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公开(公告)号：US20110060314A1
公开(公告)日：2011-03-10
申请号：US12911537
申请日：2010-10-25
申请人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
发明人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
CPC分类号： A61B17/32 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/320016 , A61B17/3401 , A61B17/3403 , A61B17/3468 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/003 , A61B2017/00331 , A61B2017/00867 , A61B2017/22038 , A61B2017/22049 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61M25/0067 , A61M25/09 , A61M2210/1003 , A61N1/0551 , A61N1/36017
摘要： 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.
摘要翻译： 本文描述了用于治疗患者脊柱中的靶组织的装置，系统和方法。 通常，所述方法包括以下步骤：从第一位置，通过神经孔进入患者，并从第二位置离开患者; 将组织修改装置连接到所述线; 通过使用丝线的神经孔定位组织修饰装置; 通过将组织改变装置移动到目标组织上来改变脊柱中的目标组织; 以及将药剂递送至修饰的靶组织，其中所述药剂被配置为抑制来自所述修饰的靶组织的血液流动。 在一些实施方案中，修饰靶组织的步骤包括去除位于上关节进程的腹侧的靶组织，同时避免位于上关节突侧的非靶组织。
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公开(公告)号：US09101386B2
公开(公告)日：2015-08-11
申请号：US12911537
申请日：2010-10-25
申请人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
发明人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
IPC分类号： A61M25/00 , A61B17/3205 , A61B17/32 , A61B17/16 , A61B19/00 , A61F2/00 , A61B17/34 , A61B18/14 , A61B17/00 , A61B17/14 , A61B17/22 , A61N1/05 , A61N1/36
CPC分类号： A61B17/32 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/320016 , A61B17/3401 , A61B17/3403 , A61B17/3468 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/003 , A61B2017/00331 , A61B2017/00867 , A61B2017/22038 , A61B2017/22049 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61M25/0067 , A61M25/09 , A61M2210/1003 , A61N1/0551 , A61N1/36017
摘要： 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.
摘要翻译： 本文描述了用于治疗患者脊柱中的靶组织的装置，系统和方法。 通常，所述方法包括以下步骤：从第一位置，通过神经孔进入患者，并从第二位置离开患者; 将组织修改装置连接到所述线; 通过使用丝线的神经孔定位组织修饰装置; 通过将组织改变装置移动到目标组织上来改变脊柱中的目标组织; 以及将药剂递送至修饰的靶组织，其中所述药剂被配置为抑制来自所述修饰的靶组织的血液流动。 在一些实施方案中，修饰靶组织的步骤包括去除位于上关节进程的腹侧的靶组织，同时避免位于上关节突侧的非靶组织。
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公开(公告)号：US20080086114A1
公开(公告)日：2008-04-10
申请号：US11468247
申请日：2006-08-29
IPC分类号： A61B17/00
CPC分类号： A61B17/00 , A61B1/3135 , A61B17/00234 , A61B17/0482 , A61B17/0483 , A61B17/1604 , A61B17/1611 , A61B17/1659 , A61B17/1671 , A61B17/1757 , A61B17/8897 , A61B2017/00477 , A61M25/09
摘要： A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.
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公开(公告)号：US20080033465A1
公开(公告)日：2008-02-07
申请号：US11535000
申请日：2006-09-25
IPC分类号： A61B17/32
CPC分类号： A61B17/1604 , A61B17/1671 , A61B17/320016 , A61B17/32002 , A61B17/320783 , A61B2017/00261 , A61B2017/003 , A61B2017/2901 , A61B2017/2902 , A61B2017/2905 , A61B2017/32006 , A61B2017/320069 , A61B2017/32007
摘要： A device for cutting tissue in a human body may include an elongate shaft having a proximal portion and a distal portion, at least one translatable blade disposed along one side of the distal portion of the shaft, and at least one actuator coupled with the at least one translatable blade and extending to the proximal portion of the shaft, wherein the actuator is configured to translate the blade to cut tissue. In various embodiments, various components of the device may have dimensions that facilitate passing a portion of the device into or through a small space and also facilitate and/or enhance the device's tissue cutting abilies.
