An electrosurgical probe with internal cooling for use in systems and methods for lesioning in bone and other tissue is disclosed. The probe includes a distal electrical insulator, a proximal electrical insulator, a distal electrical conductor defining a distal electrode with a closed distal end and a proximal electrical conductor defining a proximal electrode, the distal electrode longitudinally spaced apart and electrically isolated from the proximal electrode by the distal electrical insulator. The distal electrode has a closed proximal end formed by a distal face of the distal electrical insulator to thereby define a closed distal inner lumen for circulating the cooling fluid. The proximal electrode has a closed distal end formed by a proximal face of the distal electrical insulator and a closed proximal end formed by a distal face of the proximal electrical insulator to thereby define a closed proximal inner lumen for circulating the cooling fluid.

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.

Provided are methods for anesthetizing a human patient undergoing surgery, and/or pain block procedures. In some forms, the methods include inserting at least one cryo-needle into a target region of the patient, the target region including a site superficial to a target intercostal nerve and cooling the cryo-needle to inhibit the target intercostal nerve.

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 system and method for delivering energy to a patient's body includes a plurality of probes each having an elongate member with a distal region having an electrically non-conductive outer circumferential portion and a proximal region. Each of the plurality of probes further includes an electrically conductive energy delivery device extending distally from the electrically non-conductive outer circumferential portion for delivering one of electrical and radiofrequency energy to the patient's body. The energy delivery devices further include an electrically conductive outer circumferential surface. The system also includes at least one controller communicatively coupled to each of the plurality of probes. The controller includes a user interface having a control screen. The control screen includes an independent control module and a simultaneous control module that allows a user to select between independent control or simultaneous control of the plurality of probes.

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 (e.g., an energy delivery device).

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.

An articulated robotic platform is provided as an end-actuator intended to be fitted to an articulated robotic arm. One use of the articulated robotic platform is to more accurately guide surgical tools during a surgical intervention making it possible to achieve positional accuracy on the level of millimeters or fractions of a millimeter. The articulated robotic platform includes support members attached to the patient or anchoring the articulated robotic platform onto a clamp. The support members of the articulated robotic platform are capable of changing in length, and this change can be monitored by an extension measurement sensor fitted to one or more of the support members. The controller, when provided with feedback information of the extension measurement and direction of several of the legs, can calculate accurately the position of the articulated robotic platform relative to an intervention area of a patient.

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.

An ablation system for treating tissue in a patient's body includes an energy source, one or more probes connected to the energy source, and a controller communicatively coupled to one or more probes. Each of the probes includes an elongate member having a distal region with an electrically non-conductive outer circumferential portion and a proximal region. The probes further include an electrically conductive energy delivery device extending distally from the electrically non-conductive outer circumferential portion. The controller includes one or more processors and one or more memory devices. The one or more memory devices are configured to store computer-readable instructions that when executed by the one or more processors cause the one or more processors to perform operations that include detecting a number of probes connected to the energy source and allocating a portion of the predetermined power supply to each of the probes.