Methods and apparatus for treating back pain

• US 20050261754A1
• Filed: 04/12/2005
• Published: 11/24/2005
• Est. Priority Date: 02/26/2003
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean
• Application Number:
  US11/105,274
• Publication Number:
  US 20050261754A1
• Time in Patent Office: Days
• US Class Current: 607/99
• 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 2018/0044 Spinal cord

Abstract

Apparatus and methods for treating back pain of a patient by denervation of an intervertebral disc or a region of the posterior longitudinal ligament by the controlled application of heat to a target tissue. In one embodiment, the invention may include a procedure combining both decompression of a disc, and denervation of the annulus fibrosus. In one embodiment, a method of the invention includes positioning an active electrode of an electrosurgical instrument in at least close proximity to an intervertebral disc, and applying at least a first high frequency voltage between the active electrode and a return electrode, wherein nervous tissue within the annulus fibrosus is inactivated, and discogenic pain of the patient is alleviated. In one embodiment, the invention includes positioning a first electrode of a dual-shaft electrosurgical instrument at a first location in relation to a target disc, positioning a second electrode of the instrument at a second location, and applying a high frequency voltage between the first and second electrodes, wherein the first and second electrodes are disposed on separate shafts of the instrument.

Claims

1. A method for treating discogenic pain, comprising:

a) providing access to an annulus fibrosus of a disc;

b) advancing an electrosurgical probe into contact or nearby said annulus fibrosus, the electrosurgical probe having a distal section and a distal tip, said distal tip having a tissue treatment surface, said probe further comprising at least one return electrode and at least one active electrode protruding from said tissue treatment surface; and

c) applying a high frequency voltage difference between said active electrode and said return electrode sufficient to shrink disc tissue.

2. The method of claim 1, wherein said tissue treatment surface is substantially planar.

3. The method of claim 1, wherein the at least one active electrode is at least two active electrodes and the at least one return electrode is at least two return electrodes.

4. The method of claim 3, comprising an equal number of active and return electrodes.

5. The method of claim 1, wherein said probe comprises a shaft distal section that forms an angle with said distal tip.

6. The method of claim 5, wherein said angle is between 30 and 60 degrees.

7. The method of claim 1 wherein said providing access of step a) is performed by open surgery.

8. The method of claim 1 wherein said providing access of step a) is performed by percutaneous surgery.

9. The method of claim 1 wherein said applying energy of step c) is performed by applying energy to outer layers of said annulus.

10. The method of claim 9 wherein said access of step a) is provided without penetrating the nucleus pulposus.

11. An electrosurgical apparatus, comprising:

a spatula-shaped distal section, said distal section comprising a body portion having a first axis, and a substantially planar tissue treatment section, said tissue treatment section distal to said body portion and having a second axis wherein said first axis and second axis form an angle in a range from 30 to 60 degrees;

an active electrode disposed on said tissue treatment surface;

a return electrode disposed on the tissue treatment surface of said distal tip; and

a connector to electrically couple said active electrode and said return electrode to a voltage supplier adapted to supply a high frequency voltage difference sufficient to shrink collagen layers of a disc without ablating said disc tissue.

12. The apparatus of claim 11 comprising a plurality active electrodes and a plurality of return electrodes.

13. The apparatus of claim 12 comprising equal number of active and return electrodes.

14. The apparatus of claim 11 wherein said angle is in the range of 40 to 50 degrees.

15. The apparatus of claim 11 wherein said distal section is an integral injection molded component.

16. The apparatus of claim 11 wherein said connector includes a connecting wire for each of said electrodes.

17. The apparatus of claim 13 wherein said active electrodes are diagonally arranged on said planar tissue treatment surface.

18. The apparatus of claim 13 wherein said active and return electrodes are made of ball wires, each of said ball wires having a wire shaft and a distal sphere-shaped head wherein at least a portion of the head protrudes from said tissue treatment surface.