Thermal denervation devices and methods

Abstract

A method and apparatus for treating an intraosseous nerve. The method includes positioning a hollow shaft through the cortical shell of a vertebral body and into a cancellous bone region of the vertebral body. The hollow shaft includes an annular wall having a longitudinal bore therein, a proximal portion and a distal portion, and a first window extending transversely through the annular wall. An electrosurgical probe is advanced within the longitudinal bore from the proximal portion toward the distal portion. The electrosurgical probe includes a first treatment element at a distal end of the probe, wherein the first treatment element being in electrical connection with a power supply. The first treatment element is slidably disposed within the longitudinal bore so that the first treatment element is advanced radially outward from the window and shaft to affect treatment of the intraosseous nerve within the cancellous bone region.

1 . (canceled) 
     
     
         2 . A bipolar electrosurgical device comprising:
 an elongate shaft having a proximal end and a distal end;   a distal electrode on an outer surface of the elongate shaft;   a proximal electrode on an outer surface of the elongate shaft and positioned proximal to the distal electrode on the elongate shaft, the distal and proximal electrodes forming a bipolar heating device;   insulation on the outer surface of the shaft between the distal and proximal electrodes; and   a fluid delivery lumen extending through the elongate shaft.   
     
     
         3 . The bipolar electrosurgical device of  claim 2 , further comprising a thermocouple. 
     
     
         4 . The bipolar electrosurgical device of  claim 3 , wherein the thermocouple extends through the fluid delivery lumen. 
     
     
         5 . The bipolar electrosurgical device of  claim 3 , wherein the thermocouple extends through an axial bore provided in the elongate shaft. 
     
     
         6 . The bipolar electrosurgical device of  claim 3 , wherein the thermocouple extends out of the elongate shaft through an opening at the distal end of the elongate shaft. 
     
     
         7 . The bipolar electrosurgical device of  claim 2 , wherein the distal electrode is at the distal end of the elongate shaft. 
     
     
         8 . The bipolar electrosurgical device of  claim 7 , wherein the distal electrode forms a sharp tip. 
     
     
         9 . The bipolar electrosurgical device of  claim 2 , wherein the distal electrode has an annular shape. 
     
     
         10 . The bipolar electrosurgical device of  claim 9 , wherein the proximal electrode has an annular shape. 
     
     
         11 . The bipolar electrosurgical device of  claim 2 , wherein the proximal electrode has an annular shape. 
     
     
         12 . A bipolar electrosurgical device comprising:
 a shaft having annular wall and having a proximal end and a distal end;   a distal electrode on a distal portion of the elongate shaft;   a proximal electrode on the shaft positioned proximal to the distal electrode, the distal and proximal electrodes forming a bipolar heating device;   an electrically insulating spacer positioned on the shaft between the distal and proximal electrodes; and   a fluid delivery lumen formed by the annular wall of the shaft.   
     
     
         13 . The bipolar electrosurgical device of  claim 12 , further comprising a thermocouple. 
     
     
         14 . The bipolar electrosurgical device of  claim 13 , wherein the thermocouple extends through the fluid delivery lumen. 
     
     
         15 . The bipolar electrosurgical device of  claim 13 , wherein the thermocouple extends through the shaft. 
     
     
         16 . The bipolar electrosurgical device of  claim 15 , wherein the thermocouple extends out of the shaft through an opening at the distal end of the shaft. 
     
     
         17 . The bipolar electrosurgical device of  claim 12 , wherein the distal electrode is at the distal end of the shaft. 
     
     
         18 . The bipolar electrosurgical device of  claim 17 , wherein the distal electrode forms a sharp tip. 
     
     
         19 . The bipolar electrosurgical device of  claim 12 , wherein the distal electrode has an annular shape. 
     
     
         20 . The bipolar electrosurgical device of  claim 19 , wherein the proximal electrode has an annular shape. 
     
     
         21 . The bipolar electrosurgical device of  claim 12 , wherein the proximal electrode has an annular shape.