Method of treating an intraosseous nerve

Abstract

This invention relates to a method of straddling an intraosseous nerve with an energy transmitting device to improve the therapeutic treatment of the nerve.

We claim: 
     
       1. A method of therapeutically treating a vertebral body having an outer cortical bone region, an inner cancellous bone region, and a basivertebral nerve BVN, comprising the steps of:
 providing a probe configured to deploy an energy device having an a first electrode; 
 the probe comprising a longitudinal bore extending from a proximal end of the probe toward a distal end of the probe; 
 the probe comprising a recess in communication with said bore, said recess forming a lateral opening at or near the distal end of the probe; 
 the probe further comprising 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, and a second electrode; 
 wherein the pivotable member comprises an undeployed mode where the free end extends proximally from the fixed end within said recess, and a deployed mode where the free end is configured to pivot about said fixed end and extend outward from said probe; 
 articulating the pivotable member from the undeployed mode to the deployed mode to facilitate delivery of the energy device second electrode along a path associated with the free end of the pivotable member into the cancellous bone region of the vertebral body; and 
 applying a sufficiently high frequency voltage to difference between the first electrode and the second electrode to generate a current therebetween to therapeutically heat the BVN. 
 
     
     
       2. A method as recited in  claim 1 , the BVN having a trunk extending from the outer cortical bone region and into the inner cancellous bone region and branches extending from the trunk to define a BVN junction, wherein therapeutically heating the BVN comprises:
 depositing therapeutic energy within the inner cancellous bone region of the vertebral body. 
 
     
     
       3. The method of  claim 2 , wherein the therapeutic energy is deposited in a region of the vertebral body located between 60% and 90% of the distance between the posterior and anterior ends of the vertebral body. 
     
     
       4. The method of  claim 3 , wherein said therapeutic energy is deposited in a region of the vertebral body located between 60% and 90% of the distance from the anterior wall to the posterior wall of the vertebral body. 
     
     
       5. The method of  claim 2 , wherein said therapeutic energy deposited includes a region that is proximal of the BVN junction. 
     
     
       6. The method of  claim 2 , wherein said therapeutic energy is deposited within a region that is at least 1 cm in diameter. 
     
     
       7. The method of  claim 2 , wherein said therapeutic energy deposited comprises a steady-state heated zone having a peak temperature of between 80 degrees C. and 95 degrees C. 
     
     
       8. The method of  claim 7 , wherein said steady-state heated zone heats at least 1 cc of bone to a temperature of at least 50 degrees C. 
     
     
       9. The method of  claim 2 , wherein the method is performed to treat pain in a patient diagnosed with pain. 
     
     
       10. The method of  claim 1 , wherein the method is performed to treat pain in a patient diagnosed with pain. 
     
     
       11. The method of  claim 1 , wherein the pivotable member in the undeployed mode is entirely contained within said recess. 
     
     
       12. The method of  claim 1 , wherein articulating the pivotable member from the undeployed mode to the deployed mode comprises advancing a member distally along said bore to push the free end of the of the pivotable member laterally out the recess. 
     
     
       13. The method of  claim 1 , wherein the free end of the pivotable member deploys pivotably outward from the recess into the cancellous bone region.