METHOD FOR TREATING INTERVERTEBRAL DISCS

• US 20080051859A1
• Filed: 10/30/2007
• Published: 02/28/2008
• Est. Priority Date: 08/13/1996
• Status: Active Grant

• Current Assignee: NeuroTherm, Inc. (Abbott Laboratories)
• Original Assignee: Oratec Interventions Incorporated (Smith & Nephew PLC)
• Inventors: Ashley, John, Sharkey, Hugh, Saal, Joel, Saal, Jeffrey, Le, Le
• Granted Patent: US 8,128,619 B2
• Time in Patent Office: Days
• US Class Current: 607/96
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• CPC Class Codes: A61B 17/7061 for stabilising vertebrae or discs by improving the condition of their tissues, e.g. using implanted medication or fluid exchange intraosseous injection devices A61B17/3472
• CPC Class Codes: A61B 17/8836 for heating, cooling or curing of bone cement or fluid fillers
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00022 : Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00084 : Temperature
• CPC Class Codes: A61B 2017/0011 : piezoelectric
• CPC Class Codes: A61B 2017/00119 : alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00261 : Discectomy
• CPC Class Codes: A61B 2017/00274 : Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/003 : Steerable
• CPC Class Codes: A61B 2017/00336 : with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00455 : Orientation indicators, e.g. recess on the handle
• CPC Class Codes: A61B 2017/00867 : shape memory effect
• CPC Class Codes: A61B 2017/22044 : with a pointed tip
• CPC Class Codes: A61B 2017/22049 : Means for locking the guide wire in the catheter
• CPC Class Codes: A61B 2017/22082 : after introduction of a substance
• CPC Class Codes: A61B 2017/22087 : photodynamic
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/320008 : Scrapers
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00011 : with fluids
• CPC Class Codes: A61B 2018/00267 : having a basket shaped structure
• CPC Class Codes: A61B 2018/00434 : Neural system
• CPC Class Codes: A61B 2018/0044 : Spinal cord
• CPC Class Codes: A61B 2018/00547 : Prostate
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00595 : Cauterization
• CPC Class Codes: A61B 2018/00625 : Vaporization
• CPC Class Codes: A61B 2018/00654 : with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/046 : in liquid form
• CPC Class Codes: A61B 2018/1266 : with DC current output
• CPC Class Codes: A61B 2018/1405 : Electrodes having a specific shape
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1435 : Spiral
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/1807 : using light other than laser radiation
• CPC Class Codes: A61B 2090/0454 : by reflection
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3937 : Visible markers
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61F 2/442 : Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2007/0298 : with a section for heating and a section for cooling
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• CPC Class Codes: A61M 25/0133 : Tip steering devices
• CPC Class Codes: A61M 25/0144 : having flexible regions as a result of inner reinforcement means, e.g. struts or rods
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0155 : with hydraulic or pneumatic means, e.g. balloons or inflatable compartments
• CPC Class Codes: A61M 25/0158 : with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia

Abstract

A method of treating an intervertebral disc includes inserting an introducer into an intervertebral disc, inserting a catheter through the introducer and into the intervertebral disc, advancing a distal region of the catheter through a nucleus pulposus of the intervertebral disc to an annular wall of an annulus fibrosus, delivering energy to material of the intervertebral disc using an electrode disposed at the distal region of the catheter, and removing the material with the delivered energy, wherein removing material with the delivered energy reduces pressure in the intervertebral disc.

Claims

1. A method of treating an intervertebral disc, the method comprising:

inserting an introducer into an intervertebral disc;

inserting a catheter through the introducer and into the intervertebral disc;

advancing a distal region of the catheter through a nucleus pulposus of the intervertebral disc to an annular wall of an annulus fibrosus;

delivering energy to material of the intervertebral disc using an electrode disposed at the distal region of the catheter; and

removing the material with the delivered energy,

wherein removing material with the delivered energy reduces pressure in the intervertebral disc.

2. The method of claim 1 wherein removing the material comprises removing water.

3. The method of claim 1 wherein removing the material with the delivered energy comprises ablating the material.

4. The method of claim 1 wherein removing the material comprises removing disc tissue.

5. The method of claim 1 wherein delivering energy comprises delivering thermal energy or electromagnetic energy selected from the group consisting of radiofrequency (“

RF”

) energy, coherent light, incoherent light, microwave, and ultrasound.

6. The method of claim 1 wherein delivering energy comprises delivering radiofrequency (“

RF”

) energy from a bipolar or monopolar configuration.

7. The method of claim 6 further comprising denervating at least a portion of the intervertebral disc with the delivered RF energy.

8. The method of claim 6 wherein delivering RF energy comprises delivering RF energy to the inner wall of the annulus fibrosus.

9. The method of claim 6 wherein delivering RF energy comprises delivering RF energy while the catheter is positioned at a location adjacent the inner wall of the annulus fibrosus.

10. The method of claim 6 wherein delivering RF energy comprises delivering RF energy to multiple locations in the intervertebral disc using at least the electrode.

11. The method of claim 10 wherein delivering RF energy tho multiple locations comprises delivering RF energy to the multiple locations simultaneously.

12. The method of claim 10 wherein delivering RF energy to multiple locations comprises:

delivering RF energy to at least a first of the multiple locations using the electrode; and

delivering RF energy to at least a second of the multiple locations using a second electrode.

13. The method of claim 10 wherein delivering RF energy to multiple locations comprises delivering RF energy to the multiple locations serially.

14. A method of treating an intervertebral disc of a body, the method comprising:

inserting an introducer comprising a proximal end and a distal end into the body so that the proximal end is external to the body and the distal end is internal to the body;

inserting a catheter comprising a functional element disposed at a distal region of the catheter through the introducer and into the intervertebral disc so that the functional element is positioned at a selected location of the intervertebral disc;

delivering energy at the selected location of the intervertebral disc using the functional element; and

removing the material with the delivered energy, wherein removing material with the delivered energy reduces pressure in the intervertebral disc.

15. The method of claim 14 wherein the introducer is inserted into the body so that the distal end is internal to the body and internal to an annulus fibrosus of the intervertebral disc.

16. The method of claim 14 wherein the introducer is inserted into the body so that the distal end is internal to the body and adjacent to an annular opening leading to a nucleus pulposus of the intervertebral disc.

17. The method of claim 14 wherein the introducer comprises a needle and inserting the introducer comprises inserting the needle.

18. The method of claim 17 wherein the introducer comprises a needle disposed around a trocar and inserting the introducer comprises inserting the needle and trocar.

19. The method of claim 14 wherein the selected location of the intervertebral disc is selected from the group consisting of a posterior medial, a posterior lateral, an anterior lateral and an anterior medial region of an inner wall of an annulus fibrosus of the intervertebral disc or combinations thereof.

20. The method of claim 14 wherein delivering energy comprises delivering radiofrequency (“

RF”

) energy from an electromagnetic probe.

21. The method of claim 20 wherein the electromagnetic probe comprises an RF electrode.

22. The method of claim 21 wherein the RF electrode is monopolar or bipolar.

23. The method of claim 20 wherein delivering RF energy comprises delivering RF energy to multiple locations in the intervertebral disc using at least the electromagnetic probe.

24. The method of claim 23 wherein delivering RF energy to multiple locations comprises delivering RF energy to the multiple locations simultaneously.

25. The method of claim 24 wherein delivering RF energy to multiple locations comprises:

delivering RF energy to at least a first of the multiple locations using the electromagnetic probe; and

delivering RF energy to at least a second of the multiple locations using a second electromagnetic probe.