摘要翻译： 用于在人体中切割组织的装置可以包括具有近端部分和远侧部分的细长轴，至少一个沿着轴的远端部分的一侧设置的可平移刀片，以及至少一个致动器， 一个可平移的叶片并且延伸到所述轴的近端部分，其中所述致动器构造成将所述叶片平移到切割的组织。 在各种实施例中，装置的各种部件可以具有便于将装置的一部分通入或穿过小空间的尺寸，并且还促进和/或增强装置的组织切割装置。
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公开(公告)号：US20110046613A1
公开(公告)日：2011-02-24
申请号：US12917253
申请日：2010-11-01
IPC分类号： A61B17/00
CPC分类号： A61B17/00 , A61B1/3135 , A61B17/00234 , A61B17/0482 , A61B17/0483 , A61B17/1604 , A61B17/1611 , A61B17/1659 , A61B17/1671 , A61B17/1757 , A61B17/8897 , A61B2017/00477 , A61M25/09
摘要： A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.
摘要翻译： 用于将外科装置的至少一部分引导到患者身体的两个组织之间的期望位置的方法和系统包括将导丝连接到装置并拉动导丝的远端以引导手术装置的至少一部分 到两个组织之间的期望位置。 手术装置通常包括一个或多个导丝联接构件，并且可以包括组织接近装置。 系统可以包括导丝和外科装置。 在一些实施例中，可以提供导丝，纸巾接近装置以及与接入装置一起使用的一个或多个附加装置。 在各种实施例中，方法，装置和系统可以用于开放式，小侵入性或经皮外科手术。
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公开(公告)号：US08430881B2
公开(公告)日：2013-04-30
申请号：US11405848
申请日：2006-04-17
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： A device for modifying one or more tissues in a patient's spine may include: an elongate, at least partially flexible body having a proximal portion and a distal portion, wherein at least the distal portion has dimensions that allow it to be passed into an epidural space and between target and non-target tissues of the spine; at least one movable blade disposed along one side of the elongate body; at least one actuator coupled with the at least one blade and disposed at or near the proximal or distal portion of the body for moving the blade(s) to modify one or more target tissues, wherein the at least one actuator is configured to move the blade(s) without significantly translating the elongate body proximally or distally; and means at or near the proximal and distal portions of the elongate body for facilitating application of at least one of anchoring force and tensioning force to the body to urge the at least one blade against the target tissue.
摘要翻译： 用于修改患者脊柱中的一个或多个组织的装置可以包括：细长的至少部分柔性的身体，其具有近端部分和远端部分，其中至少远端部分具有允许其进入硬膜外腔的尺寸 和脊柱的靶和非靶组织之间; 沿着所述细长体的一侧设置的至少一个可动刀片; 至少一个致动器，其与所述至少一个叶片耦合并且设置在所述主体的近端或远端部分处或附近，用于移动所述叶片以修改一个或多个目标组织，其中所述至少一个致动器被配置成使所述至少一个致动器移动 刀片不在近侧或远端显着地平移细长体; 以及在所述细长体的近端部分和远端部分附近的装置，用于便于将至少一个锚定力和张紧力施加到身体以将至少一个刀片推向靶组织。
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公开(公告)号：US07857813B2
公开(公告)日：2010-12-28
申请号：US11468247
申请日：2006-08-29
CPC分类号： A61B17/00 , A61B1/3135 , A61B17/00234 , A61B17/0482 , A61B17/0483 , A61B17/1604 , A61B17/1611 , A61B17/1659 , A61B17/1671 , A61B17/1757 , A61B17/8897 , A61B2017/00477 , A61M25/09
摘要： A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.
摘要翻译： 用于将外科装置的至少一部分引导到患者身体的两个组织之间的期望位置的方法和系统包括将导丝连接到装置并拉动导丝的远端以引导手术装置的至少一部分 到两个组织之间的期望位置。 手术装置通常包括一个或多个导丝联接构件，并且可以包括组织接近装置。 系统可以包括导丝和外科装置。 在一些实施例中，可以提供导丝，纸巾接近装置以及与接入装置一起使用的一个或多个附加装置。 在各种实施例中，方法，装置和系统可以用于开放式，小侵入性或经皮外科手术。
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公开(公告)号：US20080086034A1
公开(公告)日：2008-04-10
申请号：US11468252
申请日：2006-08-29
IPC分类号： A61B1/32
CPC分类号： A61B17/00 , A61B1/3135 , A61B17/00234 , A61B17/0482 , A61B17/0483 , A61B17/1604 , A61B17/1611 , A61B17/1659 , A61B17/1671 , A61B17/1757 , A61B17/8897 , A61B2017/00477 , A61M25/09
摘要： A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.
