Systems and methods for performing surgical procedures and assessments
First Claim
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1. A system for forming a path to a spinal target site via a trans-psoas approach, comprising:
- a dilating cannula having longitudinal axis, a distal end, a proximal end, and a length such that said proximal end extends beyond a skin surface when said distal end is positioned adjacent to said spinal target site via a trans-psoas approach to said spinal target site, said dilator being insulated along the entire length with the exception of at least one exposed electrical contact at said proximal end and an exposed stimulation electrode at said distal end, said stimulation electrode being exposed along only a radial portion of said distal end, said dilating cannula further including a reference mark viewable when said distal end of said dilating cannula is located between said skin surface and said spinal target site and indicative of the radial position of said exposed stimulation electrode.
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Abstract
The present invention involves systems and related methods for performing surgical procedures and assessments, including the use of neurophysiology-based monitoring to: (a) determine nerve proximity and nerve direction to surgical instruments employed in accessing a surgical target site; (b) assess the pathology (health or status) of a nerve or nerve root before, during, or after a surgical procedure; and/or (c) assess pedicle integrity before, during or after pedicle screw placement, all in an automated, easy to use, and easy to interpret fashion so as to provide a surgeon-driven system.
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Citations
23 Claims
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1. A system for forming a path to a spinal target site via a trans-psoas approach, comprising:
a dilating cannula having longitudinal axis, a distal end, a proximal end, and a length such that said proximal end extends beyond a skin surface when said distal end is positioned adjacent to said spinal target site via a trans-psoas approach to said spinal target site, said dilator being insulated along the entire length with the exception of at least one exposed electrical contact at said proximal end and an exposed stimulation electrode at said distal end, said stimulation electrode being exposed along only a radial portion of said distal end, said dilating cannula further including a reference mark viewable when said distal end of said dilating cannula is located between said skin surface and said spinal target site and indicative of the radial position of said exposed stimulation electrode. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A surgical system for forming a path to a spinal target site via a trans-psoas approach, comprising:
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a sequential dilation access system comprising a plurality of dilating cannulas to form a trans-psoas corridor between a skin surface and a targeted spine site, the plurality of dilating cannulas comprising an outer dilating cannula fitting over another of the dilating cannulas when advanced in a trans-psoas path toward the targeted spine site, wherein a stimulation electrode is positioned on at least one of the dilating cannulas to deliver a stimulation signal for nerve monitoring proximate to a distal end of the dilating cannula when advanced in the trans-psoas path, the stimulation electrode being arranged in a fixed position relative to a longitudinal axis of the at least one dilating cannula such that the stimulation electrode rotates with the at least one dilating cannula when the at least one dilating cannula is rotated about the longitudinal axis. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23)
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Specification