An exemplary nucleus removal device may be used to remove a portion of nucleus pulposus from an intervertebral disc. A nucleus removal device may include a cannula, an access tool, a maceration tool, and an evacuation tool. The access cannula is inserted into an intervertebral body laterally, creating a fissure in the annular fibrosis. The access tool 304 is slid through the access cannula and the fissure in annular fibrosis, such that a portion of access tool extends into the nucleus pulposus. The maceration tool is extended from the access tool into the nucleus pulposus, in a direction orthogonal to the axial extension of access tool, and macerates the nucleus pulposus. To assist in maceration, a stream of liquid may also be introduced into the vertebral body through the access tool before, during, or after maceration. Macerated material and liquid is removed from the intervertebral disc by the evacuation tool.
