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US 2020/0046335 A1Published application
Surgical access system and related methods
AssigneeNuVasive, Inc.
InventorsPatrick Miles, Scot Martinelli, Eric Finley, James E. Gharib, Allen Farquhar, Norbert F. Kaula, Jeffrey J. Blewett
Life of this patent
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Abstract
A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.
Claims16
A system for accessing a surgical target site, the system comprising:
- a three-bladed tissue retraction assembly comprising:
- a first retractor arm having a first length extending between a first proximal end and a first distal end and defining a first top surface, a first bottom surface, a first inner surface, and a first outer surface, wherein the first retractor arm comprises a first coupling portion extending laterally inward from first inner surface, wherein the first retractor arm defines a first hole extending laterally through the first retractor arm from the first outer surface to the first inner surface, and wherein the first coupling portion and the first hole are positioned along the first retractor arm between the first proximal end and the first distal end such that the first hole is positioned nearer the first proximal end and the first coupling portion is positioned nearer the first distal end;
- a second retractor arm having a second length extending between a second proximal end and a second distal end and defining a second top surface, a second bottom surface, a second inner surface, and a second outer surface, wherein the second retractor arm comprises a second coupling portion extending laterally inward from second inner surface, wherein the second retractor arm defines a second hole extending laterally through the second retractor arm from the second outer surface to the second inner surface, and wherein the second coupling portion and the second hole are positioned along the second retractor arm between the second proximal end and the second distal end such that the second hole is positioned nearer the second proximal end and the second coupling portion is positioned nearer the second distal end;
- a translating retractor member having a third length extending between a third proximal end and a third distal end, wherein the first retractor arm is pivotably connected with respect to the translating retractor member via the first coupling portion and the second retractor arm is pivotably connected with respect to the translating retractor member via the second coupling portion such that the first and second retractor arms can pivot with respect to the translating retractor member and the translating retractor member can translate with respect to the first and second retractor arms;
- a caudal-most retractor blade coupled to the first retractor arm;
- a cephalad-most retractor blade coupled to the second retractor arm;
- a posterior-most retractor blade coupled to the translating retractor member;
- an intradiscal shim element that releasably mounts to the posterior-most retractor blade such that a maximum length of the intradiscal shim element extends generally parallel to a maximum length of the posterior-most retractor blade and a tip portion of the intradiscal shim element extends from the posterior-most retractor blade, wherein the intradiscal shim element engages with a groove defined by the posterior-most retractor blade to penetrate into a spinal disc at the targeted spinal site when the intradiscal shim element is releasably mounted to the posterior-most retractor blade;
- and
- a mechanism comprising a bolt extending through at least one of the first and second holes so as to selectively position the first retractor arm with respect to the second retractor arm.
7 more elements
A system for accessing a surgical target site, the system comprising:
- a three-bladed tissue retraction assembly comprising:
- a first retractor arm having a first length extending between a first proximal end and a first distal end and defining a first top surface, a first bottom surface, a first inner surface, and a first outer surface, wherein the first retractor arm comprises a first coupling portion extending laterally inward from first inner surface, wherein the first retractor arm defines a first hole extending laterally through the first retractor arm from the first outer surface to the first inner surface, and wherein the first coupling portion and the first hole are positioned along the first retractor arm between the first proximal end and the first distal end such that the first hole is positioned nearer the first proximal end and the first coupling portion is positioned nearer the first distal end;
- a second retractor arm having a second length extending between a second proximal end and a second distal end and defining a second top surface, a second bottom surface, a second inner surface, and a second outer surface, wherein the second retractor arm comprises a second coupling portion extending laterally inward from second inner surface, wherein the second retractor arm defines a second hole extending laterally through the second retractor arm from the second outer surface to the second inner surface, and wherein the second coupling portion and the second hole are positioned along the second retractor arm between the second proximal end and the second distal end such that the second hole is positioned nearer the second proximal end and the second coupling portion is positioned nearer the second distal end;
