The MaXcess retractor’s primary feature is a split-blade design, with three main blades, one in the posterior orientation to the surgical approach and one each in cranial and caudal orientations (Fig. 14.3). The diameter of the closed blades is approximately 12 mm. Each of these blades can be manipulated independently of each other both to retract separately in cranial, caudal, and/or anterior orientations (by the cranial-caudal blades) simultaneously and posteriorly, if needed, by the posterior blade (Fig. 14.4). Each of the cranial and caudal blades can also be splayed either inwardly or outwardly to allow for additional or less cranial or caudal surgical site exposure without extension of the surgical incision (Fig. 14.5). Light sources are placed into each of the cranial and caudal blades for visualization of the lateral disk and working space (Fig. 14.6). A shim is placed down the posterior blade and into the disk space to hold the retractor in the chosen position. A fourth retractor blade can be placed anterior to the cranial and caudal blades, primarily to realize the potential space anterior to the anterior longitudinal ligament (ALL) or to provide a barrier between those structures and the working space (Fig. 14.1). Intraoperatively, the MaXcess retractor allows for broad visibility of the working corridor and disk space (Fig. 14.7).

Categorically, the features of the MaXcess retractor include: