Devices and methods for minimally invasive spinal stabilization and instrumentation

A surgical apparatus configured to advance an implantable device through a tissue corridor and to a target location within a subject, the implantable device configured to be retained at the target location and comprising a top surface, an opposing bottom surface and at least one interconnecting side surface, the apparatus comprising:

• a tissue retraction device configured to at least partially create the tissue corridor to the target location, the tissue retraction device comprising:
• (i) a body member comprising a front side, a back side opposing the front side, a top side, a bottom side opposing the top side, a first side, a second side opposing the first side and separated from the first side by a fixed distance, and an internal cavity;
• (ii) a first arm movably coupled to the body member and configured to rotate about a first axis relative to the body member, the first axis extending from the top side to the bottom side of the body member;
• (iii) a second arm movably coupled to the body member and configured to rotate about a second axis relative to the body member, the second axis being non-collinear with the first axis;
• (iv) a third arm extending along a longitudinal axis from a proximal end surface to a distal end surface of the third arm, the third arm comprising a top surface extending along the longitudinal axis, a bottom surface opposing the top surface, a first side surface, a second side surface opposing the first side surface, and a third aperture extending along a central axis from the top surface to the bottom surface and at least partially open onto the distal end surface of the third arm;
• (v) a handle extending along a longitudinal axis from a proximal segment to a distal segment of the handle, wherein the longitudinal axis of the handle is collinear with the longitudinal axis of the third arm;
• and
• (vi) an elongated member extending along a longitudinal axis from a first end surface to a second end surface, the elongated member comprising at least a segment configured to be at least partially received within the third aperture of the third arm;
• wherein (1) the proximal end surface of the third arm is configured to at least translate within the internal cavity of the body member between a fully extended configuration and a fully retracted configuration, the proximal end surface of the third arm being positioned outside of the handle when the third arm is in any configuration;
• (2) a length of the elongated member along the longitudinal axis of the elongated member is greater than a distance between the top side surface and the bottom side surface of the third arm;
• and (3) the segment of the elongated member is configured to translate along the direction of the central axis within the third aperture;
• and
• wherein the implantable device is further configured and sized to be at least partially advanced through the tissue corridor created by a tissue retraction device.

A method for delivering an implantable device to a target site within a functional spinal unit of a subject using a tissue retraction device, the method comprising:

• obtaining a tissue retraction device, the tissue retraction device comprising at least (i) a body member comprising an internal cavity, a front surface having an opening to the internal cavity, a back surface opposing the front surface, a first side surface, and a second side surface opposing the first side surface, the first side surface and the second side surface separated by a fixed distance, (ii) a first arm comprising a first segment at least partially extending into the first side surface of the body member and a second segment extending from the first segment, wherein the first arm is configured to rotate about a first axis relative to the body member;
• (iii) a second arm comprising a first segment at least partially extending into the second side of the body member and a second segment extending from the first segment, wherein the second arm is configured to rotate about a second axis relative to the body member, the second axis being non-collinear with the first axis, (iv) a third arm extending along a longitudinal axis from a proximal segment to a distal segment, the proximal segment configured to at least translate within the internal cavity of the body member from a fully extended position to a fully retracted position;
• (v) a handle extending along the longitudinal axis of the third arm;
• and (vi) a first coupler configured to reversibly couple with an articulating retention frame;
• using a radiographic imaging modality to identify the target site within the functional spinal unit, the functional spinal unit comprising a superior vertebral bone, an inferior vertebral bone, and an intervertebral disc disposed therebetween,
• creating a tissue corridor that extends from a skin incision on the subject to the target site;
• advancing at least a portion of the second segment of the first arm of the tissue retraction device, at least a portion of the second segment of the second arm, and at least a portion of the distal segment of the third arm into the tissue corridor, wherein a first distance between a distal end of the second segment of the first arm and a distal end of the second segment of the second arm is maintained during the advancing;
• attaching a first portion of the articulating retention frame to an operating room table onto which the subject is positioned;
• coupling a second portion of the articulating retention frame with the first coupler of the tissue retraction device;
• transitioning a locking feature of the articulating retention frame from a first configuration to a second configuration, the transitioning of the locking feature immobilizing the tissue retraction device relative to the operating room table;
• rotating the first arm and the second arm about the first axis and the second axis, respectively, wherein the act of rotating increases the first distance;
• actuating an actuator of the tissue retraction device, the actuating producing translation of the proximal segment of the third arm within the internal cavity of the body member;
• accessing the target site through a tissue corridor at least partially formed between the distal end of the second segment of the first arm, the distal end of the second segment of the second arm and a distal end surface of the distal segment of the third arm;
• advancing the implantable device to the target site through the tissue corridor, the implantable device comprising at least a top surface, an opposing bottom surface, and an interconnecting side surface;
• and
• implanting the implantable device at the target site.