Guided retractor and methods of use

Abstract

The present invention provides methods and apparatus in which a surgical retractor comprises a plurality of mechanically coupled tissue retaining walls that are guided into position along one or more guides previously implanted into the patient. The walls are preferably coupled by pivots, so that separating some of the walls from one another opens an operating space. There are preferably two guides, which are driven or screwed into the pedicles of vertebrae, or other bone. Oversized channels are best disposed in a frame, which also serves to hold lock the walls apart. Various convenience features are contemplated including a web disposed between the walls, which expands as the walls are separated. Also contemplated are projections from near the bottoms of one or more of the walls, which can alternatively or additionally help to hold the underlying tissue in place.

1 . A retractor system comprising: 
 first and second retractor walls forming a first opening;    first and second bone fasteners; and    first and second guides associated with the first and second bone fasteners, respectively;    wherein the first and second guides pass through the first opening; and    wherein the orientation of least the first guide is configured to be manipulated.    
   
   
       2 . The retractor system of  claim 1 , wherein the first guide is bendable.  
   
   
       3 . The retractor system of  claim 1 , wherein the first guide has a first joint.  
   
   
       4 . The retractor system of  claim 3 , wherein the first joint is located adjacent the first bone fastener.  
   
   
       5 . The retractor system of  claim 3 , wherein the first guide has a second joint.  
   
   
       6 . The retractor system of  claim 1 , further comprising a frame associated with at least the first retractor wall.  
   
   
       7 . The retractor system of  claim 6 , wherein the frame has a second opening, and wherein the first and second guides pass through the second opening.  
   
   
       8 . The retractor system of  claim 6 , wherein at the first guide is fixedly attached to the frame.  
   
   
       9 . The retractor system of  claim 1 , wherein the first and second retractor walls are configured to be urged away from each other.  
   
   
       10 . The retractor system of  claim 1 , wherein the first and second bone fasteners are pedicle screws.  
   
   
       11 . The retractor system of  claim 1 , wherein the first and second retractor walls are configured to be lowered over the first and second guides.  
   
   
       12 . The retractor system of  claim 1 , wherein the orientation of the first guide is configured to be manipulated after the first bone fastener is inserted into bone.  
   
   
       13 . The retractor system of  claim 1 , wherein the first and second retractor walls are joined by a living hinge.  
   
   
       14 . The retractor system of  claim 1 , wherein the first and second retractor walls are substantially continuous.  
   
   
       15 . The retractor system of  claim 1 , wherein at least a portion of the first guide is threaded.  
   
   
       16 . The retractor system of  claim 1 , wherein the first guide is configured to polyaxially rotate about the first bone fastener.