Percutaneous access and visualization of the spine

• US 20070213584A1
• Filed: 03/10/2006
• Published: 09/13/2007
• Est. Priority Date: 03/10/2006
• Status: Abandoned Application

• Current Assignee: Spine View, Inc., Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Spine View, Inc., Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Kim, Daniel, Chin, Singfatt
• Application Number:
  US11/373,848
• Publication Number:
  US 20070213584A1
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners

Abstract

Devices, systems and methods are provided for the percutaneous access and visualization of the spine for the purposes of diagnosing and/or treating a target area of the spine or the surrounding tissue.

Claims

1. A method of percutaneously accessing a target site within the body, the method comprising:

introducing into the body an access device comprising a tissue manipulation member and having direct visualization capability, wherein the tissue manipulation member is deployable from a distal portion of the access device;

deploying the tissue manipulation member thereby displacing tissue adjacent the distal end of the access device to create a space within the tissue between the distal end and the target site; and

directly visualizing the space.

2. The method of claim 1, wherein the tissue manipulation member is deployed in a distal direction.

3. The method of claim 1, wherein the tissue manipulation member is deployed in a lateral direction.

4. The method of claim 1, wherein the tissue displaced by the tissue manipulation member is distal to the distal end of the access device.

5. The method of claim 1, wherein the tissue displaced by the tissue manipulation member is lateral to the distal end of the access device.

6. The method of claim 1, wherein the tissue displaced by the tissue manipulation member is proximal to the distal end of the access device.

7. The method of claim 6, wherein the tissue displaced by the tissue manipulation member is also distal or lateral to the distal portion of the access device.

8. The method of claim 1, wherein the target site is at the spine.

9. The method of claim 8, wherein the target site is an intervertebral disc.

10. The method of claim 1, further comprising delivering an instrument to within the space.

11. The method of claim 1, further comprising deploying a second tissue manipulation member from the access device to stabilize the access device within the body.

12. A method of percutaneously treating a target site within the body, the method comprising:

percutaneously accessing an area of tissue adjacent the target site with an access device having a scope;

expanding a material from the a distal portion of the access device wherein a space is created adjacent the distal portion;

visualizing the space with the scope; and

advancing an instrument to within the space to treat the target site.

13. The method of claim 12, wherein the material defines a balloon.

14. The method of claim 12, wherein the balloon defines a central opening when expanded and the method further comprises advancing the scope through the opening.

15. The method of claim 14, wherein the balloon is expanded substantially laterally of the scope.

16. The method of claim 14, further comprising expanding two or more balloons from a distal portion of the access device.

17. The method of claim 16, further comprising stabilizing the access device within the body wherein using at least one balloon.

18. The method of claim 16, wherein the balloon is transparent and encases the scope when deployed.

19. The method of claim 12, wherein the material is a compliant membrane and the act of expanding comprises expelling a gel from the access device against the membrane.

20. The method of claim 19, wherein the membrane and the gel are both clear.

21. The method of claim 12, further comprising rupturing the expandable membrane.

22. The method of claim 21, wherein the scope is used to rupture the expandable membrane.

23. The method of claim 21, wherein the instrument is used to rupture the expandable membrane.

24. The method of claim 19, further comprising expanding the membrane until it contacts the target site.

25. A system for accessing a target site within the body, the system comprising:

a cannula having at least one lumen;

a scope deliverable through the at least one lumen; and

an expandable material deployable from a distal portion of the cannula, wherein expanding the material creates a space within tissue adjacent the distal portion of the cannula wherein the space facilitates visualization by the scope.

26. The system of claim 25, wherein the expandable material is a balloon.

27. The system of claim 26, wherein the balloon, when expanded, has a donut configuration having a central opening through which the scope has an unobstructed view.

28. The system of claim 26, wherein the balloon is expandable laterally of the distal portion of the cannula.

29. The system of claim 25, wherein the material is rupturable to release an expansion medium.

30. The system of claim 29, wherein the expansion medium comprises a therapeutic agent.

31. The system of claim 29, wherein the expansion medium comprises a gel.

32. The system of claim 25, wherein the material comprises a membrane.

33. A system for accessing a target site within the body, the system comprising:

a cannula having at least one lumen having an open distal end;

a scope deliverable through the at least one lumen; and

an expandable material affixed to and covering the open distal end of the lumen.

34. The system of claim 33, wherein the expandable material is expanded by an expansion medium delivered through the cannula.

35. The system of claim 34, wherein the expansion medium comprises a therapeutic agent.

36. The system of claim 34, wherein the expansion medium is transparent.

37. The system of claim 34, wherein the expansion medium comprises a gel.

38. The system of claim 34, wherein the expansion medium comprises saline.

39. The system of claim 33, wherein the expandable material is a balloon.

40. The system of claim 33, wherein the expandable material is membrane.

41. The system of claim 33, wherein the expandable material is rupturable.

42. The system of claim 41, wherein the scope is configured to rupture the expandable material.