Abstract: A sequence of access channels to provide access to a surgical site on a spine using: 1) a first retractor adapted to provide an access channel from outside the patient's body; 2) an inserted second retractor with a set of blades with a set of distal tips for insertion into tissue distal to the distal end of the first retractor; and 3) a retractor inserter for use with the second retractor.

Abstract: A sequence of access channels to provide access to a surgical site on a spine using: 1) a first retractor adapted to provide an access channel from outside the patient's body; 2) an inserted second retractor with a set of blades with a set of distal tips for insertion into tissue distal to the distal end of the first retractor; and 3) a retractor inserter for use with the second retractor.

Abstract: A method for creating a sequence of access channels to provide access for performing surgery on a lumbar spine; through positioning a patient to facilitate surgical access to the lumbar spine; docking a retractor device against a proximal surface of the psoas muscle and maintaining the pre-psoas access channel with the retractor device docked at the proximal surface of the psoas muscle. Making a direct visual inspection of the psoas muscle before splitting the psoas muscle to create and maintain a psoas access channel that extends from the pre-psoas access channel to the spine. Holding open the psoas access channel with a pair of retractor blades. After completing a surgical process on the spine removing the pair of retractor blades from the psoas access channel.

Abstract: An interbody implant system for use with a first vertebra having a first endplate and a second vertebra having a second endplate. The system includes an expandable implant that includes a plurality of supports and means for linking the plurality of supports. The plurality of supports are capable of moving apart from one another so that the expandable implant is in an expanded condition. A channel extends through the first vertebra from a pedicle or the body wall to the first endplate. An unexpanded diameter for the expandable implant is configured to permit passage of the expandable implant through the channel. An expanded diameter for the expandable implant is greater than the channel diameter at the first endplate. The support height is configured to permit the plurality of supports to be positioned between the first endplate and the second endplate. Methods for the use of the system are described.

Abstract: A method for creating a sequence of access channels to provide access for performing surgery on a lumbar spine; through positioning a patient to facilitate surgical access to the lumbar spine; docking a retractor device against a proximal surface of the psoas muscle and maintaining the pre-psoas access channel with the retractor device docked at the proximal surface of the psoas muscle. Making a direct visual inspection of the psoas muscle before splitting the psoas muscle to create and maintain a psoas access channel that extends from the pre-psoas access channel to the spine. Holding open the psoas access channel with a pair of retractor blades. After completing a surgical process on the spine removing the pair of retractor blades from the psoas access channel.

Abstract: A surgical retractor system includes a first retractor and a second retractor. The first retractor comprises a first working channel for receiving a tool therethrough. The second retractor is capable of being advanced through the first working channel, and its proximal end is positioned in the vicinity of the distal end of the first retractor. The second retractor includes a second working channel for receiving a tool therethrough. In another aspect, a method for accessing a surgical site comprises inserting a first retractor into a first tissue, advancing a second retractor through a first working channel in the first retractor, and inserting the second retractor into a second tissue to retract the second tissue, with the distal end of the first retractor remaining in the vicinity of the proximal end of the second retractor sufficiently to allow access to the target tissue by a surgical tool. A tool for operating a second retractor located distally in a first retractor is described.

Abstract: A surgical retractor system includes a first retractor and a second retractor. The first retractor comprises a first working channel for receiving a tool therethrough. The second retractor is capable of being advanced through the first working channel, and its proximal end is positioned in the vicinity of the distal end of the first retractor. The second retractor includes a second working channel for receiving a tool therethrough. In another aspect, a method for accessing a surgical site comprises inserting a first retractor into a first tissue, advancing a second retractor through a first working channel in the first retractor, and inserting the second retractor into a second tissue to retract the second tissue, with the distal end of the first retractor remaining in the vicinity of the proximal end of the second retractor sufficiently to allow access to the target tissue by a surgical tool. A tool for operating a second retractor located distally in a first retractor is described.

Abstract: An interbody implant system for use with a first vertebra having a first endplate and a second vertebra having a second endplate. The system includes an expandable implant that includes a plurality of supports and means for linking the plurality of supports. The plurality of supports are capable of moving apart from one another so that the expandable implant is in an expanded condition. A channel extends through the first vertebra from a pedicle or the body wall to the first endplate. An unexpanded diameter for the expandable implant is configured to permit passage of the expandable implant through the channel. An expanded diameter for the expandable implant is greater than the channel diameter at the first endplate. The support height is configured to permit the plurality of supports to be positioned between the first endplate and the second endplate. Methods for the use of the system are described.

Abstract: A device for treating a spine includes a proximal component positioned partially or entirely within a first vertebra and a distal component positioned partially or entirely within a second vertebra and may also include an intermediate component. A method for treating a spine includes forming a curved channel that extends through a first vertebra from a pedicle to an endplate, and advancing the components through the curved channel, the orientation of the proximal component relative to the distal component changing by at least 40 degrees while the proximal component passes through the curved channel. In another aspect, a method for treating a spine includes forming a curved channel that has a pedicle region, a central region, and an endplate region, where the channel diameter for the central region is larger than the channel diameter for the pedicle region or the endplate region, and advancing an implant through the channel.