SYSTEM FOR HEATING A VERTEBRAL BODY TO TREAT BACK PAIN

• US 20130012936A1
• Filed: 09/13/2012
• Published: 01/10/2013
• Est. Priority Date: 09/30/2002
• Status: Abandoned Application

• 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
• Application Number:
  US13/615,300
• Publication Number:
  US 20130012936A1
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• 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 17/8819 characterised by the introducer proximal part, e.g. cannula handle, or by parts which are inserted inside each other, e.g. stylet and cannula A61B17/8825 takes 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 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00017 : with gas
• CPC Class Codes: A61B 2018/00339 : Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/00434 : Neural system
• 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 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/0072 : Current
• CPC Class Codes: A61B 2018/00761 : Duration
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00821 : measured by a thermocouple
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1807 : using light other than laser radiation
• CPC Class Codes: A61B 2018/2005 : with beam delivery through an interstitially insertable device, e.g. needle
• CPC Class Codes: A61B 2034/301 : for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2090/374 : NMR or MRI
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00
• CPC Class Codes: A61N 7/00 : Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain.

Claims

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

a cannula having a curved bore configured to be inserted through the outer cortical bone region of the vertebral body and into the inner cancellous bone region of the vertebral body;

a bipolar radiofrequency (RF) energy delivery probe having an active electrode and a return electrode,

wherein said RF energy delivery probe is sized and configured to be inserted within a central passageway of the cannula,

wherein the cannula is shaped so as to guide said RF energy delivery probe towards a midline between a first lateral side of the vertebral body and a second opposite lateral side of the vertebral body of the vertebral body;

wherein the active electrode is positioned at a distal tip of a distal end of the RF energy delivery probe and the return electrode is spaced proximal to the active electrode at the distal end of the RF energy delivery probe, and

wherein the active and return electrodes are positioned at locations such that when said energy delivery probe is advanced within the inner cancellous bone region of the vertebral body, the active and return electrodes are on opposite sides of the midline of the vertebral body, and

wherein said two electrodes are configured to deliver radiofrequency energy to a basivertebral nerve within the vertebral body sufficient to ablate the basivertebral nerve.

2. The system of claim 1, wherein the return electrode is spaced about 2 mm proximal to the active electrode.

3. The system of claim 2, wherein the return electrode is a cylindrical electrode.

4. The system of claim 1, wherein the frequency of the radiofrequency energy is between about 400 kHz and 600 kHz.

5. The system of claim 1, wherein the radiofrequency energy is configured to be delivered at a temperature of between 80°

C. and 95°

C.

6. The system of claim 1, wherein said RF energy delivery probe comprises a plurality of electrode pairs configured to treat multiple vertebral bodies simultaneously.

7. The system of claim 1, wherein a first electrode pair and a second electrode pair are connected by a “

y”

-shaped connector.

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

a cannula having a curved bore configured to be inserted through the outer cortical bone region of the vertebral body and into the inner cancellous bone region of the vertebral body;

a flexible radiofrequency energy delivery probe having two electrodes that is sized and configured to be inserted within a central passageway of the cannula,

wherein the cannula is shaped so as to guide said energy delivery probe towards a midline between a first lateral side of the vertebral body and a second opposite lateral side of the vertebral body of the vertebral body;

wherein the two electrodes are positioned at locations of a distal end of said energy delivery probe such that when said energy delivery probe is advanced within the inner cancellous bone region of the vertebral body, the two electrodes are on opposite sides of the midline; and

wherein said two electrodes are configured to deliver radiofrequency energy to a basivertebral nerve within the vertebral body sufficient to denervate the basivertebral nerve.

9. The system of claim 8, wherein said energy device comprises a bipolar radiofrequency device having and the two electrodes comprise an active electrode and a return electrode.

10. The system of claim 9, wherein the active electrode is located at the distal tip of the probe and the return electrode is spaced about 2 mm proximal to the active electrode.

11. The system of claim 10, wherein the return electrode is a cylindrical electrode.

12. The system of claim 8, wherein the frequency of the radiofrequency energy is between about 400 kHz and 600 kHz.

13. The system of claim 8, wherein the radiofrequency energy has a temperature of between 80°

C. and 95°

C.

14. The system of claim 8, wherein the radiofrequency energy is sufficient to ablate the basivertebral nerve.

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

a cannula having a curved bore configured to be inserted through the outer cortical bone region of the vertebral body and into the inner cancellous bone region of the vertebral body;

a flexible energy delivery probe having two electrodes that is sized and configured to be inserted within a central passageway of the cannula, and

an energy delivery source coupled to the two electrodes,

wherein the two electrodes are positioned at locations of a distal end of said energy delivery probe such that when said energy delivery probe is advanced within the inner cancellous bone region of the vertebral body, a first electrode is configured to be positioned on a first side of the vertebral body and a second electrode is configured to be positioned on a second side of the vertebral body; and

wherein said two electrodes are configured to deliver thermal energy to a basivertebral nerve within the vertebral body sufficient to modulate the basivertebral nerve.

16. The system of claim 15, wherein said energy device comprises a bipolar radiofrequency device having and the two electrodes comprise an active electrode and a return electrode.

17. The system of claim 15, wherein the frequency of the energy is between about 400 kHz and 600 kHz.

18. The system of claim 15, wherein the thermal energy has a temperature of between 80°

C. and 95°

C.

19. The system of claim 15, wherein the radiofrequency energy is sufficient to ablate the basivertebral nerve.

20. The system of claim 15, wherein the radiofrequency energy is sufficient to denervate the basivertebral nerve.