Method of straddling an intraosseous nerve
First Claim
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1. A method of therapeutically treating a bone having an intraosseous nerve ION defining first and second sides of the bone, comprising the steps of:
- a) inserting an energy device having an active and a return electrode into the bone, b) placing the active electrode on the first side of the bone and the return electrode on the second side of the bone to define a total heating zone therebetween, and c) applying a sufficiently high frequency voltage between the active and return electrodes to generate a current therebetween to resistively heat the total heating zone sufficient to denervate the ION.
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Abstract
This invention relates to a method of straddling an intraosseous nerve with an energy transmitting device to improve the therapeutic treatment of the nerve.
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Citations
77 Claims
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1. A method of therapeutically treating a bone having an intraosseous nerve ION defining first and second sides of the bone, comprising the steps of:
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a) inserting an energy device having an active and a return electrode into the bone, b) placing the active electrode on the first side of the bone and the return electrode on the second side of the bone to define a total heating zone therebetween, and c) applying a sufficiently high frequency voltage between the active and return electrodes to generate a current therebetween to resistively heat the total heating zone sufficient to denervate the ION. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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30. A method of therapeutically treating a vertebral body having a basivertebral nerve BVN defining first and second sides of the vertebral body, comprising the steps of:
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a) determining a BVN residence zone within which the BVN likely resides, the BVN residence zone having a first side and a second side, b) inserting an energy device having an active and a return electrode into the vertebral body, c) placing the active electrode on the first side of the residence zone and the return electrode on the second side of the residence zone to define a total heating zone therebetween, and d) applying a sufficiently high frequency voltage between the active and return electrodes to generate a current therebetween to resistively heat the total heating zone to a temperature sufficient to denervate the BVN.
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31. A method of therapeutically treating a vertebral body having a basivertebral nerve BVN, comprising the steps of:
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a) providing an energy device having an active electrode having a first face and a return electrode having a second face into the vertebral body, and b) placing the active electrode in the vertebral body to face a first direction, c) placing the return electrode in the vertebral body to face a second direction, the first and second faces defining an angle 2δ
of no more than 60 degrees, andd) applying a sufficiently high frequency voltage difference between the active and return electrodes to generate a current therebetween to produce a total heating zone to therapeutically heat the BVN. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40)
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41. A method of therapeutically treating a vertebral body having a basivertebral nerve BVN, comprising the steps of:
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a) providing an energy device having an active electrode and a return electrode, b) placing the active and return electrodes in the vertebral body to define an electrode axis, the axis forming an angle β
of between 50 and 90 degrees with the BVN, andc) applying a sufficiently high frequency voltage difference between the active and return electrodes to generate a current therebetween to produce a total heating zone to therapeutically heat the BVN. - View Dependent Claims (51)
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42. An intraosseous nerve denervation device, comprising:
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a) a first probe having an active electrode and a first lead, b) a second probe having a return electrode and a second lead, c) means for creating first and second bores within a bone for accommodating the first and second probes, d) a power supply capable of generating a voltage difference between the active and return electrodes, the supply having third and fourth leads, wherein the first and third leads are in electrical connection, and the second and fourth leads are in electrical connection. - View Dependent Claims (43, 44, 45, 46, 47, 48, 49, 50)
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52. A method of therapeutically treating a healthy vertebral body having a basivertebral nerve BVN, comprising the steps of:
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a) providing an energy device having an active and a return electrode, b) inserting the active electrode into the healthy vertebral body, c) inserting the return electrode into the healthy vertebral body, d) placing the active electrode on a first side of the healthy vertebral body and the return electrode on a second side of the healthy vertebral body, and e) applying a sufficiently high frequency voltage difference between the active and return electrodes to generate a current therebetween to produce a total heating zone to therapeutically heat the BVN.
