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1. 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。

2. 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。

3. 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。

4. 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。

5. 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。

6. 发明授权

US09101386B2 Devices and methods for treating tissue 有权
标题翻译：用于治疗组织的装置和方法
公开(公告)号：US09101386B2
公开(公告)日：2015-08-11
申请号：US12911537
申请日：2010-10-25
申请人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
发明人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
IPC分类号： A61M25/00 , A61B17/3205 , A61B17/32 , A61B17/16 , A61B19/00 , A61F2/00 , A61B17/34 , A61B18/14 , A61B17/00 , A61B17/14 , A61B17/22 , A61N1/05 , A61N1/36
CPC分类号： A61B17/32 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/320016 , A61B17/3401 , A61B17/3403 , A61B17/3468 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/003 , A61B2017/00331 , A61B2017/00867 , A61B2017/22038 , A61B2017/22049 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61M25/0067 , A61M25/09 , A61M2210/1003 , A61N1/0551 , A61N1/36017
摘要： 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.
摘要翻译：本文描述了用于治疗患者脊柱中的靶组织的装置，系统和方法。通常，所述方法包括以下步骤：从第一位置，通过神经孔进入患者，并从第二位置离开患者; 将组织修改装置连接到所述线; 通过使用丝线的神经孔定位组织修饰装置; 通过将组织改变装置移动到目标组织上来改变脊柱中的目标组织; 以及将药剂递送至修饰的靶组织，其中所述药剂被配置为抑制来自所述修饰的靶组织的血液流动。在一些实施方案中，修饰靶组织的步骤包括去除位于上关节进程的腹侧的靶组织，同时避免位于上关节突侧的非靶组织。

7. 发明授权

US07938830B2 Powered tissue modification devices and methods 有权
标题翻译：动力组织修饰装置及方法
公开(公告)号：US07938830B2
公开(公告)日：2011-05-10
申请号：US11406486
申请日：2006-04-17
申请人： Vahid Saadat , Jeffery L. Bleich , Kenneth Michlitsch , John E. Ashley
发明人： Vahid Saadat , Jeffery L. Bleich , Kenneth Michlitsch , 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 device for modifying tissue in a spine may include: a shaft having a proximal portion and a distal portion, the distal portion having dimensions which allow it to be passed into an epidural space of the spine and between target and non-target tissues; at least one distal force application member extending from the distal portion of the shaft and configured to facilitate application of at least one of anchoring force and tensioning force to the shaft; at least one movable tissue modifying member coupled with the shaft at or near its distal portion; at least one drive member coupled with the at least one tissue modifying member to activate the at least one tissue modifying member; and at least one power transmission member coupled with the at least one drive member to deliver power to the at least one drive member.
摘要翻译：用于修改脊柱中的组织的装置可以包括：具有近端部分和远侧部分的轴，所述远端部分具有允许其进入脊柱的硬膜外腔中以及靶和非靶组织之间的尺寸; 至少一个远端力施加构件，其从所述轴的远侧部分延伸并且构造成便于将锚固力和张紧力中的至少一个施加到所述轴; 至少一个可动组织修改构件，其在远端部分处或其附近与所述轴联接; 至少一个驱动构件与所述至少一个组织修改构件联接以激活所述至少一个组织修改构件; 以及与所述至少一个驱动构件联接的至少一个动力传递构件，以向所述至少一个驱动构件输送动力。

8. 发明授权

US08430881B2 Mechanical tissue modification devices and methods 有权
标题翻译：机械组织修饰装置及方法
公开(公告)号：US08430881B2
公开(公告)日：2013-04-30
申请号：US11405848
申请日：2006-04-17
申请人： Jeffery L. Bleich , Vahid Saadat , Roy Leguidleguid , Jefferey Bleam
发明人： Jeffery L. Bleich , Vahid Saadat , Roy Leguidleguid , Jefferey Bleam
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 device for modifying one or more tissues in a patient's spine may include: an elongate, at least partially flexible body having a proximal portion and a distal portion, wherein at least the distal portion has dimensions that allow it to be passed into an epidural space and between target and non-target tissues of the spine; at least one movable blade disposed along one side of the elongate body; at least one actuator coupled with the at least one blade and disposed at or near the proximal or distal portion of the body for moving the blade(s) to modify one or more target tissues, wherein the at least one actuator is configured to move the blade(s) without significantly translating the elongate body proximally or distally; and means at or near the proximal and distal portions of the elongate body for facilitating application of at least one of anchoring force and tensioning force to the body to urge the at least one blade against the target tissue.
摘要翻译：用于修改患者脊柱中的一个或多个组织的装置可以包括：细长的至少部分柔性的身体，其具有近端部分和远端部分，其中至少远端部分具有允许其进入硬膜外腔的尺寸和脊柱的靶和非靶组织之间; 沿着所述细长体的一侧设置的至少一个可动刀片; 至少一个致动器，其与所述至少一个叶片耦合并且设置在所述主体的近端或远端部分处或附近，用于移动所述叶片以修改一个或多个目标组织，其中所述至少一个致动器被配置成使所述至少一个致动器移动刀片不在近侧或远端显着地平移细长体; 以及在所述细长体的近端部分和远端部分附近的装置，用于便于将至少一个锚定力和张紧力施加到身体以将至少一个刀片推向靶组织。

9. 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。

10. 发明申请

US20110060314A1 DEVICES AND METHODS FOR TREATING TISSUE 有权
标题翻译：用于治疗组织的装置和方法
公开(公告)号：US20110060314A1
公开(公告)日：2011-03-10
申请号：US12911537
申请日：2010-10-25
申请人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
发明人： Michael P. Wallace , Robert Garabedian , Gregory B. Arcenio , Jeffery L. Bleich , Vahid Saadat , Winnie Chung
IPC分类号： A61M25/00 , A61B17/16
CPC分类号： A61B17/32 , A61B17/149 , A61B17/1659 , A61B17/1671 , A61B17/320016 , A61B17/3401 , A61B17/3403 , A61B17/3468 , A61B18/1477 , A61B18/1487 , A61B90/04 , A61B2017/00261 , A61B2017/003 , A61B2017/00331 , A61B2017/00867 , A61B2017/22038 , A61B2017/22049 , A61B2017/320004 , A61B2017/320044 , A61B2017/32006 , A61B2018/1407 , A61B2018/1425 , A61B2090/061 , A61B2090/08021 , A61F2/0045 , A61M25/0067 , A61M25/09 , A61M2210/1003 , A61N1/0551 , A61N1/36017
摘要： 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.
摘要翻译：本文描述了用于治疗患者脊柱中的靶组织的装置，系统和方法。通常，所述方法包括以下步骤：从第一位置，通过神经孔进入患者，并从第二位置离开患者; 将组织修改装置连接到所述线; 通过使用丝线的神经孔定位组织修饰装置; 通过将组织改变装置移动到目标组织上来改变脊柱中的目标组织; 以及将药剂递送至修饰的靶组织，其中所述药剂被配置为抑制来自所述修饰的靶组织的血液流动。在一些实施方案中，修饰靶组织的步骤包括去除位于上关节进程的腹侧的靶组织，同时避免位于上关节突侧的非靶组织。

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