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18 条记录 (耗时 0.03 秒)

    Devices and methods for tissue access
    11.
    发明申请
    Devices and methods for tissue access 有权

    公开(公告)号：US20060100651A1

    公开(公告)日：2006-05-11

    申请号：US11251186

    申请日：2005-10-15

    申请人： Jeffery Bleich

    发明人： Jeffery Bleich

    IPC分类号： A61B17/32

    CPC分类号： A61B17/320758 ,  A61B17/149 ,  A61B17/1659 ,  A61B17/1671 ,  A61B17/29 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/32053 ,  A61B17/3401 ,  A61B17/3403 ,  A61B17/3421 ,  A61B17/3496 ,  A61B18/1477 ,  A61B18/1487 ,  A61B90/04 ,  A61B2017/00261 ,  A61B2017/00287 ,  A61B2017/003 ,  A61B2017/00867 ,  A61B2017/320004 ,  A61B2017/320044 ,  A61B2017/32006 ,  A61B2017/3445 ,  A61B2017/3447 ,  A61B2018/1407 ,  A61B2018/1425 ,  A61B2090/061 ,  A61B2090/08021 ,  A61F2/0045 ,  A61N1/0551 ,  A61N1/36017

    摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. Once the sharp tip of the needle is in the epidural space, it is converted to a blunt tipped instrument for further safe advancement. A specially designed epidural catheter that is used to cover the previously sharp needle tip may also contain a fiberoptic cable. Further embodiments of the current invention include a double barreled epidural needle or other means for placement of a working channel for the placement of tools within the epidural space, beside the epidural instrument. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue removal device is provided including a thin belt or ribbon with an abrasive cutting surface. The device may be placed through the neural foramina of the spine and around the anterior border of a facet joint. Once properly positioned, a medical practitioner may enlarge the lateral recess and neural foramina via frictional abrasion, i.e., by sliding the tissue removal surface of the ribbon across impinging tissues. A nerve stimulator optionally may be provided to reduce a risk of inadvertent neural abrasion. Additionally, safe epidural placement of the working barrier and epidural tissue modification tools may be further improved with the use of electrical nerve stimulation capabilities within the invention that, when combined with neural stimulation monitors, provide neural localization capabilities to the surgeon. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired. Furthermore, an endoscope may be incorporated into the device in order to monitor safe tissue removal. Finally, tissue remodeling within the epidural space may be ensured through the placement of compression dressings against remodeled tissue surfaces, or through the placement of tissue retention straps, belts or cables that are wrapped around and pull under tension aspects of the impinging soft tissue and bone in the posterior spinal canal.

    Flexible tissue rasp
    13.
    发明申请
    Flexible tissue rasp 有权

    公开(公告)号：US20110130758A9

    公开(公告)日：2011-06-02

    申请号：US11429377

    申请日：2006-05-04

    申请人： Jeffery Bleich ,  Edwin Hlavka

    发明人： Jeffery Bleich ,  Edwin Hlavka

    IPC分类号： A61B17/00

    CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

    摘要： 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.

    PERCUTANEOUS SPINAL STENOSIS TREATMENT
    14.
    发明申请
    PERCUTANEOUS SPINAL STENOSIS TREATMENT 审中-公开

    公开(公告)号：US20080103504A1

    公开(公告)日：2008-05-01

    申请号：US11870370

    申请日：2007-10-10

    申请人： Gregory SCHMITZ ,  Jeffery Bleich ,  Eric Miller ,  Scott Smith

    发明人： Gregory SCHMITZ ,  Jeffery Bleich ,  Eric Miller ,  Scott Smith

    IPC分类号： A61B17/32 ,  A61B18/14 ,  A61N1/36

    CPC分类号： A61B17/320016 ,  A61B5/04001 ,  A61B5/0488 ,  A61B5/4893 ,  A61B10/0275 ,  A61B17/221 ,  A61B17/320725 ,  A61B17/320758 ,  A61B17/320783 ,  A61B18/1482 ,  A61B2017/00261 ,  A61B2017/00336 ,  A61B2017/320733 ,  A61B2018/0044 ,  A61B2018/1472 ,  A61B2090/0427 ,  A61B2090/08021

    摘要： A method for percutaneously removing ligamentum flavum tissue in a spine to treat spinal stenosis may involve percutaneously advancing a distal portion of a tissue removal cannula into the ligamentum flavum tissue, uncovering a side-opening aperture disposed on the distal portion of the cannula to expose a tissue cutter disposed in the cannula, and cutting ligamentum flavum tissue using the tissue cutter while the aperture is uncovered. A device for percutaneously removing ligamentum flavum tissue in a spine to treat spinal stenosis may include a cannula including a side-facing aperture, an aperture cover slidably coupled with the cannula and configured to advance and retract to cover and uncover the aperture, and a tissue cutter slidably disposed within the cannula and configured to extend through the aperture to cut ligamentum flavum tissue.

