SYSTEM FOR ENHANCING VISIBILITY IN THE EPIDURAL SPACE

• US 20020007144A1
• Filed: 07/13/1999
• Published: 01/17/2002
• Est. Priority Date: 07/06/1992
• Status: Active Grant

• Current Assignee: Phillip Jack Snoke
• Original Assignee: Phillip Jack Snoke
• Inventors: SNOKE, PHILLIP JACK
• Granted Patent: US 6,470,209 B2
• Time in Patent Office: Days
• US Class Current: 604/95.04
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• 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 2017/00261 Discectomy
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61M 25/0009 Making of catheters or other medical or surgical tubes
• CPC Class Codes: A61M 25/0133 Tip steering devices
• CPC Class Codes: A61M 25/0136 Handles therefor

Abstract

A method of epidural surgery is provided that improves visibility in the epidural space of a patient for more effectively conducting therapeutic surgery therein. The method includes the steps of distending a portion of the epidural space of a patient by filling the portion of the epidural space with a fluid supplied from a catheter and positioning a portion of an optical scope in the distended portion of the epidural space by inserting the optical scope through the same catheter that supplies the distending fluid to thereby provide a visual image of the epidural space.

Claims

1. A method of epidural surgery that improves visibility in the epidural space of a patient for more effectively conducting therapeutic surgery therein, the method comprising the steps of:

distending a portion of the epidural space of a patient by filling the portion of the epidural space with a fluid supplied from a catheter; and

positioning a portion of an optical scope in the distended portion of the epidural space by inserting the portion of the optical scope through the same catheter that supplies the distending fluid to thereby provide a visual image of the epidural space.

2. A method of epidural surgery according to claim 1, further comprising the step of performing a therapeutic treatment on a problem area within the distended portion of the epidural space.

3. A method of epidural surgery according to claim 1, further comprising the step of positioning a portion of a catheter into a portion of the epidural space of a patient prior to the step of distending the portion of the epidural space.

4. A method of epidural surgery according to claim 3, wherein the step of positioning a portion of a catheter comprises the steps of:

inserting a portion of a catheter through an opening in a sacrum region of a patient and into the epidural space; and

advancing the portion of the catheter through the epidural space of a patient through the opening in the sacrum region and adjacent a suspected problem area.

5. A method of epidural surgery according to claim 3, wherein the step of positioning a portion of a catheter comprises the steps of:

inserting a portion of a catheter through an opening in a lumbar region of a patient and into the epidural space; and

advancing the portion of the catheter through the epidural space of a patient through the opening in the lumbar region and adjacent a suspected problem area.

6. A method of epidural surgery according to claim 3, further comprising the following steps prior to the step of positioning the catheter:

inserting a portion of a needle through the skin of a patient and into a portion of the epidural space to thereby provide an opening from the skin to the epidural space of the patient;

inserting a portion of a guide wire through the needle and into the epidural space;

advancing the portion of the guide wire to a suspected problem area within the epidural space; and

extracting the needle from the epidural space.

7. A method of epidural surgery according to claim 6, further comprising the steps of:

inserting the portion of the catheter over the guide wire and into the opening to the epidural space;

supplying fluid through the catheter and into a portion of the epidural space; and

advancing the portion of the catheter to the suspected problem area.

8. A method of epidural surgery according to claim 4 or claim 5, further comprising the step of fluoroscopically observing the advancement of the portion of the catheter within the epidural space for positioning the portion of the catheter adjacent the suspected problem area.

9. A method of epidural surgery according to claim 1, wherein the step of positioning a portion of an optical scope in a distended portion of the epidural space comprises the steps of:

inserting the portion of the optical scope into the catheter;

advancing the portion of the optical scope through the catheter and into a portion of the epidural space; and

illuminating the distended portion of the epidural space with the optical scope to thereby provide a visual image of the epidural space and a problem area therein.

10. A method of epidural surgery according to claim 2, wherein the step of performing a therapeutic treatment comprises the steps of:

positioning a distal end of the catheter adjacent the problem area within the epidural space; and

treating the problem area within the epidural space through the catheter.

11. A method of epidural surgery according to claim 1, wherein the fluid supplied from the catheter to distend the portion of the epidural space is a liquid.

12. A method of epidural surgery according to claim 1, wherein the distended portion of the epidural space comprises an amount of the epidural space less than entire boundaries of the epidural space.

13. A method of epidural surgery that improves visibility in the epidural space of a patient for more effectively conducting therapeutic surgery therein, the method comprising the steps of:

fluoroscopically observing the positioning of a portion of the catheter within the epidural space and adjacent a suspected problem area;

distending a portion of the epidural space by filling the portion of the epidural space with a fluid supplied from a catheter;

positioning a portion of an optical scope in the distended portion of the epidural space by inserting the portion of the optical scope through the same catheter that supplies the distending fluid to thereby provide a visual image of the epidural space and the suspected problem area; and

performing a therapeutic treatment on the problem area within the distended portion of the epidural space.

