Dilation system and method of using the same

Patent metadata

Field	Value
Publication number	US-9974533-B2
Application number	US-201715680433-A
Country	US
Kind code	B2
Filing date	Aug 18, 2017
Priority date	Oct 5, 2007
Publication date	May 22, 2018
Grant date	May 22, 2018

Abstract

A method of forming an access opening through a psoas muscle to a patient's spine includes laterally inserting a stimulating dilator into the psoas muscle. The stimulating dilator has a stimulation channel formed in an outer surface thereof. An electrical pulse is transmitted via an EMG into the stimulating dilator to locate a position of a nerve in the patient's psoas muscle. The stimulating dilator is laterally inserted through the psoas muscle and toward the patient's spine in a way that avoids the nerve. A stimulating probe is inserted into the stimulation channel along the outer surface of the stimulating dilator while transmitting an electrical pulse via the EMG into the stimulating probe to verify the position of the nerve.

First claim

What is claimed is:

1. A directional sequential dilation system for dilating away from a nerve of a patient's anatomy, the directional sequential dilation system comprising:
a stimulating probe having a probe axis;
a first directional dilator including a first longitudinal axis, a first bore having a length extending from a proximal end to a distal end of the first directional dilator and a first channel formed in an outer surface of the first directional dilator so as to be in communication with the first bore along at least a portion of the length of the first bore, the first bore having a first bore axis, the first longitudinal axis offset from the first bore axis; and
a second directional dilator including a second longitudinal axis, a second bore having a length extending from a proximal end to a distal end of the second directional dilator and a second channel formed in an outer surface of the second directional dilator so as to be in communication with the second bore along at least a portion of the length of the second bore, the second bore having a second bore axis, the second longitudinal axis offset from the second bore axis,
wherein the stimulating probe is removably receivable in the first bore and the first directional dilator removably receivable in the second bore,
wherein the stimulating probe extends into the first channel when the stimulating probe is received in the first bore, and
wherein the first directional dilator extends into the second channel when the first directional dilator is received in the second bore.

2. The directional sequential dilation system of claim 1 , wherein the probe axis is coaxial with the first bore axis in an assembled configuration.

3. The directional sequential dilation system of claim 1 , wherein the first longitudinal axis is coaxial with the second bore axis in an assembled configuration.

4. The directional sequential dilation system of claim 1 , further comprising:
a first tip located at the distal end of the first directional dilator, the first longitudinal axis passing through the first tip; and
a second tip located at the distal end of the second directional dilator, the second longitudinal axis passing through the second tip.

5. The directional sequential dilation system of claim 4 , further comprising:
a plurality of first depth indicators located on a first outer surface of the first directional dilator, the plurality of first depth indicators extending on the first outer surface generally perpendicular to the first longitudinal axis, respectively, the plurality of first depth indicators defining a plurality of first distances between the first tip and the plurality of first depth indicators, respectively; and
a plurality of second depth indicators located on a second outer surface of the second directional dilator, the plurality of second depth indicators extending on the second outer surface generally perpendicular to the second longitudinal axis, respectively, the plurality of second depth indicators defining a plurality of distances between the second tip and the plurality of second depth indicators, respectively.

6. The directional sequential dilation system of claim 1 , wherein the first and second dilators include first and second grips located at proximal ends thereof, respectively.

7. The directional sequential dilation system of claim 1 , wherein the first directional dilator has a first length and the second directional dilator has a second length, the first length being greater than the second length.

8. The directional sequential dilation system of claim 7 , wherein the stimulating probe has a probe length, the probe length being greater than the first length and the second length.

9. The directional sequential dilation system of claim 1 , wherein the first directional dilator has a first diameter and the second directional dilator has a second diameter, the second diameter being greater than the first diameter.

10. The directional sequential dilation system of claim 1 , wherein the first channel is radially aligned with the second channel when the stimulating probe is received in the first bore and when the first directional dilator is received in the second bore.

11. A directional sequential dilation system for dilating away from a nerve of a patient's anatomy, the directional sequential dilation system comprising:
a stimulating probe having a probe axis;
a first directional dilator including a first longitudinal axis, a first bore having a length extending from a proximal end to a distal end of the first directional dilator and a first channel formed in an outer surface of the first directional dilator so as to be in communication with the first bore along at least a portion of the length of the first bore, the first bore having a first bore axis, the first longitudinal axis offset from the first bore axis; and
a second directional dilator including a second longitudinal axis, a second bore having a length extending from a proximal end to a distal end of the second directional dilator and a second channel formed in an outer surface of the second directional dilator so as to be in communication with the second bore along at least a portion of the length of the second bore, the second bore having a second bore axis, the second longitudinal axis offset from the second bore axis,
wherein the stimulating probe is removably receivable in the first bore and the first directional dilator removably receivable in the second bore,
wherein the stimulating probe extends through the first channel when the stimulating probe is received in the first bore, and
wherein the first directional dilator extends through the second channel when the first directional dilator is received in the second bore.

12. The directional sequential dilation system of claim 11 , wherein the probe axis is coaxial with the first bore axis in an assembled configuration.

13. The directional sequential dilation system of claim 11 , wherein the first longitudinal axis is coaxial with the second bore axis in an assembled configuration.

14. The directional sequential dilation system of claim 11 , further comprising:
a first tip located at the distal end of the first directional dilator, the first longitudinal axis passing through the first tip; and
a second tip located at the distal end of the second directional dilator, the second longitudinal axis passing through the second tip.

15. The directional sequential dilation system of claim 14 , further comprising:
a plurality of first depth indicators located on a first outer surface of the first directional dilator, the plurality of first depth indicators extending on the first outer surface generally perpendicular to the first longitudinal axis, respectively, the plurality of first depth indicators defining a plurality of first distances between the first tip and the plurality of first depth indicators, respectively; and
a plurality of second depth indicators located on a second outer surface of the second directional dilator, the plurality of second depth indicators extending on the second outer surface generally perpendicular to the second longitudinal axis, respectively, the plurality of second depth indicators defining a plurality of distances between the second tip and the plurality of second depth indicators, respectively.

16. The directional sequential dilation system of claim 11 , wherein the first and second dilators include first and second grips located at proximal ends thereof, respectively.

17. The directional sequential dilation system of claim 11 , wherein the first di

Assignees

• Depuy Synthes Products Inc

Inventors

• Fatone Peter
• Randall Brandon

Classifications

• A61B17/3417

  Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00) · CPC title

• A61B17/3423

  Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247) · CPC title

• A61B17/0218

  for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title

• A61B2017/003

  Steerable · CPC title

• A61B2017/00331

  with preformed bends · CPC title