Configured and sized cannula
A dilator retractor and the dilators that are used for minimally invasive spinal surgery or other surgery are configured to accommodate the anatomical structure of the patient as by configuring the cross sectional area in an elliptical shape, or by forming a funnel configuration with the wider end at the proximate end. In some embodiments the distal end is contoured to also accommodate the anatomical structure of the patient so that a cylindrically shaped, funnel shaped, ovoid shaped dilator retractor can be sloped or tunneled to accommodate the bone structure of the patient or provide access for implants. The dilator retractor is made with different lengths to accommodate the depth of the cavity formed by the dilators.
1. A surgical method, comprising:
inserting a non-cannulated dilator into an incision in a patient's skin;
forcing the non-cannulated dilator through tissue of the patient until a distal tip of the non-cannulated dilator reaches a target location in the patient;
inserting a plurality of cannulated dilators over the non-cannulated dilator to enlarge an opening formed by the non-cannulated dilator, at least one of the cannulated dilators having an ovoid cross-section; and
positioning a distal end of at least one of the cannulated dilators in contact with a vertebra of the patient,
wherein the plurality of cannulated dilators includes a first cannulated dilator having a circular interior cross-section and an ovoid exterior cross-section,
wherein the plurality of cannulated dilators includes a second cannulated dilator having an ovoid interior cross-section and an ovoid exterior cross-section,
wherein the inserting step further comprises inserting the plurality of cannulated dilators such that the non-cannulated dilator is disposed within the first cannulated dilator and the first cannulated dilator is disposed within the second cannulated dilator, and
wherein each of the plurality of cannulated dilators has a sloped distal end, the sloped distal end being beveled to define a sharp edge.
2. The method of claim 1 , further comprising removing the non-cannulated dilator from the patient and removing all but an outermost one of the plurality of cannulated dilators from the patient to form a working channel to the target location, the working channel having an ovoid cross-section.
3. The method of claim 1 , wherein inserting the plurality of cannulated dilators comprises inserting a plurality of cannulated dilators each having a successively shorter length.
4. The method of claim 1 , wherein the method comprises inserting at least one cannulated dilator having a funnel-shaped proximal end.
5. The method of claim 1 , further comprising positioning the at least one cannulated dilator having an ovoid cross section such that a major axis of said dilator extends parallel to the patient's spinal column and a minor axis of said dilator extends transverse to the patient's spinal column.
6. The method of claim 1 , wherein the sloped distal end is sloped to follow a slope of the posterior portion of the vertebra.
7. The method of claim 1 , wherein the positioning step further includes positioning the sloped distal end of the at least one of the cannulated dilators in contact with the vertebra between the facet joint and the spinous process.