Epidural thermal posterior annuloplasty

Abstract

An apparatus for thermally treating intervertebral discs includes an energy application head having an energy application region and a tissue protecting region. A control member operationally connected to the energy application head preferably controls the energy application head during treatment. Significantly, the energy application head is preferably wedge-shaped and has a thin insertion edge sloped to a thick region for lifting vulnerable tissues away from a site of energy application to the at least one intervertebral disc. Preferably, the energy application head has a smooth surface suitable for gliding over surfaces of an annulus fibrosis without snagging other tissues. The present invention also includes a method for thermally treating an intervertebral disc.

What is claimed is:  
     
         1 . An apparatus for thermally treating at least one intervertebral disc, comprising: 
 (a) an energy application head having an energy application region and a tissue protecting region;    (b) a circumferencial intersection between said energy application region and said tissue protecting region;    (c) at least part of said circumferencial intersection being a thin insertion edge;    (d) said tissue protecting region being sloped from said thin insertion edge to a thick region for lifting vulnerable tissues away from a site of energy application to said at least one intervertebral disc; and    (e) a control member operationally connected to said energy application head, said control member suitable for controlling said energy application head during treatment of said at least one intervertebral disc.    
     
     
         2 . The apparatus of  claim 1 , wherein said energy application head is wedge-shaped.  
     
     
         3 . The apparatus of  claim 1 , wherein said tissue protecting region has a domed center.  
     
     
         4 . The apparatus of  claim 1 , wherein said energy application region has a smooth surface suitable for gliding over surfaces of an annulus fibrosis without snagging other tissues.  
     
     
         5 . The apparatus of  claim 1 , said energy application head further comprising at least one instrument selected from the group consisting of: 
 (a) a temperature measuring instrument;    (b) a tissue visualizing instrument    (c) an energy measuring instrument;    (d) a distance measuring instrument;    (e) an area measuring instrument;    (f) a pressure measuring instrument; and    (g) a volume measuring instrument.    
     
     
         6 . The apparatus of  claim 1 , said energy application head further comprising at least one energy applicator selected from the group consisting of: 
 (a) a laser;    (b) a fiber-optic strand;    (c) a lens;    (d) an electrode;    (e) a wire;    (f) a lightbulb;    (g) a heating element; and    (h) an ultrasound transducer.    
     
     
         7 . The apparatus of  claim 1 , wherein said energy application head applies energy selected from the group consisting of: 
 (a) electric current;    (b) radio frequency waves;    (c) microwaves;    (d) infrared waves;    (e) visible light waves;    (f) ultraviolet waves;    (g) ultrasonic sound waves; and    (h) conductive thermal energy.    
     
     
         8 . The apparatus of  claim 7 , said energy further comprising energy in a form selected from the group consisting of: 
 (a) incoherent electromagnetic radiation;    (b) defocused laser energy; and    (c) collimated laser energy.    
     
     
         9 . The apparatus of  claim 1 , said tissue protecting region further comprising at least one thermal protector for protecting vulnerable tissues from energy applied by said energy application head.  
     
     
         10 . The apparatus of  claim 9 , wherein said at least one thermal protector is selected from the group consisting of: 
 (a) at least one layer of insulation;    (b) airflow coolant;    (c) liquid coolant;    (d) coolant from a refrigeration system;    (e) a thermocouple; and    (f) a heat-pipe.    
     
     
         11 . The apparatus of  claim 1 , said control member further comprising at least one member selected from the group consisting of: 
 (a) a wire;    (b) a fiber-optic strand;    (c) one or more hollow tubes;    (d) a radio control mechanism;    (e) a moving mechanical link; and    (f) a beam of light;    (g) a lumen for adding and removing instruments;    (h) a lumen for adding and removing tissue; and    (i) a lumen for irrigating.    
     
     
         12 . An apparatus for thermally treating at least one intervertebral disc, comprising: 
 (a) an energy application head having an energy application region and a tissue protecting region;    (b) a thin insertion edge formed at the anterior portion of a circumferencial intersection between said energy application region and said tissue protecting region;    (c) said tissue protecting region being sloped from said thin insertion edge to a thick region for lifting vulnerable tissues away from a site of energy application to said at least one intervertebral disc; and    (d) a control member operationally connected to said energy application head, said control member suitable for controlling said energy application head during treatment of said at least one intervertebral disc.    
     
