WO2005102440A2 - Spinal diagnostic methods and apparatus - Google Patents
Spinal diagnostic methods and apparatus Download PDFInfo
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- WO2005102440A2 WO2005102440A2 PCT/US2005/012981 US2005012981W WO2005102440A2 WO 2005102440 A2 WO2005102440 A2 WO 2005102440A2 US 2005012981 W US2005012981 W US 2005012981W WO 2005102440 A2 WO2005102440 A2 WO 2005102440A2
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- disc
- distal portion
- introducing
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00261—Discectomy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00469—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for insertion of instruments, e.g. guide wire, optical fibre
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
- A61B2017/3488—Fixation to inner organ or inner body tissue
Definitions
- the present invention generally relates to medical devices and methods. More particularly, the present invention relates to devices and methods for diagnosing and/or treating spinal pain.
- back pain is not only extremely common, but can also be difficult to accurately diagnose and effectively treat. Challenges stem from the fact that it is often difficult to pinpoint exactly what is causing a patient's pain or even where the pain originates. Although a number of effective treatments exist for various types of back pain, a number of them are highly invasive and may actually exacerbate pain or cause pain in other parts ofthe back. Therefore, due to the challenges involved in diagnosing and treating back pain, and fueled by the large number of patients suffering from back pain, improved diagnostic and treatment methods and devices and constantly being sought.
- Back pain may be classified into two general categories: (1) "axial spinal pain,” which arises from pathology or dysfunction in the structural components ofthe spine, such as the vertebrae or the intervertebral discs between the vertebrae; and (2) "radicular pain,” which originates from pressure on or irritation of nerve roots.
- Radicular pain is often relatively simple to diagnose and pinpoint, because pain tends to radiate from irritated nerve roots out into the body in predictable patterns, and nerve root compression can often be seen on an MRI study or other radiological study ofthe spine. Treatment of radicular pain is also often quite straightforward, typically involving injections or surgical procedures to decrease inflammation in or remove the structures impinging on the effected nerve root.
- Discogenic pain is a type of spinal pain originating in one or more intervertebral discs (soft tissue structures between vertebrae ofthe spine), is particularly difficult to diagnose and pinpoint to one or more specific discs.
- the physical examination and complaints ofthe patient typically provide only general clues as to the actual cause and originating location ofthe pain, and no currently available radiological studies can accurately assess which of a patient's discs (if any) is causing discogenic pain. Adding to the difficulty of diagnosis is the fact that many different factors may lead to discogenic pain.
- the most commonly performed surgipal procedure for treating discogenic pain is spinal fusion, in which adjacent vertebrae above and below the disc causing pain are fused together to prevent motion, thus bypassing the painful disc.
- Spinal fusion can be a very effective treatment, but it is relatively costly and invasive, and may be associated with a prolonged recovery and a number of potential complications. For example, fusion may sometimes lead to accelerated degeneration of one or more discs adjacent the treated disc due to increased forces placed on the adjacent discs from the fusion.
- Another possible treatment of discogenic pain involves replacement ofthe disc with an artificial (prosthetic) disc. This treatment may allow for better patient mobility than spinal fusion, but this treatment option is still in its infancy. Regardless ofthe method used to treat discogenic pain, an accurate diagnosis is essential for the treatment's success.
- a diagnostic test referred to as "discography” is the most commonly used and accepted diagnostic technique. Discography involves inserting a needle into an intervertebral disc and injecting a contrast dye into the compliant inner core ofthe disc (the nucleus pulposus) under pressure. A radiograph (or "X-ray") ofthe spine is then taken. Sometimes, anatomical defects ofthe disc, such as tears in the fibrous outer layer ofthe disc (the annulus fibrosis) can been seen on a radiograph, which may be indicative of a possible cause of pain.
- the injection of contrast into the disc under pressure has been shown to sometimes cause the patient to feel pain, caused by the chemical composition ofthe contrast and/or by increased pressure within the nucleus pulposus. Sometimes this pain mimics the back pain that the patient usually feels during daily activities.
- the physician attempts to determine whether the particular disc is causing the patient's pain, hi some instances, multiple discs on one patient are injected during a diagnostic procedure.
- a number of currently available epidural catheters and techniques provide for injecting substances, typically anesthetics, into an epidural space of a spine.
- substances typically anesthetics
- Examples of such epidural catheters are described in U.S. Patent Nos.: 3,885,561; 4,737,146; 4,973,305; 5,004,456; 5,024,655; 5,084,016; 5,129,889; 5,234,406; 5,344,439; 5,800,407; 6,676,643 and 6,368,315.
- Such catheters are not adapted for delivery into an intervertebral disc.
- injecting substances into the epidural space is not helpful for diagnosing discogenic pain.
- Methods and devices ofthe present invention generally facilitate diagnosis, and in some cases treatment, of discogenic pain. More specifically, methods and devices ofthe invention help determine whether one or more intervertebral discs in a patient are actually causing the patient's back pain, and also help pinpoint which disc or discs are causing the pain.
- a distal portion of a catheter device is positioned transannularly or transosseously in an intervertebral disc that is thought to be the cause ofthe patient's pain.
- One or more anchoring members are then used to maintain the distal portion in the disc. The patient is asked to assume a position or perform a task, such as bending over, which typically causes the patient to experience back pain.
- one or more substances such as an anesthetic or analgesic
- an anesthetic or analgesic
- the patient reports whether the anesthetic has alleviated the pain.
- additional mtervertebral discs may be tested, one or more placebo injections may be used, a conventional discography may be added to the procedure and/or the like.
- a determination may be made as to whether one or more specific discs are causing the patient's pain. Diagnostic and treatment decisions may be based on such a determination.
- An "intervertebral disc” is generally refened to herein as soft tissue between any two adjacent vertebrae.
- An intervertebral disc generally includes a fibrous outer layer called the “annulus fibrosis” and a more compliant inner core called the “nucleus pulposus.”
- substances may be introduced into an annulus fibrosis, nucleus pulposus, or both.
- one or more substances may be introduced into such soft tissues as well.
- devices and methods for diagnosing discogenic pain may also be used for treating pain.
- Catheter devices ofthe invention generally include one or more anchoring members for maintaining a distal portion ofthe catheter device in a position within a disc.
- a catheter device may be coupled with, for example, an implantable pump or injection port, and the pump or port may be used to supply one or more substances, such as anesthetic or analgesic, to the disc to treat a patient's back pain.
- substances such as anesthetic or analgesic
- Many other substances may be introduced to the disc, as discussed fully below, and other treatment modalities are possible, such as transcutaneous electrical nerve stimulation (TENS).
- TNS transcutaneous electrical nerve stimulation
- a method for introducing one or more substances into an intervertebral disc involves positioning a distal portion of a catheter device in the disc, anchoring the distal portion ofthe catheter device to maintain the distal portion in the disc, and introducing at least one substance into the disc through the catheter device.
- a number of different methods for positioning the distal portion may be employed in various embodiments ofthe invention.
- the catheter device is passed through a lumen of an introducer device.
- positioning the distal portion ofthe catheter involves passing the catheter device through the lumen ofthe introducer device over a pointed stylet, piercing through an annulus fibrosis ofthe disc using the stylet, and withdrawing the stylet from the catheter device, hi an alternative embodiment, positioning the distal portion involves piercing through an annulus fibrosis ofthe disc into the disc with a tapered distal end ofthe catheter device.
- the catheter device is passed over a guidewire.
- the introducer device may either be advanced to a position within the disc or to a position just outside the disc.
- the catheter device may have a distal end or portion configured to facilitate advancement ofthe distal end through the annulus fibrosis.
- the catheter device is passed over a guidewire.
- the catheter is passed over the guidewire within the needle, while in alternative embodiments the introducer is removed over the guidewire before the catheter device is passed over the guidewire.
- positioning the distal portion is facilitated by visualizing at least one radioopaque marker or material at or near the distal portion to assess its location.
- anchoring the catheter device involves deploying one or more anchoring members disposed along the catheter body.
- anchoring members may be disposed at or near the distal portion ofthe catheter, while in other embodiments anchoring may occur at locations farther from the distal portion.
- anchoring may be achieved by using a separate anchoring device, such as by applying adhesive, suture or the like to anchor the catheter to the patient in a desired position.
- anchoring involves inflating at least a first expandable member in the disc.
- this technique may further involve inflating at least a second expandable member adjacent an outer surface of the disc, such that there is one inflatable member in the disc and another inflatable member just outside the annulus fibrosis.
- anchoring comprises deploying at least one mechanism along the distal portion ofthe catheter device to increase the effective cross- sectional diameter ofthe catheter at one or more locations.
- the cross-sectional diameter is increased by releasing one or more shape memory or spring loaded members from constraint
- the cross-sectional diameter may be increased by actuating one or more mechanical members or moving an inner catheter shaft of the catheter device relative to an outer catheter shaft ofthe catheter device to cause one or more anchoring members to buckle outwards.
- anchoring comprises causing at least part ofthe distal portion to change from a substantially straight shape to a substantially curved or geometric shape.
- anchoring comprises attaching part ofthe distal portion to an annulus fibrosis ofthe disc.
- the attachment member may be screwed, twisted or pierced into the annulus fibrosis in various embodiments.
- the access and treatment catheters ofthe present invention can be modified to promote tissue growth on or into at least selected portions ofthe catheter.
- tissue growth promotion could be accomplished by modifying the exterior texture or shape ofthe catheter exterior, or by providing additional physical structure which would promote tissue ingrowth and attachment.
- the catheter could be provided with an osteogenic substance, drug, or chemical to promote the desired tissue attachment.
- tissue attachment can be promoted in bone, muscle, fibrotic tissue, scar tissue, chondrocytes, or other tissue which occurs in or around the disc space of vertebral bodies. Anchoring by promoting tissue ingrowth is particularly useful when the catheter will be implanted for an extended length of time, as will often be the case for therapeutic treatment protocols.
- the substance (or substances) introduced into the disc may be any suitable substance, typically introduced for diagnosis and/or treatment of discogemc pain, but in alternative embodiments for any other suitable pu ⁇ ose. Any suitable combination of substances may be introduced, either simultaneously or sequentially, for diagnosis, treatment or other pu ⁇ oses. In some embodiments, one or more placebo substances may be introduced into one or more discs, typically to assist in diagnosis but in other embodiments for study or experimental pu ⁇ oses or the like.
- introduced substance(s) may include, but are not limited to, an anesthetic; an analgesic; an antibiotic; a hydrating agent such as hypotonic saline, isotonic saline or hypertonic saline; a supportive agent such as a hydrogel, ethylene- vinyl alcohol copolymer, Dimethyl Sulfoxide or Tantalum; a prolotherapy agent such as sodium morrhuate, cod oil, phenol, minerals or ethyl alcohol; and other agents such as collagen, stem cells, Osteogenic Protein- 1, ethanol, alcohol, steroids, radio-opaque contrast agents, ultrasound contrast agent, Bone Mo ⁇ hogenetic Protein (BMP), BMP-2, BMP-4, BMP-6, BMP-7, BMP-12, Serotonin 5-HT2A receptor inhibitors, LMP-1, TMP-l, TGF-1, TGF-2, Rofecoxib, Ketorolac, Glucosamine, Chondroitin Sulfe, aceta
- anesthetics and analgesics include, but are not limited to lidocaine, chloroprocaine, mepivacaine, ropivacaine, xylocaine, prilocaine, mo ⁇ hine, bupivocaine, marcaine, 2-chloroprocain, fentanyl, diamo ⁇ hine, meperidine, methadone, alfentanil, hydromo ⁇ hone, lofentanil, sufentanil, bupreno ⁇ hine, other opiates, adrenergic agonists, somatostatin analogs, calcium channel blockers, ⁇ -methyl-D-aspartate receptor antagonists, ketamine, benzodiazepines, klonidine, tizanidine, midazolam, levo ⁇ hanol, heterocyclic antidepressants, nonheterocyclic, serotonin-enhancning antidepressants, GABA analogues, psycho genie
- antibiotics include, but are not limited to, Penicillins, Cephalosporins, Tetracycline, Erythromycin, Clindamycin, Nancomycin, Bacitracin, Doxycycline, Ampicillin, Levaquin, Metronidazole, Azithromycin, Ciprofloxacin, Augmentin, Bactrim, TMP-SMX, Rocephin, Gentamycin, Keflex and Macrobid.
- the method further involves, before introducing the substance, causing the patient to assume a position in which substantial spinal pain is experienced.
- the substance introduced is often an anesthetic or analgesic, and determimng whether the patient feels the spinal pain after introduction ofthe substance helps determine whether pain is caused by that particular disc.
- Such a method may optionally further include positioning a distal portion of a second catheter device in a second intervertebral disc, anchoring the distal portion ofthe second catheter device to maintain the distal portion in the second disc, and introducing at least one substance into the second disc through the second catheter device.
- the method may also involve, before introducing the at least one substance into the second disc, causing the patient to assume a position in which substantial spinal pain is experienced, wherein the at least one substance includes at least one anesthetic or analgesic.
- the method involves determining which ofthe discs into which the at least one substance was introduced is causing the patient's spinal pain.
- Such methods may optionally further include performing a discography procedure on the intervertebral disc before positioning the distal portion ofthe catheter device in the disc.
- the discography procedure may be performed on the intervertebral disc after introducing the at least one anesthetic.
- the at least one substance is introduced into the disc (or into multiple discs) automatically over a period of time. This may involve, for example, coupling the catheter device with an automated injection device, which will allow the patient to rest alone in a clinic or hospital room, assume various back-pain-generating positions or the like, while various substances are being introduced into one or more discs.
- such a method may also include recording one or more patient inputs describing back pain experienced by the patient.
- Some embodiments ofthe method further include leaving the catheter device in position with the distal portion in the disc and administering the at least one substance over time to provide treatment of spinal pain.
- the substance(s) may be administered over time via a subcutaneous injection port or implanted pump, the method further comprising coupling the catheter device to the subcutaneous injection port or implanted pump.
- the substance(s) may be administered over time via any other suitable combination of devices or other means.
- a method for identifying an intervertebral disc that is causing pain involves positioning a distal portion of a catheter device in a disc of a patient, anchoring the distal portion ofthe catheter device to maintain the distal portion in the disc, causing the patient to assume a position in which substantial spinal pain is experienced, and introducing at least one substance into the disc through the catheter.
- the method may include any ofthe features, steps or variations described above.
- a catheter device for introducing one or more substances into an intervertebral disc comprises an elongate flexible catheter body and at least one anchoring member disposed along the catheter body for anchoring at least part ofthe distal portion ofthe catheter in the intervertebral disc.
- the catheter body itself has a proximal portion, a self-introducing distal portion for facilitating penetration of an annulus fibrosis ofthe disc, and at least one lumen for introducing one or more substances into the intervertebral disc.
- self-introducing it is meant that the distal portion ofthe catheter body has at least one feature that facilitates penetration of an annulus fibrosis by the distal portion.
- the anchoring member is disposed on or near the distal portion ofthe catheter, while in other embodiments it may be located farther from the distal portion or may even be a separate device used to anchor the catheter.
- the anchoring member (or multiple anchoring members) ofthe catheter device may take any of a number of various forms.
