Pelvic Bracket for Stable Lateral Spinal Access
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Solution Overview
Problem
Traditional minimally invasive spinal surgical techniques, such as XLIF, are contraindicated for the L5-S1 intervertebral disc space due to anatomical challenges, where patient movement affects instrument alignment, hindering precise access and stability during surgical procedures.
Innovation Solution
A method and apparatus involving a pelvic bracket mounted on the iliac crest, with an iris retractor and surgical tools, allowing lateral access to the lumbosacral intervertebral disc space, ensuring instrument stability and alignment independent of patient movement, facilitated by a surgical kit including a pelvic bracket, retractor, and offset tools for precise surgical interventions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If traditional minimally invasive spinal surgical techniques (XLIF) are used for L5-S1 intervertebral disc space, then smaller incisions and minimal tissue disruption are achieved, but patient movement affects instrument alignment and precise access is hindered
Solution Approach 1:
The surgical system is segmented into multiple independent components: a mounting bracket fixed to the patient's anatomy, a retractor assembly that can be independently positioned, and surgical instruments that can be independently manipulated. This segmentation allows the mounting bracket to remain stable while the retractor and instruments can accommodate patient movement, maintaining alignment without requiring the entire system to be rigidly fixed.
Solution Approach 2:
The retractor assembly incorporates dynamic adjustment capabilities, allowing it to be repositioned and realigned during the surgical procedure. This dynamic adjustment enables the system to compensate for patient movement, maintaining proper instrument alignment with the L5-S1 intervertebral disc space even as the patient's anatomy shifts during surgery.
2Ease of operation
If lateral access approach is used for L5-S1 intervertebral disc space, then access to the disc space is enabled, but instrument stability and alignment are compromised due to patient movement
Solution Approach 1:
The mounting bracket is pre-positioned and secured to the patient's anatomy (iliac crest or pelvis) before the actual surgical access is established. This preliminary action creates a stable reference frame that remains fixed throughout the procedure, allowing subsequent surgical instruments to be accurately aligned with the L5-S1 disc space regardless of patient movement during the surgery.
Solution Approach 2:
The mounting bracket acts as an intermediary between the patient's moving anatomy and the surgical instruments. By anchoring the bracket to stable bony structures and using it as a reference point, the system mediates between patient movement and instrument stability, enabling precise surgical access while compensating for anatomical shifts.
3Reliability
If open surgical approach is used, then adequate exposure and stable instrument positioning are achieved, but larger incisions and increased tissue disruption occur
Solution Approach 1:
The mounting bracket is designed to be self-anchoring, utilizing the patient's own anatomy (iliac crest or pelvic structures) as the fixation point. This eliminates the need for external support structures or complex fixation systems, providing stable instrument positioning through a minimally invasive approach that avoids the tissue disruption associated with open surgical exposure.
Data Source
AI summary
A method for laterally accessing a lumbosacral intervertebral disc space of a patient includes positioning the patient laterally and making an incision to provide lateral access to the patient's iliac crest. A bracket (24) may be placed on the iliac crest and a retractor (28) may be attached to the bracket such that a distal end of the retractor is positioned over the lumbosacral intervertebral disc space while a proximal end of the retractor provides an entry space for a surgeon to insert at least one tool (90). The surgeon may perform a surgical procedure on the lumbosacral intervertebral disc space through a channel (49) defined by the retractor.