System and method for determining the size of an electrode probe in an ablation procedure

Abstract

Systems and methods for ablating tissue within a vertebral body. A drill shaft is guided through an access cannula to form a tissue path. It is determined that a first mark or a second mark on the drill shaft overlaps with the cannula hub of the access cannula. The first and second marks may be of different colors. The colors are correlated with complementary marks associated with the first and second probes. Based on the correlation, through the access cannula, a first probe or a second probe is selected to be guided into the formed tissue path to ablate the tissue. The marks may be longitudinally positioned on the drill shaft such that they are recessed along one side surface of the drill shaft. The marks may be substantially coincident, or the length of the second mark may be greater than the length of the first mark.

Description

Technical Field

[0001] [Priority Claim] This application claims the priority and all benefits of U.S. Provisional Patent Application No. 69 / 391,442, filed on July 22, 2022, the entire content of which is incorporated herein by reference.

Background Art

[0002] Among other anatomical structures, radiofrequency (RF) energy is utilized to ablate diseased tissues such as sensory nerves, intramedullary nerves, or intramedullary tumors. An electrode probe may be coupled to an electrosurgical console, and RF energy is conducted from the emitter of the electrode probe to adjacent tissue, causing damage to the treatment site. Of particular interest is the destruction of intramedullary tumors within the vertebral body, where RF energy heats the tissue to destroy tumor cells.

[0003] The transpedicular approach involves guiding an access cannula through the pedicle of the vertebral body. The electrode probe may be guided through the access cannula and positioned within or adjacent to at least a portion of the tumor. It is desirable to ablate as much of the tumor as possible, and thus it is known to provide a kit having one electrode probe of each of a plurality of "sizes" as an option, more particularly an electrode probe with an increased emitter length to generate an ablation zone over a greater width or length of the tumor. Regardless of the selected size of the electrode probe, the proximal end of the proximal emitter should not remain within the access cannula to avoid electrical short circuits or other sub-optimal ablation patterns. At the same time, due to the fibrous tissue characteristics of the tumor itself and the relative fragility of the electrode probe, it is often shown that a tissue path is penetrated or perforated through at least a portion of the tumor. If the tissue path is of insufficient length, or if an inappropriate electrode probe from the kit is selected for a given length of the tissue path, the contact between the distal end of the electrode probe and the end of the tissue path can prevent the proximal emitter from exiting the access cannula.

[0004] It is known to provide a mark on the shaft of a surgical instrument. In one example, the mark is a thin ring of a fixed increment that correlates to the numerical depth at which the distal portion of the instrument is exposed beyond the access cannula. Such a mark does not intuitively provide the user with information regarding the corresponding size of the electrode probe to be selected. In other words, it would be preferable that the user not be required to count the exposed ring-shaped marks by hand and then calculate and determine the corresponding size of the electrode probe. As another example, U.S. Patent No. 10,729,490, issued on August 4, 2020, which is hereby incorporated by reference in its entirety, discloses a system in which a ring-shaped mark on a drill is aligned with an access cannula to provide an indication of the resulting size of the ablation zone generated by a corresponding electrode probe, also referred to herein as ablation zone mapping. Such a system requires that one of the thin rings be accurately aligned with the access cannula in order for it to provide its intended benefit and may correlate to a near-optimal depth of the tissue path formed by the drill. Alternatively, the optimal depth formed by the drill (e.g., as desired by the user) may result in misalignment of the ring-shaped marks, in which case the ablation zone mapping may be inaccurate. SUMMARY OF THE INVENTION

[0005] Accordingly, there is a need in the art for an improved system and method that provides an intuitive selection of the size of an electrode probe based on the depth of a user-selected tissue path formed by a drill. It is further desirable to provide easily distinguishable information regarding the position of the emitter within the formed tissue path. BRIEF DESCRIPTION OF THE DRAWINGS

[0006]

