Deflectable tissue disruption device

Abstract

A tissue disruption device may comprise a deflectable elongated tissue disrupting element rotatable around its central axis, the central axis being a longitudinal axis when the disrupting element is in a straightened state. The tissue disrupting element may be rotatably anchored at a distal location and may be deflectable into a curved configuration. A rotary drive configured to rotate the tissue disrupting element around its central axis in the straightened state and in the curved configuration. An elongated element may be wound around and rigidly affixed to the tissue disrupting element. In some embodiments, the elongated element protrudes sufficiently radially from the tissue disrupting element that rotation of the tissue disrupting element generates an axial motion of disrupted tissue. In one preferred embodiment, the tissue disrupting element and/or elongated element comprises wire mesh.

What is claimed is: 
     
         1 . A tissue disruption device, comprising:
 a deflectable elongated tissue disrupting element rotatable around its central axis, the central axis being a longitudinal axis when the disrupting element is in a straightened state, the tissue disrupting element rotatably anchored at a distal location and deflectable into a curved configuration, and   a rotary drive configured to rotate the tissue disrupting element around its central axis in the straightened state and in the curved configuration,   wherein the tissue disrupting element is deflectable into the curved configuration by axially moving a movable pivot toward the distal location, the movable pivot defining a proximal end of the curved configuration of the tissue disrupting element.   
     
     
         2 . The device of  claim 1 , wherein the curved configuration of the deflectable elongated fissile disrupting element when combined with a longitudinal axis of the device forms a “D” shape. 
     
     
         3 . The device of  claim 1 , wherein the curved configuration comprises an arch. 
     
     
         4 . The device of  claim 1 , wherein the curved configuration extends from the distal location to a proximal location, the proximal location lying on a longitudinal axis of the device. 
     
     
         5 . The device of  claim 1 , wherein the curved configuration extends from the distal location to a proximal location, the proximal location situated in a proximal half of the tissue disrupting element. 
     
     
         6 . The device of  claim 1 , wherein the curved configuration extends from the distal location to a proximal end of the tissue disrupting element. 
     
     
         7 . The device of  claim 6 , wherein the proximal end lies on the longitudinal axis of the device. 
     
     
         8 . The device of  claim 1 , wherein the distal location is a distal end of a support element of the device. 
     
     
         9 . The device of  claim 8 , wherein the movable pivot is situated at a proximal end of the tissue disrupting element. 
     
     
         10 . The device of  claim 1 , further comprising a conduit through which the tissue disruption device is deployed and wherein the axial motion of disrupted tissue moves the disrupted tissue through the conduit. 
     
     
         11 . The device of  claim 1 , further comprising an elongated element wound around and rigidly affixed to the tissue disrupting element, wherein the tissue disrupting element is a flexible shaft. 
     
     
         12 . The device of  claim 11 , wherein the elongated element is wound around the tissue disrupting element. 
     
     
         13 . The device of  claim 12 , wherein the elongated element is wound helically around the tissue disrupting element. 
     
     
         14 . The device of  claim 13 , wherein the elongated element is rigidly affixed to the tissue disrupting element and protrudes sufficiently radially from the tissue disrupting element that rotation of the tissue disrupting element generates an axial motion of disrupted tissue. 
     
     
         15 . The tissue disruption device of  claim 11 , wherein the elongated element has a cylindrical shape in cross-section. 
     
     
         16 . The tissue disruption device of  claim 11 , wherein the elongated element has a square shape in cross-section. 
     
     
         17 . The tissue disruption device of  claim 11 , wherein the elongated element has a triangular shape in cross-section. 
     
     
         18 . The tissue disruption device of  claim 17 , wherein the triangular shape has two longer sides and wherein the two longer sides project along a radial length of the elongated element outwardly from the flexible shaft. 
     
     
         19 . The tissue disruption device of  claim 11 , wherein the elongated element has a rectangular shape in cross-section, and wherein the longer sides of the rectangular shape project radially outward from the flexible shaft. 
     
     
         20 . The tissue disruption device of  claim 11 , wherein the elongated element has a thickness that tapers as the radial length from the flexible shaft increases. 
     
     
         21 . The tissue disruption device of  claim 11 , wherein rotation of the tissue disrupting element while the tissue disrupting element deflects into the curved configuration results in vibration of the flexible shaft. 
     
     
         22 . The tissue disruption device of  claim 11 , wherein the elongated element is tightly wound around the flexible shaft. 
     
     
         23 . The tissue disruption device of  claim 11 , wherein configuration of points of attachment of the tissue disrupting element to a support element predetermines, at least in part, an amount of radial displacement of the tissue disrupting element from the longitudinal axis during the arching motion. 
     
     
         24 . The tissue disruption device of  claim 11 , wherein a volume of disrupted tissue is predetermined, at least in part, by configuration of the tissue disrupting element, elongated element and a support element. 
     
     
         25 . The tissue disruption device of  claim 11 , wherein a volume of disrupted tissue is predetermined, at least in part, by configuration of the tissue disrupting element, the elongated element and a relative position between a movable pivot and a fixed pivot. 
     
