Method for providing directional therapy to skeletal joints

• US 8,915,949 B2
• Filed: 05/17/2010
• Issued: 12/23/2014
• Est. Priority Date: 01/15/2002
• Status: Expired due to Term

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Diederich, Chris J., Lotz, Jeffrey C., Nau, Will, Bradford, David S.
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US12/781,689
• Publication Number:
  US 20110022133A1
• Time in Patent Office: 1,681 Days
• Field of Search: 601/2, 601/3, 606/41, 606/49, 607/105, 607/109, 607115-117, 128/898
• US Class Current: 607/96
• 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 2017/00092 using thermocouples
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61N 2007/0021 Neural system treatment
• CPC Class Codes: A61N 2007/003 Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0056 Beam shaping elements
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

An ultrasound therapy system and method is provided that provides directional, focused ultrasound to localized regions of tissue within body joints, such as spinal joints. An ultrasound emitter or transducer is delivered to a location within the body associated with the joint and heats the target region of tissue associated with the joint from the location. Such locations for ultrasound transducer placement may include for example in or around the intervertebral discs, or the bony structures such as vertebral bodies or posterior vertebral elements such as facet joints. Various modes of operation provide for selective, controlled heating at different temperature ranges to provide different intended results in the target tissue, which ranges are significantly affected by pre-stressed tissues such as in-vivo intervertebral discs. In particular, treatments above 70 degrees C., and in particular 75 degrees C., are used for structural remodeling, whereas lower temperatures achieve other responses without appreciable remodeling.

Claims

1. A method for treating a medical condition associated with a spinal joint within a body of a patient, comprising:

positioning a directional treatment assembly at a location external to all of the vertebral bodies and all of the intervertebral discs of a spine;

using the directional treatment assembly at the external location, directionally delivering a therapeutic level of energy in a first direction into a region of tissue in a vertebral body associated with the spinal joint from the external location; and

denervating nociceptive fibers or cells within said region of tissue.

2. A method as recited in claim 1, further comprising:

necrosing the nociceptive fibers or cells.

3. A method as recited in claim 1, wherein the therapeutic level of energy is delivered in the first direction into the region without delivering a substantial level of energy in a second direction opposite the first direction.

4. A method as recited in claim 1, wherein the therapeutic level of energy is sufficient to necrose nociceptive nerve fibers or cells in such tissue region without substantially affecting collagenous structures associated with the structure.

5. A method as recited in claim 1, wherein the directional energy is delivered in a manner that does not substantially remodel collagen in tissue associated with the spinal joint.

6. A method as recited in claim 1, further comprising:

focusing the therapeutic energy toward the region of tissue in the first direction from the location.

7. A method as recited in claim 6, wherein the focused energy converges toward the region of tissue.

8. A method for treating a medical condition associated with a spinal joint within a body of a patient, the spinal joint comprising at least the entirety of two adjacent vertebra and an intervertebral disc disposed therebetween, comprising:

positioning a directional treatment assembly at an external location with respect to all of the vertebral bodies and all of the intervertebral discs of a spine;

using the directional treatment assembly at the external location, delivering a field of therapeutic energy in a first direction into a treatment region in a vertebral body associated with the spinal joint;

the field of therapeutic energy converging from the external location to a focus within the treatment region; and

denervating nociceptive fibers or cells at the treatment region.

9. A method as recited in claim 8, further comprising:

necrosing the nociceptive fibers or cells.

10. A method as recited in claim 8, wherein the field of therapeutic energy is delivered in the first direction into the region without delivering a substantial level of energy in a second direction opposite the first direction.

11. A method as recited in claim 8, wherein the field of therapeutic energy is sufficient to necrose nociceptive nerve fibers or cells in the treatment region without substantially affecting collagenous structures associated with the spinal joint.

12. A method as recited in claim 8, wherein the directional energy is delivered in a manner that does not substantially remodel collagen in tissue associated with the spinal joint.

13. A method for therapeutically treating a medical condition associated with a spinal joint of a patient, the spinal joint comprising an intervertebral disc and the entirety of first and second vertebral bodies, each of the first and second bodies having a bony mass and being disposed on either side of the intervertebral disc, comprising:

positioning a directional treatment assembly at a location external to all of the vertebral bodies and all of the intervertebral discs of a spine;

using the directional treatment assembly at the external location, directionally delivering a focused field of therapeutic energy from the external location toward a treatment location within the bony mass of a first vertebral body; and

denervating nociceptive fibers or cells at said treatment location.

14. A method as recited in claim 13, further comprising:

necrosing the nociceptive fibers or cells.

15. A method as recited in claim 13, wherein the therapeutic field of energy is sufficient to necrose nociceptive nerve fibers or cells at the treatment location without substantially affecting collagenous structures associated with the structure.

16. A method as recited in claim 13, wherein the field of energy is delivered in a manner that does not substantially remodel collagen in tissue associated with the spinal joint.

17. A method as recited in claim 13, wherein the focused energy converges from the external location toward the treatment location within the first vertebral body.