Figure 1

Figure 2A

Figure 2B

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7A

Figure 7B

Figure 7C

Figure 8

Figure 9

DETAILED DESCRIPTION OF THE INVENTION

[0007] This disclosure is directed to an ablation system 20 in which the “size” of an electrode probe is efficiently and intuitively “determined” based on the depth of a tissue path formed by a drill 24 within tissue, for example, through a tumor (T) within a vertebral body. Referring to FIGS. 1 and 2, ablation system 20 includes an access cannula 22, a drill 24, a first probe 26, and a second probe 28. Ablation system 20 further includes an electrosurgical console (not shown) configured such that the first and second probes 26, 28 are removably coupled for generating and transmitting RF energy. An exemplary console is disclosed in International Publication No. WO2023 / 009697 to common owners, published Feb. 2, 2023, the entire contents of which are incorporated herein by reference. As will be further described, access cannula 22 is configured to be percutaneously guided through the pedicle of a vertebral body and then the drill 24 is guided through access cannula 22 to form a tissue path. FIG. 1 shows the drill 24 further forming a tissue path through a tumor (T) within the vertebral body. The drill 24 is removed from the access cannula 22 and at least one of the first and second probes 26, 28 is guided through the access cannula such that proximal and distal emitters 30, 32 are positioned within the tissue path (see FIGS. 3-6). The electrosurgical console is operated to transmit RF energy through emitters 30, 32 to supply and destroy the cells of the tumor.

[0008] The access cannula 22 includes a cannula hub 34 and a cannula shaft 36 that extends distally from the cannula hub 34 to provide a distal end 38 of the access cannula 22. A trocar (not shown) may be removably disposed within the access cannula 22 and may include a sharp tip configured to penetrate cortical bone during percutaneous insertion of the access cannula 22. The cannula hub 34 includes a proximal surface 40 that provides a visual and structural reference plane to be described in further detail. It is understood that the access cannula 22 may include a luer fitting (not shown) coupled to the cannula hub 34 configured such that the drill 24 and the first and second probes 26, 28 are guided therethrough. In such an arrangement, the proximal edge of the luer fitting may provide a visual and structural reference plane.

[0009] The first and second probes 26, 28 each include a probe hub 42 and a probe shaft 44 extending from the probe hub 42. The probe hub 42 provides a handle for the user to grip one of each of the first and second probes 26, 28. The probe hub 42 may include a hub neck 46 that defines a distal surface 48 of the probe hub 42, and the probe shaft 44 extends from the hub neck 46. The proximal and distal emitters 30, 32 are installed on the probe shaft 44. The distal emitter 32 may be spaced from the proximal emitter 30 by a portion of the probe shaft 44 such that the first and second probes 26, 28 are self-grounding bipolar probes. The distal emitter 32 may define the distal ends 50 of the first and second probes 26, 28. Further details of the probe are disclosed in International Publication No. WO2020 / 198150, published November 5, 2020, commonly owned, the entire contents of which are incorporated herein by reference. The first and second probes 26, 28 are of different sizes. In particular, FIGS. 2A and 2B show that the first probe 26 may be considered smaller than the second probe 28. The probe shaft 44 may include a length defined between a proximal end 52 at the interface of the distal end 50 and the probe hub 42. The length of the probe shaft 44 of the first probe 26 is smaller than the length of the probe shaft 44 of the second probe 28. It is further understood that the active tip region 54 of the first probe 26 - defined between the distal end 50 and the proximal end 56 of the proximal emitter 30 - is smaller than the corresponding active tip region 54 of the second probe 28. In other words, the proximal and distal emitters 30, 32 of the second probe 28 may be larger.

