Device and method for treatment of intervertebral disc disruption
First Claim
1. A method of treatment of the interior of a mammalian intervertebral disc, comprising the steps of:
- a) forming an opening through a posterior wall of a mammalian intervertebral disc;
b) advancing a sheath having a preformed S-shape through said opening in the posterior wall of the mammalian intervertebral disc, wherein said sheath extends into the interior of the mammalian intervertebral disc;
c) advancing an elongated tool through a lumen in said sheath until a least a portion of said elongated tool is advanced out of said sheath and into the interior of the mammalian intervertebral disc;
d) performing a process on the interior of the mammalian intervertebral disc using said tool; and
e) withdrawing said sheath and said tool from the interior of the mammalian intervertebral disc.
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Accused Products
Abstract
A method of positioning an arcuate catheter against an inner annular wall of the disc, and particularly on the posterior and postero-lateral portions of the inner annulus of the disc, by arthroscopy is presented. The arcuate catheter retains its predetermined arcuate shape when no pressure or force is applied to the catheter. This present device and method require no forward tip pressure on the inner annular wall of a mammalian intervertebral disc. An arcuate sheath having a cutter is used to remove tissue from the inner annulus of the disc. In another embodiment an arcuate sheath is used to progressively remove material from the interior of the mammalian intervertebral disc. In yet another embodiment, an arcuate sheath and catheter are used to remove the entire intervertebral disc and place supports to maintain a disc space.
155 Citations
55 Claims
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1. A method of treatment of the interior of a mammalian intervertebral disc, comprising the steps of:
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a) forming an opening through a posterior wall of a mammalian intervertebral disc; b) advancing a sheath having a preformed S-shape through said opening in the posterior wall of the mammalian intervertebral disc, wherein said sheath extends into the interior of the mammalian intervertebral disc; c) advancing an elongated tool through a lumen in said sheath until a least a portion of said elongated tool is advanced out of said sheath and into the interior of the mammalian intervertebral disc; d) performing a process on the interior of the mammalian intervertebral disc using said tool; and e) withdrawing said sheath and said tool from the interior of the mammalian intervertebral disc. - View Dependent Claims (8, 10, 11, 13)
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2. A method of treatment of the interior of a mammalian intervertebral disc, comprising the steps of:
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a) forming an opening through a posterior wall of a mammalian intervertebral disc; b) advancing a guide introducer through said opening in said posterior wall of the mammalian intervertebral disc, wherein said guide introducer extends into the interior of the mammalian intervertebral disc; c) advancing a sheath having a preformed compound arcuate shape at a distal end thereof through said opening in the posterior wall of the mammalian intervertebral disc using said introducer, wherein said sheath is transported by said introducer and said sheath extends into the interior of the mammalian intervertebral disc; d) advancing an elongated tool through a lumen in said sheath until a least a portion of said elongated tool is advanced out of said sheath, and positioning said elongated tool as desired in the interior of the mammalian intervertebral disc by variably advancing and retracting said guide introducer within the interior of the mammalian intervertebral disc and variably advancing and retracting said sheath relative to said introducer; and e) withdrawing said sheath and said tool from the interior of the mammalian intervertebral disc. - View Dependent Claims (3, 5, 6, 7, 9, 12, 14, 15, 16, 17, 18, 19, 20, 21, 22, 38, 39, 42, 43, 44, 45, 48, 55)
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4. A method of treatment of the interior of a mammalian intervertebral disc, comprising the steps of:
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a) forming an opening through a posterior wall of a mammalian intervertebral disc; b) advancing an introducer through said opening in said posterior wall of the mammalian intervertebral disc, wherein said introducer extends into the interior of the mammalian intervertebral disc; c) advancing a sheath through said opening in the posterior wall of the mammalian intervertebral disc using said introducer, wherein said sheath extends into the interior of the mammalian intervertebral disc; d) advancing an elongated tool having a preformed S-shape through a lumen in said sheath until a least a portion of said elongated tool is advanced out of said sheath and into the interior of the mammalian intervertebral intervertebral disc, and positioning said elongated tool as desired within the interior of the mammalian intervertebral disc by variably advancing and retracting said sheath within the interior of the mammalian intervertebral disc and variably advancing and retracting said elongated tool relative to said sheath; and e) withdrawing said sheath and said tool from the interior of the mammalian intervertebral disc.
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23. A device for use in treatment or evacuation of the interior of a mammalian intervertebral disc, comprising:
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a) a guide introducer that traverses an opening in the mammalian intervertebral disc; b) a sheath having a preformed S-shape, wherein said sheath is transported into the interior of the mammalian intervertebral disc by said guide introducer, and said sheath is deformable and is deformed by said guide introducer as said sheath is transported, and said sheath regains its preformed S-shape upon exiting said guide introducer; and c) an elongated tool that traverses an interior lumen of said sheath, wherein at least a portion of said elongated tool extends from said sheath opposite said introducer and within the interior of the mammalian intervertebral disc. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 40, 41, 46, 47, 49, 50, 51, 52)
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53. A method of treatment of the interior of a mammalian intervertebral disc, comprising the steps of:
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a) forming an opening through a posterior wall of a mammalian intervertebral disc; b) positioning a lumen through said opening in said posterior wall of said mammalian intervertebral disc, wherein said lumen extends from an exterior of said posterior wall through said opening and into the interior of said mammalian intervertebral disc; c) advancing a catheter through said lumen and into said interior of said mammalian intervertebral disc; d) continuing to advance said catheter until said catheter contacts a lateral wall of said mammalian intervertebral disc, and thereafter, maintaining a distal end of said catheter in substantially a static position relative to said lateral wall of said mammalian intervertebral disc, while continuing to advance said catheter into an interior of said mammalian intervertebral disc until a length of said catheter having a preformed arcuate shape approximating a shape of a lateral posterior wall of said mammalian intervertebral disc is positioned against a lateral posterior wall of said mammalian intervertebral disc; e) performing a therapeutic process on said interior of said mammalian intervertebral disc with said catheter; and f) withdrawing said catheter from the interior of said mammalian intervertebral disc through said lumen.
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54. A method of treatment of the interior of a mammalian intervertebral disc, comprising the steps of:
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a) forming a opening through a posterior wall of the mammalian intervertebral disc; b) positioning a lumen through said opening in said posterior wall of said mammalian intervertebral disc, wherein said lumen extends from an exterior of said posterior wall through said opening and into the interior of said mammalian intervertebral disc; c) advancing a distal end of said lumen to a position that is near a lateral wall of said mammalian intervertebral disc opposite said opening in said posterior wall; d) advancing a catheter through said lumen and into said interior of said mammalian intervertebral disc; e) continuing to advance said catheter until said catheter contacts a lateral wall of said mammalian intervertebral disc; f) retracting said distal end of said lumen to a position that is near said opening in said posterior wall, and thereafter, maintaining a distal end of said catheter in a substantially static position relative to said lateral wall of said mammalian intervertebral disc while continuing to advance said catheter into an interior of said mammalian intervertebral disc until a length of said catheter having a preformed arcuate shape approximating a shape of a lateral posterior wall of said mammalian intervertebral disc is positioned against a lateral posterior wall of said mammalian intervertebral disc; g) performing a therapeutic process on said interior of said mammalian intervertebral disc with said catheter; and h) withdrawing said catheter from the interior of said mammalian intervertebral disc through said lumen.
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Specification