- the anchoring member comprises at least one expandable member coupled with an inflation lumen.
- the anchoring member comprises at least one shape memory, spring loaded or mechanically activated member for increasing the effective cross-sectional diameter ofthe catheter body at or near the distal portion.
- the anchoring member may comprise at least one outwardly buckling member coupled with an inner catheter shaft and an outer catheter shaft ofthe catheter body so as to outwardly buckle when the inner shaft is moved axially relative to the outer shaft.
- the anchoring member comprises at least one attachment member for attaching to an annulus fibrosis ofthe disc.
- Such an attachment member may include at least one threaded surface, spiral needle or the like.
- the anchoring member comprises at least one deformable member to change at least part ofthe distal portion from a substantially straight shape to a substantially curved or geometric shape.
- the catheter body may have any suitable configuration, dimensions, features or the like.
- the self-introducing distal portion ofthe catheter body comprises at least one pushable portion, the pushable portion having a stiffness greater than adjacent portions ofthe catheter body.
- the self- introducing portion may further comprise a tapered distal end ofthe catheter device.
- the device may include a pointed stylet removably disposed within a lumen of the catheter device for piercing through the annulus fibrosis ofthe disc.
- the catheter body includes a friction resistant outer surface.
- the outer diameter ofthe catheter body is less than 2 mm.
- a cross-sectional diameter ofthe catheter body is larger near a proximal end ofthe body than near a distal end ofthe body.
- the catheter body may also include an outer surface having one or more markings for indicating depth of insertion ofthe catheter device into a patient's body, h alternative embodiments, the catheter body may include an outer surface having two or more different colors for indicating depth of insertion ofthe catheter device into a patient's body.
- the catheter body may further include at least one radioopaque marker or material for facilitating visualization ofthe catheter device in a patient.
- the catheter device includes an injection tube extending through at least part ofthe lumen ofthe catheter body for introducing one or more substances into the disc and an inflation tube extending through at least part ofthe lumen for expanding the deployable anchoring member.
- the injection tube may be made of any suitable material or combination of materials, such as but not limited to stainless steel, tempered stainless steel, annealed stainless steel, polymers, and superelastic alloys.
- the injection and inflation tubes exit a proximal end ofthe catheter body and are removably coupled with at least one adapter to provide for injection and inflation.
- the injection and inflation tubes extend through at least part ofthe catheter body lumen coaxially.
- the injection and inflation tubes may extend through at least part ofthe catheter body lumen side-by-side.
- the injection and inflation tubes may extend through part ofthe catheter body lumen coaxially and through another part ofthe lumen side-by-side.
- the catheter body does not include injection and inflation tubes but instead comprises a single extrusion having an injection lumen for introducing one or more substances into the disc and an inflation lumen for expanding the at least one anchoring member.
- the catheter device may have any suitable proximal end configurations for providing connection to one or more injection, inflation, suction, irrigation or other devices, for providing guidewire access and/or the like.
- a proximal end ofthe proximal portion ofthe catheter body is bifurcated into two separate catheter body proximal ends.
- each ofthe two proximal ends is removably coupled with an adapter for facilitating injection or inflation via either end.
- Some embodiments ofthe device also include a guidewire having a distal end shaped to maintain the distal end within the disc. Such a distal end may include, for example, a double guidewire, a coil or a pigtail.
- Such guidewires can be made from any conventional guidewire material, including stainless steels and superelastic materials such as nickel-titanium alloys. Generally, the use of superelastic guidewires is preferred since other materials, such as stainless steel, may inadvertently kink in a location distal to the tip ofthe catheter as it is being advanced. If the guidewire kinks, it can be difficult to remove the guidewire from the catheter, interfering with the remainder ofthe procedure.
- the guidewire will have a small diameter, and superelastic materials, such as nitinol, have low visibility under fluoroscopic imaging.
- the radioopacity ofthe guidewire can be improved by adding a radiopaque material in a variety of conventional ways.
- the guidewire can be coated with the radioopaque material, a radioopaque core may be provided within the guidewire, a radioopaque material may be braided over the guidewire, or the material provided as ring-like markers.
- Such coated guidewires having improved radioopacity can be manufactured in a variety of ways, including sputtering, electroplating, electroless plating, and the like.
- a system for introducing one or more substances into an intervertebral disc includes an introducer device and a catheter device passable through the introducer device.
- the catheter device includes an elongate flexible catheter body and at least one deployable anchoring member disposed along the catheter body for anchoring at least part ofthe distal portion ofthe catheter in the disc.
- the catheter body includes a proximal portion, a self-introducing distal portion for facilitating penetration of an annulus fibrosis ofthe disc, and at least one lumen for introducing one or more substances into the intervertebral disc.
- the catheter device may include any of the features, configurations or combinations described above.
- the system further includes a pointed stylet removably disposed within a lumen ofthe catheter device for piercing through the annulus fibrosis.
- the system includes a guidewire over which the catheter device may be passed within the introducer device.
- the catheter device and introducer device may have any suitable dimensions, but in one embodiment the outer diameter ofthe catheter body is less than 2 mm.
- An inner diameter ofthe needle in some embodiments, is between about 0.1 mm and about 0.01 mm larger than the outer diameter ofthe catheter body.
- the system may further include an automatic injection device removably coupled with the catheter device for automatically introducing the at least one substance into the disc.
- an automatic injection device removably coupled with the catheter device for automatically introducing the at least one substance into the disc.
- These or other embodiments may optionally further include a recording device for recording patient inputs describing pain felt by a patient.
- a kit for introducing one or more substances into an intervertebral disc includes a catheter device, at least one implantable device removably couplable with the catheter device for introducing the one or more substances into a disc over time, and instructions for using the catheter device and implantable device.
- the catheter device includes: an elongate flexible catheter body having a proximal portion, a self-introducing distal portion for facilitating penetration of an annulus fibrosis ofthe disc, and at least one lumen for introducing one or more substances into the intervertebral disc; and at least one anchoring member disposed along the catheter body for anchoring at least part ofthe distal portion ofthe catheter within the disc.
- This catheter device may have any ofthe features described above.
- the implantable device may include any of a number of suitable devices in various embodiments.
- the implantable device comprises a pump.
- the implantable device comprises an injection port.
- the kit may also include one or more additional devices, such as but not limited to an introducer device for facilitating positioning ofthe catheter device in the disc, a pointed stylet removably disposed within a lumen ofthe catheter device for piercing through the annulus fibrosis and/or a guidewire passable through the needle.
- additional devices such as but not limited to an introducer device for facilitating positioning ofthe catheter device in the disc, a pointed stylet removably disposed within a lumen ofthe catheter device for piercing through the annulus fibrosis and/or a guidewire passable through the needle.
- FIGs. 1 A-1K illustrate a method for positioning a catheter device to introduce a substance into an mtervertebral disc, shown from a transverse cross-section ofthe spinal column, according to one embodiment ofthe present invention.
- Figs. IL and IM illustrate catheter introduction needles having sha ⁇ ened tips (Fig. IL) and atraumatic tips (Fig. IM).
- Fig. IN illustrates a catheter-introducing needle having an axial slot and frangible cover to facilitate removal ofthe needle from over the catheter after the catheter has been implanted.
- FIGs. 2A and 2B illustrate part of a method for positioning a catheter device to introduce a substance into an intervertebral disc using a pointed stylet, according to one embodiment ofthe present invention.
- Fig. 2C illustrates a catheter device in place for introducing a substance into an intervertebral disc and an introducer device being split, according to another embodiment of the present invention.
- Figs. 2D and 2E illustrate catheters and stylets having modified distal ends to enhance coupling during introduction ofthe catheter and stylet assemblies.
- FIGs. 3 A and 3B are perspective and cross-sectional views, respectively, of a distal end of a catheter device, according to one embodiment ofthe present invention.
- FIGs. 4A and 4B are cross-sectional views of a distal end of a catheter device with an anchoring member in an undeployed and deployed state, respectively, according to one embodiment ofthe present invention.
- FIGs. 5 A and 5B are cross-sectional views of a distal end of an alternative catheter device with an anchoring member in an undeployed and deployed state, respectively, according to another embodiment ofthe present invention.
- Figs. 6A and 6B are cross-sectional views of a distal end of an alternative catheter device with an anchoring member in an undeployed and deployed state, respectively, according to another embodiment ofthe present invention.
- Figs. 7A and 7B are perspective views of a distal end of an alternative catheter device with an anchoring member in an undeployed and deployed state, respectively, according to another embodiment ofthe present invention.
- Fig. 8 illustrates a catheter device having a deforming, anchoring distal portion, according to one embodiment ofthe present invention.
- Fig. 9 illustrates a catheter device having a deforming, anchoring distal portion, according to another embodiment ofthe present invention.
- Fig. 10A illustrates a longitudinal cross-section of a spinal column with a catheter device with a radially symmetric anchor, according to one embodiment ofthe present invention.
- Fig. 10B illustrates a longitudinal cross-section of a spinal column with a catheter device with a radially asymmetric anchor, according to another embodiment ofthe present invention.
- Fig. 10C illustrates a longitudinal cross-section of a spinal column with a catheter device with an elliptical shaped anchor, according to another embodiment ofthe present invention.
- Fig. 10D illustrates a longitudinal cross-section of a spinal column with a catheter device with a non-spherically shaped anchor, according to another embodiment ofthe present invention.
- FIG. 11 illustrates a spiral anchor for attaching to the annulus fibrosis of an intervertebral disc, according to one embodiment ofthe present invention.
- Fig. 12 illustrates a distal end of a catheter device having a threaded portion for attaching to an annulus fibrosis of an intervertebral disc, according to one embodiment ofthe present invention.
- Fig. 13 illustrates a catheter device having two anchoring members for anchoring inside and outside an annulus fibrosis of an intervertebral disc, according to one embodiment ofthe present invention.
- Fig. 14 illustrates a catheter device coupled with an implanted device for facilitating delivery of substances to the intervertebral disc, according to one embodiment ofthe present invention.
- Figs. 14A and 14B illustrate introduction of a treatment or other access catheter into a disc space using a transosseous approach.
- Fig. 15A illustrates a catheter device passed over a guidewire having a spiral-shaped distal end, according to one embodiment ofthe present invention.
- Fig. 15B illustrates a catheter device passed over a guidewire having a zigzag- shaped distal end, according to another embodiment ofthe present invention.
- Figs. 16A and 16B illustrate a double- wire guidewire in undeployed and deployed states, respectively, according to one embodiment ofthe present invention.
- FIGs. 17A and 17B are perspective and cross-sectional views, respectively, of a proximal adapter for use with a catheter device, according to one embodiment ofthe present invention.
- Methods, devices and systems ofthe present invention generally provide for introduction of one or more substances into an intervertebral disc to facilitate diagnosis and/or treatment of discogenic pain (i.e., back pain originating in one or more intervertebral discs).
- Methods, devices and systems may be used alone or in conjunction with other methods or devices that are currently known or hereafter developed, such as discography, radiological studies, physical examination and/or the like.
- methods and devices ofthe invention maybe used for pmposes other than diagnosis or treatment, such as for study or experimental pu ⁇ oses or the like. Therefore, although the following description focuses on diagnostic and therapeutic applications, various embodiments may be used for any other suitable application.
- an intervertebral disc D includes an annulus fibrosis AF surrounding a nucleus pulposus NP, and is positioned adjacent a spinous process of a vertebra V. Anatomically, the disc D is sandwiched between two vertebrae ofthe spine (not shown), which lie on top of and beneath the disc D.
- an introducer device 2 and a pointed obturator 4 are introduced together through the skin S of a patient's back to position their distal ends near the intervertebral disc D.
- Introducer device 2 and obturator 4 may have any suitable dimensions, but in one embodiment introducer device 2 is about 18-22 gauge and obturator 4 is about 20- 25 gauge.
- obturator 4 is then removed, leaving introducer device 2 in place.
- an injection needle 6 is then passed through introducer device 2 and through the annulus fibrosis AF to position its distal tip in the nucleus pulposus NP. Position of introducer device 2 and/or injection needle 6 may be confirmed using x-ray, fluoroscopy, or other suitable means.
- contrast dye may be injected through injection needle 6, and the appearance ofthe contrast dye in the disc as well as the patient's response to the injection may be monitored. This part ofthe procedure generally describes a known discography procedure. In alternative embodiments, discography may be performed at a later time or no discography may be performed.
- a guidewire 8 may be passed through injection needle 6 into the disc, as shown in Fig. ID.
- Injection needle 6 may then be removed, as shown in Fig. IE, and a catheter device 10 may be passed over guidewire 8 through introducer device 2, as shown in Fig. IF.
- Catheter device 10 is described in further detail below, but in one embodiment it may include two or more tubes, such as a guidewire tube 11 and an injection or inflation tube 12, which may separate proximally to attach to multiple adapters or the like.
- introducer device 2 may be removed, as shown in Fig. 1G, and adapters 13 and 14 may be coupled with the proximal ends of tubes 11 and 12.
- Adapters 13, 14 may facilitate guidewire passage, inflation of an expandable member, injection of one or more substances into the disc and/or the like.
- anchoring member 16 disposed along catheter 10 are deployed to maintain a distal portion of catheter 10 in the disc.
- anchoring member 16 comprises an expandable balloon, but as is described in more detail below, many other types of anchoring members may be used in various alternative embodiments.
- guidewire 8 may be removed.
- a marker expandable member 17 may be deployed outside the patient's body. With anchoring member 16 and thus the distal portion of catheter 10 in place in the disc, one or more substances are introduced into the disc through catheter 10.
- a conventional needle having a sha ⁇ ened tip as illustrated in Fig. IL presents a risk of damaging the catheter, particularly as the catheter may be retracted proximally through the needle.
- an introducer "needle" having a blunt, rounded, or other atraumatic tip as illustrated in Fig. IM.
- the atraumatic tip can be square-cut and the edges rounded to form a smooth surface which will not damage the catheter as it is advanced or retracted through the lumen ofthe needle.
- the tip could also be made of a softer material, a more flexible material, be coated with a lubricious material or otherwise modified to reduce the risk of damaging the catheter.
- the needle may be introduced using a stylet having a sha ⁇ ened tip.
- a sha ⁇ ened needle as illustrated in Fig. IL or atraumatic needle as illustrated in Fig. IM it will often be desirable to remove the needle.
- the catheter has a proximal hub or other enlarged features, it may not be possible to draw the needle proximally over the enlarged structure.
- it will often be desirable to use a needle 6 having an axial slot 6A, optionally covered by a frangible outer sheath, cover, or tube 7.
- the width ofthe slot 6A will be sufficient to permit the catheter to pass, and the outer tube or sheath 7 prevents accidental passage ofthe catheter through the slot 6 A while the catheter is being introduced.
- the material ofthe tube 7 should be strong enough to contain the catheter during delivery, but still provide for easy longitudinal tearing when it is desired to withdraw the needle over the catheter.
- Suitable materials include polyester, PET, FEP, PTFE, polyolefins, nylons, PVCs, neoprenes, and other materials. Many ofthe materials may be heat-slirunk over the needle shaft.
- the needle shaft will typically be a metal, such as stainless steel or nitinol, but could also be composed of a polymer having sufficient strength such as a polycarbonate, a polyethylene, PEEK, a nylon, a polypropylene, or the like.
