SYSTEMS AND METHODS FOR NAVIGATING AN INSTRUMENT THROUGH BONE

• US 20110034884A9
• Filed: 01/07/2010
• Published: 02/10/2011
• Est. Priority Date: 09/30/2002
• Status: Active Grant

• Current Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Original Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Inventors: Patel, Samit, Pellegrino, Richard, Carrison, Harold
• Granted Patent: US 8,613,744 B2
• Time in Patent Office: Days
• US Class Current: 604/272
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3454 Details of tips
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00565 : Bone
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1475 : Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61F 7/007 : characterised by electric heating
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes

Abstract

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a radial opening at or near the distal end of the trocar. The system includes a curveable cannula sized to be received in the central channel, the curveable cannula comprising a curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar. The curveable cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Claims

1. A system for channeling a path into bone, comprising:

a trocar having a proximal end, distal end and a central channel;

wherein the central channel is disposed along a central axis of the trocar and extends from the proximal end toward the distal end;

wherein the trocar comprises a radial opening at or near the distal end of the trocar, the radial opening being in communication with the central channel; and

a curveable cannula sized to be received in said central channel and delivered from the proximal end toward said radial opening;

the curveable cannula comprising a curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar;

wherein the curveable cannula comprises a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

2. A system as recited in claim 1, wherein the trocar further comprises a sharp distal tip configured to pierce through bone to generate a linear path through bone.

3. A system as recited in claim 2, wherein the curveable cannula comprises a sharpened distal tip configured to pierce through bone to generate a curved path extending from a linear path generated by the trocar.

4. A system as recited in claim 1, wherein the distal end of the curveable cannula is deformable so as to be delivered in a straight configuration through the trocar and deployed in a curved configuration outward from the radial opening at an angle with respect to the central axis.

5. A system as recited in claim 4, further comprising:

a pull cord coupled to the distal tip of the curveable cannula, the pull cord extending to the proximal end of the trocar;

wherein the pull cord is configured to apply a tensile force to the distal end of the curveable cannula to bias the curveable cannula into a curved configuration.

6. A system as recited in claim 5, wherein the tensile force applied to the distal tip of the curveable cannula may be controlled from the proximal end of the trocar to steer the curveable cannula along a desired path.

7. A system as recited in claim 4, wherein a distal end of the curveable cannula comprises a plurality of mating links, the links configured to articulate into a curved shape.

8. A system as recited in claim 4, wherein the central channel of the trocar terminates at a ramp leading to the radial window, said ramp facilitating deployment of said curveable cannula outward from said window.

9. A system as recited in claim 1, wherein:

the curveable cannula comprises a proximal end comprising a proximal body

wherein the proximal end of the trocar comprises a housing;

said housing having a proximal recess configured to allow reciprocation of the proximal body of the curveable cannula;

wherein the proximal recess is in communication with the central channel.

10. A system as recited in claim 9, wherein a proximal body of the curveable cannula is configured to be releasably restrained with respect to translation within the trocar housing.

11. A system as recited in claim 10, further comprising a probe sized to fit within the central channel of the cannula;

the probe comprising a proximal end configured to be releasably restrained with respect to translation within the cannula proximal body.

12. A system as recited in claim 11, further comprising a drive nut coupled to the curveable cannula;

wherein the drive nut comprises a hardened proximal surface suitable for applying an impact force to advance one or more of the trocar, curveable cannula, or probe through bone.

13. A system as recited in claim 12, wherein the drive nut comprises a threaded distal recess configured to house the proximal end of the probe.

14. A system as recited in claim 12, wherein the proximal surface of the drive nut comprises an interchangeable cap;

said interchangeable cap configured to provide access to the probe for providing a therapeutic energy.

15. A method for channeling a path into bone to a treatment location in the body of a patient, comprising:

inserting a trocar into a region of bone near the treatment location;

the trocar having a having a proximal end, distal end and a central channel disposed therebetween;

wherein the trocar comprises a radial opening at or near the distal end of the trocar, the radial opening being in communication with the central channel;

delivering a curveable cannula through said central channel and to said radial opening; and

deploying the curveable cannula laterally outward from the radial opening in a curved path extending away from the trocar.