[0010] Referring now to FIGS. 1, 2A, 2B, 7A, and 7B, drill 24 includes a drill hub 58 and a drill shaft 60 extending distally from drill hub 58. Drill shaft 60 includes a cutting profile 62 at or near the distal end 64 of drill shaft 60. The length of drill shaft 60 is greater than the length of the probe shafts 44 of the first probe 26 and the second probe 28. As mentioned, drill 24 is configured to be coaxially guided through access cannula 22, and drill hub 58 may be operated such that cutting profile 62 forms a tissue path. FIGS. 3-6 show an illustration of a tissue path that may be formed as a groove having an end 66. Once an initial tissue path is formed, an exemplary workflow may include imaging, e.g., confirming the distal end 64 of drill shaft 60 with intraoperative fluoroscopy. For example, the end 66 of the tissue path may be determined by visualizing the distal end 64 of drill shaft 60. It is often shown that the ablation zones of the first or second probes 26, 28, which are later positioned, penetrate to or beyond the distal edge of the tumor such that the ablation zones include at least a majority or all of the tumor.

[0011] The first and second marks 68, 70 are positioned on the proximal portion of the drill shaft 60. The first mark 68 is positioned distal to the second mark 70. The first mark 68 may include a distal edge 72 and a proximal edge 74 that define a length therebetween. Similarly, the second mark 70 may include a distal edge 76 and a proximal edge 78 that define a length therebetween. The length of the second mark 70 is greater than the length of the first mark 68. In an alternative configuration, the length of the first mark 68 may be greater, or the lengths may be the same. The length of the first mark 68 may be in the range of about 0.3 to 1.0 centimeter (cm), more particularly in the range of about 0.4 to 0.6 cm. The length of the second mark 70 may be in the range of about 0.5 to 2.0 centimeter (cm), more particularly in the range of about 0.75 to 1.25 cm. The length of the first mark 68 may be equal to the difference in length between the probe shafts 44 of the first and second probes 26, 28. For example, the active tip regions 54 of the first probe 26 and the second probe 28 may be 15 and 20 millimeters, respectively, and thus the length of the first mark 68 may be approximately 5 millimeters. Each length is at least sufficient for the first and second marks 68, 70 to align with the proximal surface 40 of the cannula hub 34 over the range of positions of the drill 24 relative to the access cannula 22. In other words, it should be understood that each of the first and second marks 68, 70 is not a very thin ring of negligible length, or else it would be hidden within the cannula hub 34 with only the minimum distal movement of the drill 24 relative to the access cannula 22. In an exemplary implementation, there are exactly two marks corresponding to the first and second probes 26, 28, however, more or fewer marks may be provided.

[0012] The distal edge 76 of the second mark 70 may substantially coincide with the proximal edge 74 of the first mark 68. In other words, the first mark 68 and the second mark 70 may abut or be adjacent to each other with little or no distance therebetween. As best shown in FIGS. 7A and 7B, only the thin portion 80 of the drill shaft 60 is located between the first mark 68 and the second mark 70. The thin portion 80 may be less than 1 millimeter or may not exist at all. For example, FIGS. 8 and 9 show that the first mark 68 and the second mark 70 are in abutment with each other.

[0013] The first and second marks 68, 70 may be disposed on or formed within the proximal portion of the drill shaft 60 in any number of suitable ways. FIGS. 7A and 7B show the first mark 68 and the second mark 70 as being elongated, linear, and longitudinally directed along one side surface of the proximal portion of the drill shaft. For example, the first and second marks 68, 70 may be recessed within the drill shaft 60 and formed by milling operations, laser operations, etc. In one variation, the first and second marks 68, 70 are elongated, linear, and longitudinally recessed along opposite side surfaces of the proximal portion of the drill shaft 60. The opposite side surfaces may be defined by being aligned with the major surface 82 (one is shown) of the drill hub 58. FIG. 8 shows that the first mark 68 and the second mark 70 are opaque bands extending around the drill shaft 60, and FIG. 9 shows that the first mark 68 and the second mark 70 are translucent bands extending around the drill shaft 60. In yet another example, the band may be a colored adhesive applied to the drill shaft 60. The band, as used herein, is intended to denote a length greater than that of a very thin ring of negligible length.

