JP2013027782A - 骨内神経を除神経する装置 - Google Patents
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Abstract
【解決手段】 (a)作用電極603および第1のリード線を備えた第1のプローブ601と、(b)戻り電極613および第2のリード線を備えた第2のプローブ611と、(c)第1のプローブおよび第2のプローブを収容するための第1のボアおよび第2のボアを骨内に形成するための手段と、(d)第1のリード線と電気的に接続された第3のリード線および第2のリード線と電気的に接続された第4のリード線を備えた、作用電極および戻り電極の間に電位差を生成する電源とを有する。
【選択図】 図12
Description
本出願が主張する優先権の基礎となる米国特許出願は、2002年9月30日に出願された米国特許出願(第10/259,689号:代理人整理番号DEP0807)「機能的な素子を組織を通して前進させるための新規な装置(Novel Device for Advancing a Functional Element Through Tissue)」に関連し、その米国特許出願の明細書は参照文献として引用される。
(a)作用電極および戻り電極を備えたエネルギー装置を骨に挿入する過程と、
(b)作用電極を骨の第1の側面に配置し、戻り電極を骨の第2の側面に配置して、作用電極および戻り電極の間に全加熱領域を画定する過程と、
(c)作用電極および戻り電極の間に十分に高い周波数の電圧を加えて、IONを除神経するのに十分に全加熱領域を抵抗加熱するために作用電極および戻り電極の間に電流を生成する過程と
を有する。
(1)IONの正確な位置を知る必要がない、
(2)IONに直接アクセスする必要がない、
(3)その制御された加熱分布によって、臨床医が健康な隣接する海綿骨、脊髄、または、向かい合う椎骨の終板のような隣接する構造を加熱するのを回避できるようになる、
ということである。
(a)第1の側面および第2の側面を備えた、BVNが存在すると考えられるBVN存在領域を求める過程と、
(b)作用電極および戻り電極を備えたエネルギー装置を椎体内に挿入する過程と、
(c)作用電極をBVN存在領域の第1の側面に配置し、戻り電極をBVN存在領域の第2の側面に配置して、作用電極および戻り電極の間に全加熱領域を画定する過程と、
(d)作用電極および戻り電極の間に十分に高い周波数の電圧を加えて、BVNを除神経するのに十分な温度に全加熱領域を抵抗加熱するための電流を作用電極および戻り電極の間に生成する過程と
を有する。
(a)第1の面を備えた作動電極および第2の面を備えた戻り電極を有するエネルギー装置を椎体内に提供する過程と、
(b)作用電極を椎体内に第1の向きで配置する過程と、
(c)第1の面および第2の面が60度以下の角度2δを画定するように、戻り電極を椎体内に第2の向きで配置する過程と、
(d)作用電極および戻り電極の間に十分に高い周波数の電圧を加えて、BVNを治療的に加熱するために全加熱領域を形成するための電流を作用電極および戻り電極の間に生成する過程と
を有する。
(a)作用電極および戻り電極を備えたエネルギー装置を提供する過程と、
(b)BVNに対して50度から90度までの範囲内の角度βをなす電極軸を画定するように作用電極および戻り電極を椎体内に配置する過程と、
(c)作用電極および戻り電極の間に十分に高い周波数の電圧を加えて、BVNを治療的に加熱するために全加熱領域を形成するための電流を作用電極および戻り電極の間に生成する過程と
を有する。
(a)長手方向のボアを備えたカニューレと、
(b)長手方向のボア内に受容されるように適合された外径と皮質骨を穿通するように適合された遠位の先端とを備えたスタイレットと、
(c)(1)長手方向のボア内に受容されるように適合された外径、(2)第1の電極、および、(3)第1の電極に電気的に接続されたリード線を備えた第1のプローブと
を有する。
(a)電源1409と電気的に接続された内側の導電性シャフト1403と、
(b)導電性シャフトの一部を取り囲んだ外側の絶縁ジャケット1405と
