Tissue modification devices and methods

• US 8,398,641 B2
• Filed: 12/27/2011
• Issued: 03/19/2013
• Est. Priority Date: 07/01/2008
• Status: Active Grant

• Current Assignee: Spinal Elements, Inc.
• Original Assignee: Baxano, Inc. (Baxano Surgical, Inc.)
• Inventors: Wallace, Michael P., Garabedian, Robert, Cantorna, Nestor C., Bleich, Jeffery L., Leguidleguid, Roy, Leguidleguid, Ronald
• Primary Examiner(s): WOODALL, NICHOLAS W
• Application Number:
  US13/338,103
• Publication Number:
  US 20120095468A1
• Time in Patent Office: 448 Days
• Field of Search: 606/79, 606/82, 606/84, 606/85, 606/176, 606/177, 407/29.11
• US Class Current: 606/79
• 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 17/025 Joint distractors
• 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 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7062 Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs rib fixation devices A61B17/8076; Tools for such devices
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 5/4893 Nerves

Abstract

Described herein are devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; at least two flexible elongate lengths of cable that extend substantially adjacent to each other proximally to distally; a plurality of rungs extending between the lengths of cable; and a pair of flexible elongate cutting members extending along the length of the tissue modification region of the device. Each elongate cutting member has a thickness cuts a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. The device may further include a substrate sized and configured to releasably hold the cutting members a distance from one another and a pair of couplers positioned toward an outer edge region of the substrate and configured to releasably secure a cutting member to the outer edge region of the substrate.

Claims

1. A bimanually controlled tissue modification device for cutting tissue in a patient, the device comprising:

a tissue modification region;

at least two flexible elongate lengths of cable, wherein the lengths of cable extend substantially adjacent to each other proximally to distally;

a plurality of rungs extending between the lengths of cable, wherein the rungs are proximal to the tissue modification region of the device;

at least one region of each length of cable that is within the tissue modification region which is configured as a cutting member;

a spacer extending between the cutting members and comprising a plurality of restraints at outer edges of the spacer and configured to releasably hold the cutting members apart from one another until the cutting members have cut into tissue to a depth that is greater than a thickness of the cutting member; and

a guidewire coupler at the distal end region of the device configured to engage a tip of a guidewire.

2. The device of claim 1, wherein the flexible elongate lengths of cable link adjacent rungs.

3. The device of claim 1, wherein the cutting members and the cable are integrally formed.

4. The device of claim 1, wherein the cutting members are coupled to the cable.

5. The device of claim 1, wherein distal ends of the flexible elongate lengths of cable are secured together.

6. The device of claim 1, wherein proximal ends of the flexible elongate lengths of cable are secured together.

7. The device of claim 1, wherein the tissue modification region is configured to be actuated by pulling on a proximal handle and a distal guidewire coupled to the guidewire coupler.

8. The device of claim 1, wherein the guidewire coupler is configured such that the device is removably attachable to a proximal end region of a guidewire such that the tissue modification region can be pulled into position by pulling on the guidewire while the proximal end region of the guidewire is secured to the guidewire coupler.

9. The device of claim 1, wherein at least one cutting member comprises an elongate wire having a helical cutting edge along the length of the wire.

10. The device of claim 1, wherein the plurality of rungs are proximal and distal to the tissue modification region of the device.

11. A bimanually controlled tissue modification device for cutting tissue in a patient, the device comprising:

a tissue modification region;

at least two flexible elongate lengths of cable, wherein the lengths of cable extend substantially adjacent to each other proximally to distally and at least one region of each length of cable is a cutting member;

a spacer extending between the cutting members and comprising a plurality of restraints at outer edges of the spacer and configured to releasably hold the cutting members apart from one another until the cutting members have cut into tissue to a depth that is greater than a thickness of the cutting member; and

a guidewire coupler at the distal end region of the device configured to engage a tip of a guidewire.

12. The device of claim 11, wherein the cutting members and the cable are integrally formed.

13. The device of claim 11, wherein the cutting members are coupled to the cable.

14. The device of claim 11, wherein distal ends of the flexible elongate lengths of cable are secured together.

15. The device of claim 11, wherein the tissue modification region is configured to be actuated by pulling on a proximal handle and a distal guidewire coupled to the guidewire coupler.

16. The device of claim 11, wherein the guidewire coupler is configured such that the device is removably attachable to a proximal end region of a guidewire such that the tissue modification region can be pulled into position by pulling on the guidewire while the proximal end region of the guidewire is secured to the guidewire coupler.

17. The device of claim 11, wherein at least one cutting member comprises an elongate wire having a helical cutting edge along the length of the wire.