Granted Patent B2

US 9,125,682 · App. 13/757,599 · Granted Sep 8, 2015

Abstract

Claims (35)

1. A method of accessing target tissue of a patient, comprising:

accessing, through an access location, a spine location of the patient;

inserting a first flexible device through the access location to the spine location;

advancing a distal portion of the first flexible device from the spine location to a first exit location;

passing the distal portion of the first flexible device through the first exit location and out of the patient;

inserting the first flexible device or a second flexible device through a second access location to the spine location;

advancing a distal portion of the first flexible device or the second flexible device from the spine location to the first exit location;

passing the distal portion of the first flexible device or the second flexible device through the first exit location and out of the patient; and

pulling a tissue modification element through the first access location to the spine location and positioning the tissue modification element at least partially around a target tissue and modifying the target tissue with the tissue modification element.

2. The method of claim 1 , wherein advancing the distal portion of the first flexible device from the spine location to the first exit location comprises pulling the distal portion of a tissue modification device from the spine location to the first exit location.

3. The method of claim 1 , further comprising pulling in a tissue modification element through the second access location to the spine location and positioning the tissue modification element at least partially around a target tissue and modifying the target tissue with the tissue modification element.

4. The method of claim 1 , wherein advancing the distal portion of the first flexible device or the second flexible device from the spine location to the first exit location comprises pulling the distal portion of a tissue modification device from the spine location to the first exit location.

5. A method of accessing target tissue of a patient, the method comprising:

accessing a spine location of the patient by entering the patient through a first access location;

inserting a first flexible tissue modification device through the first access location to the spine location;

advancing a distal portion of the first flexible tissue modification device from the spine location to an exit location;

passing the distal portion of the first flexible tissue modification device through the exit location and out of the patient;

inserting the first or a second flexible tissue modification device through a second access location to the spine location;

advancing a distal portion of the first or a second flexible tissue modification device from the spine location to the same exit location; and

passing the distal portion of the first or the second flexible tissue modification device through the same exit location and out of the patient;

wherein advancing the first or second flexible tissue modification device from the spine location to the exit location comprises advancing the first or second flexible tissue modification device from the spine location to an interlaminar window.

6. The method of claim 5 , further comprising accessing a spine location of the patient through a third access location; inserting the first, the second or a third flexible device through the third access location to the spine location; and advancing the first, second or third flexible device from the spine location to the same exit location.

7. The method of claim 5 , wherein the spine location is anterior to the posterior aspect of the ligamentum flavum and posterior to the dura mater of the spinal cord and cauda equina.

8. A method of accessing target tissue adjacent to a spinal nerve of a patient, comprising:

accessing a spine location of the patient by entering the patient through a first access location, wherein the spine location is anterior to the posterior aspect of the ligamentum flavum and posterior to the dura mater of the spinal cord and cauda equina;

inserting a first flexible tissue modification device through the first access location to the spine location;

pulling a distal portion of the first flexible tissue modification device from the spine location toward an exit location using a first guidewire extending from the exit location;

inserting the first or a second flexible tissue modification device through a second access location to the spine location;

pulling a distal portion of the first or a second flexible tissue modification device from the spine location toward the same exit location; using the first or a second guidewire extending from the same exit location.

9. The method of claim 8 , further comprising using the first flexible tissue modification device to modify tissue at the spine location.

10. The method of claim 8 , further comprising using the second flexible tissue modification device to modify tissue at the spine location.

11. The method of claim 8 , further comprising removing the first flexible tissue modification device before inserting the second flexible tissue modification device.

12. The method of claim 8 , further comprising inserting a distal end of the first guidewire from the first access location and out of the same exit location.

13. The method of claim 8 , further comprising inserting the distal end of the first guidewire or a distal end of a second guidewire from the second access location and out of the same exit location.

14. The method of claim 8 , wherein pulling the distal portion of the first flexible tissue modification device from the spine location towards the exit location comprises positioning the tissue modification element at least partially around a target tissue and modifying the target tissue with the tissue modification element.

Assignments (9)