Oratec Interventions, Inc.

Neurotherm, Inc.

Laurimed, LLC

Joel Stuart Saal

Jeffrey Alan Saal

John E Ashley

Hugh R Sharkey

Le Trong Le

Hugh J Sharkey

Brian Robert Dubois

Sepehr Fariabi

Jeff A Saal

James T Nielsen

Jeff Christian

A set of styli comprised of a shaped memory or elastic metal are disclosed wherein each stylus has a different preformed curvatures for use with a cutting device for performing a selective discectomy. The device is inserted at a point chosen from contralateral, anterior or anterolateral relative to a herniation site. Once the cutting device is inserted its cutting window is moved to the desired position by inserting a first stylus having an appropriate curvature and moving the device, removing the stylus, inserting a second stylus with a different curvature relative to the first stylus before or after moving the device. By using a plurality of styli with different curvatures and using positioning movements the cutting window is positioned at the site of herniation and a selective discectomy is carried out.

Styli used to position device for carrying out selective discetomy

Device and method are provided for diagnosing and treating diseases and injuries to the spine by injecting drugs into the diseased or injured area. The device and method of the subject invention provide improvements to patient and operator safety, along with ease-of-use and convenience improvements over conventional techniques.

Method of accessing two lateral recesses

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&#xb0; 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 disc

A method of treating an intervertebral disc includes inserting an introducer into an intervertebral disc, inserting a catheter through the introducer and into the intervertebral disc, advancing a distal region of the catheter through a nucleus pulposus of the intervertebral disc to an annular wall of an annulus fibrosus, delivering energy to material of the intervertebral disc using an electrode disposed at the distal region of the catheter, and removing the material with the delivered energy, wherein removing material with the delivered energy reduces pressure in the intervertebral disc.

Method for treating intervertebral discs

Methods and devices for treating tissue

A percutaneous method treats degenerate disc disease characterized by a circumferential bulge. The method provides a catheter having a distal end, a proximal end, and a longitudinal axis, the distal end having an intradiscal section with at least one energy delivery device. The next step is applying a force longitudinally to the proximal end of the catheter which is sufficient to advance the intradiscal section through a nucleus pulposus and around an inner wall of an annulus, but which force is insufficient for the intradiscal section to puncture the annulus fibrosus. Next the energy delivery device is positioned at a selected location of the annulus by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. The thermal energy delivery device is positioned adjacent the annulus and used to heat and stiffen the disc. Optionally, there is an additional step of adding a substance to reinforce the area. Optionally, access to the disc is provided by an introducer having an introducer lumen with an opening at a terminus of the introducer. An externally guidable intervertebral disc apparatus also is disclosed.

Method for treating intervertebral disc degeneration

A method of treating an annular fissure in an intervertebral disc includes providing a catheter having a distal end, a proximal end and a longitudinal axis, the distal end having an intradiscal section with at least one functional element, applying a force longitudinally to the proximal end 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 for the intradiscal section to puncture the annulus fibrosus, positioning the functional element at the selected location of the disc by advancing or retracting the catheter and optionally twisting the proximal end of the catheter, and using the functional element to treat the annular fissure.

An interverterbral fissure 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.

A method of manipulating a disc tissue of an intervertebral disc is described, the disc has a nucleus pulposus, an annulus fibrosus, and an inner wall of the annulus fibrosus. The method includes providing a catheter having a radiofrequency electrode at a distal region of the catheter and a proximal region for externally guiding the distal region of the catheter within an intervertebral disc. The method also includes positioning the electrode at the inner wall of the annulus fibrosus by applying a sufficient force to advance the catheter through the nucleus pulposus to the inner wall of the annulus fibrosus. The force is insufficient to puncture the annulus fibrosus. The method further includes delivering energy to the disc tissue using the electrode.

A catheter for delivering energy to a surgical site is disclosed. The catheter includes at a proximal end a handle and at a distal end a probe. The catheter includes at least one energy delivery device and an activation element. The at least one energy delivery device is located at the distal end of the catheter to deliver energy to portions of the surgical site. The activation element is located at the distal end of the catheter, to transition the probe from a linear to a multi-dimensional shape, within the surgical site. Methods for deploying the probe from the linear to multi-dimensional shape are disclosed. In another embodiment of the invention the catheter includes a heating element fabricated on a substrate by photo-etching to deliver thermal energy to portions of the surgical site. In another embodiment of the invention the catheter includes an energy delivery element, a tip and a blade. The energy delivery element is located at the distal end of the catheter to deliver energy to portions of the intervertebral disc. The blade is positioned within a first lumen of the tip and is extensible beyond the tip, to cut selected portions within the intervertebral disc. In another embodiment of the invention a catheter includes both energy and material transfer elements and an interface on the handle thereof. The interface couples the energy delivery element and the material transfer element to external devices for energy and material transfer to and from the intervertebral disc.

Catheter for delivery of energy to a surgical site

Method of treating intervertebral disc

Apparatus and methods are disclosed for accessing the interior of an intervertebral disc to perform a function within the disc. One such 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 disc 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 example, for the removal or addition of material to the intervertebral disc.

Growing community of inventors

Portola Valley, CA, United States of America

Joel Stuart Saal