Granted Patent B2

US 8,608,762 · App. 12/188,360 · Granted Dec 17, 2013

Abstract

Claims (49)

1. A method for treating stenosis of a patient comprising:

percutaneously accessing tissue with a tool from a first side of the medial plane of the spine, wherein the tool is inserted into a back surface of the patient on the first side and at an initial angle relative to the longitudinal axis of the spine;

advancing the tool generally between adjacent vertebrae and substantially parallel to a long axis of the interlaminar space; and

reducing stenosis.

2. The method of claim 1 , further comprising the step of generating at least one view of the interlaminar space.

3. The method of claim 1 , wherein the reducing stenosis step comprises excising a portion of the tissue.

4. The method of claim 3 , wherein the tissue includes at least one of ligamentum flavum, bone, and fat.

5. The method of claim 1 , wherein the tool is introduced into the interlaminar space at an angle ranging from between about 5 degrees to about 90 degrees relative to the back surface.

6. The method of claim 1 , further comprising the step of creating a safety zone within the epidural space by injecting a fluid into the epidural space.

7. The method of claim 6 , wherein the fluid comprises a contrast agent.

8. The method of claim 1 , wherein the tool is initially inserted into the back surface of the patient between about 5 and about 10 cm inferior to the tissue.

9. The method of claim 1 , wherein the tool is initially inserted into the back surface of the patient substantially parallel to the longitudinal axis of the spine.

10. The method of claim 1 , wherein the tool is adjustable to an angle θ that ranges between about 0 to about 90 degrees relative to the back surface.

11. The method of claim 1 , wherein the tool includes a cannula having a central bore configured to receive a tissue removal instrument.

12. The method of claim 1 , wherein the tool is a tissue removal tool.

13. The method of claim 1 , wherein the tool is advanced generally between adjacent vertebrae at an angle ranging from between about 60 degrees to about 75 degrees relative to the back surface.

14. The method of claim 1 , further comprising:

advancing the tool through the medial plane of the spine to a second side of the medial plane; and

reducing stenosis located on the second side of the medial plane of the spine.

15. The method of claim 1 , wherein the initial angle is less than about 45 degrees.

16. The method of claim 15 , wherein the initial angle is between about 0 degrees and about 10 degrees.

17. A method for treating a spinal disorder of a patient, comprising:

generating at least one view of the patient's vertebral column, wherein said at least one view is a caudal-cranial posterior view;

inserting a percutaneous tool into a back surface of the patient on a first side of the medial plane of the spine at an initial angle;

advancing the percutaneous tool generally through the interlaminar space and substantially parallel to a long axis of the interlaminar space; and

removing spinal tissue.

18. The method of claim 17 , wherein the caudal-cranial posterior view is generated by positioning an imaging device at a viewing angle θ relative to the back surface and positioning the imaging device lateral to the spine, wherein the viewing angle θ ranges from between about 50 to about 80 degrees.

19. The method of claim 17 , wherein the spinal tissue includes at least one of the ligamentum flavum, fat and bone.

20. The method of claim 17 , further comprising injecting a radio-opaque fluid into the epidural space.

21. The method of claim 17 , wherein the percutaneous tool is advanced generally between adjacent vertebrae at an angle ranging from between about 60 degrees to about 75 degrees relative to the back surface.

22. The method of claim 17 , further comprising:

advancing the percutaneous tool through the medial plane of the spine to a second side of the medial plane; and

removing spinal tissue located on the second side of the medial plane of the spine.

23. The method of claim 17 , wherein the initial angle is less than about 45 degrees.

24. The method of claim 23 , wherein the initial angle is between about 0 degrees and about 10 degrees.

25. A method for treating a spinal disorder of a patient, comprising:

generating at least one view of the patient's vertebral column, wherein said at least one view is a caudal-cranial posterior-lateral view;

inserting a percutaneous tool into a back surface of the patient on a first side of the medial plane of the spine at an initial angle;

advancing the percutaneous tool generally through the interlaminar space and substantially parallel to a long axis of the interlaminar space; and

removing spinal tissue.

26. The method of claim 25 , wherein the caudal-cranial posterior-lateral view is generated by positioning an imaging device at a viewing angle θ relative to the back surface and positioning the imaging device lateral to the spine, wherein the viewing angle θ ranges from between about 50 and to about 80 degrees.

27. The method of claim 25 , wherein the spinal tissue includes at least one of ligamentum flavum, fat and bone.

28. The method of claim 25 , further comprising injecting a radio-opaque fluid into the epidural space.

29. The method of claim 25 , wherein the percutaneous tool is advanced generally between adjacent vertebrae at an angle ranging from between about 60 degrees to about 75 degrees relative to the back surface.

30. The method of claim 25 , further comprising:

advancing the percutaneous tool through the medial plane of the spine to a second side of the medial plane; and

removing spinal tissue located on the second side of the medial plane of the spine.

31. The method of claim 25 , wherein the initial angle is less than about 45 degrees.

32. The method of claim 31 , wherein the initial angle is between about 0 degrees and about 10 degrees.

Assignments (8)