Methods and apparatus for treating back pain
First Claim
1. A method for treating discogenic pain, comprising:
- a) advancing an electrosurgical probe comprising an energy-applying element from a location outside an intervertebral disc towards an annulus fibrosus of the disc;
b) positioning said energy-applying element within the posterior of the annulus fibrosus; and
c) electrosurgically coagulating nerve tissue within the posterior of the annulus fibrosus by applying heat using said energy-applying element, whereby the pain is alleviated.
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Accused Products
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.
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Citations
103 Claims
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1. A method for treating discogenic pain, comprising:
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a) advancing an electrosurgical probe comprising an energy-applying element from a location outside an intervertebral disc towards an annulus fibrosus of the disc;
b) positioning said energy-applying element within the posterior of the annulus fibrosus; and
c) electrosurgically coagulating nerve tissue within the posterior of the annulus fibrosus by applying heat using said energy-applying element, whereby the pain is alleviated. - View Dependent Claims (2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, 20, 100)
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3. (canceled)
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13. (canceled)
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21. A method for denervating an intervertebral disc, comprising:
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a) advancing an energy-applying element of an electrosurgical instrument from a location outside the disc towards a posterior region of an annulus fibrosus of the disc;
b) positioning the energy-applying element in at least close proximity to the posterior region of the annulus fibrosus; and
c) applying a high frequency voltage between the energy-applying element and a return electrode to coagulate tissue within the annulus fibrosus, wherein the posterior region of the annulus fibrosus is denervated. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 101)
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33. A method for treating an intervertebral disc, comprising:
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a) advancing an energy-applying element of an electrosurgical instrument from a location outside an intervertebral disc to the posterior of the annulus fibrosus; and
b) electrosurgically coagulating collagen within the posterior of the annulus fibrosus by applying heat with an energy-applying element of said instrument. - View Dependent Claims (34, 35, 36, 37, 102)
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38-65. -65. (canceled)
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66. A method for treating an intervertebral disc, comprising:
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a) providing an apparatus adapted for the controlled heating of a target tissue;
b) via the apparatus, heating a posterior region of an annulus fibrosus of the disc, thereby denervating at least a portion of the posterior of the annulus fibrosus by coagulating the annulus fibrosus, whereby discogenic pain is alleviated, and wherein the apparatus does not contact a nucleus pulposus of the intervertebral disc. - View Dependent Claims (67, 68, 103)
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69-70. -70. (canceled)
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71. A method for treating back pain, comprising:
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a) applying heat at a target tissue within a posterior region of an annulus fibrosus of a patient'"'"'s spine;
b) controlling the temperature to which the target tissue is exposed, such that the target tissue is exposed to a temperature in the range of from about 43°
C. to 53°
C.; and
c) as a result of said steps a) and b), denervating at least a portion of the target tissue by coagulating nerve tissue therein, whereby the pain is alleviated. - View Dependent Claims (72, 73, 74, 75, 76)
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77-96. -96. (canceled)
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97. A method for treating an intervertebral disc, comprising:
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a) providing an electrosurgical instrument, the instrument having a first shaft and a second shaft, the first shaft having a first electrode disposed at the first shaft distal end, and the second shaft having a second electrode disposed at the second shaft distal end;
b) positioning the first electrode at a first location, the first location within the annulus fibrosus adjacent to a posterior region of a nucleus pulposus of the disc;
c) positioning the second electrode at a second location, the second location spaced from the first location in a direction towards the posterior of the disc; and
d) applying a high frequency voltage between the first electrode and the second electrode, wherein a portion of the annulus fibrosus is at least partially denervated. - View Dependent Claims (98, 99)
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Specification