を有する。この構成では、ジャケットを配置することによって、電極として使用できるシャフトの遠位の絶縁されていない部分1407が提供される。好ましくは、シャフトの遠位の絶縁されていない部分1407は、3mmから8mmまでの範囲内の長さを有し、より好ましくは、約5mmの長さを有する。これらの実施の形態のうちの好ましい実施の形態では、絶縁材は、ポリイミドテープ、PTFE(ポリテトラフルオロエチレン)テープ、およびヒートシンクチューブからなる集合から選択される。絶縁材の好ましい厚みは、約0.000635cm(0.00025インチ)から約0.00127cm(0.0005インチ)までの範囲内にある。
(a)作用電極および第1のリード線を備えた第1のプローブと、
(b)戻り電極および第2のリード線を備えた第2のプローブと、
(c)第1のプローブおよび第2のプローブを収容するための第1のボアおよび第2のボアを骨内に形成するための手段と、
(d)第1のリード線と電気的に接続された第3のリード線および第2のリード線と電気的に接続された第4のリード線を備えた、作用電極および戻り電極の間に電位差を生成する電源と
を有する。
(a)第1の電極および第1の電極に電気的に接続された第1のリード線を備え、第1の電極が近位の直径を有する近位の端部および遠位の直径を有する遠位の端部を備え、遠位の直径が近位の直径よりも小さい、第1のプローブと、
(b)第2の電極および第2の電極に接続された第2のリード線を備え、第2の電極が近位の直径を有する近位の端部および遠位の直径を有する遠位の端部を備え、遠位の直径が近位の直径よりも小さい、第2のプローブと
を有し、
第1の電極および第2の電極が平行になるように配置されている。
(a)第1の軸を画定する長手方向のボアを備えたカニューレと、
(b)長手方向のボアに受容されるように適合された外径と皮質骨を穿通するように適合された遠位の先端とを備えたスタイレット、
(c)(d)長手方向のボア内に受容されるように適合された外径と、(1)第1の電極および(2)第1の電極に電気的に接続されたリード線とを備えた第1のプローブと
を有する。
(a)第1の軸を画定する長手方向のボアを備えたカニューレと
(b)長手方向のボア内に受容されるように適合された外径と、皮質骨を穿通するように適合された遠位の先端とを備えたスタイレットと、
(c)(1)長手方向のボア内に受容されるように適合された外径と、(2)第1の電極と、(3)第1の電極に電気的に接続されたリード線とを備えた第1のプローブと
を有する。
(a)(1)第1の電極を備えた遠位の部分と、(2)第1の電極と電気的に接続された第1のリード線を備えた近位の部分と、(3)近位の部分および遠位の部分を回動可能に結合するピボットとを備えた第1のプローブを有する。
(a)第1の電極および第1の電極に電気的に接続された第1のリード線を備えた第1のプローブを有し、
第1の電極は、近位の直径を有する近位の端部と、近位の直径より大きい遠位の直径を有する遠位の端部とを備えている。
(a)遠位の作用電極および近位の作用電極を備えた第1のエネルギー装置を提供する過程と、
(b)遠位の戻り電極および近位の戻り電極を備えた第2のエネルギー装置を提供する過程と、
(c)遠位の作用電極および遠位の戻り電極の間に第1の間隔を画定すると共に近位の作用電極および近位の戻り電極の間に第1の間隔よりも大きい第2の間隔を画定するために、椎体内に第1のエネルギー装置および第2のエネルギー装置を配置する過程と、
(d)遠位の作用電極および遠位の戻り電極の間に第1の高周波数の電圧を加える過程と、
(e)近位の作用電極および近位の戻り電極の間に第1の高周波数よりも大きい第2の高周波数の電圧を加える過程と
を有する。
(a)(1)第1の表面積を備えた作用電極と、(2)第1の電極(作用電極)に電気的に接続された第1のリード線とを有する第1のプローブと、
(b)第2の表面積を備えた戻り電極と、(2)第2の電極(戻り電極)に電気的に接続された第2のリード線とを有する第2のプローブと
を有し、第2の表面積は第1の表面積の少なくとも2倍であり、
第1のプローブおよび第2のプローブを収容するために骨内に第1のボアおよび第2のボアを形成する手段をさらに有する。
(a)電源に電気的に接続された第1の電極をその表面に備えた固定プローブと、