- the axial slot 6A may be formed in the needle by cutting or machining the opening, typically for metal needle shafts, or by extruding the material that has a C-shaped cross-section, typically for polymers. Although usually being straight, the longitudinal opening 6A could have other geometries, such as spiral, zigzag, or other arbitrary shape.
- the outer tube 7 may be opened by tearing, shearing, and the like, and may be pre-scored, perforated, or otherwise weakened to assist in separation. In addition to heat- slirinking, the outer tube could be attached to the shaft ofthe needle by melting, adhesfves, or the like.
- FIGs. 2A and 2B illustrate part of an alternative embodiment of a method for passing a catheter device 20 into a disc for introducing one or more substances.
- catheter device 20 is passed through an introducer device 22 with a pointed stylet 24 extending through a lumen of catheter 20 and out its distal tip.
- Stylet 24 enables catheter 20 to be passed through the tough annulus fibrosis AF without the help of a guidewire and injection needle.
- Stylet 24 is then removed, as shown in Fig. 2B, to leave catheter 20 in position for anchor deployment and substance introduction.
- Stylets such as illustrated in Figs. 2A and 2B are usually much more rigid in both the axial and bending directions than the catheter which is being advanced.
- the catheter can freely slide relative to the stylet.
- the tips ofthe stylet and the catheter can be modified to hold them together.
- the stylet 24 may have a step or other geometry at its distal end which mates with a complementary shape formed inside the distal tip ofthe catheter 20, as illustrated in Fig. 2D.
- the stylet 24 may have a tapered or cone-shaped distal end which mates with a similar shape in the distal end ofthe catheter 20, as illustrated in Fig. 2E.
- the distal ends ofthe catheter and the stylet could also be modified to have mating threaded ends for a more secure but still releasable attachment.
- the distal tips ofthe stylets may be made to be radioopaque in order to enhance fluoroscopic imaging.
- the distal portions ofthe stylets 24 could be composed at least partly, or plated with, a radioopaque material such as platinum, iridium, or gold.
- the remaining portions ofthe stylet may be made from stainless steel, nitinol, or other materials having the desired column strength and flexibility to provide for "pushability" ofthe combination of stylet 24 and catheter 20.
- split-away introducer device 23 may be used just as the introducer devices have been described above. Rather than removing split-away introducer device 23 by sliding it off the proximal end of catheter device 21, however, split-away introducer device 23 is split along its length to be removed from catheter device 21.
- Split- away introducer device 23 may be constructed from any suitable material or materials so as to readily tear, crack, fissure, rip or separate along the length of needle 23. Splitting may be accomplished by including a perforation, thin section or other weakness along the length of needle 23.
- a catheter device is in place, with a distal portion residing in a disc and one or more anchoring members deployed to maintain the catheter's position, the patient is instructed to assume a position or perform a task that typically causes the patient pain, such as bending over to pick up an object or the like.
- a substance is then introduced into the disc, and the patient is asked to relate whether pain is lessened, eliminated, remains the same or the like.
- the patient is asked to rate the experienced pain on a scale of 1 to 10 before and after introduction of substances into the disc.
- the substance introduced is an anesthetic or analgesic, and thus may alleviate the patient's pain if injected into the disc that is actually causing the pain, hi some instances multiple injections are performed, and one or more injected substances may be placebos, to test the accuracy of the test results.
- testing may be performed either alone or before or after traditional discography.
- multiple discs of one patient may be accessed and tested.
- testing may be performed over a prolonged period of time, to test multiple discs and/or to enhance the accuracy or certainty of test results.
- any of a number of different substances may be introduced into a disc.
- pu ⁇ oses such as diagnosis or treatment of discogenic pain, study pu ⁇ oses or experimentation or the like
- introduction of different substances maybe warranted.
- examples of possible substances that may be introduced into a disc include, but are not limited to anesthetics; analgesics; antibiotics; hydrating agents such as hypotonic saline, isotonic saline or hypertonic saline; supportive agents such as a hydrogel, ethylene- vinyl alcohol copolymer, Dimethyl Sulfoxide or Tantalum; prolotherapy agents such as sodium morrhuate, cod oil, phenol, minerals or ethyl alcohol; and/or other agents such as collagen, stem cells, Osteogenic Protein- 1, ethanol, alcohol, steroids, radio-opaque contrast agents, ultrasound contrast agent, Bone Mo ⁇ hogenetic Protein (BMP), BMP-2, BMP -4, BMP-6, BMP-7, B
- BMP Bone
- anesthetics and analgesics include, but are not limited to lidocaine, chloroprocaine, mepivacaine, ropivacaine, xylocaine, prilocaine, mo ⁇ hine, bupivocaine, marcaine, 2-chloroprocain, fentanyl, diamo ⁇ hine, meperidine, methadone, alfentanil, hydromo ⁇ hone, lofentanil, sufentanil, bupreno ⁇ hine, other opoids, adrenergic agonists, somatostatin analogs, calcium channel blockers, N-methyl-D-aspartate receptor antagonists, ketamine, benzodiazepines, klonidine, tizanidine, midazolam, levo ⁇ hanol, heterocyclic antidepressants, nonheterocyclic, serotonin-enhancning antidepressants, GABA analogues, psychogenic amine
- antibiotics include, but are not limited to, Penicillins, Cephalosporins, Tetracycline, Erythromycin, Clindamycin, Vancomycin, Bacitracin, Doxycycline, Ampicillin, Levaquin, Metronidazole, Azithromycin, Ciprofloxacin, Augmentin, Bactrim, TMP-SMX, Rocephin, Gentamycin, Keflex and Macrobid.
- the method further includes leaving the catheter device in place to provide treatment of a patient's back pain, such as with anesthetic or analgesic agent(s) or other substances.
- the catheter device may be coupled with an implantable pump, injection port or other device to provide such treatment.
- catheter device 30 suitably includes a catheter body 32, which includes an expandable anchoring member 36, houses an inflation tube 34 and an injection tube 38, and has several radioopaque markers 33 disposed along its distal portion.
- Anchoring member 36 enables a distal portion of catheter device 30 to be maintained in a position within a disc.
- Inflation tube 34 is used to expand anchoring member 36, which in the embodiment shown comprises an expandable balloon.
- Injection tube 38 is used to introduce one or more fluids into the nucleus pulposus ofthe disc.
- Radioopaque markers 33 facilitate visualization ofthe distal portion of catheter device 30 so that its location may be assessed before, during or after a diagnostic or therapeutic procedure.
- the distal portion of catheter device 30 may have one or more features that facilitate advancement ofthe distal portion through an annulus fibrosis of an intervertebral disc.
- a distal portion having one or more such features is generally referred to as "self-introducing.” Therefore, by “self-introducing” it is meant simply that the distal portion has one or more features for facilitating its passage through annulus fibrosis tissue.
- Such features may include, for example, one or more sections on a catheter shaft that are stiffer than adjacent sections to help make the shaft pushable.
- Another feature may comprise a tapered or pointed distal tip for piercing through annulus fibrosis.
- catheter device 30 may be coupled with a removable, pointed stylet.
- catheter device 30 may be constructed from any suitable materials and may have any suitable shapes, sizes, dimensions or the like in various embodiments.
- the cross-sectional diameter of catheter body 32 decreases along its length from its proximal end to its distal end. Such a tapered configuration may allow catheter device 30 to be easily introduced through an introducer device.
- the outer diameter of catheter body 32 will also generally be slightly smaller than an inner diameter of an introducer device.
- catheter body 32 has an outer diameter of about 2 mm or less along at least part of its length.
- catheter body 32 may comprise a rigid single polymer or a composite consisting of reinforced metallic or polymeric components.
- Metallic components may include, for example, stainless steel, nitinol or other superelastic alloys.
- Polymers may include, but are not limited to Polyetheretherketone (PEEK), Polyether Block Amide (PEBAX), Nylon, Polyester, Polyolefin, polyamide, Polyimide, Polycarbonate, Polypropylene, Fluorinated Ethylene Polymer (FEP), Perfluoroalkoxy (PFA), Polytetrafluoroethylene-Perfluoromethylvinylether (MFA), Polyurethane or Low density polyethylene (LDPE).
- PEEK Polyetheretherketone
- PEBAX Polyether Block Amide
- Nylon Polyamide
- Polyimide Polycarbonate
- FEP Fluorinated Ethylene Polymer
- PFA Perfluoroalkoxy
- MFA Polytetrafluoroethylene-Perfluoromethylvinylether
- Such materials may be reinforced with coils or braids in some embodiments.
- the materials may also be coated internally or externally with materials the resist friction such as Teflon (Poly-Tetra-Flouro-Ethylene), hydrophilic materials, parylene or the like.
- catheter shaft may include one or more radiopaque markers 33 and/or may be made from one or more radiopaque materials to facilitate visualization.
- radiopaque markers/materials may include, but are not limited to, gold, Platinum, Iridium, Tungsten, Tantulum, resins containing Barium Sulfate, Bismuth trioxide or Tungsten and/or the like.
- Anchoring member 36 may also be made of any suitable materials now known or discovered in the future, according to various embodiments.
- expandable anchoring member 36 may comprise flexible polyvinyl chloride (PNC), Polyethylene, Polyether Block Amide (PEBAX), Polyethylene Terepthalate (PET), Polyester, Nylon, Polyurethanes, Polyether Block Amide (PEBAX), Polyolefins or any suitable combination thereof.
- PNC flexible polyvinyl chloride
- PEBAX Polyethylene
- PET Polyethylene Terepthalate
- Polyester Nylon
- Polyurethanes Polyether Block Amide
- PEBAX Polyolefins
- Various adhesives may be used to attach anchoring member 36 to catheter shaft 32 or for any other suitable pu ⁇ ose.
- Any suitable adhesive(s) may be used, such as but not limited to, light activated acrylics, light activated cyanoacrylates, light activated silicones, heat activated adhesives, ambient curing adhesives, cyanoacrylates, epoxy adhesives, and/or polyurethane adhesives.
- Various parts of catheter device 30 may also be attached using alternative means, such as friction fitting, snap fitting, screw fitting, application of energy such as thermal or radiofrequency energy, and/or the like.
- a catheter device 40 comprises an outer shaft 42, an inner shaft 44, and an anchoring member 46 coupled with both outer shaft 42 and inner shaft 44.
- Shafts 42, 44 are axially slidable relative to one another, such that when inner shaft 44 is moved proximally relative to outer shaft 42, anchoring member 46 buckles outward to perform its anchoring function, as shown in Fig. 4B.
- inner shaft 44 acts as an injection lumen and also possibly as a guidewire lumen, and no inflation lumen is needed
- anchoring member 46 may be constructed as a cylinder with slots or other shapes cut out of it to form colurnn- like buckling structures. Components of this embodiment may be made ofthe same or different materials as just described.
- catheter device 50 includes an outer shaft 52, an inner shaft 54, an anchoring member 56 coupled to outer shaft 52 and inner shaft 54, and a sheath 58 slidably disposed over outer shaft 52.
- anchoring member 56 When sheath 58 is disposed over anchoring member 56, as in Fig. 5 A, anchoring member 56 remains in an undeployed state suitable for delivery into the disc.
- anchoring member 56 When sheath 58 is retracted and/or outer shaft 52 is advanced, as in Fig. 5B, anchoring member 56 may be deployed.
- anchoring member 56 may be deployed via buckling or via inflation, as described above.
- anchoring member 56 may self-expand, for example if it is comprised of shape-memory or spring-loaded materials that expand when released from sheath 58.
- a catheter device 60 in another embodiment, includes an outer shaft 62 having an expandable anchoring portion 66 and an inner shaft 64.
- Expandable anchoring portion 66 generally comprises a buckling portion of outer shaft 62 and may include multiple features such as small cut-outs 68 and larger openings 67.
- anchoring member 66 buckles, due to features 67, 68, thus providing the anchoring function.
- Tine anchors 76 may be deployed from a retracted state, as in Fig. 7 A, to a deployed state, as in Fig. 7B.
- Tine anchors 76 may be pre-bent so that they readily take on a pre-determined shape when deployed out of catheter body 72, and anchors 76 may be made of metal, such as stainless steel or shape-memory metal such as Nitinol, polymers, or any other suitable material.
- tine anchors 76 may be deployed either by pushing them out of their housing lumens or by releasing them from constraint to allow them to self-deploy.
- a distal portion of a catheter device may deform to anchor the distal portion in the disc D.
- a catheter device 80 may have a distal portion 82 that deforms to a spiral configuration.
- a catheter device may have a distal portion 86 that deforms to a zig-zag configuration. Any other suitable shape for a distal portion may be used in various embodiments. Deformation of a distal portion may be achieved by any suitable means, such as by using a shape-memory or spring-loaded material, by using a pull cord, tendon, stylet or other actuator to deform the distal portion or the like.
- FIGs. 10A-10D illustrate that an anchoring member of a catheter device may have any suitable shape, size, configuration, orientation to the catheter shaft or the like, in various embodiments, hi the embodiment shown in Fig. 10 A, for example, an anchoring member 100 of a catheter device is shown in cross-section within a disc D between two vertebrae V. In this embodiment, anchoring member 100 has a circular cross-sectional shape and is disposed concentrically over a catheter shaft 102 ofthe catheter device. In the embodiment shown in Fig. 10B, an anchoring member 104 is asymmetrically attached to a catheter shaft 106 and has a non-circular, asymmetric shape. In the embodiment shown in Fig.
- an anchoring member 108 is concentrically disposed over a catheter shaft 110 and has an elliptical cross-sectional shape.
- Fig. 10D shows a longitudinal view of a catheter device 112 having an approximately conical-shaped anchoring member 114. This embodiment demonstrates that anchoring member 114 may have not only various cross-sectional shapes but also various longitudinal shapes in various embodiments.
- yet another embodiment of a catheter device 116 advanced over a guidewire 120 includes an anchoring member 118 that attaches to annulus fibrosis AF of a disc to maintain the distal portion of device 116 in the disc D.
- anchoring member 118 comprises a spiral needle that may be screwed, twisted or otherwise driven into the annulus fibrosis AF.
- FIG. 12 shows another embodiment of a catheter device 122, in this case comprising a catheter shaft having threads 126 for anchoring in an annulus fibrosis.
- a catheter shaft having threads 126 for anchoring in an annulus fibrosis.
- any other suitable means for anchoring into the annulus fibrosis may be used, such as hooks, anchors, barbs, T-tags or the like.
- a catheter device 128 includes two an outer anchoring member 130 for anchoring outside the annulus fibrosis AF and an inner anchoring member 132 for anchoring inside the disc D, typically in the nucleus pulposus NP.
- anchoring members 130, 132 may comprise expandable members, such as inflatable balloons, hi other embodiments, alternative anchoring members may be used, more than two anchoring members may be used and/or the like. Using two anchoring members 130, 132 may further ensure that a distal portion of catheter device 128 remains in position within the disc.
- a catheter device 134 having an anchoring member 136 may be used for treating discogenic pain.
- catheter device 134 may be coupled with an implantable device 138 for providing treatment, implantable device 138 being positioned under a patient's skin S or in any other suitable location in the patient's body.
