Intervertebral disc anulus repair

Abstract

Systems for minimally invasive disc augmentation include an anulus augmentation component and a nucleus augmentation component. Both are suited for minimally invasive deployment. The nucleus augmentation component restores disc height and/or replaces missing nucleus pulposus. The anulus augmentation component shields weakened regions of the anulus fibrosis and/or resists escape of natural nucleus pulposus and/or the nucleus augmentation component. Methods and deployment devices are also disclosed. Methods of repairing a herniated disc by displacing at least a portion of the herniated segment to within the pre-herniated borders of the disc and anchoring at least a portion of the displaced herniated segment to a site within the disc are also provided.

1 . A method of treating an intervertebral disc comprising: 
 providing an implant delivery tool having a proximal end and a distal end, the distal end adapted to deliver a treatment device;    providing a fixation tool having a proximal end and a distal end, the distal end adapted to deliver a fixation element;    introducing the distal end of the implant delivery tool beyond at least a first outer layer of the anulus of an intervertebral disc    deploying said implant in the intervertebral disc;    introducing the distal end of said fixation tool beyond at least a first outer layer of the anulus;    deploying at least one fixation device into, or through, the wall of an anulus and through the implant to hold said implant at least partially beyond a first outer layer of the anulus;    removing said fixation tool; and    removing said implant delivery tool.    
     
     
         2 . The method of  claim 1 , wherein the implant delivery tool carries said implant.  
     
     
         3 . The method of  claim 1 , wherein the implant is held along an innermost layer of the anulus.  
     
     
         4 . The method of  claim 1 , wherein the implant is held in the space occupied by the nucleus.  
     
     
         5 . The method of  claim 1 , wherein the implant is a treatment device.  
     
     
         6 . The method of  claim 1 , wherein said fixation device comprises at least one suture.  
     
     
         7 . The method of  claim 6 , wherein said surgical suture material is resorbable.  
     
     
         8 . The method of  claim 1 , wherein said fixation device comprises at least one anchor portion and at least one connection member.  
     
     
         9 . The method of  claim 1 , wherein said fixation device comprises a resorbable material.  
     
     
         10 . The method of  claim 8 , wherein said anchor portion comprises at least one barb.  
     
     
         11 . The method of  claim 8 , wherein said at least one connection member comprises a suture.  
     
     
         12 . The method of  claim 8 , wherein said at least one connection member comprises a wire.  
     
     
         13 . The method of  claim 1 , wherein said fixation device comprises a woven or web-like material.  
     
     
         14 . The method of  claim 8 , wherein said fixation device comprises a connection member that is knotted.  
     
     
         15 . A fixation device useful for intervertebral disc reconstruction for treating a disc having a hole, defect, aperture, or weakenedportion in the wall of the anulus fibrosis of said intervertebral disc, said device comprising: 
 at least one anchor portion and at least one support member.    
     
     
         16 . The device of  claim 15 , wherein said anchor portion comprises at least one barb.  
     
     
         17 . The device of  claim 15 , wherein said anchor portion comprises a resorbable material.  
     
     
         18 . The device of  claim 15 , wherein said support member comprises at least two different materials.  
     
     
         19 . A method of treating an intervertebral disc comprising: 
 providing a first delivery tool having a proximal end and a distal end, the distal end carrying a treatment device;    providing at least one second delivery tool having a proximal end and a distal end, the distal end carrying a fixation element;    introducing the distal end of the first delivery tool at least partially into subannular intervertebral disc space;    deploying said treatment device;    introducing the distal end of said at least one second delivery tool at least partially into subannular intervertebral disc space;    deploying at least one fixation device into, or through, the wall of an annulus to hold said treatment device at least partially within the subannular intervertebral disc space.    removing said at least one second delivery tool;    removing said first delivery tool.    
     
     
         20 . The method of  claim 19 , wherein said fixation device comprises at least one surgical suture.  
     
     
         21 . The method of  claim 20 , wherein said surgical suture material is biodegradable.  
     
     
         22 . The method of  claim 19 , wherein said fixation device comprises at least one anchor portion and at least one band portion.  
     
     
         23 . The method of  claim 19 , wherein said fixation device is formed from biodegradable material or bioabsorbable material.  
     
     
         24 . The method of  claim 22 , wherein said anchor portion comprises at least one barb.  
     
     
         25 . The method of  claim 22 , wherein said at least one band is formed from suture material.  
     
     
         26 . The method of  claim 22 , wherein said at least one band is formed from wire.  
     
     
         27 . The method of  claim 19 , wherein said fixation device is secured with a knot.  
     
     
         28 . A fixation device useful for intervertebral disc reconstruction for treating a disc having an aperture, weakened, or thin portion in the wall of the annulus fibrosis of said intervertebral disc, said device comprising: 
 at least one anchor portion and at least one band.    
     
     
         29 . The device of  claim 28 , wherein said anchor portion comprises at least one barb.  
     
     
         30 . The device of  claim 28 , wherein said at least one band is formed from suture material.  
     
     
         31 . The device of  claim 28 , wherein said at least one band is formed from wire.  
     
     
         32 . The device of  claim 28 , wherein said band comprises at least two different materials.  
     
     
         33 . The device of  claim 28 , wherein said band is formed of mesh tube.