     
         26 . The tissue disruption device of  claim 11 , wherein a volume of disrupted tissue is predetermined, at least in part, by a shape of the elongated element, a diameter of the tissue disrupting element, a length of the tissue disrupting element between a movable pivot and a fixed pivot and a maximum displacement of an arching motion during deflection to the curved configuration. 
     
     
         27 . The device of  claim 1 , further comprising a blocking element that directs the tissue disrupting element to move in the arching motion in a direction along a plane perpendicular to a direction of elongation of the device. 
     
     
         28 . The device of  claim 27 , wherein the blocking element is a C-shaped beam that directs movement of the tissue disrupting element laterally along the plane. 
     
     
         29 . The device of  claim 28 , wherein a movable pivot moves within the C-shaped beam that comprises the blocking element. 
     
     
         30 . The device of  claim 29 , wherein a support element is attached to the tissue disrupting element at the movable pivot and at one or more fixed pivots. 
     
     
         31 . The device of  claim 1 , wherein an outer surface of the tissue disrupting element is formed of a mesh of wires. 
     
     
         32 . The device of  claim 31 , further comprising an elongated element wound around and rigidly affixed to the tissue disrupting element and wherein the elongated element is formed of the mesh of wires. 
     
     
         33 . The device of  claim 31 , wherein the wires are helically wound around the central axis of the device, the wires supporting one another without being rigidly connected to one another. 
     
     
         34 . The device of  claim 31 , wherein one of the helical wires has a surface that protrudes radially beyond the outer surface and forms a cutting edge for disrupting tissue. 
     
     
         35 . The device of  claim 33 , wherein one of the helical wires has a triangular shape in cross-section. 
     
     
         36 . The device of  claim 31 , wherein the tissue disrupting element comprises a cylindrical surface and the mesh of wires surrounds at least a portion of a length of the cylindrical surface. 
     
     
         37 . The device of  claim 36 , wherein at least one end of mesh of wires is connected to the cylindrical surface to inhibit axial translation of wires during rotation. 
     
     
         38 . The device of  claim 1 , wherein the tissue disrupting element has only two degrees of freedom, rotation around its central axis and deflectability to its curved configuration. 
     
     
         39 . The device of  claim 1 , wherein the tissue disrupting element has three degrees of freedom including rotation around its central axis, deflectability to its curved configuration and swaying away from a plane of deflection to either side of the plane of deflection when the tissue disrupting element is in the curved configuration. 
     
     
         40 . The device of  claim 1 , wherein the tissue disrupting element is segmented. 
     
     
         41 . A method of disrupting target tissue in a human or animal body, the method comprising:
 rotatably anchoring at a distal location a deflectable elongated tissue disrupting element to a support element, the tissue disrupting element rotatable around its central axis, the central axis being a longitudinal axis when the disrupting element is in a straightened state;   introducing the deflectable elongated tissue disrupting element and support element into the body; and   deflecting the tissue disrupting element into a curved configuration while rotating the tissue disrupting element around its central axis, so as to disrupt target tissue.   
     
     
         42 . The method of  claim 41 , wherein the tissue disrupting element rotates at a plurality of arching positions. 
     
     
         43 . The method of  claim 41 , further comprising introducing a rigid conduit into the body adjacent the target tissue and introducing through the rigid conduit the tissue disrupting device. 
     
     
         44 . The method of  claim 41 , further comprising using a support element to move the tissue disrupting element in an arching motion while the tissue disrupting element is rotating. 
     
     
         45 . The method of  claim 41 , further comprising axially moving a movable pivot attached to the tissue disrupting element. 
     
     
         46 . The method of  claim 41 , further comprising using a blocking element to direct the tissue disrupting element to deflect to the curved configuration in a direction along a plane perpendicular to a direction of elongation of the device. 
     
     
         47 . The method of  claim 46 , further comprising using a blocking element having a C-shaped cross-section to direct the tissue disrupting element. 
     
     
         48 . The method of  claim 41 , further comprising pivoting the tissue disrupting element at a proximal location so that the curved configuration of the tissue disrupting element extends from the distal location to the proximal location. 
     
     
         49 . The method of  claim 41 , further comprising using a C-shaped support element to guide the arching motion in an anterior direction. 
     
     
         50 . The method of  claim 41 , further comprising using a helically wound elongated element to draw disrupted tissue back through a conduit through which the tissue disrupting element was delivered. 
     
     
         51 . The method of  claim 41 , further comprising using an elongated element rigidly affixed to and wound around the tissue disrupting element as a cutting edge to disrupt the target tissue. 
     
     
         52 . The method of  claim 41 , further comprising configuring the tissue disrupting element to comprise a mesh of wires such that the wires support one another without being rigidly connected to one another. 
     
