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.

Method for treating intervertebral discs

An intervertebral disc device is provided comprising a distal probe sized to be extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, a distal section of the probe comprising a flexible neck which tapers in a proximal to distal direction, and a distal tip which is larger in cross sectional diameter than the flexible neck adjacent the distal tip, the flexible neck and distal tip serving to prevent the probe distal end from piercing an internal wall of the intervertebral disc; and a proximal handle for externally guiding the probe within an intervertebral disc.

Intervertebral disc device employing flexible probe

An intervertebral disc device is provided comprising a probe capable of being extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, the probe forming a loop when extended from the distal end of the introducer, the loop having first and second proximal ends external to the introducer which are brought together adjacent the introducer distal end to form the loop by the proximal ends being either attached to or entering the distal end of the introducer; and a proximal handle for externally causing the probe to be extended from the distal end of the introducer and externally guiding the probe within an intervertebral disc.

Intervertebral disc device employing looped probe

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.

Apparatus and method for accessing and performing a function within an intervertebral disc

An intervertebral disc device is provided comprising a distal sheath (914) sized to be extended from a distal end of an introducer (912) that is percutaneously delivered into an interior of an intervertebral disc, a distal section of the sheath (918) being predisposed to adopting a bent configuration when extended from the introducer; a probe (916) adapted to be extended from a distal end of the sheath, the bent section of the sheath (918) causing the probe (916) to adopt a same bent configuration; and a proximal handled for externally guiding the probe within an intervertebral disc.

Intervertebral disc device employing prebent sheath

A method of controllably heating the annulus of an intervertebral disc is disclosed. The method comprises the steps of forming an access channel through the annulus of an intervertebral disc while avoiding the nucleus of the intervertebral disc, inserting a light-emitting diffuser into the annulus, and activating the light-emitting diffuser to emit diffuse light while maintaining the light-emitting diffuser within the access channel to raise the temperature of the annulus to a value sufficient to cause a change in the characteristics of the annulus.

Martin J. Reynolds

Papers

Method of treating intervertebral discs by inserting a diffuser directly into the annulus