[0014] The first mark 68 may be of a first color, and the second mark 70 may be of a second color different from the first color. For example, the first color is blue and the second color is yellow, although other combinations of colors are contemplated. Similarly, other types of marks may be utilized, such as textures, raised areas, shapes, or other visually distinguishable patterns that may not be feasible for very thin ring-shaped marks having only a slight length. Each probe hub 42 of the first and second probes 26, 28 may include a mark 84 or label (see FIGS. 2A and 2B), where the mark 84 of the first probe 26 corresponds to the first mark 68 and the mark 84 of the second probe 28 corresponds to the second mark 70. For example, the mark 84 may include text of the corresponding color. By the corresponding color, the first and second marks 68, 70 provide the user with intuitive and rapid information regarding which of the first and second probes 26, 28 should be used without concern as to whether the tissue path is of insufficient depth. In other words, the user can immediately ascertain which of the first and second probes 26, 28 will fit the size of the tissue path formed by the drill 24 based on the first and second marks 68, 70 being aligned with the visual reference plane provided by the proximal surface 40 (or luer fitting) of the cannula hub 34. By being aligned, information or recognition by the user may also be provided regarding whether the probes 26, 28 are positioned adjacent to or spaced from the end 66 of the tissue path. The first and second marks 68, 70 do not necessarily provide any information regarding the size of the ablation zone or ablation zone mapping.

[0015] As shown in FIG. 2A, a first distance between the distal edge 72 of the first mark 68 and the distal end 64 of the drill shaft 60 is configured to be equal to a first probe length defined between the probe hub 42 of the first probe 26 and the distal end 50 of the probe shaft 44. Similarly, a second distance between the proximal edge 74 of the first mark 68 and the distal end 64 of the drill shaft 60 is configured to be equal to a second probe length defined between the probe hub 42 of the second probe 28 and the distal end 50 of the probe shaft 44. As a result, if a tissue path is formed with the first mark 68 visible adjacent to the cannula hub 34, the tissue path formed may be of insufficient path length to allow the active tip region 54 of the second probe 28 to be positioned beyond the distal end 38 of the access cannula 22.

[0016] An exemplary method may thus include guiding the distal end 64 of the drill shaft 60 beyond the distal end 38 of the access cannula 22 to form a tissue path of a desired length. The distal end 64 of the drill shaft 60 may be confirmed by imaging and adjusted as desired accordingly. The drill 24 is positioned at a desired location such that the drill hub 58 is spaced from the cannula hub 34 and the proximal portion of the drill shaft 60 is exposed. The method includes determining whether the first mark 68 or the second mark 70 overlaps the cannula hub 34 of the access cannula 22. By the contrasting colors of the first and second marks 68, 70, for example, a user can quickly confirm the information. FIG. 3 shows that the first mark 68 is aligned with the proximal surface 40 of the access cannula 22. The drill 24 may be removed from the access cannula 22.

[0017] This method includes correlating one of the first and second indicia 68, 70 that overlap the cannula hub 34 of the access cannula 22 with a complementary indicium 84 associated with each of the first probe 26 and the second probe 28. In an exemplary implementation, the first color or the second color that overlaps the cannula hub 34 of the access cannula 22 is correlated with the corresponding color of the complementary indicium 84. One of the first and second probes 26, 28 is selected based on the corresponding color. In other words, if the first indicium 68 is aligned with the cannula hub 34, it can be assumed that the path length is sufficient to accommodate at least the active tip region 54 of the first probe 26, and if the second indicium 70 is aligned with the cannula hub 34, it can be assumed that the path length is sufficient to accommodate at least the active tip region 54 of the second probe 28. This method includes guiding a selected one of the first probe 26 and the second probe 28 through the access cannula 22 into the formed tissue path. The distal surface 48 of the probe hub 42 may be positioned to abut, for example, the proximal surface 40 (or luer fitting) of the cannula hub 34 that provides a structural reference plane. Depending on the relative lengths of the probe shaft 44 and the cannula shaft 36, it can further be assumed that the active tip region 54 is exposed beyond the distal end 38 of the access cannula 22, including the proximal end 56 of the proximal emitter 30. The selected one of the first and second probes 26, 28 is operated (with RF energy provided by the console) to ablate tissue adjacent to the formed tissue path.

