Spine treatment kits

• US 10,028,753 B2
• Filed: 10/30/2015
• Issued: 07/24/2018
• Est. Priority Date: 09/26/2008
• Status: Active Grant

• Current Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Original Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Inventors: Pellegrino, Richard, Patel, Samit, Carrison, Harold
• Primary Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US14/928,037
• Publication Number:
  US 20160278791A1
• Time in Patent Office: 998 Days
• Field of Search: 606 41, 606129, 606 79, 607 46, 607 99, 607117
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/126 bipolar

Abstract

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, the curved cannula comprising a curved distal end configured to be extended outward from the distal opening to generate a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured to allow a treatment device to be delivered through the central passageway to a location beyond the curved path.

Claims

1. A kit for therapeutically treating multiple different vertebrae in a spine, the kit including:

a trocar having a central channel and an opening at a distal tip of the trocar; and

a set of cannulas sized to be received in said central channel of the trocar and delivered to said opening at the distal tip of the trocar;

each cannula of the set of cannulas comprising a deflectable distal end portion with a preformed curve such that the deflectable distal end portion straightens while being delivered through the central channel of the trocar and transitions to a curved configuration upon exiting and extending past the opening at the distal tip of the trocar to generate a curved path in a vertebral body corresponding to the curved configuration of the deflectable distal end portion;

a set of curved stylets, each curved stylet sized and configured to be introduced within a respective cannula of the set of cannulas, wherein a distal end portion of each curved stylet has a preformed curve corresponding to the preformed curve of the respective cannula; and

a radiofrequency energy delivery probe adapted to be delivered through a respective cannula of the set of cannulas such that an active element of the radiofrequency energy delivery probe is positioned at a location in the vertebral body beyond the curved path,

wherein each cannula of the set of cannulas comprises a central passageway having a diameter configured to allow the radiofrequency energy delivery probe to be delivered through the central passageway to the location beyond the curved path after removal of the respective curved stylet,

wherein the deflectable distal end portion of each cannula of the set of cannulas has a different preformed curvature adapted to facilitate access to a respective vertebra of the spine,

wherein a first cannula of the set of cannulas comprises a first preformed curvature configured to facilitate access by the radiofrequency energy delivery probe to a first vertebra, and

wherein a second cannula of the set of cannulas comprises a second preformed curvature configured to facilitate access by the radiofrequency energy delivery probe to a second vertebra different from the first vertebra.

2. The kit of claim 1, wherein the deflectable distal end portion of each cannula of the set of cannulas has a varying preformed radius of curvature.

3. The kit of claim 1, wherein the deflectable distal end portion of each cannula of the set of cannulas terminates at a different angle with respect to the central channel of the trocar.

4. The kit of claim 3, wherein the angle is between approximately 45°

and approximately 110°

for each cannula of the set of cannulas.

5. The kit of claim 1, further comprising a straight stylet configured to be installed in the trocar;

the straight stylet comprising a sharp distal tip that is configured to extend beyond the distal opening of the trocar to pierce the vertebral body as the trocar is being delivered within the vertebral body.

6. The kit of claim 1, wherein each curved stylet is configured to be installed in the corresponding cannula while the cannula is extended past the opening at the distal tip of the trocar.

7. The kit of claim 6, wherein each curved stylet is configured to block a distal opening of the corresponding cannula while being delivered into the vertebral body.

8. The kit of claim 7, wherein each curved stylet has a varying curved distal end corresponding to the curve of the corresponding cannula.

9. The kit of claim 8, wherein each curved stylet and each corresponding cannula have mating proximal ends that facilitate alignment.

10. The kit of claim 1, further comprising a channeling stylet adapted to be delivered through the respective cannula of the set of cannulas and advanced out of a distal opening of the respective cannula to form a linear path beyond the curved path prior to delivery of the radiofrequency energy delivery probe through the respective cannula.

11. The kit of claim 1, wherein the active element of the radiofrequency energy delivery probe comprises a first electrode, and wherein the radiofrequency energy delivery probe further comprises a second electrode.

12. A kit for therapeutically treating multiple different vertebrae in a spine, the kit including:

an introducer having a central channel and an opening at a distal tip of the introducer; and

a plurality of cannulas sized to be received in said central channel of the introducer and delivered to said opening at the distal tip of the introducer;

each cannula comprising a deflectable distal end portion having a preformed curve such that the deflectable distal end portion straightens while being delivered through the central channel of the introducer and transitions to a curved configuration upon exiting and extending past the opening at the distal tip of the introducer to generate a curved path in a vertebral body corresponding to the curved configuration of the deflectable distal end portion of the cannula;

a set of curved stylets, each curved stylet sized and configured to be introduced within a respective cannula of the plurality of cannulas, wherein a distal end portion of each curved stylet has a preformed curve corresponding to the preformed curve of the respective cannula; and

an energy device,

wherein each cannula comprises a central passageway having a diameter configured to allow the energy delivery device to be delivered through the central passageway to a location beyond the curved path after removal of the corresponding curved stylet; and

wherein the deflectable distal end portion of each cannula has a different preformed curvature.

13. The kit of claim 12, wherein the deflectable distal end portion of each cannula of the plurality of cannulas has a varying preformed radius of curvature.

14. The kit of claim 12, wherein the deflectable distal end portion of each cannula of the plurality of cannulas terminates at a different angle with respect to the central channel of the introducer.

15. The kit of claim 14, wherein the angle is between approximately 45°

and approximately 110°

for each cannula.

16. The kit of claim 12, further comprising a straight stylet configured to be inserted though the central channel of the introducer.

17. The kit of claim 16, wherein the straight stylet comprises a sharp distal tip that is configured to extend beyond the opening at the distal tip of the introducer to pierce the vertebral body as the introducer is being delivered within the vertebral body.

18. The kit of claim 12, wherein the energy delivery device comprises a radiofrequency energy delivery device.

19. The kit of claim 12, further comprising a channeling stylet adapted to be delivered through a respective cannula of the plurality of cannulas and advanced out of a distal opening of the respective cannula to form a linear path beyond the curved path prior to delivery of the energy delivery device through the respective cannula.

20. The kit of claim 12, wherein the energy delivery device is configured to deliver one of:

ultrasound energy, laser energy, thermal energy and radiofrequency energy.