Aleeva Medical Inc.

Other

Neotract, Inc.

Collagen Corporation

Cohesion Technologies, Inc.

Alleva Medical Inc.

Kensey Nash Corporation

Yeung, Teresa T.

Yeung, Jeffrey E.

Jeffrey Eric Yeung

Teresa Tan Yeung

Frank A DeLustro

George H Chu

Woonza M Rhee

Andrew Yeung

Disc degeneration and chronic back pain are caused by a transport hindrance of oxygen, nutrients and pH buffer from capillaries in endplates into mid-layer of the intervertebral disc. A fluid absorbing conduit is inserted into the intervertebral disc, drawing and delivering the oxygen, nutrients and pH buffer in fluid of body circulation from capillaries at endplates into the mid-layer of the disc. The disc undergoes thousands of relaxation and compression cycles each day from daily activity of the patient. During relaxation phase, the fluid of body circulation containing oxygen, nutrients, and pH buffer is infused into the fluid absorbing conduit. During compression phase, the oxygen, nutrients, and pH buffer in the fluid absorbing conduit is dispersed into the mid-layer of the disc. The pH buffer, bicarbonate, neutralizes the lactic acid to relieve the discogenic pain. Oxygen inhibits hypoxic inflammation and production of lactic acid to further reduce the discogenic pain. Nutrients nourish the disc cells to rebuild or regenerate the disc matrix. Therapeutic agents can be added into the fluid absorbing conduit or injected into the disc implanted with the fluid absorbing conduit to expedite pain relief and disc regeneration. The therapeutic agents can be pH buffering agent, antibiotic, anti-inflammatory drug, anesthetic, antacid, nutrient, sulfate, anti-depressant, calcium channel blocker, growth factor, cells or other.

Method for relieving pain and regenerating intervertebral disc

A distal portion of a filament is extended beyond the distal end of a needle containing a gripper. A flexible one-way filament retainer with a snagging point is positioned adjacent to the extended filament. The needle with the extended filament and the one-way filament retainer are inserted into a cannula. During partial withdrawal of the needle, the snagging point of the one-way filament retainer hooks or retains the distal portion of the filament, depositing a section of the filament between the snagging point of the one-way filament retainer and the needle. When the needle is re-advanced, the needle pushes open the flexible one-way filament retainer, and the section of the filament is expelled or deposited in tissue. The needle can be rotated; the gripper engages and spirals the expelled filament to burrow into tissue. The method of needle partial withdrawal, re-advancement, rotation and pushing is repeated to pack and fill the tissue with interconnecting spirals of filament.

Method for relieving back/neck pain and repairing intervertebral disc

Intervertebral discs are avascular. Oxygen, nutrients and bicarbonate diffuse from capillaries in cartilaginous endplates into discs to feed and maintain disc cells. As we age, calcified layers form at the endplates, blocking and occluding capillaries. Diffusion zones of oxygen and nutrients in disc become shallow. Cells in mid-layer of the disc suffer chronic anaerobic and starving conditions. Lactic acid is produced. Disc cells die from starvation, causing disc degeneration and forming fissures in annulus. Lactic acid leaks from fissures to the outer annulus of the disc to cause irritation, inflammation and persistent pain. Spirals of filament are implanted into the painful and degenerating disc to draw oxygen, nutrients and bicarbonate from the shallow diffusion zones of the cartilaginous endplates into the mid-layer of the degenerating disc. Oxygen inhibits anaerobic production of lactic acid; nutrients feed disc cells to halt disc degeneration; bicarbonate neutralizes lactic acid in the mid-layer to relieve pain.

The distal portion of a shape-memory filament extends from a needle containing at least one filament gripping element. To implant the shape-memory filament in tissue, the needle is inserted into a cannula with a flexible and removable hook. During partial withdrawal of the needle, the hook holds the distal portion of the filament stationary to deposit a section of filament in the distal portion of the cannula. The needle is re-advanced, pushing the section of the shape-memory filament to coil or fold within the tissue. Rotation of the needle with the filament gripping element further tightens the coiled or folded filament. Partial withdrawal, re-advancement, rotation and pushing of the needle are repeated to fill, pack, strengthen, enlarge or augment the tissue with the shape-memory filament.

Tissue repair with space-seeking spirals of filament

A distal portion of a filament is extended beyond the distal end of a needle with a gripper. The needle with the extended filament is inserted into a cannula with snagging points at the distal opening of the cannula in tissue. The snagging points of the cannula hook and retain the distal portion of the filament. During partial withdrawal of the needle, a section of filament is deposited in the lumen of the cannula between the distal ends of the needle and cannula. When the needle is re-advanced, the section of filament is expelled or pushed out of the cannula into tissue. The needle is then rotated; the gripper engages and spirals the expelled filament, burrowing into tissue. The needle can further advanced to push and pack the spiral of filament deep into the tissue. The knot-like filament spiral is individually formed by rotation of the needle and friction between the extended filament and tissue. The process of needle partial withdrawal, re-advancement, rotation and pushing is repeated to pack and fill the tissue with interconnecting spirals of filament to prevent migration from tissue. Spiraling of the filament driven by the rotating needle is space seeking, filling, fitting or conforming to fortify, bulk, fill, cushion or repair the tissue. Bulking with filament spirals can repair degenerated disc, urinary incontinence, fecal incontinence or other defective tissue. The filament spirals can also be used as a suture anchor deep within tissue.

