Systems and methods for accessing an intervertebral disc space in a body of a patient

• US 9,408,598 B1
• Filed: 05/18/2015
• Issued: 08/09/2016
• Est. Priority Date: 05/18/2015
• Status: Active Grant

• Current Assignee: Altus Partners LLC
• Original Assignee: Altus Partners LLC
• Inventors: Fantini, Gary A., Goodwin, Charlie, Hughes, Alex, Fitzgerald, Michael A., Bankoski, Brian
• Primary Examiner(s): Hammond, Ellen C
• Assistant Examiner(s): Negrellirodrigue, Christina
• Application Number:
  US14/714,951
• Time in Patent Office: 449 Days
• Field of Search: 600201-246
• US Class Current: 1/1
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/0262 with a provision for protecting nerves
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 6/0492 using markers or indicia for aiding patient positioning
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 of spinal prostheses

Abstract

A method for accessing an intervertebral disc space in a patient'"'"'s body involves making an incision in a region of the patient'"'"'s body that permits access to the psoas muscle, directing a blade of a first dissecting refractor through the incision and such that a distal end of the first dissecting retractor blade is positioned proximate the intervertebral disc space, and directing, independently of the first dissecting retractor blade, a blade of a second dissecting retractor through the incision and such that a distal end of the second dissecting retractor blade is positioned proximate the intervertebral disc space. During their placement within the patient'"'"'s body, the first and second dissecting retractor blades are employed in a tissue dissection process. Following the positioning of the distal ends of the first and second dissecting retractor blades proximate the intervertebral disc space, the first and second dissecting refractors are coupled to one another.

Claims

1. A method for accessing an intervertebral disc space in a body of a patient, the method comprising:

making an incision in a region of the patient'"'"'s body that permits access to a psoas muscle;

directing a blade of a first dissecting retractor through the incision and such that a distal end of the first dissecting retractor blade is positioned proximate the intervertebral disc space;

directing, independently of the first dissecting retractor blade, a blade of a second dissecting retractor through the incision and such that a distal end of the second dissecting retractor blade is positioned proximate the intervertebral disc space, the first and second dissecting retractor blades employed during their placement within the patient'"'"'s body in a tissue dissection process to gain access to the intervertebral disc space; and

following the positioning of the distal ends of the first and second dissecting retractor blades proximate the intervertebral disc space, coupling the first and second dissecting retractors to one another.

2. The method of claim 1 further comprising manually palpating the psoas muscle subsequent to making the incision in the region of the patient'"'"'s body.

3. The method of claim 1, wherein directing the first dissecting retractor blade comprises directing the first dissecting retractor blade anterior to, or through, the psoas muscle.

4. The method of claim 1, wherein directing the second dissecting retractor blade comprises positioning the second dissecting retractor blade posterior to the first dissecting retractor blade.

5. The method of claim 1, wherein the first and second dissecting retractor blades are both directed to avoid a region in the psoas muscle comprising a lumbar plexus nerve group.

6. The method of claim 1, wherein coupling the first and second dissecting retractors to one another comprises coupling a retractor stabilizing frame to both the first and second dissecting retractors.

7. The method of claim 6 further comprising removing a handle from each of the first and second dissecting retractors subsequent to coupling the retractor stabilizing frame to each of the first and second dissecting retractors.

8. The method of claim 6, further comprising coupling a stabilizing arm to the retractor stabilizing frame and to a rigid structure.

9. The method of claim 8, wherein the rigid structure comprises an operating table.

10. The method of claim 6, wherein the retractor stabilizing frame comprises a translation mechanism for adjusting a spacing between the first and second dissecting retractor blades.

11. The method of claim 10 further comprising adjusting a size of a working channel defined within the patient'"'"'s body by manipulating the translation mechanism.

12. The method of claim 1 further comprising directing third and fourth blades through the incision and such that distal ends of the third and fourth blades are positioned proximate the intervertebral disc space.

13. The method of claim 12, wherein the third and fourth blades are both coupled to a blade stabilization frame.

14. The method of claim 13 further comprising coupling the blade stabilization frame to at least one of the first and second dissecting retractors.

15. The method of claim 13, wherein the blade stabilization frame comprises a translation mechanism for adjusting a spacing between the third and fourth blades.

16. The method of claim 15 further comprising adjusting a size of a working channel defined within the patient'"'"'s body by manipulating the translation mechanism.

17. The method of claim 1 further comprising directing a surgical instrument through the incision and to the intervertebral disc space.

18. The method of claim 17, wherein the surgical instrument comprises an intervertebral fusion cage inserter.

19. The method of claim 1 further comprising delivering a surgical implant through the incision and to the intervertebral disc space.

20. The method of claim 19, wherein the surgical implant comprises an intervertebral fusion cage.

21. The method of claim 1 further comprising targeting a desired surgical level and sizing lengths of the first and second dissecting retractor blades prior to making the incision.

22. The method of claim 21, wherein a measurement caliper is employed to target the desired surgical level and size the lengths of the first and second dissecting retractor blades.