Lateral Spinal Access Assembly Minimizing Tissue Trauma
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Solution Overview
Problem
Current surgical techniques for stabilizing the spine, particularly in the thoracic and lumbar regions, face challenges such as large incisions, muscle damage, lengthy healing times, post-operative pain, and risks to vital structures like nerves and vessels, especially when performing anterior or posterior approaches for disc stabilization and fusion.
Innovation Solution
A lateral or anterolateral access assembly that uses a needle assembly with a removable handle and dilators to create a small incision for guiding surgical tools and implants, allowing for controlled access and distraction of bony structures without mobilizing vital vessels or nerves, enabling procedures like discectomy, fusion, and internal fixation through a minimally invasive approach.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional open surgical techniques are used for spinal stabilization, then adequate access and visualization of the spine is achieved, but large incisions and muscle damage occur leading to lengthy healing times and post-operative pain
Solution Approach 1:
The surgical procedure is divided into sequential steps using a staged approach: first creating a small initial incision, then progressively dilating through multiple stages with increasing diameter dilators, allowing access to the spine without requiring a large incision. This segmented approach minimizes tissue damage while achieving adequate access.
Solution Approach 2:
The access system uses nested dilators where each dilator fits within the previous one, with progressively larger diameters. The initial dilator is inserted through the small incision, and subsequent dilators are advanced over the previous one to progressively enlarge the access channel to the required diameter for surgical instruments.
2Ease of operation
If anterior or posterior approaches are used for disc stabilization, then direct access to the disc space is achieved, but risks to vital structures like nerves and vessels increase
Solution Approach 1:
The invention transitions from traditional anterior or posterior approaches to a lateral approach for accessing the disc space. By changing the dimensional angle of access to the spine, the procedure avoids vital structures located in the anterior and posterior regions while still achieving direct access to the disc space for stabilization procedures.
3Ease of operation
If large incisions are made for open spinal surgery, then adequate exposure for fastener placement is achieved, but considerable muscle must be cut and retracted causing extensive tissue trauma
Solution Approach 1:
The surgical access is achieved through segmentation of the incision and dilation process into multiple small stages rather than one large incision. This allows adequate exposure for fastener placement through a minimally invasive pathway that preserves muscle integrity.
Solution Approach 2:
The dilator system acts as an intermediary tool that creates a controlled pathway through the tissue to the spine. This intermediary mechanism allows surgical instruments to reach the target site without requiring direct large-scale dissection of muscle tissue.
4Ease of operation
If the pedicle is removed to gain access to the spinal canal, then adequate space for disc removal is achieved, but further weakening of the already diseased area occurs
Solution Approach 1:
Instead of removing the pedicle to access the spinal canal, the invention uses a lateral approach that accesses the disc space and spinal canal through the side of the vertebral body. This dimensional change in access pathway preserves the pedicle and maintains spinal structure integrity while still providing adequate space for disc removal and stabilization procedures.
Data Source
AI summary
The present invention is directed to methods and instrumentation for performing surgery on the spine along its lateral aspect (side) and generally by a lateral, anterior or an anterolateral surgical approach, such that the instruments enter the body from an approach that is other than posterior and make contact with the spine along its lateral aspect. The present invention provides for the entire surgical procedure to be performed through a relatively small incision and may be performed in either the thoracic or lumbar spine.