Implantable thermal treatment method and apparatus

• US 8,414,509 B2
• Filed: 10/05/2010
• Issued: 04/09/2013
• Est. Priority Date: 01/23/2002
• 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, William H. Jr., Bradford, David S.
• Primary Examiner(s): Cwern, Jonathan
• Application Number:
  US12/898,401
• Publication Number:
  US 20110087314A1
• Time in Patent Office: 917 Days
• Field of Search: 601/3, 607/96
• US Class Current: 601/3
• 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 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 8/56 Details of data transmission or power supply
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• 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
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

A long-term implantable 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 effected 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 achieves other responses without appreciable remodeling.

Claims

1. A method for providing long-term thermal therapy to a patient, comprising:

positioning a delivery assembly at a location associated with a region of tissue of a spinal joint;

wherein the delivery assembly comprises a needle;

wherein the needle is delivered into and through at least a portion of a bony structure to the location;

wherein positioning a delivery assembly comprises positioning the delivery assembly into and through at least a portion of a vertebral body to the location, said vertebral body comprising a bony structure located above a lower vertebral endplate and below an upper vertebral endplate;

delivering a long-term thermal therapy implant through the needle to a treatment location within the bony structure of the vertebral body;

implanting the long-term thermal therapy implant at the treatment location;

delivering a therapeutic level of energy from the implant to the tissue; and

heating the region of tissue associated with the spinal joint so as to cause a therapeutic result in the tissue.

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

denervating a nociceptive nerve at said region of tissue as a result of the delivered therapeutic level of energy.

3. A method as recited in claim 1, wherein the delivery assembly comprises a cannula with a sharpened tip that is adapted to puncture the bony structure of the vertebral body.

4. A method for providing thermal therapy to a patient, comprising:

positioning a delivery assembly at a location associated with a region of tissue of a spinal joint;

wherein the delivery assembly comprises a needle;

wherein the needle is delivered into and through at least a portion of a bony structure to the location;

wherein positioning a delivery assembly comprises positioning the delivery assembly into and through at least a portion of a vertebral body to the location, said vertebral body comprising a bony structure located above a lower vertebral endplate and below an upper vertebral endplate;

delivering a thermal therapy implant through the needle to said a treatment location within the bony structure of the vertebral body;

implanting the thermal therapy implant at the treatment location;

delivering a therapeutic level of energy from the implant to the tissue;

denervating a nociceptive nerve at said region of tissue as a result of the therapeutic level of energy.

5. A method as recited in claim 4, wherein the delivery assembly comprises a cannula with a sharpened tip that is adapted to puncture the bony structure of the vertebral body.

6. A method as recited in claim 4, wherein the delivering a therapeutic level of energy comprises delivering a converging field of energy to the region of tissue.

7. A method for providing thermal therapy to a patient, comprising:

positioning a delivery assembly at a location associated with a region of tissue of a spinal joint;

wherein the delivery assembly comprises a needle;

wherein the needle is delivered into and through at least a portion of a bony structure to the location;

wherein positioning a delivery assembly comprises positioning the delivery assembly into and through at least a portion of a vertebral body to the location, said vertebral body comprising a bony structure located above a lower vertebral endplate and below an upper vertebral endplate;

delivering a thermal therapy device through the needle to a treatment location within the bony structure of the vertebral body;

delivering a therapeutic level of energy from the thermal therapy device to the tissue; and

denervating a nociceptive nerve at said region of tissue as a result of the therapeutic level of energy.

8. A method as recited in claim 7, wherein the delivery assembly comprises a cannula with a sharpened tip that is adapted to puncture the bony structure of the vertebral body.

9. A method as recited in claim 7, wherein the delivering a therapeutic level of energy comprises delivering a converging field of energy to the region of tissue;

wherein the converging field of energy is delivered via a plurality of elements along a curvilinear path;

the plurality of elements directing energy to a common focal point.