SYSTEMS AND METHODS FOR TREATING BACK PAIN

• US 20150005614A1
• Filed: 12/21/2012
• Published: 01/01/2015
• Est. Priority Date: 12/30/2011
• Status: Active Grant

• Current Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Original Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Inventors: Heggeness, Michael H., Pellegrino, Richard C., Peters, Rex
• Granted Patent: US 10,390,877 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61F 7/00 Heating or cooling appliances for medical or therapeutic treatment of the human body heating or cooling means in connection with bedsteads or mattresses A47C21/00 ; massage, therapeutic baths A61H; hyperthermia using electric or magnetic fields or ultrasound A61N; electric heating elements H05B
• CPC Class Codes: A61M 5/00 Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests vaccination appliances for veterinary use A61D1/025 ; tube connectors, tube couplings, valves or branch units specially adapted for medical use A61M39/00; containers specially adapted for medical or pharmaceutical purposes A61J1/00; combinations of vial and syringe for mixing or transferring their contents A61J1/20; holders for containers for collecting, storing or administering blood or medical fluids A61J1/16
• CPC Class Codes: A61N 5/045 specially adapted for treatment inside the body
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

Systems and methods are disclosed for treating back pain associated with a vertebral body of a patient. The system may include an external energy source configured to be positioned at a location external to the body of the patient, a linear configured to drive translation of the external source in one or more axes, a computer coupled to the external source and linear drive and programming executable on said computer for determining a target treatment site within or near the vertebral body based on acquired imaging data, positioning a focal point of the external energy source to substantially coincide with the target treatment site, and delivering a treatment dose of therapeutic energy at said target treatment site, wherein the treatment dose is configured to modulate a nerve within or near the vertebral body.

Claims

1-65. -65. (canceled)

66. A method for treating back pain associated with a vertebral body of a patient, comprising:

identifying a junction of a sinuvertebral nerve at a location external to the vertebral body,

wherein the junction comprises a trifurcated junction having an ascending nerve branch, a descending nerve branch, and a medial nerve branch;

isolating the medial nerve branch extending from the junction toward the vertebral body; and

denervating the medial nerve branch at a position at or near the junction.

67. The method of claim 66, further comprising:

verifying that the medial nerve branch courses under a posterior longitudinal ligament prior to denervating the medial nerve branch;

dilating a space under the posterior longitudinal ligament to allow visualization of a foramen leading to the vertebral body prior to denervation of the medial nerve branch; and

wherein the step of denervating the medial nerve branch comprises percutaneously delivering a treatment device to the location via a delivery assembly and operating the treatment device at the position at or near the junction.

68. The method of claim 66, further comprising verifying that the medial nerve branch courses under the posterior longitudinal ligament prior to denervating the medial nerve branch.

69. The method of claim 66, further comprising dilating a space under the posterior longitudinal ligament to allow visualization of a foramen leading to the vertebral body prior to denervation of the medial nerve branch.

70. The method of claim 66, wherein the step of denervating the medial nerve branch comprises altering a conductive property of the medial nerve branch.

71. The method of claim 66, wherein the step of denervating the medial nerve branch comprises severing conduction across the medial nerve branch.

72. The method of claim 70, wherein altering a conductive property of the medial nerve branch comprises one or more of:

stimulation, alteration, blocking, or elimination of conduction across the medial nerve branch sufficient to provide a therapeutic effect within or related to the vertebral body.

73. The method of claim 70, wherein altering a conductive property of the medial nerve branch comprises one or more of:

heating, cooling, radiating, agitating, or altering the chemical composition of the medial nerve branch sufficient to provide a therapeutic effect within or related to the vertebral body.

74. The method of claim 70, wherein altering a conductive property of the medial nerve branch comprises cutting or crimping the medial nerve branch.

75. The method of claim 66, wherein the step of denervating the medial nerve branch comprises percutaneously delivering a treatment device to the location and operating the treatment device at the position at or near the junction.

76. A method for treating back pain associated with a vertebral body of a patient, comprising:

locating a junction of a sinuvertebral nerve at a location external to the vertebral body;

locating a nerve branch extending from the junction of the sinuvertebral nerve toward a foramen of a vertebral body; and

denervating the nerve branch at a position between the junction and the foramen.

77. The method of claim 76, wherein the nerve branch comprises a medial branch of the junction that courses under a posterior longitudinal ligament.

78. The method of claim 76, wherein the step of locating the junction comprises visual identification through an open surgery approach.

79. The method of claim 76, wherein the step of locating the junction comprises visualizing the location using an imaging means.

80. The method of claim 79, further comprising percutaneously guiding the imaging means to the location, wherein the imaging means comprises a camera.

81. The method of claim 79, wherein the imaging means is located external to the patient.

82. The method of claim 76, wherein the step of denervating the nerve branch comprises altering a conductive property of the nerve branch using a treatment device.

83. The method of claim 76, wherein the step of denervating the nerve branch comprises severing conduction across the nerve branch using a treatment device.

84. The method of claim 82, wherein altering a conductive property of the nerve branch comprises one or more of:

stimulation, alteration, blocking, or elimination of conduction across the nerve branch sufficient to provide a therapeutic effect within or related to the vertebral body.

85. The method of claim 82, wherein altering a conductive property of the nerve branch comprises one or more of:

cutting, crimping, heating, cooling, radiating, agitating, or altering the chemical composition of the nerve branch sufficient to provide a therapeutic effect within or related to the vertebral body.