[0018] The intuitiveness and efficiency of the ablation system 20 of the present disclosure are immediately recognizable. Briefly stated, if any part of the first mark 68 is visible, the user understands that the second probe 28 should not be used. Otherwise, the proximal emitter 30 of the second probe 28 cannot be exposed beyond the access cannula 22 before the distal end 50 of the second probe 28 reaches the bottom within the tissue path. Similarly, if only the second mark 70 is visible, the user understands that the first probe 26 is too short to significantly occupy the formed tissue path and that it should not be used. If the user still wishes to use the first probe 26 in such a case, it may be shown that the access cannula 22 is repositioned to reach the target site. If the first and second probes 26, 28 are separately packaged in a sterilization kit, the user can advantageously avoid opening the non-selected probe. The packaged sterilized probes may be stored for later ablation procedures, thereby reducing costs and waste.

[0019] Further information may be realized based on the positions of the edges 72, 74, 76, 78 relative to the cannula hub 34 of the access cannula 22. If the user can visualize a portion of the drill axis 60 distal to the distal edge 72 of the first mark 68, the user will recognize that the first probe 26 (and the second probe 28) is too long for the formed tissue path. The user will understand that the drill 24 is advanced further relative to the access cannula 22 to deepen the tissue path (e.g., until at least the distal edge 72 of the first mark 68 is aligned with the proximal surface 40). FIG. 3 shows that the distal edge 72 of the first mark 68 is aligned with the proximal surface 40 of the access cannula 22. That arrangement shows that the path length is approximately equal to the distance configured such that the first probe 26 extends beyond the distal end 38 of the access cannula 22. The distal end 50 of the first probe 26 is adjacent to or abuts the end 66 of the tissue path.

[0020] In one method, the proximal edge 74 of the first mark 68 may be correlated as overlapping the cannula hub 34. FIG. 4 shows that the proximal edge 74 of the first mark 68 appears adjacent to the proximal surface 40 of the access cannula 22. The user may select the first probe 26 based on the correlation and guide the first probe 26 through the access cannula 22 into the formed tissue path. In such an arrangement, the user will recognize that the distal end 50 of the first probe 26 will be spaced from the end 66 of the tissue path with the probe hub 42 engaged with the cannula hub 34. FIG. 4 shows the unoccupied portion of the tissue path. Based on the proportion of the first mark 68 that is visible proximal to the cannula hub 34, the user can intuitively infer that the size of the interval is within the tissue path distal to the distal end 50 of the first probe 26. In other cases, the proximal edge 74 of the first mark 68 may be aligned with the cannula hub 34 so that the first mark 68 is not visible, or just within it, or alternatively the narrow portion 80 between the first and second marks 68, 70 may overlap the cannula hub 34. Since the user cannot see the first mark 68, the user may select the second probe 28 based on the correlation, and the second probe 28 may be guided through the access cannula 22 into the formed tissue path.

[0021] In one method, the distal edge 76 of the second mark 70 may be correlated as overlapping the cannula hub 34. FIG. 5 shows that the distal edge 76 of the second mark 70 is aligned with the proximal surface 40 of the access cannula 22. The user may select the second probe 28 based on the correlation, and the second probe 28 may be guided through the access cannula 22 into the formed tissue path. The distal end 50 of the second probe 28 is close to, adjacent to, or in contact with the end 66 of the formed tissue path with the probe hub 42 engaged with the cannula hub 34. There may be a minimum interval corresponding to the distance between the proximal edge 74 of the first mark 68 and the distal edge 76 of the second mark 70.

[0022] In one method, the proximal edge 78 of the second mark 70 may be correlated as overlapping the cannula hub 34. FIG. 6 shows that the proximal edge 78 of the second mark 70 is aligned with the proximal surface 40 of the access cannula 22. The user may select the second probe 28 based on the correlation, and the second probe 28 may be guided through the access cannula 22 into the formed tissue pathway. The distal end 50 of the second probe 28 is spaced from the end 66 of the tissue pathway with the probe hub 42 engaged to the cannula hub 34. FIG. 6 shows another unoccupied portion of the tissue pathway. Based on the proportion that the second mark 70 is visible proximal to the cannula hub 34, the user can intuitively infer that the size of the interval is within the tissue pathway distal to the distal end 50 of the second probe 28.

