`
`(12) United States Patent
`Miles et al.
`
`(10) Patent N0.:
`(45) Date of Patent:
`
`US 8,192,356 B2
`*Jun. 5, 2012
`
`(54)
`
`(75)
`
`SURGICAL ACCESS SYSTEM AND RELATED
`METHODS
`
`Inventors: Patrick Miles, San Diego, CA (US);
`Scot Martinelli, San Diego, CA (US);
`Eric Finley, San Diego, CA (US);
`James Gharib, San Diego, CA (US);
`Allen Farquhar, San Diego, CA (US);
`Norbert Kaula, Arvada, CO (US);
`Jeffrey BleWett, San Diego, CA (US);
`Goretti Medeiros, legal representative,
`Plantsville, CT (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
`USC 154(b) by 370 days.
`This patent is subject to a terminal dis
`claimer.
`
`(21)
`
`(22)
`
`(65)
`
`(63)
`
`(60)
`
`(51)
`
`(52)
`
`Appl. N0.: 12/635,418
`
`Filed:
`
`Dec. 10, 2009
`
`Prior Publication Data
`
`US 2010/0094093 A1
`
`Apr. 15, 2010
`
`Related US. Application Data
`
`Continuation of application No. 12/428,081, ?led on
`Apr. 22, 2009, noW Pat. No. 7,935,051, Which is a
`continuation of application No. 10/608,362, ?led on
`Jun. 26, 2003, noW Pat. No. 7,582,058.
`
`Provisional application No. 60/392,214, ?led on Jun.
`26, 2002.
`
`Int. Cl.
`(2006.01)
`A61B 1/32
`US. Cl. ...................................... .. 600/202; 600/546
`
`(58) Field of Classi?cation Search ................ .. 600/221,
`600/215, 202, 210, 546, 223, 201, 214, 224,
`600/219; 607/131,130,129,117,119,43,
`607/2; 606/90, 324, 99, 129
`See application ?le for complete search history.
`
`(56)
`
`References Cited
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`(Continued)
`Primary Examiner * Pedro Philogene
`(74) Attorney, Agent, or Firm * Fish & Richardson RC.
`(57)
`ABSTRACT
`A system for accessing a surgical target site and related meth
`ods, involving an initial distraction system for creating an
`initial distraction corridor, and an assembly capable of dis
`tracting from the initial distraction corridor to a secondary
`distraction corridor and thereafter sequentially receiving a
`plurality of retractor blades for retracting from the secondary
`distraction corridor to thereby create an operative corridor to
`the surgical target site, 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 struc
`tures before, during, and after the establishment of an opera
`tive corridor to a surgical target site.
`37 Claims, 33 Drawing Sheets
`
`
`
` 1
`
`NUVASIVE 1070
`NuVasive, Inc. v. Warsaw Orthopedic, Inc.
`IPR2013-00206
`IPR2013-00208
`
`
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`U.S. Patent
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`Jun. 5, 2012
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`US. Patent
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`Jun. 5, 2012
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`US. Patent
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`Jun. 5, 2012
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`Jun. 5, 2012
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`Jun. 5, 2012
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`Jun. 5, 2012
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`1
`SURGICAL ACCESS SYSTEM AND RELATED
`METHODS
`
`CROSS-REFERENCES TO RELATED
`APPLICATIONS
`
`This application is a continuation of US. patent Ser. No.
`12/428,081 filed onApr. 22, 2009, which is a continuation of
`US. patent application Ser. No. 10/608,362 filed on Jun. 26,
`2003 (now US. Pat. No. 7,582,058), which claims priority to
`US. Provisional Patent Application Ser. No. 60/392,214 filed
`Jun. 26, 2002 (the contents being incorporated herein by
`reference). The present application also incorporates by ref-
`erence the following co-assigned patent applications in their
`entireties: PCT App. Ser. No. PCT/USO2/22247, entitled
`“System and Methods for Determining Nerve Proximity,
`Direction, and Pathology During Surgery,” filed on Jul. 11,
`2002 (published as W003/005887); PCT App. Ser. No. PCT/
`USO2/30617, entitled “System and Methods for Performing
`Surgical Procedures andAssessments,” filed on Sep. 25, 2002
`(published as WO 03/026482); PCT App. Ser. No. PCT/
`USO2/35047, entitled “System and Methods for Performing
`Percutaneous Pedicle Integrity Assessments,” filed on Oct.
`30, 2002 (published as WO/03037170); and PCT App. Ser.
`No. PCT/USO3/02056, entitled “System and Methods for
`Determining Nerve Direction to a Surgical Instrument,” filed
`Jan. 15, 2003 (published as WO/2004064634).
`
`BACKGROUND
`
`I. Field
`
`The present invention relates generally to systems and
`methods for performing surgical procedures and, more par-
`ticularly, for accessing a surgical target site in order to per-
`form surgical procedures.
`II. Description of Related Art
`A noteworthy trend in the medical community is the move
`away from performing surgery via traditional “open” tech-
`niques in favor of minimally invasive or minimal access tech-
`niques. Open surgical techniques are generally undesirable in
`that they typically require large incisions and high amounts of
`tissue displacement to gain access to the surgical target site,
`which produces concomitantly high amounts of pain, length-
`ened hospitalization (increasing health care costs), and high
`morbidity in the patient population. Less-invasive surgical
`techniques (including so-called “minimal access” and “mini-
`mally invasive” techniques) are gaining favor due to the fact
`that they involve accessing the surgical target site via inci-
`sions of subs