Cooling systems for medical probe assemblies are provided. For example, a cooling system comprises a pump assembly including a control unit having a controller, a motor, and a pump head driven by the motor; a fluid reservoir; a lumen for delivering a cooling fluid to the medical probe assembly distal end; tubing extending through the pump head for conveying the cooling fluid from the fluid reservoir to the lumen; and a flow sensor for sensing the cooling fluid flow rate. The pump head is disposed between the fluid reservoir and the medical probe assembly to pump the cooling fluid from the fluid reservoir to the lumen. The flow sensor is disposed between the pump head and the medical probe assembly to sense the cooling fluid flow rate. Methods for controlling fluid flow rate through a cooling circuit and systems for using a plurality of medical probe assemblies also are provided.

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.

Systems and methods for tissue ablation. Systems include needles with deployable filaments capable of producing asymmetrical offset lesions at target volumes, which may include a target nerve. Ablation of at least a portion of the target nerve may inhibit the ability of the nerve to transmit signals, such as pain signals, to the central nervous system. The offset lesion may facilitate procedures by directing energy towards the target nerve and away from collateral structures. Example anatomical structures include lumbar, thoracic, and cervical medial branch nerves and rami and the sacroiliac joint.

A method of treating tissue of a patient's body includes providing a power source coupled to at least one probe assembly. The probe assembly includes an elongate member with a distal region and a proximal region. The distal region has an electrically and thermally-conductive energy delivery device for delivering one of electrical and radiofrequency energy to the patient's body. The electrically and thermally-conductive energy delivery device has one or more internal lumens for circulating a cooling fluid therethrough and an electrically and thermally-conductive protrusion having a temperature sensing element. The temperature sensing element extends from a distal end of the energy delivery device. The method includes inserting the energy delivery device of the at least one probe assembly into the patient's body. Further, the method includes routing the energy delivery device of the at least one probe assembly to the tissue of the patient's body. The method also includes simultaneously circulating the cooling fluid through the one or more internal lumens via at least one pump assembly and delivering energy from the power source to the tissue through the energy delivery device. Further, the method includes monitoring one or more procedure parameters while delivering the energy from the power source to the tissue through the energy delivery device. Moreover, the method includes determining, in real-time, whether a rising impedance event is likely to occur in a predetermined time period based on the one or more procedure parameters and determining a command for the pump assembly based on whether the rising impedance event is likely to occur in the predetermined time period.

A system and method of treating tissue of a patient's body includes providing a power source coupled to at least one probe assembly. The probe assembly has at least one an elongate member with a distal region and a proximal region. The distal region has an electrically and thermally-conductive energy delivery device that includes one or more internal lumens and an electrically and thermally-conductive protrusion having a temperature sensing element. The method also includes inserting the energy delivery device into the patient's body. Further, the method includes routing the energy delivery device to the tissue of the patient's body. Moreover, the method includes simultaneously circulating the cooling fluid through the internal lumens via at least one pump assembly and delivering energy from the power source to the tissue through the energy delivery device. The method further includes actively controlling energy delivered to the tissue by controlling an amount of energy delivered through the energy delivery device and by controlling a flow rate of the pump assembly.

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.

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.

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.

A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.

Apparatus for radiofrequency neurotomy are disclosed. Needles with deployable filaments capable of producing lesions at target volumes, which include a target nerve, and systems including such needles are disclosed. Ablation of at least a portion of the target nerve may inhibit the ability of the nerve to transmit signals, such as pain signals, to the central nervous system. The lesion may facilitate procedures by directing energy towards the target nerve and away from collateral structures. Example anatomical structures include lumbar, thoracic, and cervical medial branch nerves and rami and the sacroiliac joint.