Surgical access system and related methods
First Claim
1. A trans-psoas surgical access system for accessing a spinal disc of a lumbar spine, comprising:
- a distraction assembly to create a trans-psoas distraction corridor to a lumbar spine, wherein said distraction assembly comprises;
an elongate inner member configured to be delivered toward a spinal disc along a lateral, trans-psoas path to the lumbar spine, and a first dilator configured to be delivered to the spinal disc along the lateral, trans-psoas path to the lumbar spine, the first dilator having a passage configured to slidably receive the elongate inner member, wherein at least one instrument from the group consisting of the elongate inner member and the first dilator has a stimulation electrode situated at a distal end region thereof to deliver electrical stimulation for nerve monitoring when said stimulation electrode is positioned in the lateral, trans-psoas path to the lumbar spine; and
a trans-psoas retraction assembly comprising;
a blade holder apparatus, and a plurality of retractor blades configured to enlarge the trans-psoas distraction corridor and configured to maintain a trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine when the plurality of retractor blades are delivered to the lumbar spine, wherein the blade holder apparatus that is configured to retain the first and second retractor blades in an orientation in which the first retractor blade is spaced apart from the second retractor blade by a gap therebetween, wherein the plurality of retractor blades are sized and shaped to maintain the trans-psoas operative corridor that is so dimensioned to pass a spinal implant through the trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine, and wherein with a first retractor blade of the plurality of retractor blades defines a first channel that is fixedly positioned relative to a proximal end of the respective retractor blade and that is configured to slidably engage a first fixation member for anchoring to the lumbar spine, the first fixation member having a proximal portion with a proximal end, a distal portion extending from the proximal portion to a distal end, a length between the proximal end and distal end, a corridor facing surface and a blade facing surface, a thickness defined between the corridor facing surface and the blade facing surface, and a width, wherein the width is greater than the thickness, the fixation member being slidably advanceable along the channel to a position wherein the distal end extends distally from the retractor blade to anchor into the lumbar spine.
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Accused Products
Abstract
A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, 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.
549 Citations
19 Claims
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1. A trans-psoas surgical access system for accessing a spinal disc of a lumbar spine, comprising:
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a distraction assembly to create a trans-psoas distraction corridor to a lumbar spine, wherein said distraction assembly comprises;
an elongate inner member configured to be delivered toward a spinal disc along a lateral, trans-psoas path to the lumbar spine, and a first dilator configured to be delivered to the spinal disc along the lateral, trans-psoas path to the lumbar spine, the first dilator having a passage configured to slidably receive the elongate inner member, wherein at least one instrument from the group consisting of the elongate inner member and the first dilator has a stimulation electrode situated at a distal end region thereof to deliver electrical stimulation for nerve monitoring when said stimulation electrode is positioned in the lateral, trans-psoas path to the lumbar spine; anda trans-psoas retraction assembly comprising;
a blade holder apparatus, and a plurality of retractor blades configured to enlarge the trans-psoas distraction corridor and configured to maintain a trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine when the plurality of retractor blades are delivered to the lumbar spine, wherein the blade holder apparatus that is configured to retain the first and second retractor blades in an orientation in which the first retractor blade is spaced apart from the second retractor blade by a gap therebetween, wherein the plurality of retractor blades are sized and shaped to maintain the trans-psoas operative corridor that is so dimensioned to pass a spinal implant through the trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine, and wherein with a first retractor blade of the plurality of retractor blades defines a first channel that is fixedly positioned relative to a proximal end of the respective retractor blade and that is configured to slidably engage a first fixation member for anchoring to the lumbar spine, the first fixation member having a proximal portion with a proximal end, a distal portion extending from the proximal portion to a distal end, a length between the proximal end and distal end, a corridor facing surface and a blade facing surface, a thickness defined between the corridor facing surface and the blade facing surface, and a width, wherein the width is greater than the thickness, the fixation member being slidably advanceable along the channel to a position wherein the distal end extends distally from the retractor blade to anchor into the lumbar spine. - 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