Abstract: The present invention provides an inflatable retractor for providing access to a surgical site, such as a patient's spine, during a surgical process. When used in spinal surgery, the inflatable retractor allows a surgeon to operate on one or more spinal levels. The inflatable retractor includes an inflatable body defining a central cavity, wherein the body is flaccid in a non-inflated state and increasingly rigid in an inflated state. The inflatable retractor is inserted into an incision in a deflated, or partially inflated, state and then inflated once the retractor is in position. The inflation of the retractor retracts skin and muscle from the surgical site, allowing adequate visualization of the surgical site and forms a passage providing access for implants and surgical instruments to pass through the retractor and into the surgical site.

Abstract: A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a working channel for accessing a surgical site and an integrated light emitter for illuminating the surgical site. The light emitter is integrated in proximity to a distal end of the surgical access device. In some embodiments, the light emitter is offset from the distal end. In certain embodiments, the integrated light emitter includes a light transmission medium for transmitting light from a proximal end of the access device to the distal end.

Abstract: A tissue expander system for expanding tissue, skin and muscle along a pathway to a surgical site through a minimally invasive incision includes a tissue expander having a plurality of arms adapted to bear against tissue, the plurality of arms coupled at a first end to an actuating member and at a second end to a shaft, movement of the actuating member relative to the shaft adjusts the arms between a first position having a first diameter and a second position having second diameter greater than the first diameter and an outer sleeve having a lumen sized and shaped to receive the tissue expander in the second position.

Abstract: A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a working channel for accessing a surgical site and an integrated annular light emitter for illuminating the working channel. The integrated annular light emitter is coupled to a proximal end of the surgical access device and includes a central opening aligned with the working channel. The integrated annular light emitter includes a light transmission path formed about the central opening that emits circumferential light transmitted from a light source about the circumference of the surgical access device. The light emitter may emit light directly into the interior of the surgical access device, or into a smooth, light-transmitting portion of the side wall of the surgical access device to illuminate a working space.

Abstract: A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a port and a light emitter coupled to the surgical access device for illuminating the port. The light emitter preferably comprises an elongated shaft having a light transmitting element housed therein, which emits light transmitted to the elongated shaft from a light source. The elongated shaft is configured to be inserted in an elongated channel in the access device. The elongated channel has or forms a window for transmitting light emitted by the light emitter into the interior of the access device.

Abstract: A system for guiding an implant to an optimal placement within a patient includes a trajectory guide for guiding instruments along a selected trajectory and a trajectory fixation device for fixing the trajectory guide in a selected position. The trajectory guide defines a path configured to align with the selected trajectory. A movable support mounts the trajectory guide and selectively moves the trajectory guide to align the trajectory guide with the selected trajectory prior to fixing the trajectory guide in the selected position. The trajectory is aligned coarsely by hand, then the trajectory is aligned using a fine adjustment system. After fixing the trajectory guide, instruments can be inserted along the trajectory through the path defined by the trajectory guide.

Abstract: An access device for providing access from a skin incision to a surgical site is described. The access device has a first section having a proximal end and a distal end defining a first path therethrough. The access device has a second section having a proximal end and a distal end defining a second path therethrough, the second section is movable relative to the first section, and the first and second sections cooperate to form a continuous path such that movement of the second section changes the length of the path.

Abstract: A self retaining screw inserter for inserting, positioning and removing a set screw of a spinal fixation system, includes an active reverse-collet retainer. The active reverse-collet retainer has fingers configured to move outward to engage and retain a set screw. When engaged, the fingers flare outward to engage the set screw.

Abstract: A system for guiding an implant to an optimal placement within a patient includes a trajectory guide for guiding instruments along a selected trajectory and a trajectory fixation device for fixing the trajectory guide in a selected position. The trajectory guide defines a path configured to align with the selected trajectory. A movable support mounts the trajectory guide and selectively moves the trajectory guide to align the trajectory guide with the selected trajectory prior to fixing the trajectory guide in the selected position. After fixing the trajectory guide, instruments can be inserted along the trajectory through the path defined by the trajectory guide.

Abstract: A method for introducing a spinal fixation element between two bone anchors includes engaging a spinal fixation element to a shaft of an instrument, positioning the shaft of the instrument through a sidewall opening of a first percutaneous access device connected to a first bone anchor and through a side wall opening of a second percutaneous access device connected to a second bone anchor, the spinal fixation element extending in an orientation substantially parallel to the longitudinal axis of at least one of the first percutaneous access device and the second percutaneous access device, and pivoting the instrument to change the orientation of the spinal fixation element and position the spinal fixation element in proximity to the first bone anchor and in proximity to the second bone anchor.

Abstract: Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In one embodiment, a dissection tool is provided for separating muscles along a muscle plane without causing damage to the muscles. The dissection tool can also include a lumen extending therethrough for receiving a guide wire. The tool allows the guide wire to be positioned relative to a vertebra, and once properly positioned, the tool can be removed to allow a spinal anchor to be delivered along the guide wire and implanted into the vertebra.

Abstract: A medical inserter tool is provided for introducing medical implants into a surgical site, preferably using minimally invasive techniques. The inserter tool can have a variety of configurations, but in general, the inserter tool should be effective to engage and manipulate the implant into two or more positions. In an exemplary embodiment, the tool includes an elongate shaft having proximal and distal ends and defining a longitudinal axis extending therebetween, and a pivoting element that is coupled to the distal end of the shaft and that is adapted to engage a spinal implant. In use, the pivoting element is movable between first and second positions to allow an implant to be introduced through a percutaneous access device in a lengthwise orientation, and to be manipulated subcutaneously to be positioned in a desired orientation.

Abstract: Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In general, the method involves advancing a spinal fixation element in a first, lengthwise orientation along a pathway extending from a minimally invasive percutaneous incision to a spinal anchor site. As the spinal fixation element approaches the spinal anchor site, the fixation element can be manipulated to extend in a second orientation, which is preferably substantially transverse to the first orientation, to position the fixation element in relation to one or more spinal anchors.

Abstract: A medical inserter tool is provided for introducing medical implants into a surgical site, preferably using minimally invasive techniques. The inserter tool can have a variety of configurations, but in general, the inserter tool should be effective to engage and manipulate the implant into two or more positions. In an exemplary embodiment, the tool includes an elongate shaft having proximal and distal ends and defining a longitudinal axis extending therebetween, and a pivoting element that is coupled to the distal end of the shaft and that is adapted to engage a spinal implant. In use, the pivoting element is movable between first and second positions to allow an implant to be introduced through a percutaneous access device in a lengthwise orientation, and to be manipulated subcutaneously to be positioned in a desired orientation.