Percutaneous endoscopic access tools for the spinal epidural space and related methods of treatment

• US 20060206118A1
• Filed: 02/23/2006
• Published: 09/14/2006
• Est. Priority Date: 03/11/2005
• Status: Abandoned Application

• Current Assignee: Spine View, Inc., Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Spine View, Inc., Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Kim, Daniel H., Chin, Roy
• Application Number:
  US11/362,431
• Publication Number:
  US 20060206118A1
• Time in Patent Office: Days
• US Class Current: 606/86.R
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/320036 adapted for use within the carpal tunnel
• CPC Class Codes: A61B 17/3421 Cannulas
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• 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

Abstract

Several alternative spinal access devices are described. A number of alternative methods for performing therapies in the spinal region using the described spinal access devices are also described.

Claims

1. A method for treating intervertebral disc degeneration, comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

steering the spinal acess device to a position adjacent an outer surface of the spinal dura matter using visualization information provided by the spinal access device;

displacing the spinal dura matter with a portion of the spinal access device to create a working area; and

using the spinal access device to deliver a disc augmentation device for treating intervertebral disc degeneration.

2. The method according to claim 1 wherein the augmentation device provides structural support to the annulus.

3. The method according to claim 1 wherein the augmentation device seals a torn annulus.

4. The method according to claim 1 wherein the augmentation device adds additional material to the nucleus.

5. A method for treating intervertebral disc degeneration, comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

steering the spinal acess device to a position adjacent an outer surface of the spinal dura matter using visualization information provided by the spinal access device;

displacing the spinal dura matter with a portion of the spinal access device to create a working area; and

using the spinal access device to deliver a nucleus decompression device for treating intervertebral disc degeneration.

6. The method according to claim 5 wherein the nucleus decompression device removes a portion of the nucleus.

7. The method according to claim 5 wherein the nucleus decompression device shrinks a portion of the nucleus.

8. A system for intervertebral disc augmentation comprising:

a spinal access device configured to deliver a disc augmentation device to an intervertebral disc comprising;

at least one disc augmentation device;

an elongate body;

a direct visualization device; and

a working channel.

9. The system of claim 8 wherein augmentation includes repairing a herniated disc.

10. The system of claim 8 wherein augmentation includes supporting a damaged annulus.

11. The system of claim 8 wherein augmentation includes sealing an annulus.

12. The system of claim 8 wherein augmentation includes the addition of material to the nucleus.

13. The system of claim 8 wherein the spinal access device includes an expanding structure.

14. The system of claim 13 wherein the expanding structure is mesh, a balloon, or an atraumatic element.

15. The system of claim 13 wherein expanding the expanding structure deforms a portion of the spinal dura matter.

16. The system of claim 13 wherein expanding the structure creates a working area.

17. The system of claim 8 wherein the visualization information is provided from an image generated by a sensor located on the instrument.

18. The system of claim 8 wherein the augmentation device further comprises at least one mesh, cage, barrier, patch, scaffold, sealing means, hydrogels, silicones, or growth factors.

19. The system of claim 8 wherein the augmentation device is an ablation device.

20. A system for intervertebral nuclear decompression comprising:

a spinal access device configured to deliver a nuclear decompression device to an intervertebral disc comprising;

a nuclear decompression device;

an elongate body;

a direct visualization device;

a working channel; and

a dissection tip.

21. The system according to claim 20 wherein the decompression device further comprises a temperature-controlled energy element.

22. The system according to claim 21 wherein the energy element may be a thermal energy device that delivers resistive heat, radiofrequency, coherent and incoherent light, microwave, ultrasound or liquid thermal jet energies to the nucleus.

23. The system of claim 20 wherein the spinal access device includes an expanding structure.

24. The system of claim 23 wherein the expanding structure is mesh, a balloon, or an atraumatic element.

25. The system of claim 23 wherein expanding the expanding structure deforms a portion of the spinal dura matter.

26. The system of claim 23 wherein expanding the structure creates a working area.

27. The system of claim 20 wherein the visualization information is provided from an image generated by a sensor located on the instrument.

