Spinal ligament modification kit
A method for treating stenosis in a spine comprises percutaneously accessing the epidural space in a stenotic region of interest, compressing the thecal sac in the region of interest to form a safety zonem, inserting a tissue removal tool into tissue in the working zone, using the tool to percutaneously reduce the stenosis; and utilizing imaging to visualize the position of the tool during at least a part of the reduction step. A tissue excision system for performing percutaneous surgery, comprises a cannula comprising a tissue-penetrating member having a distal end defining an aperture on one side thereof, an occluding member slidably received on or in the cannula and closing the aperture when the occluding member is adjacent the cannula distal end, means for engaging adjacent tissue via the aperture, and cutting means for resecting a section of the engaged tissue.
1 . A kit for performing a procedure on a spine, the spine including an epidural space containing a thecal sac, the kit comprising:
an insertion member for accessing the epidural space;
an expandable device adapted to be inserted into the epidural space by the insertion member and expanded so as to compress a portion of the thecal sac and provide a safety zone within the epidural space.
2 . The kit according to claim 1 wherein said expandable device comprises a volume of a contrast medium.
3 . The method according to claim 2 wherein the contrast medium comprises a radio-opaque non-ionic myelographic contrast medium.
4 . The kit according to claim 2 wherein said expandable device comprises a volume of a medium that is injectable at ambient temperatures and more viscous at body temperature.
5 . The kit according to claim 2 wherein the contrast medium includes a bioactive agent.
6 . The kit according to claim 2 wherein the contrast medium includes a steroid.
7 . The kit according to claim 1 , further including a surgical device.
8 . The kit according to claim 7 wherein said surgical device comprises:
a cannulated scalpel having a side aperture proximal its distal end;
an elongate body housed within said cannulated scalpel and comprising two radially extendable arms constructed such that radially extending said arms causes them to extend outward through said side aperture and retracting said arms causes them to close.
9 . The kit according to claim 7 wherein said surgical device comprises:
means for engaging the ligamentum flavum; and
means for resecting a section of the ligamentum flavum.
10 . The kit according to claim 7 wherein said surgical device comprises:
a cannula;
a barbed member coaxially received within said cannula; and
a blade slidably mounted on said cannula.
11 . The kit according to claim 7 wherein said surgical device comprises:
means for engaging a first anatomical structure; and
means for affixing said first anatomical structure to a second anatomical structure.
12 . The kit according to claim 7 wherein said surgical device comprises:
means for engaging the ligamentum flavum and soft tissues in the Para spinal region of the patient so as to anchor the ligamentum flavum.
13 . The kit according to claim 7 wherein said surgical device comprises:
means for engaging and retracting the ligamentum flavum; and
means for anchoring the retracted ligamentum flavum.
14 . A kit for performing a desired procedure on a spine, the spine including an epidural space containing a thecal sac, the kit comprising:
a volume of an injectable fluid;
means for injecting at least a portion of said a fluid into the epidural space so as to compress a portion of the thecal sac and provide a safety zone within the epidural space; and
a tool for performing the desired procedure in tissue adjacent to the safety zone.
15 . The kit according to claim 14 wherein said surgical device comprises:
a cannulated scalpel having a side aperture proximal its distal end;
an elongate body housed within said cannulated scalpel and comprising two radially extendable arms constructed such that radially extending said arms causes them to extend outward through said side aperture and retracting said arms causes them to close.
16 . The kit according to claim 14 wherein said surgical device comprises:
means for engaging the ligamentum flavum; and
means for resecting a section of the ligamentum flavum.
17 . The kit according to claim 14 wherein said surgical device comprises:
a cannula;
a barbed member coaxially received within said cannula; and
a blade slidably mounted on said cannula.
18 . The kit according to claim 14 wherein said surgical device comprises:
means for engaging a first anatomical structure; and
means for affixing said first anatomical structure to a second anatomical structure.
19 . The kit according to claim 14 wherein said surgical device comprises:
means for engaging the ligamentum flavum and soft tissues in the Para spinal region so as to anchor the ligamentum flavum.
20 . The kit according to claim 14 wherein said surgical device comprises:
a double-headed anchor for engaging and retracting the ligamentum flavum and anchoring the retracted ligamentum flavum to tissue; and
a delivery cannula in which said anchor is disposed until it is deployed.