Surgical access system and related methods
First Claim
1. A method of accessing a spinal target site via a lateral, trans-psoas surgical approach, comprising the steps of:
- establishing a distraction corridor via a lateral, trans-psoas surgical approach to said spinal target site with a distraction assembly prior to the introduction of a first retractor blade;
affixing said first retractor blade introduced to said spinal target site via said lateral, trans-psoas approach such that said first retractor blade forms a posterior border of an operative corridor along said lateral, trans-psoas surgical approach to said spinal target site and is fixed relative to said spinal target site, wherein affixing said first retractor blade is accomplished with a fixation element removably engaged with said first retractor blade after said first retractor blade is introduced to said spinal target site and such that a distal tip of said fixation element extends past said first retractor blade and penetrates into the spinal target site; and
moving a second retractor blade introduced to said spinal target site via said lateral, trans-psoas approach relative to said affixed first retractor blade such that said operative corridor is established between said first and second retractor blades to said spinal target site.
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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.
425 Citations
48 Claims
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1. A method of accessing a spinal target site via a lateral, trans-psoas surgical approach, comprising the steps of:
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establishing a distraction corridor via a lateral, trans-psoas surgical approach to said spinal target site with a distraction assembly prior to the introduction of a first retractor blade; affixing said first retractor blade introduced to said spinal target site via said lateral, trans-psoas approach such that said first retractor blade forms a posterior border of an operative corridor along said lateral, trans-psoas surgical approach to said spinal target site and is fixed relative to said spinal target site, wherein affixing said first retractor blade is accomplished with a fixation element removably engaged with said first retractor blade after said first retractor blade is introduced to said spinal target site and such that a distal tip of said fixation element extends past said first retractor blade and penetrates into the spinal target site; and moving a second retractor blade introduced to said spinal target site via said lateral, trans-psoas approach relative to said affixed first retractor blade such that said operative corridor is established between said first and second retractor blades to said spinal target site. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method of accessing a spinal target site via a lateral, trans-psoas surgical approach, comprising the steps of:
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introducing a first retractor blade and a second retractor blade to said spinal target site via a lateral, trans-psoas surgical approach such that said first retractor blade is positioned along a posterior aspect of a lumbar intervertebral disc comprising said spinal target site and comprises a posterior border of an operative corridor along said lateral, trans-psoas surgical approach to said spinal target site; penetrating the intervertebral disc with a shim element removeably engaged to said first retractor blade after introducing said first retractor blade to said spinal target site and extending from a distal end of the first retractor blade so as to affix said first retractor blade relative to said spinal target site; moving said second retractor blade relative to said affixed first retractor blade to establish said operative corridor along said lateral, trans-psoas surgical approach between said first and second retractor blades to said spinal target site; and passing an implant toward said spinal target site through said operative corridor established between said first retractor blade and said second retractor blade. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. A method of accessing a targeted site on the spine of a patient via a lateral, trans-psoas surgical approach, comprising the steps of:
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establishing an initial distraction corridor through the use of an initial distraction assembly via a lateral, trans-psoas surgical approach to a targeted site on said spine while performing neuromonitoring during insertion of said initial distraction assembly via said lateral, trans-psoas surgical approach to the targeted site, wherein at least a component of the initial distraction assembly penetrates into an intervertebral disc of said spine; after establishing said initial distraction corridor, introducing a first retractor blade to said targeted site on said spine via a lateral, trans-psoas surgical approach such that said first retractor blade is positioned in a first position along said spine; after said first retractor blade is positioned in said first position along said spine, removably engaging an extension element to said first retractor blade such that the extension element extends from said first retractor blade into said spine to affix said first retractor blade relative to said spine; moving a second retractor blade away from said affixed first retractor blade such that an operative corridor is established between said first and second retractor blades to said targeted site on said spine. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
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Specification