Surgical access system and related methods
First Claim
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1. A system for forming a working corridor along a lateral, trans-psoas path to a targeted intervertebral disc of a lumbar spine, comprising:
- a trans-psoas dilator system, which includes at least a first dilator cannula, to create a tissue distraction corridor along the lateral, trans-psoas path through bodily tissue to the targeted intervertebral disc of the lumbar spine;
an elongate member sized to be slidably received within the first dilator cannula and being deliverable to the targeted intervertebral disc along the lateral, trans-psoas path, each of the elongate member and the first dilator cannula having a maximum width smaller than the working corridor, and at least one of the elongate member and the first dilator cannula comprising a stimulation electrode along a distal region to deliver electrical stimulation for nerve monitoring when the stimulation electrode is positioned in the lateral, trans-psoas path, said at least one of the elongate member and the first dilator cannula defining a proximal electrical connector region for releasable electrical connection with a nerve monitoring system; and
a bladed retractor assembly comprising a blade holder apparatus and a plurality of retractor blades that are simultaneously slidable over an outermost dilator cannula of the trans-psoas dilator system along the lateral, trans-psoas path to enlarge the tissue distraction corridor and form the working corridor along the lateral, trans-psoas path to the targeted intervertebral disc of the lumbar spine, wherein the blade holder apparatus is adjustable from a first position in which the plurality of retractor blades collectively define a cylindrical corridor to slide over the outermost dilator cannula of the trans-psoas dilator system to a second position in which the plurality of retractor blades are spaced apart from one another, wherein the bladed retractor assembly is configured to define the working corridor that is dimensioned so as to pass an implant through the working corridor along the lateral, trans-psoas 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.
350 Citations
20 Claims
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1. A system for forming a working corridor along a lateral, trans-psoas path to a targeted intervertebral disc of a lumbar spine, comprising:
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a trans-psoas dilator system, which includes at least a first dilator cannula, to create a tissue distraction corridor along the lateral, trans-psoas path through bodily tissue to the targeted intervertebral disc of the lumbar spine; an elongate member sized to be slidably received within the first dilator cannula and being deliverable to the targeted intervertebral disc along the lateral, trans-psoas path, each of the elongate member and the first dilator cannula having a maximum width smaller than the working corridor, and at least one of the elongate member and the first dilator cannula comprising a stimulation electrode along a distal region to deliver electrical stimulation for nerve monitoring when the stimulation electrode is positioned in the lateral, trans-psoas path, said at least one of the elongate member and the first dilator cannula defining a proximal electrical connector region for releasable electrical connection with a nerve monitoring system; and a bladed retractor assembly comprising a blade holder apparatus and a plurality of retractor blades that are simultaneously slidable over an outermost dilator cannula of the trans-psoas dilator system along the lateral, trans-psoas path to enlarge the tissue distraction corridor and form the working corridor along the lateral, trans-psoas path to the targeted intervertebral disc of the lumbar spine, wherein the blade holder apparatus is adjustable from a first position in which the plurality of retractor blades collectively define a cylindrical corridor to slide over the outermost dilator cannula of the trans-psoas dilator system to a second position in which the plurality of retractor blades are spaced apart from one another, wherein the bladed retractor assembly is configured to define the working corridor that is dimensioned so as to pass an implant through the working corridor along the lateral, trans-psoas 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, 18, 19, 20)
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Specification