Surgical access system and related methods
First Claim
1. A method of accessing a surgical target site on the lumbar spine, comprising the steps of:
- advancing an elongate dilator along a lateral trans-psoas path to the surgical target site on the lumbar spine, the elongate dilator comprising a stimulation electrode along a distal region, and wherein an electrical stimulation is delivered to the stimulation electrode when the stimulation electrode is positioned in the lateral, trans-psoas path to detect the proximity of one or more nerves relative to the stimulation electrode;
advancing at least one additional dilator of larger diameter over the elongate dilator along the lateral trans-psoas path to the surgical target site on the lumbar spine;
advancing a plurality of retractor blades over an outermost of the at least one additional dilator along the trans-psoas path to the surgical target site one the lumbar spine;
moving at least one of said plurality of retractor blades away from at least one other of said plurality of retractor blades to retract body tissue away from the lateral trans-psoas path and create an operative corridor along the lateral trans-psoas path to said surgical target site on the lumbar spine;
maintaining the operative corridor along the lateral trans-psoas path to said surgical target site on the lumbar spine with said plurality of retractor blades;
measuring the pressure exerted upon the retracted body tissue adjacent the operative corridor along the trans-psoas path, the pressure being measured with a pressure sensor situated on at least one of the plurality of retractor blades; and
selectively controlling the amount of stress applied to the retracted body tissue adjacent the operative corridor along the trans-psoas path by altering the degree of retraction until a desired balance between access and tissue stress is achieved.
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Accused Products
Abstract
A surgical access system including a tissue distraction assembly and a tissue retraction assembly, 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. The tissue retraction assembly has a plurality of blades which may be introduced while in a closed configuration, after which point they may be opened to create an operation corridor to the surgical target site, including pivoting at least one blade to expand the operative corridor adjacent to the operative site. The surgical access system further includes pressure sensing technology to measure the pressure being exerted upon body tissues before, during, and/or after retraction and/or distraction.
321 Citations
14 Claims
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1. A method of accessing a surgical target site on the lumbar spine, comprising the steps of:
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advancing an elongate dilator along a lateral trans-psoas path to the surgical target site on the lumbar spine, the elongate dilator comprising a stimulation electrode along a distal region, and wherein an electrical stimulation is delivered to the stimulation electrode when the stimulation electrode is positioned in the lateral, trans-psoas path to detect the proximity of one or more nerves relative to the stimulation electrode; advancing at least one additional dilator of larger diameter over the elongate dilator along the lateral trans-psoas path to the surgical target site on the lumbar spine; advancing a plurality of retractor blades over an outermost of the at least one additional dilator along the trans-psoas path to the surgical target site one the lumbar spine; moving at least one of said plurality of retractor blades away from at least one other of said plurality of retractor blades to retract body tissue away from the lateral trans-psoas path and create an operative corridor along the lateral trans-psoas path to said surgical target site on the lumbar spine; maintaining the operative corridor along the lateral trans-psoas path to said surgical target site on the lumbar spine with said plurality of retractor blades; measuring the pressure exerted upon the retracted body tissue adjacent the operative corridor along the trans-psoas path, the pressure being measured with a pressure sensor situated on at least one of the plurality of retractor blades; and selectively controlling the amount of stress applied to the retracted body tissue adjacent the operative corridor along the trans-psoas path by altering the degree of retraction until a desired balance between access and tissue stress is achieved. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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Specification