A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

Certain embodiments provide an adjustable length infusion cannula having a cannula including a first proximal end and a first distal end, and a hub having a second proximal end, a second distal end, and a central aperture that extends between the second proximal end and the second distal end. The central aperture is configured to accept the first distal end of the cannula and allow the cannula upward movement and downward movement through the hub. The adjustable length infusion cannula also includes a locking mechanism configured to lock the cannula within the hub such that the first distal end extends a first distance past the second distal end of the hub.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

A cannula assembly includes an elongate shaft assembly that is adjustable by a clinician to vary the length of the cannula assembly. In particular, the elongate shaft assembly may be transitioned to provide various lengths of the cannula assembly by selectively positioning a plurality of segments of the elongate shaft assembly. In this manner, a single cannula assembly may be tailored to each patient or a surgical procedure being performed.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; a flexible outer ring; an inner ring; a flexible sheath extending between the outer ring and the inner ring; and at least one rigid segment adapted to attach to the flexible outer ring to thereby increase the rigidity of the outer ring. Embodiments of the retractor/protector are described that have interlocking and non-interlocking rigid segments. Embodiments are also described that have bases that insert into or under the flexible outer ring in addition to or in lieu of rigid segments to increase rigidity and/or provide support for a detachable cap.

A surgical system for use in establishing and maintaining an opening to an anatomical space of a body, the system comprising an obturator assembly having a cutting portion at a distal end and a cannula, the cannula being detachably coupled to the cutting portion and deployable into the anatomical space of a patient, the cannula comprises a locking portion, and a lengthwise extendable body; a valve assembly comprising a passage for receiving the cannula, a first end for coupling to a fluid extraction device and a second end for placement external and adjacent the anatomical space; a base comprising a plate for placement on a patient external and adjacent the anatomical space, the plate has an aperture configured for receiving the obturator assembly and coupling means located about the aperture for coupling with the valve assembly; and wherein, in use, the locking portion of the cannula is configured to be retained in the valve assembly with the extendable body extended into the anatomical space to facilitate a path for fluid extraction, and wherein the cannula comprises means for retaining the cannula in its extended state.

A medical device to protect a body opening, such as a vagina. The medical device may include a lumen and anchoring structure(s) for securing the device in the body opening. In some embodiments, the medical device includes a sleeve, a proximal ring attached to a proximal end of the sleeve, and a distal ring attached to a distal end of the sleeve.

The use of stepped cannulas, wherein a step structure creates a backstop to reduce backflow along the cannula body, is known for convection enhanced delivery of agents to the brain and other structures within an animal. Described herein are novel and improved stepped cannula designs wherein the length of the cannula segment between the step and the dispensing outlet is variable and can be controllably adjusted inside the patient during delivery. This advantageously allows the operator to place the cannula step at the optimal position and deliver agents at one or more positions within the target structure.

A surgical access device includes a cannula having a variable length. The cannula may include a shaft assembly including an outer shaft, an intermediate shaft disposed within and longitudinal slidable relative to the outer shaft, and an inner shaft disposed within and longitudinal slidable relative to the intermediate shaft. The shaft assembly is movable between an unextended position, a fully extended position, and a semi-extended position between the unextended and fully extended positions. The cannula may include a shaft having annular folds formed therein. The annular folds are axially movable relative to each other such that the shaft is longitudinally movable between an unextended position and a plurality of extended positions.