Patent ID: 8696559
Filing Date: 2014-04-15
Classification: A61B

Abstract:
1. A system for accessing a lateral aspect of a lumbar spine, comprising: an initial dilator configured to advance to a targeted spinal disc along a lateral, trans-psoas path to the lumbar spine, a distal tip region of the initial dilator including a stimulation electrode configured to deliver electrical stimulation away from the distal tip region for nerve monitoring when the initial dilator is positioned in the lateral, trans-psoas path; an elongate guidewire instrument advanceable through an inner lumen of the initial dilator, the elongate guidewire instrument having a distal tip configured to penetrate into a lateral aspect of a targeted spinal disc along the lateral, trans-psoas path to the lumbar spine, the elongate guidewire instrument having a longitudinal length that is greater than a longitudinal length of the initial dilator; plurality of supplemental dilators of increasing diameters to create a tissue distraction corridor along the lateral, trans-psoas path to the lumbar spine, a first supplemental dilator of the plurality of supplemental dilators having a lumen to slidably receive the initial dilator and having a longitudinal length that is less than the longitudinal length of the initial dilator, and a second supplemental dilator of the plurality of supplemental dilators having a lumen to slidably receive the first supplemental dilator and having a longitudinal length that is less than the longitudinal length of the first supplemental dilator; and a three-bladed retractor assembly comprising three retractor blades that are simultaneously advanceable over an exterior of an outer dilator of the plurality of supplemental dilators while the three-bladed retractor assembly is advanced toward the spinal disc along the lateral, trans-psoas path, the three retractor blades being configured to enlarge the distraction corridor and maintain a trans-psoas operative corridor along the lateral, trans-psoas path to the lumbar spine, the three-bladed retractor assembly further comprising a respective extension element to mate with each retractor blade of the three retractor blades so that a distal region of the respective extension element is configured to extend distally from a distal end of the retractor blade, the three-bladed retractor assembly further comprising a blade holder assembly configured to adjust the three retractor blades from a first position in which the three retractor blades are advanceable over the exterior of the outer dilator of the plurality of supplemental dilators to a second position in which the three retractor blades are moved away from one another, and wherein the three retractor blades are configured to maintain the trans-psoas operative corridor at a size so dimensioned to pass an implant through the trans-psoas operative corridor along the lateral, trans-psoas path toward the lumbar spine.