Minimally Open Retraction Device

Abstract

A retractor having a pair of blades is disclosed. A ring having an opening is attached to one end of the blades. The blades define a channel therebetween. The blades may be pivotally coupled to the ring. The retractor may have at least two conditions. In a first condition, the retractor is insertable through an incision in a patient's skin to an operative site. In a second condition, the retractor may be manipulated for retracting tissue surrounding the operative site. Instruments, prostheses, or tissue may be inserted or removed through the channel of the retractor.

1 . A system, comprising:
 a first extension having a proximal end and a distal end, the first extension having a first attachment at the distal end; and   a first pedicle screw assembly including a first pedicle screw having a head and a shank,   wherein the first extension is coupleable to the first pedicle screw assembly by the first attachment such that the first attachment encircles at least a portion of the shank of the first pedicle screw.   
     
     
         2 . The system of  claim 1 , wherein the first attachment creates a closed loop around the shank of the first pedicle screw. 
     
     
         3 . The system of  claim 1 , wherein the first extension is a blade. 
     
     
         4 . The system of  claim 3 , wherein the blade includes a plurality of holes spaced apart along a longitudinal axis of the blade. 
     
     
         5 . The system of  claim 3 , wherein the blade is a flexible blade. 
     
     
         6 . The system of  claim 3 , wherein the blade includes a living hinge. 
     
     
         7 . The system of  claim 1 , further comprising a central longitudinal axis, wherein the first extension is on a first side of the central longitudinal axis. 
     
     
         8 . The system of  claim 1 , wherein the first attachment includes an opening larger than the shank of the first pedicle screw and smaller than the head of the first pedicle screw. 
     
     
         9 . The system of  claim 8 , wherein the first attachment further includes a relief region configured to allow the head of the first pedicle screw through the opening to separate the first extension from the first pedicle screw. 
     
     
         10 . The system of  claim 1 , wherein the first attachment includes a concave surface adapted to mate with the head of the first pedicle screw. 
     
     
         11 . The system of  claim 1 , wherein the first pedicle screw is a polyaxial screw. 
     
     
         12 . The system of  claim 1 , further comprising a second pedicle screw assembly. 
     
     
         13 . The system of  claim 12 , further comprising:
 a second extension having a proximal end and a distal end, the second extension having a second attachment at the distal end; and   a second pedicle screw assembly including a second pedicle screw having a head and a shank,   wherein the second extension is coupleable to the second pedicle screw assembly by the second attachment such that the second attachment encircles at least a portion of the shank of the second pedicle screw.   
     
     
         14 . The system of  claim 13 , wherein the second attachment creates a closed loop around the shank of the second pedicle screw. 
     
     
         15 . The system of  claim 13 , further comprising an intermediate retractor blade. 
     
     
         16 . The system of  claim 15 , wherein the intermediate retractor blade is configured to be coupled to the first and second pedicle screw assemblies via an intervening structure. 
     
     
         17 . The system of  claim 16 , wherein
 the intervening structure is shaped to be received within a first channel defined by the head of the first pedicle screw and a second channel defined by the head of the second pedicle screw.   
     
     
         18 . The system of  claim 17 , wherein the intervening structure includes first and second rod portions shaped to be received within the respective first and second channels. 
     
     
         19 . The system of  claim 16 , wherein the intervening structure includes a pair of feet each having an opening therethrough for receiving a portion of a respective one of the first or second pedicle screws. 
     
     
         20 . The system of  claim 19 , wherein the respective one of the first or second pedicle screw portions are temporary set screws.