Methods and apparatus for tissue modification

A method for modifying tissue in a spine of a patient, the method comprising:

• advancing a flexible distal portion of an elongate tissue modification device into the patient's epidural space and between one or more target tissues and one or more non-target tissues;
• positioning a tissue modifying portion of the tissue modification device adjacent the target tissue such that a tissue modifying member of the tissue modifying portion faces the target tissue and does not face the non-target tissue;
• anchoring the distal portion of the tissue modification device relative to the patient from outside of the patient through an exit point out of the patient located apart from the location where the device was advanced into the patient;
• applying a tensioning force to the proximal portion of the device, to urge the intermediate tissue modifying portion of device against the target tissue;
• and
• cutting the target tissue by moving the tissue modifying member relative to rest of the tissue modifying portion of the tissue modification device while the distal portion is fixed relative to the patient preventing any portion of the tissue modification device from extending further distally beyond the exit point out of the patient.

A method for modifying tissue in a spine of a patient, the method comprising:

• advancing a flexible distal portion of an elongate tissue modification device into an epidural space of the patient and between one or more target tissues and one or more non-target tissues;
• positioning a tissue modifying portion of the tissue modification device adjacent the target tissue such that a tissue modifying member of the tissue modifying portion faces the target tissue and does not face the non-target tissue;
• anchoring the tissue modification device relative to the patient from the flexible distal portion of the device so that the distal portion is fixed relative to the patient, preventing any portion of the tissue modification device from extending further distally beyond the exit point out of the patient;
• applying a tensioning force to the tissue modification device from the proximal portion of the device to urge the tissue modifying portion of device against the target tissue;
• and
• applying radiofrequency energy to the target tissue, using the tissue modifying member while the distal portion is anchored.

A method for modifying tissue in a spine of a patient, the method comprising:

• advancing a flexible distal portion of an elongate tissue modification device into an epidural space of the patient and between one or more target tissues and one or more non-target tissues;
• positioning a tissue modifying portion of the tissue modification device adjacent the target tissue such that a tissue modifying member of the tissue modifying portion faces the target tissue and does not face the non-target tissue;
• anchoring the tissue modification device relative to the patient from the flexible distal portion of the device so that the distal portion is fixed relative to the patient, preventing any portion of the tissue modification device from extending further distally beyond the exit point out of the patient;
• and
• translating a first blade of the tissue modifying member to move it towards a second blade of the tissue modifying member to cut the target tissue, while the distal portion is anchored.