Abstract: Disc degeneration and chronic back pain are caused by a transport hindrance of oxygen, nutrients and pH buffer from capillaries in endplates into mid-layer of the intervertebral disc. A fluid absorbing conduit is inserted into the intervertebral disc, drawing and delivering the oxygen, nutrients and pH buffer in fluid of body circulation from capillaries at endplates into the mid-layer of the disc. The disc undergoes thousands of relaxation and compression cycles each day from daily activity of the patient. During relaxation phase, the fluid of body circulation containing oxygen, nutrients, and pH buffer is infused into the fluid absorbing conduit. During compression phase, the oxygen, nutrients, and pH buffer in the fluid absorbing conduit is dispersed into the mid-layer of the disc. The pH buffer, bicarbonate, neutralizes the lactic acid to relieve the discogenic pain. Oxygen inhibits hypoxic inflammation and production of lactic acid to further reduce the discogenic pain.

Abstract: A distal portion of a filament is extended beyond the distal end of a needle containing a gripper. A flexible one-way filament retainer with a snagging point is positioned adjacent to the extended filament. The needle with the extended filament and the one-way filament retainer are inserted into a cannula. During partial withdrawal of the needle, the snagging point of the one-way filament retainer hooks or retains the distal portion of the filament, depositing a section of the filament between the snagging point of the one-way filament retainer and the needle. When the needle is re-advanced, the needle pushes open the flexible one-way filament retainer, and the section of the filament is expelled or deposited in tissue. The needle can be rotated; the gripper engages and spirals the expelled filament to burrow into tissue. The method of needle partial withdrawal, re-advancement, rotation and pushing is repeated to pack and fill the tissue with interconnecting spirals of filament.

Abstract: Disc degeneration and chronic back pain are caused by a transport hindrance of oxygen, nutrients and pH buffer from capillaries in endplates into mid-layer of the intervertebral disc. A fluid absorbing conduit is inserted into the intervertebral disc, drawing and delivering the oxygen, nutrients and pH buffer in fluid of body circulation from capillaries at endplates into the mid-layer of the disc. The disc undergoes thousands of relaxation and compression cycles each day from daily activity of the patient. During relaxation phase, the fluid of body circulation containing oxygen, nutrients, and pH buffer is infused into the fluid absorbing conduit. During compression phase, the oxygen, nutrients, and pH buffer in the fluid absorbing conduit is dispersed into the mid-layer of the disc. The pH buffer, bicarbonate, neutralizes the lactic acid to relieve the discogenic pain. Oxygen inhibits hypoxic inflammation and production of lactic acid to further reduce the discogenic pain.

Abstract: Intervertebral discs are avascular. Oxygen, nutrients and bicarbonate diffuse from capillaries in cartilaginous endplates into discs to feed and maintain disc cells. As we age, calcified layers form at the endplates, blocking and occluding capillaries. Diffusion zones of oxygen and nutrients in disc become shallow. Cells in mid-layer of the disc suffer chronic anaerobic and starving conditions. Lactic acid is produced. Disc cells die from starvation, causing disc degeneration and forming fissures in annulus. Lactic acid leaks from fissures to the outer annulus of the disc to cause irritation, inflammation and persistent pain. Spirals of filament are implanted into the painful and degenerating disc to draw oxygen, nutrients and bicarbonate from the shallow diffusion zones of the cartilaginous endplates into the mid-layer of the degenerating disc.

Abstract: A distal portion of a filament is extended beyond the distal end of a needle containing a gripper. A flexible one-way filament retainer with a snagging point is positioned adjacent to the extended filament. The needle with the extended filament and the one-way filament retainer are inserted into a cannula. During partial withdrawal of the needle, the snagging point of the one-way filament retainer hooks or retains the distal portion of the filament, depositing a section of the filament between the snagging point of the one-way filament retainer and the needle. When the needle is re-advanced, the needle pushes open the flexible one-way filament retainer, and the section of the filament is expelled or deposited in tissue. The needle can be rotated; the gripper engages and spirals the expelled filament to burrow into tissue. The method of needle partial withdrawal, re-advancement, rotation and pushing is repeated to pack and fill the tissue with interconnecting spirals of filament.

