Surgical access system and related methods

  • US 8,355,780 B2
  • Filed: 11/20/2009
  • Issued: 01/15/2013
  • Est. Priority Date: 09/25/2003
  • Status: Active Grant
First Claim
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1. A system for forming an operating corridor to a lumbar spine, comprising:

  • an elongate member deliverable to a spinal disc along a lateral, trans-psoas path to the lumbar spine such that a distal tip region of the elongate member penetrates into an annulus of the spinal disc, the distal tip region of the elongate member including a stimulation electrode to deliver electrical stimulation for nerve monitoring when the stimulation electrode is positioned along the lateral, trans-psoas path to the lumbar spine;

    a dilator system to create a distraction corridor along the lateral, trans-psoas path to the lumbar spine, the dilator system comprising at least one dilator cannula that slidably engages an exterior of the elongate member, the at least one dilator being deliverable to the spinal disc along the lateral, trans-psoas path to the lumbar spine;

    a three-bladed retractor assembly slidable over the dilator system toward the spinal disc along the lateral, trans-psoas path, the three-bladed retractor assembly including;

    a blade holder assembly and first, second, and third retractor blades that extend generally perpendicularly relative to arm members of the blade holder assembly,wherein the three-bladed retractor assembly is adjustable from a first position in which the first, second, and third retractor blades are adjacent to one another and slidable over the dilator system to a second position in which the second and third retractor blades are moved away from the first retractor blade to enlarge the distraction corridor and thereby form an operative corridor along the lateral, trans-psoas path to the lumbar spine,wherein the first retractor blade is linearly movable relative to the second and third retractor blades in response to rotation of a knob element on the blade holder assembly, andwherein the second and third retractor blades are movable relative to the first blade in response to pivoting movement of two of the arm members of the blade holder assembly; and

    wherein when the three-bladed retractor assembly is adjusted to the second position to form the operative corridor along the lateral, trans-psoas path to the lumbar spine, the first retractor blade is a posterior-most retractor blade of the first, second, and third retractor blades and the operative corridor is dimensioned so as to pass an implant through the operative corridor and into the lumbar spine.

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