Surgical access system and related methods

摘要

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. The tissue retraction assembly has a plurality of blades which may be introduced while in a closed configuration, after which point they may be opened to create an operation corridor to the surgical target site, including pivoting at least one blade to expand the operative corridor adjacent to the operative site.

主权项

1. A system for establishing and maintaining an operative corridor to a spinal site during a surgical procedure, comprising:
a retractor assembly having a blade holder and a plurality of blades coupled to said blade holder, wherein the retractor assembly is adjustable from a first position in which the plurality of blades are adjacent to one another and simultaneously advanceable to the spinal site over a tissue dilator to a second position in which the plurality of blades are spaced apart from one another; and a fixation shim for fixing one of the plurality of blades to bone at the spinal site, the fixation shim having a shim member that slidably engages one of the plurality of retractor blades and a fixation element coupled to the shim member, the shim member including a body having a longitudinal channel extending therethrough, the fixation element having a proximal portion that extends above the shim member and includes an engagement feature for mating with a driver, a distal portion that extends below the shim member and including threading for anchoring in the bone at the spinal site, a middle portion that extends through the longitudinal channel in the body, and a retainer having an outer profile that does not fit within the longitudinal channel and does not extend beyond an outermost profile of the body, the fixation element being translatable through the longitudinal channel along a range limited in both the proximal and distal directions.