161 results about "Fibrous ring" patented technology

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

A device is described that may be positioned at a location in an intervertebral disc for diagnosis or treatment of the disc. Treatment may include, for example, applying energy or removing material, and may decrease intradiscal pressure. Radiofrequency energy may be applied. A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus. Next the functional element is positioned at a selected location of the disc by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. Then the functional unit treats the annular fissure. Optionally, there is an additional step of adding a substance to seal the fissure. An externally guidable intervertebral disc apparatus also is disclosed.

Apparatus and methods for treating an inter-vertebral disc by ablation, coagulation, shrinking, stiffening, or other treatment of disc tissue. A method of the invention includes positioning at least one active electrode within the inter-vertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. An apparatus of the invention includes an electrosurgical probe, an introducer needle adapted for passing the distal end of the probe therethrough, and a positioning unit for monitoring a position of the probe in relation to the introducer needle.

Apparatus and methods are disclosed for accessing the interior of an intervertebral disc to perform a function within the disc. The apparatus comprises a catheter having a lumen; and a guide wire having a distal portion and a proximal portion, and configured to be positioned within and moved relative to the lumen of the catheter; wherein the guide wire is capable of navigating itself within an intradiscal section of the intervertebral to a selected section of the disc and the catheter is capable of being advanced relative to the guide wire such that the catheter follows a path of the guide wire within the intradiscal section of the disc to the selected section. These apparatus and methods may be used for the treatment of intervertebral disc disorders such as sealing fissures of the annulus fibrosus, which may or may not be accompanied with contained or escaped extrusions. These apparatus and methods may also be used for the removal or addition of material to the intervertebral disc.

The invention broadly facilitates reconstruction of the Annulus Fibrosus (AF) or the AF and the Nucleus Pulposus (NP). Such Reconstruction prevents recurrent herniation following Microlumbar Discectomy (MLD) other procedures. The invention may also be used in the treatment of herniated discs, annular tears of the disc, or disc degeneration, while enabling surgeons to preserve the contained NP. The methods and apparatus may be used to treat discs throughout the spine including the cervical, thoracic, and lumbar spines of humans and animals. In the preferred embodiment, a spinal repair system according to the invention comprises a first end portion adapted for placement within an intervertebral body, a second end portion adapted for placement within an adjacent intervertebral body, and a bridge portion connecting the first and second end portions, the bridge portion being adapted to span a portion of an intervertebral disc space and prevent excessive outward bulging.

A minimally invasive spinal disc defect repair method is disclosed. The method relates to insertion of disc defect repair materials that are substantially two-dimensionally shaped and which allow for insertion and preferably self retention within the disc defect with plugging of the annulus fibrosis.

A method for treating a diseased or damaged spinal disc comprises the steps of: (a) providing access to the nucleus pulposus through the annulus; (b) removing at least a portion of the nucleus pulposus to create an intradiscal space; determining the size of the intradiscal space; and (c) sealably introducing under pressure a curable biomaterial through the annulus directly into the intradiscal space. The method may include the additional steps of applying a force to distract the opposing vertebral bodies about the intradiscal space and then removing the distraction force after the biomaterial has cured. The step of determining the size of the intradiscal space may be accomplished by expanding a compliant balloon within the intradiscal space using a contrast medium capable of visualization under fluoroscopy. The curable material is sealably introduced through a vented needle inserted through the opening. The curable biomaterial is introduced until a quantity of the material flows into the vent.

An apparatus and method for treating an intervertebral disc having an inner nucleus pulpous and an outer annulus fibrous includes a thermal probe defining proximal and distal ends and having a guidable region adjacent the distal end thereof. The guidable region is characterized by having sufficient rigidity to advance within the annulus fibrous of the intervertebral disc in response to an axial force exerted on the proximal end of the thermal probe while having sufficient flexibility to substantially follow and conform to an azimuthal course defined by the natural striata of the annulus fibrous. The thermal probe is adapted for connection to a thermal energy source to provide thermal energy to the annulus fibrous to alleviate pain associated with the intervertebral disc.

