Methods for treating defects and injuries of an intervertebral disc

• US 20060009778A1
• Filed: 06/29/2005
• Published: 01/12/2006
• Est. Priority Date: 06/29/2004
• Status: Active Grant

• Current Assignee: Spine Wave Incorporated
• Original Assignee: Spine Wave Incorporated
• Inventors: LoGuidice, Mark D., Pafford, John, Carter, Andrew, Wilson, Thomas G., Collins, Keith, Lee, Dennis, Walkenhorst, Jared, Middleton, Lance, Boyd, Lawrence
• Granted Patent: US 7,740,660 B2
• Time in Patent Office: Days
• US Class Current: 606/90
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/8811 characterised by the introducer tip, i.e. the part inserted into or onto the bone
• CPC Class Codes: A61B 17/8827 with filtering, degassing, venting or pressure relief means
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/444 for replacing the nucleus pulposus
• 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 2002/4663 for measuring volumes or other three-dimensional shapes
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A method for treating a herniated spinal disc between opposing vertebral bodies having a damaged outer annulus and an inner nucleus pulposus comprises the steps of: providing access to the nucleus pulposus through the annulus; removing at least a portion of the nucleus pulposus to create an intradiscal space; applying a first distraction force on the opposing vertebral bodies from within the intradiscal space; applying a second distraction force on the opposing vertebral bodies externally of the intradiscal space; and introducing a curable biomaterial through the annulus access directly into the intradiscal space. The first distraction force is applied within the disc space to distract the anterior aspect of the intradiscal space, while the second distraction force is applied exterior to the disc to act on the posterior aspect of the vertebral bodies. The first distraction force is applied prior to the application of the second distraction force and then removed. The second distraction force is maintained during the introduction of the biomaterial into the intradiscal space.

Claims

1. A method for treating a herniated spinal disc between opposing vertebral bodies having a damaged outer annulus and an inner nucleus pulposus, comprising the steps of:

providing access to the nucleus pulposus through the annulus;

removing at least a portion of the nucleus pulposus to create an intradiscal space;

applying a first distraction force on said opposing vertebral bodies from within said intradiscal space;

applying a second distraction force on said opposing vertebral bodies externally of said intradiscal space; and

introducing a curable biomaterial through said annulus access directly into said intradiscal space.

2. The method of claim 1 wherein said access through the annulus is a tear resulting from said herniation.

3. The method of claim 2, further including the step of enhancing said access by performing an annulotomy about said tear.

4. The method of claim 1, wherein said first distraction force is applied to distract the anterior aspect of the intradiscal space.

5. The method of claim 4, wherein said second distraction force is applied to act on the posterior aspect of the vertebral bodies.

6. The method of claim 1, wherein said first distraction force is applied by an expandable device inserted into said intradiscal space in a non-expanded condition and expanded within the intradiscal space.

7. The method of claim 6, wherein said expandable device is a non-compliant balloon.

8. The method of claim 6, wherein said second distraction force applies force on the posterior bony structures of the opposing vertebral bodies.

9. The method of claim 8, wherein said second distraction force is applied by a laminar distractor applying a force on the superior and inferior laminar arches of said vertebral bodies.

10. The method of claim 8, wherein said second distraction force is applied by an interspinous instrument applying a force against the superior and inferior spinous processes of said vertebral bodies.

11. The method of claim 1, wherein said first distraction force is applied prior to the application of said second distraction force.

12. The method of claim 11, wherein said first distraction force is removed after said second distraction force is applied.

13. The method of claim 12, wherein said second distraction force is maintained during the introduction of said biomaterial into said intradiscal space.

14. The method of claim 1, further including the step of placing the patient in a prone position with the spine flexed for access posteriorly to the spinal disc.

15. The method of claim 1, wherein said biomaterial is introduced into said intradiscal space under pressure.

16. The method of claim 15, wherein said pressure is within the range of about 25-40 psi.

17. The method of claim 15, further including the step of sealing said annulus access during the introduction of said biomaterial.

18. The method of claim 17, further including the step of providing a vent for venting said intradiscal space.

19. The method of claim 15, further including the step of determining the integrity of said annulus.

20. The method of claim 19, wherein the integrity of said annulus is determined by introducing into said intradiscal space a quantity of saline solution under pressure.

21. A method for introducing a curable biomaterial into a spinal disc comprising the steps of:

performing a discectomy on the spinal disc to remove a portion of disc nucleus pulposus to form an intradiscal space;

introducing an expandable element into the anterior aspect of the intradiscal space;

expanding the expandable element to distract at least the anterior aspect of the intradiscal space;

with the expandable element expanded, distracting the posterior aspect of the intradiscal space;

removing the expandable element; and

then introducing the curable biomaterial into the intradiscal space.

22. The method of claim 21, further including the step of determining the volume of the intradiscal space prior to the introduction of the curable biomaterial.

23. The method of claim 21, wherein the expandable element is an inflatable non-compliant balloon.

24. The method of claim 21, wherein the posterior aspect of the intradiscal space is distracted exteriorly of the intradiscal space.

25. The method of claim 24, wherein the distraction on the posterior aspect is maintained until the biomaterial is substantially cured.