Systems and methods for treating back pain

• US 10,390,877 B2
• Filed: 12/21/2012
• Issued: 08/27/2019
• Est. Priority Date: 12/30/2011
• Status: Active Grant

• Current Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Original Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Inventors: Heggeness, Michael H, Pellegrino, Richard C, Peters, Rex
• Primary Examiner(s): Chao, Elmer M
• Application Number:
  US14/369,661
• Publication Number:
  US 20150005614A1
• Time in Patent Office: 2,440 Days
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61F 7/00 Heating or cooling appliances for medical or therapeutic treatment of the human body heating or cooling means in connection with bedsteads or mattresses A47C21/00 ; massage, therapeutic baths A61H; hyperthermia using electric or magnetic fields or ultrasound A61N; electric heating elements H05B
• CPC Class Codes: A61M 5/00 Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests vaccination appliances for veterinary use A61D1/025 ; tube connectors, tube couplings, valves or branch units specially adapted for medical use A61M39/00; containers specially adapted for medical or pharmaceutical purposes A61J1/00; combinations of vial and syringe for mixing or transferring their contents A61J1/20; holders for containers for collecting, storing or administering blood or medical fluids A61J1/16
• CPC Class Codes: A61N 5/045 specially adapted for treatment inside the body
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

Systems and methods are disclosed for treating back pain associated with a vertebral body of a patient. The system may include an external energy source configured to be positioned at a location external to the body of the patient, a linear configured to drive translation of the external source in one or more axes, a computer coupled to the external source and linear drive and programming executable on said computer for determining a target treatment site within or near the vertebral body based on acquired imaging data, positioning a focal point of the external energy source to substantially coincide with the target treatment site, and delivering a treatment dose of therapeutic energy at said target treatment site, wherein the treatment dose is configured to modulate a nerve within or near the vertebral body.

Claims

1. A method for treating back pain associated with a vertebral body of a patient, comprising:

imaging a vertebral body to generate one or more images of the vertebral body;

locating, based on said images, a portion of a sinuvertebral nerve within an epidural space associated with the vertebral body;

identifying one or more nerve branches associated with the vertebral body and emanating at a first end at a junction with the sinuvertebral nerve at a location external to the vertebral body and that course medially from the junction under a posterior longitudinal ligament,

percutaneously guiding a delivery assembly to the location external to the vertebral body,

wherein the delivery assembly comprises at least one lumen for advancing an imaging device and for advancing a treatment device;

isolating the one or more nerve branches for treatment,

wherein isolating the one or more nerve branches comprises verifying that the one or more nerve branches course under the posterior longitudinal ligament;

delivering the treatment device to the external location via the delivery assembly; and

denervating the one or more isolated nerve branches at a position at or near the junction with the sinuvertebral nerve,

wherein denervating the one or more isolated nerve branches comprises operating the treatment device at the position at or near the junction with the sinuvertebral nerve.

2. The method of claim 1, further comprising dilating a space under the posterior longitudinal ligament to allow visualization of a foramen leading to the vertebral body prior to denervation of the one or more nerve branches.

3. The method of claim 1, wherein the step of denervating the one or more isolated nerve branches comprises altering a conductive property of the one or more nerve branches.

4. The method of claim 1, wherein the step of denervating the one or more isolated nerve branches comprises severing conduction across the one or more nerve branches.

5. The method of claim 3, wherein altering a conductive property of the one or more nerve branches comprises one or more of:

stimulation, alteration, blocking, or elimination of conduction across the one or more nerve branches sufficient to provide a therapeutic effect within or related to the vertebral body.

6. The method of claim 3, wherein altering a conductive property of the one or more nerve branches comprises one or more of:

heating, cooling, radiating, agitating, or altering the chemical composition of the one or more nerve branches sufficient to provide a therapeutic effect within or related to the vertebral body.

7. The method of claim 3, wherein altering a conductive property of the one or more nerve branches comprises cutting or crimping the one or more nerve branches.

8. The method of claim 1, wherein said denervating is effected by at least one of radiofrequency, ultrasound, radiation, steam, microwave, or laser.