(b)固定プローブに回動して係合する近位の部分を備えると共に第2の電極を有する回動可能なプローブと
を有する。
(a)固定プローブのピボットより遠位の位置(図25に示すように)
(b)固定プローブのピボットより近位の位置
(c)回動可能なプローブのピボットにより近い位置
(d)押し出しロッド上の位置
からなる集合から選択された位置に配置される。
(a)作用電極および戻り電極を備えたエネルギー装置を提供する過程と、
(b)作用電極を椎体内に挿入する過程と、
(c)戻り電極を椎体内に挿入する過程と、
(d)作用電極および戻り電極の間に十分に高い周波数の電圧を加えて、少なくとも0.5cmの直径および少なくとも50℃の定常状態温度を備えた全加熱領域を形成するための電流を作用電極および戻り電極の間に生成する過程と
を有する。
(a)作用電極および戻り電極を備えたエネルギー装置を提供する過程と、
(b)作用電極を健康な椎体内に挿入する過程と、
(c)戻り電極を健康な椎体内に挿入する過程と、
(d)作用電極を健康な椎体の第1の側面に配置し、戻り電極を健康な椎体の第2の側面に配置する過程と、
(e)作用電極および戻り電極の間に十分に高い周波数の電圧を加えて、BVNを治療的に加熱するための全加熱領域を形成する過程と
を有する。
(a)椎体内にエネルギー装置を挿入する過程と、
(b)BVN接合部および外側の皮質骨領域の間でBVN接合部および外側の皮質骨領域を除いた椎体の内側の海綿骨領域内に限定的にエネルギーを加えて、BVNを除神経する過程と
を有する。
この預言的な例は本発明の好ましい2つのプローブの実施の形態を記載している。
この例は、双極エネルギー装置で椎体の広い領域を加熱する効力を記載する。
この例は本発明の好ましい関節を備えた実施の形態を記載している。
図32を参照すると、本発明の関節を備えた2つの針の実施の形態が示されていて、関節を備えた針の各々は椎体の椎弓根を通って進められて、回動可能なプローブの各々は90度未満の角度で展開されて、回動可能なプローブの電極が互いに本質的に平行な関係で整合している。この実施の形態によって形成される電界は電極間で比較的均一なので、その結果の全加熱領域も望ましく均一である。電極が椎体の中心の後方部分内で展開されているので、BVNは神経幹の近くで望ましく除神経される。
(A)骨の第1の側面および第2の側面を画定する骨内神経ION含む骨を治療するための方法であって、
(a)作用電極および戻り電極を備えたエネルギー装置を上記骨内に挿入する過程と、
(b)上記作用電極を上記骨の上記第1の側面に配置し上記戻り電極を上記骨の上記第2の側面に配置して、上記作用電極および上記戻り電極の間に全加熱領域を画定する過程と、
(c)上記作用電極および上記戻り電極の間に十分に高い周波数の電圧を加えて、上記骨内神経IONを除神経するのに十分なだけ上記全加熱領域を抵抗加熱するための電流を上記作用電極および上記戻り電極の間に生成する過程と
を有する、骨内神経IONを含む骨を治療するための方法。
(B)椎体の第1の側面および第2の側面を画定する椎体の神経BVNを含む椎体を治療するための方法であって、
(a)第1の側面および第2の側面を含む、椎体の神経BVNが存在すると推定されるBVN存在領域を求める過程と、
(b)作用電極および戻り電極を備えたエネルギー装置を上記椎体内に挿入する過程と、
(c)上記BVN存在領域の上記第1の側面に上記作用電極を配置し上記BVN存在領域の上記第2の側面に上記戻り電極を配置して、上記作用電極および上記戻り電極の間に全加熱領域を画定する過程と、
(d)上記作用電極および上記戻り電極の間に十分に高い周波数の電圧を加えて、上記椎体の神経BVNを除神経するのに十分な温度まで上記全加熱領域を抵抗加熱するための電流を上記作用電極および上記戻り電極の間に生成する過程と
を有する、椎体の神経BVNを含む椎体を治療するための方法。
(C)椎体の神経BVNを含む椎体を治療するための方法であって、
(a)第1の面を備えた作用電極および第2の面を備えた戻り電極を有するエネルギー装置を上記椎体内に提供する過程と、
(b)上記作用電極を上記椎体内に第1の向きで配置する過程と、
(c)上記戻り電極を上記椎体内に上記第1の面および上記第2の面が60度以下の角度2δをなすような第2の向きで配置する過程と、