16. A method as recited in claim 15, further comprising:

delivering a treatment device through a central passageway in the curveable cannula to a treatment location beyond the curved path.

17. A method as recited in claim 16, further comprising:

delivering a therapeutic amount of thermal energy to the treatment location.

18. A method as recited in claim 17, wherein inserting a trocar into a region of bone comprises:

deploying the trocar through a cortical bone region and into a cancellous bone region of a vertebral body;

wherein the curved path is generated though at least a portion of the cancellous bone region of the vertebral body.

19. A method as recited in claim 16, further comprising:

steering the curveable cannula via a pull cord coupled to the distal tip of the curveable cannula to bias the curveable cannula in the curved path.

20. A method as recited in claim 18, wherein the treatment location comprises a BVN associated with the vertebral body, the method further comprising:

delivering the thermal energy to the treatment location to denervate at least a portion of the BVN.

21. A spine therapy system, comprising:

a trocar having a proximal end, distal end and a central channel;

wherein the central channel is disposed along a central axis of the trocar and extends from the proximal end toward the distal end;

wherein the trocar comprises a radial opening at or near the distal end of the trocar, the radial opening being in communication with the central channel;

wherein the trocar is configured to be deployed through a cortical bone region and into a cancellous bone region of a vertebral body;

a curveable cannula sized to be received in said central channel and delivered from the proximal end toward said radial opening;

the curveable cannula comprising a central passageway and curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar;

wherein the curved path is generated though at least a portion of the cancellous bone region of the vertebral body; and

a treatment probe configured to be delivered through the central passageway to a location beyond the curved path.

22. A system as recited in claim 21, wherein the trocar further comprises a sharp distal tip configured to pierce through bone to generate a linear path through bone.

23. A system as recited in claim 22, wherein the curveable cannula comprises a sharpened distal tip configured to pierce through bone to generate a curved path extending from a linear path generated by the trocar.

24. A system as recited in claim 21, wherein the distal end of the curveable cannula is deformable so as to be delivered in a straight configuration through the trocar and deployed in a curved configuration outward from the radial opening at an angle with respect to the central axis.

25. A system as recited in claim 24, further comprising:

a pull cord coupled to the distal tip of the curveable cannula, the pull cord extending to the proximal end of the trocar;

wherein the pull cord is configured to apply a tensile force to the distal end of the curveable cannula to bias the curveable cannula into a curved configuration.

26. A system as recited in claim 24, wherein a distal end of the curveable cannula comprises a plurality of mating links, the links configured to articulate into a curved shape.

27. A system as recited in claim 21, wherein:

the curveable cannula comprises a proximal end comprising a proximal body

wherein the proximal end of the trocar comprises a housing;

said housing having a proximal recess configured to allow reciprocation of the proximal body of the curveable cannula;

wherein the proximal recess is in communication with the central channel.

28. A system as recited in claim 27, wherein a proximal body of the curveable cannula is configured to be releasably restrained with respect to translation within the trocar housing.

29. A system as recited in claim 28, wherein the probe comprises a proximal end configured to be releasably restrained with respect to translation within the cannula proximal body.

30. A system as recited in claim 29, further comprising:

a drive nut coupled to the curveable cannula;

wherein the drive nut comprises a hardened proximal surface suitable for applying an impact force to advance one or more of the trocar, curveable cannula, or probe through bone;

wherein the drive nut comprises a threaded distal recess configured to house the proximal end of the probe; and

wherein the probe comprises mating threads with the distal recess so as to allow controlled translation of the probe with respect to the drive nut.

31. A system as recited in claim 30, wherein the proximal surface of the drive nut comprises an interchangeable cap;

said interchangeable cap configured to provide access to the probe for providing a therapeutic energy.