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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.

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1. A method for accessing a spinal disc of a lumbar spine of a patient, comprising: (a) sequentially inserting a plurality of sequentially larger diameter dilators into said patient along a lateral, trans-psoas path to create a distraction corridor along said lateral, trans-psoas path, wherein each

1. A method for accessing a spinal disc of a lumbar spine of a patient, comprising: (a) sequentially inserting a plurality of sequentially larger diameter dilators into said patient along a lateral, trans-psoas path to create a distraction corridor along said lateral, trans-psoas path, wherein each of said plurality of sequentially larger diameter dilators comprises a stimulation electrode and is inserted under conditions wherein an electrical stimulation is delivered to said stimulation electrode for nerve monitoring when said stimulation electrode is positioned in said lateral, trans-psoas path,(b) advancing a plurality of retractor blades of a retractor assembly along said lateral, trans-psoas path and over an exterior of the outermost dilator of said plurality of sequentially larger diameter dilators inserted in step (a), said retractor assembly comprising a retractor blade holder and said plurality of retractor blades attached to said retractor blade holder,(c) moving at least one of said plurality of retractor blades in a direction away from at least one other of said plurality of retractor blades to create an operative corridor along said lateral, trans-psoas path, wherein said operative corridor is dimensioned so as to pass a spinal implant through said operative corridor along said lateral, trans-psoas path to the lumbar spine,(d) removing said plurality of sequentially larger diameter dilators from said patient, and(e) maintaining said operative corridor along said lateral, trans-psoas path using said retractor assembly to deliver said spinal implant to the lumbar spine, wherein, during delivery of said spinal implant, said operative corridor is maintained by a posterior-most retractor blade of said retractor assembly, an anterior-most retractor blade of said refractor assembly, a caudal-most retractor blade of said retractor assembly, and a cephalad-most retractor blade of said retractor assembly. 2. The method of claim 1, wherein said anterior-most retractor blade is movable away from said posterior-most retractor blade in an anterior-posterior direction. 3. The method of claim 1, wherein said caudal-most retractor blade is movable away from said cephalad-most refractor blade in a caudal-cephalad direction. 4. The method of claim 1, wherein said plurality of sequentially larger diameter dilators are removed from said patient after at least one of said plurality of retractor blades is moved in a direction away from at least one other of said plurality of retractor blades to create said operative corridor. 5. The method of claim 1, wherein the retractor assembly further comprises a light emitting device to direct light through the operative corridor toward a spinal disc, the light emitting device being coupled to said posterior-most retractor blade. 6. The method of claim 1, wherein the retractor assembly further comprises a light emitting device to direct light through the operative corridor toward a spinal disc, the light emitting device being coupled to said anterior-most retractor blade. 7. The method of claim 1, further comprising the additional step of advancing a K-wire along said lateral, trans-psoas path and into a disc space. 8. The method of claim 1, wherein each of said plurality of sequentially larger diameter dilators comprises a distal end on which said stimulation electrode is situated, said distal end being angled relative to a longitudinal axis of said dilator such that said stimulation electrode is angled relative to said longitudinal axis for determining a direction of a nerve relative to said distal end during advancement of said sequentially larger diameter dilators along said lateral trans-psoas path. 9. The method of claim 1, wherein each of said posterior-most retractor blade, said anterior-most retractor blade, said caudal-most retractor blade, and said cephalad-most retractor blade comprise a stimulation electrode capable of delivering electrical stimulation for nerve monitoring. 10. The method of claim 1, wherein said method comprises using a monitoring system for nerve monitoring, wherein said monitoring system delivers an electrical stimulation signal to the stimulation electrode of each of the sequentially larger diameter dilators and monitors electromyographic activity detected by a set of sensor electrodes in muscle myotomes associated with nerves in a vicinity of a spinal disc. 11. The method of claim 10, 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, and an EMG sensor harness having the set of sensor electrodes connected to the patient module. 12. The method of claim 11, wherein the control unit receives signals from the patient module and processes EMG response output from the sensor electrodes to extract characteristic information for each of said muscle myotomes. 13. The method of claim 10, wherein the monitoring system comprises a display that displays a numeric stimulation threshold required to obtain the electromyographic activity in at least one of said muscle myotomes. 