- a third retractor member having a third length extending between a third proximal end and a third distal end, wherein the first retractor arm is pivotably connected with respect to the third retractor member via the first coupling portion and the second retractor arm is pivotably connected with respect to the third retractor member via the second coupling portion such that the first and second retractor arms can pivot with respect to the third retractor member;
- a caudal-most retractor blade coupled to the first retractor arm;
- a cephalad-most retractor blade coupled to the second retractor arm;
- a posterior-most retractor blade coupled to the third retractor member;
- an intradiscal shim element that releasably mounts to the posterior-most retractor blade such that a maximum length of the intradiscal shim element extends generally parallel to a maximum length of the posterior-most retractor blade and a tip portion of the intradiscal shim element extends from the posterior-most retractor blade, wherein the intradiscal shim element engages with a groove defined by the posterior-most retractor blade to penetrate into a spinal disc at the targeted spinal site when the intradiscal shim element is releasably mounted to the posterior-most retractor blade;
- a first link connected between the first retractor arm and the third retractor member such that the first link is pivotably connected to the third retractor member;
- and
- a second link connected between the second retractor arm and the third retractor member such that the second link is pivotably connected to the third retractor member.
8 more elements
A system for accessing a surgical target site, the system comprising:
- a three-bladed tissue retraction assembly comprising:
- a first retractor arm having a first length extending between a first proximal end and a first distal end and defining a first top surface, a first bottom surface, a first inner surface, and a first outer surface, wherein the first retractor arm comprises a first coupling portion extending laterally and rigidly inward from the first inner surface, wherein the first retractor arm defines a first hole extending laterally through the first retractor arm from the first outer surface to the first inner surface, and wherein the first coupling portion and the first hole are positioned along the first retractor arm between the first proximal end and the first distal end such that the first hole is positioned nearer the first proximal end and the first coupling portion is positioned nearer the first distal end;
- a second retractor arm having a second length extending between a second proximal end and a second distal end and defining a second top surface, a second bottom surface, a second inner surface, and a second outer surface, wherein the second retractor arm comprises a second coupling portion extending laterally and rigidly inward from the second inner surface, wherein the second retractor arm defines a second hole extending laterally through the second retractor arm from the second outer surface to the second inner surface, and wherein the second coupling portion and the second hole are positioned along the second retractor arm between the second proximal end and the second distal end such that the second hole is positioned nearer the second proximal end and the second coupling portion is positioned nearer the second distal end;
- a translating retractor member having a third length extending between a third proximal end and a third distal end, wherein the first retractor arm is pivotably connected with respect to the translating retractor member via the first coupling portion and the second retractor arm is pivotably connected with respect to the translating retractor member via the second coupling portion such that the first and second retractor arms can pivot with respect to the translating retractor member and the translating retractor member can translate with respect to the first and second retractor arms;
- a caudal-most retractor blade coupled to the first retractor arm;
- a cephalad-most retractor blade coupled to the second retractor arm;
- a posterior-most retractor blade coupled to the translating retractor member;
- an intradiscal shim element that releasably mounts to the posterior-most retractor blade such that a maximum length of the intradiscal shim element extends generally parallel to a maximum length of the posterior-most retractor blade and a tip portion of the intradiscal shim element extends from the posterior-most retractor blade, wherein the intradiscal shim element engages with a groove defined by the posterior-most retractor blade to penetrate into a spinal disc at the targeted spinal site when the intradiscal shim element is releasably mounted to the posterior-most retractor blade;
- a first link connected between the first retractor arm and the translating retractor member such that the first link is pivotably connected to the translating retractor member;
- a second link connected between the second retractor arm and the translating retractor member such that the second link is pivotably connected to the translating retractor member;
- and
- a mechanism comprising a bolt extending through at least one of the first and second holes so as to selectively position the first retractor arm with respect to the second retractor arm.
9 more elements
Dependencies are inferred from the claim text.