Method for removal of prolapsed nucleus pulposus material on an intervertebral disc using a laser

• US 5,437,661 A
• Filed: 03/23/1994
• Issued: 08/01/1995
• Est. Priority Date: 03/23/1994
• Status: Expired due to Fees

• Current Assignee: Bernhard Rieser
• Original Assignee: Bernhard Rieser
• Inventors: Rieser, Bernhard
• Primary Examiner(s): ASCHENBRENNER, PETER
• Application Number:
  US08/216,300
• Time in Patent Office: 496 Days
• Field of Search: 606/3, 606/13-19, 604/164
• US Class Current: 606/15
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A method for removal of prolapsed nucleus pulposus material of an intervertebral disc of a patient using a laser is disclosed. The present invention provides applying a laser beam directly in contact with the prolapsed nucleus pulposus material within the spinal foramen of an intervertebral disc, whereby the laser beam eliminates the prolapsed nucleus pulposus material, without touching the intervertebral disc. A cannula is inserted into the spinal foramen. Once the cannula has passed the ligamentum flavum, a laser fiber is inserted into the cannula. The laser fiber contacts the prolapsed material and a laser beam substantially eliminates the prolapsed material within the spinal foramen.

Claims

1. A method for removal of prolapsed nucleus pulposus material within a spinal foramen of an intervertebral disc of a patient using a laser, comprising the steps of:

puncturing said patient'"'"'s skin at an entry point with a leading wire;

inserting said leading wire into said spinal foramen up to said nucleus pulposus material along an entry path, whereby said entry path passes through a section of ligamentum flavum alongside the dural sac;

inserting a blunt tipped dilatator and a cannula over said leading wire down to the ligamentum flavum, wherein said dilatator is located between said leading wire and said cannula;

replacing said dilatator with a sharp tipped trepan;

drilling a hole through the ligamentum flavum;

replacing said trepan with said dilatator;

passing said cannula and said dilatator through said ligamentum flavum into said spinal foramen

removing said dilatator;

removing said leading wire from said cannula;

inserting into said cannula, in place of said leading wire, a laser fiber;

touching said prolapsed nucleus pulposus material with said laser fiber; and

applying a laser beam to said prolapsed nucleus pulposus material with said laser fiber,

whereby said prolapsed nucleus pulposus material is thereafter substantially eliminated.

2. The method of claim 1 further comprising prior to said step of inserting a laser fiber, inserting an optical system into said cannula.

3. The method of claim 1 further comprising prior to said step of puncturing said spinal foramen, employing a visual system throughout to allow visualization of said method.

4. The method of claim 3 wherein said step of employing a visual system comprises employing a fluoroscopic X-ray system.

5. The method of claim 3 wherein said step of employing a visual system comprises employing a Computed Tomograph (CT).

6. The method of claim 3 wherein said step of employing a visual system comprises employing a (MRI) Magnetic Resonance Imaging system.

7. The method of claim 1 further comprising after said step of inserting a laser fiber, inserting a free channel into said spinal foramen for suction.

8. The method of claim 1 further comprising after said step of inserting a laser fiber, inserting a second channel, into said spinal foramen for a peristaltic pump.

9. The method of claim 1 further comprising after said step of passing said leading wire through a section of ligamentum flavum, cooling an area around said intervertebral disc, whereby said cooling extends to an associated root and a section of a spinal cord near said intervertebral disc.

10. The method of claim 3 further comprising prior to said step of puncturing said spinal foramen employing a computer for enhanced visual monitoring.

11. A method for removal of prolapsed nucleus pulposus material within a spinal foramen of an intervertebral disc of a patient using a laser, comprising applying a laser beam directly in contact with said prolapsed nucleus pulposus material, whereby said laser beam eliminates said prolapsed nucleus pulposus material;

wherein said step of applying said laser beam comprises the steps of;

puncturing said patient'"'"'s skin at an entry point with a leading wire;

inserting said leading wire into said spinal foramen up to said nucleus pulposus material along an entry path, whereby said entry path passes through a section of ligamentum flavum alongside the dural sac;

inserting a blunt tipped dilatator and said cannula over said leading wire down to the ligamentum flavum, wherein said dilatator is located between said leading wire and said cannula;

replacing said dilatator with a sharp tipped trepan;

drilling a hole through the ligamentum flavum;

replacing said trepan with said dilatator;

passing said cannula and said dilatator through said ligamentum flavum into said spinal foramen;

removing said dilatator from said cannula;

removing said leading wire from said cannula;

inserting into said cannula, in place of said leading wire, an optical system into said cannula, wherein said optical system includes a laser fiber;

touching said prolapsed nucleus pulposus material with said laser fiber; and

applying a laser beam to said prolapsed nucleus pulposus material with said laser fiber, whereby said prolapsed nucleus pulposus material is thereafter substantially eliminated.