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WO2008140519A1 - Aiguille d'administration à accès amélioré pour vertébroplastie percutanée - Google Patents

Aiguille d'administration à accès amélioré pour vertébroplastie percutanée Download PDF

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Publication number
WO2008140519A1
WO2008140519A1 PCT/US2007/068658 US2007068658W WO2008140519A1 WO 2008140519 A1 WO2008140519 A1 WO 2008140519A1 US 2007068658 W US2007068658 W US 2007068658W WO 2008140519 A1 WO2008140519 A1 WO 2008140519A1
Authority
WO
WIPO (PCT)
Prior art keywords
tube
proximal end
needle
handle
end opening
Prior art date
Application number
PCT/US2007/068658
Other languages
English (en)
Inventor
Robert Sommerich
Original Assignee
Depuy Spine, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Depuy Spine, Inc. filed Critical Depuy Spine, Inc.
Priority to EP07762087A priority Critical patent/EP2020955A4/fr
Priority to PCT/US2007/068658 priority patent/WO2008140519A1/fr
Publication of WO2008140519A1 publication Critical patent/WO2008140519A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8833—Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8819—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer proximal part, e.g. cannula handle, or by parts which are inserted inside each other, e.g. stylet and cannula
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0042—Surgical instruments, devices or methods with special provisions for gripping
    • A61B2017/00424—Surgical instruments, devices or methods with special provisions for gripping ergonomic, e.g. fitting in fist

