Methods for visualizing and treating intervertebral discs

• US 20040127893A1
• Filed: 12/11/2003
• Published: 07/01/2004
• Est. Priority Date: 12/13/2002
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Hovda, David C.
• Application Number:
  US10/735,477
• Publication Number:
  US 20040127893A1
• Time in Patent Office: Days
• US Class Current: 606/15
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

Methods and systems for treating intervertebral discs and other difficult to access sites are provided. The methods include accessing the intervertebral disc with a small gauge access device and viewing a site within the disc with a fiber optic bundle delivered using the access device. The systems include a small gauge access device and a fiber optic bundle adapted to be delivered by means of the access device to a target tissue site.

Claims

1. A method for treating an intervertebral disc comprising:

advancing at least one optic fiber into a nucleus of the disc via the access device; and

viewing an interior of the disc using at least one of the optic fibers.

2. The method of claim 1 further comprising advancing an access device into the disc to create a passageway into the disc with the access device.

3. The method of claim 2 where advancing the access device into the disc comprises separating layers of a fibrous outer portion of the disc to create a passageway into the disc with the access device.

4. The method of claim 2 further comprising;

advancing a treatment device through the access device; and

activating the treatment device to treat the disc.

5. The method of claim 4, wherein activating the treatment device occurs prior to viewing the interior of the disc.

6. The method of claim 4, wherein at least one of the optic fibers is attached to the treatment device.

7. The method of claim 4, wherein said advancing of the at least one optic fiber and viewing the interior of the disc are performed intermittently throughout said method.

8. The method of claim 2, wherein advancing the access device comprises inserting a needle into at least a fibrous outer portion of the disc.

9. The method of claim 2 where the treatment device is selected from a group comprising pituitary rongeurs, curettes, graspers, cutters, drills, and microdebriders.

10. The method of claim 4, wherein the treatment device includes at least one active electrode and a return electrode, wherein activating the treatment device comprises applying a high frequency voltage between the active and return electrodes.

11. The method of claim 10, further comprises using a conductive medium to form a current path between the active and return electrodes.

12. The method of claim 11, where the conductive medium is provided from a source external to the disc.

13. The method of claim 11, where the conductive medium is the naturally occurring fluid within the disc.

14. The method of claim 2, wherein advancing the treatment device comprises advancing the treatment device into a nucleus pulposus of the disc.

15. The method of claim 4, wherein activating the treatment device comprises ablating tissue within the disc.

16. The method of claim 15, further comprising observing the effect of the ablating of tissue using the optic fiber.

17. The method of claim 16, wherein observing the effect comprises measuring a void created by the ablating of tissue.

18. The method of claim 16, wherein observing the effect comprises observing an outer portion of the disc.

19. The method of claim 4, wherein activating the treatment device comprises coagulating tissue within the disc.

20. The method of claim 19, further comprising observing the effect of the coagulating of tissue using the optic fiber.

21. The method of claim 20, wherein observing the effect comprises measuring shrinkage of tissue resulting from the coagulating of tissue.

22. The method of claim 20, wherein observing the effect comprises observing an outer portion of the disc.

23. The method of claim 4, further comprising performing non-invasive imaging prior to or during activating the treatment device.

24. The method of claim 1, further comprising injecting a dye into the disc.

25. The method of claim 1, where advancing the at least one optic fiber into the nucleus of the disc via the access device is performed during an open surgical procedure.

26. The method of claim 1, where advancing the at least one optic fiber into the nucleus of the disc via the access device is performed during a percutaneous surgical procedure.