Apparatus for modifying tissue in a patient may include: an elongate, at least partially flexible body having a proximal portion and a distal portion; a tissue modifying member disposed along one side of the body; an atraumatic surface located adjacent the tissue modifying member; an actuator coupled with the tissue modifying member and extending to the proximal portion of the body; and means at or near the proximal and distal portions of the elongate body for facilitating application of tensioning and/or anchoring force to urge the tissue modifying member against the target tissue. In some embodiments, a flexible portion of the elongate body may be configured to extend through an intervertebral foramen of the patient's spine while the proximal and distal portions of the device extend out of the patient, and the tissue modifying member may be configured to remove soft tissue and/or bone to treat or alleviate spinal stenosis.