Definitions

  • the surgeon seeks to treat a compression fracture of a vertebral body by injecting bone cement such as PMMA into the fracture site.
  • bone cement such as PMMA
  • One clinical report describes mixing two PMMA precursor components (one powder and one liquid) in a dish to produce a viscous bone cement; filling 10 cc syringes with this cement, injecting it into smaller 1 cc syringes, and finally delivering the mixture into the desired area of the vertebral body through needles attached to the smaller syringes.
  • the conventional access needle used in a vertebroplasty procedure is a simple straight cannula extending along a single longitudinal axis, and has a handle formed near its proximal end.
  • a single delivery port made from a luer connection is typically located at the proximal end of the cannula.
  • the distal end of an injection syringe is typically attached to this delivery port via the luer connection.
  • a stylet may also be placed within the cannula from the proximal end of the cannula in order to stabilize the cannula during insertion into the vertebral bone.
  • the injection syringe is typically connected to the proximal port of the cannula so that the injection syringe is also aligned along the same longitudinal axis.
  • this assembly When this assembly is placed upon the prone patient's back, it typically sticks straight up in a vertical direction. Actuation of a vertically-disposed and vertically-displaced delivery syringe may be ergonomically challenging to the surgeon or clinician.
  • US Patent No. 6,916,292 (“Morawski”) discloses a bone biopsy needle having a single access port and a cannula that does not extend along a straight longitudinal axis, but rather curves near the proximal end. Because of its curved nature, this needle can not accommodate the insertion of a conventional straight stylet. The stylet is particularly important in percutaneous vertebroplasty procedures, as tracts of implant materials may be left in the body in unwanted locations if the access needle has not been cleared.
  • US Patent No. 6,302,852 (“Fleming III”) discloses a bone marrow biopsy needle including an outer cannula having a proximal end, a distal end, a hollow section therebetween and a handle portion associated with the proximal end, and an inner rod having a proximal end, a distal end and a handle cap.
  • the handle portion further includes a grip enhancement member which is formed from a material distinct from at least a portion of the handle portion, such as rubber.
  • the grip enhancement member may take the form of insert members which fit into cavities in the handle portion of the outer cannula.
  • the grip enhancement member not only enhances the gripping surface of the bone marrow biopsy needle, but also provides cushioning for a user and adds weight to the handle portion to facilitate weight distribution throughout the outer cannula handle.
  • a biopsy needle for sampling bone marrow tissue comprising a handle, and tissue sampling means comprising a sampling tube with a bore therein to receive a tissue sample, the outer surface of the sampling tube having an abrading formation extending in an axial direction along the tube, for abrading the sampled tissue, to permit the cannula tip to be laterally displaced whilst the tube is inserted into the bone marrow tissue.
  • a biopsy needle for sampling bone marrow tissue comprising a handle, tissue sampling means comprising a sampling tube with a bore therein to receive a tissue sample, and coupling means, separable from the needle, for coupling the needle to a rotary motor drive, whereby the needle is adaptable to both manual insertion and motor-assisted insertion.
  • US Patent No. 6,582,439 discloses an orthopedic surgical kit for inserting a biological material into the cancellous portion of bone by a minimally invasive technique has several components which are manually operated using a universal handle.
  • the kit includes a docking needle used as a guide for placing a cannula in a bone.
  • the cannula is filled with a biological material, for support or treatment of the bone, and the material is expressed from the cannula by a plunger.
  • One object of the present invention is to provide the surgeon a more ergonomic means of delivering a viscous material through a needle.
  • the invention provides a more ergonomic approach to delivery of viscous materials used in percutaneous vertebroplasty and kyphoplasty procedures.
  • the needle of the present invention includes a second off-angle cannula whose proximal end is used as the delivery port for an injection syringe. The distal end of this second needle then merges with the first cannula at an angle within the handle of the needle to provide fluid connection with the first cannula .
  • This new needle provides a more horizontal posture to the injection syringe upon its connection with the off angle cannula and therefore provides a better ergonomic and tactile feel for implant delivery.
  • an injection needle for use in percutaneous vertebroplasty comprising:
  • a substantially longitudinal first tube having a throughbore, a proximal end portion defining a proximal end opening and a distal end portion defining a distal end opening
  • a handle surrounding the proximal end portion of the first tube and having an outer surface, wherein the proximal end opening of the first tube opens onto the outer surface of the handle
  • a second tube located at least partially within the handle and having a throughbore, a distal end in fluid connection with the first tube at a junction, and a proximal end defining a proximal end opening that opens onto the outer surface of the handle.
  • FIG. IA shows a cross-section of the needle of the present invention.
  • FIG. IB shows a cross-section of a needle, wherein the second tube is directed upwards from the first tube.
  • FIG. 1C shows a cross-section of needle of FIG. IA with a stylet partially inserted therein.
  • FIG. 2 shows a cross-section of a needle of the present invention having a modular handle.
  • FIGS. 3A and 3B shows perspective views of the needle and syringe of the present invention in their respective assembled and exploded forms.
  • an injection needle 1 for use in percutaneous vertebroplasty comprising:
  • the tube component of the present invention can be formed of a material that is distinct from the surrounding handle.
  • the tube is formed by simply making a throughbore in the surrounding handle.
  • the needle When assembled, the needle comprises a bone access port at its distal end, and two ports on its proximal end.
  • the proximal end of the needle includes a first pathway to the bone access port to accommodate a stylet and a second pathway to the bone access port for attachment of a cement injection system.
  • the second pathway is more horizontally disposed than the first pathway, allowing for improved positioning and ergonomics during delivery of the viscous implant material.
  • the first and second tubes meet at a junction and form an angle ⁇ .
  • FIG. IB there is provided an embodiment of the present invention wherein the second tube 30 is directed upwards from the first tube 32 whereby angle ⁇ is greater than 90 degrees.
  • the second pathway is directed at a lateral angle (i.e., to the left or right of the handle). In other embodiments, the angle is rotatably adjustable.
  • This invention provides multiple pathways to the bone access port of an access needle for PV procedures, one of which is an access pathway for a straight stylet. It advantageously provides the surgeon with better positioning in relation to the proximal injection port during delivery of the implant material, while at the same time including the required stylet access for PV procedures.
  • a one-way valve or silicone plug is provided to prohibit backflow of implant material through the second proximal pathway.
  • the one -way valve is located in the first tube at a location proximal of the junction.