    摘要翻译： 用于经皮去除脊柱中的黄韧带组织以治疗脊柱狭窄的方法可以包括将组织去除套管的远端部分经皮推进到黄韧带组织中，露出设置在套管的远端部分上的侧开口孔以暴露 设置在套管中的组织切割器，以及在未被覆盖的情况下使用组织切割器切割黄韧带组织。 用于经皮去除脊柱中的黄韧带组织以治疗脊柱狭窄的装置可以包括套管，其包括面向侧的孔，与套管可滑动地联接并被配置为前进和后退以覆盖和露出孔的孔组件，以及组织 切割器可滑动地设置在套管内并且构造成延伸穿过孔以切割黄韧带组织。

    Flexible tissue rasp
    15.
    发明申请
    Flexible tissue rasp 有权
    柔性组织锉

    公开(公告)号：US20070123888A1

    公开(公告)日：2007-05-31

    申请号：US11429377

    申请日：2006-05-04

    申请人： Jeffery Bleich ,  Edwin Hlavka

    发明人： Jeffery Bleich ,  Edwin Hlavka

    IPC分类号： A61B17/00

    CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

    摘要： 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.

    摘要翻译： 描述了用于修改患者脊柱中的组织以治疗或减轻脊柱狭窄的方法和装置。 在一个实施例中，一种方法可以包括：将细长组织修饰装置的至少远端部分推进到脊柱中的硬膜外腔和目标组织与非靶组织之间; 定位组织改变装置使得装置的至少一个研磨表面面向靶组织，并且至少一个非研磨表面面向非靶组织; 在组织改变装置的分离的远侧和近端部分处或附近施加张紧力; 并且在保持至少一些张紧力的同时使所述组织改变装置来回移动，以利用所述至少一个研磨表面磨蚀所述目标组织的至少一部分。 可以通过至少一个非研磨表面来防止对非目标组织的不良伤害。

    Devices and methods for selective surgical removal of tissue
    18.
    发明申请
    Devices and methods for selective surgical removal of tissue 有权

    公开(公告)号：US20060094976A1

    公开(公告)日：2006-05-04

    申请号：US11250332

    申请日：2005-10-15

    申请人： Jeffery Bleich

    发明人： Jeffery Bleich

    IPC分类号： A61B5/05

    CPC分类号： A61B17/320758 ,  A61B17/149 ,  A61B17/1659 ,  A61B17/1671 ,  A61B17/29 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/32053 ,  A61B17/3401 ,  A61B17/3403 ,  A61B17/3421 ,  A61B17/3496 ,  A61B18/1477 ,  A61B18/1487 ,  A61B90/04 ,  A61B2017/00261 ,  A61B2017/00287 ,  A61B2017/003 ,  A61B2017/00867 ,  A61B2017/320004 ,  A61B2017/320044 ,  A61B2017/32006 ,  A61B2017/3445 ,  A61B2017/3447 ,  A61B2018/1407 ,  A61B2018/1425 ,  A61B2090/061 ,  A61B2090/08021 ,  A61F2/0045 ,  A61N1/0551 ,  A61N1/36017

    摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. Once the sharp tip of the needle is in the epidural space, it is converted to a blunt tipped instrument for further safe advancement. A specially designed epidural catheter that is used to cover the previously sharp needle tip may also contain a fiberoptic cable. Further embodiments of the current invention include a double barreled epidural needle or other means for placement of a working channel for the placement of tools within the epidural space, beside the epidural instrument. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue removal device is provided including a thin belt or ribbon with an abrasive cutting surface. The device may be placed through the neural foramina of the spine and around the anterior border of a facet joint. Once properly positioned, a medical practitioner may enlarge the lateral recess and neural foramina via frictional abrasion, i.e., by sliding the tissue removal surface of the ribbon across impinging tissues. A nerve stimulator optionally may be provided to reduce a risk of inadvertent neural abrasion. Additionally, safe epidural placement of the working barrier and epidural tissue modification tools may be further improved with the use of electrical nerve stimulation capabilities within the invention that, when combined with neural stimulation monitors, provide neural localization capabilities to the surgeon. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired. Furthermore, an endoscope may be incorporated into the device in order to monitor safe tissue removal. Finally, tissue remodeling within the epidural space may be ensured through the placement of compression dressings against remodeled tissue surfaces, or through the placement of tissue retention straps, belts or cables that are wrapped around and pull under tension aspects of the impinging soft tissue and bone in the posterior spinal canal.