최소 단어 이상 선택하여야 합니다.
최대 10 단어까지만 선택 가능합니다.
다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
NTIS 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
DataON 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Edison 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Kafe 바로가기국가/구분 | United States(US) Patent 등록 |
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국제특허분류(IPC7판) |
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출원번호 | US-0712007 (2003-11-14) |
등록번호 | US-7282061 (2007-10-16) |
발명자 / 주소 |
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출원인 / 주소 |
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대리인 / 주소 |
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인용정보 | 피인용 횟수 : 94 인용 특허 : 362 |
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 o
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 45-70째 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.
What is claimed is: 1. A method comprising: advancing a member into a nucleus pulposus of an intervertebral disc by blunt dissection, the nucleus pulposus having a volume, and applying radiofrequency energy from the member to decrease the volume of the nucleus pulposus. 2. The method of claim 1 w
What is claimed is: 1. A method comprising: advancing a member into a nucleus pulposus of an intervertebral disc by blunt dissection, the nucleus pulposus having a volume, and applying radiofrequency energy from the member to decrease the volume of the nucleus pulposus. 2. The method of claim 1 wherein applying radiofrequency energy removes material of the nucleus pulposus. 3. The method of claim 1 wherein applying radiofrequency energy removes water of the nucleus pulposus. 4. The method of claim 1 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 5. The method of claim 2 or 3 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 6. The method of claim 1, 2, 3, or 4 wherein applying radiofrequency energy from the member to decrease the volume of the nucleus pulposus reduces pressure in the intervertebral disc. 7. The method of claim 1, 2, 3, or 4 wherein applying radiofrequency energy to decrease the volume of the nucleus pulposus comprises ablating material of the nucleus pulposus. 8. The method of claim 1, 2, 3, or 4 further comprising denervating at least a portion of the intervertebral disc with the applied radiofrequency energy. 9. The method of claim 1, 2, 3, or 4 wherein advancing the member comprises advancing the member through an introducer. 10. The method of claim 1, 2, 3, or 4 wherein advancing the member comprises advancing the member beyond a central region of the nucleus pulposus. 11. The method of claim 1, 2, 3, or 4 wherein applying radiofrequency energy comprises applying radiofrequency energy from an electrode of the member. 12. The method of claim 11 further comprising advancing the electrode beyond an introducer. 13. The method of claim 11 further comprising providing the member with a bipolar electrode configuration. 14. The method of claim 1 further comprises applying rotation to a proximal region of the member to rotate a distal region of the member within the nucleus pulposus. 15. The method of claim 1 or 14 further comprising positioning a portion of the member at an inner wall of an annulus fibrosus of the intervertebral disc. 16. The method of claim 1 or 14 wherein advancing the member comprises advancing the member along a curved path. 17. The method of claim 1 further comprising providing the member with a total length between 5 and 24 inches. 18. The method of claim 1 further comprising providing the member in the form of a catheter. 19. The method of claim 1, 2, 3, or 4 wherein applying radiofrequency energy comprises applying radiofrequency energy to an inner wall of an annulus fibrosus. 20. The method of claim 1, 2, 3, or 4 wherein applying radiofrequency energy comprises applying radiofrequency energy while the member is positioned at a location adjacent an inner wall of an annulus fibrosus. 21. The method of claim 1, 2, 3, or 4 wherein applying radiofrequency energy comprises applying radiofrequency energy to multiple locations in the intervertebral disc. 22. The method of claim 21 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations simultaneously. 23. The method of claim 21 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using separate energy delivery elements of the member. 24. The method of claim 21 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations serially. 25. The method of claim 21 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using a single energy delivery element of the member. 26. The method of claim 1, 2, 3, or 4 further comprising advancing the member along an inner wall of an annulus fibrosus. 27. A method comprising: advancing a member through a nucleus pulposus of an intervertebral disc beyond a central region of the nucleus pulposus, the nucleus pulposus having a volume, and applying radiofrequency energy from the member to decrease the volume of the nucleus pulposus. 28. The method of claim 27 wherein applying radiofrequency energy removes material of the nucleus pulposus. 29. The method of claim 27 wherein applying radiofrequency energy removes water of the nucleus pulposus. 30. The method of claim 27 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 31. The method of claim 28 or 29 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 32. The method of claim 27, 28, 29, or 30 wherein applying radiofrequency energy from the member to decrease the volume of the nucleus pulposus reduces pressure in the intervertebral disc. 33. The method of claim 27, 28, 29, or 30 wherein applying radiofrequency energy to decrease the volume of the nucleus pulposus comprises ablating material of the nucleus pulposus. 