1. Technical Field
The present disclosure relates to methods for treating intervertebral disc problems using percutaneous techniques without the need for major surgical intervention, and more particularly, to methods for the insertion of a cannula into the intervertebral disc and the insertion of a thermal probe into the disc material to heat the intervertebral disc thereby relieving and treating abnormalities or pain related to the disc.
2. Background of Related Art
The use of thermal therapy in and around the spinal column is known. Also, the insertion of cannula into the intervertebral discs is commonly done for injection of contrast mediums to implement X-ray discograms. This technique is used to detect or diagnose abnormalities or damage to the intervertebral disc. The use of heating of an intervertebral disc to relieve pain is described in U.S. Pat. No. 5,433,739, issued Jul. 18, 1995, and in U.S. Pat. No. 5,571,147, issued Nov. 5, 1996, the entire contents of each of which being incorporated herein by reference. In these patents, electrodes are described for either radiofrequency or resistive thermal heating of all or a portion of the intervertebral disc. Straight, curved, and flexible-tipped electrodes are described for this purpose. The thermal treatment of an intervertebral disc for the relief of back pain is also described within the patents cited above.
The use of a resistively heated probe adapted to be inserted into the intervertebral disc is described in U.S. Pat. No. 6,073,051, issued Jun. 6, 2000, the entire content of which is incorporated herein by reference. As seen in FIG. 1, U.S. Pat. No. 6,073,051, an apparatus or probe for treating intervertebral discs, the apparatus including a flexible catheter 14 which is introduced into the nucleus pulposus “N” and manipulated about (i.e., a functional element 16 of catheter 14 is introduced from a lateral side of nucleus pulposus “N”, opposite the area to be treated, and extended around to the opposite lateral side of nucleus pulposus “N”, adjacent to the area to be treated) an inner wall of the annulus fibrosus along annulus fibrosus/nucleus pulposus interface 28. Accordingly, functional element or intradiscal section 16 of catheter 14 delivers a therapeutic effect to the area of nucleus pulposus “N” to be treated, i.e., fissures “F”.
It is desirable to treat the posterior or posterior/lateral portion of the intervertebral disc for the indication of mechanical degeneration of the disc and discogenic back pain. Pain can be derived from degeneration or compression of the intervertebral disc in its posterior or posterior/lateral portions. There is some innervation of the intervertebral disc near the surface of the disc and also within its outer portion known as the annulus fibrosus. Fissures or cracks within the disc caused by age, mechanical trauma, or disc degeneration are believed to be associated with painful symptoms.
Thus, a configuration of insertion cannula, to approach and enter the intervertebral disc, and a thermal probe to be built into or associated with said cannula, to adequately reach the posterior/lateral and posterior portions of the intervertebral disc, is desirable. Additionally, a novel method of introducing and advancing a thermal probe, toward the tissue to be treated, is also desirable.