Methods and apparatus for adhering musculoskeletal tissues

#This invention relates generally to spinal surgery and, in particular, for adhering musculoskeletal tissues.

#According to current practice, musculoskeletal tissues such as tendons, ligaments, and cartilage are connected surgically with sutures and staples. Generally, the synthetic staples and sutures provide provisional fixation. Long-term connection of the tissues is dependent upon the tissues healing together, however. The natural healing process relies on the formation of fibrous scar tissue between the surgically connected tissues. In a sense, there is a race between failure of the suture and the formation of scar tissue with sufficient tensile strength to hold the tissues together. At times a patient's anatomy can make suturing or stapling of tissues difficult. For example, a surgeon may wish to connect two or more tissues inside a structure such as the intervertebral disc.

#This invention is direct to a method of adhering musculoskeletal tissues such as tendons, ligaments, and cartilage. Broadly the method involves applying one or more substances to the musculoskeletal tissues to be connected which enhances adhesion therebetween.

#FIGS. 1A and 1B are drawings which show a retractable catheter according to the invention;

#FIG. 2A shows a coronal cross-section of a retractable catheter and syringe; and

#FIG. 2B shows a coronal cross-section of a retracted catheter and syringe shown in FIG. 2A.

#This invention addresses the above problems associated with sutures or staples. According to one aspect, scar-forming substances are applied to the tissues that the surgeon wishes to connect. For example, tetracycline, nitrogen mustard, sterile talcum powder, erythromycin, or alternative substances may be applied to the tissues. The scarring affects of tetracycline and nitrogen mustard are well known to surgeons who perform pleurodesis (for the lung). This method could be used to “glue” tissues of the intervertebral disc together using, for example, adhesives such as Dermabond and those used in Dentistry.

#A second aspect of the invention uses growth factors such as those found in platelet-rich plasma (PRP) to accelerate the healing. The growth factors could be sprayed onto the tissues the surgeon wishes to connect. A third aspect uses “glue” such as “fibrin glue” to bond the tissues together.

#Regardless of the embodiment, an inventive retractable catheter may be used to administer the agent(s) so as not to expose unintended areas. As shown in FIG. 1A, a syringe is coupled to the catheter in an extended state to deliver the substance(s), which is retracted after delivery (FIG. 1B).