Powered tissue modification devices and methods

A system for treating spinal stenosis, the system comprising:

• a tissue modification device, comprising:
• an elongate body having a flexible distal portion configured for passing into an epidural space and at least partway into an intervertebral foramen;
• a guidewire coupling member disposed at the distal portion, wherein the guidewire coupling member is configured to facilitate application of a distal pulling force to urge the flexible distal portion against a target tissue, wherein the guidewire coupling member is configured to grasp the end of a guidewire to the distal end portion of the tissue modification device;
• a tissue modifying member connected to one side of the flexible distal portion of the elongate body proximal to the distal end of the distal portion;
• a protective surface on one side of the flexible distal portion of the elongate body opposite and behind the tissue modifying member that prevents non-target tissues from being modified by the tissue modification member;
• a proximal handle coupled with a proximal portion of the elongate body;
• a drive shaft disposed along the elongate body having a proximal end coupled to the handle and a distal end coupled with the tissue modifying member to activate the tissue modifying member;
• and
• a guidewire couplable with the guidewire coupling member.

A system for treating spinal stenosis, the system comprising:

• a tissue modification device, comprising:
• an elongate body having a flexible distal portion configured for passing into an epidural space and at least partway into an intervertebral foramen;
• a guidewire coupling member disposed at the distal portion, wherein the guidewire coupling member is configured to facilitate application of a distal pulling force to urge the flexible distal portion against a target tissue;
• a tissue modifying member connected to one side of the flexible distal portion of the elongate body proximal to the distal end of the distal portion;
• a protective surface on one side of the flexible distal portion of the elongate body opposite and behind the tissue modifying member that prevents non-target tissues from being modified by the tissue modification member;
• a proximal handle coupled with a proximal portion of the elongate body;
• a drive shaft disposed along the elongate body having a proximal end coupled to the handle and a distal end coupled with the tissue modifying member to activate the tissue modifying member;
• a guidewire couplable with the guidewire coupling member;
• and
• a distal handle couplable with the guidewire.

A device for modifying spinal tissue, the device comprising:

• an elongate shaft having a flexible distal portion that is configured to be passed into an epidural space of the spine and between target and non-target tissues;
• a movable blade, connected to one side of the flexible distal portion of the elongate shaft proximal to the distal end of the flexible distal portion of the elongate shaft;
• a protective surface on one side of the flexible distal portion of the elongate shaft opposite and behind the movable blade that prevents non-target tissues from being cut by the blade;
• a guidewire coupling member at the distal end of the flexible distal portion of the elongate shaft and configured to facilitate application of a pulling force in the distal direction to urge the movable blade against the target tissue;
• a handle at the proximal end of the shaft, wherein the handle includes an actuator to actuate movement of the movable blade;
• a drive shaft disposed along the elongate shaft having a proximal end coupled to the handle and a distal end coupled to the movable blade, wherein the drive shaft is configured to move the movable blade to cut a target tissue without significantly translating the elongate shaft proximally or distally.

A system for treating spinal stenosis, the system comprising:

• a tissue modification device, comprising:
• an elongate body having a flexible distal portion configured for passing into an epidural space and at least partway into an intervertebral foramen;
• a guidewire coupling member disposed at the distal portion, wherein the guidewire coupling member is configured to facilitate application of a pulling force in the distal direction to urge the flexible distal portion against a target tissue;
• a tissue modifying member connected to one side of the flexible distal portion of the elongate body proximal to the distal end of the distal portion;
• a protective surface on one side of the flexible distal portion of the elongate body opposite and behind the tissue modifying member that prevents non-target tissues from being modified by the tissue modification member;
• a proximal handle coupled with a proximal portion of the elongate body;
• a drive shaft disposed along the elongate body having a proximal end coupled to the handle and a distal end coupled with the tissue modifying member to activate the tissue modifying member;
• and
• a guidewire couplable with the guidewire coupling member such that it extends distally from the distal portion of the shaft.