     
         53 . A method of disrupting tissue of an intervertebral disc of a human or animal body, the method comprising:
 (a) introducing into the human or animal body a deflectable elongated tissue disrupting element, the tissue disrupting element rotatable around its central axis, the central axis being a longitudinal axis when the disrupting element is in a straightened state, the tissue disrupting element anchored at a distal location;   (b) deflecting the tissue disrupting element into a curved configuration while the tissue disrupting element is rotating around its central axis and anchored at the distal location, in order to disrupt a volume of tissue within a space occupied by the intervertebral disc while leaving at least an arcuate volume of tissue of the intervertebral disc; and   (c) implanting the implant so that the implant is enclosed by the at least arcuate volume of tissue of the intervertebral disc.   
     
     
         54 . The method of  claim 53 , further comprising leaving the arcuate volume of tissue such that the at least an arcuate volume of tissue lies on a plane that the intervertebral disc lies in. 
     
     
         55 . The method of  claim 53 , further comprising leaving the at least an arcuate volume of tissue such that the at least an arcuate volume of tissue separates the implant from spinal cord tissue in the human or animal body. 
     
     
         56 . A method of disrupting tissue of an intervertebral disc of a human or animal body, the method comprising:
 (a) introducing into the human or animal body a deflectable elongated tissue disrupting element rotatable around its central axis, the central axis being a longitudinal axis when the disrupting element is in a straightened state, the tissue disrupting element anchored at a distal location, the tissue disrupting element having an elongated element rigidly and helically wound around the tissue disrupting element;   (b) predefining a volume and location of tissue for disruption by configuring a support element attached to the tissue disrupting element; and   (c) deflecting the tissue disrupting element into a curved configuration while the tissue disrupting element is rotating, in order to disrupt a volume of tissue within a space occupied by the intervertebral disc while leaving at least an arcuate volume of tissue of the intervertebral disc.   
     
     
         57 . The method of  claim 56 , further comprising configuring the support element by setting a relative position of a movable pivot and a fixed pivot that are attached to the tissue disrupting element. 
     
     
         58 . The method of  claim 56 , further comprising further predefining the volume and location of the tissue for disruption by setting a diameter of the tissue disrupting element and by setting a shape of an elongated element fixedly attached to and wound around the tissue disrupting element. 
     
     
         59 . The device of  claim 8 , wherein a distal end of the tissue disrupting device is rotatably anchored at the distal end of the support element. 
     
     
         60 . A tissue disruption device, comprising:
 a deflectable elongated tissue disruptor rotatable around its central axis, the central axis being a longitudinal axis when the tissue disruptor is in a straightened state, the tissue disruptor rotatably anchored at a distal location and deflectable into a curved configuration, the tissue disruptor including a helical element that defines a volume of space radially inward of the helical element for accumulation of disrupted tissue; and   a rotary drive configured to rotate the tissue disruptor element around its central axis in the straightened state and in the curved configuration.   
     
     
         61 . The tissue disruption device of  claim 60 , wherein the tissue disruptor also includes a shaft positioned radially inward of the helical element, the shaft of the tissue disruptor being rotatably anchored at the distal location. 
     
     
         62 . The tissue disruption device of  claim 61 , wherein the helical element is rigidly affixed to the shaft. 
     
     
         63 . The tissue disruption device of  claim 62 , wherein in the curved configuration of the tissue disruptor, the shaft and helical element are each deflected. 
     
     
         64 . The tissue disruption device of  claim 60 , wherein rigid affixation of the helical element to a shaft defines one or more longitudinal/axial ends of the volume of space. 
     
     
         65 . The tissue disruption device of  claim 60 , wherein the helical element is rigidly affixed to a shaft of the tissue disruptor such that the shaft is surrounded by the volume of space that is radially inward of the helical element. 
     
     
         66 . The tissue disruption device of  claim 65 , wherein the helical element is rigidly affixed to a shaft of the tissue disruptor such that the shaft is centered within the volume of space that is radially inward of the helical element. 
     
     
         67 . The tissue disruption device of  claim 60 , wherein the tissue disruptor is rotatably anchored at a distal location to one of (i) a support element and (ii) the rotary drive. 
     
     
         68 . The tissue disruption device of  claim 60 , wherein a distal end of the tissue disrupting device is rotatably anchored at a distal end of a support element. 
     
     
         69 . The tissue disruption device of  claim 60 , wherein the volume of space extends along at least a majority of a length of the tissue disruption device. 
     
     
         70 . The tissue disruption device of  claim 60 , wherein the volume of space extends along an entire length of the tissue disruption device. 
     
     
         71 . A tissue disruption device, comprising:
 a deflectable elongated tissue disruptor rotatable around its central axis, the central axis being a longitudinal axis when the disrupting element is in a straightened state, the tissue disruptor rotatably anchored at a distal location and deflectable into a curved configuration, and   a rotary drive configured to rotate the tissue disruptor around its central axis in the straightened state and in the curved configuration,   wherein the tissue disruptor is deflectable into the curved configuration by axially moving a movable pivot toward the distal location, the movable pivot defining a proximal end of the curved configuration of the tissue disruptor.