(d)上記作用電極および上記戻り電極の間に十分に高い周波数の電圧を加えて、上記椎体の神経BVNを治療的に加熱するための全加熱領域を形成するための電流を上記作用電極および上記戻り電極の間に生成する過程と
を有する、椎体の神経BVNを含む椎体を治療するための方法。
(D)椎体の神経BVNを含む椎体を治療するための方法であって、
(a)作用電極および戻り電極を備えたエネルギー装置を提供する過程と、
(b)上記作用電極および上記戻り電極を上記椎体内に配置して、上記椎体の神経BVNに対して50度から90度までの範囲内の角度βをなす電極軸を画定する過程と、
(c)上記作用電極および上記戻り電極の間に十分に高い周波数の電圧を加えて、上記椎体の神経BVNを治療的に加熱するための全加熱領域を形成するための電流を上記作用電極および上記戻り電極の間に生成する過程と
を有する、椎体の神経BVNを含む椎体を治療するための方法。
(C)骨内神経を除神経する装置であって、
(a)作用電極および第1のリード線を備えた第1のプローブと、
(b)戻り電極および第2のリード線を備えた第2のプローブと、
(c)上記第1のプローブおよび上記第2のプローブを収容するために骨内に第1のボアおよび第2のボアを形成するための手段と、
(d)上記第1のリード線と電気的に接続された第3のリード線および上記第2のリード線に電気的に接続された第4のリード線を備え、上記作用電極および戻り電極の間に電圧を生成する電源と
を有する、骨内神経を除神経する装置。
(D)椎体の神経BVNを含む健康な椎体を治療するための方法であって、
(a)作用電極および戻り電極を備えたエネルギー装置を提供する過程と、
(b)上記作用電極を上記健康な椎体内に挿入する過程と、
(c)上記戻り電極を上記健康な椎体内に挿入する過程と、
(d)上記作用電極を上記健康な椎体の第1の側面に配置し、上記戻り電極を上記健康な椎体の第2の側面に配置する過程と、
(e)上記作用電極および上記戻り電極の間に十分に高い周波数の電圧を加えて、上記椎体の神経BVNを治療的に加熱するための全加熱領域を形成するための電流を上記作用電極および上記戻り電極の間に生成する過程と
を有する、椎体の神経BVNを含む健康な椎体を治療するための方法。
(E)骨内神経を除神経するシステムであって、
(a)第1の電極と、上記第1の電極に電気的に接続された第1のリード線とを備え、上記第1の電極が近位の直径を備えた近位の端部および上記近位の直径より小さい遠位の直径を備えた遠位の端部を有する、第1のプローブと、
(b)第2の電極と、上記第2の電極に電気的に接続された第2のリード線とを備え、上記第2の電極が近位の直径を備えた近位の端部および上記近位の直径より小さい遠位の直径を備えた遠位の端部を有する、第2のプローブと
を有し、
上記第1の電極および上記第2の電極が平行になるように配置されている、骨内神経を除神経するシステム。
(F)骨内神経を除神経するシステムであって、
(a)(1)第1の電極を備えた遠位の部分と、(2)上記第1の電極と電気的に接続された第1のリード線を備えた近位の部分と、(3)上記近位の部分および上記遠位の部分を回動可能に結合するピボットとを備えた第1のプローブ
を有する、骨内神経を除神経するシステム。
(G)骨内神経を除神経するシステムであって、
(a)(1)ピボットを備えた遠位の部分と、(2)上記遠位の部分から回動可能に延出すると共に第1の電極を有するアームと、(3)上記第1の電極に電気的に接続された第1のリード線を備えた近位の部分とを備えた第1のプローブ
を有する、骨内神経を除神経するシステム。
(H)骨内神経を除神経するシステムであって、
(a)第1の電極と、上記第1の電極に電気的に接続された第1のリード線とを備えた第1のプローブを有し、
上記第1の電極が、近位の直径を備えた近位の部分と、上記近位の直径より小さい遠位の直径を備えた遠位の部分とを有する、骨内神経を除神経するシステム。
(I)骨内神経を除神経するシステムであって、
(a)第1の軸を画定する長手方向のボアを備えたカニューレと、
(b)上記長手方向のボア内に受容されるように適合された外径と、皮質骨を穿通するように適合された遠位の先端とを備えたスタイレットと、