- Implantable device 138 may comprise, for example, an implantable pump with or without a drug reservoir, an implantable drug infusion/injection port, transcutaneous electrical nerve stimulation (TENS) device or any other suitable device in various embodiments.
- Substances introduced into the disc DS via catheter device 134 and implantable device 138 may include any ofthe substances listed above, such as an anesthetic or analgesic to relieve pain.
- Implantable device 138 may be left in the patient for any suitable length of time to provide treatment.
- implantable device 138 may comprise an implantable pump 139.
- the pump may be programmed to deliver drug from an attached reservoir into the nucleus pulposus at a constant rate, at programmed intervals, upon triggering by the patient or physician through the use of an external device capable of commumcating with the pump, such as but not limited to magnetic reed switches, electromagnetic wave communication devices such as visible light, radio-wave, microwave, or short-wave, or wireless communication protocols such as Bluetooth.
- the patient may control pump-mediated drug delivery by physically manipulating switches, toggles, or other similar devices coupled with the pump.
- the implantable pump may be configured to store data related to the usage pattern ofthe drug by the patient. This information could be downloaded for review through wireless communication with an external device such as those listed above.
- the implantable device may also include an injection port to allow the reservoir to be refilled transcutaneously.
- catheter device 134 may extend between implantable device 138 and the disc D in a circular, spiral, curved, se ⁇ entine, or otherwise nonlinear path, thus providing an amount of slack (as shown in broken line) in catheter device to allow for movement between the disc D and the implantable device 138 with patient movement.
- Implantable catheter devices such as catheter device 134, will be provided with anchoring members 136, which typically may be inflatable balloons or other structures.
- the catheter devices 134 will have an integral balloon inflation lumen, or will be provided with separate balloon inflation tubes to permit inflation ofthe balloon anchor 136 after proper positioning ofthe catheter.
- the catheter devices 134 may be provided with self-sealing septum structures at an end ofthe inflation lumen.
- the catheter devices 134 could also include substance delivery lumens which also terminate at a proximal end in a self- sealing septum to allow for drug and substance delivery after the device has been implanted.
- Suitable septum materials include silicone, rubber, latex rubber, isoprene rubber, polyisoprene rubber, and numerous other known materials.
- a balloon inflation lumen on the catheter device 134 or separate balloon inflation tube could be sealed using a suture, clip, filament loop, or any of a variety of other external closure elements.
- Such clips or crimps could be formed from a spring-like material, such that they can be pre-shaped to collapse the inflating lumen.
- the clips or crimps could be deformable so that they could be tightened over the balloon inflation lumen to effect closure.
- multiple closure members could be placed at different points along the balloon inflation lumen in order to enhance the seal.
- the closure elements could be removable to permit deflation and reinflation ofthe balloon, should it be desired during or after implantation. The closure elements could also be removed to permit deflation ofthe balloon for explanation ofthe catheter.
- the balloon inflation lumen could be sealed using heat, adhesives, or ultrasonic energy, resulting in melting or fusing ofthe lumen.
- Heat can come from a variety of sources, including electrical resistance heaters, electrical inductive heaters, or the like.
- some systems include a shaped guidewire 146 configured to maintain a distal portion of guidewire 146 within the disc during delivery ofthe catheter device.
- guidewire 146 is delivered through an injection needle 142, which has been delivered through an introducer device 140.
- a distal portion of guidewire 146a is advanced out ofthe distal end of injection needle 142, it assumes a shape, in this case a spiral shape, which secures distal portion 146a in the disc.
- Guidewire 146 may be formed of any suitable material to provide for such a shape change, such as but not limited to shape-memory materials such as Nitinol, spring stainless steel or the like.
- a distal tip ofthe guidewire includes one or more radiopaque markers, coils or the like, or is made of one or more radiopaque materials.
- a guidewire 148 has a distal portion 148a that assumes a zig-zag shape upon being advanced beyond the distal end of injection needle.
- guidewires may have distal portions with any suitable shapes for anchoring in the disc D.
- a guidewire 150 has a double-wire configuration for enhancing its ability to maintain its position within a disc D.
- Double- wire guidewire 150 includes two wires joined at their distal ends, the attachment being achieved by welding, soldering, bonding, gluing, folding a single wire, or any other suitable technique.
- a distal end of guidewire 150a may be delivered into the disc D in a relatively straight, undeployed configuration.
- Double- wire guidewire 150 is then deployed, as shown in Fig. 16B, by differentially pushing or pulling on one ofthe wires ofthe double wire guidewire causing distal portion 150a to deform. In its deployed state, double- wire guidewire 150 is less likely to dislodge or pull out ofthe disc D than a single-wire guidewire.
- the disc space has been accessed using a transannular approach.
- a transannular approach As illustrated in Figs. 14A and 14B, however, in some cases it may be preferable to approach the nucleus pulposus NP through the adjacent vertebral body V in a fransosseous approach, i.e., across the bone.
- Use of a fransosseous approach avoids the necessity of performing an annulotomy, thus avoiding puncturing and potentially damaging the annulus fibrosis AF.
- the catheter 134 passes through the vertebral body V and into the disc space. As shown in Fig. 14A, the catheter 134 may pass through a single vertebral body into the adjacent disc space.
- the catheter 134 may be desirable to pass the catheter 134 through multiple disc spaces, as shown in Fig. 14B, deploying the anchoring member 136 in the distal-most disc space, or alternatively in one ofthe vertebral bodies.
- Such an approach is advantageous since it permits treatment of multiple disc spaces simultaneously.
- the disc space or spaces could be accessed from the superior or inferior vertebral body.
- the fransosseous approach could be performed by drilling or chiseling an access path through the vertebral body using a twist drill bit, a abrasive burr, sha ⁇ chisel, or other tools known in the art of surgery.
- the tool utilized to make the access path in the bone can be introduced alone or through the introducer needle. In some cases it may be necessary to pre-bend the introducer needle or tool to achieve the correct angle for the access hole in the vertebral body.
- one embodiment includes one or more adapters 160 for removably coupling with one or more proximal ends of a catheter device 162.
- Adapter 160 is typically coupled with catheter device 162 after the distal end of catheter device 162 is in place within the disc and after the introducer device, stylet or the like has been removed, although in alternative embodiments adapter 160 may be coupled with catheter device 162 at any other suitable time.
- Adapter 160 may comprise or resemble a Touhy Bourst adapter, compression fitting, instant tube fitting, or other similar adapter or connector.
- adapter includes a distal sealed connector 164, a proximal sealed connector 166 having an injection port 167, an anchoring member inflation port 168, and a stopcock 169 for controlling fluid flow through inflation port 168.
- Injection port 167 is in fluid communication with a lumen of catheter device 162 and may be used for injection of substance(s) into the disc and/or for passage of a guidewire.
- Injection port 167 and inflation port 168 may include leur fittings, press fits, barbs or any other suitable tube connection methods.
- Proximal sealed connector 166 and distal sealed connector 164 may be activated by rotating the sealed connectors on threads, automatic press activation, spring actuation or any other suitable method.
- a catheter device in some embodiments may be coupled with one or more automated injection devices.
- Such injection devices may facilitate testing of one disc or multiple discs over an extended period of time, with only periodic supervision by a physician, nurse or other clinician.
- the patient could remain in clinic or hospital room while a series of substances are introduced into a disc, while the patient assumes different positions to test the pain response, while substances are injected into multiple discs through multiple catheter devices and/or the like.
- Such an automated system may facilitate and enhance diagnosis of discogenic pain by allowing for more extensive testing.
- such a system may also include a device for recording patient pain responses, such as an instrument that allows a patient to record pain felt before and after an injection on a scale from 1 to 10 and/or to relate the pain felt to the patient's usual back pain.
- a device for recording patient pain responses such as an instrument that allows a patient to record pain felt before and after an injection on a scale from 1 to 10 and/or to relate the pain felt to the patient's usual back pain.
Abstract
Description
Claims
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CN (1) | CN101005870A (en) |
AU (1) | AU2005235099A1 (en) |
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Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008027017A1 (en) * | 2006-08-31 | 2008-03-06 | Singapore Health Services Pte Ltd | Modulation of neural activity and/or condition |
US7713303B2 (en) | 2002-09-18 | 2010-05-11 | Warsaw Orthopedic, Inc. | Collagen-based materials and methods for augmenting intervertebral discs |
US7731981B2 (en) | 2002-11-15 | 2010-06-08 | Warsaw Orthopedic, Inc. | Collagen-based materials and methods for treating synovial joints |
US7744651B2 (en) | 2002-09-18 | 2010-06-29 | Warsaw Orthopedic, Inc | Compositions and methods for treating intervertebral discs with collagen-based materials |
US7771414B2 (en) | 2006-04-24 | 2010-08-10 | Warsaw Orthopedic, Inc. | Controlled release devices for therapeutic treatments of spinal discs |
US7785314B2 (en) | 2007-06-15 | 2010-08-31 | Kyphon SÀRL | Systems and methods for needle access to an intervertebral disc |
US7879027B2 (en) | 2006-04-24 | 2011-02-01 | Warsaw Orthopedic, Inc. | Controlled release devices for fusion of osteal structures |
US8118779B2 (en) | 2006-06-30 | 2012-02-21 | Warsaw Orthopedic, Inc. | Collagen delivery device |
US8399619B2 (en) | 2006-06-30 | 2013-03-19 | Warsaw Orthopedic, Inc. | Injectable collagen material |
US8642059B2 (en) | 2006-04-24 | 2014-02-04 | Warsaw Orthopedic, Inc. | Controlled release systems and methods for intervertebral discs |
US8642060B2 (en) | 2006-04-24 | 2014-02-04 | Warsaw Orthopedic, Inc. | Controlled release systems and methods for osteal growth |
US8920828B2 (en) | 2003-08-06 | 2014-12-30 | Warsaw Orthopedic, Inc. | Implants for treatment of symptomatic or degenerated intervertebral discs |
Families Citing this family (291)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8252738B2 (en) * | 1999-04-30 | 2012-08-28 | Warsaw Orthopedic, Inc. | Method for changing cell phenotype using LIM mineralization proteins |
DE60207902T2 (en) * | 2001-01-30 | 2006-06-14 | Nissan Chemical Ind Ltd | Isocyanurate compound and process for its preparation |
DE10105592A1 (en) | 2001-02-06 | 2002-08-08 | Achim Goepferich | Placeholder for drug release in the frontal sinus |
WO2003037165A2 (en) * | 2001-11-01 | 2003-05-08 | Boyd Lawrence M | System and method for the pretreatment of the endplates of an intervertebral disc |
US8317816B2 (en) | 2002-09-30 | 2012-11-27 | Acclarent, Inc. | Balloon catheters and methods for treating paranasal sinuses |
WO2004073563A2 (en) | 2003-02-14 | 2004-09-02 | Depuy Spine, Inc. | In-situ formed intervertebral fusion device |
US7255714B2 (en) | 2003-09-30 | 2007-08-14 | Michel H. Malek | Vertically adjustable intervertebral disc prosthesis |
US7862586B2 (en) | 2003-11-25 | 2011-01-04 | Life Spine, Inc. | Spinal stabilization systems |
EP1729672A2 (en) | 2004-01-08 | 2006-12-13 | Spine Wave, Inc. | Apparatus and method for injecting fluent material at a distracted tissue site |
US8523904B2 (en) | 2004-03-09 | 2013-09-03 | The Board Of Trustees Of The Leland Stanford Junior University | Methods and systems for constraint of spinous processes with attachment |
US7458981B2 (en) | 2004-03-09 | 2008-12-02 | The Board Of Trustees Of The Leland Stanford Junior University | Spinal implant and method for restricting spinal flexion |
US8945223B2 (en) * | 2004-03-12 | 2015-02-03 | Warsaw Orthopedic, Inc. | In-situ formable nucleus pulposus implant with water absorption and swelling capability |
US7452351B2 (en) | 2004-04-16 | 2008-11-18 | Kyphon Sarl | Spinal diagnostic methods and apparatus |
US7559925B2 (en) | 2006-09-15 | 2009-07-14 | Acclarent Inc. | Methods and devices for facilitating visualization in a surgical environment |
US10188413B1 (en) | 2004-04-21 | 2019-01-29 | Acclarent, Inc. | Deflectable guide catheters and related methods |
