Methods of delivering chemical denervation to the vertebral body

• US 10,589,131 B2
• Filed: 10/15/2018
• Issued: 03/17/2020
• Est. Priority Date: 01/15/2002
• Status: Active Grant

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Diederich, Chris J., Lotz, Jeffrey C., Nau, Will, Bradford, David S.
• Primary Examiner(s): Roane, Aaron F
• Application Number:
  US16/161,021
• Publication Number:
  US 20190118003A1
• Time in Patent Office: 519 Days
• Field of Search: 607 96
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 2017/00092 using thermocouples
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61N 2007/0021 Neural system treatment
• CPC Class Codes: A61N 2007/003 Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0056 Beam shaping elements
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

An ultrasound therapy system and method is provided that provides directional, focused ultrasound to localized regions of tissue within body joints, such as spinal joints. An ultrasound emitter or transducer is delivered to a location within the body associated with the joint and heats the target region of tissue associated with the joint from the location. Such locations for ultrasound transducer placement may include for example in or around the intervertebral discs, or the bony structures such as vertebral bodies or posterior vertebral elements such as facet joints. Various modes of operation provide for selective, controlled heating at different temperature ranges to provide different intended results in the target tissue, which ranges are significantly affected by pre-stressed tissues such as in-vivo intervertebral discs. In particular, treatments above 70 degrees C., and in particular 75 degrees C., are used for structural remodeling, whereas lower temperatures achieve other responses without appreciable remodeling.

Claims

1. A method for treating back pain of a subject, the method comprising:

forming a bore into a bony structure of a vertebral body of a spine of the subject;

inserting a distal end of a treatment device within the vertebral body through the bore;

wherein the treatment device comprises a balloon;

wherein the treatment device is torqueable; and

delivering a chemical using the treatment device to a target region within the vertebral body sufficient to denervate at least a portion of a nerve within the target region.

2. The method of claim 1, wherein delivering the chemical is performed at various regions along the treatment device.

3. The method of claim 1, further comprising delivering ultrasound energy using the treatment device.

4. The method of claim 1, wherein the treatment device comprises one or more temperature sensors.

5. The method of claim 1, further comprising obtaining feedback related to the treating via a treatment feedback device.

6. The method of claim 1, further comprising performing real time monitoring of the treating using an imaging modality.

7. A method of treating back pain of a subject, the method comprising:

positioning a treatment device within or adjacent a vertebral body of the subject;

wherein the treatment device comprises a balloon; and

administering treatment to a target region within or adjacent the vertebral body sufficient to denervate a nociceptive nerve located within or at the target region;

wherein the treatment comprises delivering chemicals to the target region.

8. The method of claim 7, wherein delivering chemicals to the target region is performed at various regions along the treatment device.

9. The method of claim 7, further comprising delivering ultrasound energy to the target region using the treatment device.

10. The method of claim 7, wherein the treatment device comprises one or more temperature sensors.

11. The method of claim 7, further comprising obtaining feedback related to the treatment via a treatment feedback device.

12. The method of claim 7, further comprising performing real time monitoring of the treatment using an imaging modality.

13. The method of claim 7, wherein the nerve is within the vertebral body.

14. The method of claim 7, wherein the nerve is external to the vertebral body.

15. The method of claim 7, wherein the treatment device is flexible.

16. The method of claim 7, wherein the treatment device comprises multiple lumens.

17. The method of claim 7, wherein the treatment device is steerable.

18. The method of claim 7, wherein the treatment device comprises one or more ultrasound transducers.

19. The method of claim 7, further comprising inserting a delivery assembly to a location within or adjacent the vertebral body and introducing the treatment device through the delivery assembly.

20. The method of claim 7, wherein the treatment device comprises a pre-shaped distal end having a curve.