Surgical access system and related method
First Claim
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1. A system for forming an operative corridor to a lumbar spine, comprising:
- plurality of sequential dilators of increasing diameters to create a tissue distraction corridor along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, the plurality of dilators comprising;
an initial dilator and at least a second dilator that slidably advances over an exterior of the initial dilator and engages the lumbar spine, wherein at least one dilator of the plurality of sequential dilators includes markings indicative of a depth distance between a distal end of the at least one dilator and a skin location;
a three-bladed retractor tool slidable over an outer dilator of the plurality of sequential dilators toward the lumbar spine to enlarge the tissue distraction corridor and thereby form an operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the three-bladed refractor tool including;
a blade holder assembly coupled to first, second, and third retractor blades, wherein the three-bladed retractor tool is adjustable from a first position in which the first, second, and third retractor blades are positioned to simultaneously slide over the outer dilator of the plurality of sequential dilators to a second position in which the first, second, and third refractor blades are spaced apart from one another to enlarge the tissue distraction corridor and thereby form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine,wherein the blade holder assembly comprises;
a rotatable actuator that causes linearly adjustment of a position of the first retractor blade relative to the second and third retractor blades in response to rotation of the rotatable actuator, a first pivotable arm portion to pivotably adjust the third retractor blade relative to the first retractor blade, and a second pivotable arm portion to pivotably adjust the second retractor blade relative to the first retractor blade,a plurality of retractor blade extenders that are removably engageable with one or more of the second and third retractor blades, andwherein when the three-bladed retractor tool is adjusted to the second position to form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the operative corridor is dimensioned so as to pass an implant through the operative corridor along the selected path toward the targeted intervertebral disc of the lumbar spine.
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Abstract
A surgical access system including a tissue distraction assembly and a tissue refraction 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.
338 Citations
28 Claims
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1. A system for forming an operative corridor to a lumbar spine, comprising:
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plurality of sequential dilators of increasing diameters to create a tissue distraction corridor along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, the plurality of dilators comprising;
an initial dilator and at least a second dilator that slidably advances over an exterior of the initial dilator and engages the lumbar spine, wherein at least one dilator of the plurality of sequential dilators includes markings indicative of a depth distance between a distal end of the at least one dilator and a skin location;a three-bladed retractor tool slidable over an outer dilator of the plurality of sequential dilators toward the lumbar spine to enlarge the tissue distraction corridor and thereby form an operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the three-bladed refractor tool including; a blade holder assembly coupled to first, second, and third retractor blades, wherein the three-bladed retractor tool is adjustable from a first position in which the first, second, and third retractor blades are positioned to simultaneously slide over the outer dilator of the plurality of sequential dilators to a second position in which the first, second, and third refractor blades are spaced apart from one another to enlarge the tissue distraction corridor and thereby form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, wherein the blade holder assembly comprises;
a rotatable actuator that causes linearly adjustment of a position of the first retractor blade relative to the second and third retractor blades in response to rotation of the rotatable actuator, a first pivotable arm portion to pivotably adjust the third retractor blade relative to the first retractor blade, and a second pivotable arm portion to pivotably adjust the second retractor blade relative to the first retractor blade,a plurality of retractor blade extenders that are removably engageable with one or more of the second and third retractor blades, and wherein when the three-bladed retractor tool is adjusted to the second position to form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the operative corridor is dimensioned so as to pass an implant through the operative corridor along the selected path toward the targeted intervertebral disc of the lumbar spine. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A system for forming an operative corridor to a lumbar spine, comprising:
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plurality of sequential dilators of increasing diameters to create a tissue distraction corridor along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, the plurality of dilators comprising;
an initial dilator and at least a second dilator that slidably advances over an exterior of the initial dilator and engages the lumbar spine, wherein at least one dilator of the plurality of sequential dilators includes markings indicative of a depth distance between a distal end of the at least one dilator and a skin location;a three-bladed retractor tool slidable over an outer dilator of the plurality of sequential dilators toward the lumbar spine to enlarge the tissue distraction corridor and thereby form an operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the three-bladed refractor tool including; a blade holder assembly coupled to first, second, and third retractor blades, wherein the three-bladed retractor tool is adjustable from a first position in which the first, second, and third retractor blades are positioned to simultaneously slide over the outer dilator of the plurality of sequential dilators to a second position in which the first, second, and third refractor blades are spaced apart from one another to enlarge the tissue distraction corridor and thereby form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, wherein the blade holder assembly comprises;
a rotatable actuator to linearly adjust a position of the first retractor blade relative to the second and third retractor blades, a first pivotable arm portion to pivotably adjust the third retractor blade relative to the first retractor blade, and a second pivotable arm portion to pivotably adjust the second retractor blade relative to the first retractor blade, wherein the rotatable actuator of the blade holder assembly linearly adjusts a translating arm portion of the blade holder assembly that is coupled to the first retractor blade, and wherein the rotatable actuator of the blade holder assembly interacts with teeth on a rack of the translating arm portion to linearly adjust the position of the first retractor blade relative to the second and third retractor blades,a plurality of retractor blade extenders that are removably engageable with one or more of the second and third retractor blades, and wherein when the three-bladed retractor tool is adjusted to the second position to form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the operative corridor is dimensioned so as to pass an implant through the operative corridor along the selected path toward the targeted intervertebral disc of the lumbar spine. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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Specification