(c)(d)上記長手方向のボア内に受容されるように適合された外径と、(1)第1の電極と、(2)上記第1の電極に電気的に接続されたリード線とを有する第1のプローブと
を有する、骨内神経を除神経するシステム。
(J)骨内神経を除神経するシステムであって、
(a)第1の軸を画定する長手方向のボアを備えたカニューレと、
(b)上記長手方向の軸内に受容されるように適合された外径と、皮質骨を穿通するように適合された遠位の先端とを備えたスタイレットと、
(c)(1)上記長手方向のボア内に受容されるように適合された外径と、(2)第1の電極と、(3)上記第1の電極に電気的に接続されたリード線とを備えた第1のプローブと
を有する、骨内神経を除神経するシステム。
(K)骨内神経を除神経するシステムであって、
(a)(1)第1の表面積を有する作用電極と、(2)上記作用電極に電気的に接続された第1のリード線とを備えた第1のプローブと、
(b)(1)第2の表面積を有する戻り電極と、(2)上記戻り電極に電気的に接続された第2のリード線とを備えた第2のプローブと
を有し、
上記第2の表面積は上記第1の表面積の少なくとも2倍の大きさであり、
(c)骨内に上記第1のプローブおよび上記第2のプローブを収容するための第1のボアおよび第2のボアを形成するための手段
をさらに有する、骨内神経を除神経するシステム。
(L)骨内神経を除神経するシステムであって、
(a)長手方向の軸を備えたカニューレと、
(b)上記長手方向のボア内に受容されるように適合された外径と、皮質骨を穿通するように適合された遠位の先端とを備えたスタイレットと、
(c)(1)上記長手方向のボア内に受容されるように適合された外径と、(2)第1の電極と、(3)上記第1の電極に電気的に接続されたリード線とを備えた第1のプローブとを有する、骨内神経を除神経するシステム。
(M)骨内神経を除神経するシステムであって、
(a)第1の電極および上記第1の電極に電気的に接続された第1のリード線を備えた第1のプローブを有し、
上記第1の電極は、近位の直径を備えた近位の端部と、上記近位の直径より小さい遠位の直径を備えた遠位の端部とを有する、骨内神経を除神経するシステム。
(N)椎体の神経BVNを含む椎体を治療するための方法であって、
(a)遠位の作用電極および近位の作用電極を備えた第1のエネルギー装置を提供する過程と、
(b)遠位の戻り電極および近位の戻り電極を備えた第2のエネルギー装置を提供する過程と、
(c)上記椎体内に上記第1のエネルギー装置および上記第2のエネルギー装置を配置して、上記遠位の作用電極および上記遠位の戻り電極の間に第1の距離を画定し、上記近意の作用電極および上記近位の戻り電極の間に上記第1の距離より長い第2の距離を画定する過程と、
(d)上記遠位の作用電極および上記遠位の戻り電極の間に第1の高い周波数の電圧を加える過程と、
(e)上記近位の作用電極および上記近位の戻り電極の間に上記第1の高い周波数の電圧より大きい第2の高い周波数の電圧を加える過程と
を有する、椎体の神経BVNを含む椎体を治療するための方法。
(O)椎体の神経BVNを含む椎体を治療するための方法であって、
(a)作用電極および戻り電極を備えたエネルギー装置を提供する過程と、
(b)上記椎体内に上記作用電極を挿入する過程と、
(c)上記椎体内に上記戻り電極を挿入する過程と、
(d)上記作用電極および上記戻り電極の間に十分に高い周波数の電圧を加えて、少なくとも0.5cmの直径および少なくとも50℃の定常状態温度を備えた全加熱領域を形成するための電流を上記作用電極および上記戻り電極の間に生成する過程と
を有する、椎体の神経BVNを含む椎体を治療するための方法。
(P)外側の皮質骨領域および内側の海綿骨領域を備えた椎体、および、上記外側の皮質骨領域から上記内側の海綿骨領域内に延在する神経幹および上記神経幹から延出してBVN結合部を画定する枝を備えた椎体の神経BVNを治療するための方法であって、
(a)エネルギー装置を上記椎体内に挿入する過程と、
(b)上記BVN接合部および上記外側の皮質骨領域の間であって上記BVN接合部および上記外側の皮質骨領域を含まない上記椎体の上記内側の海綿骨領域内にエネルギーを優先的に加える過程と
を有する、椎体および椎体の神経BVNを治療するための方法。
