Method and devices for treating spinal stenosis
Systems and methods for treating spinal stenosis include endoscopic access devices and bone removal devices used to perform a foraminotomy or other bone removal procedures. Some of the bone removal devices include expandable members which may be used to control the forced exerted and/or position of the bone removal mechanism, and to protect neurovascular structures and other soft tissue structures from the bone removal mechanism. Other bone removal devices include a trephine with a viewing window and a guide wire lumen used to position the trephine at a target tissue site using an anchored wire. The viewing window may be used to monitor structures or tissues adjacent to the target tissue site.
1. A system, comprising:
a cannula body with a proximal end, a distal end, a guide lumen, a drive shaft lumen, and a scope lumen;
a drive shaft, the drive shaft lumen configured to receive the drive shaft;
a trephine coupled to the drive shaft;
a guidewire, the guide lumen configured to receive the guidewire, the guidewire including a threaded distal end configured to attach to bony tissue; and
a viewing apparatus, the scope lumen configured to receive the viewing apparatus,
the scope lumen ending in a closed distal end within the cannula body, and including a distal viewing aperture in a longitudinal sidewall of the cannula body, such that a longitudinal axis of the scope lumen is generally parallel to a length of the distal viewing aperture.
2. The system of claim 1 , wherein the guide lumen is located within the driveshaft.
3. The system of claim 1 , wherein the trephine is a rotatable trephine with a rotation axis.
4. The system of claim 3 , wherein the trephine is configured with a rotation range of less than about 15 degrees.
5. The system of claim 4 , wherein the trephine is coupled to a reciprocation assembly.
6. The system of claim 3 , wherein the rotatable trephine is coupled to a motor.
7. The system of claim 3 , wherein on an axial-cross section, the guide lumen is located a distance from the rotation axis of the rotatable trephine, the distance being equal to or greater than about the radius of the rotatable trephine.
8. The system of claim 1 , wherein the trephine has a fixed position relative to the cannula body.
9. The system of claim 1 , further comprising a handle attached to the cannula body.
10. The system of claim 1 , wherein the guide lumen comprises at least one deformable tension element.
11. The system of claim 10 , wherein the guide lumen comprises at least two deformable tension elements.
12. The system of claim 11 , wherein one of the at least two deformable tension elements is user-controlled.
13. The system of claim 1 , wherein the viewing apparatus includes at least one fiber optic.
14. The system of claim 1 , wherein the viewing apparatus is a fiber optic scope.
15. The system of claim 1 , wherein the distal viewing aperture is covered by a transparent material.
16. The system of claim 1 , wherein the distal viewing aperture is located at the closed distal end of the scope lumen.