Surgical access system and related methods
First Claim
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1. A method for inserting an implant through a trans-psoas operative corridor to a lumbar spine, comprising:
- simultaneously advancing plurality of retractor blades of a trans-psoas retractor tool slidably over a trans-psoas dilator and along a lateral, trans-psoas path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, wherein the plurality of retractor blades each have an outwardly facing convex surface region configured to engage a psoas muscle and that each have an inwardly facing concave surface region configured to engage a cylindrical exterior surface region of the trans-psoas dilator, the plurality of retractor blades including at least a caudal-most retractor blade and a cephalad-most retractor blade when the trans-psoas retractor tool creates the operative corridor along the lateral, trans-psoas path, wherein the trans-psoas refractor tool further comprises a blade holder assembly comprising adjustable arm portions, wherein the plurality of retractor blades extend generally perpendicularly relative to the arm portions of the blade holder assembly, wherein a first pivotable arm portion of the adjustable arm portions is configured to pivotably adjust the cephalad-most retractor blade relative to the caudal-most retractor blade, wherein the trans-psoas refractor tool is configured to adjust from a first position in which the plurality of retractor blades are positioned to simultaneously advance along the lateral, trans-psoas path to a second position in which the caudal-most retractor blade and the cephalad-most retractor blade are spaced apart from one another, the blade holder assembly comprising a rotatable actuator that causes independent linear movement of a position of one retractor blade of the plurality of retractor blades relative to another refractor blade of the plurality of retractor blades in response to rotation of the rotatable actuator; and
passing an implant through the operative corridor along the lateral, trans-psoas path toward the targeted intervertebral disc of the lumbar spine while the plurality of retractor blades of the trans-psoas retractor tool maintain the operative corridor along the lateral, trans-psoas path.
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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.
381 Citations
19 Claims
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1. A method for inserting an implant through a trans-psoas operative corridor to a lumbar spine, comprising:
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simultaneously advancing plurality of retractor blades of a trans-psoas retractor tool slidably over a trans-psoas dilator and along a lateral, trans-psoas path through bodily tissue toward a targeted intervertebral disc of a lumbar spine, wherein the plurality of retractor blades each have an outwardly facing convex surface region configured to engage a psoas muscle and that each have an inwardly facing concave surface region configured to engage a cylindrical exterior surface region of the trans-psoas dilator, the plurality of retractor blades including at least a caudal-most retractor blade and a cephalad-most retractor blade when the trans-psoas retractor tool creates the operative corridor along the lateral, trans-psoas path, wherein the trans-psoas refractor tool further comprises a blade holder assembly comprising adjustable arm portions, wherein the plurality of retractor blades extend generally perpendicularly relative to the arm portions of the blade holder assembly, wherein a first pivotable arm portion of the adjustable arm portions is configured to pivotably adjust the cephalad-most retractor blade relative to the caudal-most retractor blade, wherein the trans-psoas refractor tool is configured to adjust from a first position in which the plurality of retractor blades are positioned to simultaneously advance along the lateral, trans-psoas path to a second position in which the caudal-most retractor blade and the cephalad-most retractor blade are spaced apart from one another, the blade holder assembly comprising a rotatable actuator that causes independent linear movement of a position of one retractor blade of the plurality of retractor blades relative to another refractor blade of the plurality of retractor blades in response to rotation of the rotatable actuator; and passing an implant through the operative corridor along the lateral, trans-psoas path toward the targeted intervertebral disc of the lumbar spine while the plurality of retractor blades of the trans-psoas retractor tool maintain the operative corridor along the lateral, trans-psoas path. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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Specification