(54)
`
`(75)
`
`Inventors: Luiz Pimenta, Sao Paulo (BR); Patrick
`Miles, San Diego, CA (US); Scot
`Martinelli, San Diego, CA (US); Eric
`Finley, San Diego, CA (US)
`
`(73)
`
`Assignee: NuVasive, Inc., San Diego, CA (US)
`
`(*)
`
`Notice:
`
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 154 days.
`This patent is subject to a terminal dis
`claimer.
`
`DE
`EP
`
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`(Continued)
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`(Continued)
`OTHER PUBLICATIONS
`
`(12) United States Patent
`Pimenta et al.
`
`(10) Patent N0.:
`(45) Date of Patent:
`
`US 8,591,432 B2
`*Nov. 26, 2013
`
`US008591432B2
`
`SURGICAL ACCESS SYSTEM AND RELATED
`METHODS
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`(21)
`
`(22)
`
`(65)
`
`(63)
`
`(60)
`
`(51)
`
`(52)
`
`(58)
`
`Appl. N0.: 12/983,627
`
`Filed:
`
`Jan. 3, 2011
`
`Prior Publication Data
`
`US 2011/0098535 A1
`
`Apr. 28, 2011
`
`Related US. Application Data
`
`Continuation of application No. 12/635,869, ?led on
`Dec. 11, 2009, noW Pat. No. 8,303,515, and a
`continuation of application No. 10/967,668, ?led on
`Oct. 18, 2004, noW Pat. No. 7,905,840.
`
`Provisional application No. 60/512,594, ?led on Oct.
`17, 2003, provisional application No. 60/506,136,
`?led on Sep. 25, 2003.
`
`(2006.01)
`
`Int. Cl.
`A61B 5/05
`US. Cl.
`USPC ........................................................ .. 600/554
`Field of Classi?cation Search
`USPC ................... .. 600/554, 546; 606/41, 86 A, 79
`See application ?le for complete search history.
`
`“Electromyography System,” International Search report from Inter
`national Application No. PCT/US00/32329, Apr. 27, 2001, 9 pages.
`(Continued)
`
`Primary Examiner * Brian SZmal
`Assistant Examiner * Fangemonique Smith
`(74) Attorney, Agent, or Firm * Fish & Richardson RC.
`
`ABSTRACT
`(57)
`A surgical access system including a tissue distraction assem
`bly and a tissue retraction assembly, both of Which may be
`equipped With one or more electrodes for use in detecting the
`existence of (and optionally the distance and/ or direction to)
`neural structures before, during, and after the establishment
`of an operative corridor to a surgical target site. Some
`embodiments of the surgical access system may be particu
`larly suited for establishing an operative corridor to a surgical
`target site in the spine. Such an operative corridor may be
`established through the retroperitoneal space and the psoas
`muscle during a direct lateral, retroperitoneal approach to the
`spine.
`
`19 Claims, 50 Drawing Sheets
`
`
`
` 1
`
`NUVASIVE 1060
`NuVasive, Inc. v. Warsaw Orthopedic, Inc.
`IPR2013-00206
`IPR2013-00208
`
`

`

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`
`
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`US. Patent
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`Nov. 26, 2013
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`FIG. 1
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`US. Patent
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`FIG. 3
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`FIG. 5
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`11
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`FIG. 7
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`13
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`US. Patent
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`FIG. 8
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`US. Patent
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`FIG. 9
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`US. Patent
`US. Patent
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`Nov. 26, 2013
`Nov. 26, 2013
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`Sheet 11 0150
`Sheet 11 0150
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`US. Patent
`US. Patent
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`Nov. 26, 2013
`Nov. 26, 2013
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`Sheet 12 0150
`Sheet 12 0150
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`US 8,591,432 B2
`US 8,591,432 B2
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`US. Patent
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`US 8,591,432 B2
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`US. Patent
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`U.S. Patent
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`U.S. Patent
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`NOV. 26, 2013
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`US. Patent
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`Nov. 26, 2013
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`Sheet 17 of 50
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`US. Patent
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`Sheet 18 of 50
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`US 8,591,432 B2
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`US. Patent
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`U.S. Patent
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`NOV. 26, 2013
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`US 8,591,432 B2
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`US. Patent
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`Nov. 26, 2013
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`Sheet 21 0150
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`US 8,591,432 B2
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`FIG.21
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`US. Patent
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`Nov. 26, 2013
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`Sheet 22 of 50
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`US 8,591,432 B2
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`US. Patent
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`Nov. 26, 2013
`
`Sheet 23 of 50
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`US 8,591,432 B2
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`
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`
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`
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`FIG.23
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`29
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`29
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`

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`US. Patent
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`Nov. 26, 2013
`
`Sheet 24 of 50
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`US 8,591,432 B2
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`FIG. 24
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`30
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`30
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`US. Patent
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`Nov. 26, 2013
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`Sheet 25 of 50
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`US 8,591,432 B2
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`FI