A surgical spinal waxer is disclosed with a plurality of differently contoured surfaces for applying bone wax to a number of differently contoured portions of lamina in the spine. The different surfaces include a concave surface, a convex surface, two flat side surfaces, at least one which has a depression for holding bone wax and at least one which has an abraded area, a butted flat pushing surface, and a flat top surface. The shapes and dimensions of the different surfaces all correspond to the anatomy of the spinal canal.
A surgical instrument with near-axial geometry includes a linearly elongated handle portion having a handle axis defined along its length. The handle portion is joined to a linearly elongated working portion by an offset portion. The working portion includes a working axis defined along its length, and the working axis and handle axis intersect at an angle which is no greater than 5 degrees. In a specific embodiment, the base of the working tip of the working portion falls within 4 millimeters of the vertex of the angle.
A surgical instrument with near-axial geometry includes a linearly elongated handle portion having a handle axis defined along its length. The handle portion is joined to a linearly elongated working portion by an offset portion. The working portion includes a working axis defined along its length, and the working axis and handle axis intersect at an angle which is no greater than 5 degrees. In a specific embodiment, the base of the working tip of the working portion falls within 4 millimeters of the vertex of the angle.
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.
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.
A method in which a probe is advanced between a neural tissue structure and a non-neural tissue structure such as the intervertebral foramen. The probe includes electrodes on opposite surfaces. Threshold currents required to stimulate action potentials for each electrode are determined. A ratio of the threshold currents are calculated. Tissue is removed from the non-neural tissue structure when the ratio is greater than a predetermined threshold.