34. The method of claim 27, 28, 29, or 30 further comprising denervating at least a portion of the intervertebral disc with the applied radiofrequency energy. 35. The method of claim 27, 28, 29, or 30 wherein advancing the member comprises advancing the member through an introducer. 36. The method of claim 27, 28, 29, or 30 wherein applying radiofrequency energy comprises applying radiofrequency energy from an electrode of the member. 37. The method of claim 36 further comprising advancing the electrode beyond an introducer. 38. The method of claim 36 further comprising providing the member with a bipolar electrode configuration. 39. The method of claim 27 further comprising applying rotation to a proximal region of the member to rotate a distal region of the member within the nucleus pulposus. 40. The method of claim 27 or 39 further comprising positioning a portion of the member at an inner wall of an annulus fibrosus of the intervertebral disc. 41. The method of claim 27 or 39 wherein advancing the member comprises advancing the member along a curved path. 42. The method of claim 27 further comprising providing the member with a total length between 5 and 24 inches. 43. The method of claim 27 further comprising providing the member in the form of a catheter. 44. The method of claim 27, 28, 29, or 30 wherein applying radiofrequency energy comprises applying radiofrequency energy to an inner wall of an annulus fibrosus. 45. The method of claim 27, 28, 29, or 30 wherein applying radiofrequency energy comprises applying radiofrequency energy while the member is positioned at a location adjacent an inner wall of an annulus fibrosus. 46. The method of claim 27, 28, 29, or 30 wherein applying radiofrequency energy comprises applying radiofrequency energy to multiple locations in the intervertebral disc. 47. The method of claim 46 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations simultaneously. 48. The method of claim 46 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using separate energy delivery elements of the member. 49. The method of claim 46 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations serially. 50. The method of claim 46 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using a single energy delivery element of the member. 51. The method of claim 27, 28, 29, or 30 further comprising advancing the member along an inner wall of an annulus fibrosus. 52. A method comprising: advancing a radiofrequency electrode into a nucleus pulposus of an intervertebral disc by blunt dissection, the nucleus pulposus having a volume, and activating the electrode to decrease the volume of the nucleus pulposus. 53. The method of claim 52 wherein activating the electrode to decrease the volume of the nucleus pulposus reduces pressure in the intervertebral disc. 54. The method of claim 52 or 53 wherein activating the electrode to decrease the volume of the nucleus pulposus comprises ablating material of the nucleus pulposus. 55. The method of claim 52 or 53 wherein advancing the electrode comprises advancing the electrode beyond a central region of the nucleus pulposus. 56. The method of claim 52 wherein advancing the electrode further comprises advancing a bipolar electrode configuration. 57. The method of claim 52 or 56 further comprising positioning the electrode at an inner wall of an annulus fibrosus of the intervertebral disc. 58. The method of claim 52 or 56 wherein advancing the electrode comprises advancing the electrode along a curved path. 59. The method of claim 52 or 53 wherein activating the electrode comprises activating the electrode while the electrode is positioned at a location adjacent an inner wall of an annulus fibrosus. 60. The method of claim 52 or 53 wherein activating the electrode comprises delivering radiofrequency energy from the electrode to multiple locations in the intervertebral disc. 61. The method of claim 60 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations simultaneously. 62. The method of claim 60 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations serially. 63. The method of claim 52 or 53 further comprising advancing the electrode along an inner wall of an annulus fibrosus. 64. A method comprising: advancing a radiofrequency electrode through a nucleus pulposus of an intervertebral disc beyond a central region of the nucleus pulposus, the nucleus pulposus having a volume, and activating the electrode to decrease the volume of the nucleus pulposus. 65. The method of claim 64 wherein activating the electrode to decrease the volume of the nucleus pulposus reduces pressure in the intervertebral disc. 66. The method of claim 64 or 65 wherein activating the electrode to decrease the volume of the nucleus pulposus comprises ablating material of the nucleus pulposus. 67. The method of claim 64 wherein advancing the electrode further comprises advancing a bipolar electrode configuration. 68. The method of claim 64 or 67 further comprising positioning the electrode at an inner wall of an annulus fibrosus of the intervertebral disc. 69. The method of claim 64 or 67 wherein advancing the electrode comprises advancing the electrode along a curved path. 70. The method of claim 64 or 65 wherein activating the electrode comprises activating the electrode while the electrode is positioned at a location adjacent an inner wall of an annulus fibrosus. 71. The method of claim 64 or 65 wherein activating the electrode comprises delivering radiofrequency energy from the electrode to multiple locations in the intervertebral disc. 72. The method of claim 71 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations simultaneously. 73. The method of claim 71 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations serially. 