(Q)骨内神経IONを除神経する装置であって、
(a)電源に電気的に接続された第1の電極を備えた固定プローブと、
(b)上記固定プローブに回動可能に係合した近位の部分を備えた第2の電極を有する回動可能なプローブと
を有する、骨内神経IONを除神経する装置。
(1)骨が椎体からなり、骨内神経IONが椎体の神経BVNからなる、実施態様(3)記載の方法。
(2)骨が健康な骨である、実施態様(1)記載の方法。
(3)全加熱領域が、抵抗加熱領域および伝導加熱領域を含み、椎体の神経BVNが、上記抵抗加熱領域および上記伝導加熱領域の両方によって治療的に処理される、実施態様(2)記載の方法。
(4)抵抗加熱領域が長さL1 の骨内神経IONを治療的に加熱し、全加熱領域が長さLT の上記骨内神経IONを治療的に加熱し、上記長さL1 が上記骨内神経IONの全長である上記長さLT の少なくとも25%である、実施態様(3)記載の方法。
(5)抵抗加熱領域がピーク温度TIRを有し、伝導加熱領域がピーク温度TICを有し、上記抵抗加熱領域の上記ピーク温度TIRが上記伝導加熱領域の上記ピーク温度TICより15℃以下の温度だけ高い、実施態様(3)記載の方法。
(7)全加熱領域が抵抗加熱領域および伝導加熱領域を含み、椎体の神経BVNが本質的に上記伝導加熱領域のみによって治療的に処理される、実施態様(6)記載の方法。
(8)椎体の神経BVNが、10mm以下の距離だけ抵抗加熱領域から離れている、実施態様(7)記載の方法。
(9)全加熱領域が、伝導加熱領域によって分離された2つの抵抗加熱領域を含む、実施態様(6)記載の方法。
(10)エネルギー装置を骨内に挿入する過程が、カニューレを骨内に挿入する過程を含む、実施態様(2)記載の方法。
(12)スタイレットがプローブからなる、実施態様(11)記載の方法。
(13)カニューレがプロープからなる、実施態様(11)記載の方法。
(14)カニューレがプローブが挿入される前に後退させられて骨の穴を形成し、次に上記プローブが上記骨の穴に挿入される、実施態様(10)記載の方法。
(15)カニューレがプローブが挿入される前に骨内に挿入されて、次にプローブが上記カニューレのボアに挿入される、実施態様(10)記載の方法。
(17)角度2δが30度以下である、実施態様(16)記載の方法。
(18)角度2δが1度以下である、実施態様(16)記載の方法。
(19)全加熱領域が80℃から95℃までの範囲内のピーク温度を有する、実施態様(2)記載の方法。
(20)全加熱領域が86℃から94℃までの範囲内のピーク温度を有する、実施態様(2)記載の方法。
(22)電極が、5mmから15mmまでの範囲内の間隔を置いて配置されている、実施態様(2)記載の方法。
(23)電極が、10mmから15mmまでの範囲内の間隔を置いて配置されている、実施態様(2)記載の方法。
(24)エネルギー装置が、作用電極を備えた第1のプローブと、戻り電極を備えた第2のプローブとを有する、実施態様(2)記載の方法。
(25)エネルギー装置を骨内に挿入する過程が、作用電極を備えた第1のプローブを第1の椎弓根内に挿入する過程と、戻り電極を備えた第2のプローブを第2の椎弓根内に挿入する過程とを有する、実施態様(2)記載の方法。
(27)抵抗加熱するための電流を作用電極および戻り電極の間に生成する過程が、約0.5分間から約1.5分間までの範囲内の間に全加熱領域の最低温度を少なくとも50℃に上昇させるのに十分なものである、実施態様(2)記載の方法。
(28)椎体の神経BVNが後方部分を有し、抵抗加熱するための電流を作用電極および戻り電極の間に生成する過程が、上記椎体の神経BVNの上記後方部分のみを除神経するのに十分なものである、実施態様(2)記載の方法。
(29)電極が円錐形の形状を有する、実施態様(C)記載の方法。
(30)各電極が、近位の直径DP と遠位の直径DD とを有し、上記遠位の直径DD が上記近位の直径DP の20%以下である、実施態様(29)記載の方法。
(32)各電極が、近位の直径DP と遠位の直径DD とを有し、上記遠位の直径DD が上記近位の直径DP の少なくとも25%である、実施態様(31)記載の方法。
(33)各電極が、近位の直径DP と遠位の直径DD とを有し、上記近位の直径DP が上記遠位の直径DD よりも大きい、実施態様(C)記載の方法。
