System and methods for performing surgical procedures and assessments
First Claim
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1. A system for inserting a spinal implant through a trans-psoas operative corridor to an intervertebral disc, comprising:
- an elongate inner instrument to advance in a trans-psoas path through bodily tissue toward a lateral aspect of the targeted intervertebral disc of the lumbar spine, the elongate inner instrument being configured to engage an annulus of the targeted intervertebral disc;
a plurality of trans-psoas dilators of increasing diameters to dilate the trans-psoas path through the bodily tissue toward the lateral aspect of the targeted intervertebral disc of the lumbar spine, the plurality of dilators comprising;
a first dilator to slidably engage with an exterior of the elongate inner instrument and having a first length,a second dilator to slidably engage with an exterior of the initial dilator and having a second length less than the first length of the initial dilator, anda third dilator to slidably engage with an exterior of the second dilator and having a third length less than the second length of the second dilator;
wherein at least one instrument of the group consisting of the elongate inner instrument, the first dilator, the second dilator, and the third dilator comprises a stimulation electrode exposed along a distal tip portion of said at least one instrument to emit an electrical stimulation signal to the bodily tissue for nerve monitoring when said at least one instrument is positioned in the trans-psoas path through the bodily tissue; and
a working corridor instrument slidable over an outermost dilator of the plurality of trans-psoas dilators along the trans-psoas path through the bodily tissue to the lateral aspect of the targeted intervertebral disc of the lumbar spine, the working corridor instrument being configured to enlarge the trans-psoas path through the bodily tissue and maintain a trans-psoas operative corridor that is dimensioned so as to pass a spinal implant through the trans-psoas operative corridor to the lumbar spine.
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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.
345 Citations
18 Claims
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1. A system for inserting a spinal implant through a trans-psoas operative corridor to an intervertebral disc, comprising:
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an elongate inner instrument to advance in a trans-psoas path through bodily tissue toward a lateral aspect of the targeted intervertebral disc of the lumbar spine, the elongate inner instrument being configured to engage an annulus of the targeted intervertebral disc; a plurality of trans-psoas dilators of increasing diameters to dilate the trans-psoas path through the bodily tissue toward the lateral aspect of the targeted intervertebral disc of the lumbar spine, the plurality of dilators comprising; a first dilator to slidably engage with an exterior of the elongate inner instrument and having a first length, a second dilator to slidably engage with an exterior of the initial dilator and having a second length less than the first length of the initial dilator, and a third dilator to slidably engage with an exterior of the second dilator and having a third length less than the second length of the second dilator; wherein at least one instrument of the group consisting of the elongate inner instrument, the first dilator, the second dilator, and the third dilator comprises a stimulation electrode exposed along a distal tip portion of said at least one instrument to emit an electrical stimulation signal to the bodily tissue for nerve monitoring when said at least one instrument is positioned in the trans-psoas path through the bodily tissue; and a working corridor instrument slidable over an outermost dilator of the plurality of trans-psoas dilators along the trans-psoas path through the bodily tissue to the lateral aspect of the targeted intervertebral disc of the lumbar spine, the working corridor instrument being configured to enlarge the trans-psoas path through the bodily tissue and maintain a trans-psoas operative corridor that is dimensioned so as to pass a spinal implant through the trans-psoas operative corridor to the lumbar spine. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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Specification