THERMAL DENERVATION DEVICES AND METHODS

• US 20150057658A1
• Filed: 11/07/2014
• Published: 02/26/2015
• 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: Sutton, Jeffrey K., Ryan, Thomas P., Patel, Samit, Pellegrino, Richard C.
• Granted Patent: US 9,848,944 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/00071 Electrical conductivity
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe

Abstract

A method and apparatus for treating an intraosseous nerve. The method includes positioning a hollow shaft through the cortical shell of a vertebral body and into a cancellous bone region of the vertebral body. The hollow shaft includes an annular wall having a longitudinal bore therein, a proximal portion and a distal portion, and a first window extending transversely through the annular wall. An electrosurgical probe is advanced within the longitudinal bore from the proximal portion toward the distal portion. The electrosurgical probe includes a first treatment element at a distal end of the probe, wherein the first treatment element being in electrical connection with a power supply. The first treatment element is slidably disposed within the longitudinal bore so that the first treatment element is advanced radially outward from the window and shaft to affect treatment of the intraosseous nerve within the cancellous bone region.

Claims

1. A method of treating an intraosseous nerve within a cancellous bone region of a vertebral body, comprising:

positioning an electrosurgical device through a cortical shell of a vertebral body and into a cancellous bone region of the vertebral body,

wherein said electrosurgical device comprises a hollow electrically conductive shaft mechanically connected to an insulating spacer,

wherein said insulating spacer is mechanically connected to an electrically conductive tip,

wherein said hollow electrically conductive shaft is in electrical connection with a power supply via a first lead,

wherein said electrically conductive tip is in electrical connection with said power supply via a second lead,

wherein said second lead runs through said hollow electrically conductive shaft and said insulating spacer; and

heating an intraosseous nerve by applying a voltage between said electrically conductive tip and said hollow electrically conductive shaft sufficient to generate a current between said electrically conductive tip and said hollow electrically conductive shaft, thereby heating at least a portion of the cancellous bone region of the vertebral body.

2. The method of claim 1, wherein said voltage is sufficient to heat at least a portion of the cancellous bone region to at least 45°

C.

3. The method of claim 1, wherein said insulating spacer is hollow and wherein said second lead runs through said hollow electrically conductive shaft and said insulating spacer.

4. The method of claim 1, wherein at least a portion of said shaft comprises an outer insulating sleeve to electrically isolate the shaft from adjacent tissue.

5. The device of claim 4, wherein the sleeve has a length that is between 50% and 95% of the length of the shaft.

6. The method of claim 1, wherein the shaft comprises a shape memory alloy such that the shaft is flexible.

7. The method of claim 1, wherein said proximal end of said insulating spacer extends inside said distal end of said shaft, and wherein said proximal end of said tip extends inside said proximal end of said insulating spacer.

8. An electrosurgical device, comprising:

an inner shaft having a proximal end and a distal end;

a sharp tip located at the distal end of said inner shaft adapted for piercing cortical bone of a vertebral body,

wherein said sharp tip comprises a first electrode,

wherein said inner shaft comprises a second electrode,

wherein said second electrode is spaced proximally from said first electrode,

wherein said first electrode and said second electrode are separated by an electrically insulating material,

wherein said first electrode and said second electrode form a bipolar heating device,

wherein said bipolar heating device is configured to denervate an intraosseous nerve within a cancellous bone region of a vertebral body by transmission of radiofrequency energy to heat at least a portion of the cancellous bone region; and

an outer shaft having a hollow bore defining an inner surface and a distal opening,

wherein the outer shaft comprises a third electrode located on or near the distal opening of the outer shaft, and

wherein said inner shaft is configured to be contained within said outer shaft in a concentric telescoping manner such that the first electrode and the second electrode are deployable from the hollow outer shaft and such that the location of the electrodes can be adjusted to treat multiple locations without moving the outer shaft.

9. The device of claim 8, wherein the outer shaft comprises a fourth electrode spaced from the third electrode.

10. The device of claim 9, wherein the device is configured to provide a voltage between at least one of the first and second electrodes and the third electrode after the inner shaft is advanced out of the outer shaft such that the device provides the ability to adjust the location of the electrodes to treat multiple locations without moving the outer shaft.

11. The device of claim 10, wherein said voltage is sufficient to heat at least a portion of the cancellous bone region to at least 45°

C.

12. The device of claim 8, wherein an inner portion of the outer shaft and the outer portion of the inner shaft form a complementary pin-and-helical groove structure, thereby allowing for a more rapid deployment of the electrodes to a fixed distal position.