US20060063973A1 (en) | 2004-04-21 | 2006-03-23 | Acclarent, Inc. | Methods and apparatus for treating disorders of the ear, nose and throat |
US7361168B2 (en) | 2004-04-21 | 2008-04-22 | Acclarent, Inc. | Implantable device and methods for delivering drugs and other substances to treat sinusitis and other disorders |
US8702626B1 (en) | 2004-04-21 | 2014-04-22 | Acclarent, Inc. | Guidewires for performing image guided procedures |
US9101384B2 (en) | 2004-04-21 | 2015-08-11 | Acclarent, Inc. | Devices, systems and methods for diagnosing and treating sinusitis and other disorders of the ears, Nose and/or throat |
US8932276B1 (en) | 2004-04-21 | 2015-01-13 | Acclarent, Inc. | Shapeable guide catheters and related methods |
US7419497B2 (en) | 2004-04-21 | 2008-09-02 | Acclarent, Inc. | Methods for treating ethmoid disease |
US7803150B2 (en) | 2004-04-21 | 2010-09-28 | Acclarent, Inc. | Devices, systems and methods useable for treating sinusitis |
US20070167682A1 (en) | 2004-04-21 | 2007-07-19 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US7462175B2 (en) | 2004-04-21 | 2008-12-09 | Acclarent, Inc. | Devices, systems and methods for treating disorders of the ear, nose and throat |
US9399121B2 (en) | 2004-04-21 | 2016-07-26 | Acclarent, Inc. | Systems and methods for transnasal dilation of passageways in the ear, nose or throat |
US20060004323A1 (en) | 2004-04-21 | 2006-01-05 | Exploramed Nc1, Inc. | Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures |
US8747389B2 (en) * | 2004-04-21 | 2014-06-10 | Acclarent, Inc. | Systems for treating disorders of the ear, nose and throat |
US8764729B2 (en) | 2004-04-21 | 2014-07-01 | Acclarent, Inc. | Frontal sinus spacer |
US20190314620A1 (en) | 2004-04-21 | 2019-10-17 | Acclarent, Inc. | Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures |
US7654997B2 (en) | 2004-04-21 | 2010-02-02 | Acclarent, Inc. | Devices, systems and methods for diagnosing and treating sinusitus and other disorders of the ears, nose and/or throat |
US8864787B2 (en) | 2004-04-21 | 2014-10-21 | Acclarent, Inc. | Ethmoidotomy system and implantable spacer devices having therapeutic substance delivery capability for treatment of paranasal sinusitis |
US9089258B2 (en) | 2004-04-21 | 2015-07-28 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US20070208252A1 (en) | 2004-04-21 | 2007-09-06 | Acclarent, Inc. | Systems and methods for performing image guided procedures within the ear, nose, throat and paranasal sinuses |
US9351750B2 (en) | 2004-04-21 | 2016-05-31 | Acclarent, Inc. | Devices and methods for treating maxillary sinus disease |
US9554691B2 (en) | 2004-04-21 | 2017-01-31 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US7410480B2 (en) | 2004-04-21 | 2008-08-12 | Acclarent, Inc. | Devices and methods for delivering therapeutic substances for the treatment of sinusitis and other disorders |
US8146400B2 (en) | 2004-04-21 | 2012-04-03 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US8894614B2 (en) | 2004-04-21 | 2014-11-25 | Acclarent, Inc. | Devices, systems and methods useable for treating frontal sinusitis |
JP2008504895A (en) * | 2004-06-29 | 2008-02-21 | スパイン・ウェイブ・インコーポレーテッド | Method for treating disc defects and injuries |
US20160001066A1 (en) * | 2004-08-31 | 2016-01-07 | Stephen T. Pyles | Spinal catheter having multiple obstruction-clearing features |
US7887538B2 (en) | 2005-10-15 | 2011-02-15 | Baxano, Inc. | Methods and apparatus for tissue modification |
US8430881B2 (en) | 2004-10-15 | 2013-04-30 | Baxano, Inc. | Mechanical tissue modification devices and methods |
US8257356B2 (en) | 2004-10-15 | 2012-09-04 | Baxano, Inc. | Guidewire exchange systems to treat spinal stenosis |
US8062300B2 (en) | 2006-05-04 | 2011-11-22 | Baxano, Inc. | Tissue removal with at least partially flexible devices |
US20100331883A1 (en) | 2004-10-15 | 2010-12-30 | Schmitz Gregory P | Access and tissue modification systems and methods |
US7578819B2 (en) | 2005-05-16 | 2009-08-25 | Baxano, Inc. | Spinal access and neural localization |
US8613745B2 (en) | 2004-10-15 | 2013-12-24 | Baxano Surgical, Inc. | Methods, systems and devices for carpal tunnel release |
US9247952B2 (en) | 2004-10-15 | 2016-02-02 | Amendia, Inc. | Devices and methods for tissue access |
US7938830B2 (en) | 2004-10-15 | 2011-05-10 | Baxano, Inc. | Powered tissue modification devices and methods |
US8221397B2 (en) | 2004-10-15 | 2012-07-17 | Baxano, Inc. | Devices and methods for tissue modification |
US9101386B2 (en) | 2004-10-15 | 2015-08-11 | Amendia, Inc. | Devices and methods for treating tissue |
US8048080B2 (en) | 2004-10-15 | 2011-11-01 | Baxano, Inc. | Flexible tissue rasp |
US8192435B2 (en) | 2004-10-15 | 2012-06-05 | Baxano, Inc. | Devices and methods for tissue modification |
US7738969B2 (en) | 2004-10-15 | 2010-06-15 | Baxano, Inc. | Devices and methods for selective surgical removal of tissue |
US7963915B2 (en) | 2004-10-15 | 2011-06-21 | Baxano, Inc. | Devices and methods for tissue access |
US20110190772A1 (en) | 2004-10-15 | 2011-08-04 | Vahid Saadat | Powered tissue modification devices and methods |
US20080103504A1 (en) * | 2006-10-30 | 2008-05-01 | Schmitz Gregory P | Percutaneous spinal stenosis treatment |
US20060085073A1 (en) * | 2004-10-18 | 2006-04-20 | Kamshad Raiszadeh | Medical device systems for the spine |
US20060161087A1 (en) * | 2005-01-17 | 2006-07-20 | Portal, Inc. | Spinal compression system and methods of use |
US20060184192A1 (en) * | 2005-02-11 | 2006-08-17 | Markworth Aaron D | Systems and methods for providing cavities in interior body regions |
US20060247657A1 (en) * | 2005-04-27 | 2006-11-02 | Sdgi Holdings, Inc. | Methods and systems for characterizing intervertebral disc space |
US8951225B2 (en) | 2005-06-10 | 2015-02-10 | Acclarent, Inc. | Catheters with non-removable guide members useable for treatment of sinusitis |
US7666226B2 (en) | 2005-08-16 | 2010-02-23 | Benvenue Medical, Inc. | Spinal tissue distraction devices |
WO2008103781A2 (en) | 2007-02-21 | 2008-08-28 | Benvenue Medical, Inc. | Devices for treating the spine |
US8366773B2 (en) | 2005-08-16 | 2013-02-05 | Benvenue Medical, Inc. | Apparatus and method for treating bone |
US20070073290A1 (en) * | 2005-09-13 | 2007-03-29 | Boehm Frank H Jr | Insertion of artificial/prosthetic facet joints with ballotable/compressible joint space component |
GB2430396A (en) * | 2005-09-23 | 2007-03-28 | Thomas Hoogland | A surgical drill |
US8114113B2 (en) | 2005-09-23 | 2012-02-14 | Acclarent, Inc. | Multi-conduit balloon catheter |
US8062298B2 (en) | 2005-10-15 | 2011-11-22 | Baxano, Inc. | Flexible tissue removal devices and methods |
US20080086034A1 (en) | 2006-08-29 | 2008-04-10 | Baxano, Inc. | Tissue Access Guidewire System and Method |
US8366712B2 (en) | 2005-10-15 | 2013-02-05 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US8092456B2 (en) | 2005-10-15 | 2012-01-10 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
EP1951167B1 (en) * | 2005-11-16 | 2010-01-27 | William, a Cook Australia Pty. Ltd. | Introducer for implantable device |
US20070135768A1 (en) * | 2005-12-14 | 2007-06-14 | Carlsen Wayne D | Spinal and epidural regional anesthesia catheter |
US7993269B2 (en) * | 2006-02-17 | 2011-08-09 | Medtronic, Inc. | Sensor and method for spinal monitoring |
US9789161B2 (en) | 2006-04-28 | 2017-10-17 | Warsaw Orthopedic, Inc. | Methods for treating back or neck pain caused by NGF using a therapeutic agent consisting of ReN-1820, ALE-0540 and capsaicin |
US8916611B2 (en) * | 2006-04-28 | 2014-12-23 | Warsaw Orthopedic, Inc. | Pharmaceutical removal of neuronal extensions from a degenerating disc |
US20070253960A1 (en) * | 2006-04-28 | 2007-11-01 | Josee Roy | Pharmaceutical removal of vascular extensions from a degenerating disc |
US20090304747A1 (en) * | 2006-05-16 | 2009-12-10 | Mayo Foundation For Medical Education And Research | Use of dmso and botulinum toxin therapy for urinary incontinence and related disorders |
US8190389B2 (en) | 2006-05-17 | 2012-05-29 | Acclarent, Inc. | Adapter for attaching electromagnetic image guidance components to a medical device |
US20070282300A1 (en) * | 2006-06-05 | 2007-12-06 | Mohamed Attawia | Intervertebral Disc Puncture and Treatment System |
US20070287991A1 (en) * | 2006-06-08 | 2007-12-13 | Mckay William F | Devices and methods for detection of markers of axial pain with or without radiculopathy |
US20080009876A1 (en) * | 2006-07-07 | 2008-01-10 | Meera Sankaran | Medical device with expansion mechanism |
US20080027554A1 (en) * | 2006-07-31 | 2008-01-31 | Talmadge Karen D | Kit and methods of treatment of an intervertebral disc |
US7777399B2 (en) * | 2006-07-31 | 2010-08-17 | Boston Scientific Scimed, Inc. | Medical balloon incorporating electroactive polymer and methods of making and using the same |
US20080097491A1 (en) * | 2006-08-28 | 2008-04-24 | Fred Gobel | Tissue to tissue anchoring device and method of using the same |
US8357168B2 (en) * | 2006-09-08 | 2013-01-22 | Spine Wave, Inc. | Modular injection needle and seal assembly |
US9820688B2 (en) | 2006-09-15 | 2017-11-21 | Acclarent, Inc. | Sinus illumination lightwire device |
US20080082051A1 (en) * | 2006-09-21 | 2008-04-03 | Kyphon Inc. | Device and method for facilitating introduction of guidewires into catheters |
US20080312637A1 (en) * | 2007-06-15 | 2008-12-18 | Kyphon Inc. | Device and Methods for Introducing a Catheter into an Intervertebral Disc |
WO2008036842A2 (en) * | 2006-09-21 | 2008-03-27 | Kyphon Sarl | Device and method for facilitating introduction of catheters |
US8029541B2 (en) | 2006-10-19 | 2011-10-04 | Simpirica Spine, Inc. | Methods and systems for laterally stabilized constraint of spinous processes |
US8162982B2 (en) | 2006-10-19 | 2012-04-24 | Simpirica Spine, Inc. | Methods and systems for constraint of multiple spine segments |
US8187307B2 (en) * | 2006-10-19 | 2012-05-29 | Simpirica Spine, Inc. | Structures and methods for constraining spinal processes with single connector |
US20080107711A1 (en) * | 2006-11-08 | 2008-05-08 | Alexis Paul Shelokov | Bioabsorbable Implantable Material Fortified with Antibiotics for Localized Delivery of Drugs |
US20080140056A1 (en) * | 2006-12-06 | 2008-06-12 | Medtronic, Inc. | Method for delivering large molecules to the brain |
WO2008070863A2 (en) | 2006-12-07 | 2008-06-12 | Interventional Spine, Inc. | Intervertebral implant |
US8529570B2 (en) * | 2006-12-15 | 2013-09-10 | The Adelman Research Ltd | Technique and device for laminar osteotomy and laminoplasty |
US8439687B1 (en) | 2006-12-29 | 2013-05-14 | Acclarent, Inc. | Apparatus and method for simulated insertion and positioning of guidewares and other interventional devices |
US20080183192A1 (en) | 2007-01-26 | 2008-07-31 | Laurimed Llc | Contralateral insertion method to treat herniation with device using visualization components |
US8088119B2 (en) * | 2007-02-01 | 2012-01-03 | Laurimed, Llc | Methods and devices for treating tissue |
ES2757819T3 (en) | 2007-02-21 | 2020-04-30 | Benvenue Medical Inc | Devices to treat the spine |
WO2008121404A1 (en) * | 2007-03-30 | 2008-10-09 | Kyphon Sarl | Methods and systems for the diagnosis and treatment of medical conditions in the spine and other body parts |
US8118757B2 (en) | 2007-04-30 | 2012-02-21 | Acclarent, Inc. | Methods and devices for ostium measurement |
US8485199B2 (en) | 2007-05-08 | 2013-07-16 | Acclarent, Inc. | Methods and devices for protecting nasal turbinate during surgery |
WO2008140364A1 (en) * | 2007-05-15 | 2008-11-20 | St. Jude Medical Ab | Medical implantable lead with flexible segmented sleeve |
US20080300684A1 (en) * | 2007-05-31 | 2008-12-04 | Shelokov Alexis P | System and method for controlled delivery of bone morphogenic protein and other bone graft substitutes for bone formation, repair and healing |
US20100036424A1 (en) | 2007-06-22 | 2010-02-11 | Simpirica Spine, Inc. | Methods and systems for increasing the bending stiffness and constraining the spreading of a spinal segment |
EP2182864B1 (en) * | 2007-06-22 | 2016-06-08 | Empirical Spine, Inc. | Devices for controlled flexion restriction of spinal segments |
US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
WO2009009621A2 (en) * | 2007-07-09 | 2009-01-15 | Baxano, Inc. | Spinal access system and method |
WO2009032363A1 (en) | 2007-09-06 | 2009-03-12 | Baxano, Inc. | Method, system and apparatus for neural localization |
US20090088789A1 (en) | 2007-09-28 | 2009-04-02 | O'neil Michael J | Balloon With Shape Control For Spinal Procedures |
US20090088788A1 (en) * | 2007-09-28 | 2009-04-02 | Steven Mouw | Methods and apparatus having multiple separately actuatable expandable members |
WO2009046164A1 (en) | 2007-10-05 | 2009-04-09 | Tyco Healthcare Group Lp | Seal anchor for use in surgical procedures |
US20090112332A1 (en) * | 2007-10-31 | 2009-04-30 | Alexis Paul Shelokov | Bone graft and bone graft substitutes with antibiotics for sustained, localized release of antibiotics for reducing postoperative surgical wound infection in spinal and other bone surgery |
US9510885B2 (en) | 2007-11-16 | 2016-12-06 | Osseon Llc | Steerable and curvable cavity creation system |
US20090131886A1 (en) | 2007-11-16 | 2009-05-21 | Liu Y King | Steerable vertebroplasty system |
US20090131867A1 (en) | 2007-11-16 | 2009-05-21 | Liu Y King | Steerable vertebroplasty system with cavity creation element |
WO2009076188A2 (en) * | 2007-12-05 | 2009-06-18 | Donahue John R | Retractor and sealing system for surgical/non-surgical instruments |
US8192436B2 (en) | 2007-12-07 | 2012-06-05 | Baxano, Inc. | Tissue modification devices |
US10206821B2 (en) | 2007-12-20 | 2019-02-19 | Acclarent, Inc. | Eustachian tube dilation balloon with ventilation path |
