FLEXIBLE TISSUE RASP

• US 20120016368A1
• Filed: 09/23/2011
• Published: 01/19/2012
• Est. Priority Date: 10/15/2004
• Status: Active Grant

• Current Assignee: Spinal Elements, Inc.
• Original Assignee: Baxano Surgical, Inc.
• Inventors: Bleich, Jeffery L., Hlavka, Edwin J.
• Granted Patent: US 8,652,138 B2
• Time in Patent Office: Days
• US Class Current: 606/85
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• 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 17/1757 for the spine
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/08021 of the patient or his organs

Abstract

Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.

Claims

1. A device for treating spinal stenosis, the device comprising:

an elongate body having a tapered flexible distal portion that is configured to be passed into an epidural space of the spine between target and non-target tissues and out of a patient'"'"'s body;

a tissue modifying member disposed along one side of the elongate body proximal to the tapered flexible distal portion of the elongate body;

a protective surface along the elongate body opposite and behind the tissue modifying member that prevents non-target tissues from being modified by the tissue modification member; and

a handle at the proximal end of the shaft.

2. The device of claim 1, wherein the tissue modifying member comprises at least one blade member for cutting target tissue.

3. The device of claim 1, wherein the tapered flexible distal portion is configured to penetrate tissue.

4. The device of claim 1, wherein the tissue modifying member comprises a flat ribbon-shaped region along the elongate body.

5. The device of claim 1 further comprising a drive member coupled with the tissue modifying member to activate the tissue modifying member.

6. A device for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis, the device comprising:

an elongate, at least partially flexible body having a proximal portion and a distal portion;

at least one abrasive surface disposed along a portion of one side of the elongate body;

at least one non-abrasive surface located adjacent the at least one abrasive surface so as to face non-target tissue when the abrasive surface is positioned to face target tissue;

at least one proximal tensioning member coupled with the elongate body at or near the proximal portion for facilitating application of tensioning force to, and translation of, the elongate body; and

at least one distal tensioning member, coupled with the elongate body at or near the distal portion and not directly connected to the proximal tensioning member, for facilitating application of tensioning force to, and translation of, the elongate body.

7. A device as in claim 6, wherein the elongate body has a rectangular cross-sectional shapethrough the abrasive surface portion of the elongate body.

8. A device as in claim 6, wherein the elongate body includes a guidewire coupler at the distal end of the elongate body.

9. A device as in claim 6, wherein the at least one abrasive surface comprises a rasp.

10. A device as in claim 6, wherein each of the proximal and distal tensioning members comprises a handle.

11. A device as in claim 6, wherein at least one of the proximal and distal tensioning members is removably attachable to the elongate body.

12. A device as in claim 6, wherein at least one of the proximal and distal tensioning members is deployable from the elongate body.

13. A device as in claim 6, further comprising at least one shield member coupled with the elongate body to protect the non-target tissue from damage during a tissue modification procedure.

14. A device as in claim 13, wherein the shield member is removably coupled with the elongate body.

15. A device as in claim 13, wherein the shield member comprises at least one anchor for anchoring the shield member outside the patient.

16. A device as in claim 15, wherein the shield member comprises:

a proximal anchor; and

a distal anchor.

17. A device as in claim 16, wherein the proximal and distal anchors are removably coupled with the shield member at or near proximal and distal portions thereof, respectively.

18. A device as in claim 13, wherein the shield member comprises at least one window along its length, through which the at least one abrasive surface may be exposed to modify target tissue.

19. A device as in claim 18, wherein at least one edge of the window includes a protective surface for protecting the shield member from damage by the abrasive surface.

20. A device as in claim 13, further comprising at least one electrode coupled with the shield member for testing positioning of the shield member.

21. A device as in claim 6, further comprising at least one electrode coupled with the device for testing positioning of the device.

22. A device as in claim 6, further comprising at least one lumen in the elongate body for providing at least one of suction and irrigation.

23. A device for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis, the device comprising:

an elongate, at least partially flexible shield member having a proximal portion, a distal portion and at least one opening along its length;

an elongate, at least partially flexible tissue modification member disposed at least partly within the shield member, the tissue modification member having a proximal portion, a distal portion, and at least one abrasive surface;

at least one proximal tensioning member at or near the proximal portion of at least one of the shield member and the tissue modification member for facilitating application of tensioning force in a first direction; and

at least one distal tensioning member at or near the distal portion of at least one of the shield member and the tissue modification member and not directly connected to the proximal tensioning member, for facilitating application of tensioning force in a second direction.

24. A device as in claim 23, wherein the shield member comprises a hollow member, and the opening comprises a window in a sidewall of the hollow member.

25. A device as in claim 24, wherein at least one edge of the window includes a protective surface for protecting the shield member from damage by the abrasive surface.

26. A device as in claim 23, wherein the opening of the shield member extends along one side of the entire length of the shield member.

27. A device as in claim 23, wherein the shield member is removably coupled with the tissue modification member.

28. A device as in claim 23, wherein the shield member comprises at least one anchor for anchoring the shield member outside the patient.

29. A device as in claim 28, wherein the shield member comprises:

a proximal anchor; and

a distal anchor.

30. A device as in claim 29, wherein the proximal and distal anchors are removably couplabled with the shield member at or near proximal and distal portions thereof, respectively.

31. A device as in claim 23, wherein the shield member includes a guidewire coupler at the distal end of the elongate body.

32. A device as in claim 23, wherein the tissue modification member comprises a rasp.

33. A device as in claim 23, wherein each of the proximal and distal tensioning members comprises a handle.

34. A device as in claim 23, wherein at least one of the proximal and distal tensioning members is removably attachable to at least one of the shield member and the tissue modification member.

35. A device as in claim 23, wherein at least one of the proximal and distal tensioning members is deployable from at least one of the shield member and the tissue modification member.

36. A device as in claim 23, further comprising at least one electrode coupled with the shield member for testing positioning of the device.

37. A device as in claim 23, further comprising at least one electrode coupled with the tissue modification member for testing positioning of the device.

38. A device as in claim 23, further comprising at least one lumen in at least one of the shield member and the tissue modification member for providing at least one of suction and irrigation.