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Surgical access system and related methods

  • US 8,679,006 B2
  • Filed: 02/01/2013
  • Issued: 03/25/2014
  • Est. Priority Date: 10/08/2002
  • Status: Expired due to Term
First Claim
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1. A system for accessing a spinal disc of a lumbar spine through a trans-psoas operative corridor, comprising:

  • an initial dilator configured to advance to a targeted spinal disc along a lateral, trans-psoas path to the lumbar spine, a distal tip region of the initial dilator including a stimulation electrode configured to deliver electrical stimulation away from the distal tip region for nerve monitoring when the initial dilator is positioned in the lateral, trans-psoas path;

    an elongate guidewire instrument advanceable through an inner lumen of the initial dilator, the elongate guidewire instrument having a distal tip configured to penetrate into a lateral aspect of a targeted spinal disc along the lateral, trans-psoas path to the lumbar spine, the elongate guidewire instrument having a longitudinal length that is greater than a longitudinal length of the initial dilator;

    a plurality of sequential dilators of sequentially larger diameter deliverable to the targeted spinal disc along the lateral, trans-psoas path, at least three of the plurality of sequential dilators having an outer diameter that is greater than an outer diameter of the initial dilator; and

    a retraction assembly comprising a blade holder apparatus and a plurality of retractor blades coupled to said blade holder apparatus, wherein at least two retractor blades of the plurality of retractor blades are releasably attachable to said blade holder apparatus, wherein the plurality of retractor blades of the retraction assembly are configured to maintain a trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine after advancement of the elongate stimulation member and the plurality of sequential dilators along the lateral, trans-psoas path to the lumbar spine,wherein the blade holder apparatus is configured to retain the plurality of retractor blades in a selected position so that the trans-psoas operative corridor is so dimensioned to pass an implant through the trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine.

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