摘要翻译： 用于将外科装置的至少一部分引导到患者身体的两个组织之间的期望位置的方法和系统包括将导丝连接到装置并拉动导丝的远端以引导手术装置的至少一部分 到两个组织之间的期望位置。 手术装置通常包括一个或多个导丝联接构件，并且可以包括组织接近装置。 系统可以包括导丝和外科装置。 在一些实施例中，可以提供导丝，纸巾接近装置以及与接入装置一起使用的一个或多个附加装置。 在各种实施例中，方法，装置和系统可以用于开放式，小侵入性或经皮外科手术。
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公开(公告)号：US08801626B2
公开(公告)日：2014-08-12
申请号：US13340363
申请日：2011-12-29
CPC分类号： A61N1/0551 , A61B5/04001 , A61B5/0488 , A61B5/1107 , A61B5/4519 , A61B5/4893 , A61B5/6852 , A61B5/6855 , A61B17/149 , A61B17/1671 , A61B17/1757 , A61B17/7092 , A61B17/8897 , A61B2562/0209 , A61B2562/0261 , A61B2562/043 , A61B2562/046 , A61N1/0553
摘要： Methods for determining if a nerve is nearby a device. The neural stimulation tools described herein are configured to be flexible and low-profile, so that they can be used within body regions that may be tortuous or difficult to reach, such as within a compressed or partially occluded neural foramen. In most cases, these tools described herein are ribbon-shaped and adapted to be manipulated bimanually, applying force to the ends of the devices from separate locations outside of the patient's body. Thus, the distal end region of the device may be configured to couple to the proximal end of a guidewire. One or more surfaces of the devices may include an electrode or multi-polar network of electrodes configured to stimulate only nerves within a predetermined distance of a particular face of the device. Methods of using these devices are described.
摘要翻译： 确定神经是否在设备附近的方法。 本文所述的神经刺激工具被配置为柔性和低轮廓，使得它们可以在可能曲折或难以到达的身体区域内使用，例如在压缩或部分闭塞的神经孔内。 在大多数情况下，这里描述的这些工具是带状的并且适于双向操纵，从患者身体外部的分离位置向装置的端部施加力。 因此，装置的远端区域可以被配置为联接到导丝的近端。 器件的一个或多个表面可以包括电极或多极电极网络，其被配置为仅在装置的特定面部的预定距离内刺激神经。 描述使用这些装置的方法。
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公开(公告)号：US08617163B2
公开(公告)日：2013-12-31
申请号：US13112886
申请日：2011-05-20
申请人： Jeffery L. Bleich
发明人： Jeffery L. Bleich
IPC分类号： A61B17/00
CPC分类号： A61B17/320016 , A61B17/149 , A61B17/1671 , A61B17/29 , A61B17/32002 , A61B17/32053 , A61B17/320758 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/02 , A61B18/04 , A61B18/1442 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/00577 , A61B2018/00589 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61N1/0551 , A61N1/36017
摘要： Described herein are methods, systems and devices for cutting a ligament of a patient. In some embodiments, the method may include the steps of advancing a cannulated probe into a patient, advancing the distal end of the tissue modification device assembly posteriorly through the skin of the patient such that it exits the patient, exposing at least one tissue modification element of the tissue modification device assembly, and reciprocating at least a portion of the tissue modification device assembly by alternately pulling on proximal and distal portions of the tissue modification device assembly to draw the at least one tissue modification element across the ligament to cut the ligament, in some embodiments, the system may include a probe, a tissue modification device, and a sheath. The tissue modification device may include a proximal handle, at least one tissue modification element configured cut ligament, and a sharp distal tip.
摘要翻译： 本文描述了用于切割患者韧带的方法，系统和装置。 在一些实施例中，该方法可以包括以下步骤：将插管的探针推进到患者体内，使组织改变装置组件的远端向后穿过患者的皮肤，使其离开病人，暴露至少一个组织修饰元件 并且通过交替地拉动所述组织改变装置组件的近端部分和远端部分来使所述至少一部分所述组织改变装置组件往复运动，以将所述至少一个组织修饰元件拉过所述韧带以切割所述韧带， 在一些实施例中，系统可以包括探针，组织改变装置和护套。 组织改变装置可以包括近端手柄，至少一个组织修改元件构造的切割韧带和尖锐的远端尖端。
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