a proximal end of said second elongated extension member, said post being received within said second recess to removably couple said second elongated extension member and said second arm member;

a plurality of blade holder assemblies slideably and rotatably coupled to said first and second elongated extension members, said first and second elongated extension members having a generally circular cross-section to enable the rotation of said blade holder assemblies; and

a plurality of blades, each of said blades configured to be coupled to one of said blade holder assemblies while in a closed position and thereafter selectively opened to create a customized operative corridor to said surgical target site.

2. The system of claim 1, wherein at least one of said first and second elongated extension members has a generally arcuate shape.

3. The system of claim 1, wherein each of said plurality of blade holder assemblies comprises:

a base member configured to slideably receive a portion of one of said first and second elongated extension members; and

an elongated member adjustably coupled to said base member and having an end portion dimensioned to engage at least one of said plurality of blades.

4. The system of claim 3, wherein said elongated member further includes at least one anti-migration feature.

5. The system of claim 4, wherein said anti-migration feature comprises a plurality of ridges.

6. The system of claim 1, wherein each of said plurality of blades includes a shaped distal end.

7. The system of claim 6, wherein said shaped distal end is generally pointed.

8. The system of claim 1, wherein at least one of said plurality of blades is adapted for providing light near said surgical target site.

9. The system of claim 8, wherein said at least one of said plurality of blades is coupled to at least one light source.

10. The system of claim 8, wherein said at least one of said plurality of blades is constructed from clear polycarbonate.

11. The system of claim 1, wherein at least one of said plurality of blades includes at least one stimulation electrode.

12. The system of claim 1, wherein said surgical target site comprises a spinal target site.

13. The system of claim 1, further comprising a first and second locking elements configured to lock said first and second elongated extension members to said first and second arm members.

14. The system of claim 13, wherein said first and second locking elements comprise first and second set screws, respectively.

15. The system of claim 14, wherein:

said first set screw is received within a first aperture formed near said distal end of said first arm member, said first aperture in communication with said first recess; and

said second set screw is received within a second aperture formed near said distal end of said second arm member, said second aperture in communication with said second recess.

16. A method of accessing a surgical target site, comprising the steps of:

(a) introducing a plurality of retractor blades into a surgical target site while in a closed position;

(b) coupling said plurality of retractor blades to a plurality of blade holder assemblies;

(c) attaching said blade holder assemblies to a handle assembly including a first arm member hingedly coupled to a second arm member, said first arm member having a first recess formed within a distal end thereof, said second arm member having a second recess formed within a distal end thereof, said handle assembly further including first and second shaped extension members removably coupled to said first and second arm members, said first and second shaped extension members each having a post extending from a proximal end thereof, said post of said first shaped extension member being received within said first recess to couple said first shaped extension member and said first arm member, said post of said second shaped extension member being received within said second recess to couple said second shaped extension member and said second arm member, each of said first and second elongated extension members having a generally circular cross-section to enable the rotation of said blade holder assemblies; and

(d) selectively opening said plurality of retractor blades to create a customized operative corridor to said surgical target site.

17. The method of claim 16, wherein each of said retractor blades comprises a pointed end.

18. The method of claim 17, wherein introducing a plurality of retractor blades into a surgical target site comprises penetrating at least one targeted vertebral body with said pointed ends of said plurality of retractor blades.

19. The method of claim 16, wherein at least one of said first and second shaped extension members has a generally arcuate shape.

20. The method of claim 16, wherein each of said plurality of blade holder assemblies comprises:

a base portion configured to slideably receive a portion of one of said first and second shaped extension members; and

an elongated member adjustably coupled to said base portion and having an end portion dimensioned to engage at least one of said plurality of blades.

21. A method of accessing a spinal target site, comprising the steps of:

providing a tissue retraction assembly in a closed position, said tissue retraction assembly having a handle assembly and a plurality of blade holder assemblies, said handle assembly including a first arm member hingedly coupled to a second arm member, each of said first and second arm members having a recess formed within a distal end thereof, said first arm member further including a first shaped extension member coupled thereto, the first shaped extension member including a first post extending from a proximal end thereof, said first post being received within said first recess to couple said first shaped extension member and said first arm member, said second arm member further including a second shaped extension member coupled thereto, the second shaped extension member including a second post extending from a proximal end thereof, said second post being received within said second recess to couple said second shaped extension member and said second arm member, said blade holder assemblies each comprising a base portion and an elongated member, wherein said base portion is slideably attached to one of said first and second extension members, said first and second extension members each having a generally circular cross-section to enable the rotation of said blade holder assemblies;

introducing a plurality of retractor blades into said spinal target site while in a closed position;

coupling each of said plurality of retractor blades to an end portion of at least one elongated member; and

selectively opening said plurality of retractor blades to create a customized operative corridor to said spinal target site.

22. The method of claim 21, further comprising:

coupling said elongated member to said base portion.

23. The method of claim 21, wherein each of said plurality of retractor blades includes a pointed end.

24. The method of claim 23, wherein introducing a plurality of retractor blades into said spinal target site comprises penetrating at least one vertebral body with said pointed end of at least one retractor blade.