Apparatus and methods for disrupting intervertebral disc tissue
An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.
1. A method for disrupting tissue in the intervertebral disc space, comprising:
forming a barrier in the intervertebral disc space wherein the barrier at least partially defines a perimeter of a working region within the disc space, wherein forming of the barrier comprises inserting a barrier into the intervertebral disc space in a substantially linear configuration, wherein the configuration of the barrier changes to a generally arcuate configuration; and
disrupting tissue on only one side of the barrier and within the working region up to a distalmost tip of the barrier, without disrupting tissue beyond the distalmost tip of the barrier, wherein disrupting tissue within the perimeter comprises cutting, scraping, puncturing, brushing, tearing and/or extracting tissue.
2. The method of claim 1 wherein the tissue within the perimeter comprises nucleus pulposus tissue, vertebral body end plate tissue and/or annulus fibrosus tissue.
3. The method of claim 1 wherein the generally arcuate configuration comprises a partial generally circular shape.
4. The method of claim 1 wherein the generally arcuate configuration extends between about 270 degrees and about 355 degrees.
5. The method of claim 1 wherein the barrier substantially completely surrounds tissue to be disrupted.
6. The method of claim 1 wherein disrupting tissue within the working region comprises inserting a tissue disruption tool within the perimeter.
7. The method of claim 1 wherein forming the barrier within the disc space isolates tissue to be disrupted from other tissue within the disc space.
8. The method of claim 6 , wherein the tissue disruption tool is advanced along at least a portion of the barrier to disrupt tissue within the working region.
9. The method of claim 6 , further comprising advancing a delivery cannula into the intervertebral disc space, the delivery cannula having the barrier and the tissue disruption tool at least partially positioned therein, with the barrier in a substantially linear configuration.
10. The method of claim 6 , wherein the perimeter defined by the barrier is generally circular and includes an open access region configured for passage of the tissue disruption tool therethrough and into the working region.
11. The method of claim 6 , wherein the tissue disruption tool includes a distal end portion having a tissue disruptor associated therewith.
12. The method of claim 11 , wherein the tissue disruptor comprises one or more of sharp edges, jaws, and bristles.
13. The method of claim 11 , wherein the tissue disruption tool comprises at least one shaft, and the distal end portion of the tissue disruption tool is connected to the shaft by a joint that allows the distal end portion of the tissue disruption tool to move relative to the shaft.
14. The method of claim 1 , wherein the barrier comprises a ribbon of material.
15. The method of claim 1 , wherein the barrier is formed of a shape memory material.
16. A method for disrupting tissue in an intervertebral disc space, comprising:
forming a barrier in the intervertebral disc space wherein the barrier at least partially defines a perimeter of a working region within the disc space; and
disrupting tissue on only one side of the barrier and within the working region up to a distalmost tip of the barrier, without disrupting tissue beyond the distalmost tip of the barrier, wherein disrupting tissue within the working region comprises inserting a tissue disruption tool within the perimeter; and
advancing a delivery cannula into the intervertebral disc space, the delivery cannula having the barrier and the tissue disruption tool at least partially positioned therein, with the barrier in a substantially linear configuration, wherein the delivery cannula includes first and second lumens, with the barrier at least partially positioned within one of the first and second lumens and the tissue disruption tool at least partially positioned within the other one of the first and second lumens.
17. The method of claim 16 wherein the tissue disruption tool is advanced along at least a portion of the barrier to disrupt tissue within the working region.
18. The method of claim 16 wherein the perimeter defined by the barrier is generally circular and includes an open access region configured for passage of the tissue disruption tool therethrough and into the working region.
19. The method of claim 16 wherein the tissue disruption tool includes a distal end portion having a tissue disruptor associated therewith, wherein the tissue disruptor comprises one or more of sharp edges, jaws, and bristles.
20. A method for disrupting tissue in the intervertebral disc space, comprising:
advancing a delivery cannula into an intervertebral disc space, the delivery cannula having a barrier member and a tissue disruption tool at least partially positioned therein, with the barrier member in a first configuration;
advancing at least a portion of the barrier member out of the delivery cannula and into the intervertebral disc space in a second configuration to at least partially define a perimeter of a working region within the intervertebral disc space; and
advancing at least a portion of the tissue disruption tool out of the delivery cannula and along said at least a portion of the barrier member into the working region to disrupt tissue on only one side of the barrier member, within the working region, wherein the barrier member substantially completely surrounds tissue to be disrupted.
21. The method of claim 20 wherein the first configuration comprises a substantially linear configuration and the second configuration comprises a generally arcuate configuration.
22. The method of claim 20 wherein advancing at least a portion of the tissue disruption tool comprises cutting, scraping, puncturing, brushing, tearing and/or extracting tissue.
23. The method of claim 20 wherein the barrier is formed of a shape memory material.
24. A method for disrupting tissue in the intervertebral disc space, comprising:
advancing a delivery cannula into an intervertebral disc space, the delivery cannula having first and second lumens, with a barrier member at least partially positioned within one of the first and second lumens in a first configuration and a tissue disruption tool at least partially positioned within the other one of the first and second lumens;
advancing at least a portion of the barrier member out of the delivery cannula and into the intervertebral disc space in a second configuration to at least partially define a perimeter of a working region within the intervertebral disc space; and
advancing at least a portion of the tissue disruption tool out of the delivery cannula and along said at least a portion of the barrier member into the working region to disrupt tissue on only one side of the barrier member, within the working region.
25. The method of claim 24 wherein the first configuration comprises a substantially linear configuration and the second configuration comprises a generally arcuate configuration.
26. The method of claim 25 wherein the generally arcuate configuration extends between about 270 degrees and about 355 degrees.
27. The method of claim 24 wherein the perimeter defined by the barrier is generally circular and includes an open access region configured for passage of the tissue disruption tool therethrough and into the working region.
28. The method of claim 24 wherein the tissue disruptor comprises one or more of sharp edges, jaws, and bristles.
29. The method of claim 24 wherein the tissue disruption tool comprises at least one shaft, and the tissue disruption tool is connected to the shaft by a joint that allows the tissue disruption tool to move relative to the shaft.
30. The method of claim 24 wherein the barrier comprises a shape memory material.