An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has a flexible body that allows the clearing tool to deflect when entering the epidural space through a window in the vertebral bone and ligaments. The clearing tool is guided into the epidural space and to a target site by a guidewire present in the epidural space. Upon removal of the guidewire and clearing tool, the medical lead is inserted through the window and cleared epidural space until reaching the target site. The clearing tool may include a distal tip with a shape and size that aids in the clearing of the epidural space. The distal tip may be integral to the clearing tool or may be removable so as to allow for different sizes of the distal tip to be installed as needed.

The present invention provides methods and systems for conditioning cerebrospinal fluid (CSF) by removing target compounds from CSF. The systems provide for a catheter flow path and exchange of a majority volume portion of CSF in the CSF space. The removal and/or delivery of specific compounds can be tailored to the pathology of the specific disease. The removal is targeted and specific, for example, through the use of specific size-exclusion thresholds, antibodies against specific toxins, and other chromatographic techniques, as well as delivery and/or removal of targeted therapeutic agents.

An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has a flexible body that allows the clearing tool to deflect when entering the epidural space through a window in the vertebral bone and ligaments. The clearing tool is guided into the epidural space and to a target site by a guidewire present in the epidural space. Upon removal of the guidewire and clearing tool, the medical lead is inserted through the window and cleared epidural space until reaching the target site. The clearing tool may include a distal tip with a shape and size that aids in the clearing of the epidural space. The distal tip may be integral to the clearing tool or may be removable so as to allow for different sizes of the distal tip to be installed as needed.

Injection devices and methods for delivering a trail of therapeutic cells and/or one or more therapeutic substances or diagnostic substances or injectable medium into an anatomical space of an animal or human subject, particularly a trail of therapeutic cells and/or one or more therapeutic substances or diagnostic substances or injectable medium into the spinal cord of a subject and to deliver a trail of therapeutic cells and/or one or more therapeutic substances or diagnostic substances or injectable medium inside the spinal cord, to treat an injury or disorder of the central nervous system requiring injection of cells and/or one more therapeutic substances. The devices and methods are useful for the treatment of a variety of traumas, conditions and diseases, in particular, spinal cord injuries, amyotrophic lateral sclerosis, multiple sclerosis and spinal ischemia as well as other spinal cord degenerative conditions and pathologies.

A spinal catheter for insertion into the epidural space of a human or animal subject includes first and second lumens. A pressurized fluid can be discharged through the first lumen directly onto a tissue obstruction to form a partial/pilot or full/final opening in the tissue obstruction. If a full opening was not formed sufficient for passage of the stimulator lead, the distal-end portion of the stimulator lead can be inserted into the partial opening and then a pressurized fluid can be delivered through the second lumen and into a distensible balloon for expanding the balloon to clear the tissue obstruction sufficient for passage of the stimulator lead. In this way the catheter can be advanced past a tissue obstruction and into place for use within the epidural space, without having to remove and reinsert multiple surgical implements.

The present invention provides methods and systems for conditioning cerebrospinal fluid (CSF) by removing target compounds from CSF. The systems provide for a catheter flow path and exchange of a majority volume portion of CSF in the CSF space. The removal and/or delivery of specific compounds can be tailored to the pathology of the specific disease. The removal is targeted and specific, for example, through the use of specific size-exclusion thresholds, antibodies against specific toxins, and other chromatographic techniques, as well as delivery and/or removal of targeted therapeutic agents.

A method of implanting a cerebrospinal fluid-access device is provided. The method can include interlocking the device onto a delivery assembly to keep the device fixed longitudinally on the delivery assembly, advancing the delivery assembly into the cerebrospinal fluid space, and releasing the interlock to allow the delivery assembly to be removed while leaving the device implanted in the cerebrospinal fluid.

Epidural catheters include a tubular member and at least one bend indicator located proximate a distal end of the tubular member to provide a reference point for a user to bend the catheter. Catheter assemblies may include such catheters. Methods of inserting an epidural catheter having a bent distal end into a patient include bending a catheter at a location proximate at least one bend indicator formed proximate a distal end of the catheter and inserting at least a portion of the catheter into a patient. Methods of making an epidural catheter include forming a tubular member having a proximal end and a distal end and forming at least one bend indicator on the catheter proximate the distal end of the tubular member to provide a reference point for a user to bend the catheter.

A catheter assembly for regional anaesthesia includes a catheter assembly with a capillary housing, a capillary tube, and a catheter tube. The catheter tube is inserted proximally in the capillary tube and protrudes distally out of the capillary tube. The catheter tube is arranged in the capillary tube with limited linear displaceability. The catheter assembly also includes a manually actuatable clamping device for detachable fixing of the catheter tube relative to the capillary tube and the capillary housing. The catheter assembly further includes an adjustment device on the capillary housing that ensures a graduated or continuous displacement of the catheter tube in the capillary tube. Moreover, the catheter assembly includes at least one manually grippable radial projection on the catheter tube that is displaceably guided along the capillary housing.

The present invention provides methods and systems for conditioning cerebrospinal fluid (CSF) by removing target compounds from CSF. The systems provide for a catheter flow path and exchange of a majority volume portion of CSF in the CSF space. The removal and/or delivery of specific compounds can be tailored to the pathology of the specific disease. The removal is targeted and specific, for example, through the use of specific size-exclusion thresholds, antibodies against specific toxins, and other chromatographic techniques, as well as delivery and/or removal of targeted therapeutic agents.