Spinal Tissue Modification via Neural Foramen Access
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Solution Overview
Problem
Current minimally invasive surgical techniques for spinal stenosis are challenging due to the difficulty in accessing and modifying tissue in confined spaces with limited visualization, often requiring extensive incisions and causing significant muscle damage and long-term morbidity.
Innovation Solution
The development of devices and methods involving a guidewire and tissue modification device that can be advanced through a neural foramen to modify target tissue in the spine, allowing for precise tissue removal while avoiding non-target tissues like nerves and blood vessels, and delivering agents to inhibit bleeding.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If minimally invasive surgical techniques are used for spinal stenosis, then patient morbidity and muscle damage are reduced, but tissue access and modification in confined spaces become more difficult
Solution Approach 1:
The patent utilizes the neural foramen as an alternative access pathway (another dimension) to reach the spinal canal and target tissues. Instead of approaching from the posterior midline, the device enters through the lateral neural foramen, allowing access to the spinal canal and facet joints while avoiding extensive muscle dissection. This dimensional change in access route reduces muscle damage while maintaining surgical capability.
Solution Approach 2:
The patent employs a guidewire as an intermediary element to facilitate device navigation through the neural foramen and into the spinal canal. The guidewire serves as a mediator that enables the delivery device to reach target tissues through the confined foramenal space, solving the access difficulty while maintaining minimal invasiveness.
2Length of moving object
If small-diameter tools are used in confined spinal spaces, then incision size is reduced, but the ability to cut or contour bone and ligamentous tissue is limited
Solution Approach 1:
The tissue modification device incorporates adjustable cutting elements that can be deployed or activated only when needed. The device transitions from a compact delivery state to an active cutting state, allowing small-diameter access to be combined with effective tissue modification capability. The cutting elements can be extended or engaged dynamically during the procedure.
Solution Approach 2:
The device is segmented into multiple functional components: a delivery catheter, cutting elements, and deployment mechanisms. This segmentation allows the cutting components to be delivered through a small incision in a compact form and then deployed or activated at the target site, combining minimal invasiveness with effective tissue cutting capability.
3Length of moving object
If direct visualization of tissue is reduced or eliminated in minimally invasive procedures, then incision size is minimized, but surgical precision and control are compromised
Solution Approach 1:
The patent replaces direct visual inspection with image guidance systems. Fluoroscopic or other imaging modalities provide real-time visualization of the device position and target anatomy, substituting the mechanical/optical system of direct visualization with a radiographic imaging system. This allows minimal incisions while maintaining surgical precision through image-based navigation.
Data Source
AI summary
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.