IPC분류정보
국가/구분 |
United States(US) Patent
등록
|
국제특허분류(IPC7판) |
|
출원번호 |
US-0650123
(2009-12-30)
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등록번호 |
US-8114019
(2012-02-14)
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발명자
/ 주소 |
- Miles, Patrick
- Martinelli, Scot
- Finley, Eric
- Gharib, James
- Farquhar, Allen
- Kaula, Norbert
- Blewett, Jeffrey
- Medeiros, legal representative, Goretti
|
출원인 / 주소 |
|
대리인 / 주소 |
|
인용정보 |
피인용 횟수 :
20 인용 특허 :
197 |
초록
▼
A surgical access system including a tissue distraction assembly and a tissue refraction 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 establi
A surgical access system including a tissue distraction assembly and a tissue refraction 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.
대표청구항
▼
1. A system for forming an operating corridor to a lumbar spine, comprising: an initial guidewire deliverable along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine;a plurality of sequential dilators of increasing diameters to create a tissue distraction
1. A system for forming an operating corridor to a lumbar spine, comprising: an initial guidewire deliverable along a selected path through bodily tissue toward a targeted intervertebral disc of a lumbar spine;a plurality of sequential dilators of increasing diameters to create a tissue distraction corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the plurality of dilators comprising: an initial dilator configured to slidably engage with an exterior of the initial guidewire and configured to engage the lumbar spine, and at least a second dilator configured to slidably advance over an exterior of the initial dilator and configured to engage the lumbar spine, wherein at least one dilator of the plurality of sequential dilators includes markings indicative of a depth distance between a distal end of the at least one dilator and a skin location;a three-bladed retractor tool slidable over an outer dilator of the plurality of sequential dilators toward the lumbar spine to enlarge the tissue distraction corridor and thereby form an operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the three-bladed refractor tool including: a external assembly and first, second, and third retractor blades that extend generally perpendicularly relative to arm portions of the external assembly,wherein the three-bladed retractor tool is adjustable from a closed position in which the first, second, and third refractor blades are adjacent to one another and slidable over the outer dilator of the plurality of sequential dilators to an opened position in which the first, second, and third retractor blades are spaced apart from one another to thereby form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar,at least one shim member to releasably engage with an engagement slot along an inner facing surface of a corresponding retractor blade of the first, second, and third retractor blades so that a distal portion of the shim member extends distally from the corresponding retractor blade, the shim member having a rearwardly extending tab to engage with a mating recess formed along the inner facing surface of the corresponding retractor blade to lock the position of the shim member relative to the corresponding retractor blade, anda fiber optic cable to couple with one of the first, second, and third retractor blades and emit light toward the targeted intervertebral disc of the lumbar spine when the three-bladed retractor tool forms the operative corridor; andwherein when the three-bladed retractor tool is adjusted to the opened position to form the operative corridor along the selected path through the bodily tissue toward the targeted intervertebral disc of the lumbar spine, the operative corridor is dimensioned so as to pass an implant through the operative corridor along the selected path toward the targeted intervertebral disc of the lumbar spine. 2. The system of claim 1, wherein the external assembly is actuatable to adjust the three-bladed retractor tool from the closed position to the opened position. 3. The system of claim 2, wherein the external assembly comprises: a first pivotable arm coupled to the third retractor blade, a second pivotable arm coupled to the second retractor blade, and a movable assembly coupled to the first retractor blade. 4. The system of claim 3, wherein when the three-bladed retractor tool is adjusted to the opened position to form the operative corridor along the selected path, the distal portion of the shim member is configured to hinder the migration of tissue into the operative corridor. 5. The system of claim 4, further comprising an introducer tool that releasably attaches to the shim member during engagement of the shim member to the corresponding refractor blade. 6. The system of claim 4, wherein the shim member comprises a longitudinally extending ridge that mates with the engagement slot along the inner facing surface of the corresponding retractor blade. 7. The system of claim 4, wherein the outer dilator of the plurality of sequential dilators includes the markings indicative of the depth distance. 8. The system of claim 1, wherein the distal portion of the shim member is operable to penetrate into the targeted intervertebral disc of the lumbar spine. 9. The system of claim 1, wherein the distal portion of the shim member has a width that is less than a proximal portion of the shim member. 10. The system of claim 9, wherein the distal portion of the shim member has a smallest width at a rounded distal tip. 11. The system of claim 1, wherein when the three-bladed retractor tool is adjusted to the opened position to form the operative corridor along the selected path, the first retractor blade is a posterior-most refractor blade, and the shim member is configured to releasably engage with the posterior-most refractor blade. 12. The system of claim 1, further comprising a fourth retractor blade that removably couples with the external assembly of the three-bladed retractor tool. 13. The system of claim 1, wherein the initial guidewire is adapted to be advanced together with the initial dilator along the selected path. 14. The system of claim 1, wherein when the three-bladed retractor tool is in the closed position, each of the first, second, and third retractor blades are in abutting relation with the other two of the first, second, and third retractor blades. 15. The system of claim 1, wherein at least one of of the plurality of sequential dilators comprises a stimulation electrode that delivers electrical stimulation for nerve monitoring. 16. The system of claim 15, further comprising a monitoring system that delivers an electrical stimulation signal to the stimulation electrode of the at least one the plurality of sequential dilators, monitors electromyographicactivity detected by a set of sensor electrodes in leg muscle myotomes associated with nerves in the vicinity of the spinal disc, and displays to a user a numeric stimulation threshold required to obtain the electromyographic activity in at least one of said leg muscle myotomes. 17. The system of claim 16, wherein the monitoring system comprises a control unit having a video display device, a patient module connected to the control unit via a data cable, an EMG sensor harness having the set of sensor electrodes connected to the patient module. 18. The system of claim 17, wherein the control unit is configured to receive signals from the patient module and process EMG responses output from the sensor electrodes to extract characteristic information for each of said leg muscle myotomes. 19. The system of claim 1, wherein the initial guidewire comprises a K-wire. 20. The system of claim 1, wherein the initial guidewire comprises a stimulation electrode along a distal region that delivers electrical stimulation for nerve monitoring.
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