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1. 发明授权

US08192435B2 Devices and methods for tissue modification 有权
标题翻译：组织修饰的装置和方法
公开(公告)号：US08192435B2
公开(公告)日：2012-06-05
申请号：US11251199
申请日：2005-10-15
申请人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , Steven A. Spisak , David R. Miller , James Yurchenco
发明人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , Steven A. Spisak , David R. Miller , James Yurchenco
IPC分类号： A61B17/00
CPC分类号： A61B17/320758 , A61B1/3135 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/29 , A61B17/320016 , A61B17/32002 , A61B17/32053 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B90/361 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/00907 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61N1/0551 , A61N1/36017
摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures. The current invention includes specific tools that enable safe tissue modification in epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue abrasion device is provided including a thin belt or ribbon with an abrasive cutting surface. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired.
摘要翻译：提供了用于选择性手术去除组织的方法和装置，例如用于扩大患病的脊柱结构。本发明包括能够在硬膜外腔中进行安全组织修复的特定工具，包括将相邻易受伤的神经和血管结构发生组织修饰的区域分开的屏障。在一个实施例中，提供了一种组织磨损装置，其包括具有研磨切割表面的薄带或带。该装置可选择地放置在保护套内，仅在期望组织移除的区域中暴露带的研磨表面。

2. 发明授权

US08579902B2 Devices and methods for tissue modification 有权
标题翻译：组织修饰的装置和方法
公开(公告)号：US08579902B2
公开(公告)日：2013-11-12
申请号：US13430500
申请日：2012-03-26
申请人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , Steven A. Spisak , David R. Miller , James R. Yurchenco
发明人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , Steven A. Spisak , David R. Miller , James R. Yurchenco
IPC分类号： A61B17/00
CPC分类号： A61B17/320758 , A61B1/3135 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/29 , A61B17/320016 , A61B17/32002 , A61B17/32053 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B90/361 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/00907 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61N1/0551 , A61N1/36017
摘要： Described herein are methods for achieving access to a compressed space in spinal anatomy. In some embodiments, a method for achieving access may include the steps of advancing a distal portion of a cannulated probe toward a neural foramen from a lateral side of the foramen, extending a first end of a elongate member from a distal end of the cannulated probe and through the neural foramen from the lateral side to a medial side of the foramen and at least partially around an anterior portion of a facet joint and posterior to a spinal disc, and extending the first end of the elongate member out of the patient, wherein a portion of the elongate member remains curved around the facet joint. In some embodiments, the method may further include the step of extending a first end of an inner cannula from a distal end of the cannulated probe.
摘要翻译：这里描述了用于实现进入脊柱解剖学中的压缩空间的方法。在一些实施例中，用于实现进入的方法可以包括以下步骤：将插管式探头的远侧部分从孔的侧面推向神经孔，从插管探头的远端延伸细长构件的第一端并且通过从孔的侧面到内侧的神经孔，并且至少部分地围绕小关节的前部和脊椎盘的后部延伸，并且将细长构件的第一端延伸出患者，其中细长构件的一部分在小面关节周围保持弯曲。在一些实施例中，该方法还可以包括从插管式探头的远端延伸内套管的第一端的步骤。

