Postero-lateral inter-muscular cervical spine access
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Solution Overview
Problem
Current surgical approaches for accessing the cervical spine, such as the anterior and posterior midline methods, pose significant risks to vital structures and result in complications like dysphagia, airway obstruction, and extensive muscle disruption, while also often requiring reconstruction or fusion procedures.
Innovation Solution
A novel postero-lateral, inter-muscular approach that utilizes a triangular surgical window defined by the trapezius, splenius capitis, and levator scapulae muscles, allowing for deep spine access with minimal muscle disruption and sparing of vital structures, enabling unilateral or bilateral access to the cervical spine from C2 to T1.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If anterior or posterior midline surgical approaches are used to access the cervical spine, then the surgical target can be reached, but vital structures are at risk and extensive muscle disruption occurs
Solution Approach 1:
The surgical approach is segmented into specific inter-muscular planes that are sequentially dissected. The posterior cervical region is divided into distinct muscle layers (trapezius, splenius capitis, levator scapulae) with defined dissection planes between them, allowing targeted access while preserving adjacent muscle groups and their innervation.
Solution Approach 2:
The invention uses the inter-muscular plane as an intermediary pathway to reach the cervical spine. By dissecting between the splenius capitis and levator scapulae muscles rather than through them, the approach creates a safe corridor that mediates between the skin surface and the spinal target, avoiding direct injury to vital structures while still achieving surgical access.
2Ease of operation
If traditional posterior midline approach is used, then access to the spine is achieved, but extensive muscle disruption and post-operative pain occur
Solution Approach 1:
The surgical approach applies local quality by targeting only the specific inter-muscular plane needed for access (between splenius capitis and levator scapulae) while leaving surrounding muscle groups intact. This localized dissection strategy provides adequate surgical exposure for cervical procedures without the extensive muscle disruption characteristic of traditional midline approaches, thereby reducing post-operative pain and facilitating faster recovery.
3Productivity
If anterior approach is used to access cervical spine, then pathology can be treated, but dysphagia and airway complications may occur
Solution Approach 1:
The invention inverts the traditional anterior approach by using a posterior lateral entry point to reach the same cervical pathology. Instead of approaching from the front where airway and swallowing structures are directly in the surgical field, the approach comes from the back, using the inter-muscular plane between splenius capitis and levator scapulae to access the spine, thereby treating the same conditions while avoiding anterior structure injury.
4Ease of operation
If standard posterior approach is used, then surgical access is obtained, but reconstruction or fusion procedures are often required
Solution Approach 1:
The surgical approach uses partial action by limiting the dissection to only what is necessary for access and treatment within the inter-muscular plane. Rather than performing extensive muscle detachment and broad exposure that would require subsequent reconstruction, the approach performs just enough dissection to reach the pathology and perform the necessary procedure, avoiding excessive tissue manipulation that would mandate fusion or reconstruction.
Data Source
AI summary
A novel posterolateral inter-muscular approach has been developed to access the cervical. spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises:i) an anterior superior border of the trapezius muscle;ii) an anterior inferior border of the splenius capitis muscle, andiii) a posterior superior border of the levator scapulae muscle.Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.