[0023] The objectives of the present disclosure may be extended to a system including three, four, or five or more probes. For example, FIGS. 2B and 7C represent an ablation system 20 including a drill shaft 60 with first, second, third, and fourth marks 68, 70, 86, 88 corresponding to the first probe 26, the second probe 28, the third probe 27, and the fourth probe 29, respectively. The third and fourth probes 27, 29 and the third and fourth marks 86, 88 may correspond to the first and second probes 26, 28 and the first and second marks 68, 70, respectively. In other words, the active tip regions 54 of the third probe 27 and the fourth probe 29 may be 15 and 20 millimeters, respectively, and thus the length of the third mark 86 may be approximately 5 millimeters.

[0024] In this implementation example, the active tip regions 54 of the first probe 26 and the second probe 28 may be 7 and 10 millimeters respectively, and thus the lengths of the first mark 68 and the second mark 70 may be approximately 3 and 5 millimeters respectively. More specifically, the first mark 68 may include a distal edge 72 and a proximal edge 74 that define a length therebetween, and the second mark 70 may include a distal edge 76 and a proximal edge 78 that define a length therebetween. The length of the second mark 70 is greater than the length of the first mark 68. The length of the first mark 68 may be equal to the difference in length between the probe axes 44 of the first and second probes 26, 28. Further, in this implementation example, the active tip regions 54 of the third probe 27 and the fourth probe 29 may be 15 and 20 millimeters respectively, and thus the length of the third mark 86 may be approximately 5 millimeters. The third mark 86 may include a distal edge 90 and a proximal edge 92 that define a length therebetween, and the fourth mark 88 may include a distal edge 94 and a proximal edge 96 that define a length therebetween. The length of the second mark 86 may be equal to the difference in length between the probe axes 44 of the second and third probes 27, 28. The length of the third mark 86 may be equal to the difference in length between the probe axes 44 of the third and fourth probes 26, 28. Thus, the length of the third mark 86 may be the same as the length of the second mark 70.

[0025] The first, second, third, and fourth marks 68, 70, 86, 88 may be elongated, linear, and longitudinally directed along one side of the proximal portion of the drill axis. For example, the first, second, third, and fourth marks 68, 70, 86, 88 may be recessed within the drill axis 60 and formed by milling operations, laser operations, or the like. The first, second, third, and fourth marks 68, 70, 86, 88 may be of different colors. For example, the first color is blue, the second color is pink, the third color is green, and the fourth color is yellow, although other color combinations are contemplated. Each probe hub 42 of the first, second, third, and fourth probes 26, 27, 28, 29 may include a mark 84 or a label having a corresponding mark 84 (see FIGS. 2A and 2B). By the corresponding colors, the first, second, third, and fourth marks 68, 70, 86, 88 intuitively and quickly provide the user with information regarding which of the first, second, third, and fourth probes 26, 27, 28, 29 should be used without concern as to whether the tissue path is of insufficient depth.

[0026] An exemplary method may thus include guiding the distal end 64 of the drill axis 60 beyond the distal end 38 of the access cannula 22 to form a tissue path of a desired length. The distal end 64 of the drill axis 60 may be confirmed by imaging and adjusted as desired accordingly. Positioning the drill 24 such that the drill hub 58 is spaced from the cannula hub 34 and the proximal portion of the drill axis 60 is exposed. The method includes determining whether the first, second, third, and fourth marks 68, 70, 86, 88 overlap the cannula hub 34 of the access cannula 22. By the contrasting colors of the first, second, third, and fourth marks 68, 70, 86, 88, for example, the user can quickly confirm the information.