3. 发明申请

US20120184809A1 DEVICES AND METHODS FOR TISSUE MODIFICATION 有权
标题翻译：用于组织修改的装置和方法
公开(公告)号：US20120184809A1
公开(公告)日：2012-07-19
申请号：US13430500
申请日：2012-03-26
申请人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , Steven A. Spisak , David R. Miller , James R. Yurchenco
发明人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , Steven A. Spisak , David R. Miller , James R. Yurchenco
IPC分类号： A61B1/00
CPC分类号： A61B17/320758 , A61B1/3135 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/29 , A61B17/320016 , A61B17/32002 , A61B17/32053 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B90/361 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/00907 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61N1/0551 , A61N1/36017
摘要： Described herein are methods for achieving access to a compressed space in spinal anatomy. In some embodiments, a method for achieving access may include the steps of advancing a distal portion of a cannulated probe toward a neural foramen from a lateral side of the foramen, extending a first end of a elongate member from a distal end of the cannulated probe and through the neural foramen from the lateral side to a medial side of the foramen and at least partially around an anterior portion of a facet joint and posterior to a spinal disc, and extending the first end of the elongate member out of the patient, wherein a portion of the elongate member remains curved around the facet joint. In some embodiments, the method may further include the step of extending a first end of an inner cannula from a distal end of the cannulated probe.
摘要翻译：这里描述了用于实现进入脊柱解剖学中的压缩空间的方法。在一些实施例中，用于实现进入的方法可以包括以下步骤：将插管式探头的远侧部分从孔的侧面推向神经孔，从插管探头的远端延伸细长构件的第一端并且通过从孔的侧面到内侧的神经孔，并且至少部分地围绕小关节的前部和脊椎盘的后部延伸，并且将细长构件的第一端延伸出患者，其中细长构件的一部分在小面关节周围保持弯曲。在一些实施例中，该方法还可以包括从插管式探头的远端延伸内套管的第一端的步骤。

4. 发明授权

US09247952B2 Devices and methods for tissue access 有权
标题翻译：用于组织进入的装置和方法
公开(公告)号：US09247952B2
公开(公告)日：2016-02-02
申请号：US12984162
申请日：2011-01-04
申请人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , David J. Miller , James R. Yurchenco
发明人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , David J. Miller , James R. Yurchenco
IPC分类号： A61B17/00 , A61B17/32 , A61B17/16 , A61B17/29 , A61B17/3205 , A61B17/3207 , A61B17/34 , A61B19/00 , A61F2/00 , A61B5/00 , A61B17/295 , A61B18/02 , A61B18/08 , A61B18/14 , A61B18/18 , A61B18/20 , A61B17/14 , A61B18/00 , A61N1/36 , A61N7/02
CPC分类号： A61B17/320016 , A61B5/4893 , A61B17/149 , A61B17/1671 , A61B17/29 , A61B17/295 , A61B17/32002 , A61B17/32053 , A61B17/320758 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/02 , A61B18/082 , A61B18/1477 , A61B18/1487 , A61B18/1815 , A61B18/20 , A61B90/04 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/00577 , A61B2018/00595 , A61B2018/1407 , A61B2018/1425 , A61B2034/2063 , A61B2090/061 , A61B2090/08021 , A61B2090/374 , A61B2090/376 , A61B2090/3762 , A61F2/0045 , A61N1/36017 , A61N7/02
摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In some embodiments, a surgical tissue removal device includes a flexible elongate body that is adapted to conform with the target anatomy and a guidewire connector at the distal end region of the flexible elongate body configured to removably connect to the end of a guidewire so that the guidewire and flexible elongate body can be pulled distally. The body may have at least one blade edge, and the flexible elongate body may be a thin, flat, ribbon shaped flexible body that includes a profile having a width that is substantially greater than a height.
摘要翻译：提供了用于选择性手术去除组织的方法和装置，例如用于扩大患病的脊柱结构，例如冲击的侧向凹陷和病理变窄的神经孔。在一些实施例中，手术组织去除装置包括适于与目标解剖结构一致的柔性细长主体和在柔性细长主体的远端区域处的导丝连接器，其构造成可移除地连接到导丝的端部，使得导丝和柔性细长体可以向远侧拉。主体可以具有至少一个叶片边缘，并且柔性细长主体可以是薄的，扁平的带状柔性主体，其包括具有基本上大于高度的宽度的轮廓。

