Flexible tissue rasp
View Patent ↗Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.
1. A device for modifying tissue in a spine of a patient, the device comprising:
a flexible elongate body having a tapered distal portion that is configured to couple to a guidewire and to be passed through a first incision on the patient's back into the spine between target and non-target tissues, and out a second incision on the patient's back;
a handle at a proximal end of the flexible elongate body;
a tissue modifying region comprising at least one wire between the tapered distal portion and the handle;
a shield member housing attached to the flexible elongate body adjacent to the tissue modifying region, wherein the shield member housing includes a shield receiving space therein; and
a shield member movably coupled to at least one of the shield member housing and the flexible elongate body, wherein the shield member is selectively deployable from within the shield receiving space to at least partially cover the tissue modifying region for preventing a non-target tissue from being modified by the tissue modification member.
2. The device of claim 1 , wherein the tissue modifying region comprises an abrasive surface.
3. The device of claim 1 , wherein the shield member comprises at least one opening along its length.
4. The device of claim 1 , wherein the shield member comprises a hollow member having an opening in a sidewall of the hollow member.
5. The device of claim 1 , further comprising a second handle configured to apply tension to the distal portion of the elongate body.
6. The device of claim 1 , wherein the shield member comprises an opening extending along one side of the entire length of the shield member.
7. The device of claim 1 , wherein the shield member comprises at least one anchoring member for anchoring or leveraging against the patient's skin, the anchoring member being coupled with the shield member outside the patient.
8. The device of claim 1 , wherein the shield member comprises: a proximal anchor member; and a distal anchor member.
9. A device for modifying tissue in a spine of a patient, the device comprising:
a flexible elongate body extending externally through a first incision and a second incision on the patient's back distally to proximally;
a shield member housing attached to the flexible elongate body, wherein the shield member housing includes a shield member receiving space therein;
an elongate flexible shield member having a proximal portion and a distal portion, wherein the shield member is selectively extendable from within the shield member receiving space for allowing a portion of the shield member extending from within the shield member housing to be adjusted;
a flexible tissue modification member forming a portion of the flexible elongate body, wherein the tissue modification member is disposed at least partly within the shield member, wherein the tissue modification member has a proximal portion, a distal portion, and at least one abrasive region between the proximal and distal portions, and wherein the at least one abrasive region is adjacent to the shield member such that a portion of the at least one abrasive region covered by the shield member is correspondingly adjusted as the portion of the shield member extending from within the shield member housing is adjusted; and
a proximal handle coupled to the flexible elongate body and configured to provide proximal tensioning at or near the proximal portion of at least one of the shield member and the tissue modification member for facilitating application of tensioning force in a first direction on the flexible tissue modification member by grasping the proximal handle and pulling.
10. The device of claim 9 , wherein the shield member comprises at least one opening along its length.
11. The device of claim 9 , wherein the shield member comprises a hollow member, and the opening comprises a window in a sidewall of the hollow member.
12. The device of claim 9 , wherein the tissue modification member comprises at least one wire.
13. The device of claim 9 , wherein the portion of the shield member selectively extendable from within the shield member receiving space includes a sheet of material that unfurls in response to the shield member being extended from within the shield member receiving space.
14. The device of claim 9 , wherein the shield member comprises an opening extending along one side of the entire length of the shield member.
15. The device of claim 9 , wherein the shield member is removably coupled with the tissue modification member.
16. The device of claim 9 , wherein the shield member comprises at least one anchor for anchoring the shield member outside the patient.
17. The device of claim 9 , wherein the shield member comprises: a proximal anchor; and a distal anchor.
18. The device of claim 9 , wherein the shield member includes a guidewire coupler at the distal end of the elongate body.
19. A device for modifying tissue in a spine of a patient, the device comprising:
a flexible elongate body including a shield receiving space therein, the flexible elongate body having a distal end and a proximal end extending externally through a first incision and a second incision on the patient's back;
a handle at the proximal end of the flexible elongate body;
a tissue modifying region comprising at least one wire between the distal end and the handle; and
a shield member movably coupled to the flexible elongate body for allowing the shield member to be selectively deployed from within the shield receiving space, wherein the shield member at least partially covers the tissue modifying region when deployed from within the shield receiving space to prevent a non-target tissue from being modified by the tissue modification member;
wherein the device is configured to couple to a guidewire and to be passed into a spinal region between a target tissue and the non-target tissue and extending through the first incision on the patient's back on the proximal end out the second incision on the patient's back to the distal end.