Retractor cannula system for accessing and visualizing spine and related methods

Abstract

Retractor cannula systems may be used for accessing and visualizing the spine and related methods of treatment, including a forward-looking retractor cannula system for creating a working space and the retractor cannula system having atraumatic dissection capability to allow visualization in spine. The devices and methods described may be used, for example, to perform annulus repair, herniated disc excision, and denervation of neurological tissue; to dispense pharmacological agents and/or cell or tissue therapy agents; to diagnose disc degeneration and bony degeneration, spinal stenosis, and nucleus decompression, and to perform disc augmentation.

1 .- 29 . (canceled) 
     
     
         30 . A retractor cannula device comprising:
 a first tubular body having a central axis and a distal end, the tubular body comprising at least one lumen configured to hold an endoscope;   a second tubular body slidably positioned within the first tubular body; and   a retractor assembly located at the distal end of the tubular body, the retractor assembly including at least one movable element having a distal tip, and having a first closed configuration and a second open configuration, the retractor assembly coupled to the first tubular body and the second tubular body, such that the retractor assembly transitions from the first closed configuration to the second open configuration in response to movement of the second tubular member in a distal direction, the distal tip of a first of the at least one moveable element configured to pass through the central axis of the second tubular body as the retractor assembly transitions from the first closed configuration to the second open configuration.   
     
     
         31 . The device of  claim 30 , wherein the retractor assembly is coupled to the first tubular body through a living hinge. 
     
     
         32 . The device of  claim 30 , further comprising an endoscopic system. 
     
     
         33 . The device of  claim 30 , wherein the at least one movable element comprising a curved surface. 
     
     
         34 . The device of  claim 30 , wherein the retractor assembly comprises at least two movable elements. 
     
     
         35 . The device of  claim 30 , wherein the at least one movable element comprises an optically transparent material. 
     
     
         36 . The device of  claim 30 , further comprising a handle at the proximal end of the first tubular body. 
     
     
         37 . The device of  claim 36 , wherein the handle comprises a pivot member and a device-locking mechanism. 
     
     
         38 . The device of  claim 36 , wherein the handle further comprises a pivot member configured to control the configuration of the retractor assembly and a pivot member lock configured to restrict the movement of the pivot member. 
     
     
         39 . The device of  claim 36 , wherein the handle further comprises a resistance mechanism to set the actuation force of the pivot member. 
     
     
         40 . The device of  claim 36 , wherein the handle further comprises a bias member configured to exert a bias force against the pivot member. 
     
     
         41 . The device of  claim 37 , wherein the device-locking mechanism is configured to secure an endoscopic system. 
     
     
         42 . The device of  claim 36 , wherein the handle comprises one or more ports. 
     
     
         43 . The device of  claim 42 , wherein at least one port is a visualization port in communication with the at least one lumen configured to hold the endoscopic system. 
     
     
         44 . The device of  claim 30 , wherein the at least one lumen configured to hold the endoscopic system is configured to removably receive the endoscopic system. 
     
     
         45 . A method for contacting and visualizing spinal tissue comprising:
 advancing an introducer cannula toward a spine;   inserting an endoscope into a retractor cannula, wherein the retractor cannula comprises a tubular assembly comprising at least one lumen configured to hold an endoscope, and a retractor assembly located at the distal end of the tubular assembly,
 the retractor assembly including a first element with a convex outer surface and a concave inner surface, and a second element with a convex outer surf ace and a concave inner surface, the first and second elements including an optically transparent material and at least one of the elements is pivotable with respect to the tubular assembly, and the retractor assembly further includes a first closed configuration and a second open configuration; 
   viewing surrounding structure through the optically transparent material of the first and second elements using the endoscope, while the retractor cannula is the in the first closed configuration; and   advancing the retractor cannula into and out of the introducer cannula in the first closed configuration.   
     
     
         46 . The method of  claim 45 , further comprising advancing an inner shaft of the tubular assembly to move the retractor assembly from the first closed configuration to the second open configuration. 
     
     
         47 . The method of  claim 45 , further comprising partially closing the retractor assembly against a target structure. 
     
     
         48 . The method of  claim 47 , further comprising:
 inserting a tissue removal device into the retractor assembly; and   removing tissue from the target structure using the tissue removal device.   
     
     
         49 . The method of  claim 45 , wherein viewing surrounding structures through the optically transparent material is performed simultaneously with advancing the retractor cannula.