Intradiscal lesioning apparatus

• US 20020147444A1
• Filed: 04/09/2001
• Published: 10/10/2002
• Est. Priority Date: 04/09/2001
• Status: Active Grant

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Baylis Medical Company
• Inventors: Leung, Mark, Shah, Krishan, Baylis, Frank Headley
• Granted Patent: US 6,562,033 B2
• Time in Patent Office: Days
• US Class Current: 606/28
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1435 Spiral

Abstract

An intradiscal lesioning device for percutaneous treatment of a patient'"'"'s intervertebral disc. An elongate introducer having a longitudinal hollow bore is surgically inserted from the patient'"'"'s skin to extend through the annulus fibrosus thereby providing external surgical access to the nucleus pulposus through the introducer bore. An elongate probe slides through and flexibly conforms to the bore when longitudinally inserted through the bore of the introducer. The distal portion of the probe is capable of resiliently conforming to the bore in a longitudinally slidably confined configuration and resiliently rebounding to a deployed configuration when released within the nucleus pulposus. The distal portion houses lesioning devices for emitting energy toward the inner wall of the annulus fibrosus when the distal portion is in the deployed configuration. Examples of suitable energy sources include: thermal energy; radio frequency electric current; microwave emission; ultrasound emission; radioactive emission; and optical emission.

Claims

1. An intradiscal lesioning device for percutaneous treatment of a patient'"'"'s intervertebral disc, the disc including a nucleus pulposus bounded by an annulus fibrosus and cartilage endplates, an inner wall of the annulus being defined between the nucleus and the annulus, said device comprising:

an elongate introducer, comprising a tube having an inner end, an outer end and a longitudinal hollow bore extending therebetween, for percutaneous surgical insertion through the annulus fibrosus thereby providing external surgical access to the nucleus pulposus through said bore;

an elongate probe having a proximal portion and a distal portion, the probe slidably engaging and flexibly conforming to the bore when longitudinally inserted through the bore from the inner to the outer end of the introducer tube;

wherein the distal portion is capable of conforming to the bore in a longitudinally slidably confined configuration therein and being deployed into a configuration when released within the nucleus pulposus in which the distal portion forms at least one loop of a dimension able to remain within the nucleus pulposus without depending on contact with said inner wall; and

the distal portion comprising means for emitting energy in the disc when the distal portion is in the deployed configuration.

2. An intradiscal lesioning device according to claim 1 wherein the distal portion includes passive shape biasing means for resiliently urging the distal portion to adopt a selected preform shape.

3. An intradiscal lesioning device according to claim 2 wherein the passive shape biasing means is a resilient solid fiber.

4. An intradiscal lesioning device according to claim 2 wherein the passive shape biasing means contains shape memory metallic alloy.

5. An intradiscal lesioning device according to claim 2 wherein the preform shape is a closed loop.

6. An intradiscal lesioning device according to claim 1 wherein the distal portion includes active shape control means for progressively deploying the trajectory of the distal portion in three-dimensional space, as the distal portion is longitudinally slidably released from the outer end of the introducer tube into the nucleus pulposus.

7. An intradiscal lesioning device according to claim 6 wherein the active shape control means comprises a cable extending from the distal portion through the introducer tube.

8. An intradiscal lesioning device according to claim 1 wherein the lesioning means emit resistive heating energy.

9. An intradiscal lesioning device according to claim 1 wherein the probe includes monitors selected from the group consisting of:

thermometer;

thermistor;

thermocouple; and

ammeter.

10. A method for percutaneous treatment of a patient'"'"'s intervertebral disc, the disc including a nucleus pulposus bounded by an annulus fibrosus and cartilage endplates, an inner wall of the annulus fibrosus being defined between the nucleus pulposus and the annulus fibrosus, said method comprising:

surgically inserting and placing an elongate introducer, comprising a tube having an inner end, an outer end and a longitudinal hollow bore extending therebetween through the annulus fibrosus thereby providing external surgical access to the nucleus pulposus through said bore;

inserting an elongate probe having a proximal portion and a distal portion into said bore, the probe slidably engaging and flexibly conforming to the bore when longitudinally inserted through the bore from the inner end to the outer end of the introducer tube;

deploying a distal portion of said probe into a configuration within the nucleus pulposus in which the distal portion forms at least one loop of a dimension able to remain within the nucleus pulposus without depending on contact with said inner wall;

connecting said probe to an energy source; and

emitting energy from said energy source at said distal portion into the disc.

11. A method as claimed in claim 10, further comprising a step of identifying a region of said disc wherein said percutaneous treatment should be performed.

12. A method as claimed in claim 10, further comprising a step of measuring a temperature of a region of said disc.

13. A method as claimed in claim 10, further comprising a step of measuring a quantity of energy delivered to said disc.

14. A method as claimed in claim 12, further comprising a step of measuring a quantity of energy delivered to said disc and a step of determining an amount of energy to deliver to said disc using said temperature of a region and said quantity of energy delivered.

15. A method as claimed in claim 10, wherein said step of connecting comprises connecting an adaptor to said proximal portion of said probe and connecting a cable between said adaptor and said energy source.

16. A method as claimed in claim 12, wherein said region of said disc is a region where said distal portion is located.

17. A method as claimed in claim 10, wherein said step of emitting energy comprises delivering volume heating.