Hinged Retractor Ring for Anterior-to-Psoas Spine Access
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Solution Overview
Problem
Existing spinal surgery methods face challenges in accessing the spine minimally invasively without damaging the lumbar plexus and psoas muscle, particularly when navigating through the psoas muscle, which requires complex neuromonitoring and can cause nerve damage.
Innovation Solution
A hinged retractor ring system with adjustable angles and removable connections, combined with retractors and blades, allows for a minimally invasive anterior-to-psoas approach (ATP) that avoids the psoas muscle, using radio-lucent materials to maintain visibility and stability during surgery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a traditional spinal surgery approach is used to access the spine, then the surgical corridor can be established, but the lumbar plexus and psoas muscle may be damaged requiring complex neuromonitoring
Solution Approach 1:
The retractor system is divided into multiple independent components including a retractor ring, multiple retractor blades, and positioning elements that can be independently adjusted. This segmentation allows precise control of each blade's position to maintain safe distances from neural structures while establishing the surgical corridor
Solution Approach 2:
The retractor ring acts as an intermediary structure that indirectly accesses the spinal target without requiring direct traversal through the psoas muscle and lumbar plexus. The ring provides a stable platform from which blades can retract soft tissues to create a working corridor that bypasses harmful anatomical structures
2Object-affected harmful factors
If a minimally invasive approach is used to avoid nerve damage, then nerve safety is improved, but access to a wide range of disc levels becomes more difficult
Solution Approach 1:
The retractor blades are designed with dynamic positioning capabilities, allowing intraoperative adjustment of blade angles, depths, and orientations. This dynamic adaptability enables the same minimally invasive approach to access multiple disc levels by repositioning blades rather than requiring separate incisions or approaches for each level
Solution Approach 2:
The retractor ring system is designed as a universal platform that can accommodate various blade configurations and positions to access different spinal levels. The system provides multi-functionality by combining a single minimally invasive access point with the capability to reach multiple disc spaces through adjustable retractor positioning
3Illumination intensity
If radio-lucent materials are used for the retractor ring, then visibility during imaging is improved, but the mechanical strength and wear resistance may be reduced
Solution Approach 1:
The retractor ring is constructed from composite materials that combine radio-lucent properties with enhanced mechanical strength. This may include radio-lucent metals such as titanium or aluminum alloys, or composite structures combining radio-lucent polymers with reinforcing elements, achieving both imaging visibility and structural durability
Solution Approach 2:
Different portions of the retractor system may use different materials optimized for their specific functions. The retractor ring uses radio-lucent material for imaging visibility, while critical load-bearing components or surface layers may use harder, more wear-resistant materials to compensate for the relatively lower strength of radio-lucent materials
Data Source
AI summary
An supine anterior-to-psoas approach includes a patient being rotated for the initial approach. Further, various blades and retractor rings provide various features to allow for the supine ATP approach or a conventional ATP to be performed.