US8617214B2 (en) | 2008-01-07 | 2013-12-31 | Mmsn Limited Partnership | Spinal tension band |
CN102626338B (en) | 2008-01-14 | 2014-11-26 | 康文图斯整形外科公司 | Apparatus and methods for fracture repair |
JP5441922B2 (en) | 2008-01-17 | 2014-03-12 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | Inflatable intervertebral implant and related manufacturing method |
WO2009097328A2 (en) * | 2008-01-28 | 2009-08-06 | Boston Scientific Neuromodulation Corporation | Fixation of implantable pulse generators |
US7935133B2 (en) | 2008-02-08 | 2011-05-03 | Mmsn Limited Partnership | Interlaminar hook |
EP2259712A1 (en) * | 2008-03-03 | 2010-12-15 | Geisert Square Gmbh | Intervertebral disc analysis system and method |
US8182432B2 (en) | 2008-03-10 | 2012-05-22 | Acclarent, Inc. | Corewire design and construction for medical devices |
WO2009124192A1 (en) | 2008-04-02 | 2009-10-08 | Laurimed, Llc | Methods and devices for delivering injections |
EP2262449B1 (en) | 2008-04-05 | 2020-03-11 | Synthes GmbH | Expandable intervertebral implant |
US8777870B2 (en) * | 2008-05-15 | 2014-07-15 | Michel H. Malek | Functional discography catheter |
WO2009149399A1 (en) * | 2008-06-06 | 2009-12-10 | Simpirica Spine, Inc. | Methods and apparatus for deploying spinous process constraints |
WO2009149414A1 (en) | 2008-06-06 | 2009-12-10 | Simpirica Spine, Inc. | Methods and apparatus for locking a band |
US9314253B2 (en) | 2008-07-01 | 2016-04-19 | Amendia, Inc. | Tissue modification devices and methods |
US8398641B2 (en) | 2008-07-01 | 2013-03-19 | Baxano, Inc. | Tissue modification devices and methods |
US8409206B2 (en) | 2008-07-01 | 2013-04-02 | Baxano, Inc. | Tissue modification devices and methods |
CA2730732A1 (en) | 2008-07-14 | 2010-01-21 | Baxano, Inc. | Tissue modification devices |
US20100030139A1 (en) * | 2008-07-30 | 2010-02-04 | Copa Vincent G | Anastomosis Devices and Methods Utilizing Colored Bands |
ES2700863T3 (en) | 2008-07-30 | 2019-02-19 | Acclarent Inc | Devices for localization of the paranasal ostium |
WO2010033629A1 (en) | 2008-09-18 | 2010-03-25 | Acclarent, Inc. | Methods and apparatus for treating disorders of the ear nose and throat |
USD738500S1 (en) | 2008-10-02 | 2015-09-08 | Covidien Lp | Seal anchor for use in surgical procedures |
US8187304B2 (en) | 2008-11-10 | 2012-05-29 | Malek Michel H | Facet fusion system |
US9492214B2 (en) | 2008-12-18 | 2016-11-15 | Michel H. Malek | Flexible spinal stabilization system |
US10045860B2 (en) | 2008-12-19 | 2018-08-14 | Amicus Design Group, Llc | Interbody vertebral prosthetic device with self-deploying screws |
US8470043B2 (en) * | 2008-12-23 | 2013-06-25 | Benvenue Medical, Inc. | Tissue removal tools and methods of use |
US9161773B2 (en) | 2008-12-23 | 2015-10-20 | Benvenue Medical, Inc. | Tissue removal tools and methods of use |
US20100174243A1 (en) * | 2009-01-05 | 2010-07-08 | Warsaw Orthopedic, Inc. | Apparatus for Delivery of Therapeutic Material to an Intervertebral Disc and Method of Use |
US20100228097A1 (en) * | 2009-03-04 | 2010-09-09 | Warsaw Orthopedic, Inc. | Methods and compositions to diagnose pain |
US8529606B2 (en) * | 2009-03-10 | 2013-09-10 | Simpirica Spine, Inc. | Surgical tether apparatus and methods of use |
US8562653B2 (en) | 2009-03-10 | 2013-10-22 | Simpirica Spine, Inc. | Surgical tether apparatus and methods of use |
JP5681122B2 (en) * | 2009-03-10 | 2015-03-04 | シンピライカ スパイン, インコーポレイテッド | Surgical tether device and method of use |
EP2405823A4 (en) | 2009-03-13 | 2012-07-04 | Baxano Inc | Flexible neural localization devices and methods |
US8535327B2 (en) | 2009-03-17 | 2013-09-17 | Benvenue Medical, Inc. | Delivery apparatus for use with implantable medical devices |
US20100241155A1 (en) | 2009-03-20 | 2010-09-23 | Acclarent, Inc. | Guide system with suction |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
WO2010114853A1 (en) | 2009-03-30 | 2010-10-07 | Simpirica Spine, Inc. | Methods and apparatus for improving shear loading capacity of a spinal segment |
US8435290B2 (en) | 2009-03-31 | 2013-05-07 | Acclarent, Inc. | System and method for treatment of non-ventilating middle ear by providing a gas pathway through the nasopharynx |
US7978742B1 (en) | 2010-03-24 | 2011-07-12 | Corning Incorporated | Methods for operating diode lasers |
US9344902B2 (en) * | 2009-04-03 | 2016-05-17 | Broadcom Corporation | Method and system for evaluating deployment of femtocells as part of a cellular network |
US8911497B2 (en) * | 2009-04-09 | 2014-12-16 | DePuy Synthes Products, LLC | Minimally invasive spine augmentation and stabilization system and method |
US20100298646A1 (en) * | 2009-05-19 | 2010-11-25 | Tyco Healthcare Group Lp | Flexible access assembly with reinforced lumen |
US20100298832A1 (en) | 2009-05-20 | 2010-11-25 | Osseon Therapeutics, Inc. | Steerable curvable vertebroplasty drill |
ES2527819T3 (en) * | 2009-06-17 | 2015-01-30 | Trinity Orthopedics, Llc | Intervertebral device that expands and methods of using it |
US8394102B2 (en) | 2009-06-25 | 2013-03-12 | Baxano, Inc. | Surgical tools for treatment of spinal stenosis |
US20110021877A1 (en) * | 2009-07-24 | 2011-01-27 | Tyco Healthcare Group Lp | Surgical port and frangible introducer assembly |
US20110071497A1 (en) * | 2009-09-23 | 2011-03-24 | Alinsod Red M | Balloon fixated catheter |
US8597192B2 (en) * | 2009-10-30 | 2013-12-03 | Warsaw Orthopedic, Inc. | Ultrasonic devices and methods to diagnose pain generators |
KR101234733B1 (en) | 2009-11-11 | 2013-02-19 | 윤강준 | Artificial disc apparatus |
US20110118553A1 (en) * | 2009-11-19 | 2011-05-19 | Tyco Healthcare Group Lp | Access device including an integrated light source |
US8740904B2 (en) * | 2009-11-24 | 2014-06-03 | Covidien Lp | Seal anchor introducer including biasing member |
US8480683B2 (en) | 2009-11-24 | 2013-07-09 | Covidien Lp | Foam introduction system including modified port geometry |
US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US20110166423A1 (en) * | 2010-01-07 | 2011-07-07 | Tyco Healthcare Group Lp | Foam port introduction system including dilator |
AU2011203850A1 (en) * | 2010-01-11 | 2012-08-02 | Arstasis, Inc. | Device for forming tracts in tissue |
EP2523614A4 (en) | 2010-01-15 | 2017-02-15 | Conventus Orthopaedics, Inc. | Rotary-rigid orthopaedic rod |
AU2011207550B2 (en) | 2010-01-20 | 2016-03-10 | Conventus Orthopaedics, Inc. | Apparatus and methods for bone access and cavity preparation |
US8825129B2 (en) * | 2010-03-05 | 2014-09-02 | Sri International | Indwelling nerve block catheters |
EP2544608A4 (en) | 2010-03-08 | 2017-02-22 | Conventus Orthopaedics, Inc. | Apparatus and methods for securing a bone implant |
US9017252B2 (en) | 2010-04-12 | 2015-04-28 | Covidien Lp | Access assembly with flexible cannulas |
US8673007B2 (en) | 2010-04-20 | 2014-03-18 | Warsaw Orthopedic, Inc. | Implant with insertion device and method |
EP2563233B1 (en) | 2010-04-29 | 2020-04-01 | Dfine, Inc. | System for use in treatment of vertebral fractures |
US8936592B2 (en) | 2010-06-03 | 2015-01-20 | Ams Research Corporation | Laser tissue ablation system |
US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
US8845733B2 (en) | 2010-06-24 | 2014-09-30 | DePuy Synthes Products, LLC | Lateral spondylolisthesis reduction cage |
TW201215379A (en) | 2010-06-29 | 2012-04-16 | Synthes Gmbh | Distractible intervertebral implant |
US8685052B2 (en) | 2010-06-30 | 2014-04-01 | Laurimed, Llc | Devices and methods for cutting tissue |
WO2012003383A1 (en) | 2010-06-30 | 2012-01-05 | Laurimed, Llc | Devices and methods for cutting and evacuating tissue |
US9155492B2 (en) | 2010-09-24 | 2015-10-13 | Acclarent, Inc. | Sinus illumination lightwire device |
US9301787B2 (en) | 2010-09-27 | 2016-04-05 | Mmsn Limited Partnership | Medical apparatus and method for spinal surgery |
US9402732B2 (en) | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US9414930B2 (en) * | 2010-10-26 | 2016-08-16 | Kyphon SÀRL | Activatable devices containing a chemonucleolysis agent |
US8905996B2 (en) * | 2010-11-01 | 2014-12-09 | Biomet Manufacturing, Llc | Cannulated syringe |
US9022926B2 (en) | 2010-11-23 | 2015-05-05 | Covidien Lp | Reinforced flexible access assembly |
US8876804B2 (en) * | 2010-12-17 | 2014-11-04 | Ams Research Corporation | Ablation device |
US8641610B2 (en) | 2010-12-20 | 2014-02-04 | Covidien Lp | Access assembly with translating lumens |
US20120158099A1 (en) * | 2010-12-20 | 2012-06-21 | Kyphon Sarl | Low level laser therapy for low back pain |
US8602983B2 (en) | 2010-12-20 | 2013-12-10 | Covidien Lp | Access assembly having undercut structure |
US8753267B2 (en) | 2011-01-24 | 2014-06-17 | Covidien Lp | Access assembly insertion device |
JP2014516604A (en) | 2011-03-24 | 2014-07-17 | シー・アール・バード・インコーポレーテッド | Immobilization and protection of implanted medical devices |
US9259240B2 (en) | 2011-03-29 | 2016-02-16 | Covidien Lp | Articulating surgical access system for laparoscopic surgery |
US8986283B2 (en) | 2011-05-18 | 2015-03-24 | Solo-Dex, Llc | Continuous anesthesia nerve conduction apparatus, system and method thereof |
CA3192660A1 (en) | 2011-05-18 | 2012-11-22 | Solo-Dex, Inc. | Continuous anesthesia nerve conduction apparatus, system and method |
US9161807B2 (en) | 2011-05-23 | 2015-10-20 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
CN102198091B (en) * | 2011-05-25 | 2013-02-27 | 李跃华 | Acupuncture point injection |
US8814873B2 (en) | 2011-06-24 | 2014-08-26 | Benvenue Medical, Inc. | Devices and methods for treating bone tissue |
US9770289B2 (en) | 2012-02-10 | 2017-09-26 | Myromed, Llc | Vacuum powered rotary devices and methods |
US8685104B2 (en) | 2012-03-19 | 2014-04-01 | Amicus Design Group, Llc | Interbody vertebral prosthetic and orthopedic fusion device with self-deploying anchors |
US9566165B2 (en) | 2012-03-19 | 2017-02-14 | Amicus Design Group, Llc | Interbody vertebral prosthetic and orthopedic fusion device with self-deploying anchors |
US9393126B2 (en) * | 2012-04-20 | 2016-07-19 | Peter L. Mayer | Bilaterally placed disc prosthesis for spinal implant and method of bilateral placement |
US9364339B2 (en) * | 2012-04-30 | 2016-06-14 | Peter L. Mayer | Unilaterally placed expansile spinal prosthesis |
KR101352799B1 (en) * | 2012-05-10 | 2014-02-17 | 광주과학기술원 | Diagnostic probe and inspection apparatus having the same |
US10220186B2 (en) * | 2012-05-23 | 2019-03-05 | Becton, Dickinson And Company | Collapse-resistant swellable catheter |
WO2014074237A1 (en) * | 2012-11-09 | 2014-05-15 | Solodex Llc | Continuous anesthesia nerve conduction apparatus, system and method thereof |
US20140155973A1 (en) * | 2012-12-05 | 2014-06-05 | Spinal Modulation, Inc. | Tissue-captured anchors and methods of use |
WO2014113721A1 (en) * | 2013-01-18 | 2014-07-24 | Sri International | Anchoring nerve block catheter |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
US9271750B2 (en) * | 2013-03-13 | 2016-03-01 | Kyphon Sarl | Expandable cannula and method of use |
US10085783B2 (en) | 2013-03-14 | 2018-10-02 | Izi Medical Products, Llc | Devices and methods for treating bone tissue |
US9433437B2 (en) | 2013-03-15 | 2016-09-06 | Acclarent, Inc. | Apparatus and method for treatment of ethmoid sinusitis |
US9629684B2 (en) | 2013-03-15 | 2017-04-25 | Acclarent, Inc. | Apparatus and method for treatment of ethmoid sinusitis |
EP3799812B1 (en) | 2013-05-22 | 2023-11-29 | Covidien LP | Apparatus for controlling surgical instruments using a port assembly |
DE202013007340U1 (en) * | 2013-08-14 | 2014-08-18 | Joimax Gmbh | Operation set for placing a access tube in the disc of a patient |
WO2015061052A1 (en) * | 2013-10-24 | 2015-04-30 | St. Jude Medical, Cardiology Division, Inc. | Flexible catheter shaft and method of manufacture |
CN105813689B (en) | 2013-11-25 | 2019-06-25 | 定制医学应用有限公司 | Anchoring element, the medical device including one or more anchoring elements and associated component and method |
CA2969316A1 (en) * | 2013-12-12 | 2015-06-18 | Conventus Orthopaedics, Inc. | Tissue displacement tools and methods |
US8815099B1 (en) | 2014-01-21 | 2014-08-26 | Laurimed, Llc | Devices and methods for filtering and/or collecting tissue |
WO2015120165A1 (en) | 2014-02-05 | 2015-08-13 | Marino James F | Anchor devices and methods of use |
US20150227586A1 (en) * | 2014-02-07 | 2015-08-13 | Futurewei Technologies, Inc. | Methods and Systems for Dynamically Allocating Resources and Tasks Among Database Work Agents in an SMP Environment |
KR101649399B1 (en) * | 2014-04-10 | 2016-08-18 | 경북대학교 산학협력단 | Apparatus for teating disc |
US10172902B2 (en) * | 2014-05-28 | 2019-01-08 | Lunovus Llc | Ocular eyelid scrub composition for the treatment of demodex blepharitis |
EP2962720B1 (en) * | 2014-07-04 | 2020-01-15 | Abiomed Europe GmbH | Sheath for sealed access to a vessel |
EP2962721B1 (en) | 2014-07-04 | 2019-05-08 | Abiomed Europe GmbH | Sheath for sealed access to a vessel |
US10064649B2 (en) | 2014-07-07 | 2018-09-04 | Covidien Lp | Pleated seal for surgical hand or instrument access |
US10314605B2 (en) | 2014-07-08 | 2019-06-11 | Benvenue Medical, Inc. | Apparatus and methods for disrupting intervertebral disc tissue |
US9707011B2 (en) | 2014-11-12 | 2017-07-18 | Covidien Lp | Attachments for use with a surgical access device |
KR101672992B1 (en) * | 2014-12-05 | 2016-11-04 | 가톨릭대학교 산학협력단 | Snare |
US10022243B2 (en) | 2015-02-06 | 2018-07-17 | Benvenue Medical, Inc. | Graft material injector system and method |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
CN106492330B (en) * | 2015-09-07 | 2019-09-17 | 先健科技(深圳)有限公司 | Intracavitary administration conduit device |
