METHODS FOR TREATING THE THORACIC REGION OF A PATIENT'S BODY

• US 20090054962A1
• Filed: 08/27/2008
• Published: 02/26/2009
• Est. Priority Date: 03/05/2002
• Status: Active Grant

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Baylis Medical Company Inc. (Boston Scientific Corporation)
• Inventors: LEFLER, Amy, HARRISON, Robert, GODARA, Neil
• Granted Patent: US 9,364,281 B2
• Time in Patent Office: Days
• US Class Current: 607/117
• 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 2018/00023 closed, i.e. without wound contact by the fluid
• 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 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00815 measured by a thermistor
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

A method is disclosed for the treatment of a thoracic region of a patient'"'"'s body. Embodiments of the method comprise positioning an energy delivery portion of an electrosurgical device to face a segment of a thoracic vertebra at a distance from the segment; and cooling the energy delivery portion and delivering energy through the energy delivery portion.

Claims

1. A method of treatment of a thoracic region of a patient'"'"'s body, the method comprising:

positioning an energy delivery portion of an electrosurgical device to face a segment of a thoracic vertebra at a distance from the segment; and

cooling the energy delivery portion and delivering energy through the energy delivery portion.

2. The method of claim 1, wherein the cooling and the delivering energy cooperate to form a lesion at least substantially distal to the energy delivery portion.

3. The method of claim 1, wherein the cooling and the delivering energy cooperate to form a lesion at a location at least between the energy delivery portion and the segment of the thoracic vertebra.

4. The method of claim 1 wherein the distance between the energy delivery portion and the segment of the thoracic vertebra is about 0.5 mm to about 4 mm.

5. The method of claim 1, wherein the distance between the energy delivery portion and the segment of the thoracic vertebra is about 2 mm.

6. The method of claim 1, wherein the electrosurgical device is generally upstanding relative to the segment of the thoracic vertebra.

7. The method of claim 6, wherein the electrosurgical device is at an angle of about 15°

to about 60°

relative to an anterior-posterior axis in a substantially cranial direction.

8. The method of claim 6, wherein the electrosurgical device is at an an angle of about 45°

relative to an anterior-posterior axis in a substantially cranial direction.

9. The method of claim 6, wherein the electrosurgical device is at an angle of about 15°

relative to an anterior-posterior axis in a substantially cranial direction.

10. The method of claim 1, wherein the segment of the thoracic vertebra comprises a superior-lateral aspect of a transverse process.

11. The method of claim 10, wherein the energy delivery portion is positioned at a location in the region bounded by

a superior margin of the transverse process,

an inferior margin of a superjacent transverse process,

an anterior margin of the transverse process and an anterior margin of the superjacent transverse process,

a posterior margin of a spinous process of the thoracic vertebra,

an inferior articular process of the thoracic vertebra and a superior articular process of a superjacent thoracic vertebra,

a lateral margin of the transverse process and a lateral margin of the superjacent transverse process.

12. The method of claim 1, wherein the segment of the thoracic vertebra comprises a centroid region of a transverse process.

13. The method of claim 1, wherein the segment of the thoracic vertebra comprises a centroid region of a transverse process the method further comprising:

inserting an introducer apparatus into the patient'"'"'s body, the apparatus comprising a cannula and an obturator disposed within a lumen of the cannula, the obturator protruding from a distal end of the cannula;

positioning the apparatus such that a distal tip of the obturator abuts a segment of a thoracic vertebra;

removing the obturator from within the cannula; and

inserting an electrosurgical device within the cannula.

14. The method of claim 12, further comprising positioning the introducer apparatus within an intertransverse space, prior to inserting the electrosurgical device within the cannula.

15. The method of claim 13, wherein positioning the introducer apparatus within the intertransverse space comprises:

moving the apparatus from the centriod region in a substantially cranial direction until the intertransverse space is reached.

16. The method of claim 14, the method further comprising:

placing a depth stopper on the cannula adjacent to the surface of the patient'"'"'s skin and partially withdrawing the apparatus prior to moving the apparatus; and

advancing the apparatus until the depth stopper is adjacent to the patient'"'"'s skin, after moving the apparatus.

18. The method of claim 16, wherein the lesion is formed at least substantially distal to the energy delivery portion.

17. A method of treating a nerve in the thoracic region of a patient'"'"'s body, the method comprising:

positioning an energy delivery portion of an electrosurgical device to face a region where the nerve is likely to be found, at a distance from the region, the region being located substantially distal to the energy delivery portion; and

cooling the energy delivery portion and delivering energy from the energy delivery portion to form a lesion at the nerve.

19. The method of claim 17, wherein the nerve innervates a thoracic facet joint.

20. The method of claim 17, wherein the nerve is a medial branch of the thoracic dorsal ramus nerve.

22. The method of claim 20, wherein the cooling and the delivering energy cooperate to form a lesion substantially between the first electrosurgical device and the second electrosurgical device.

21. A method of treating a thoracic region of a patient'"'"'s spine, the method comprising:

inserting a first electrosurgical device at a segment of a transverse process of a first thoracic vertebra;

moving the first electrosurgical device in a substantially cranial direction until a distal tip of the first electrosurgical device slips over a superolateral aspect of the transverse process;

inserting a second electrosurgical device at a segment of a second thoracic vertebra adjacent to the first thoracic vertebra;

moving the second electrosurgical device in a substantially caudal direction until a distal tip of the second electrosurgical device slips over the inferiolateral aspect of the transverse process; and

delivering energy between the first electrosurgical device and the second electrosurgical device in a bipolar manner while substantially cooling the first electrosurgical device and the second electrosurgical device.