An instrument for inserting an elongated hydrogel prosthesis into an intervertebral disc includes an insertion cannula that is inserted through the annulus fibrosus of an intervertebral disc to provide access to the nucleus region of the disc, an elongated hydrogel prosthesis packaged within a tubular container adapted to be coupled to a proximal end of the insertion cannula, and a source of fluid pressure adapted to be coupled to a proximal end of the tubular container. Auxiliary instruments for use in convenient insertion of the insertion cannula through the nucleus pulposus and providing for a complete and controlled passage of the hydrogel prosthesis through the insertion cannula are provided in a kit with the insertion cannula. A sizing apparatus for determining the volume of prosthesis to be inserted includes a catheter or cannula capable of being inserted through the insertion cannula into the nucleus region of the intervertebral disc and having at its distal end a balloon capable of being inflated within the intervertebral disc with a measurable volume of a fluid in order to determine the amount of hydrogel prosthesis to be injected.

Methods for treating an annulus fibrosis having a defect include inserting a flexible device into the defect. The flexible device is advanced distally beyond an outer layer of the annulus fibrosus. The flexible device is then expanded such that a width of the flexible device is larger than the defect, where the flexible device prevents escape of nucleus pulposus through the defect. The flexible device may have at least two appendages made from a shape-memory metal. Alternatively, the flexible device may have a U-shaped structure that includes a central portion and two legs. The flexible device may also be anchored to the annulus fibrosis and/or the vertebrae.

Methods and devices for fixing a defect in the annulus fibrosis of a patient. The devices include first and second vertical components extending from the middle region of the horizontal component, each of the first and second vertical components having a width and an end. The middle region of the horizontal component of the device to block the defect in the annulus fibrosis. The first vertical component is attached to the upper vertebra and the second vertical component is attached to the lower vertebra. The horizontal component can be positioned beyond at least an outer layer of the annulus fibrosis, alternatively positioned beyond the innermost layer of annulus fibrosis, alternatively positioned between adjacent layers of annulus fibrosis, or alternatively positioned on the exterior of the annulus fibrosis.

Disc spacers (DS) are assembled within a disc space, allowing them to be inserted through smaller openings in the Annulus Fibrosus (AF). The large size of the assembled DS decreases the pressure on the vertebral endplates. Embodiments of the invention may be used in the cervical, thoracic, or lumbar spine. The DS may be inserted through an anterior, lateral, or posterior approach to the spine using annulus preserving techniques. The devices are preferably made of biocompatible materials such as titanium, chrome cobalt, and ceramic. Alternative materials, including materials with shape memory properties, such as Nitinol, may be used to form one or more components of the device.

Methods and devices are described for occluding openings in an annulus fibrosis to prevent conditions such as disc herniation and recurrent disc herniation. An occluding device having an intradiscal component, an extradiscal component, and a barrier element disposed between the intradiscal and extradiscal components is provided. The intradiscal component has first and second arms having a collapsed state with a horizontal dimension less than the width of the opening and an expanded state having a horizontal dimension greater than the width of the opening. The barrier element and the intradiscal component in the collapsed state are inserted through the annulus fibrosis opening, the extradiscal component being positioned adjacent an outer surface of the annulus fibrosis. The intradiscal component assumes the expanded state in the intradiscal space, the first and second arms urging the barrier element against the inner wall of the annulus fibrosis adjacent the opening, thereby occluding the opening.

A method of treating an intervertebral disc without piercing the disc involves navigating a treatment element to the intervertebral disc and contacting the treatment element with an exterior of the intervertebral disc. The method further involves applying an energy-based treatment to the exterior of the intervertebral disc to modify a property of a target tissue of the intervertebral disc. The target tissue may be, for example, annulus fibrosus and/or nucleus pulposus tissue. The treatment element is then removed, and the property remains modified after the treatment element is removed and the target tissue heals, thereby treating the intervertebral disc.

In the repair/regenerate of the intervertebral disc, all or a portion of the nucleus pulposus or annulus fibrosus is excised and treated for reinsertion into the disc or adjacent or alternate level disc. Alternatively certain bioactive agents may be injected into the degenerative disc without excising disc material.