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.

The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

An access and radio-frequency (RF) ablation system and method for use thereof is provided. The access and RF ablation system can include an RF ablation probe, a stylet, a cannula, a needle, and a drill. The method of using the access and radio-frequency ablation system can include inserting portions of a combined stylet into a patient's body to create a pathway therethrough and position a distal end of the stylet and a distal end of the cannula adjacent hard and/or soft tissues requiring ablation or tissues adjacent thereto; pushing portions of the needle into, through, and out of an interior cavity of the cannula to position a curved distal end of the needle adjacent the distal end of the cannula in the pathway; lengthening the pathway in an angled and curved direction relative to a mid-longitudinal axis of the cannula by pushing the curved distal end portion of the needle further into the hard and/or soft tissues requiring ablation or the tissues adjacent thereto; guiding a drill using the needle to enlarge and/or further lengthen the pathway in the hard and/or soft tissues requiring ablation or the tissues adjacent thereto in an angled and curved direction relative to the mid-longitudinal axis of the cannula; pushing portions of the RF ablation probe into, through, and out of the cannula and into and through the pathway to position a distal end portion of the RF ablation probe adjacent the hard and/or soft tissues requiring ablation; and activating the RF ablation probe to ablate all or portions of the hard and/or soft tissues requiring ablation.

A method is disclosed for the treatment of a thoracic region of a patient's body. Embodiments of the method comprise positioning an energy delivery portion of an electrosurgical device to face a segment of a thoracic vertebra at a distance from the segment; and cooling the energy delivery portion and delivering energy through the energy delivery portion.

A computer-assisted surgery system may have a robotic arm including a surgical tool and a processor communicatively connected to the robotic arm. The processor may be configured to receive, from a neural monitor, a signal indicative of a distance between the surgical tool and a portion of a patient's anatomy including nervous tissue. The processor may be further configured to generate a command for altering a degree to which the robotic arm resists movement based on the signal received from the neural monitor; and send the command to the robotic arm.

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 distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved 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.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

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 distal opening at the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, the curved cannula comprising a curved distal end configured to be extended outward from the distal opening to generate a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured to allow a treatment device to be delivered through the central passageway to a location beyond the curved path.

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 distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved 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.

A method for treating back pain in a patient in need of such treatment is provided. The method includes positioning a balloon catheter in or adjacent to a treatment zone containing a basivertebral nerve. A chemical denervation agent is administered with the balloon catheter such that the chemical denervation agent chemically ablates at least a portion of the basivertebral nerve. Kits, systems and methods are disclosed.