Abstract: A distal portion of a filament is extended beyond the distal end of a needle with a gripper. The needle with the extended filament is inserted into a cannula with snagging points at the distal opening of the cannula in tissue. The snagging points of the cannula hook and retain the distal portion of the filament. During partial withdrawal of the needle, a section of filament is deposited in the lumen of the cannula between the distal ends of the needle and cannula. When the needle is re-advanced, the section of filament is expelled or pushed out of the cannula into tissue. The needle is then rotated; the gripper engages and spirals the expelled filament, burrowing into tissue. The needle can further advanced to push and pack the spiral of filament deep into the tissue. The knot-like filament spiral is individually formed by rotation of the needle and friction between the extended filament and tissue.

Abstract: An elastically curved suture anchor is resiliently straightened and delivered into tissue by a needle. When the needle is withdrawn, resumption of the curvature provides leverage for anchor rotation as the attached suture is pulled to fasten the anchor within the tissue. A fin at the proximal end of the anchor further increases the rotational leverage and expedites anchor fastening. When two or more anchors with connecting suture are delivered in series on a needle, the tension of the suture helps to draw the anchors together and approximates the pierced tissue.

Abstract: An elastically curved suture anchor is resiliently straightened and delivered into tissue by a needle. When the needle is withdrawn, resumption of the curvature provides leverage for anchor rotation as the attached suture is pulled to fasten the anchor within the tissue. A fin at the proximal end of the anchor further increases the rotational leverage and expedites anchor fastening. When two or more anchors with connecting suture are delivered in series on a needle, the tension of the suture helps to draw the anchors together and approximates the pierced tissue.

Abstract: The intervertebral disc is avascular. With aging, endplates become occluded by calcified layers, and diffusion of nutrients and oxygen into the disc diminishes. The disc degenerates, and pain ensues. Conduits are delivered and deployed into the intervertebral disc to re-establish the exchange of nutrients and waste between the disc and bodily circulation to stop or reverse disc degeneration and relieve pain. The intervertebral disc installed with semi-permeable conduits may be used as an immuno-isolated capsule to encapsulate donor cells capable of biosynthesizing therapeutic molecules. The semi-permeable conduits establish the exchange of nutrients and therapeutic molecules between disc and bodily circulation to treat a disease without using immuno-suppressive drugs.

Abstract: An elastically curved suture anchor is resiliently straightened and delivered into tissue by a needle. When the needle is withdrawn, resumption of the curvature provides leverage for anchor rotation as the attached suture is pulled to fasten the anchor within the tissue. A fin at the proximal end of the anchor further increases the rotational leverage and expedites anchor fastening. When two or more anchors with connecting suture are delivered in series on a needle, the tension of the suture helps to draw the anchors together and approximates the pierced tissue.

Abstract: The intervertebral disc contains no blood vessels. Nutrients and waste are diffused mainly through adjacent vertebral bodies. As we age, calcified layers form between the disc and vertebral bodies, blocking diffusion. The disc begins to starve and flatten. The weight shifts abnormally from disc to the facet joints causing strain and back pain. Under anaerobic conditions, lactic acid is produced causing acidic irritation and unspecific pain. A U-shaped disc shunt (126) is delivered into and sealed within the degenerated disc simply by needle puncturing and withdrawal, to draw nutrients from bodily circulation into the avascular disc. A continual supply of nutrients increases biosynthesis of the water-retaining sulfated glycosaminoglycans, hence swelling pressure within the disc. The weight is re-shifted from the facet joints to the regenerated disc, alleviating back pain. With oxygen transported through the shunt, anaerobic production of lactic acid is minimized.

Abstract: The intervertebral disc is avascular. With aging, endplates become occluded by calcified layers, and diffusion of nutrients and oxygen into the disc diminishes. The disc degenerates, and pain ensues. Conduits are delivered and deployed into the intervertebral disc to reestablish the exchange of nutrients and waste between the disc and bodily circulation to stop or reverse disc degeneration and relieve pain. The intervertebral disc installed with semi-permeable conduits may be used as an immuno-isolated capsule to encapsulate donor cells capable of biosynthesizing therapeutic molecules. The semi-permeable conduits establish the exchange of nutrients and therapeutic molecules between disc and bodily circulation to treat a disease without using immunosuppressive drugs.

Abstract: A solid stepped needle delivers a disc shunt bridging between muscle and a degenerated disc, drawing blood plasma from muscle into the degenerated disc to alleviate back pain and regenerate the disc. The device further includes pull lines attached to the ends of the disc shunt for withdrawing and repositioning the stepped needle during shunt delivery.

