Denervation methods

摘要

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.

主权项

1. A method of denervating a nerve within a vertebral body, comprising:
inserting a curved stylet within a lumen of a curved cannula such that a distal end of the curved stylet extends beyond an open distal end of the curved cannula; inserting the curved cannula and the curved stylet together within an inner cancellous bone region of the vertebral body; advancing the curved cannula and the curved stylet together toward a midline of the vertebral body, thereby forming a curved path within the inner cancellous bone region of the vertebral body; removing the curved stylet from the curved cannula; inserting a channeling stylet within the lumen of the curved cannula, wherein the channeling stylet is flexibly deformable to navigate the curved cannula yet retain a straight form upon exiting the open distal end of the curved cannula; advancing a distal end of the channeling stylet out of the open distal end of the curved cannula and beyond the curved path to form a linear path; removing the channeling stylet; inserting an energy delivery device through the curved cannula and positioning a distal end of the energy delivery device within the linear path, and delivering energy to the inner cancellous bone region of the vertebral body sufficient to denervate at least a portion of a basivertebral nerve within the vertebral body.