Systems and methods for performing surgical procedures and assessments

摘要

The present invention involves systems and related methods for performing surgical procedures and assessments, including the use of neurophysiology-based monitoring to: (a) determine nerve proximity and nerve direction to surgical instruments employed in accessing a surgical target site; (b) assess the pathology (health or status) of a nerve or nerve root before, during, or after a surgical procedure; and/or (c) assess pedicle integrity before, during or after pedicle screw placement, all in an automated, easy to use, and easy to interpret fashion so as to provide a surgeon-driven system.

主权项

1. A system for inserting a spinal implant through a trans-psoas operative corridor to an intervertebral disc, comprising:
an elongate inner instrument to advance in a trans-psoas path through bodily tissue toward a lateral aspect of the targeted intervertebral disc of the lumbar spine, the elongate inner instrument being configured to engage an annulus of the targeted intervertebral disc; a set of trans-psoas dilators to dilate the trans-psoas path through the bodily tissue toward the lateral aspect of the targeted intervertebral disc of the lumbar spine, the set of trans-psoas dilators comprising at least a first dilator to slidably engage with an exterior of the elongate inner instrument and having a first length; wherein at least one instrument of the group consisting of the elongate inner instrument and a dilator of the set of trans-psoas dilators comprises a stimulation electrode exposed along a distal tip portion of said at least one instrument to emit an electrical stimulation signal to the bodily tissue for nerve monitoring when said at least one instrument is positioned in the trans-psoas path through the bodily tissue, wherein said at least one of instrument is electrically insulated along an entire length thereof with the exception of: at least one exposed electrical contact positioned at a proximal end region of said at least one of instrument, and said stimulation electrode positioned on the distal tip region of said at least one of instrument; and a working corridor instrument slidable over an outermost dilator of the set of trans-psoas dilators along the trans-psoas path through the bodily tissue to the lateral aspect of the targeted intervertebral disc of the lumbar spine, the working corridor instrument being configured to enlarge the trans-psoas path through the bodily tissue and maintain a trans-psoas operative corridor that is dimensioned so as to pass a spinal implant through the trans-psoas operative corridor to the lumbar spine.