  • Alternatives to a one-way valve or silicone plug include a thumb-trigger that opens the second pathway when depressed, or a ball-plunger that retracts when the stylet is placed within the second pathway.
  • the handle includes a feature to fully or partially cover the luer connection 33 (shown open in FIG. IA) associated with the injection port.
  • An ergonomic handle component is provided that is able to separate into a delivery section and a stylet to partially or fully cover the luer connector to the delivery device so that implant material may not be injected while the stylet is in place. Thereafter, when the stylet is removed, there is full exposure of the luer connection.
  • the luer connector to the delivery system may be placed at an angle to the handle or adapted to allow rotation to a preferred position.
  • allowable rotation provides a single beveled needle to be optimally oriented (typically anteriorly) while allowing the proximal inlet port to be oriented towards the surgeon. This not only provides improved ergonomics, it also may allow for elimination of extension tubing from the system.
  • an injection needle for use in percutaneous vertebroplasty comprising: a. a substantially longitudinal first tube having a throughbore, a proximal end portion defining a proximal end opening and a distal end portion defining a distal end opening, b. a handle surrounding the proximal end portion of the first tube and having an outer surface, wherein the proximal end opening of the first tube opens onto the outer surface of the handle, and c. a rotatable luer connection disposed at the distal end opening of the first tube
  • the stylet may be removed from the handle. In so doing, most of the bulk of the handle is likewise removed.
  • the handle may include two or more components that contain the stylet and the delivery access tube to the vertebral body.
  • the handle may have a luer connection in the injection system that is partially or full contained within the removal stylet component.
  • an injection needle for use in percutaneous vertebroplasty comprising:
  • a substantially longitudinal outer tube 2 having a throughbore 4, a proximal end portion 3 defining a proximal end opening 5 and a distal end portion 7 defining a distal end opening 9, b) an outer handle 11 surrounding the proximal end portion of the outer tube and having a proximal surface 15 having a recess 17, wherein the proximal end opening of the outer tube opens onto the proximal surface of the handle within the recess, c) a substantially longitudinal inner stylet 41 having a proximal end portion 43 and a distal end portion 45, and d) an inner handle 51 surrounding the proximal end portion of the inner stylet,
  • the inner handle has a proximal surface 53, the proximal surface of the the outer handle forms a first plane, and the proximal surface of the inner handle lies substantially the first plane when the inner stylet is received within the throughbore of the outer tube
  • the handle is manufactured as a modular component of the injection needle.
  • the handle can be modularized by providing a first luer attachment at the distal end of the substantially longitudinal first tube, and a second luer attachment adapted to mate with the first luer attachment upon the delivery tube.
  • a substantially longitudinal first tube 71 having a throughbore, a proximal end portion 73 defining a proximal end opening and a distal end portion 75 defining a distal end opening having a first luer connection thereon 77
  • a handle 81 surrounding the proximal end portion of the first tube and having an outer surface 83, wherein the proximal end opening of the first tube opens onto the outer surface of the handle
  • a delivery tube 85 having a throughbore and a proximal end portion 87 defining a proximal end opening having a second luer connection 89 thereon that mates with the first luer connection.
  • the surgeon can inject cement through the needle, and then remove the handle in order to have better visualization of the operative site when using the stylet.
  • the surgeon can inject the cement through the delivery tube 85 and second luer 89 without the handle attached.
  • remnant materials inherently remaining within the tube or on the stylet. This is typically seen as grey material within the cement during injection. While cleaning with brushes or high pressure fluids assists in removing some of the remnant material, there is typically some remnant material left behind.
  • the present invention seeks to reduce the delivery to the patient of debris remaining from the manufacturing process. This is accomplished by providing a coating on the inside surface of the needle to encapsulate or cover the inside of the tube (or outside surface of the stylet).
  • the inner surface of the needle may be coated with a variety of materials (i.e. PTFE (Teflon), or its surface may be conditioned by a variety of manufacturing methods (such as electropolishing or plating) that may cover up undesirable manufacturing debris present upon the inside of the needle, thereby precluding their delivery to the patient.
  • PTFE Teflon
  • manufacturing methods such as electropolishing or plating
  • such a coating may reduce the friction on the inner surface of the cannula, thereby easing the flow of the cement passing through the needle and requiring less pressure to deliver the implant material. Therefore, in accordance with the present invention, there is provided (claim
  • injection needle for use in percutaneous vertebroplasty comprising:
  • a substantially longitudinal first tube having an inner surface defining a throughbore, a proximal end portion defining a proximal end opening and a distal end portion defining a distal end opening
  • a handle surrounding the proximal end portion of the first tube and having an outer surface, wherein the proximal end opening of the first tube opens onto the outer surface of the handle, and wherein the inner surface of the first tube is coated, electropolished or electroplated.
  • the device of the present invention is connected to a syringe contain a bone paste, and the paste is injected into the bone via the needle.
  • the bone paste used in the vertebroplasty procedure may be any material typically used to augment vertebral bodies. Therefore, in accordance with the present invention, there is provided (claim 20) a device for use in percutaneous vertebroplasty, comprising:
  • an injection needle 1 comprising:
  • a substantially longitudinal first tube 2 having a throughbore, a proximal end portion defining a proximal end opening 5 and a distal end portion 7 defining a distal end opening 9, ii) a handle 11 surrounding the proximal end portion of the first tube and having an outer surface 13, wherein the proximal end opening of the first tube opens onto the outer surface of the handle, and ii) a second tube 21 located at least partially within the handle and having a throughbore, a distal end in fluid connection with the first tube at a junction, and a proximal end defining a proximal end opening 31 , and b) a syringe 61 fluidly connected to the proximal end opening of the second tube.
  • the syringe can be replaced with a delivery device having a material reservoir and tubing adapted to deliver the cement from the reservoir to the proximal end opening of the second tube.
  • Preferred bone pastes include bone cements (such as acrylic-based bone cements, such as PMMA-based bone cements), pastes comprising bone particles (either mineralized or demineralized or both; and either autologous, allogenic or both), and ceramic-based bone cements (such as HA and TCP-based pastes).
  • bone cements such as acrylic-based bone cements, such as PMMA-based bone cements
  • pastes comprising bone particles (either mineralized or demineralized or both; and either autologous, allogenic or both)
  • ceramic-based bone cements such as HA and TCP-based pastes

