Devices and methods for treating tissue defects
The present disclosure describes embodiments for treating a defect in a tissue, the tissue having internal and external surfaces. A device includes a first portion for positioning at one of the internal and external surfaces for applying a treatment force to the defect. In addition, the device has a second portion for applying a counter-force, where the second portion is operable to be positioned so that the counter-force is applied on the other of the internal and external surfaces, away from the defect so as to substantially avoid application of force at the defect. Furthermore, the device includes a coupling member for connecting the inner and outer portions. Methods of using the device are described, for example in an intervertebral disc having a herniation.
1. A method for treating a defect within a tissue comprising the steps of :
(a) anchoring an inner portion of a device within a nucleus pulposus of an intervertebral disc at an inner wall of a disc annulus away from the defect by engaging a portion of the inner wall substantially without contacting an inner surface of a disc annulus at the defect;
(b) positioning an outer portion of said device at an outer surface of the disc annulus of the intervertebral disc at the defect; and
(c) applying a pulling force between said outer portion and said inner portion, such that said outer portion is forced against said outer surface at the defect while said inner portion does not substantially apply a force to said inner surface at the defect while applying a force to the inner wall of the disc annulus away from the defect.
2. The method of claim 1 , wherein said inner portion is connected to said outer portion prior to, following or during step (a).
3. The method of claim 1 , wherein the step of anchoring the inner portion comprises positioning said inner portion within said disc nucleus.
4. The method of claim 3 , wherein the step of anchoring the inner portion further comprises deploying anchoring elements forming a part of, or being attached to, said inner portion.
5. The method of claim 1 , wherein the inner portion is inserted into the intervertebral disc using an introducer device.
6. The method of claim 5 , further comprising a step of retracting the introducer device.
7. The method of claim 6 , wherein retracting the introducer device causes said inner portion to be anchored within the intervertebral disc, whereby at least a part of the inner portion engages an inner surface of the disc annulus.
8. The method of claim 6 , wherein retracting the introducer device causes said inner portion to be anchored within the nucleus pulposus substantially without contacting an inner surface of the disc annulus.
9. The method of claim 6 , wherein the step of retracting the introducer device allows the inner portion to move from a retracted position into an expanded position thereby anchoring the inner portion within the intervertebral disc.
10. The method of claim 1 , wherein the step of anchoring the inner portion comprises applying force to the inner portion to expand the inner portion within the disc.
11. The method of claim 1 , further comprising a step of connecting the outer portion to the inner portion via a coupling member.
12. The method of claim 1 , wherein a coupling member is pre-attached to the inner portion and is inserted into the disc along with the inner portion.
13. The method of claim 12 , further comprising a step of manipulating the coupling member.
14. The method of claim 13 , wherein manipulating the coupling member comprises adjusting a length of the coupling member to reduce a distance between the inner portion and the outer portion.
15. The method of claim 11 , wherein the coupling member applies a pulling force between said outer portion and said inner portion, such that said outer portion is forced against said outer surface at the defect while said inner portion does not substantially apply a force to said inner surface at the defect.
16. The method of claim 15 , wherein the coupling member comprises a suture and a knot, and wherein the step of applying a pulling force comprises (i) pulling said inner portion radially outwards using the suture, and (ii) pushing said outer portion radially inwards using the knot and suture, to force said outer portion against said outer surface at said defect.
17. The method of claim 13 , where the coupling member comprises a screw and wherein the step of manipulating the coupling member comprises actuating the screw.
18. The method of claim 1 wherein the defect comprises a herniation of the intervertebral disc.
19. The method of claim 1 , wherein said defect comprises a tear within a region of the annulus.
20. The method of claim 1 , wherein said defect comprises a delamination of the annulus.
21. The method of claim 1 , wherein said defect comprises a substantially sealed discectomy hole.
22. The method of claim 21 , wherein said defect comprises a substantially sealed discectomy hole that has been sealed using sutures.
23. The method of claim 1 , wherein said defect comprises a fissure within a region of the annulus.