(34)電極が区分されている、実施態様(C)記載の方法。
(35)角度2δが30度以下である、実施態様(C)記載の方法。
(37)電極が本質的に平行に配置されている、実施態様(C)記載の方法。
(38)第1のボアおよび第2のボアを形成するための手段が、第1のプローブを受容するように適合された貫通するボアを備えたカニューレを含む、実施態様(E)記載の装置。
(39)第1のボアおよび第2のボアを形成するための手段が、カニューレのボア内に受容されるように適合されたスタイレットをさらに含む、実施態様(38)記載の装置。
(40)電極が円錐形の形状を有する、実施態様(E)記載の装置。
(42)電極が切頭円錐形の形状を有する、実施態様(E)記載の装置。
(43)各電極が、近位の直径DP と遠位の直径DD とを有し、上記遠位の直径DD が上記近位の直径DP の少なくとも25%である、実施態様(40)記載の装置。
(44)各電極が、近位の直径DP と遠位の直径DD とを有し、上記近位の直径DP が上記遠位の直径DD よりも大きい、実施態様(E)記載の装置。
(45)電極が区分されている、実施態様(E)記載の装置。
(47)(c)骨内に第1のプローブおよび第2のプローブを収容するための第1のボアおよび第2のボアを形成するための手段をさらに有する、実施態様(G)記載のシステム。
(48)(b)骨内にプローブを収容するための第1のボアを形成するための手段をさらに有する、実施態様(H)記載のシステム。
(49)(b)骨内に第1のプローブを収容するための第1のボアを形成するための手段をさらに有する、実施態様(I)記載のシステム。
(50)(b)骨内にプローブを収容するための第1のボアを形成するための手段をさらに有する、実施態様(J)記載のシステム。
(52)(b)骨内にプローブを収容するための第1のボアを形成するための手段をさらに有する、実施態様(O)記載のシステム。
(53)全加熱領域が80℃から95℃までの範囲内のピーク温度を有する、実施態様(Q)記載の方法。
(54)全加熱領域が86℃から94℃までの範囲内のピーク温度を有する、実施態様(Q)記載の方法。
(55)全加熱領域が少なくとも1ccの体積の骨を含む、実施態様(Q)記載の方法。
(57)全加熱領域が少なくとも60℃の定常状態温度を有する、実施態様(Q)記載の方法。
(58)エネルギーが、椎体の前方端部および後方端部の間の距離の60%から90%までの範囲内に位置する上記椎体の領域に加えられる、実施態様(R)記載の方法。
103 シャフト
105 ボア
107 遠位の端部
109 開口
151 第2のカニューレ
201 第1のスタイレット
203 シャフト
205 近位の端部
207 遠位の端部
209 先端
251 第2のスタイレット
301 第1のプローブ
303 シャフト
305 遠位の端部
307 近位の端部
309 第1の電極
311 ボア
321 配線
323 第1の端部
325 第2の端部
331 第1の面
333 接続面
351 第2のプローブ
401 電源
403 第1のリード線
501 電極
503 遠位の端部
505 近位の端部
511 電極
513 表面
531 プローブ
533 遠位の端部
535 近位の端部
537 肘部
551 第1のカニューレ
552 第2のカニューレ
553,554 ボア
555,556 遠位の端部
557,558 プローブ
559,560 電極
561,562 遠位の端部
563,564 開口
601 第1のプローブ
603 作用電極
605 電極の内側面
611 第2のプローブ
613 戻り電極
615 電極の内側面
701 第1のカニュー
703 ボア
705 遠位の部分
707 開口
711 第1のプローブ
713 電極
715 内側面
751 第1のカニュー
753 ボア
755 遠位の部分
757 開口
761 第2のプローブ
763 電極
765 内側面
801 プローブ
803 遠位の部分
805 電極
807 近位の部分
809 ピボット
821 第1のプローブ
823 第1の電極
825 近位の部分
827 遠位の部分
831 第2のプローブ
833 第2の電極
835 近位の部分
837 遠位の部分
