Lateral Spine Access with Tissue Oximetry Vessel Avoidance
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Solution Overview
Problem
Current spine surgery techniques face challenges in minimizing contact with sensitive vascular and neural structures, particularly when accessing the L5-S1 and L4-L5 disc spaces, where traditional approaches may be impractical due to anatomical constraints and the need for large exposure, leading to increased risk and morbidity.
Innovation Solution
A minimally invasive method using an optical imaging system with tissue oximetry and sensors to detect vascular tissue, allowing for real-time adjustment of the access instrument's path to avoid vascular tissue, combined with a sequential dilation system and retractor assembly to create an operative corridor, facilitating safer access to the spinal target site.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional posterior approach is used to access the lumbar spine, then the surgical path is unimpeded by major nerves or vessels and involves traversing a relatively short distance, but the exposure of the target site (intervertebral disc) is limited and requires cutting away part of the posterior bony structures
Solution Approach 1:
The patent transitions from traditional posterior (back) approach to a lateral approach, accessing the lumbar spine from the side. This dimensional change in surgical trajectory allows simultaneous achievement of minimal invasiveness and adequate exposure of the intervertebral disc target site without requiring extensive bone resection
2Area of stationary object
If anterior approach is used to access the lumbar spine, then large exposure of the target site is accommodated, but the surgeon must traverse a greater distance through patient's body tissue and move various internal organs and vessels out of the way
Solution Approach 1:
The patent employs a lateral approach that accesses the lumbar spine from the side rather than from the front (anterior) or back (posterior). This lateral trajectory provides adequate exposure of the target site while avoiding the need to traverse through abdominal organs and vessels, thus achieving large exposure with minimal disruption to internal structures
3Area of stationary object
If lateral approach is used to access the lumbar spine, then large exposure is achieved through a smaller incision without retracting abdominal contents, but the approach may be impracticable at L5-S1 and sometimes L4-L5 level because the iliac crest blocks the disc space
Solution Approach 1:
The patent utilizes image guidance technology to enable real-time adjustment of the surgical trajectory. When the iliac crest blocks access to L5-S1 or L4-L5 disc spaces through the lateral approach, the image guidance system allows the surgeon to dynamically modify the approach angle and path to navigate around the bony obstruction and reach the target disc space
4Device complexity
If traditional surgical techniques are used without real-time vascular detection, then the surgical procedure is simpler, but the risk of inadvertently contacting or impinging on sensitive vascular and neural structures is increased
Solution Approach 1:
The patent incorporates image guidance technology that provides real-time feedback during the surgical procedure. The system continuously monitors the position of surgical instruments relative to vascular and neural structures, allowing the surgeon to adjust the approach in real-time to avoid these sensitive structures, thus enhancing safety without significantly complicating the overall surgical technique
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This method reduces the risk of damaging vascular tissue during spine surgery by providing real-time feedback for precise instrument guidance, enabling safer and more effective access to the spinal target site with reduced morbidity and recovery time.
Implementation Method 1
monitoring for the presence of vascular tissue located in the path of advancement of the access instrument with an optical imaging system that detects vascular tissue... the optical imaging system is a tissue oximetry system and monitoring for the presence of vascular tissue includes determining the oxygen saturation levels of tissue adjacent to the surgical access instrument
Data Source
AI summary
Systems and methods are disclosed for accessing and forming an operative corridor to targeted spinal sites using optical imaging to detect and avoid vascular tissue. The optical imaging may include tissue oximetry to measure the oxygen saturation of tissue proximate to surgical access instruments utilized during surgery. Sensors may be situated near the distal end of the surgical access instruments and monitoring for vessel proximity may be performed during advancement of the instrument.