SYSTEMS FOR DENERVATION OF BASIVERTEBRAL NERVES

• US 20130012933A1
• Filed: 09/14/2012
• Published: 01/10/2013
• 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: Pellegrino, Richard, Papineau, Paula, Crombie, John S., Patel, Samit, Ryan, Thomas
• Granted Patent: US 8,623,014 B2
• Time in Patent Office: Days
• US Class Current: 606/28
• 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 therapeutically heating a vertebral body to treat back pain, comprising:

a bipolar radiofrequency (“

RF”

) energy delivery device having two electrodes configured to deliver RF energy to a target location of a basivertebral nerve within a vertebral body;

a cannula having an internal passageway and a distal opening at a distal end of the cannula,

wherein a distal end portion of the cannula is curved,

wherein the diameter of the internal passageway is configured to receive the bipolar energy device,

wherein the distal opening of the cannula provides a working portal for the bipolar energy device as it is advanced past the distal end of the cannula,

wherein the curved distal end portion is configured to guide the two electrodes of the bipolar energy delivery device to the target location,

wherein the cannula comprises polymeric material,

wherein the cannula has a length sufficient to provide access to the target location within the vertebral body by the bipolar energy delivery device,

wherein the target location is within an inner cancellous bone region of the vertebral body, and

wherein the RF energy is configured to heat the target location sufficient to denervate a basivertebral nerve at the target location.

2. The system of claim 1, wherein the RF energy is configured to heat the target location sufficient to ablate the basivertebral nerve.

3. The system of claim 1, wherein the RF energy is configured to heat the target location sufficient to denervate the basivertebral nerve without necrosis of tissue.

4. The system of claim 1, wherein the target location is within the inner cancellous bone region of the vertebral body between, but exclusive of, a basivertebral nerve junction and an outer cortical bone region of the vertebral body.

5. The system of claim 1, wherein the target location is within the inner cancellous bone region of the vertebral body and proximal to a junction of the basivertebral nerve.

6. The system of claim 1, wherein the target location is in a region of the vertebral body located between 60% and 90% of the distance between the anterior and posterior ends of the vertebral body.

7. The system of claim 1, wherein the cannula is configured to form a curved path within the inner cancellous bone region.

8. The system of claim 1, wherein the curved distal end of the cannula is pre-curved.

9. The system of claim 7, further comprising a trocar configured to be advanced through an outer cortical bone portion of the vertebral body and into the inner cancellous region, and wherein the cannula is configured to be inserted through a central lumen of the trocar and advanced past a distal end of the trocar to form the curved path within the inner cancellous bone region.

10. A system for therapeutically heating a vertebral body to treat back pain, comprising:

an energy delivery device configured to delivery energy to heat a target location of a basivertebral nerve within a vertebral body;

a cannula having an internal passageway and a distal opening at a distal end of the cannula,

wherein a distal end portion of the cannula is curved,

wherein the diameter of the internal passageway is configured to receive the energy device,

wherein the distal opening of the cannula provides a working portal for the energy device as it is advanced past the distal end of the cannula,

wherein the cannula comprises polymeric material,

wherein the cannula has a length sufficient to provide access to the target location within the vertebral body by the energy delivery device,

wherein the target location is within an inner cancellous bone region of the vertebral body, and

wherein the energy is configured to heat the target location sufficient to denervate a basivertebral nerve at the target location.

11. The system of claim 10, wherein the energy is configured to heat the target location sufficient to ablate the basivertebral nerve.

12. The system of claim 10, wherein the energy is configured to heat the target location sufficient to denervate the basivertebral nerve without necrosis of tissue.

13. The system of claim 10, wherein the energy delivery device comprises a bipolar radiofrequency probe comprising at least one electrode.

14. The system of claim 13, wherein the bipolar radiofrequency probe comprises an active electrode and a return electrode.

15. The system of claim 10, wherein the energy delivery device comprises a microwave energy delivery device.

16. The system of claim 10, wherein the energy delivery device comprises an ultrasonic energy delivery device.

17. The system of claim 10, wherein the target location is within the inner cancellous bone region of the vertebral body between, but exclusive of, a basivertebral nerve junction and an outer cortical bone region of the vertebral body.

18. The system of claim 10, wherein the target location is within the inner cancellous bone region of the vertebral body and proximal to a junction of the basivertebral nerve.

19. The system of claim 10, wherein the target location is in a region of the vertebral body located between 60% and 90% of the distance between the anterior and posterior ends of the vertebral body.

20. The system of claim 10, wherein the curved distal end of the cannula is pre-curved.