5. 发明申请

US20110160731A1 DEVICES AND METHODS FOR TISSUE ACCESS 有权
标题翻译：用于组织接触的装置和方法
公开(公告)号：US20110160731A1
公开(公告)日：2011-06-30
申请号：US12984162
申请日：2011-01-04
申请人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , David J. Miller , James R. Yurchenco
发明人： Jeffery L. Bleich , Edwin J. Hlavka , Vahid Saadat , David J. Miller , James R. Yurchenco
IPC分类号： A61B17/3205
CPC分类号： A61B17/320016 , A61B5/4893 , A61B17/149 , A61B17/1671 , A61B17/29 , A61B17/295 , A61B17/32002 , A61B17/32053 , A61B17/320758 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/02 , A61B18/082 , A61B18/1477 , A61B18/1487 , A61B18/1815 , A61B18/20 , A61B90/04 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/00577 , A61B2018/00595 , A61B2018/1407 , A61B2018/1425 , A61B2034/2063 , A61B2090/061 , A61B2090/08021 , A61B2090/374 , A61B2090/376 , A61B2090/3762 , A61F2/0045 , A61N1/36017 , A61N7/02
摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In some embodiments, a surgical tissue removal device includes a flexible elongate body that is adapted to conform with the target anatomy and a guidewire connector at the distal end region of the flexible elongate body configured to removably connect to the end of a guidewire so that the guidewire and flexible elongate body can be pulled distally. The body may have at least one blade edge, and the flexible elongate body may be a thin, flat, ribbon shaped flexible body that comprises a profile having a width that is substantially greater than a height.
摘要翻译：提供了用于选择性手术去除组织的方法和装置，例如用于扩大患病的脊柱结构，例如冲击的侧向凹陷和病理变窄的神经孔。在一些实施例中，手术组织去除装置包括适于与目标解剖结构一致的柔性细长主体和在柔性细长主体的远端区域处的导丝连接器，其构造成可移除地连接到导丝的端部，使得导丝和柔性细长体可以向远侧拉。主体可以具有至少一个叶片边缘，并且柔性细长主体可以是薄的，扁平的带状柔性主体，其包括具有基本上大于高度的宽度的轮廓。

6. 发明授权

US07887538B2 Methods and apparatus for tissue modification 有权
标题翻译：组织修复的方法和装置
公开(公告)号：US07887538B2
公开(公告)日：2011-02-15
申请号：US11375265
申请日：2006-03-13
申请人： Jeffery L. Bleich , Vahid Saadat , Steven A. Spisak , John E. Ashley
发明人： Jeffery L. Bleich , Vahid Saadat , Steven A. Spisak , John E. Ashley
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 method for modifying tissue in a patient may involve one or more of the following steps: advancing at least a distal portion of at least one elongate, at least partially flexible tissue modification device into a patient and between one or more target tissues and one or more non-target tissues; positioning at least one tissue modifying member of the tissue modification device adjacent the target tissue such that the tissue modifying member(s) face the target tissue and do not face the non-target tissue; applying an anchoring force to the tissue modification device at or near the distal portion or a proximal portion of the device; applying a tensioning force to the tissue modification device at or near an opposite end of the device relative to the end to which anchoring force is applied, while maintaining the anchoring force, to urge the tissue modifying member(s) against the target tissue; and modifying the target tissue, using the tissue modifying member(s), while preventing the tissue modifying member(s) from extending significantly beyond the target tissue toward the proximal or distal portion of the tissue modification device during tissue modification.
摘要翻译：用于修改患者组织的方法可以涉及一个或多个以下步骤：将至少一个细长的，至少部分柔性的组织改变装置的至少远端部分推进到患者体内，并将一个或多个靶组织与一个或多个靶组织更多的非靶组织; 将所述组织改变装置的至少一个组织修改构件定位成邻近所述目标组织，使得所述组织修改构件面向所述靶组织并且不面向所述非靶组织; 在组件修改装置的远端部分或近端部分处或附近施加锚定力; 在保持锚固力的同时相对于施加锚定力的端部在装置的相对端处或附近施加张紧力，以促使组织修改构件抵靠目标组织; 以及在组织改变期间，使组织改变部件改变目标组织，同时防止组织改变部件显着地超出目标组织向组织改变装置的近端或远端部分延伸。

