Systems and methods for navigating an instrument through bone

• US 8,613,744 B2
• Filed: 01/07/2010
• Issued: 12/24/2013
• 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: Pellegrino, Richard, Patel, Samit, Papineau, Paula, Crombie, John S., Ryan, Thomas
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US12/683,555
• Publication Number:
  US 20100185161A1
• Time in Patent Office: 1,447 Days
• Field of Search: 606/32, 606/41, 606/46, 606/48, 606/50, 606/129, 604/114, 604/272, 607 98-100, 607/113, 607/115, 607/117
• US Class Current: 606/41
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3454 Details of tips
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00565 : Bone
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1475 : Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61F 7/007 : characterised by electric heating
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes

Abstract

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a radial opening at or near the distal end of the trocar. The system includes a curveable cannula sized to be received in the central channel, the curveable cannula comprising a curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar. The curveable cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Claims

1. A method of therapeutically treating a vertebral body, comprising:

inserting a probe within an inner cancellous bone region of a vertebral body;

wherein the probe is configured to deploy an energy delivery device;

wherein the probe comprises a longitudinal bore extending from a proximal end of the probe toward a distal end of the probe;

wherein the probe comprises a recess in communication with said longitudinal bore, said recess forming a lateral opening at or near the distal end of the probe;

wherein the probe further comprises a pivotable member, the pivotable member having a fixed end pivotably secured to the probe at a distal location within the recess of the probe, and a free end configured to be seated in said recess;

wherein the pivotable member comprises an undeployed mode in which the free end extends proximally from the fixed end within said recess, and a deployed mode in which the free end is configured to pivot about said fixed end and extend outward from said probe;

wherein the free end of the pivotable member is coupled to a distal end of a curveable cannula;

advancing the curveable cannula within the longitudinal bore of the probe, thereby articulating the pivotable member from the undeployed mode to the deployed mode to guide the distal end of the curveable cannula outward from the recess into the cancellous bone region of the vertebral body;

advancing the energy delivery device through the curveable cannula and along a path associated with the free end of the pivotable member into the cancellous bone region of the vertebral body; and

causing the energy delivery device to deliver thermal energy sufficient to heat a basivertebral nerve.

2. A method as recited in claim 1, wherein the thermal energy is deposited within the inner cancellous bone region of the vertebral body.

3. A method as recited in claim 1, wherein the thermal energy delivery is delivered in a region that is proximal of a basivertebral nerve junction.

4. A method as recited in claim 1, wherein the thermal energy is sufficient to denervate at least a portion of the basivertebral nerve.

5. A method as recited in claim 1, wherein the to thermal energy is sufficient to stimulate at least a portion of the basivertebral nerve.

6. A method as recited in claim 1, wherein the pivotable member in the undeployed mode is entirely contained within said recess.

7. A method as recited in claim 1, wherein the free end of the pivotable member constrains motion of the distal end of the curveable cannula to a curved path of a specified radius.