Devices and methods for selective surgical removal of tissue
First Claim
1. A method for protecting neural and neurovascular tissue within a neural foramen of a patient'"'"'s spine adjacent to target anatomy, the method comprising:
- placing a first device adjacent to the target anatomy;
advancing a protective barrier through the first device, where the protective barrier comprises a thin, flat, and flexible barrier surface configured to form a mechanical backstop that is adapted to be reduced to fit within the first device and adapted to expand after exiting the first device;
placing the flexible barrier over neural and neurovascular tissue in the neural foramen adjacent to the target anatomy so that the barrier surface of the protective barrier forms a backstop between target anatomy and neural and neurovascular tissue in the neural foramen; and
locating a nerve using an electrode on the protective barrier.
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Accused Products
Abstract
Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.
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Citations
17 Claims
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1. A method for protecting neural and neurovascular tissue within a neural foramen of a patient'"'"'s spine adjacent to target anatomy, the method comprising:
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placing a first device adjacent to the target anatomy; advancing a protective barrier through the first device, where the protective barrier comprises a thin, flat, and flexible barrier surface configured to form a mechanical backstop that is adapted to be reduced to fit within the first device and adapted to expand after exiting the first device; placing the flexible barrier over neural and neurovascular tissue in the neural foramen adjacent to the target anatomy so that the barrier surface of the protective barrier forms a backstop between target anatomy and neural and neurovascular tissue in the neural foramen; and locating a nerve using an electrode on the protective barrier. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method for protecting neural and neurovascular tissue within a spinal neural foramen adjacent to target anatomy in a patient, the method comprising:
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placing a first device adjacent to the target anatomy; advancing a protective barrier comprising a thin, flat and flexible barrier surface configured to form a mechanical backstop through the first device in a collapsed state; expanding the protective barrier surface over neural or neurovascular tissue in the neural foramen adjacent to the target anatomy to form a backstop between target anatomy and neural or neurovascular non-target anatomy; positioning a tissue abrasion device between the target anatomy and the protective barrier; and applying electrical current to stimulate a nerve within the tissue adjacent to the target anatomy.
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14. A method for protecting tissue adjacent to target tissue in a patient, the method comprising:
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accessing a neural foramina of a patient'"'"'s spine; positioning a protective barrier within the neural foramina to protect a nerve or neurovascular tissue therein, wherein the protective barrier comprises a thin, fiat, and flexible barrier surface configured to form a mechanical backstop; expanding the barrier surface of the protective barrier within the neural foramen so that one side of the barrier surface faces target tissue and an opposite side of the barrier surface faces non-target nerve or neurovascular tissue; locating a nerve using an electrode on the protective barrier; and positioning a surgical instrument adjacent to the barrier surface of the protective barrier so that the surgical instrument contacts the target tissue but is prevented from contacting non-target nerve or neurovascular tissue by the protective barrier. - View Dependent Claims (15, 16, 17)
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Specification