7. 发明申请

US20120016368A1 FLEXIBLE TISSUE RASP 有权
标题翻译：灵活组织RASP
公开(公告)号：US20120016368A1
公开(公告)日：2012-01-19
申请号：US13243095
申请日：2011-09-23
申请人： Jeffery L. Bleich , Edwin J. Hlavka
发明人： Jeffery L. Bleich , Edwin J. Hlavka
IPC分类号： A61B17/16
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： Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.
摘要翻译：描述了用于修改患者脊柱中的组织以治疗或减轻脊柱狭窄的方法和装置。在一个实施例中，一种方法可以包括：将细长组织修饰装置的至少远端部分推进到脊柱中的硬膜外腔和目标组织与非靶组织之间; 定位组织改变装置使得装置的至少一个研磨表面面向靶组织，并且至少一个非研磨表面面向非靶组织; 在组织改变装置的分离的远侧和近端部分处或附近施加张紧力; 并且在保持至少一些张紧力的同时使所述组织改变装置来回移动，以利用所述至少一个研磨表面磨蚀所述目标组织的至少一部分。可以通过至少一个非研磨表面来防止对非目标组织的不良伤害。

8. 发明授权

US07553307B2 Devices and methods for tissue modification 有权
标题翻译：组织修饰的装置和方法
公开(公告)号：US07553307B2
公开(公告)日：2009-06-30
申请号：US11251165
申请日：2005-10-15
申请人： Jeffery L. Bleich , Edwin J. Hlavka
发明人： Jeffery L. Bleich , Edwin J. Hlavka
IPC分类号： A61B17/00
CPC分类号： A61B17/320758 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/29 , A61B17/320016 , A61B17/32002 , A61B17/32053 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61N1/0551 , A61N1/36017
摘要： Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.
摘要翻译：提供了用于选择性手术去除组织的方法和装置。在一个变化中，组织可以被通过硬膜外针递送到硬膜外腔的标准小内窥镜工具进行消融，切除，去除或其它改造。在硬膜外腔中的尖锐尖端，可以转换成钝器，以进一步安全推进。本发明包括能够在硬膜外腔中进行安全组织修复的特定工具，包括将相邻的脆弱神经和血管结构发生组织修饰的区域分开的屏障。可以提供神经刺激器以减少无意神经磨损的风险。

9. 发明授权

US08647346B2 Devices and methods for tissue modification 有权
标题翻译：组织修饰的装置和方法
公开(公告)号：US08647346B2
公开(公告)日：2014-02-11
申请号：US13484744
申请日：2012-05-31
申请人： Jeffery L. Bleich , Edwin J. Hlavka
发明人： Jeffery L. Bleich , Edwin J. Hlavka
IPC分类号： A61B17/00 , A61F2/44
CPC分类号： A61B17/320016 , A61B17/1671 , A61B17/29 , A61B17/32002 , A61B17/32053 , A61B17/320758 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3496 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00867 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2017/3445 , A61B2017/3447 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61N1/0551 , A61N1/36017
摘要： Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.
摘要翻译：提供了用于选择性手术去除组织的方法和装置。在一个变化中，组织可以被通过硬膜外针递送到硬膜外腔的标准小内窥镜工具进行消融，切除，去除或其它改造。在硬膜外腔中的尖锐尖端，可以转换成钝器，以进一步安全推进。本发明包括能够在硬膜外腔中进行安全组织修复的特定工具，包括将相邻的脆弱神经和血管结构发生组织修饰的区域分开的屏障。可以提供神经刺激器以减少无意神经磨损的风险。

10. 发明授权

US08048080B2 Flexible tissue rasp 有权
标题翻译：柔性组织锉
公开(公告)号：US08048080B2
公开(公告)日：2011-11-01
申请号：US11429377
申请日：2006-05-04
申请人： Jeffery L. Bleich , Edwin J. Hlavka
发明人： Jeffery L. Bleich , Edwin J. Hlavka
IPC分类号： A61B17/00 , A61F2/46
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： Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.
摘要翻译：描述了用于修改患者脊柱中的组织以治疗或减轻脊柱狭窄的方法和装置。在一个实施例中，一种方法可以包括：将细长组织修饰装置的至少远端部分推进到脊柱中的硬膜外腔和目标组织与非靶组织之间; 定位组织改变装置使得装置的至少一个研磨表面面向靶组织，并且至少一个非研磨表面面向非靶组织; 在组织改变装置的分离的远侧和近端部分处或附近施加张紧力; 并且在保持至少一些张紧力的同时使所述组织改变装置来回移动，以利用所述至少一个研磨表面磨蚀所述目标组织的至少一部分。可以通过至少一个非研磨表面来防止对非目标组织的不良伤害。

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