MINIMALLY INVASIVE RETRACTOR SCREW AND METHODS OF USE
A device, system and method for orthopedic spine surgery using a novel screw-based retractor, disclosed herein, that allows for access to the spine through a minimally or less invasive approach. The retractor device is designed as an integrally formed part of the tulip of a pedicle screw assembly with opposed arms of the retractor spread apart to open the wound proximally. The arms are removed by separating the arms from the tulip and pulling it out of the wound. The retractor device is intended to be made of a stiff material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.
1 . (canceled)
2 . A surgical retractor comprising:
a pedicle screw tulip defining an opening at a distal end thereof configured to receive a head of a pedicle screw therethrough with the head of the pedicle screw residing therein and a shank of the pedicle screw extending therefrom;
a pair of arms extending from a proximal end of the pedicle screw tulip and having a threaded inner surface configured to threadably couple with a set screw; and
a pair of retractor blades removably affixed to the pair of arms at a flexible region, each of the retractor blades having a non-threaded inner surface and configured to bend at the flexible region to retract tissue.
3 . The surgical retractor according to claim 2 , further comprising a longitudinally extending passage defined by the pair of retractor blades and the pair of arms along at least a portion of the surgical retractor.
4 . The surgical retractor according to claim 3 , wherein the pair of retractor blades are configured to flex outward from a centerline defined by the surgical retractor to selectively expand the longitudinally extending passage.
5 . The surgical retractor according to claim 4 , wherein a rod is insertable within the expanded longitudinally extending passage and configured to be secured to the head of the pedicle screw.
6 . The surgical retractor according to claim 5 , further comprising a set screw threadably coupleable to the threaded inner surfaces of the pair of arms to secure the rod to the head of the pedicle screw.
7 . The surgical retractor according to claim 2 , wherein the pair of arms are integrally formed with the pedicle screw tulip.
8 . The surgical retractor according to claim 2 , wherein the flexible region comprises at least one score line.
9 . The surgical retractor according to claim 8 , wherein the pair of retractor blades are removably affixed to the pair of arms at the at least one score line.
10 . The surgical retractor according to claim 2 , wherein the pair of retractor blades are configured to flex proximally of the flexible region relative to a centerline of the surgical retractor.
11 . The surgical retractor according to claim 2 , wherein the pair of retractor blades are configured to separate from the arms at the flexible region upon repeated flexing of the pair of retractor blades relative to a centerline of the surgical retractor.
12 . The surgical retractor according to claim 2 , wherein each of the retractor blades includes a plurality of holes defined therethrough configured to accept a Gelpi retractor used to spread the retractor blades apart.
13 . The surgical retractor according to claim 2 , wherein the flexible region includes at least one pair of recesses defining a living hinge therebetween.
14 . A surgical retractor assembly comprising:
a pedicle screw tulip defining an opening at a distal end thereof configured to receive a pedicle screw therethrough;
a pair of arms extending from a proximal end of the pedicle screw tulip and having a threaded inner surface threadably coupled with a set screw, the set screw configured to secure a rod received within the pedicle screw tulip to the pedicle screw; and
a pair of retractor blades removably affixed to the pair of arms and configured to bend relative to each other to retract tissue.
15 . The surgical retractor assembly according to claim 14 , further comprising a longitudinally extending passage defined by the pair of retractor blades and the pair of arms along at least a portion of the surgical retractor assembly, the longitudinally extending passage configured to receive a rod therein.
16 . The surgical retractor assembly according to claim 14 , further comprising a rod receivable within the pedicle screw tulip and configured to be secured to the pedicle screw by the set screw.
17 . The surgical retractor assembly according to claim 16 , wherein the rod is configured to be secured to a pedicle screw of another surgical retractor assembly.
18 . The surgical retractor assembly according to claim 16 , wherein the pedicle screw is cannulated and configured to receive a guidewire therethrough.
19 . A method of performing spine surgery, comprising:
a) securing a first pedicle screw of a first tissue retractor to a first vertebral body, the first pedicle screw operably coupled to a first pedicle screw tulip of the first tissue retractor;
b) flexing at least one retractor blade of the first tissue retractor relative to a centerline defined by the first tissue retractor to retract tissue, the at least one retractor blade of the first tissue retractor removably affixed to the first pedicle screw tulip;
c) securing a second pedicle screw of a second surgical tissue retractor to a second vertebral body, the second pedicle screw operably coupled to a second pedicle screw tulip of the second tissue retractor;
d) flexing at least one retractor blade of the second tissue retractor relative to a centerline defined by the second tissue retractor to retract tissue, the at least one retractor blade of the second tissue retractor removably affixed to the second pedicle screw tulip;
e) inserting a rod between the first and second pedicle screw tulips;
f) threadably coupling a set screw to a threaded inner surface of each of the first and second pedicle screw tulips to secure the rod to the first and second pedicle screws; and
g) repeatedly flexing the at least one retractor blade of either the first or second tissue retractor relative to the centerline of the first or second tissue retractor to separate the at least one retractor blade from the pedicle screw tulip.
20 . The method according to claim 19 , further comprising percutaneously inserting a guidewire into at least one of the first and second vertebral bodies.
21 . The method according to claim 20 , further comprising inserting one of the first or second pedicle screws over the guidewire to the first or second vertebral bodies.