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 a nucleus pulposus of the disc;
b) positioning said energy-applying element within the nucleus pulposus of the disc;
c) electrosurgically treating the nucleus pulposus of the disc by applying a first high frequency voltage at the energy-applying element;
d) positioning said energy-applying element within the posterior of the annulus fibrosus; and
e) electrosurgically coagulating nerve tissue within the posterior of the annulus fibrosus by applying heat using said energy-applying element, whereby the pain is alleviated.
1 Assignment
0 Petitions
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.
-
Citations
41 Claims
-
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 a nucleus pulposus of the disc; b) positioning said energy-applying element within the nucleus pulposus of the disc; c) electrosurgically treating the nucleus pulposus of the disc by applying a first high frequency voltage at the energy-applying element; d) positioning said energy-applying element within the posterior of the annulus fibrosus; and e) 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, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
-
-
15. 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 positioning a return electrode adjacent to an external surface of the posterior region 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 (16, 17, 18)
-
-
19. A method for denervating an intervertebral disc, comprising:
-
a) advancing an electrosurgical probe comprising an energy-applying element from a location outside an intervertebral disc towards a nucleus pulposus of the disc; b) positioning said energy-applying element within the nucleus pulposus of the disc; c) electrosurgically treating the nucleus pulposus of the disc by applying a first high frequency voltage at the energy-applying element; d) advancing the energy-applying element of an electrosurgical instrument from a location outside the disc towards a posterior region of an annulus fibrosus of the disc; e) positioning the energy-applying element within the annulus fibrosus; and f) 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 (20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
-
-
30. A method for denervating an intervertebral disc, comprising:
-
a) advancing the energy-applying element of an electrosurgical instrument from a location outside the disc towards a posterior region of an annulus fibrosus of the disc, wherein the energy-applying element is disposed on a distal end of a first shaft; b) positioning the energy-applying element within the annulus fibrosus at a location adjacent to the posterior of the nucleus pulposus of the disc; 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, and wherein the return electrode is disposed on a distal end of a second shaft; and d) advancing the distal end of the second shaft to a location adjacent to an outer wall of the annulus fibrosus. - View Dependent Claims (31)
-
-
32. A method for treating an intervertebral disc, comprising:
-
a) advancing a first electrosurgical probe comprising a first energy-applying element from a location outside an intervertebral disc towards a nucleus pulposus of the disc; b) positioning said first energy-applying element within the nucleus pulposus of the disc; c) electrosurgically treating the nucleus pulposus of the disc by applying a first high frequency voltage at the first energy-applying element; d) advancing an energy-applying element of a second electrosurgical instrument from a location outside the intervertebral disc into the annulus fibrosus; and e) electrosurgically coagulating collagen within the posterior of the annulus fibrosus by applying heat with a second energy-applying element of said second electrosurgical instrument. - View Dependent Claims (33, 34, 35, 36, 37)
-
-
38. A method for treating back pain, comprising:
-
a) electrosurgically applying heat at a target tissue within a posterior region of an annulus fibrosus of an intervertebral disc via an electrosurgical probe; 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.; andc) 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; and wherein the probe includes an active electrode disposed on a working end of a first shaft of the probe and a return electrode disposed on a working end of a second shaft of the probe, and, prior to step a), the method further comprises; d) advancing the working end of the first shaft through a portion of the annulus fibrosus such that the active electrode is positioned within the annulus fibrosus at a first location adjacent to the posterior of the nucleus pulposus; and e) advancing the working end of the second shaft towards the posterior of the annulus fibrosus such that the return electrode is positioned external to the annulus fibrosus at a second location adjacent to the posterior of the disc.
-
-
39. A method for treating an intervertebral disc, comprising:
-
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 (40, 41)
-
Specification