# US 10,499,898 B2 · NIR/red light for lateral neuroprotection

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- Number: US 10,499,898 B2
- Document ID: US10499898B2
- Status: Granted
- Kind: B2
- Application number: 15/726,418
- Filed: 2017-10-06
- Published: 2018-01-25
- Granted: 2019-12-10
- Earliest claimed: 2012-09-26
- Assignees: DePuy Synthes Products, Inc.
- Applicants: Depuy Synthes Products, Inc.
- Inventors: Thomas M. DiMauro; William Horton
- Web page: https://patentgrep.com/patent/US10499898B2

## CPC

- A61B 17/025: {Joint distractors}
- A61B 5/4893: {Nerves}
- A61B 17/0206: {with antagonistic arms as supports for retractor elements}
- A61B 17/0293: {with ring member to support retractor elements}
- A61N 5/0601: {Apparatus for use inside the body}
- A61N 5/0622: {Optical stimulation for exciting neural tissue}
- A61B 5/746: {Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms}
- A61B 2017/00907: {for light}
- A61B 2017/0262: {with a provision for protecting nerves}
- A61N 2005/063: {comprising light transmitting means, e.g. optical fibres}
- A61N 2005/0651: {Diodes}
- A61N 2005/0659: {infrared}
- A61N 2005/0663: {Coloured light}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

The use of red or near infrared light upon neurons of the lumbar plexus that are in distress due to retraction-induced ischemia. The surgeon may protect nerves made ischemic in the surgery by: a) making an incision in a patient, b) inserting an access device into the patient through the incision to at least partially create a path to a spine of the patient, and c) irradiating nervous tissue adjacent the path with an amount of NIR or red light effective to provide neuroprotection.

## Claims

### Claim 1

A surgical method, comprising:
making an incision in a patient,
inserting a retractor into the patient through the incision to provide a working channel through tissue of the patient, the retractor being inserted such that first and second components of the retractor are in contact with tissue of the patient, the first and second components being movable with respect to one another,
irradiating nervous tissue of the patient adjacent to the retractor using a light delivery device inserted through the working channel,
visualizing the nervous tissue using an endoscope connected to the light delivery device,
moving the first and second components of the retractor relative to one another to retract the nervous tissue, and
monitoring a health or status of the nervous tissue using an electrode of the second component, the electrode being in electrical connection with a neuromonitoring system.

### Claim 2 (depends on 1)

The method of claim 1, wherein the working channel leads to an intervertebral disc space.

### Claim 3 (depends on 1)

The method of claim 1, wherein the retractor is inserted using a transforaminal lumbar interbody fusion (TLIF) approach.

### Claim 4 (depends on 1)

The method of claim 1, further comprising inserting an intervertebral fusion cage through the working channel and into an intervertebral disc space of the patient.

### Claim 5 (depends on 1)

The method of claim 1, wherein the nervous tissue comprises a nerve root.

### Claim 6 (depends on 5)

The method of claim 5, wherein the nerve root is a traversing root of a dorsal root ganglion.

### Claim 7 (depends on 1)

The method of claim 1, wherein the nervous tissue is a nerve of the lumbar plexus.

### Claim 8 (depends on 1)

The method of claim 1, wherein the retractor is inserted through a psoas muscle of the patient.

### Claim 9 (depends on 1)

The method of claim 1, further comprising docking the retractor to spinal tissue.

### Claim 10 (depends on 9)

The method of claim 9, wherein the retractor is docked via an extension of the retractor.

### Claim 11 (depends on 10)

The method of claim 10, further comprising axially adjusting the extension with respect to the retractor.

### Claim 12 (depends on 1)

The method of claim 1, further comprising securing the retractor to a rigid arm.