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.
Claims20
A device for surgical removal of a spinal stenosis, comprising:
- a tubular tissue removal device having an opening at a distal end to be inserted into the patient from a contralateral oblique angle along an insertion axis that extends across a midline of the spine at a treatment level relative to the spine such that the distal end is directed to a position to remove the spinal stenosis, the tubular tissue removal device having an internal cavity configured to capture at least a portion of the spinal stenosis to be removed;
- and
- a fluoroscopic visualization device positioned to image a field of view along the insertion axis at the contralateral oblique angle including a position of the spinal stenosis and the tissue removal device.
A method for treating a spinal stenosis comprising:
- inserting a cannula having a distal end positioned to guide a tubular tissue removal device and thereby protect duramater tissue during removal of a spinal stenosis within a spinal region of a patient;
- introducing a tubular tissue removal device through the cannula and into the spinal region along a contralateral oblique axis that extends posterior to a ventral interlaminar line (VILL) of the patient to access a spinal stenosis area;
- visualizing the spinal stenosis area with a fluoroscopic visualization device oriented along the contralateral oblique axis to position a distal end of the tubular tissue removal device within the spinal stenosis;
- and
- removing tissue from the spinal stenosis area as the tubular tissue removal device is moved along the contralateral oblique axis.
A kit for treatment of a spinal stenosis comprising;
- a rigid cannula having a diameter to access a spinal stenosis to be at least partially removed from a patient, a distal end of the cannula having a distal cutting region for insertion along a contralateral oblique axis of a spine of a patient to at least a spinolaminar junction of the spine;
- a stylet for placement with the cannula and along said contralateral oblique axis, the stylet having a distal cutting surface that can be extended beyond the distal end of the cannula wherein a stop limits advancement of the stylet beyond a fixed distance distally of the cannula;
- and
- a tissue removal device to be inserted through the cannula upon removal of the stylet, the tissue removal device having an internal tube channel to receive spinal stenotic tissue upon insertion of the tissue removal device into the spinal stenosis, the tissue removal device having distal cutting element within the internal tube channel to sever tissue within the tissue removal device from tissue remaining outside the tissue removal device such that the tissue in the tissue removal device is drawn into the internal tube channel upon rotation relative to the spinal stenosis.
Dependencies are inferred from the claim text.