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53. An intraosseous nerve denervation system comprising:
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a) a first probe having a first electrode and a first lead in electrical connection with the first electrode, wherein the first electrode has a proximal end having a proximal diameter and a distal end having a distal diameter, and the proximal end diameter is less than the distal end diameter, and b) a second probe having a first electrode and a first lead in electrical connection with the first electrode, wherein the first electrode has a proximal end having a proximal diameter and a distal end having a distal diameter, and the proximal end diameter is less than the distal end diameter, wherein the first and second electrode are disposed so that the electrodes are parallel. - View Dependent Claims (54)
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55. An intraosseous nerve denervation system comprising:
a) a first probe having;
i) a distal portion having a first electrode, ii) a proximal portion comprising a first lead in electrical connection with the first electrode, and iii) a pivot pivotally connecting the proximal and distal portions of the probe. - View Dependent Claims (56)
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57. An intraosseous nerve denervation system comprising:
a) a first probe having;
i) a distal portion having a pivot, ii) a proximal portion comprising a first lead in electrical connection with the first electrode, and iii) an arm pivotally extending from the distal portion and having a first electrode. - View Dependent Claims (58)
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59. An intraosseous nerve denervation system comprising:
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a) a first probe having a first electrode and a first lead in electrical connection with the first electrode, wherein the first electrode has a proximal end having a proximal diameter and a distal end having a distal diameter, and wherein the proximal end diameter is less than the distal end diameter. - View Dependent Claims (60)
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61. An intraosseous nerve denervation system, comprising:
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a) a cannula having a longitudinal bore defining a first axis, b) a stylet having an outer diameter adapted to be received within the longitudinal bore and a distal tip adapted to penetrate cortical bone, and c) a first probe comprising;
d) an outer diameter adapted to be received within the longitudinal bore, and i) a first electrode, and ii) a lead in electrical connection with the first electrode.
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62. An intraosseous nerve denervation system, comprising:
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a) a cannula having a longitudinal bore defining a first axis, b) a stylet having an outer diameter adapted to be received within the longitudinal bore and a distal tip adapted to penetrate cortical bone, and c) a first probe comprising;
i) an outer diameter adapted to be received within the longitudinal bore, and ii) a first electrode, and iii) a lead in electrical connection with the first electrode.
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63. An intraosseous nerve denervation system comprising:
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a) a first probe having;
i) an active electrode having a first surface area, and ii) a first lead in electrical connection with the first electrode, b) a second probe having;
i) a return electrode having a first surface area, and ii) a second lead in electrical connection with the second electrode, wherein the first surface area is at least two times greater than the second surface area, and, c) means for creating first and second bores within a bone for accommodating the first and second probes. - View Dependent Claims (64)
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65. An intraosseous nerve denervation system, comprising:
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a) a cannula having a longitudinal bore, b) a stylet having an outer diameter adapted to be received within the longitudinal bore and a distal tip adapted to penetrate cortical bone, and c) a first probe comprising;
i) an outer diameter adapted to be received within the longitudinal bore, and ii) a first electrode, and iii) a lead in electrical connection with the first electrode.
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66. An intraosseous nerve denervation system comprising:
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a) a first probe having a first electrode and a first lead in electrical connection with the first electrode, wherein the first electrode has a proximal end having a proximal diameter and a distal end having a distal diameter, and the proximal end diameter is greater than the distal end diameter. - View Dependent Claims (67)
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68. A method of therapeutically treating a vertebral body having a BVN, comprising the steps of:
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a) providing a first energy device having distal and proximal active electrodes, b) providing a second energy device having distal and proximal return electrodes, c) placing the first and second energy devices in the vertebral body to define a first distance between the distal active electrode and the distal return electrode, and a second distance between the proximal active electrode and the proximal return electrode, wherein the first distance is less than the second distance, d) applying a first high frequency voltage between the distal active and distal return electrodes, and e) applying a second high frequency voltage between the proximal active and proximal return electrodes, wherein the first high frequency voltage is less than the second high frequency voltage.
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69. A method of therapeutically treating a vertebral body having a BVN, comprising the steps of:
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a) providing an energy device having an active and a return electrode, b) inserting the active electrode into the vertebral body, c) inserting the return electrode into the vertebral body, d) applying a sufficiently high frequency voltage difference between the active and return electrodes to generate a current therebetween to produce a total heating zone having a diameter of at least 0.5 cm and a steady state temperature of at least 50°
C. - View Dependent Claims (70, 71, 72, 73, 74)
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75. A method of therapeutically treating a vertebral body having an outer cortical bone region and an inner cancellous bone region, and a BVN having a trunk extending from the outer cortical bone region into the inner cancellous region and a branches extending from the trunk to define a BVN junction, comprising the steps of:
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a) inserting an energy device into the vertebral body, and b) exclusively depositing energy within the inner cancellous bone region of the vertebral body between, but exclusive of the BVN junction and the outer cortical bone region, to denervate the BVN. - View Dependent Claims (76)
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77. A device for denervating an intraosseous nerve ION in a bone, comprising:
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a) a fixed probe having a first electrode thereon in electrical connection with the powder supply, c) a pivotable probe comprising a second electrode having a proximal portion pivotally engaged to the fixed probe.
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Specification