CA2998368C (en) | 2015-09-15 | 2024-03-26 | Custom Medical Applications Inc. | Deployment devices and related assemblies and methods |
WO2017127502A1 (en) * | 2016-01-19 | 2017-07-27 | K2M, Inc. | Tissue dilation system and methods of use |
WO2018002715A2 (en) | 2016-06-28 | 2018-01-04 | Eit Emerging Implant Technologies Gmbh | Expandable and angularly adjustable articulating intervertebral cages |
WO2018002711A2 (en) | 2016-06-28 | 2018-01-04 | Eit Emerging Implant Technologies Gmbh | Expandable, angularly adjustable intervertebral cages |
JP2019534130A (en) | 2016-10-27 | 2019-11-28 | ディーファイン,インコーポレイティド | Articulated osteotome with cement delivery channel |
KR20190082300A (en) | 2016-11-28 | 2019-07-09 | 디파인 인코포레이티드 | Tumor ablation device and related method |
US10470781B2 (en) | 2016-12-09 | 2019-11-12 | Dfine, Inc. | Medical devices for treating hard tissues and related methods |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
EP3565486B1 (en) | 2017-01-06 | 2021-11-10 | Dfine, Inc. | Osteotome with a distal portion for simultaneous advancement and articulation |
CN110325122B (en) * | 2017-02-28 | 2024-03-19 | 波士顿科学国际有限公司 | Hinge pin |
US10758286B2 (en) | 2017-03-22 | 2020-09-01 | Benvenue Medical, Inc. | Minimal impact access system to disc space |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US11160682B2 (en) | 2017-06-19 | 2021-11-02 | Covidien Lp | Method and apparatus for accessing matter disposed within an internal body vessel |
WO2019010252A2 (en) | 2017-07-04 | 2019-01-10 | Conventus Orthopaedics, Inc. | Apparatus and methods for treatment of a bone |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
US10828065B2 (en) | 2017-08-28 | 2020-11-10 | Covidien Lp | Surgical access system |
US10675056B2 (en) | 2017-09-07 | 2020-06-09 | Covidien Lp | Access apparatus with integrated fluid connector and control valve |
WO2019148083A1 (en) | 2018-01-29 | 2019-08-01 | Benvenue Medical, Inc. | Minimally invasive interbody fusion |
WO2019178575A1 (en) | 2018-03-16 | 2019-09-19 | Benvenue Medical, Inc. | Articulated instrumentation and methods of using the same |
WO2019191538A1 (en) * | 2018-03-29 | 2019-10-03 | Asahi Intecc Co., Ltd. | Catheter and recanalization catheter system |
US11389193B2 (en) | 2018-10-02 | 2022-07-19 | Covidien Lp | Surgical access device with fascial closure system |
US11457949B2 (en) | 2018-10-12 | 2022-10-04 | Covidien Lp | Surgical access device and seal guard for use therewith |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
WO2020097334A1 (en) | 2018-11-08 | 2020-05-14 | Dfine, Inc. | Ablation systems with parameter-based modulation and related devices and methods |
US10792071B2 (en) | 2019-02-11 | 2020-10-06 | Covidien Lp | Seals for surgical access assemblies |
US11166748B2 (en) | 2019-02-11 | 2021-11-09 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11369752B2 (en) * | 2019-04-22 | 2022-06-28 | Warsaw Orthopedic, Inc. | Delivery of therapeutic material via sub-ligamentous space |
US11000313B2 (en) | 2019-04-25 | 2021-05-11 | Covidien Lp | Seals for surgical access devices |
US11413068B2 (en) | 2019-05-09 | 2022-08-16 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11357542B2 (en) | 2019-06-21 | 2022-06-14 | Covidien Lp | Valve assembly and retainer for surgical access assembly |
US11259840B2 (en) | 2019-06-21 | 2022-03-01 | Covidien Lp | Valve assemblies for surgical access assemblies |
US11259841B2 (en) | 2019-06-21 | 2022-03-01 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11413065B2 (en) | 2019-06-28 | 2022-08-16 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11399865B2 (en) | 2019-08-02 | 2022-08-02 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11523842B2 (en) | 2019-09-09 | 2022-12-13 | Covidien Lp | Reusable surgical port with disposable seal assembly |
US11432843B2 (en) | 2019-09-09 | 2022-09-06 | Covidien Lp | Centering mechanisms for a surgical access assembly |
US11812991B2 (en) | 2019-10-18 | 2023-11-14 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11464540B2 (en) | 2020-01-17 | 2022-10-11 | Covidien Lp | Surgical access device with fixation mechanism |
US11576701B2 (en) | 2020-03-05 | 2023-02-14 | Covidien Lp | Surgical access assembly having a pump |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
US11642153B2 (en) | 2020-03-19 | 2023-05-09 | Covidien Lp | Instrument seal for surgical access assembly |
US11541218B2 (en) | 2020-03-20 | 2023-01-03 | Covidien Lp | Seal assembly for a surgical access assembly and method of manufacturing the same |
US11446058B2 (en) | 2020-03-27 | 2022-09-20 | Covidien Lp | Fixture device for folding a seal member |
US11717321B2 (en) | 2020-04-24 | 2023-08-08 | Covidien Lp | Access assembly with retention mechanism |
US11529170B2 (en) | 2020-04-29 | 2022-12-20 | Covidien Lp | Expandable surgical access port |
US11622790B2 (en) | 2020-05-21 | 2023-04-11 | Covidien Lp | Obturators for surgical access assemblies and methods of assembly thereof |
US11751908B2 (en) | 2020-06-19 | 2023-09-12 | Covidien Lp | Seal assembly for surgical access assemblies |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
IT202100024056A1 (en) * | 2021-09-20 | 2023-03-20 | Vivheart S R L | ADJUSTABLE DEVICE FOR INSERTING A GUIDE WIRE INTO A BLOOD VESSEL |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6258086B1 (en) * | 1996-10-23 | 2001-07-10 | Oratec Interventions, Inc. | Catheter for delivery of energy to a surgical site |
Family Cites Families (151)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US516389A (en) * | 1894-03-13 | Fruit clipper and gatherer | ||
US2496672A (en) * | 1945-04-16 | 1950-02-07 | Newman Isidor | Device for removing sealing closures |
US2498672A (en) | 1947-05-26 | 1950-02-28 | Antonina S Glass | Motor drive for medical syringes |
US3190291A (en) * | 1962-10-08 | 1965-06-22 | Frederic E B Foley | Self-inflating bag catheter |
US3352306A (en) * | 1963-12-23 | 1967-11-14 | Hrisch Sidney | Intravenous catheter assembly |
US3482576A (en) | 1966-05-09 | 1969-12-09 | Kendall & Co | Easy deflatable retention catheter |
US3885561A (en) * | 1971-12-15 | 1975-05-27 | Charles N Mazal Cami | Catheter |
US3952742A (en) * | 1974-06-12 | 1976-04-27 | Taylor Duane F | Needle-carried, transthoracic, cannula-type cardiac resuscitation instrument |
US4141365A (en) * | 1977-02-24 | 1979-02-27 | The Johns Hopkins University | Epidural lead electrode and insertion needle |
US4737146A (en) * | 1979-12-25 | 1988-04-12 | Yoshikiyo Amaki | Multi-lumen epidural catheter |
US4419095A (en) | 1980-05-14 | 1983-12-06 | Shiley, Inc. | Cannula with radiopaque tip |
US4419819A (en) | 1982-01-29 | 1983-12-13 | Medtronic, Inc. | Method of making biomedical lead with lobed lead anchor |
US4512351A (en) * | 1982-11-19 | 1985-04-23 | Cordis Corporation | Percutaneous lead introducing system and method |
US4573448A (en) * | 1983-10-05 | 1986-03-04 | Pilling Co. | Method for decompressing herniated intervertebral discs |
US4543087A (en) * | 1983-11-14 | 1985-09-24 | Quinton Instrument Company | Double lumen catheter tip |
US4684363A (en) * | 1984-10-31 | 1987-08-04 | American Hospital Supply Corporation | Rapidly inflatable balloon catheter and method |
US4626241A (en) | 1985-03-06 | 1986-12-02 | Ivac Corporation | Apparatus and method for controlling the parenteral administration of fluids |
US4715378A (en) | 1986-07-28 | 1987-12-29 | Mansfield Scientific, Inc. | Balloon catheter |
US4782834A (en) | 1987-01-06 | 1988-11-08 | Advanced Cardiovascular Systems, Inc. | Dual lumen dilatation catheter and method of manufacturing the same |
US5250069A (en) | 1987-02-27 | 1993-10-05 | Terumo Kabushiki Kaisha | Catheter equipped with expansible member and production method thereof |
JPS63212374A (en) | 1987-02-27 | 1988-09-05 | テルモ株式会社 | Catheter equipped with expander |
US4772287A (en) * | 1987-08-20 | 1988-09-20 | Cedar Surgical, Inc. | Prosthetic disc and method of implanting |
US5129889A (en) * | 1987-11-03 | 1992-07-14 | Hahn John L | Synthetic absorbable epidural catheter |
JPH01145074A (en) * | 1987-12-01 | 1989-06-07 | Terumo Corp | Balloon catheter |
US4919651A (en) * | 1988-04-15 | 1990-04-24 | Santa Barbara Medical Foundation Clinic | Catheter having a double lumen and a balloon and method of using the same for controlled operative cholangiography |
US6120437A (en) | 1988-07-22 | 2000-09-19 | Inbae Yoon | Methods for creating spaces at obstructed sites endoscopically and methods therefor |
DE8811408U1 (en) * | 1988-09-09 | 1988-12-01 | B. Braun Melsungen Ag, 3508 Melsungen, De | |
US4968298A (en) | 1988-09-12 | 1990-11-06 | Michelson Gary K | Interspace irrigator |
US5301682A (en) * | 1989-02-03 | 1994-04-12 | Elie Debbas | Method for locating a breast mass |
US5004456A (en) * | 1989-03-10 | 1991-04-02 | Arrow International Investment Corporation | In-dwelling catheter |
US5354282A (en) | 1990-05-04 | 1994-10-11 | Bierman Steven F | Catheter anchoring system |
US5024655A (en) * | 1989-09-05 | 1991-06-18 | Freeman Andrew B | Epidural catheter apparatus and associated method |
US5084016A (en) * | 1989-09-05 | 1992-01-28 | Freeman Andrew B | Epidural catheter apparatus with an inflation fitting |
US5215105A (en) * | 1989-11-14 | 1993-06-01 | Custom Medical Concepts, Inc. | Method of treating epidural lesions |
US4973305A (en) * | 1989-12-08 | 1990-11-27 | David Goltzer | Method and apparatus for inserting and retaining an epidural catheter |
US5232442A (en) * | 1989-12-11 | 1993-08-03 | Brigham And Women's Hospital | Method and apparatus for inducing anesthesia |
US5024659A (en) * | 1990-01-10 | 1991-06-18 | Smith & Nephew Dyonics Inc. | Breakable needle and hinged needle guide |
US5267960A (en) | 1990-03-19 | 1993-12-07 | Omnitron International Inc. | Tissue engaging catheter for a radioactive source wire |
US5163989A (en) | 1990-08-27 | 1992-11-17 | Advanced Cardiovascular Systems, Inc. | Method for forming a balloon mold and the use of such mold |
DE4028487A1 (en) | 1990-09-09 | 1992-03-12 | Peter Dr Med Wehling | Interleukin inhibitors of cytokine synthesis - used to treat nerve inflammation, associated pain, spinal injury and slipped disc |
US5395317A (en) * | 1991-10-30 | 1995-03-07 | Smith & Nephew Dyonics, Inc. | Unilateral biportal percutaneous surgical procedure |
US5762629A (en) * | 1991-10-30 | 1998-06-09 | Smith & Nephew, Inc. | Oval cannula assembly and method of use |
US5234406A (en) * | 1992-04-06 | 1993-08-10 | The Regents Of The University Of California | Method and system for continuous spinal delivery of anesthetics |
US5344399A (en) * | 1992-05-26 | 1994-09-06 | Dlp, Inc. | Dual flexible introducer and cannula |
US5344439A (en) * | 1992-10-30 | 1994-09-06 | Medtronic, Inc. | Catheter with retractable anchor mechanism |
US5409483A (en) * | 1993-01-22 | 1995-04-25 | Jeffrey H. Reese | Direct visualization surgical probe |
US5800402A (en) * | 1993-03-19 | 1998-09-01 | Venetec International, Inc. | Catheter anchoring system and method of use |
US5833667A (en) | 1993-03-19 | 1998-11-10 | Venetec International, Inc. | Catheter anchoring system |
US5571147A (en) | 1993-11-02 | 1996-11-05 | Sluijter; Menno E. | Thermal denervation of an intervertebral disc for relief of back pain |
US5433739A (en) * | 1993-11-02 | 1995-07-18 | Sluijter; Menno E. | Method and apparatus for heating an intervertebral disc for relief of back pain |
US5833666A (en) | 1993-11-23 | 1998-11-10 | Uresil Corporation | Catheter fixation assembly |
EP1464293B1 (en) * | 1994-01-26 | 2007-05-02 | Kyphon Inc. | Improved inflatable device for use in surgical methods relating to fixation of bone |
US6241734B1 (en) | 1998-08-14 | 2001-06-05 | Kyphon, Inc. | Systems and methods for placing materials into bone |
US6248110B1 (en) * | 1994-01-26 | 2001-06-19 | Kyphon, Inc. | Systems and methods for treating fractured or diseased bone using expandable bodies |
US20030032963A1 (en) * | 2001-10-24 | 2003-02-13 | Kyphon Inc. | Devices and methods using an expandable body with internal restraint for compressing cancellous bone |
US20030229372A1 (en) * | 1994-01-26 | 2003-12-11 | Kyphon Inc. | Inflatable device for use in surgical protocols relating to treatment of fractured or diseased bone |
US5405334A (en) * | 1994-02-18 | 1995-04-11 | Merit Medical Systems, Inc. | Catheter apparatus with means for subcutaneous delivery of anesthetic agent or other fluid medicament |
US5772639A (en) * | 1994-02-18 | 1998-06-30 | Merit Medical Systems, Inc. | Total alimentary nutrition catheter apparatus with means for subcutaneous delivery of anesthetic agent or other fluid medicament |
US5533986A (en) * | 1994-02-18 | 1996-07-09 | Merit Medical Systems, Inc. | Catheter apparatus with means for subcutaneous delivery of anesthetic agent or other fluid medicament |
US5527307A (en) * | 1994-04-01 | 1996-06-18 | Minimed Inc. | Implantable medication infusion pump with discharge side port |
DE69524636T2 (en) | 1994-09-30 | 2002-05-23 | Venetec Int Inc | FASTENING SYSTEM FOR CATHETER |
US5779688A (en) * | 1994-10-28 | 1998-07-14 | Intella Interventional Systems, Inc. | Low profile balloon-on-a-wire catheter with shapeable and/or deflectable tip and method |
GB9501424D0 (en) * | 1995-01-25 | 1995-03-15 | Carrie Len | Epidural catheter |
US6602248B1 (en) * | 1995-06-07 | 2003-08-05 | Arthro Care Corp. | Methods for repairing damaged intervertebral discs |
US7179255B2 (en) * | 1995-06-07 | 2007-02-20 | Arthrocare Corporation | Methods for targeted electrosurgery on contained herniated discs |
US6054429A (en) * | 1996-03-08 | 2000-04-25 | Elan Pharmaceuticals, Inc. | Epidural method of producing analgesia |
US6122549A (en) * | 1996-08-13 | 2000-09-19 | Oratec Interventions, Inc. | Apparatus for treating intervertebral discs with resistive energy |