74. The method of claim 64 or 65 further comprising advancing the electrode along an inner wall of an annulus fibrosus. 75. A method comprising: advancing a member into a nucleus pulposus of an intervertebral disc by blunt dissection, and applying radio frequency energy from the member to remove material of the nucleus pulposus. 76. The method of claim 75 wherein applying radiofrequency energy removes water of the nucleus pulposus. 77. The method of claim 75 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 78. The method of claim 76 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 79. The method of claim 75, 76, 77, or 78 wherein applying radiofrequency energy from the member to remove material of the nucleus pulposus reduces pressure in the intervertebral disc. 80. The method of claim 75, 76, 77, or 78 wherein applying radiofrequency energy from the member to remove material of the nucleus pulposus comprises ablating material of the nucleus pulposus. 81. The method of claim 75, 76, 77, or 78 further comprising denervating at least a portion of the intervertebral disc with the applied radio frequency energy. 82. The method of claim 75, 76, 77, or 78 wherein advancing the member comprises advancing the member through an introducer. 83. The method of claim 75, 76, 77, or 78 wherein advancing the member comprises advancing the member beyond a central region of the nucleus pulposus. 84. The method of claim 75, 76, 77, or 78 wherein applying radiofrequency energy comprises applying radiofrequency energy from an electrode of the member. 85. The method of claim 84 further comprising advancing the electrode beyond an introducer. 86. The method of claim 84 further comprising providing the member with a bipolar electrode configuration. 87. The method of claim 75 further comprising applying rotation to a proximal region of the member to rotate a distal region of the member within the nucleus pulposus. 88. The method of claim 75 or 87 further comprising positioning a portion of the member at an inner wall of an annulus fibrosus of the intervertebral disc. 89. The method of claim 75 or 87 wherein advancing the member comprises advancing the member along a curved path. 90. The method of claim 75 further comprising providing the member with a total length between 5 and 24 inches. 91. The method of claim 75 further comprising providing the member in the form of a catheter. 92. The method of claim 75, 76, 77, or 78 wherein applying radiofrequency energy comprises applying radiofrequency energy to an inner wall of an annulus fibrosus. 93. The method of claim 75, 76, 77, or 78 wherein applying radiofrequency energy comprises applying radiofrequency energy while the member is positioned at a location adjacent an inner wall of an annulus fibrosus. 94. The method of claim 75, 76, 77, or 78 wherein applying radiofrequency energy comprises applying radiofrequency energy to multiple locations in the intervertebral disc. 95. The method of claim 94 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations simultaneously. 96. The method of claim 94 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using separate energy delivery elements of the member. 97. The method of claim 94 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations serially. 98. The method of claim 94 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using a single energy delivery element of the member. 99. The method of claim 75, 76, 77, or 78 further comprising advancing the member along an inner wall of an annulus fibrosus. 100. A method comprising: advancing a member through a nucleus pulposus of an intervertebral disc beyond a central region of the nucleus pulposus, and applying radiofrequency energy from the member to remove material of the nucleus pulposus. 101. The method of claim 100 wherein applying radiofrequency energy removes water of the nucleus pulposus. 102. The method of claim 100 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 103. The method of claim 101 wherein applying radiofrequency energy removes disc tissue of the nucleus pulposus. 104. The method of claim 100, 101, 102, or 103 wherein applying radiofrequency energy from the member to remove material of the nucleus pulposus reduces pressure in the intervertebral disc. 105. The method of claim 100, 101, 102, or 103 wherein applying radiofrequency energy from the member to remove material of the nucleus pulposus comprises ablating material of the nucleus pulposus. 106. The method of claim 100, 101, 102, or 103 further comprising denervating at least a portion of the intervertebral disc with the applied radiofrequency energy. 107. The method of claim 100, 101, 102, or 103 wherein advancing the member comprises advancing the member through an introducer. 108. The method of claim 100, 101, 102, or 103 wherein applying radiofrequency energy comprises applying radiofrequency energy from an electrode of the member. 109. The method of claim 108 further comprising advancing the electrode beyond an introducer. 110. The method of claim 108 further comprising providing the member with a bipolar electrode configuration. 111. The method of claim 100 further comprises applying rotation to a proximal region of the member to rotate a distal region of the member within the nucleus pulposus. 112. The method of claim 100 or 111 further comprising positioning a portion of the member at an inner wall of an annulus fibrosus of the intervertebral disc. 113. The method of claim 100 or 111 wherein advancing the member comprises advancing the member along a curved path. 114. The method of claim 100 further comprising providing the member with a total length between 5 and 24 inches. 115. The method of claim 100 further comprising providing the member in the form of a catheter. 