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1. (WO1999047058) CATHETER FOR DELIVERY OF ENERGY TO A SURGICAL SITE
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CLAIMS
What is claimed is:

1. A catheter for delivering energy to an intervertebral disc, and said catheter including at a proximal end a handle and at a distal end a probe and said intervertebral disc having a nucleus pulposus, an annulus fibrosus, and an inner wall of said annulus fibrosus, said nucleus pulposus having a first diameter in a disc plane between opposing sections of said inner wall, and said catheter comprising:
at least one energy delivery device located at the distal end of the catheter to deliver energy to portions of the intervertebral disc; and
an activation element located at the distal end of the catheter, to transition the probe from a linear to a multi-dimensional shape, within the intervertebral disc.

2. The catheter of Claim 1 , wherein the activation element comprises:
a resilient material which in a relaxed state effects an arcuate shape and which upon introduction of external stress assumes a substantially linear shape.

3. The catheter of Claim 2, further comprising:
an introducer defining along a longitudinal axis a lumen dimensioned to apply external stress to the resilient material.

4. The catheter of Claim 1 , wherein the activation element comprises:
at least two materials exhibiting differential coefficients of thermal expansion and the at least two materials joined to one another wherein at a first temperature the at least two materials assume a substantially linear shape and at a second temperature the at least two materials assume an arcuate shape.

5. The catheter of Claim 1 , wherein the activation element comprises:
a material with a temperature dependent shape memory wherein at a first temperature the material assumes a substantially linear shape and at a second temperature the material assumes an arcuate shape.

6. The catheter of Claim 5, wherein the material comprises nickel-titanium.

7. The catheter of Claim 1 , wherein the activation element comprises:
a mandrel with a longitudinal axis, and the mandrel including a differential bending ability in two orthogonal axis which are orthogonal to the longitudinal axis; and
a piezo-electric material joined to the mandrel along a length thereof, and the piezo-electric material responsive to an electrical stimulus to vary at least one dimension thereof, to effect a transition of the mandrel from a substantially linear shape to an arcuate shape.

8. The catheter of Claim 1, wherein the activation element comprises:
a mandrel with a longitudinal axis, and the mandrel including a differential bending ability in two orthogonal axis which are orthogonal to the longitudinal axis; and
a tension member joined to the mandrel at a distal end thereof, and coextensive with the longitudinal axis of the mandrel along a length thereof, and the mandrel responsive to tension applied to the tension member, to effect a transition of the mandrel from a substantially linear shape to an arcuate shape.

9. The catheter of Claim 1 , wherein the activation element comprises:
at least two side members extending axially along a longitudinal axis of the probe and rigidly affixed at first ends thereof to the probe, and the at least two side members moveable from a first position proximate to the longitudional axis of the probe to a second position radially displaced about the longitudinal axis of the probe.

10. The catheter of Claim 9, wherein the at least two side members comprise:
a resilient material which in a relaxed state effects an arcuate shape and which upon introduction of external stress assumes a substantially linear shape.

11. The catheter of Claim 10, further comprising :
an introducer defining along a longitudional axis a lumen dimensioned to apply external stress to the resilient material.

12. The catheter of Claim 9, wherein the at least two side members comprise:
at least two materials exhibiting differential coefficients of thermal expansion and at least two materials joined to one another wherein at a first temperature the at least two materials assume a substantially linear shape and at a second temperature the at least two materials assume an arcuate shape.

13. The catheter of Claim 9, wherein the at least two side members comprise:
a material with a temperature dependent shape memory wherein at a first temperature the material assumes a substantially linear shape and at a second temperature the material assumes an arcuate shape.

14. The catheter of Claim 13, wherein the material comprises nickel-titanium.

15. The catheter of Claim 9, wherein the at least two side members comprise;

a resilient material which in a relaxed state effects a linear shape and which upon introduction of a compressive force between the first ends of the at least two side members and second ends thereof assumes a substantially arcuate shape; and
a draw member coupled to the handle for applying the compressive force to the resilient material, to effect a transition of the at least two side members from a substantially linear shape to an arcuate shape.

16. The catheter of Claim 15, wherein the energy delivery element further comprises;
a core parallel to the longitudinal axis of the probe; and
electrical couplings for applying electrical power of an opposing polarity to respectively said at least two side members and said core.

17. The catheter of Claim 1 , wherein the energy delivery element further comprises;
at least one resistive coil located within the probe at a distal end thereof; and
electrical couplings for applying electrical power to said at least one resistive coil.

18. The catheter of Claim 1 , wherein the energy delivery element includes a thermal energy delivery element.

19. The catheter of Claim 18, wherein said thermal energy delivery element comprises at least one of a resistive heating element and at least one radio frequency electrode.