14. A method of epidural surgery according to claim 13, further comprising the steps of:

inserting a portion of a catheter through an opening in a sacrum region of a patient and into the epidural space; and

advancing the portion of the catheter through the epidural space of a patient through the opening in the sacrum region and adjacent a suspected problem area.

15. A method of epidural surgery according to claim 13, further comprising the steps of:

inserting a portion of a catheter through an opening in a lumbar region of a patient and into the epidural space; and

advancing the portion of the catheter through the epidural space of a patient through the opening in the lumbar region and adjacent a suspected problem area.

16. A method of epidural surgery according to claim 13, wherein the step of positioning a portion of an optical scope in a distended portion of the epidural space comprises the steps of:

inserting the portion of the optical scope into the catheter;

advancing the portion of the optical scope through the catheter and into a portion of the epidural space; and

illuminating the distended portion of the epidural space with the optical scope to thereby provide a visual image of the epidural space and a problem area therein.

17. A method of epidural surgery according to claim 13, further comprising the following steps prior to the step of positioning the catheter:

inserting a portion of a needle through the skin of a patient and into a portion of the epidural space to thereby provide an opening from the skin to the epidural space of the patient;

inserting a portion of a guide wire through the needle and into the epidural space;

advancing the portion of the guide wire to a suspected problem area within the epidural space; and

extracting the needle from the epidural space.

18. A method of epidural surgery according to claim 17, further comprising the steps of:

inserting the portion of the catheter over the guide wire and into the opening to the epidural space;

supplying fluid through the catheter and into a portion of the epidural space; and

advancing the portion of the catheter to the suspected problem area.

19. A method of epidural surgery according to claim 13, wherein the step of performing a therapeutic treatment comprises the steps of:

positioning a distal end of the catheter adjacent the problem area within the epidural space; and

treating the problem area within the epidural space through the catheter.

20. A method of epidural surgery according to claim 13, wherein the fluid supplied from the catheter to distend the portion of the epidural space is a liquid.

21. A method of epidural surgery according to claim 13, wherein the distended portion of the epidural space comprises an amount of the epidural space less than entire boundaries of the epidural space.

22. A method of epidural surgery that improves visibility in the epidural space of a patient for more effectively conducting therapeutic surgery therein, the method comprising the steps of:

positioning a portion of a multi-lumen, steerable catheter into an opening to an epidural space of a patient;

distending a portion of the epidural space by filling the portion of the epidural space with a fluid supplied from a lumen of the steerable catheter;

positioning a portion of an optical scope in the distended portion of the epidural space by inserting the optical scope through another lumen of the same steerable catheter that supplies the distending fluid to thereby provide a visual image of the epidural space and a problem area therein; and

performing a therapeutic treatment to the problem area within the epidural space.

23. A method of epidural surgery according to claim 22, wherein the step of positioning a portion of a multi-lumen, steerable catheter comprises the steps of:

inserting a portion of a multi-lumen, steerable catheter through an opening in a sacrum region of a patient and into the epidural space; and

advancing the portion of the multi-lumen, steerable catheter in the epidural space of a patient through the opening in the sacrum region and adjacent a suspected problem area.

24. A method of epidural surgery according to claim 22, wherein the step of positioning a portion of a multi-lumen, steerable catheter comprises the steps of:

inserting a portion of a multi-lumen, steerable catheter through an opening in a lumbar region of a patient and into the epidural space; and

advancing the portion of the multi-lumen, steerable catheter in the epidural space of a patient through the opening in the lumbar region and adjacent a suspected problem area.

25. A method of epidural surgery according to claim 22, wherein the step of positioning of a portion of an optical scope in a distended portion of the epidural space comprises the steps of:

inserting a portion of an optical scope into a lumen of the steerable catheter;

advancing the portion of the optical scope through the lumen of the steerable catheter and into the distended portion of the epidural space; and

illuminating the distended portion of the epidural space with the optical scope to thereby provide a visual image of the epidural space and a problem area therein.

26. A method of epidural surgery according to claim 22, wherein the step of performing a therapeutic treatment comprises the steps of:

positioning a distal end of the multi-lumen, steerable catheter adjacent the problem area within the epidural space; and

treating the problem area within the epidural space through a lumen of the steerable catheter.

27. A method of epidural surgery according to claim 22, further comprising the following steps prior to the step of positioning a portion of the multi-lumen, steerable catheter in the epidural space:

inserting a portion of a needle through the skin of a patient and into the epidural space to thereby provide an opening from the skin into the epidural space;

inserting a portion of a guide wire through the needle and into a portion of the epidural space;

advancing the portion of the guide wire to a suspected problem area within the epidural space; and

extracting the needle from the epidural space.

28. A method of epidural surgery according to claim 27, further comprising the steps of:

inserting a portion of the multi-lumen, steerable catheter over the guide wire and into the opening to the epidural space; and

extracting the guide wire from the epidural space.

29. A method of epidural surgery according to claim 22, wherein the fluid supplied from a lumen of the steerable catheter to distend a portion of the epidural space is a liquid.

30. A method of epidural surgery according to claim 22, wherein the distended portion of the epidural space comprises an amount of the epidural space less than entire boundaries of the epidural space.