14. A method for accessing a spinal disc of a lumbar spine of a patient, comprising: sequentially inserting a plurality of sequentially larger diameter dilators into said patient along a lateral, trans-psoas path to create a distraction corridor along said lateral, trans-psoas path, wherein each of said plurality of sequentially larger diameter dilators comprises a stimulation electrode and is inserted under conditions wherein an electrical stimulation is delivered to said stimulation electrode for nerve monitoring when said stimulation electrode is positioned in said lateral, trans-psoas path,advancing a plurality of retractor blades of a retractor assembly along said lateral, trans-psoas path and over an exterior of the outermost dilator of said plurality of sequentially larger diameter dilators, said retractor assembly comprising a retractor blade holder and said plurality of retractor blades attached to said refractor blade holder,removing said plurality of sequentially larger diameter dilators from said patient while the retractor blades remain in said lateral, trans-psoas path so as to create an operative corridor along said lateral, trans-psoas path, wherein said retractor blade holder is adjustable to thereby move at least one of said plurality of retractor blades in a direction away from at least one other of said plurality of retractor blades while the retractor blades remain in said lateral, trans-psoas path, andmaintaining said operative corridor along said lateral, trans-psoas path using said retractor assembly while advancing a spinal implant through said lateral, trans-psoas path to the lumbar spine, wherein, during delivery of said spinal implant, said operative corridor is maintained by at least a posterior-most retractor blade of said retractor assembly, a caudal-most retractor blade of said retractor assembly, and a cephalad-most retractor blade of said retractor assembly. 15. The method of claim 14, wherein said operative corridor is further maintained by an anterior-most retractor blade of said retractor assembly. 16. The method of claim 15, wherein said anterior-most retractor blade being movable away from said posterior-most retractor blade in an anterior-posterior direction. 17. The method of claim 14, wherein said plurality of sequentially larger diameter dilators are removed from said patient after at least one of said plurality of retractor blades is moved in a direction away from at least one other of said plurality of retractor blades to create said operative corridor. 18. The method of claim 14, further comprising advancing a K-wire along said lateral, trans-psoas path and into a disc space, said K-wire being slidably engaged with an innermost dilator of said plurality of sequentially larger diameter dilators. 19. The method of claim 14, wherein at least one of said posterior-most retractor blade, said caudal-most retractor blade, and said cephalad-most retractor blade comprise a stimulation electrode capable of delivering electrical stimulation for nerve monitoring. 20. The method of claim 14, wherein said method comprises using a monitoring system for nerve monitoring, wherein said monitoring system delivers an electrical stimulation signal to the stimulation electrode of each of the sequentially larger diameter dilators and outputs data indicative of electromyographic activity detected by a set of sensor electrodes in muscle myotomes associated with nerves in a vicinity of a spinal disc. 21. The method of claim 20, 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, and an EMG sensor harness having the set of sensor electrodes connected to the patient module, wherein the control unit receives signals from the patient module and processes EMG response output from the sensor electrodes to extract characteristic information for each of said muscle myotomes, wherein the video display device displays a numeric stimulation threshold required to obtain the electromyographic activity in at least one of said muscle myotomes. 22. The method of claim 14, wherein the retractor assembly further comprises a light emitting device to direct light through the operative corridor toward a spinal disc, the light emitting device being coupled to one of said plurality of retractor blades. 23. The method of claim 14, wherein each of said plurality of sequentially larger diameter dilators comprises a distal end on which said stimulation electrode is situated, said distal end being angled relative to a longitudinal axis of said dilator. 24. The method of claim 23, wherein said method comprises using a monitoring system for nerve monitoring, the monitoring system comprising a control unit having a video display device, a patient module connected to the control unit via a data cable, and an EMG sensor harness having the set of sensor electrodes connected to the patient module. 25. The method of claim 24, wherein the control unit receives signals from the patient module and processes EMG response output from the sensor electrodes to extract characteristic information from muscle myotomes associated with nerves in a vicinity of a spinal disc. 26. The method of claim 14, wherein said method comprises using a monitoring system for nerve monitoring, the monitoring system comprising a display that displays a numeric stimulation threshold required to obtain electromyographic activity in at least one muscle myotome associated with a nerve in a vicinity of a spinal disc. 27. The method of claim 14, wherein said caudal-most retractor blade being movable away from said cephalad-most retractor blade in a caudal-cephalad direction.