20. The catheter of Claim 18, wherein the thermal energy delivery element comprises: a substrate fastened to the distal end of the catheter; and
a heating element fabricated on said substrate by a photo-etching.

21. A catheter for delivering energy to an intervertebral disc, and said catheter including at a proximal end a handle and at a distal end a probe and the intervertebral disc having a nucleus pulposus, an annulus fibrosus, and an inner wall of said annulus fibrosus, said nucleus pulposus having a first diameter in a disc plane between opposing sections of said inner wall, and said catheter comprising:
a substrate located at the distal end of the catheter; and
a heating element adapted to deliver thermal energy to portions of the intervertebral disc, said heating element fabricated on said substrate by a photo-etching.

22. The catheter of Claim 21 , wherein the substrate comprises a polyester film.

23. The catheter of Claim 21 , wherein the heating element is asymmetrical fabricated on said substrate to deliver thermal energy assymetrically to the portions of the intervertebral disc.

24. The catheter of Claim 21 , wherein the substrate defines a cylinder.

25. A catheter for delivering energy to an intervertebral disc, and said catheter including at a proximal end a handle and at a distal end a probe and the intervertebral disc having a nucleus pulposus, an annulus fibrosus, and an inner wall of said annulus fibrosus, said nucleus pulposus having a first diameter in a disc plane between opposing sections of said inner wall, and said catheter comprising:
a first probe section defining along the length thereof a first lumen;

at least one energy delivery element located at the distal end of the catheter to deliver energy to portions of the intervertebral disc;
a tip coupled to the first probe section at a terminus thereof, the tip defining on an exerior face a second lumen substantially concentric with said first lumen; and
a blade positioned within the first lumen and extensible from a first position within said first probe section to a second position extending through the second lumen and beyond the tip, to cut selected portions within the intervertebral disc.

26. The catheter of Claim 25, further comprising:
a second probe section defining along a length thereof a third lumen and the first probe section located within the third lumen, and the at least one energy delivery element located in an annulus defined between the second and first probe sections.

27. The catheter of Claim 25, wherein the first probe section couples with a material delivery source to remove material from the intervertebral disc via the first and second lumens.

28. The catheter of Claim 25, wherein the first probe section couples with a material delivery source to supply material to the intervertebral disc via the first and second lumens.

29. A catheter for delivering energy to an intervertebral disc, and said catheter including at a proximal end a handle and at a distal end a probe and said intervertebral disc having a nucleus pulposus, an annulus fibrosus, and an inner wall of said annulus fibrosus, said nucleus pulposus having a first diameter in a disc plane between opposing sections of said inner wall, and said catheter comprising: an energy delivery element located at the distal end of the catheter to deliver energy to portions of the intervertebral disc;
a material transfer element located at the distal end of the catheter to transfer material to and from the intervertebral disc; and
at least one interface on the handle for coupling the energy delivery element and the material transfer element to external devices for energy and material transfer to and from the intervetebral disc.

30. A method for deploying a probe portion of a catheter in a multi-dimensional shape within an intervetebral disc, and the catheter including at a proximal end a handle and at a distal end a probe and the intervertebral disc having a nucleus pulposus, an annulus fibrosus, and an inner wall of said annulus fibrosus, said nucleus pulposus having a first diameter in a disc plane between opposing sections of said inner wall, and the method for deploying the probe portion comprising:
configuring the probe of the catheter in a substantially linear
configuration;
applying a sufficient force to advance the probe of the catheter through the nucleus pulposus, which force is insufficient to puncture the annulus fibrosus;
deploying the probe in a substantially arcuate configuration within the inner wall of the annulus fibrosus, and
delivering energy from the probe to portions of the intervertebral disc.

31. The method of Claim 30, wherein the deploying step is effectuated by a resilient material which in a relaxed state effects the substantially arcuate configuration and which upon introduction of external stress assume the substantially linear configuration.

32. The method of Claim 30, wherein the deploying step is effectuated by at least two materials exhibiting differential coefficients of thermal expansion and the at least two materials joined to one another wherein at a first temperature the at least two materials assume the substantially linear configuration and at a second temperature the at least two materials assume the substantially arcuate configuration.

33. The method of Claim 30, wherein the deploying step is effectuated by a material with a temperature dependent shape memory wherein at a first temperature the material assumes the substantially linear configuration and at a second temperature the material assumes the substantially arcuate configuration.

34. A catheter for treating an intervertebral disc, and said catheter including at a proximal end a handle and at a distal end a probe and said intervertebral disc having a nucleus pulposus, an annulus fibrosus, and an inner wall of said annulus fibrosus, said nucleus pulposus having a first diameter in a disc plane between opposing sections of said inner wall, and said catheter comprising:
an electrophoretic element located at the distal end of the catheter to alter the milieu within the intervertebral disc.