System and method for repairing a damaged intervertebral disc

• US 20030130738A1
• Filed: 11/08/2002
• Published: 07/10/2003
• Est. Priority Date: 11/08/2001
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Hovda, David C.
• Application Number:
  US10/291,282
• Publication Number:
  US 20030130738A1
• Time in Patent Office: Days
• US Class Current: 623/17.11
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/4435 Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/4627 with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2250/0098 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2310/00365 Proteins; Polypeptides; Degradation products thereof

Abstract

Systems, apparatus, and methods for repairing defects within an intervertebral disc. The methods include accessing the intervertebral disc and placing a repair graft over a defect on the intervertebral disc.

Claims

1. A method of treating an intervertebral disc, the method comprising:

accessing the intervertebral disc; and

placing a graft over a defect.

2. The method of claim 1 wherein the defect is along an outer surface of the intervertebral disc.

3. The method of claim 1 wherein the defect is a fissure along an inner surface of an annulus fibrosus of the intervertebral disc.

4. The method of claim 1 comprising accessing the intervertebral disc and placing a distal tip of a delivery device within the intervertebral disc.

5. The method of claim 4 comprising identifying the defect in the intervertebral disc and moving the delivery device toward the defect in the intervertebral disc.

6. The method of claim 5 wherein moving comprises steering, biasing, rotating, or snaking around an interior of the annulus.

7. The method of claim 5 wherein accessing comprises using a cannula to create an opening in the intervertebral disc.

8. The method of claim 1 comprising placing an adhesive in the fissure prior to placing the graft.

9. The method of claim 1 comprising bonding the graft to an annulus fibrosus of the intervertebral disc.

10. The method of claim 9 wherein bonding comprises hooking, biasing, gluing, or pressuring.

11. The method of claim 1 wherein placing comprises expanding the graft.

12. The method of claim 1 wherein the graft is radio-opaque.

13. The method of claim 1 comprising monitoring the position of the delivery device.

14. A method for repairing disc fissures in an intervertebral disc, the method comprising:

accessing the intervertebral disc;

positioning a delivery device in close proximity to the disc fissure; and

placing a graft over the fissure in the intervertebral disc.

15. The method of claim 14 comprising heating the tissue around the disc fissure.

16. The method of claim 15 wherein the disc tissue is heated to a temperature in the range of about 45°

C. to about 90°

C.

17. The method of claim 14 wherein placing comprises attaching the graft along an outer surface of the disc.

18. The method of claim 14 wherein placing comprises attaching the graft along an inner surface of the disc.

19. The method of claim 14 wherein placing comprises attaching the graft only on the tissue immediately surrounding the disc fissure.

20. The method of claim 14 wherein placing comprises attaching the graft over a substantial portion of an inner surface of an annulus fibrosus of the disc.

21. The method of claim 14 wherein positioning comprises steering or biasing a distal end of the delivery device.

22. The method of claim 14 wherein placing prevents nerve growth around the fissure.

23. The method of claim 18 further comprising ablating a portion of a nucleus pulposus adjacent the fissure.

24. A system for delivering a spine graft, the system comprising:

an elongate body comprising a proximal portion and a distal portion;

a repair graft positioned at the distal portion of the elongate body; and

a delivery device that is actuatable to deliver the repair graft to an intervertebral disc.

25. The system of claim 24 wherein the repair graft comprises a wire support mesh.

26. The system of claim 25 wherein the wire mesh is self expanding.

27. The system of claim 25 wherein the wire mesh is radio-opaque.

28. The system of claim 25 wherein the wire support mesh comprises a strut design that is rectangular, square, sinusoidal, or diamond.

29. The system of claim 25 wherein the repair graft comprises at least TM one of PTFE, Dacron™

, collagen, adhesive, polypropylene, silicone, polyurethane, or polyethylene.

30. The system of claim 24 wherein the delivery device comprises a removable sheath, wherein movement of the sheath deploys the repair graft.

31. The system of claim 24 further comprising a cannula that creates a channel so that the elongate body can access the nucleus pulposus.

32. The system of claim 24 further comprising an optical fiber positioned on the distal portion of the elongate body that can monitor the intervertebral disc.

33. The system of claim 24 comprising an active electrode positioned on the distal portion of the elongate body.

34. The system of claim 33 further comprising a return electrode.

35. The system of claim 34 wherein the return electrode is positioned on the elongate body proximal of the active electrode.

36. The system of claim 34 further comprising a high frequency power supply coupled to the active electrode and return electrode, the power supply being capable of applying a high frequency voltage difference between the active and return electrodes sufficient to shrink the tissue surrounding the fissure.

37. The system of claim 34 wherein the return electrode comprises a dispersive return electrode configured for attachment to an external skin surface of the patient.

38. The system of claim 24 wherein the distal portion of the shaft is sized for delivery through a percutaneous opening in the patient.