Apparatus and method for injection of fibrin sealant in spinal applications
An apparatus for percutaneous delivery of a sealant comprising: at least two fluid reservoirs, an introducer needle having a distal tip that is in fluid communication with at least one reservoir, a fluid delivery tube that is in fluid communication with a second reservoir, wherein the fluid delivery tube has a tip and wherein the fluid delivery tube is configured so that the tip of the fluid delivery tube does not extend past the distal tip of the introducer needle during use.
1. A method of percutaneously treating a disc that is leaking nucleus pulposus into or through at least one defect in the annulus fibrosus, comprising:
advancing a hypodermic needle through skin percutaneously, through the annulus fibrosus and into the nucleus pulposus by piercing the skin, the annulus fibrosus and the nucleus pulposus with the hypodermic needle, wherein the hypodermic needle can be attached to a connector and the hypodermic needle has a distal tip;
inserting a fluid delivery tube into the hypodermic needle up to but not beyond the distal tip of the hypodermic needle;
wherein the fluid delivery tube has a distal tip and is configured so that the distal tip of the fluid delivery tube does not extend past the distal tip of the hypodermic needle;
injecting components of a biologic sealant that begin mixing after the connector and within the space between the distal tip of the hypodermic needle and the distal tip of the fluid delivery tube.
2. The method of claim 1 , wherein the fluid delivery tube is a multilumen catheter.
3. The method of claim 1 , wherein the fluid delivery tube is a second needle, wherein a fibrinogen solution passes through and in direct contact with the hypodermic needle and wherein an activating solution passes through and in direct contact with the second needle.
4. The method of claim 1 , wherein the fluid delivery tube is a second needle, wherein an activating solution passes through the hypodermic needle and wherein a fibrinogen solution passes through the second needle.
5. The method of claim 1 , wherein the biologic sealant is fibrin sealant, and wherein calcium ions are injected with the fibrin sealant.
6. The method of claim 1 , further comprising measuring the pressure of one component while the components are being injected.
7. The method of claim 1 , wherein an additive is injected with the fibrinogen and the activating compound, wherein the additive is selected from the group consisting of antibiotics; antiproliferative, cytotoxic, and antitumor drugs including chemotherapeutic drugs; analgesic; antiangiogen; antibody; antivirals; cytokines; colony stimulating factors; proteins; chemoattractants; EDTA; histamine; antihistamine; erythropoietin; antifungals; antiparasitic agents; non-corticosteroid anti-inflammatory agents; anticoagulants; anesthetics; analgesics; oncology agents; cardiovascular drugs; glycoproteins; fibronectin; peptides including polypeptides and proteins; interferons; cartilage inducing factors; protease inhibitors; vasoconstrictors, vasodilators, demineralized bone or bone morphogenetic proteins; hormones; lipids; carbohydrates; proteoglycans; antiangiogenins; antigens; DBM; hyaluronic acid and salts and derivatives thereof; polysaccharides; cellulose compounds and derivatives thereof; gene therapy reagents; genetically altered cells, stem cells including mesenchymal stem cells with transforming growth factor, and/or other cells; cell growth factors; type I and II collagen; collagen hydrolysate; elastin; sulfated glycosaminoglycan (sGAG), glucosamine sulfate; pH modifiers; methylsulfonylmethane (MSM); osteogenic compounds; osteoconductive compounds; plasminogen; nucleotides; oligonucleotides; polynucleotides; polymers; osteogenic protein 1 (OP-1 including recombinant OP-1); LMP-1 (Lim Mineralization Protein-1); cartilage; oxygen-containing components; enzymes; melatonin; vitamins; nutrients; and combinations thereof.
8. The method of claim 1 , wherein the at least one defect is a tear or fissure in the annulus fibrosus.
9. The method of claim 1 , wherein normal physiologic hydrostatic pressure in the disc is restored or normal disc height is restored or both.
10. The method of claim 1 , wherein the biologic sealant is fibrin sealant that includes a fibrinogen component and the fibrinogen of the fibrin sealant is autologous.
11. The method of claim 1 , wherein the injection is performed using a dual barrel syringe.
12. The method of claim 1 , wherein the disc is a lumbar disc.
13. The method of claim 1 , wherein the disc is a thoracic disc.
14. The method of claim 1 , wherein the disc is a cervical disc.
15. The method of claim 1 , wherein a contrast agent is injected either before, with, or after the components of the biologic sealant have been injected.
16. The method of claim 1 , wherein a local anesthetic is injected into the disc.
17. The method of claim 1 , wherein the fluid delivery tube is a bilumen catheter.
18. The method of claim 1 , wherein the fluid delivery tube is a trilumen catheter.
19. The method of claim 1 , wherein two flexible tubes are connected to the connector, wherein each component of the biologic sealant flow through opposite flexible tubes to transmit the components to the hypodermic needle and the fluid delivery tube while injecting the components.
20. The method of claim 1 , wherein after the hypodermic needle is advanced into the nucleus pulposus and the fluid delivery tube is inserted, the distal tips of hypodermic needle and the fluid delivery tube both extend past the annulus fibrosus.
21. The method of 1 , wherein the hypodermic needle is at least 5 inches long.