Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

A spinal treatment method and device are provided. The treatment method includes a catheter introduction step of inserting a balloon catheter into a treatment site between nerves extending from a spine, while being bifurcated, and a lesion area that compresses the nerves; and a treatment step of dilating a balloon, on which anti-inflammatory agent is disposed, of the balloon catheter at the treatment site, and applying the anti-inflammatory agent to the treatment site.

Surgical visualization systems and related methods are disclosed herein, e.g., for providing visualization during surgical procedures. Systems and methods herein can be used in a wide range of surgical procedures, including spinal surgeries such as minimally-invasive fusion or discectomy procedures. Systems and methods herein can include various features for enhancing end user experience, improving clinical outcomes, or reducing the invasiveness of a surgery. Exemplary features can include access port integration, hands-free operation, active and/or passive lens cleaning, adjustable camera depth, and many others.

A surgical cutting instrument (3) having a proximal end (4), a distal end (5), opposing sides (6, 7), and a longitudinal axis (8) and comprising: (i) an instrument body (2); (ii) a pivotal cutting arm (10) having a pinion (20) with an axis of rotation, the pinion being integrally formed with the pivotal cutting arm, wherein the pivotal cutting arm is mounted for rotation relative to the instrument body about a pivot axis (11), the pivot axis being the axis of rotation of the pinion, so that, rotation of the pinion about the pivot axis, causes the pivot arm to pivot relative to the instrument body; (iii) a cutting blade (40) on the pivotal cutting arm for resecting tissue; (iv) a rack (25) that can be moved in a reciprocating linear motion forward towards the distal end and rearwards toward the proximal end, the rack and the pinion being meshed together to forming a rack and pinion mechanism so that linear motion of the rack effects pivotal movement of the pivotal cutting arm about the pivot axis. This provides a very simple yet robust device which can have a minimum cross-section. It can thus be used for minimally invasive procedures such as cutting material from the interior of a spinal disc.

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

A tissue removal device and method of using the device to remove tissue from a patient is provided. The tissue removal device comprises a tissue removal probe and a sheath slideable relative to the probe. The probe has a tissue removal element, and the sheath has a portion that exposes the tissue removal element. The sheath distal end may be pre-shaped to bend when slid distal to the probe. The probe may have a window through which the tissue removal element is exposed.

A long-term implantable ultrasound therapy system and method is provided that provides directional, focused ultrasound to localized regions of tissue within body joints, such as spinal joints. An ultrasound emitter or transducer is delivered to a location within the body associated with the joint and heats the target region of tissue associated with the joint from the location. Such locations for ultrasound transducer placement may include for example in or around the intervertebral discs, or the bony structures such as vertebral bodies or posterior vertebral elements such as facet joints.

Systems and methods are described for correcting sagittal imbalance in a spine including instruments for performing the controlled release of the anterior longitudinal ligament through a lateral access corridor and hyper-lordotic lateral implants.

A surgical probe and a method for forming and enlarging an access opening through a psoas muscle to provide for minimally invasive lateral approach for surgical access to a lumber intervertebral disc. A distal end portion of the probe is equipped with an electrode useful for confirming proper location of the probe and includes an inflatable dilator body for enlarging an access opening through tissue adjacent to a spinal column. The probe includes a cannula through which a K wire can be extended to anchor the probe to a patient.

A tissue shaver and methods of use is disclosed. The tissue shaver operates to remove tissue.