[0027] This method includes correlating one of the first, second, third, and fourth marks 68, 70, 86, 88 that overlap the cannula hub 34 of the access cannula 22 with a complementary mark 84 associated with each of the first, second, third, and fourth probes 26, 27, 28, 29. One of the first, second, third, and fourth probes 26, 27, 28, 29 is selected based on the corresponding color. The selected one of the first, second, third, and fourth probes 26, 27, 28, 29 is guided through the access cannula 22 into the formed tissue pathway. Due to the relative lengths of the probe axis 44 and the cannula axis 36, it can further be envisioned that the active tip region 54 is exposed beyond the distal end 38 of the access cannula 22, including the proximal end 56 of the proximal emitter 30. The selected one of the first, second, third, and fourth probes 26, 27, 28, 29 is operated to ablate tissue adjacent to the formed tissue pathway.

[0028] During deployment of the drill 24, if any part of the first mark 68 is visible, the user understands that the second, third, or fourth probe 27, 28, 29 should not be used. If any part of the second mark 70 is visible, the user understands that the third or fourth probe 27, 29 should not be used. If any part of the third mark 86 is visible, the user understands that the fourth probe 29 should not be used. Finally, if only the fourth mark 88 is visible, the user understands that the first, second, or third probes 26, 27, 28 are too short to significantly occupy the formed tissue pathway and that they should not be used. A further aspect of the method of the ablation system 20 including four probes is similar to that described above for a two-probe system and is incorporated herein by reference. As mentioned, the ablation system 20 can be modified to accommodate any number of probes.

[0029] The above disclosure is not intended to be exhaustive or to limit the invention to any particular form. The terms used are of a descriptive nature rather than of a limiting nature. Many changes and modifications are possible in light of the above teachings, and the invention may be practiced in ways other than as specifically described. It should be understood that treatment parameters other than impedance and temperature may be utilized with the techniques described above. Furthermore, it is contemplated that the treatment parameters may be controlled or defined in ways different from those of the described techniques. It is further understood that the objectives of the present disclosure may be used in conjunction with microwave energy or electrical energy other than high-frequency energy.

Claims

1. A method of ablating tissue within a vertebral body in a system including an access cannula including a cannula hub, a drill including a drill hub, and a first probe and a second probe each including a probe hub and having different lengths, the method comprising: providing access into the vertebral body with the access cannula; guiding a distal end of the axis of the drill beyond a distal end of the access cannula to form a first tissue path of a first path length or a second tissue path of a second path length greater than the first path length, the drill hub being spaced from the cannula hub and a proximal portion of the drill axis being exposed; determining whether a first mark of a first color or a second mark of a second color overlaps the cannula hub of the access cannula, the first mark and the second mark being sized and positioned longitudinally on the proximal portion of the drill axis and associated with one of the first path length and the second path length for receiving one of the first probe and the second probe; correlating one of the first color and the second color that overlaps the cannula hub of the access cannula with a corresponding color of a complementary mark associated with one of the first probe and the second probe; selecting one of the first probe and the second probe based on the correlated one of the first color and the second color; removing the drill from the access cannula; guiding the selected one of the first probe and the second probe through the access cannula into the formed first tissue path or the formed second tissue path; operating the selected one of the first probe and the second probe to ablate the tissue adjacent to the formed first tissue path or the formed second tissue path; comprising the method.