28. A method of diagnosing disc degeneration in a patient, said method comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

steering the spinal access device using visualization information provided by the spinal access device;

displacing the spinal dura matter with a portion of the spinal access device to create a working area; and

assessing the condition of one or more intervertebral discs.

29. The method according to claim 28 wherein the spinal access device comprises a material or marker to enhance visualization of the structure using an imaging modality outside of the body.

30. The method according to claim 29 further comprising receiving visualization information from an imaging modality outside of the body.

31. The method according to claim 30 wherein the imaging modality comprises fluoroscopy.

32. The method according to claim 30 wherein the imaging modality comprises magnetic resonance imaging.

33. The method according to claim 28 wherein the visualization information is provided from an image generated by a sensor located on the instrument.

34. The method according to claim 28 wherein the spinal access device includes a sensor for collecting diagnostic data.

35. A kit for augmenting the intervertebral disc, the kit comprising:

at least one disc augmentation device;

a spinal access device having direct visualization capabilities; and

instructions for implanting the at least one disc augmentation device using the spinal access device.

36. A kit for decompressing the nucleus of an intervertebral disc, the kit comprising:

at least one nucleus decompression device;

a spinal access device having direct visualization capabilities; and

instructions for decompressing the nucleus of an intervertebral disc using the spinal access device.

37. A method for treating intervertebral disc degeneration, comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

displacing the spinal column matter with a portion of the spinal access device to create a working area; and

using the spinal access device to deliver a disc augmentation device for treating intervertebral disc degeneration.

38. The method according to claim 37 wherein the spinal access device is steered to a position within the spinal column using the direct visualization capability of the spinal access device.

39. The method according to claim 37 wherein the augmentation device provides structural support to the annulus.

40. The method according to claim 37 wherein the augmentation device seals a torn annulus.

41. The method according to claim 37 wherein the augmentation device adds additional material to the nucleus.

42. A method for treating intervertebral disc degeneration, comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

displacing the spinal column matter with a portion of the spinal access device to create a working area; and

using the spinal access device to deliver a nucleus decompression device for treating intervertebral disc degeneration.

43. The method according to claim 42 wherein the spinal access device is steered to a position within the spinal column using the direct visualization capability of the spinal access device.

44. The method according to claim 42 wherein the nucleus decompression device removes a portion of the nucleus.

45. The method according to claim 42 wherein the nucleus decompression device shrinks a portion of the nucleus.

46. A method for treating intervertebral disc degeneration, comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

displacing the spinal column matter with a portion of the spinal access device to create a working area; and

using the spinal access device to deliver a stimulation electrode device for treating intervertebral disc degeneration.

47. The method according to claim 46 wherein the spinal access device is steered to a position within the spinal column using the direct visualization capability of the spinal access device.

48. A method for treating intervertebral disc degeneration, comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

steering the spinal access device using visualization information provided by the spinal access device;

displacing the spinal column matter with a portion of the spinal access device to create a working area; and

using the spinal access device to deliver a stimulation electrode device for treating intervertebral disc degeneration.

49. A spinal access device configured to deliver a disc augmentation device to an intervertebral disc, said device comprising:

a therapeutic device;

an elongate body;

a direct visualization device; and

at least one working channel.

50. A system for intervertebral nuclear decompression comprising:

a spinal access device configured to deliver a nuclear decompression device to an intervertebral disc comprising;

a nuclear decompression device;

an elongate body;

a direct visualization device; and

a working channel.

51. A method of diagnosing disc degeneration in a patient, said method comprising:

introducing a spinal access device having direct visualization capability into a portion of the spine;

displacing the spinal dura matter with a portion of the spinal access device to create a working area; and

assessing the condition of one or more intervertebral discs.

52. A system for treating spinal disease comprising:

a spinal access device configured to deliver a therapeutic device to a spinal column comprising;

a therapeutic device;

an elongate body;

a direct visualization device; and

at least one working channel.

53. A system for treating spinal disease comprising:

a spinal access device configured to deliver a therapeutic device to a spinal column comprising;

a therapeutic device;

an elongate body;

a direct visualization device;

at least one working channel; and

at least one irrigation or aspiration channel.