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne une aiguille de vertébroplastie qui présente deux canules partageant une extrémité distale commune, la canule d'injection de ciment fusionnant avec une canule à stylet droit.
PCT/US2007/068658 2007-05-10 2007-05-10 Aiguille d'administration à accès amélioré pour vertébroplastie percutanée WO2008140519A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP07762087A EP2020955A4 (fr) 2007-05-10 2007-05-10 Aiguille d'administration à accès amélioré pour vertébroplastie percutanée
PCT/US2007/068658 WO2008140519A1 (fr) 2007-05-10 2007-05-10 Aiguille d'administration à accès amélioré pour vertébroplastie percutanée

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2007/068658 WO2008140519A1 (fr) 2007-05-10 2007-05-10 Aiguille d'administration à accès amélioré pour vertébroplastie percutanée

Publications (1)

Publication Number Publication Date
WO2008140519A1 true WO2008140519A1 (fr) 2008-11-20

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EP (1) EP2020955A4 (fr)
WO (1) WO2008140519A1 (fr)

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EP2623055A1 (fr) * 2010-09-28 2013-08-07 Terumo Kabushiki Kaisha Aiguille de perforation pour l'injection d'un ciment osseux et son procédé de fabrication
WO2014071161A1 (fr) 2012-11-05 2014-05-08 Relievant Medsystems, Inc. Système et méthodes de création de chemins incurvés à travers un os et de modulation des nerfs au sein de l'os
USRE46356E1 (en) 2002-09-30 2017-04-04 Relievant Medsystems, Inc. Method of treating an intraosseous nerve
US9724151B2 (en) 2013-08-08 2017-08-08 Relievant Medsystems, Inc. Modulating nerves within bone using bone fasteners
US9724107B2 (en) 2008-09-26 2017-08-08 Relievant Medsystems, Inc. Nerve modulation systems
US9848944B2 (en) 2002-09-30 2017-12-26 Relievant Medsystems, Inc. Thermal denervation devices and methods
US10111704B2 (en) 2002-09-30 2018-10-30 Relievant Medsystems, Inc. Intraosseous nerve treatment
US10265099B2 (en) 2008-09-26 2019-04-23 Relievant Medsystems, Inc. Systems for accessing nerves within bone
US10390877B2 (en) 2011-12-30 2019-08-27 Relievant Medsystems, Inc. Systems and methods for treating back pain
US10588691B2 (en) 2012-09-12 2020-03-17 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
US11007010B2 (en) 2019-09-12 2021-05-18 Relevant Medsysterns, Inc. Curved bone access systems
US12039731B2 (en) 2020-12-22 2024-07-16 Relievant Medsystems, Inc. Prediction of candidates for spinal neuromodulation
US12082876B1 (en) 2020-09-28 2024-09-10 Relievant Medsystems, Inc. Introducer drill

