Ligament Decompression Tool with Tissue Removal Device

Abstract

A method for treating stenosis in a spine comprises percutaneously accessing the epidural space in a stenotic region of interest, compressing the thecal sac in the region of interest to form a safety zonem, inserting a tissue removal tool into tissue in the working zone, using the tool to percutaneously reduce the stenosis; and utilizing imaging to visualize the position of the tool during at least a part of the reduction step. A tissue excision system for performing percutaneous surgery, comprises a cannula comprising a tissue-penetrating member having a distal end defining an aperture on one side thereof, an occluding member slidably received on or in the cannula and closing the aperture when the occluding member is adjacent the cannula distal end, means for engaging adjacent tissue via the aperture, and cutting means for resecting a section of the engaged tissue.

1 . (canceled)  
     
     
         2 . The percutaneous tissue excision system of  claim 7  wherein said engaging means comprises a tissue-engaging needle having a shaft and distal and proximal ends, and wherein said tissue-engaging needle is adapted for insertion through said cannula, said tissue-engaging needle comprising at least one barb extending outwardly from said shaft.  
     
     
         3 . The percutaneous tissue excision system of  claim 7  wherein said engaging means is reciprocably received in said cannula.  
     
     
         4 . The percutaneous tissue excision system of  claim 7  wherein said engaging means is rotatably received in said cannula.  
     
     
         5 . The percutaneous tissue excision system of  claim 7  wherein said engaging means is constructed such that it has a normal configuration that is retained by said occluding member when said occluding member is adjacent said cannula distal end and extends through said aperture when said occluding member is removed from said aperture.  
     
     
         6 . (canceled)  
     
     
         7 . A tissue excision system for percutaneous surgery, comprising: 
 a cannula comprising a tissue-penetrating member having a distal end defining an aperture on one side thereof;    an occluding member slidably received on or in said cannula and closing said aperture when said occluding member is adjacent said cannula distal end;    means for engaging adjacent tissue via said aperture;    cutting means for resecting a section of said engaged tissue;    means for retrieving said resected tissue from said distal tool end;    said tissue-removal system comprising a keyhole slot.    
     
     
         8 . The percutaneous tissue excision system of  claim 7  wherein said tissue-engaging means comprises a hook.  
     
     
         9 . The percutaneous tissue excision system of  claim 8  wherein said hook comprises a length of wire that has been bent through at least about 270°.  
     
     
         10 - 39 . (canceled)