Devices and methods for treating tissue
Described herein are devices, systems and methods for treating target tissue in a patient's spine. In general, the methods include the steps of advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location; connecting a tissue modification device to the wire; positioning the tissue modification device through the neural foramen using the wire; modifying target tissue in the spine by moving the tissue modification device against the target tissue; and delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue. In some embodiments, the step of modifying target tissue comprises removing target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.
1. A delivery device for delivering an agent to a surgical site, the delivery device comprising:
a guidewire, wherein an angle between an entering portion of the guidewire and an exiting portion of the guidewire is less than 90 degrees;
an elongate flexible catheter having a proximal end and a distal end, wherein the distal end of the elongate flexible catheter is configured to be advanced from a first location;
a connector coupled to the proximal end of the catheter, the connector configured to receive the agent; and
an aperture at the distal end portion of the catheter configured to deliver the agent to the surgical site;
wherein the elongate flexible catheter is configured to be pulled into position via the guidewire from a second location.
2. The device of claim 1 , further comprising a guidewire handle coupled to the guidewire at the second location.
3. The device of claim 1 , further comprising a syringe, a suction device, and/or an irrigation device, wherein the connector is configured to receive the guidewire and the syringe, the suction device, and/or the irrigation device.
4. The device of claim 1 , wherein the connector comprises a lock such that the connector can lock down on the guidewire and prevent further motion of the guidewire through the connector.
5. The device of claim 1 , wherein the elongate flexible catheter further comprises one or more radiopaque marker positioned along the length of the elongate flexible catheter.
6. The device of claim 1 , wherein the elongate flexible catheter comprises holes or fenestrations along a portion of the length of the elongate flexible catheter.
7. The device of claim 1 , wherein the agent is at least one of a haemostatic agent, a tissue sealant, a vasoconstrictor, a corticosteroid, a local anesthetic, an analgesic, and any combination thereof.
8. A delivery device for delivering an agent to a surgical site, the delivery device comprising:
a guidewire, wherein the guidewire is positionable between an interlaminar window and a neural foramen;
an elongate flexible catheter having a proximal end and a distal end, wherein the distal end of the elongate flexible catheter is configured to be advanced from a first location;
a connector coupled to the proximal end of the catheter, the connector configured to receive the agent; and
an aperture at the distal end portion of the catheter configured to deliver the agent to the surgical site;
wherein the elongate flexible catheter comprises holes or fenestrations along a portion of the length of the elongate flexible catheter; and
wherein the elongate flexible catheter is configured to be pulled into position via the guidewire from a second location.
9. The device of claim 8 , further comprising a guidewire handle coupled to the guidewire at the second location.
10. The device of claim 8 , further comprising a syringe, a suction device, and/or an irrigation device, wherein the connector is configured to receive the guidewire and the syringe, the suction device, and/or the irrigation device.
11. The device of claim 8 , wherein the connector comprises a lock such that the connector can lock down on the guidewire and prevent further motion of the guidewire through the connector.
12. The device of claim 8 , wherein the elongate flexible catheter further comprises one or more radiopaque marker positioned along the length of the elongate flexible catheter.
13. The device of claim 8 , wherein the agent is at least one of a haemostatic agent, a tissue sealant, a vasoconstrictor, a corticosteroid, a local anesthetic, an analgesic, and any combination thereof.