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Cited By (43)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9848944B2 (en) 2002-09-30 2017-12-26 Relievant Medsystems, Inc. Thermal denervation devices and methods
US11596468B2 (en) 2002-09-30 2023-03-07 Relievant Medsystems, Inc. Intraosseous nerve treatment
US10478246B2 (en) 2002-09-30 2019-11-19 Relievant Medsystems, Inc. Ablation of tissue within vertebral body involving internal cooling
USRE46356E1 (en) 2002-09-30 2017-04-04 Relievant Medsystems, Inc. Method of treating an intraosseous nerve
US10111704B2 (en) 2002-09-30 2018-10-30 Relievant Medsystems, Inc. Intraosseous nerve treatment
US10463423B2 (en) 2003-03-28 2019-11-05 Relievant Medsystems, Inc. Thermal denervation devices and methods
US10905440B2 (en) 2008-09-26 2021-02-02 Relievant Medsystems, Inc. Nerve modulation systems
US9724107B2 (en) 2008-09-26 2017-08-08 Relievant Medsystems, Inc. Nerve modulation systems
US10028753B2 (en) 2008-09-26 2018-07-24 Relievant Medsystems, Inc. Spine treatment kits
US12161350B2 (en) 2008-09-26 2024-12-10 Relievant Medsystems, Inc. Systems for treating nerves within bone using steam
US10265099B2 (en) 2008-09-26 2019-04-23 Relievant Medsystems, Inc. Systems for accessing nerves within bone
US11471171B2 (en) 2008-09-26 2022-10-18 Relievant Medsystems, Inc. Bipolar radiofrequency ablation systems for treatment within bone
EP2623055A1 (fr) * 2010-09-28 2013-08-07 Terumo Kabushiki Kaisha Aiguille de perforation pour l'injection d'un ciment osseux et son procédé de fabrication
EP2623055A4 (fr) * 2010-09-28 2015-01-14 Terumo Corp Aiguille de perforation pour l'injection d'un ciment osseux et son procédé de fabrication
US12059193B2 (en) 2011-12-30 2024-08-13 Relievant Medsystems, Inc. Methods of denervating vertebral body using external energy source
US10390877B2 (en) 2011-12-30 2019-08-27 Relievant Medsystems, Inc. Systems and methods for treating back pain
US11471210B2 (en) 2011-12-30 2022-10-18 Relievant Medsystems, Inc. Methods of denervating vertebral body using external energy source
US11690667B2 (en) 2012-09-12 2023-07-04 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
US10588691B2 (en) 2012-09-12 2020-03-17 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
US11737814B2 (en) 2012-09-12 2023-08-29 Relievant Medsystems, Inc. Cryotherapy treatment for back pain
US11701168B2 (en) 2012-09-12 2023-07-18 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
US11160563B2 (en) 2012-11-05 2021-11-02 Relievant Medsystems, Inc. Systems for navigation and treatment within a vertebral body
US11974759B2 (en) 2012-11-05 2024-05-07 Relievant Medsystems, Inc. Methods of navigation and treatment within a vertebral body
US10357258B2 (en) 2012-11-05 2019-07-23 Relievant Medsystems, Inc. Systems and methods for creating curved paths through bone
EP3598952A3 (fr) * 2012-11-05 2020-04-15 Relievant Medsystems, Inc. Systèmes et procédés pour créer des chemins incurvés à travers des os et moduler des nerfs dans l'os
US10517611B2 (en) 2012-11-05 2019-12-31 Relievant Medsystems, Inc. Systems for navigation and treatment within a vertebral body
US9775627B2 (en) 2012-11-05 2017-10-03 Relievant Medsystems, Inc. Systems and methods for creating curved paths through bone and modulating nerves within the bone
US11234764B1 (en) 2012-11-05 2022-02-01 Relievant Medsystems, Inc. Systems for navigation and treatment within a vertebral body
US11291502B2 (en) 2012-11-05 2022-04-05 Relievant Medsystems, Inc. Methods of navigation and treatment within a vertebral body
IL238516B (en) * 2012-11-05 2022-08-01 Relievant Medsystems Inc System and methods for creating curved paths through bone and modulating nerves within the bone
WO2014071161A1 (fr) 2012-11-05 2014-05-08 Relievant Medsystems, Inc. Système et méthodes de création de chemins incurvés à travers un os et de modulation des nerfs au sein de l'os
EP2914186A4 (fr) * 2012-11-05 2016-07-20 Relievant Medsystems Inc Système et méthodes de création de chemins incurvés à travers un os et de modulation des nerfs au sein de l'os
US10456187B2 (en) 2013-08-08 2019-10-29 Relievant Medsystems, Inc. Modulating nerves within bone using bone fasteners
US11065046B2 (en) 2013-08-08 2021-07-20 Relievant Medsystems, Inc. Modulating nerves within bone
US9724151B2 (en) 2013-08-08 2017-08-08 Relievant Medsystems, Inc. Modulating nerves within bone using bone fasteners
US12193719B2 (en) 2013-08-08 2025-01-14 Relievant Medsystems, Inc. Modulating nerves within bone
US11426199B2 (en) 2019-09-12 2022-08-30 Relievant Medsystems, Inc. Methods of treating a vertebral body
US11207100B2 (en) 2019-09-12 2021-12-28 Relievant Medsystems, Inc. Methods of detecting and treating back pain
US11202655B2 (en) 2019-09-12 2021-12-21 Relievant Medsystems, Inc. Accessing and treating tissue within a vertebral body
US11007010B2 (en) 2019-09-12 2021-05-18 Relevant Medsysterns, Inc. Curved bone access systems
US11123103B2 (en) 2019-09-12 2021-09-21 Relievant Medsystems, Inc. Introducer systems for bone access
US12082876B1 (en) 2020-09-28 2024-09-10 Relievant Medsystems, Inc. Introducer drill
US12039731B2 (en) 2020-12-22 2024-07-16 Relievant Medsystems, Inc. Prediction of candidates for spinal neuromodulation

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