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Surgical access system and related methods

DC
  • US 9,833,227 B2
  • Filed: 03/02/2017
  • Issued: 12/05/2017
  • Est. Priority Date: 06/26/2002
  • Status: Expired due to Term
First Claim
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1. A method for forming an operating corridor to a lumbar spine of a patient, the patient having an anterior aspect, a posterior aspect and two lateral aspects, the method comprising:

  • inserting a plurality of dilators into the patient at an insertion position on one of the two lateral aspects of the patient, the plurality of dilators comprising a first dilator having a first diameter and a second dilator having a second diameter, the first diameter being smaller than the second diameter;

    advancing the plurality of dilators along a lateral, trans-psoas path to a lateral aspect of a target intervertebral disc of the lumbar spine, the lateral, trans-psoas path having a path axis that extends from the insertion position on the one of the two lateral aspects to the other of the two lateral aspects of the patient, to create a tissue distraction corridor along the lateral, trans-psoas path through a region of a psoas muscle containing nerves to the target intervertebral disc, the tissue distraction corridor negotiating past the nerves of the psoas muscle;

    electrically stimulating, using a stimulation electrode along a distal region of a dilator of the plurality of dilators, the nerves of the psoas muscle for monitoring a nerve response, and advancing the dilator along the lateral, trans-psoas path, based on the monitoring, to avoid directly contacting the nerves of the psoas muscle;

    moving a plurality of retractor blades along the lateral, trans-psoas path to form an operative corridor along the lateral, trans-psoas path; and

    adjusting the plurality of retractor blades from a first configuration comprising the plurality of retractor blades in a first position to a second configuration comprising the plurality of retractor blades in a second position in which the plurality of retractor blades are spaced further apart from one another to form the operative corridor along the lateral, trans-psoas path, the operative corridor negotiating past the nerves of the psoas muscle without damaging the nerves and being dimensioned to pass an implant therethrough along the lateral, trans-psoas path toward the target intervertebral disc of the lumbar spine.

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