Devices and methods for arched roof cutters
View Patent ↗Disclosed herein are tissue-removal devices and methods for treating spinal diseases using such devices. The tissue-removal devices may comprise a cable and/or extendable elements with a retracted and a deployed configuration. The cable and/or extendable elements may be distally supported and restrained by a support element such that the support element may be pushed transversely away when the extendable element is distally extended into its deployed configuration. An annular cutting element may be provided about the distal end of the extendable element or the support element. Various configurations of the extendable and support elements are described herein, as well as methods of using tissue-removal devices with extendable and support elements coupled by an annular cutting element for treating spinal diseases.
1. A device comprising:
a shaft having a lumen therethrough;
a tissue-transport assembly having a distal end, the tissue-transport assembly configured to extend through the lumen of the shaft; and
a tissue-removal assembly attached to the distal end of the tissue-transport assembly, wherein the tissue-removal assembly includes:
a tubular member;
a cutting element;
a first support fixedly coupled to the tubular member at a first coupling site and coupled to the cutting element; and
a second support coupled to the tubular member at a second coupling site and coupled to the cutting element, the second support configured to be extendable;
wherein the second coupling site is distal to the first coupling site; and
wherein the tissue-removal assembly has a first retracted configuration and a second extended configuration.
2. The tissue removal device of claim 1 , wherein the first coupling site is a side aperture in a side surface of the tubular member.
3. The tissue removal device of claim 2 , wherein the second coupling site is a distal end aperture of the tubular member.
4. The tissue removal device of claim 3 , wherein the second support slidably extends out of the distal end aperture to move the tissue-removal assembly from the first retracted configuration to the second extended configuration.
5. The tissue removal device of claim 1 , wherein the tubular member is a rigid tubular member.
6. The tissue removal device of claim 5 , wherein the rigid tubular member is non-linear.
7. The tissue removal device of claim 1 , wherein the first support comprises a cable.
8. The tissue removal device of claim 1 , wherein the cutting element is a cutting ring.
9. The tissue removal device of claim 1 , wherein the first support is further coupled to the tubular member at a third coupling site.
10. The tissue removal device of claim 1 , wherein the first support and second support form a triangular support configuration.
11. The tissue removal device of claim 1 , wherein the first support has a fixed length.
12. The tissue removal device of claim 1 , wherein the tubular member includes a distal end, the first support being configured to have a length greater than a distance along the second support extending from the distal end of the tubular member to the cutting element.
13. The tissue removal device of claim 1 , wherein the first support comprises a first angle with respect to a longitudinal axis of the shaft when in the first retracted configuration and the first support comprises a second angle with respect to the longitudinal axis of the shaft when in the second extended configuration, the second angle being greater than the first angle.
14. The tissue removal device of claim 1 , wherein in the first retracted configuration, the cutting element is offset from a longitudinal axis of the tubular member a first distance and, in the second extended configuration, the cutting element is offset from the longitudinal axis of the tubular member a second distance, the second distance being greater than the first distance.
15. The tissue removal device of claim 1 , wherein the cutting element has an aperture, and the first and second supports are coupled to the cutting element through the aperture.
16. The tissue removal device of claim 1 , wherein each of the first and second supports form a loop that extends through the cutting element.
17. The tissue removal device of claim 1 , wherein the cutting element comprises a proximal lobe and a distal lobe, wherein the proximal lobe is configured to retain the first support and the distal lobe is configured to retain the second support.
18. The tissue removal device of claim 1 , wherein the first support includes a multifilament cable.
19. The tissue removal device of claim 1 , wherein the cutting element includes a lumen having a perimeter, and a leading edge that faces a direction of rotation, the leading edge having a cutting surface that borders a portion of the perimeter of the lumen of the cutting element.
20. The tissue removal device of claim 19 , wherein the cutting surface borders about 30% to 50% of the perimeter of the lumen of the cutting element.
21. The device of claim 1 , wherein the tubular member includes a distal end, and the second support is coupled to the distal end of the tubular member.
22. The device of claim 1 , wherein the tubular member includes a distal opening, the second support configured to translate through the tubular member, such that the second support is extendable out the distal opening of the tubular member.
23. The device of claim 22 , wherein the second support extends a first distance out from the distal opening of the tubular member in the retracted configuration of the tissue-removal assembly and extends a second distance out from the distal opening of the tubular member in the extended configuration of the tissue-removal assembly, the second distance being greater that the first distance.