# US 9,295,479 B2 · Surgical device > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,295,479 B2 - Document ID: US9295479B2 - Status: Granted - Kind: B2 - Application number: 13/831,355 - Filed: 2013-03-14 - Published: 2014-09-18 - Granted: 2016-03-29 - Earliest claimed: 2013-03-14 - Assignees: Spinal Stabilization Technologies LLC - Applicants: Spinal Stabilization Technologies, LLC - Inventors: Nadi Salah Hibri; James Douglas Lutz - Web page: https://patentgrep.com/patent/US9295479B2 ## CPC - A61B 17/1671: {for the spine} - A61B 17/1633: {Sleeves, i.e. non-rotating parts surrounding the bit shaft, e.g. the sleeve forming a single unit with the bit shaft (A61B17/1644 takes precedence)} - A61B 17/1642: {for producing a curved bore} - A61B 17/1644: {using fluid other than turbine drive fluid} - A61B 17/32002: {with continuously rotating, oscillating or reciprocating cutting instruments} - A61B 17/320783: {through side-hole, e.g. sliding or rotating cutter inside catheter} - A61B 2017/00261: {Discectomy} - A61B 2017/00685: {Archimedes screw} - A61B 2017/320775: {Morcellators, impeller or propeller like means} - A61B 2017/320791: {with cutter extending outside the cutting window} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract An exemplary nucleus removal device may be used to remove a portion of nucleus pulposus from an intervertebral disc. A nucleus removal device may include a cannula, an access tool, a maceration tool, and an evacuation tool. The access cannula is inserted into an intervertebral body laterally, creating a fissure in the annular fibrosis. The access tool 304 is slid through the access cannula and the fissure in annular fibrosis, such that a portion of access tool extends into the nucleus pulposus. The maceration tool is extended from the access tool into the nucleus pulposus, in a direction orthogonal to the axial extension of access tool, and macerates the nucleus pulposus. To assist in maceration, a stream of liquid may also be introduced into the vertebral body through the access tool before, during, or after maceration. Macerated material and liquid is removed from the intervertebral disc by the evacuation tool. ## Claims ### Claim 1 An apparatus comprising: an axially extending tubular access tool, comprising: a proximal first end having a first orifice along the axial extension of the tool, a distal second end, forming a point along the axial extension of the tool, a second orifice, formed between the first end and the second end and located on an axis orthogonal to the axial extension of the cannula, a first tubular channel extending from the first orifice to the second orifice, adapted to channel a liquid from the first orifice to the second orifice, a second tubular channel extending from the first orifice to the second orifice and in cooperative arrangement with a maceration tool, a third tubular channel extending from the first orifice to the second orifice and in cooperative arrangement with an evacuation tool; a maceration tool within the second channel, comprising a maceration element and a first axially extending shaft, wherein radial rotation of the first shaft results in rotation of the maceration element; an evacuation tool within the third channel, comprising one or more evacuation elements and a second axially extending shaft, wherein radial rotation of the second shaft results in rotation of the evacuation element; wherein movement of the first shaft in a proximal to distal direction results in movement of the maceration element out of the second orifice in a direction generally orthogonal to the longitudinal extension of the tubular access tool; wherein the maceration element is adapted to macerate tissue when rotated; and wherein the evacuation elements are adapted to move material through the third channel when rotated. ### Claim 2 (depends on 1) The apparatus of claim 1, further comprising: an axially extending access cannula, comprising: a distally located first end, forming a first access hole along the axial extension of the cannula, a proximally located second end, forming a second access hole along the cannula, a tubular channel extending form the first access hole of the cannula to the second access hole of the cannula, wherein the tubular channel of the cannula is adapted to receive the access tool. ### Claim 3 (depends on 1) The apparatus of claim 1, wherein the maceration tool is self-expanding. ### Claim 4 (depends on 1) The apparatus of claim 1, wherein the first or second shaft is connected to a motorized drive. ### Claim 5 (depends on 1) The apparatus of claim 1, wherein the first channel is connected to a liquid pump. ### Claim 6 (depends on 1) The apparatus of claim 1, wherein an axial cross section of the tubular access tool is of a generally polygonal, ovular, circular, or elliptical shape. ### Claim 7 (depends on 1) The apparatus of claim 1, wherein the device comprises a surgically compatible material. ### Claim 8 (depends on 1) The apparatus of claim 1, wherein device of the apparatus comprises a radiopaque material. ### Claim 9 (depends on 1) The apparatus of claim 1, wherein the cannula is adapted to be percutaneously inserted into an intervertebral disc. ### Claim 10 An apparatus for removing a portion of a nucleus pulposus, comprising: a maceration tool comprising a maceration element coupled to a first shaft, wherein rotation of the first shaft rotates the maceration element; an evacuation tool comprising one or more evacuation elements and a second shaft, wherein rotation of the second shaft rotates the one or more evacuation elements; an access tool extending from a proximal end to a distal end, comprising: a maceration tool channel extending from the proximal end to the distal end of the access tool for slidably receiving the maceration tool, wherein movement of the maceration tool in a proximal to distal direction extends the maceration element out of the distal end of the access tool in a direction generally orthogonal to a longitudinal axis of the access tool; an evacuation channel extending from the proximal end to the distal end of the access tool for receiving the evacuation tool; wherein the maceration element is adapted to macerate tissue when rotated; and wherein the one or more evacuation elements are adapted to evacuate material through the evacuation channel when rotated. ### Claim 11 (depends on 10) The apparatus of claim 10, wherein the one or more evacuation elements comprise Archimedes screws. ### Claim 12 (depends on 11) The apparatus of claim 11, wherein the second shaft comprises a flexible material. ### Claim 13 (depends on 10) The apparatus of claim 10, further comprising an irrigation channel extending from the proximal end to the distal end of the access tool for delivering irrigation fluid to the distal end of the access tool. ### Claim 14 (depends on 10) The apparatus of claim 10, wherein the maceration tool further comprises a flexible housing for receiving the rotating shaft. ### Claim 15 (depends on 14) The apparatus of claim 14, wherein the flexible housing is articulatable. ### Claim 16 (depends on 10) The apparatus of claim 10, further comprising a catheter for covering at least a portion of the first shaft.