     
         13 . The apparatus of  claim 12 , wherein said energy application head is wedge-shaped.  
     
     
         14 . The apparatus of  claim 12 , wherein said tissue protecting region has a domed center.  
     
     
         15 . The apparatus of  claim 12 , wherein said energy application region has a smooth surface suitable for gliding over surfaces of an annulus fibrosis without snagging other tissues.  
     
     
         16 . An apparatus for thermally treating at least one intervertebral disc, comprising: 
 (a) an energy application head having an energy application region and a tissue protecting region;    (b) a thin insertion edge formed at the anterior portion of a circumferencial intersection between said energy application region and said tissue protecting region;    (c) said tissue protecting region being sloped from said thin insertion edge to a thick region for lifting vulnerable tissues away from a site of energy application to said at least one intervertebral disc.    
     
     
         17 . The apparatus of  claim 16 , wherein said energy application head is wedge-shaped.  
     
     
         18 . The apparatus of  claim 16 , wherein said tissue protecting region has a domed center.  
     
     
         19 . The apparatus of  claim 16 , wherein said energy application region has a smooth surface suitable for gliding over surfaces of an annulus fibrosis without snagging other tissues.  
     
     
         20 . An apparatus for thermally treating at least one intervertebral disc, comprising: 
 (a) an energy application head having an energy application region and a tissue protecting region;    (b) a control member operationally connected to said energy application head, said control member suitable for controlling said energy application head during treatment of said at least one intervertebral disc;    (c) said energy application head further comprising a thin insertion edge at the anterior intersection of said energy application region and said tissue protecting region; and    (d) said tissue protecting region sloped to a thick region for lifting vulnerable tissues away from a site of energy application to said at least one intervertebral disc.    
     
     
         21 . The apparatus of  claim 20 , wherein said energy application head is wedge-shaped.  
     
     
         22 . The apparatus of  claim 20 , wherein said tissue protecting region has a domed center.  
     
     
         23 . The apparatus of  claim 20 , wherein said energy application region has a smooth surface suitable for gliding over surfaces of an annulus fibrosis without snagging other tissues.  
     
     
         24 . A method for epidurally treating at least one intervertebral disc using a disc refurbisher, said method comprising the steps of: 
 (a) gaining access to a vertebral column;    (b) inserting a thin insertion edge formed at the anterior portion of a circumferencial intersection between an energy application region and a tissue protecting region of an energy application head of said disc refurbisher;    (c) epidurally approaching the posterior aspect of said at least one intervertebral disc;    (d) lifting vulnerable tissues using said tissue protecting region, said tissue protecting region being sloped from said thin insertion edge to a thick region; and    (e) applying energy to a posterior aspect of said at least one intervertebral disc using said energy application region.    
     
     
         25 . A method for thermally treating an intervertebral disc while thermally protecting vulnerable tissues, said method comprising the steps of: 
 (a) providing a disc refurbisher, said disc refurbisher comprising: 
 (i) an energy application head having an energy application region and a tissue protecting region;  
 (ii) a thin insertion edge formed at the anterior portion of a circumferencial intersection between said energy application region and said tissue protecting region;  
 (iii) said tissue protecting region being sloped from said thin insertion edge to a thick region for lifting vulnerable tissues away from a site of energy application to said at least one intervertebral disc; and  
 (iv) a control member operationally connected to said energy application head, said control member suitable for controlling said energy application head during treatment of said intervertebral disc;  
   (b) gaining access to a vertebral column;    (c) epidurally approaching the posterior aspect of said at least one intervertebral disc using said control member to position said energy application head;    (d) evaluating an extent of disc injury and calculating an amount of energy needed to thermally refurbish said at least one intervertebral disc;    (e) applying energy using said disc refurbisher to a posterior aspect of said at least one intervertebral disc while maintaining a safe temperature in said vulnerable tissues near said at least one intervertebral disc;    (f) monitoring an amount of energy delivered and a temperature in said vulnerable tissues near said at least one intervertebral disc;    (g) observing and evaluating an amount of shrinkage and strengthening of said at least one intervertebral disc to determine an intensity and duration of further energy delivery; and    (h) verifying that said shrinkage and strengthening of said at least one intervertebral disc is mechanically successful.