DEVICES AND METHODS FOR TREATING TISSUE

• US 20110060314A1
• Filed: 10/25/2010
• Published: 03/10/2011
• Est. Priority Date: 10/15/2004
• Status: Active Grant

• Current Assignee: Spinal Elements, Inc.
• Original Assignee: Amendia, Inc. (Spinal Elements, Inc.)
• Inventors: Arcenio, Gregory B., Chung, Winnie, Garabedian, Robert, Wallace, Michael P., Saadat, Vahid, Bleich, Jeffery L.
• Granted Patent: US 9,101,386 B2
• Time in Patent Office: Days
• US Class Current: 604/528
• CPC Class Codes: A61B 17/149 Chain, wire or band saws
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22049 Means for locking the guide wire in the catheter
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 90/04 : Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery protection of eyes against laser radiation A61F9/022
• CPC Class Codes: A61F 2/0045 : Support slings
• CPC Class Codes: A61M 2210/1003 : Spinal column
• CPC Class Codes: A61M 25/0067 : characterised by the distal end, e.g. tips A61M25/0054, A61M25/04 take precedence; balloon catheters A61M25/10
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36017 : with leads or electrodes penetrating the skin

Abstract

Described herein are devices, systems and methods for treating target tissue in a patient'"'"'s spine. In general, the methods include the steps of advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location; connecting a tissue modification device to the wire; positioning the tissue modification device through the neural foramen using the wire; modifying target tissue in the spine by moving the tissue modification device against the target tissue; and delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue. In some embodiments, the step of modifying target tissue comprises removing target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.

Claims

1. A method for treating target tissue in a patient'"'"'s spine, the method comprising:

advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location;

connecting a tissue modification device to the wire;

positioning the tissue modification device through the neural foramen using the wire;

modifying target tissue in the spine by moving the tissue modification device against the target tissue; and

delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue.

2. The method of claim 1, wherein the step of delivering an agent to the modified target tissue comprises delivering an agent to the modified target tissue through a delivery device.

3. The method of claim 2, wherein the delivery device is a cannula having an atraumatic tip.

4. The method of claim 2, further comprising the step of providing suction and irrigation to the modified target tissue through the delivery device.

5. The method of claim 2, further comprising the step of positioning the delivery device using the wire.

6. The method of claim 5, wherein the step of positioning the delivery device comprises threading the delivery device over the wire.

7. The method of claim 5, wherein the step of positioning the delivery device comprises connecting the distal end of the delivery device to the proximal end of the wire.

8. The method of claim 5, wherein the step of positioning the delivery device comprises positioning the delivery device through the neural foramen.

9. The method of claim 5, wherein the step of positioning the delivery device comprises positioning a catheter of the delivery device, wherein the catheter comprises a distal end and a proximal end, wherein the proximal end includes a connector.

10. The method of claim 9, wherein the step of positioning the delivery device comprises positioning the distal end of the catheter adjacent to the modified target tissue while the connector remains outside of the patient.

11. The method of claim 9, wherein the step of positioning the delivery device comprises removably locking the delivery device onto the wire with the connector.

12. The method of claim 1, wherein the agent is at least one of a haemostatic agent, a tissue sealant, a vasoconstrictor, a corticosteroid, a local anesthetic, an analgesic, and any combination thereof.

13. A method for treating target tissue in a patient'"'"'s spine, the method comprising:

advancing a wire into the patient from a first location, through a neural foramen adjacent to a facet joint having a superior articular process, and out of the patient from a second location;

connecting a tissue modification device to the wire;

positioning the tissue modification device through the neural foramen using the wire; and

modifying target tissue in the spine by moving the tissue modification device against the target tissue to remove target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.

14. The method of claim 13, wherein the step of advancing a wire comprises advancing the wire through the neural foramen and away from a lateral aspect of the superior articular process.

15. The method of claim 13, wherein the step of advancing a wire comprises advancing the wire through a probe having an inner cannula and an outer cannula.

16. The method of claim 15, further comprising the step of advancing the inner cannula out of the outer cannula to a position such that a distal tip of the inner cannula points away from a lateral aspect of the superior articular process.

17. The method of claim 13, wherein the tissue modification device comprises an elongate body having a stiffness that varies along the length of the elongate body.

18. The method of claim 17, wherein the distal portion of the elongate body has a stiffness that is greater than the proximal portion such that the distal portion of the elongate body does not wrap around a lateral aspect of the superior articular process.

19. The method of claim 13, wherein the step of modifying tissue comprises reciprocating the tissue modification device against the target tissue by alternately pulling on the end of the wire extending from the first location and a proximal end of the tissue modification device extending from the second location.

20. The method of claim 19, wherein the step of modifying tissue comprises reciprocating the tissue modification device such that the tissue modification device is reciprocated against target tissue located ventral to the superior articular process and not reciprocated against non-target tissue located lateral to the superior articular process.

21. The method of claim 19, wherein a distal handle is coupled to the end of the wire extending from the second location and the tissue modification device comprises a proximal handle positioned outside of the patient at the first location.

22. The method of claim 21, wherein the step of modifying tissue comprises holding the distal handle and the proximal handle a distance apart from one another such that the tissue modification device is not reciprocated against the non-target tissue located lateral to the superior articular process.

23. A device for delivering an agent to tissue in a patient'"'"'s spine, the device comprising:

a elongate flexible catheter having a proximal end and a distal end, wherein the distal end of the elongate catheter is configured to be advanced into the patient from a first location and toward a neural foramen;

a connector coupled to the proximal end of the catheter that remains outside of the patient and is configured to receive a syringe containing an agent; and

an aperture at the distal end portion of the catheter configured to deliver the agent to the tissue.