Methods of treating the sacroilac region of a patient's body

• US 20060106376A1
• Filed: 11/15/2005
• Published: 05/18/2006
• Est. Priority Date: 11/15/2004
• Status: Active Grant

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Baylis Medical Company Inc. (Boston Scientific Corporation)
• Inventors: Godara, Neil, Hillier, Taylor, Leung, Mark, Dawkins, Wesley
• Granted Patent: US 7,819,869 B2
• Time in Patent Office: Days
• US Class Current: 606/32
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference

Abstract

Methods of treating the sacroiliac region of a patient'"'"'s body by delivering energy are described. In some embodiments, the method comprises the steps of: inserting at least one probe into the sacroiliac region, the probe comprising at least one energy delivery device; positioning the at least one energy delivery device adjacent material to be treated; and delivering energy through the at least one energy delivery device to create a longitudinal strip lesion; wherein the at least one energy delivery device remains in a substantially static position during creation of the strip lesion. In some embodiments, energy may be delivered to treat at least two branches of the sacral nerves or to create an intra-articular lesion.

Claims

1. A method of treating the sacroiliac region of a patient'"'"'s body by delivering energy, comprising the steps of:

inserting at least one probe into said sacroiliac region, the probe comprising at least one energy delivery device;

positioning said at least one energy delivery device adjacent material to be treated; and

delivering energy through said at least one energy delivery device to create a strip lesion substantially parallel to at least a portion of a longitudinal axis of the energy delivery device while said at least one energy delivery device remains in a substantially static position.

2. The method of claim 1, wherein energy is delivered in order to reduce one or more symptoms of sacroiliac joint syndrome.

3. The method of claim 2, wherein said one or more symptoms of sacroiliac joint syndrome comprises one or more of:

pain, stiffness and tingling.

4. The method of claim 1, wherein energy is delivered in order to alter the structure or function, or both, of neural tissue.

5. The method of claim 4, wherein the step of delivering energy comprises delivering energy so as to ablate one or more neural structures.

6. The method of claim 1, wherein energy is delivered in order to treat connective tissue of said sacroiliac region.

7. The method of claim 6, wherein the step of inserting at least one probe comprises positioning said at least one energy delivery device within one or more sacroiliac ligaments and wherein energy is delivered in order to tighten or loosen the ligaments.

8. The method of claim 1, wherein said at least one probe comprises at least two energy delivery devices and wherein energy is delivered in a bipolar configuration.

9. The method of claim 1, wherein said at least one probe comprises at least three energy delivery devices and wherein energy is delivered in a triphasic configuration.

10. The method of claim 1, wherein the step of delivering energy comprises delivering energy selected from the group consisting of:

electromagnetic energy ranging from radio-frequency energy to optical energy, thermal energy, and ultrasonic energy.

11. The method of claim 10, wherein the step of delivering energy comprises delivering radio-frequency energy.

12. The method of claim 11, wherein the step of delivering energy comprises delivering radio-frequency energy in a series of pulses modulated by one or more of frequency and amplitude.

13. The method of claim 1, wherein the step of positioning said at least one energy delivery device comprises positioning said at least one energy delivery device in proximity to a surface of the sacrum.

14. The method of claim 13, wherein said at least one energy delivery device is positioned in proximity to at least one posterior sacral foramina.

15. The method of claim 1, further comprising a step of visualizing or monitoring, or both, said at least one probe using fluoroscopic imaging.

16. The method of claim 1, further comprising a step of delivering energy at a physiological stimulation frequency through said at least one energy delivery device in order to stimulate one or more neural structures.

17. The method of claim 1, further comprising a step of monitoring temperature of a tissue in said patient'"'"'s body.

18. The method of claim 1, further comprising a step of monitoring impedance of a tissue in said patient'"'"'s body.

19. The method of claim 1, further comprising a step of modifying a treatment parameter selected from the group consisting of:

maximum allowable temperature, rate of coolant flow and temperature ramp rate.

20. The method of claim 19 wherein the step of modifying a treatment parameter occurs in response to a measured temperature.

21. The method of claim 1, further comprising a step of one or more of adding material to a tissue to be treated or removing material from a tissue to be treated.

22. The method of claim 21, wherein the step of adding or removing material comprises adding material selected from the group consisting of pharmaceutical agents and contrast media.

23. The method of claim 21, wherein the step of adding or removing material comprises removing connective tissue.

24. The method of claim 1, further comprising a step of actively cooling at least one of said at least one energy delivery devices.

25. A method of treating the sacroiliac region of a patient'"'"'s body by delivering energy, comprising the steps of:

inserting at least one probe into said sacroiliac region, the probe comprising at least one energy delivery device; and

delivering energy sufficient to form a lesion through said at least one energy delivery device to treat at least two branches of a sacral nerve or different sacral nerves.

26. The method of claim 25, wherein said at least two branches comprises at least one lateral branch of one sacral nerve and at least one lateral branch of a different sacral nerve.

27. The method of claim 25, wherein said at least two branches comprises at least two branches of the same sacral nerve.

28. The method of claim 25, further comprising a step of delivering energy at a physiological stimulation frequency through said at least one energy delivery device in order to stimulate one or more neural structures.

29. The method of claim 25, wherein the step of inserting at least one probe comprises inserting said at least one probe using a substantially cranial-caudal approach.

30. The method of claim 25, wherein said at least one probe comprises at least two energy delivery devices and wherein energy is delivered in a bipolar configuration.

31. The method of claim 25, further comprising a step of positioning at least a portion of said at least one energy delivery device adjacent at least one posterior sacral foramina.

32. A method of creating an intra-articular lesion of the sacroiliac joint, comprising the steps of:

positioning at least one energy delivery device within or adjacent to a sacroiliac joint; and

delivering energy through said at least one energy delivery device in a monopolar configuration to create an intra-articular lesion.

33. The method of claim 32, wherein energy is delivered sufficient to alter the function of at least one neural structure innervating said sacroiliac joint.

34. A method of treating the sacroiliac region of a patient'"'"'s body by delivering energy, comprising the steps of:

inserting at least one probe into said sacroiliac region, the probe comprising at least one energy delivery device; and

delivering radiofrequency energy through said at least one energy delivery device to treat at least two branches of a sacral nerve or different sacral nerves.

35. The method of claim 34, wherein the step of delivering radiofrequency energy comprises delivering radio-frequency energy in a series of pulses modulated by one or more of frequency and amplitude.