Abstract: The intervertebral disc is avascular. Nutrients and waste are diffused through adjacent vertebral bodies into the disc. As we age, calcified layers form between the disc and vertebral bodies, blocking diffusion of nutrients, oxygen and pH buffer in blood. Under anaerobic conditions, lactic acid is produced, irritating nerve endings and causing nonspecific pain. In addition, the disc begins to starve and flatten. The weight shifts abnormally from disc to the facet joints causing strain and back pain. Shunt coils are formed and spiraled over the distal shaft of a twistable needle, then deployed into the nucleus of a degenerated disc by a sliding sleeve. The coils serve as an internal shunt, drawing nutrients, oxygen and buffering solute from the superior and inferior diffusion zones to neutralize lactic acid in the mid layer of the degenerated disc. The coils also serve as a bulking agent within the repaired disc to sustain compression and reduce facet loading and segmental instability.

Abstract: A filament-guiding device directs a filament to spool over a rotating device within tissue. The filament-guiding device has both closed and open positions. In the closed position, the filament-guiding device is resiliently straightened for delivering into tissue. Within tissue, the filament-guiding device resumes a curved configuration in the open position to orient the filament perpendicular to the rotating device for spooling. The spooled filament is deployed by withdrawing the rotating device and filament-guiding device to bulk and repair the tissue.

Abstract: A Quincke tipped introducer needle contains two shafts with lumens, one recessed, both connected by a slit for housing a U- or V-shaped disc shunt. The recessed shaft minimizes the penetration size of the introducer needle for insertion into a narrow and nerve laden space adjacent to a degenerated intervertebral disc. The longitudinal slit connecting the two lumens allows passage of the distal portion of the U-shaped disc shunt through the introducer needle, to be delivered into the intervertebral disc. Pain emitting from the avascular disc is extremely difficult to treat due to lack of penetration or permeability of drug. The lumens of the introducer needle are also used to retain a peri-shunt injectable into the disc shunt for delivery into the painful disc. The peri-shunt injectable can be an analgesic, narcotic, anti-inflammatory drug, antibiotic, anticonvulsant, antidepressant, buffer agent or alkaline agent to alleviate pain.

Abstract: The intervertebral disc is avascular. With aging, endplates become occluded by calcified layers, and diffusion of nutrients and oxygen into the disc diminishes. The disc degenerates, and pain ensues. Conduits are delivered and deployed into the intervertebral disc to re-establish the exchange of nutrients and waste between the disc and bodily circulation to stop or reverse disc degeneration and relieve pain. The intervertebral disc installed with semi-permeable conduits may be used as an immuno-isolated capsule to encapsulate donor cells capable of biosynthesizing therapeutic molecules. The semi-permeable conduits establish the exchange of nutrients and therapeutic molecules between disc and bodily circulation to treat a disease without using immuno-suppressive drugs.

Abstract: The intervertebral disc is avascular. Nutrients and waste are diffused through adjacent vertebral bodies into the disc. As we age, calcified layers form between the disc and vertebral bodies, blocking diffusion of nutrients, oxygen and pH buffer in blood. Under anaerobic conditions, lactic acid is produced, irritating nerve endings and causing nonspecific pain. In addition, the disc begins to starve and flatten. The weight shifts abnormally from disc to the facet joints causing strain and back pain. Shunt coils are formed and spiraled over the distal shaft of a twistable needle, then deployed into the nucleus of a degenerated disc by a sliding sleeve. The coils serve as an internal shunt, drawing nutrients, oxygen and buffering solute from the superior and inferior diffusion zones to neutralize lactic acid in the mid layer of the degenerated disc. The coils also serve as a bulking agent within the repaired disc to sustain compression and reduce facet loading and segmental instability.

Abstract: Anchoring elements of a fastener are made elastically curved. The curvatures of the elements are resiliently straightened by a trocar for tissue insertion. As the trocar is withdrawn, the anchoring elements resume the curved configuration, laterally pressing the elements against tissue to anchor the fastener.

Abstract: The staple legs with tissue gripping elements are elastically curved. Curvatures of the legs are resiliently straightened and spearheaded by a pair of trocars for puncturing into tissue. While the staple is held stationary by a sleeve, the trocars are withdrawn to allow the legs to resume curvatures, elastically fastening the tissue.