MODULATING NERVES WITHIN BONE USING BONE FASTENERS

• US 20150045783A1
• Filed: 08/07/2014
• Published: 02/12/2015
• Est. Priority Date: 08/08/2013
• Status: Active Grant

• Current Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Original Assignee: Relievant Medsystems, Incorporated (Boston Scientific Corporation)
• Inventors: Edidin, Avram Allan
• Granted Patent: US 9,724,151 B2
• Time in Patent Office: Days
• US Class Current: 606/29
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• 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 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00577 Ablation

Abstract

Methods of using hardware (e.g., bone screws, anchors or other devices) previously inserted within the body to facilitate energy delivery are disclosed. The energy delivery (e.g., thermal energy) may be used for neuromodulation (such as stimulation or denervation), tissue heating and ablation, curing, and other applications in the spine and non-spine orthopedic locations.

Claims

1. A method of treating back pain in a subject having a pedicle screw inserted within a cancellous bone region of a vertebral body, the method comprising:

identifying a pedicle screw proximate a region of interest,

wherein the pedicle screw comprises a conductive material,

wherein at least a portion of the pedicle screw is in contact with a cancellous bone region,

wherein said region of interest comprises a nerve within the cancellous bone region,

applying thermal energy to the pedicle screw to conduct heat to the cancellous bone of the vertebral body sufficient to modulate the nerve within the cancellous bone region.

2. The method of claim 1, wherein the temperature of the thermal energy is between about 75 degrees Celsius and about 100 degrees Celsius.

3. The method of claim 1, wherein the thermal energy is applied for a period of about 10 to about 30 minutes.

4. The method of claim 1, wherein the applied thermal energy is sufficient to denervate the nerve.

5. The method of claim 1, wherein the applied thermal energy is sufficient to ablate the nerve to permanently treat back pain associated with the nerve.

6. The method of claim 1, wherein the thermal energy is applied using a heat source.

7. The method of claim 1, wherein the thermal energy is applied using a radio-frequency generator.

8. A method of treating back pain of a subject, the method comprising:

performing a spinal fusion procedure between two adjacent vertebral bodies;

inserting a distal end of a first pedicle screw within a cancellous bone region of a first vertebral body; and

applying thermal energy to the first pedicle screw to conduct heat to the cancellous bone region sufficient to modulate a nerve within the cancellous bone region of the first vertebral body.

9. The method of claim 8, further comprising inserting a distal end of a second pedicle screw within the cancellous bone region of the first vertebral body and applying thermal energy to the second pedicle screw to conduct heat to the cancellous bone region of the first vertebral body sufficient to modulate the nerve within the cancellous bone region of the first vertebral body in combination with the applied thermal energy to the first pedicle screw.

10. The method of claim 9, wherein the thermal energy is applied to the first pedicle screw and the second pedicle screw simultaneously.

11. The method of claim 8, further comprising inserting a distal end of a second pedicle screw within the cancellous bone region of a second vertebral body and applying thermal energy to the second pedicle screw to conduct heat to the cancellous bone region of the second vertebral body sufficient to modulate a nerve within the cancellous bone region of the second vertebral body.

12. The method of claim 11, wherein the thermal energy is applied to the first pedicle screw and the second pedicle screw simultaneously.

13. The method of claim 11, wherein the thermal energy is applied to the first pedicle screw and the second pedicle screw successively.

14. A method of applying energy to the body, the method comprising:

identifying a pre-existing implant proximate a region of interest,

wherein the pre-existing implant comprises a conductive material,

wherein said region of interest comprises a nerve within or proximate a bone; and

applying thermal energy to the pre-existing implant to conduct heat to the region of interest sufficient to modulate the nerve within or proximate the bone.

15. The method of claim 14, wherein the bone is a vertebral body and wherein the nerve is a basivertebral nerve.

16. The method of claim 14, wherein the bone is a portion of bone of any of the following:

shoulder, hip, cranium, wrist, arm, hand, knee, elbow or small joints.

17. The method of claim 14, wherein the region of interest is within a cancellous bone portion.

18. The method of claim 14, wherein the region of interest is within or proximate a periosteal or osteal potion of the bone.

19. The method of claim 14, wherein the thermal energy is applied using a radiofrequency generator.

20. The method of claim 14, wherein the thermal energy is applied using at least one electrode.