SYSTEM FOR HEATING A VERTEBRAL BODY TO TREAT BACK PAIN
Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain.
1 . A system for therapeutically heating a vertebral body to treat back pain, comprising:
a cannula having a curved bore configured to be inserted through the outer cortical bone region of the vertebral body and into the inner cancellous bone region of the vertebral body;
a bipolar radiofrequency (RF) energy delivery probe having an active electrode and a return electrode,
wherein said RF energy delivery probe is sized and configured to be inserted within a central passageway of the cannula,
wherein the cannula is shaped so as to guide said RF energy delivery probe towards a midline between a first lateral side of the vertebral body and a second opposite lateral side of the vertebral body of the vertebral body;
wherein the active electrode is positioned at a distal tip of a distal end of the RF energy delivery probe and the return electrode is spaced proximal to the active electrode at the distal end of the RF energy delivery probe, and
wherein the active and return electrodes are positioned at locations such that when said energy delivery probe is advanced within the inner cancellous bone region of the vertebral body, the active and return electrodes are on opposite sides of the midline of the vertebral body, and
wherein said two electrodes are configured to deliver radiofrequency energy to a basivertebral nerve within the vertebral body sufficient to ablate the basivertebral nerve.
2 . The system of claim 1 , wherein the return electrode is spaced about 2 mm proximal to the active electrode.
3 . The system of claim 2 , wherein the return electrode is a cylindrical electrode.
4 . The system of claim 1 , wherein the frequency of the radiofrequency energy is between about 400 kHz and 600 kHz.
5 . The system of claim 1 , wherein the radiofrequency energy is configured to be delivered at a temperature of between 80° C. and 95° C.
6 . The system of claim 1 , wherein said RF energy delivery probe comprises a plurality of electrode pairs configured to treat multiple vertebral bodies simultaneously.
7 . The system of claim 1 , wherein a first electrode pair and a second electrode pair are connected by a “y”-shaped connector.
8 . A system for therapeutically heating a vertebral body to treat back pain, comprising:
a cannula having a curved bore configured to be inserted through the outer cortical bone region of the vertebral body and into the inner cancellous bone region of the vertebral body;
a flexible radiofrequency energy delivery probe having two electrodes that is sized and configured to be inserted within a central passageway of the cannula,
wherein the cannula is shaped so as to guide said energy delivery probe towards a midline between a first lateral side of the vertebral body and a second opposite lateral side of the vertebral body of the vertebral body;
wherein the two electrodes are positioned at locations of a distal end of said energy delivery probe such that when said energy delivery probe is advanced within the inner cancellous bone region of the vertebral body, the two electrodes are on opposite sides of the midline; and
wherein said two electrodes are configured to deliver radiofrequency energy to a basivertebral nerve within the vertebral body sufficient to denervate the basivertebral nerve.
9 . The system of claim 8 , wherein said energy device comprises a bipolar radiofrequency device having and the two electrodes comprise an active electrode and a return electrode.
10 . The system of claim 9 , wherein the active electrode is located at the distal tip of the probe and the return electrode is spaced about 2 mm proximal to the active electrode.
11 . The system of claim 10 , wherein the return electrode is a cylindrical electrode.
12 . The system of claim 8 , wherein the frequency of the radiofrequency energy is between about 400 kHz and 600 kHz.
13 . The system of claim 8 , wherein the radiofrequency energy has a temperature of between 80° C. and 95° C.
14 . The system of claim 8 , wherein the radiofrequency energy is sufficient to ablate the basivertebral nerve.
15 . A system for therapeutically heating a vertebral body to treat back pain, comprising:
a cannula having a curved bore configured to be inserted through the outer cortical bone region of the vertebral body and into the inner cancellous bone region of the vertebral body;
a flexible energy delivery probe having two electrodes that is sized and configured to be inserted within a central passageway of the cannula, and
an energy delivery source coupled to the two electrodes,
wherein the two electrodes are positioned at locations of a distal end of said energy delivery probe such that when said energy delivery probe is advanced within the inner cancellous bone region of the vertebral body, a first electrode is configured to be positioned on a first side of the vertebral body and a second electrode is configured to be positioned on a second side of the vertebral body; and
wherein said two electrodes are configured to deliver thermal energy to a basivertebral nerve within the vertebral body sufficient to modulate the basivertebral nerve.
16 . The system of claim 15 , wherein said energy device comprises a bipolar radiofrequency device having and the two electrodes comprise an active electrode and a return electrode.
17 . The system of claim 15 , wherein the frequency of the energy is between about 400 kHz and 600 kHz.
18 . The system of claim 15 , wherein the thermal energy has a temperature of between 80° C. and 95° C.
19 . The system of claim 15 , wherein the radiofrequency energy is sufficient to ablate the basivertebral nerve.
20 . The system of claim 15 , wherein the radiofrequency energy is sufficient to denervate the basivertebral nerve.