US5800407A (en) * | 1995-12-21 | 1998-09-01 | Eldor; Joseph | Multiple hole epidural catheter |
US5792044A (en) * | 1996-03-22 | 1998-08-11 | Danek Medical, Inc. | Devices and methods for percutaneous surgery |
US6620155B2 (en) | 1996-07-16 | 2003-09-16 | Arthrocare Corp. | System and methods for electrosurgical tissue contraction within the spine |
US6126682A (en) * | 1996-08-13 | 2000-10-03 | Oratec Interventions, Inc. | Method for treating annular fissures in intervertebral discs |
US6733496B2 (en) * | 2001-06-06 | 2004-05-11 | Oratec Interventions, Inc. | Intervertebral disc device employing flexible probe |
US7069087B2 (en) * | 2000-02-25 | 2006-06-27 | Oratec Interventions, Inc. | Apparatus and method for accessing and performing a function within an intervertebral disc |
JP2002515793A (en) * | 1996-10-23 | 2002-05-28 | オーレイテック インターヴェンションズ インコーポレイテッド | Method and apparatus for treating an intervertebral disc |
AU7178698A (en) * | 1996-11-15 | 1998-06-03 | Advanced Bio Surfaces, Inc. | Biomaterial system for in situ tissue repair |
US6080160A (en) | 1996-12-04 | 2000-06-27 | Light Sciences Limited Partnership | Use of shape memory alloy for internally fixing light emitting device at treatment site |
US6033438A (en) * | 1997-06-03 | 2000-03-07 | Sdgi Holdings, Inc. | Open intervertebral spacer |
US6852095B1 (en) * | 1997-07-09 | 2005-02-08 | Charles D. Ray | Interbody device and method for treatment of osteoporotic vertebral collapse |
AU8619698A (en) * | 1997-07-25 | 1999-02-16 | Ban C. H. Tsui | Devices, systems and methods for determining proper placement of epidural catheters |
GB2333234B (en) | 1998-01-14 | 2002-08-21 | Smiths Industries Plc | Catheter clamps and assemblies |
US6161047A (en) | 1998-04-30 | 2000-12-12 | Medtronic Inc. | Apparatus and method for expanding a stimulation lead body in situ |
US6224630B1 (en) * | 1998-05-29 | 2001-05-01 | Advanced Bio Surfaces, Inc. | Implantable tissue repair device |
GB9812290D0 (en) | 1998-06-09 | 1998-08-05 | Univ Nottingham | Back pain diagnosis |
US6652553B2 (en) | 1998-08-20 | 2003-11-25 | Endius Incorporated | Surgical tool for use in expanding a cannula |
US6187000B1 (en) * | 1998-08-20 | 2001-02-13 | Endius Incorporated | Cannula for receiving surgical instruments |
US6544215B1 (en) * | 1998-10-02 | 2003-04-08 | Scimed Life Systems, Inc. | Steerable device for introducing diagnostic and therapeutic apparatus into the body |
GB2344054B (en) * | 1998-11-28 | 2003-02-19 | Smiths Industries Plc | Catheter retainers and assemblies |
US6086589A (en) * | 1999-02-02 | 2000-07-11 | Spineology, Inc. | Method and device for fixing spondylolisthesis posteriorly |
US6554802B1 (en) * | 1999-03-31 | 2003-04-29 | Medtronic, Inc. | Medical catheter anchor |
US6368315B1 (en) * | 1999-06-23 | 2002-04-09 | Durect Corporation | Composite drug delivery catheter |
US7637905B2 (en) * | 2003-01-15 | 2009-12-29 | Usgi Medical, Inc. | Endoluminal tool deployment system |
US6350253B1 (en) | 1999-07-19 | 2002-02-26 | I-Flow Corporation | Catheter for uniform delivery of medication |
US6685695B2 (en) * | 1999-08-13 | 2004-02-03 | Bret A. Ferree | Method and apparatus for providing nutrition to intervertebral disc tissue |
US6821276B2 (en) * | 1999-08-18 | 2004-11-23 | Intrinsic Therapeutics, Inc. | Intervertebral diagnostic and manipulation device |
US20030040796A1 (en) * | 1999-10-08 | 2003-02-27 | Ferree Bret A. | Devices used to treat disc herniation and attachment mechanisms therefore |
US6899716B2 (en) * | 2000-02-16 | 2005-05-31 | Trans1, Inc. | Method and apparatus for spinal augmentation |
US6558390B2 (en) * | 2000-02-16 | 2003-05-06 | Axiamed, Inc. | Methods and apparatus for performing therapeutic procedures in the spine |
US6575979B1 (en) * | 2000-02-16 | 2003-06-10 | Axiamed, Inc. | Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae |
US20010049518A1 (en) * | 2000-03-01 | 2001-12-06 | Hoch Reuben M. | Method of delivering a beneficial agent employing a steerable catheter |
ATE333915T1 (en) * | 2000-03-24 | 2006-08-15 | Stephen Brushey | CONDUCTING CATHETER FOR ANESTHESIA |
US6402750B1 (en) | 2000-04-04 | 2002-06-11 | Spinlabs, Llc | Devices and methods for the treatment of spinal disorders |
ES2300339T3 (en) * | 2000-05-31 | 2008-06-16 | Fox Hollow Technologies, Inc. | PROTECTION SYSTEM AGAINST EMBOLIZATION IN VASCULAR INTERVENTIONS. |
US6899713B2 (en) * | 2000-06-23 | 2005-05-31 | Vertelink Corporation | Formable orthopedic fixation system |
US6673063B2 (en) * | 2000-10-06 | 2004-01-06 | Expanding Concepts, Llc. | Epidural thermal posterior annuloplasty |
US6613044B2 (en) * | 2000-10-30 | 2003-09-02 | Allen Carl | Selective delivery of cryogenic energy to intervertebral disc tissue and related methods of intradiscal hypothermia therapy |
US20020087113A1 (en) | 2000-12-29 | 2002-07-04 | Medtronic, Inc. | Drug management techniques for an implantable medical device |
US20050240201A1 (en) | 2001-02-13 | 2005-10-27 | Yeung Jeffrey E | Disc shunt delivery devices |
US6743195B2 (en) * | 2001-03-14 | 2004-06-01 | Cardiodex | Balloon method and apparatus for vascular closure following arterial catheterization |
US20040083002A1 (en) * | 2001-04-06 | 2004-04-29 | Belef William Martin | Methods for treating spinal discs |
US20020147496A1 (en) | 2001-04-06 | 2002-10-10 | Integrated Vascular Systems, Inc. | Apparatus for treating spinal discs |
US6562033B2 (en) * | 2001-04-09 | 2003-05-13 | Baylis Medical Co. | Intradiscal lesioning apparatus |
US6524320B2 (en) * | 2001-05-15 | 2003-02-25 | Endius Incorporated | Cannula for receiving surgical instruments |
US6638276B2 (en) | 2001-06-06 | 2003-10-28 | Oratec Interventions, Inc. | Intervertebral disc device employing prebent sheath |
US20030093105A1 (en) * | 2001-07-13 | 2003-05-15 | Scimed Life Systems, Inc. | Guide catheter for introduction into the subarachnoid space and methods of use thereof |
US20030032936A1 (en) * | 2001-08-10 | 2003-02-13 | Lederman Robert J. | Side-exit catheter and method for its use |
US6736815B2 (en) * | 2001-09-06 | 2004-05-18 | Core Medical, Inc. | Apparatus and methods for treating spinal discs |
US6706069B2 (en) * | 2001-09-13 | 2004-03-16 | J. Lee Berger | Spinal grooved director with built in balloon |
AU2002362310A1 (en) | 2001-09-14 | 2003-04-01 | Arthrocare Corporation | Methods and apparatus for treating intervertebral discs |
US6648873B2 (en) | 2001-09-21 | 2003-11-18 | Durect Corp. | Aural catheter system including anchor balloon and balloon inflation device |
US6805715B2 (en) * | 2001-10-09 | 2004-10-19 | Pmt Corporation | Method and device for treating intervertebral disc herniations |
EP1448089A4 (en) * | 2001-11-01 | 2008-06-04 | Spine Wave Inc | Devices and methods for the restoration of a spinal disc |
US20040010251A1 (en) | 2001-12-10 | 2004-01-15 | Shahar Pitaru | Methods, devices, and preparations for intervertebral disc treatment |
AU2003209287A1 (en) * | 2002-01-15 | 2003-07-30 | The Regents Of The University Of California | System and method providing directional ultrasound therapy to skeletal joints |
US6733534B2 (en) * | 2002-01-29 | 2004-05-11 | Sdgi Holdings, Inc. | System and method for spine spacing |
US6896675B2 (en) * | 2002-03-05 | 2005-05-24 | Baylis Medical Company Inc. | Intradiscal lesioning device |
US6812211B2 (en) | 2002-03-19 | 2004-11-02 | Michael Andrew Slivka | Method for nonsurgical treatment of the intervertebral disc and kit therefor |
US6736835B2 (en) * | 2002-03-21 | 2004-05-18 | Depuy Acromed, Inc. | Early intervention spinal treatment methods and devices for use therein |
US6969392B2 (en) | 2002-05-01 | 2005-11-29 | Nevmet Corporation | Multiportal device and method for percutaneous surgery |
WO2003095026A1 (en) * | 2002-05-13 | 2003-11-20 | Pflueger D Russell | Spinal disc therapy system |
US7118576B2 (en) | 2002-05-15 | 2006-10-10 | Nevmet Corporation | Multiportal device with linked cannulae and method for percutaneous surgery |
US7118577B2 (en) | 2002-05-16 | 2006-10-10 | Nevmet Corporation | Multiportal device with linked segmented cannulae and method for percutaneous surgery |
US20040243101A1 (en) * | 2002-07-02 | 2004-12-02 | Gillis Edward M. | Minimally invasive drug delivery catheter |
US7901407B2 (en) * | 2002-08-02 | 2011-03-08 | Boston Scientific Scimed, Inc. | Media delivery device for bone structures |
US20040054414A1 (en) * | 2002-09-18 | 2004-03-18 | Trieu Hai H. | Collagen-based materials and methods for augmenting intervertebral discs |
US7744651B2 (en) * | 2002-09-18 | 2010-06-29 | Warsaw Orthopedic, Inc | Compositions and methods for treating intervertebral discs with collagen-based materials |
US6827716B2 (en) | 2002-09-30 | 2004-12-07 | Depuy Spine, Inc. | Method of identifying and treating a pathologic region of an intervertebral disc |
TWI231755B (en) * | 2002-10-07 | 2005-05-01 | Conformis Inc | An interpositional articular implant and the method for making the same |
US20040186471A1 (en) * | 2002-12-07 | 2004-09-23 | Sdgi Holdings, Inc. | Method and apparatus for intervertebral disc expansion |
US7069083B2 (en) * | 2002-12-13 | 2006-06-27 | Advanced Neuromodulation Systems, Inc. | System and method for electrical stimulation of the intervertebral disc |
ATE411063T1 (en) | 2002-12-23 | 2008-10-15 | Medtronic Inc | MULTIPLE INFUSION CATHETER AND ASSOCIATED METHODS |
US7684865B2 (en) | 2003-03-14 | 2010-03-23 | Endovx, Inc. | Methods and apparatus for treatment of obesity |
US7783358B2 (en) | 2003-03-14 | 2010-08-24 | Endovx, Inc. | Methods and apparatus for treatment of obesity with an ultrasound device movable in two or three axes |
US20040193274A1 (en) * | 2003-03-28 | 2004-09-30 | Trieu Hai H. | Materials and methods for augmenting and/or repairing intervertebral discs |
US7666177B2 (en) * | 2003-09-15 | 2010-02-23 | James Guest | Method and system for cellular transplantation in the spinal cord |
US20050059931A1 (en) * | 2003-09-16 | 2005-03-17 | Venomatrix | Methods and apparatus for localized and semi-localized drug delivery |
US20050059930A1 (en) * | 2003-09-16 | 2005-03-17 | Michi Garrison | Method and apparatus for localized drug delivery |
US20050065307A1 (en) * | 2003-09-19 | 2005-03-24 | Depuy Products, Inc. | Medical implant or medical implant part comprising porous UHMWPE and process for producing the same |
US7632294B2 (en) * | 2003-09-29 | 2009-12-15 | Promethean Surgical Devices, Llc | Devices and methods for spine repair |
US20050137620A1 (en) * | 2003-12-22 | 2005-06-23 | Scimed Life Systems, Inc. | Balloon catheter retrieval device |
US7452351B2 (en) | 2004-04-16 | 2008-11-18 | Kyphon Sarl | Spinal diagnostic methods and apparatus |
US20050245938A1 (en) | 2004-04-28 | 2005-11-03 | Kochan Jeffrey P | Method and apparatus for minimally invasive repair of intervertebral discs and articular joints |
-
2004
- 2004-04-16 US US10/825,961 patent/US7452351B2/en active Active
-
2005
- 2005-04-15 CA CA002563912A patent/CA2563912A1/en not_active Abandoned
- 2005-04-15 AU AU2005235099A patent/AU2005235099A1/en not_active Abandoned
- 2005-04-15 EP EP05740085A patent/EP1747037A2/en not_active Withdrawn
- 2005-04-15 WO PCT/US2005/012981 patent/WO2005102440A2/en active Application Filing
- 2005-04-15 KR KR1020067022241A patent/KR20070004059A/en not_active Application Discontinuation
- 2005-04-15 JP JP2007508597A patent/JP2007532265A/en active Pending
- 2005-04-15 CN CNA2005800174248A patent/CN101005870A/en active Pending
- 2005-04-15 MX MXPA06011821A patent/MXPA06011821A/en not_active Application Discontinuation
-
2006
- 2006-11-20 US US11/597,349 patent/US20080027407A1/en not_active Abandoned
- 2006-12-26 US US11/616,212 patent/US7955312B2/en active Active
- 2006-12-26 US US11/616,215 patent/US20080021435A1/en not_active Abandoned
- 2006-12-26 US US11/616,219 patent/US8157786B2/en active Active
- 2006-12-26 US US11/616,222 patent/US7905874B2/en active Active
- 2006-12-26 US US11/616,223 patent/US20080077172A1/en not_active Abandoned
-
2008
- 2008-09-25 US US12/237,828 patent/US20090054935A1/en not_active Abandoned
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6258086B1 (en) * | 1996-10-23 | 2001-07-10 | Oratec Interventions, Inc. | Catheter for delivery of energy to a surgical site |
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US7744651B2 (en) | 2002-09-18 | 2010-06-29 | Warsaw Orthopedic, Inc | Compositions and methods for treating intervertebral discs with collagen-based materials |
US7731981B2 (en) | 2002-11-15 | 2010-06-08 | Warsaw Orthopedic, Inc. | Collagen-based materials and methods for treating synovial joints |
US8920828B2 (en) | 2003-08-06 | 2014-12-30 | Warsaw Orthopedic, Inc. | Implants for treatment of symptomatic or degenerated intervertebral discs |
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Also Published As
Publication number | Publication date |
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US20080009826A1 (en) | 2008-01-10 |
WO2005102440A3 (en) | 2006-07-06 |
US20050234425A1 (en) | 2005-10-20 |
AU2005235099A1 (en) | 2005-11-03 |
MXPA06011821A (en) | 2007-01-26 |
US20080027407A1 (en) | 2008-01-31 |
US20090054935A1 (en) | 2009-02-26 |
US8157786B2 (en) | 2012-04-17 |
US20080021435A1 (en) | 2008-01-24 |
US20080009828A1 (en) | 2008-01-10 |
US20080077172A1 (en) | 2008-03-27 |
KR20070004059A (en) | 2007-01-05 |
CA2563912A1 (en) | 2005-11-03 |
EP1747037A2 (en) | 2007-01-31 |
CN101005870A (en) | 2007-07-25 |
US7452351B2 (en) | 2008-11-18 |
US20080077117A1 (en) | 2008-03-27 |
JP2007532265A (en) | 2007-11-15 |
US7905874B2 (en) | 2011-03-15 |
US7955312B2 (en) | 2011-06-07 |
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