Image guided spinal decompression with contralateral oblique view
AssigneeBeth Israel Deaconess Medical Center, Inc.
InventorJatinder S. Gill
Life of this patent
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Abstract
The present invention relates to a flexible surgical system for endoscopic spinal decompression and methods thereof. Various methods of accessing the epidural space with this instrument are described. The system design enables placement of the device through several approaches. It is then advanced under direct visualization or fluoroscopic (X-Ray), for example, into areas of the spine including lumbar (low back), thoracic (mid and upper back) and cervical (neck). The pathologies encroaching upon the spinal space can then be visualized wherein the epidural membrane can optionally be displaced to further aid in visualization. The membrane can be used to protect regions of tissue adjacent the site to tissue removal.
Claims32
A device for surgical removal of a spinal stenosis, comprising:
- a membrane having a size that can be inserted into an epidural space from a non-treatment level at a percutaneous insertion location along a spine of a patient between duramater and ligamentum flavum;
- a tissue removal device having a distal end to be inserted into the patient from a contralateral oblique angle that extends across a midline of the spine along a treatment level relative to the spine at a treatment location different from the insertion location such that the distal end is directed to a position to remove the spinal stenosis;
- and
- a fluoroscopic visualization device positioned to image a field of view along the contralateral oblique angle including a position of the membrane, the spinal stenosis and the tissue removal device.
A method for treating a spinal stenosis comprising:
- inserting a membrane from a non-treatment spinal level at an insertion location, the membrane having a distal end that protects duramater tissue during removal of a spinal stenosis along a spinal region of a spine of a patient;
- introducing a tubular body into the spinal region at a treatment level of the spine along a contralateral oblique axis extending across a midline of the spine such that the tubular body is inserted at a different location than the insertion location of the membrane, and thereby positioning a distal end of the tubular body into a spinal stenosis area;
- fluoroscopically visualizing the spinal stenosis area along the contralateral oblique axis to view a tissue removal device inserted through the tubular body and the membrane in the spinal region;
- and
- removing tissue from the spinal stenosis area as the tissue removal device is inserted along one side of the membrane.
A method for treating a spinal stenosis comprising:
- introducing a tubular body into the spinal region along a contralateral oblique axis of a patient to access a spinal stenosis area, the contralateral oblique axis being in a range of 35 to 45 degrees offset from a midline of the spine of the patient such that a distal end of the tubular body is inserted across the midline and into a spinal stenosis while avoiding contact with nerves of the spinal canal;
- fluoroscopically visualizing the spinal stenosis area and a tissue removal device inserted through the tubular body and into the spinal stenosis along the contralateral oblique axis;
- and
- removing tissue from the spinal stenosis as the tissue removal device is inserted sequentially and in multiple planes into the spinal stenosis.
Dependencies are inferred from the claim text.