# US 2019/0167246 A1 · Nir/red light for lateral neuroprotection

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- Number: US 2019/0167246 A1
- Document ID: US20190167246A1
- Status: Published application
- Kind: A1
- Application number: 16/271,680
- Filed: 2019-02-08
- Published: 2019-06-06
- Earliest claimed: 2012-09-26
- Assignees: DePuy Synthes Products, Inc.
- Applicants: DePuy Synthes Products, Inc.
- Inventors: Thomas M. DiMauro; William C. Horton
- Web page: https://patentgrep.com/patent/US20190167246A1

## 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 at position 1

-58. (canceled)

### Claim 59

A retractor system, comprising:
a first component adapted to retract tissue;
a second component adapted to retract tissue, the second component being movable relative to the first component to provide a working channel through tissue, the second component including an electrode in electrical connection with a neuromonitoring system adapted to monitor nerve status or health; and
a light delivery device inserted through the working channel, the light delivery device being connected to an endoscope.

### Claim 60 (depends on 59)

The system of claim 59, further comprising the neuromonitoring system, wherein the neuromonitoring system is configured to provide a warning when it detects a decline in nerve status or health.

### Claim 61 (depends on 59)

The system of claim 59, wherein the light delivery device is connected to a light source disposed outside a patient's body.

### Claim 62 (depends on 59)

The system of claim 59, wherein the second component has an arc-shaped outer wall having the electrode thereon.

### Claim 63 (depends on 59)

The system of claim 59, wherein the light delivery device runs down the length of an inner wall of the first component.

### Claim 64 (depends on 59)

The system of claim 59, wherein the light delivery device is secured within a channel or bore of the first component.

### Claim 65 (depends on 64)

The system of claim 64, wherein the light delivery device is secured within a channel formed in an inner wall of the first component.

### Claim 66 (depends on 59)

The system of claim 59, wherein the light delivery device is removably coupled to the first component.

### Claim 67 (depends on 59)

The system of claim 59, wherein the light delivery device is secured to the first component via a taper-lock configuration.

### Claim 68 (depends on 59)

The system of claim 59, wherein the light delivery device runs along a proximal portion of the first component and terminates in a distal end portion of the first component.

### Claim 69 (depends on 59)

The system of claim 59, wherein the second component is formed from a conductive metal coated with a non-conductive polymer, wherein the electrode is defined by an uncoated portion of the conductive metal.

### Claim 70 (depends on 59)

The system of claim 59, further comprising an extension adapted to dock the retractor system to spinal tissue.

### Claim 71 (depends on 70)

The system of claim 70, wherein the extension is axially adjustable with respect to the first component.

### Claim 72 (depends on 59)

The system of claim 59, further comprising a cable containing a fiber optic extending proximally from the first component.

### Claim 73 (depends on 72)

The system of claim 72, further comprising a receptacle at a proximal end of the first component that receives the cable to secure the cable to the first component.

### Claim 74 (depends on 59)

The system of claim 59, further comprising a connector adapted to receive a fiber optic cable and located on an outer surface of a proximal end of the first component.

### Claim 75 (depends on 59)

The system of claim 59, further comprising a light diffusing panel adapted to spread light emanating from a distal end of the light delivery device.

### Claim 76 (depends on 59)

The system of claim 59, wherein the light delivery device comprises a handheld light source lowered into the working channel.

### Claim 77 (depends on 59)

The system of claim 59, wherein the light delivery device comprises a red/NIR light emitter.

### Claim 78 (depends on 77)

The system of claim 77, wherein the light delivery device emits red light combined with polychrome visible or white light.