Method of retroperitoneal lateral insertion of spinal implants

摘要

A method is disclosed for introducing a spinal disc implant into an intervertebral space of a subject. The subject is placed in a lateral position, and the anterior face of the spinal disc intervertebral space is accessed, between the L5 and S1 vertebrae, from an anterior and lateral retroperitoneal approach. An operative corridor to the anterior face of the spinal disc space is established by introducing a retractor instrument anterolaterally to the spinal disc space between the anterior superior iliac spine and the anterior inferior iliac spine. The damaged spinal disc contents are removed from the intervertebral space through the operative corridor, and the implant is advanced into the intervertebral space at an oblique angle and pivoted to position the implant substantially laterally within the intervertebral space. Elongated retractor and insertion instruments, as well as a modified disc implant, are also disclosed for carrying out the method.

主权项

1. A method of positioning a spinal implant into an intervertebral space of a subject, comprising:
establishing an anterolateral operative corridor in a subject, while the subject is positioned on his/her side, wherein the anterolateral operative corridor extends from the subject's skin to a location proximate an anterolateral portion of an intervertebral space between the L5 and S1 vertebrae, wherein establishing the anterolateral operative corridor comprises:
inserting a retractor into the subject while the subject is positioned on his/her side, wherein a distal portion of the retractor comprises:
a first retraction blade;a second retraction blade, wherein the first and second retraction blades are inserted between iliac vessels of the subject proximate the anterolateral portion of the intervertebral space; andat least partially expanding the retractor to establish the anterolateral operative corridor, wherein iliac vessels are separated apart such that one iliac vessel at least partially moves in an anterior direction towards a front of the subject and one iliac vessel at least partially moves in a posterior direction towards a back of the subject; advancing the spinal implant at least partially into the intervertebral space between the L5 and S1 vertebrae via the anterolateral operative corridor, wherein the spinal implant is advanced into the intervertebral space at an oblique angle to the intervertebral space; and rotating the spinal implant at least partially within the intervertebral space.