Methods and apparatus for treating intervertebral discs

• US 7,387,625 B2
• Filed: 03/12/2004
• Issued: 06/17/2008
• Est. Priority Date: 06/07/1995
• Status: Expired due to Fees

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Hovda, David C.
• Primary Examiner(s): Cohen; Lee S.
• Application Number:
  US10/799,491
• Publication Number:
  US 20050010205A1
• Time in Patent Office: 1,558 Days
• Field of Search: 606/41
• US Class Current: 606/32
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 2017/00261 Discectomy
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

Apparatus and methods for treating a target tissue by delivering a fluid at a defined temperature to a patient'"'"'s body. An apparatus of the invention includes a fluid delivery unit for delivering fluid in at least close proximity to the target tissue, an aspiration unit for withdrawing the fluid, and a fluid source unit for providing the fluid at the defined temperature. A method of the invention includes forming a void in at least close proximity to the target tissue, and circulating a preheated fluid through the void, wherein the target tissue undergoes adjustment from body temperature to a treatment temperature due to heat exchange between the fluid and the target tissue.

Claims

1. A method for treating a target tissue within an intervertebral disc, comprising:

a) forming a void in at least close proximity to the target tissue; and

b) delivering a preheated fluid to the void, wherein the fluid is preheated to a temperature in the range of from about 45°

C. to 90°

C., and at least a portion of the target tissue undergoes contraction due to heat exchange between the target tissue and the fluid.

2. The method of claim 1, wherein the temperature of the target tissue is increased to a treatment temperature due to the heat exchange between the target tissue and the preheated fluid, wherein the treatment temperature is in the range of from about 45°

C. to 90°

C.

3. The method of claim 2, wherein the treatment temperature is in the range of from about 60°

C. to 70°

C.

4. The method of claim 1, wherein the target tissue comprises nucleus pulposus tissue.

5. The method of claim 1, wherein the target tissue lies adjacent to the annulus fibrosus.

6. The method of claim 1, wherein the target tissue lies adjacent to an annular fissure of the disc.

7. The method of claim 1, wherein said step a) comprises ablating disc tissue components using an electrosurgical probe.

8. The method of claim 7, further comprising:

c) prior to said step b), manipulating the electrosurgical probe such that the void is sculpted to a suitable size and shape.

9. The method of claim 7, wherein said step b) comprises delivering the preheated fluid to the void via a fluid delivery unit, wherein the fluid delivery unit is integral with the electrosurgical probe.

10. The method of claim 7, wherein said step b) comprises delivering the preheated fluid to the void via a fluid delivery system, wherein the fluid delivery system is separate from the electrosurgical probe.

11. The method of claim 1, wherein said step b) comprises delivering saline to the void, the saline at a temperature in the range of from about 60°

C. to 70°

C.

12. The method of claim 1, wherein said step b) comprises delivering the preheated fluid to the void at a regulated rate, and the method further comprises:

d) withdrawing the fluid from the void, whereby the fluid is circulated through the void at a substantially constant temperature.

13. A method for treating an intervertebral disc, comprising:

a) forming a void in at least close proximity to a target tissue within the intervertebral disc; and

b) delivering a preheated fluid to the void, wherein at least a portion of the target tissue is heated to a temperature in the range of from about 45°

C. to 90°

C., whereby collagen fibers within the target tissue undergo shrinkage.

14. The method of claim 13, wherein at least a portion of the target tissue is heated to a temperature in the range of from about 60°

C. to 70°

C.

15. The method of claim 13, wherein the target tissue is heated via heat exchange between the preheated fluid and the target tissue.

16. The method of claim 13, wherein said step a) comprises forming a void in the nucleus pulposus.

17. The method of claim 13, wherein said step a) comprises:

c) positioning an active electrode terminal of an electrosurgical probe within the disc at a location in at least close proximity to the target tissue; and

d) applying a high frequency voltage between the active electrode terminal and a return electrode.

18. The method of claim 17, further comprising:

e) during said step d), manipulating the electrosurgical probe such that the void is sculpted to a suitable size and shape.

19. The method of claim 17, wherein said step b) comprises delivering the preheated fluid to the void via a fluid delivery system, the fluid delivery system separate from the electrosurgical probe.