116. The method of claim 100, 101, 102, or 103 wherein applying radiofrequency energy comprises applying radiofrequency energy to an inner wall of an annulus fibrosus. 117. The method of claim 100, 101, 102, or 103 wherein applying radiofrequency energy comprises applying radiofrequency energy while the member is positioned at a location adjacent an inner wall of an annulus fibrosus. 118. The method of claim 100, 101, 102, or 103 wherein applying radiofrequency energy comprises applying radiofrequency energy to multiple locations in the intervertebral disc. 119. The method of claim 118 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations simultaneously. 120. The method of claim 118 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using separate energy delivery elements of the member. 121. The method of claim 118 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations serially. 122. The method of claim 118 wherein applying radiofrequency energy to multiple locations comprises applying radiofrequency energy to the multiple locations using a single energy delivery element of the member. 123. The method of claim 100, 101, 102, or 103 further comprising advancing the member along an inner wall of an annulus fibrosus. 124. A method comprising: advancing a radiofrequency electrode into a nucleus pulposus of an intervertebral disc by blunt dissection, and activating the electrode to remove material of the nucleus pulposus. 125. The method of claim 124 wherein activating the electrode to remove material of the nucleus pulposus reduces pressure in the intervertebral disc. 126. The method of claim 124 or 125 wherein activating the electrode to remove material of the nucleus pulposus comprises ablating material of the nucleus pulposus. 127. The method of claim 124 or 125 wherein advancing the electrode comprises advancing the electrode beyond a central region of the nucleus pulposus. 128. The method of claim 124 wherein advancing the electrode further comprises advancing a bipolar electrode configuration. 129. The method of claim 124 or 128 further comprising positioning the electrode at an inner wall of an annulus fibrosus of the intervertebral disc. 130. The method of claim 124 or 128 wherein advancing the electrode comprises advancing the electrode along a curved path. 131. The method of claim 124 or 125 wherein activating the electrode comprises activating the electrode while the electrode is positioned at a location adjacent an inner wall of an annulus fibrosus. 132. The method of claim 124 or 125 wherein activating the electrode comprises delivering radiofrequency energy from the electrode to multiple locations in the intervertebral disc. 133. The method of claim 132 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations simultaneously. 134. The method of claim 132 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations serially. 135. The method of claim 124 or 125 further comprising advancing the electrode along an inner wall of an annulus fibrosus. 136. A method comprising: advancing a radiofrequency electrode through a nucleus pulposus of an intervertebral disc beyond a central region of the nucleus pulposus, and activating the electrode to remove material of the nucleus pulposus. 137. The method of claim 136 wherein activating the electrode to remove material of the nucleus pulposus reduces pressure in the intervertebral disc. 138. The method of claim 136 or 137 wherein activating the electrode to remove material of the nucleus pulposus comprises ablating material of the nucleus pulposus. 139. The method of claim 136 wherein advancing the electrode further comprises advancing a bipolar electrode configuration. 140. The method of claim 136 or 139 further comprising positioning the electrode at an inner wall of an annulus fibrosus of the intervertebral disc. 141. The method of claim 136 or 139 wherein advancing the electrode comprises advancing the electrode along a curved path. 142. The method of claim 136 or 137 wherein activating the electrode comprises activating the electrode while the electrode is positioned at a location adjacent an inner wall of an annulus fibrosus. 143. The method of claim 136 or 137 wherein activating the electrode comprises delivering radiofrequency energy from the electrode to multiple locations in the intervertebral disc. 144. The method of claim 143 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations simultaneously. 145. The method of claim 143 wherein delivering radiofrequency energy to multiple locations comprises delivering radiofrequency energy from the electrode to the multiple locations serially. 146. The method of claim 136 or 137 further comprising advancing the electrode along an inner wall of an annulus fibrosus. 147. The method of claim 1 wherein advancing the member into the nucleus pulposus comprises conforming the member sufficiently to an inner wall of an annulus fibrosus to contact multiple locations on the inner wall. 148. A method of delivering energy to an intervertebral disc, comprising: positioning an energy delivery device adjacent an inner wall of the disc, and shrinking the nucleus pulposus. 149. The method of claim 148 wherein positioning the energy delivery device further comprises positioning an energy delivery element of the device adjacent a bulge in the intervertebral disc. 150. The method of claim 148 further comprising monitoring temperature. 151. The method of claim 150 further comprising controlling energy delivery based on the monitored temperature. 152. The method of claim 148 further comprising providing a catheter including the energy delivery device. 153. The method of claim 152 further comprising introducing the catheter into the intervertebral disc and advancing the catheter along the inner wall of the disc.
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