851 第1のプローブ
853 第1の作用電極
854 第2の作用電極
855 第3の作用電極
861 第2のプローブ
863 第1の戻り電極
864 第2の戻り電極
865 第3の戻り電極
871 第1のプローブ
873 作用電極
881 第2のプローブ
883 戻り電極
900 装置
901 固定プローブ
903 シャフト
905 遠位の部分
906 遠位の先端
907 近位の部分
909 第1の電極
911 ボア
927 凹部
933 シャフト
951 回動可能なプローブ
955 遠位の部分
957 近位の部分
961 ピボット
963 第2の電極
975 押し出しロッド
977 遠位の部分
981 先端
1401 プローブ
1403 導電性シャフト
1405 絶縁ジャケット
1407 絶縁されていない部分
1409 電源
1601 円錐形の電極
1603 電極
Claims (4)
- 骨内の骨内神経を除神経する装置において、
長手方向の軸と、遠位端部分と、近位端部分と、当該近位端部分から延在する長手方向のボアとを持つシャフトと、を備えた固定プローブ、および
長手方向の軸と、近位端部分と、前記固定プローブに回動可能に取り付けられている遠位端部分と、を持つシャフトを備えた、回動可能なプローブ
を備え、
前記固定プローブが、電源での電気的接続のための第1の電極を有し、前記回動可能なプローブのシャフトが、電源との電気的接続のための第2の電極を有し、
前記固定プローブが、当該固定プローブのシャフト中に、前記回動可能なプローブを収容するための横方向の開口を形成する凹部を備える、
装置。 - 請求項1に記載の装置において、前記回動可能なプローブが、展開モードと非展開モードとを持つ、装置。
- 請求項2に記載の装置において、前記非展開モードでは、前記回動可能なプローブのシャフトの前記軸が、前記固定プローブのシャフトの前記軸と本質的に同一線上にあるように、前記回動可能なプローブが、前記固定プローブの凹部に配置される、
装置。 - 請求項3に記載の装置において、前記展開モードでは、前記回動可能なプローブのシャフトの前記軸が、前記固定プローブのシャフトの前記軸に対して少なくとも10度の角度をなすように、前記回動可能なプローブが、前記固定プローブからある角度を持って延在する、
装置。
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AT (2) | ATE521295T1 (ja) |
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JP4540959B2 (ja) | 2010-09-08 |
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EP1611860A2 (en) | 2006-01-04 |
JP2004267759A (ja) | 2004-09-30 |
CA2443491A1 (en) | 2004-03-30 |
DE60302409D1 (de) | 2005-12-29 |
EP1402838A1 (en) | 2004-03-31 |
EP1611860B1 (en) | 2011-08-24 |
JP5653986B2 (ja) | 2015-01-14 |
DE60302409T2 (de) | 2006-08-17 |
EP1611860A3 (en) | 2008-06-25 |
PT1611860E (pt) | 2011-12-05 |
AU2008249202B2 (en) | 2011-05-26 |
JP5203338B2 (ja) | 2013-06-05 |
EP2286753A2 (en) | 2011-02-23 |
ATE521295T1 (de) | 2011-09-15 |
AU2003248436B2 (en) | 2009-01-15 |
US6907884B2 (en) | 2005-06-21 |
AU2003248436A1 (en) | 2004-04-22 |
ES2376216T3 (es) | 2012-03-12 |
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