Methods for delivering an implant and agent in an intervertebral disc

Abstract

The present invention relates generally to devices and methods for delivering medical devices, such as implants, to desired tissue sites, such as the intervertebral disc. In one aspect, an intervertebral disc repair and diagnostic device that is minimally invasive and that provides precise access to the desired site is provided. In some aspects, the device and method are adapted to deliver, position and expand implants that are initially oriented and compressed for minimally invasive, yet precise and effective implantation.

1 . A method of delivering and positioning an implant and a therapeutic agent within an intervertebral disc comprising:
 providing a delivery device, wherein said delivery device comprises a cannula, one or more lumens, a depth stop and an advancer slideably retained within the cannula,   wherein the advancer is configured to advance an implant coupled to the distal end of the advancer out of said cannula;   compressing said implant along a first axis;   inserting said cannula into an intervertebral disc;   positioning said depth stop to abut against an external surface of the intervertebral disc and delivering said implant relative to said position;   positioning said cannula such that the implant is positioned beyond the innermost surface of the anulus;   rotating the cannula, thereby rotating the implant;   retracting the cannula, thereby initially expanding the implant to a first partially expanded configuration;   delivering one or more agents through the one or more lumens into the intervertebral disc, wherein said agent is at least one of a pharmaceutical agent or a nucleus augmentation material;   uncoupling the implant from the distal end of the advancer; and   removing the delivery device from the intervertebral disc.   
     
     
         2 . The method of  claim 1 , further comprising:
 advancing one or more expanders coupled to a distal end of the cannula, thereby further expanding the implant to a second partially expanded configuration; and   advancing the thereby substantially completely expanding the implant to a fully expanded configuration.   
     
     
         3 . The method of  claim 1 , further comprising aspirating material through at least one of the one or more lumens. 
     
     
         4 . The method of  claim 1 , wherein the pharmaceutical agent comprises one or more growth factors. 
     
     
         5 . The method of  claim 1 , wherein the pharmaceutical agent comprises an anti-inflammatory agent, a steroid, or an antibiotic. 
     
     
         6 . The method of  claim 1 , wherein the pharmaceutical agent comprises a vasodilator or a vasoconstrictor. 
     
     
         7 . The method of  claim 1 , wherein the pharmaceutical agent comprises a fluid to aid in heating or cooling the site tissue. 
     
     
         8 . The method of  claim 1 , wherein the pharmaceutical agent is configured to facilitate pain reduction or inhibition of scarring. 
     
     
         9 . The method of  claim 1 , wherein the pharmaceutical agent comprises genetically active growth or healing factors. 
     
     
         10 . The method of  claim 1 , wherein the delivery device comprises a lubrication to reduce friction as the implant exits the delivery device. 
     
     
         11 . The method of  claim 1 , wherein the pharmaceutical agent is configured to stimulate tissue ingrowth. 
     
     
         12 . The method of  claim 1 , wherein the one or more agents are delivered before inserting the cannula within the intervertebral disc. 
     
     
         13 . The method of  claim 1 , wherein the one or more agents are delivered after uncoupling the implant from the distal end of the advancer. 
     
     
         14 . The method of  claim 1 , wherein the implant comprises a graft. 
     
     
         15 . The method of  claim 1 , wherein the delivery device comprises one or more anchoring mechanisms. 
     
     
         16 . The method of  claim 1 , further comprising anchoring the implant to adjacent or nearby tissue of the intervertebral disc. 
     
     
         17 . The method of  claim 1 , further comprising adjusting a temperature of surrounding tissue. 
     
     
         18 . The method of  claim 1 , wherein the implant is expanded inferiorly and superiorly with respect to vertebral endplates adjacent the intervertebral disc. 
     
     
         19 . The method of  claim 1 , wherein the implant is expanded along a direction substantially parallel to a vertebral endplate adjacent the intervertebral disc. 
     
     
         20 . The method of  claim 1 , further comprising the step of inserting the implant through a defect or iatrogenic hole.