Percutaneous methods for injecting a curable biomaterial into an intervertebral space

摘要

A method for treating a spinal disc having an outer relatively intact annulus defining a disc space and an inner defective nucleus pulposus within the disc space, comprises the steps of: determining the integrity of the annulus by subjecting the annulus to a first pressure applied internally of the annulus; providing access to the nucleus pulposus through the annulus without removing any tissue from the annulus or from the nucleus pulposus; and sealably injecting curable biomaterial through the annulus access directly into the nucleus pulposus at a second pressure correlated with the first pressure. The integrity of the annulus may be determined by a pre-operative discogram using a contrast medium that has a viscosity substantially similar to the viscosity of the biomaterial to be injected. The needle is placed initially within the center of the nucleus pulposus and then withdrawn during the injection to approximately the inner border of the annulus. The second pressure is then maintained until the biomaterial is substantially cured. In steps, the curable biomaterial has strong adhesive properties and is capable of injection under pressure to fill fissures in the nucleus pulposus. The curable biomaterial may be injected under a pressure sufficient to distract opposing vertebral bodies communicating with the disc space.