An elastically curved suture anchor is resiliently straightened and delivered into tissue by a needle. When the needle is withdrawn, resumption of the curvature provides leverage for anchor rotation as the attached suture is pulled to fasten the anchor within the tissue. A fin at the proximal end of the anchor further increases the rotational leverage and expedites anchor fastening. When two or more anchors with connecting suture are delivered in series on a needle, the tension of the suture helps to draw the anchors together and approximates the pierced tissue.

Methods for anchoring suture and approximating tissue

The intervertebral disc is avascular. Nutrients and waste are diffused through adjacent vertebral bodies into the disc. As we age, calcified layers form between the disc and vertebral bodies, blocking diffusion of nutrients, oxygen and pH buffer in blood. Under anaerobic conditions, lactic acid is produced, irritating nerve endings and causing nonspecific pain. In addition, the disc begins to starve and flatten. The weight shifts abnormally from disc to the facet joints causing strain and back pain. Lactic acid inhibitor inhibits production of lactic acid from pyruvate within the disc to reduce or alleviate back pain.

Alleviate back pain with lactic acid inhibitors

The intervertebral disc is avascular. With aging, endplates become occluded by calcified layers, and diffusion of nutrients and oxygen into the disc diminishes. The disc degenerates, and pain ensues. Conduits are delivered and deployed into the intervertebral disc to re-establish the exchange of nutrients and waste between the disc and bodily circulation to stop or reverse disc degeneration and relieve pain. The intervertebral disc installed with semi-permeable conduits may be used as an immuno-isolated capsule to encapsulate donor cells capable of biosynthesizing therapeutic molecules. The semi-permeable conduits establish the exchange of nutrients and therapeutic molecules between disc and bodily circulation to treat a disease without using immuno-suppressive drugs.

Back pain relief and immuno protection of donor cells

Method for anchoring suture and approximating tissue

A solid stepped needle delivers a disc shunt bridging between muscle and a degenerated disc, drawing blood plasma from muscle into the degenerated disc to alleviate back pain and regenerate the disc. The device further includes pull lines attached to the ends of the disc shunt for withdrawing and repositioning the stepped needle during shunt delivery.

Disc shunt delivery with stepped needle

The intervertebral disc contains no blood vessels. Nutrients and waste are diffused mainly through adjacent vertebral bodies. As we age, calcified layers form between the disc and vertebral bodies, blocking diffusion. The disc begins to starve and flatten. The weight shifts abnormally from disc to the facet joints causing strain and back pain. Under anaerobic conditions, lactic acid is produced causing acidic irritation and unspecific pain. A U-shaped disc shunt () is delivered into and sealed within the degenerated disc simply by needle puncturing and withdrawal, to draw nutrients from bodily circulation into the avascular disc. A continual supply of nutrients increases biosynthesis of the water-retaining sulfated glycosaminoglycans, hence swelling pressure within the disc. The weight is re-shifted from the facet joints to the regenerated disc, alleviating back pain. With oxygen transported through the shunt, anaerobic production of lactic acid is minimized. In addition, the residual lactic acid is expelled through the U-shaped shunt during disc compression into bodily circulation to alleviate unspecific pain.

U-shaped disc shunt and delivery device

A filament-guiding device directs a filament to spool over a rotating device within tissue. The filament-guiding device has both closed and open positions. In the closed position, the filament-guiding device is resiliently straightened for delivering into tissue. Within tissue, the filament-guiding device resumes a curved configuration in the open position to orient the filament perpendicular to the rotating device for spooling. The spooled filament is deployed by withdrawing the rotating device and filament-guiding device to bulk and repair the tissue.

Spooled filament to repair tissue

A Quincke tipped introducer needle contains two shafts with lumens, one recessed, both connected by a slit for housing a U- or V-shaped disc shunt. The recessed shaft minimizes the penetration size of the introducer needle for insertion into a narrow and nerve laden space adjacent to a degenerated intervertebral disc. The longitudinal slit connecting the two lumens allows passage of the distal portion of the U-shaped disc shunt through the introducer needle, to be delivered into the intervertebral disc. Pain emitting from the avascular disc is extremely difficult to treat due to lack of penetration or permeability of drug. The lumens of the introducer needle are also used to retain a peri-shunt injectable into the disc shunt for delivery into the painful disc. The peri-shunt injectable can be an analgesic, narcotic, anti-inflammatory drug, antibiotic, anticonvulsant, antidepressant, buffer agent or alkaline agent to alleviate pain. The peri-shunt injectable can also be a nerve toxin retained within the lumens to be loaded within the shunt for terminating transmission of pain signal emitting from the disc.

Device for disc shunt implantation and peri-shunt injection

The intervertebral disc is avascular. With aging, calcified layers occlude the capillaries at the cartilaginous endplates, reducing diffusion of nutrients and oxygen from capillaries into the avascular disc. Under anaerobic condition, excessive production of lactic acid decreases intradiscal pH and irritates surrounding nerves, causing persistent back pain. Antacid is injected into the painful disc to increase pH and alleviate back pain.

Alleviate back pain by increasing pH of the disc

Anchoring elements of a fastener are made elastically curved. The curvatures of the elements are resiliently straightened by a trocar for tissue insertion. As the trocar is withdrawn, the anchoring elements resume the curved configuration, laterally pressing the elements against tissue to anchor the fastener.

Growing community of inventors

San Jose, CA, United States of America

Jeffrey Eric Yeung