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. The modulation may be performed by a neuromodulation device an energy delivery device).

In one embodiment, a surgical rigid arm (100, 150, 200, 900) includes a first portion (102, 152, 202, 902), a second portion (103, 153, 203, 903) and a central portion (105, 154, 205, 906), where the central portion is extends between the first and second portions. A first end of the first portion and a second end of the second portion are each attached to a peripheral side (14) of a surgical bed (10, 30) such that the first portion and the second portion extend from the surgical bed in a first direction. The central portion extends substantially horizontally and is positioned over the surgical bed, the central portion being connected to the surgical instrument such that a load from the surgical instrument is distributed across the central portion to the first portion and second portion to provide rigid support for the surgical instrument.

A method and tool are described for relieving lower back pain via destruction and removal of suprapedicular tissues, particularly via the destruction and removal of the peridural membrane. The tool comprises a narrow tubular body having one of a plurality of tip designs at one end and a handle at the other end. The tool is inserted through the suprapedicular canal, and mechanical manipulation of the tool effects the destruction of the target tissues responsible for chronic lower back pain.

A plasma scalpel head for spinal percutaneous puncture and an operation method of the plasma scalpel head for spinal percutaneous puncture are provided. The plasma scalpel head for spinal percutaneous puncture includes a needle core. The needle core includes a main ablation electrode and a needle core body. The main ablation electrode is arranged at an ablation end of the plasma scalpel head. The needle core body is externally provided with a first insulating layer. The first insulating layer is externally provided with a reflow electrode layer. A part of the first insulating layer that is not covered with the reflow electrode layer forms a main ablation electrode protection insulating ring. The reflow electrode layer is provided thereon with a second insulating layer, and a part of the reflow electrode layer that is not covered with the second insulating layer forms a reflow electrode.

A multi-probe system and a method of lesioning for targeting a region of a vertebral body are disclosed. The method includes inserting a first introducer assembly into a first target location of the vertebral body to provide a first trajectory to access the vertebral body, the first introducer assembly including a first cannula. The method also includes inserting a second introducer assembly into a second target location of the vertebral body to provide a second trajectory to access the vertebral body, the second introducer assembly including a second cannula. The method further includes inserting a first bipolar probe through the first cannula of the first introducer assembly, the first bipolar probe including a first active tip at a distal end of the first bipolar probe, the first active tip including at least two electrodes. The method includes inserting a second bipolar probe through the second cannula of the second introducer assembly, the second bipolar probe including a second active tip at a distal end of the second bipolar probe, the second active tip including at least two electrodes.

A method and tool are described for relieving lower back pain via destruction and removal of suprapedicular tissues, particularly via the destruction and removal of the peridural membrane. The tool comprises a narrow tubular body having one of a plurality of tip designs at one end and a handle at the other end. The tool is inserted through the suprapedicular canal, and mechanical manipulation of the tool effects the destruction of the target tissues responsible for chronic lower back pain.

Systems and methods are disclosed for treating back pain associated with a vertebral body of a patient. The system may include an external energy source configured to be positioned at a location external to the body of the patient, a linear configured to drive translation of the external source in one or more axes, a computer coupled to the external source and linear drive and programming executable on said computer for determining a target treatment site within or near the vertebral body based on acquired imaging data, positioning a focal point of the external energy source to substantially coincide with the target treatment site, and delivering a treatment dose of therapeutic energy at said target treatment site, wherein the treatment dose is configured to modulate a nerve within or near the vertebral body.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Apparatus and methods for treating back pain are provided, in which an implantable stimulator is configured to communicate with an external control system, the implantable stimulator providing a neuromuscular electrical stimulation therapy designed to cause muscle contraction to rehabilitate the muscle, restore neural drive and restore spinal stability; the implantable stimulator further including one or more of a number of additional therapeutic modalities, including a module that provides analgesic stimulation; a module that monitors muscle performance and adjusts the muscle stimulation regime; and/or a module that provides longer term pain relief by selectively and repeatedly ablating nerve fibers. In an alternative embodiment, a standalone implantable RF ablation system is described.

Methods and devices are disclosed herein that generally involve applying thermal therapy to tissue (e.g., localized cooling or heating of tissue), and in particular applying thermal therapy to the spinal canal, tissue disposed within the spinal canal, and/or nerve roots extending from the spinal canal. In some embodiments, tissue can be cooled or heated by implanting a malleable or deformable thermal device in proximity to the targeted tissue. The thermal device can be left in place following surgery to facilitate application of post-surgical thermal therapy. In some embodiments, the thermal device can be removed post-surgery in a minimally- or non-invasive manner. The thermal device can be connectionless or can include penetrable regions, pre-attached tubing, or detachable connectors to facilitate application of cooling or heating means to the device. Methods are disclosed for utilizing thermal devices and for carrying out various treatment regimens that involve cooling or heating tissue using such devices.