Surgical access system and related methods
First Claim
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1. A system for creating an operative corridor to a spinal surgical target site, comprising:
- a retractor assembly including a retractor body and a plurality of retractor blades extending generally perpendicularly to the retractor body, the retractor body being operable to separate the plurality of retractor blades relative to each other to retract tissue away from an interior of the retractor blades when the retractor is advanced to the surgical site and the retractor blades are separated to thereby form an operative corridor to the surgical site, wherein a center retractor blade of the plurality of retractor blades is a pressure sensing blade and wherein the pressure sensing blade has a distal end; and
a disposable insert including a proximal end, the proximal end configured to insert into the distal end of the pressure sensing blade, the disposable insert configured to be removably secured in the pressure sensing blade, and wherein the insert includes a pressure sensing member configured to measure the pressure exerted on tissue adjacent the pressure sensing blade.
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Abstract
A surgical access system comprising a tissue dilation assembly and a tissue retraction 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 and one or more pressure sensors for determining and monitoring pressure on neural structures near the tissue dilation assembly or the tissue retraction assembly.
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Citations
24 Claims
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1. A system for creating an operative corridor to a spinal surgical target site, comprising:
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a retractor assembly including a retractor body and a plurality of retractor blades extending generally perpendicularly to the retractor body, the retractor body being operable to separate the plurality of retractor blades relative to each other to retract tissue away from an interior of the retractor blades when the retractor is advanced to the surgical site and the retractor blades are separated to thereby form an operative corridor to the surgical site, wherein a center retractor blade of the plurality of retractor blades is a pressure sensing blade and wherein the pressure sensing blade has a distal end; and a disposable insert including a proximal end, the proximal end configured to insert into the distal end of the pressure sensing blade, the disposable insert configured to be removably secured in the pressure sensing blade, and wherein the insert includes a pressure sensing member configured to measure the pressure exerted on tissue adjacent the pressure sensing blade. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method of accessing a surgical target site on the lumbar spine, comprising the steps of:
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advancing an elongate dilator along a retroperitoneal path toward a psoas muscle, the distal end of the elongate dilator being guided to the psoas muscle with a finger inserted through an incision into the retroperitoneal space; advancing at least one additional dilator of larger diameter over the elongate dilator along the lateral trans-psoas path to the surgical target site on the lumbar spine; advancing a plurality of retractor blades over an outermost of the at least one additional dilator along the trans-psoas path to the surgical target site on the lumbar spine, wherein a center retractor blade of the plurality of retractor blades is a pressure sensing blade including a distal end; moving at least one of said plurality of retractor blades away from at least one other of said plurality of retractor blades to retract body tissue away from the lateral trans-psoas path and create an operative corridor along the lateral trans-psoas path to said surgical target site on the lumbar spine; maintaining the operative corridor along the lateral trans-psoas path to said surgical target site on the lumbar spine with said plurality of retractor blades; measuring a pressure exerted upon the retracted body tissue adjacent the operative corridor along the trans-psoas path, the pressure being measured with a pressure sensor situated on a disposable insert inserted into said pressure sensing blade, the disposable insert configured to be removably secured in the pressure sensing blade, and wherein said disposable insert includes a proximal end, the proximal end configured to insert into the distal end of the pressure sensing blade; and selectively controlling the amount of stress applied to the retracted body tissue adjacent the operative corridor along the trans-psoas path by altering the degree of retraction until a desired balance between access and tissue stress is achieved. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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Specification