2. correlating with the proximal edge of the first mark overlapping the cannula hub with the first mark being partially visible; selecting the first probe; Guiding the first probe through the access cannula into the formed first tissue pathway such that, with the first probe hub engaged with the cannula hub, the distal end of the first probe is spaced from the end of the first tissue pathway. The method according to claim 1, further comprising. **Claim 3** Correlating with the proximal edge of the first mark overlapping the cannula hub with the first mark not visible. Selecting the second probe. Guiding the second probe through the access cannula into the formed second tissue pathway such that, with the second probe hub engaged with the cannula hub, the distal end of the second probe is at the end of the second tissue pathway. The method according to claim 1, further comprising. **Claim 4** Correlating with the thin portion of the drill axis between the first mark and the second mark overlapping the cannula hub with the first mark not visible. Selecting the second probe. Guiding the second probe through the access cannula into the formed second tissue pathway. The method according to claim 1, further comprising. **Claim 5** Correlating with the distal edge of the second mark overlapping the cannula hub. Selecting the second probe. Guiding the second probe through the access cannula into the formed second tissue pathway. The method according to claim 1, further comprising. **Claim 6** Correlating with the proximal edge of the second mark overlapping the cannula hub. Selecting the second probe. Guiding the second probe through the access cannula into the formed second tissue pathway such that, with the second probe hub engaged with the cannula hub, the distal end of the second probe is spaced from the end of the second tissue pathway. The method according to claim 1, further comprising. **Claim 7** A method of ablating tissue within a vertebral body in a system comprising an access cannula including a cannula hub, a drill including a drill hub, and first and second probes each including a probe hub and having different lengths, the method comprising: Providing access into the vertebral body with the access cannula. Guiding the distal end of the drill shaft beyond the distal end of the access cannula to form a first tissue path of a first path length or a second tissue path of a second path length greater than the first path length, wherein the drill hub is spaced from the cannula hub and the proximal portion of the drill shaft is exposed; Determining whether a first mark of a first color or a second mark of a second color on the proximal portion of the drill shaft overlaps the cannula hub of the access cannula; Correlating one of the first color or the second color with the corresponding color of a complementary mark associated with each of the first probe and the second probe, such that the distal edge of the first mark overlapping the cannula hub results in the proximal emitter of the first probe being exposed beyond the distal end of the access cannula with the first probe hub engaged with the cannula hub, and the distal end of the first probe being positioned at the end of the first tissue path, and the second probe having a length such that the proximal emitter of the second probe is not exposed beyond the distal end of the access cannula based on the distal end of the second probe engaging the tissue at the end of the first tissue path; Selecting one of the first probe and the second probe based on the correlated one of the first color and the second color; Removing the drill from the access cannula; Guiding the selected one of the first probe and the second probe through the access cannula into the formed first tissue path or the formed second tissue path; Operating the selected one of the first probe and the second probe to ablate the tissue adjacent to the formed first tissue path or the formed second tissue path; A method comprising. Claim 8 The proximal edge of the first mark overlapping the cannula hub results in the distal end of the first probe being spaced from the end of the first tissue path with the first probe hub engaged with the cannula hub, and the distal edge of the second mark overlapping the cannula hub results in the distal end of the second probe being at the end of the second tissue path with the second probe hub engaged with the cannula hub, and the proximal edge of the second mark overlapping the cannula hub results in the distal end of the second probe being spaced from the end of the second tissue path with the second probe hub engaged with the cannula hub, the method according to claim 7.

9. The step of determining whether the first mark of the first color or the second mark of the second color overlaps the cannula hub is performed after the step of visually confirming the distal end of the drill shaft, the method according to any one of claims 1 to 8.

10. The first probe is packaged in a first probe kit, the second probe is packaged in a second probe kit, and the method includes opening a single one of the first probe kit and the second probe kit based on one of the correlated first color and second color, and further including that the second probe kit remains available for a subsequent ablation procedure, the method according to any one of claims 1 to 9.

11. A system for ablating tissue, An access cannula comprising a cannula hub, A drill comprising a drill hub, a drill shaft extending from the drill hub, a first mark of a first color disposed on the proximal portion of the drill shaft, and a second mark of a second color disposed on the proximal portion of the drill shaft, wherein the distal edge of the second mark substantially coincides with the proximal edge of the first mark, Comprising, The drill shaft is configured to be guided through the access cannula to align one of the first mark and the second mark with the cannula hub of the access cannula, and a first distance between a distal edge of the first mark and a distal end of the drill shaft is equal to a first probe length defined between a first probe hub and a first distal end of a first probe shaft, and a second distance between the distal edge of the second mark and the distal end of the drill shaft is equal to a second probe length defined between a second probe hub and a second distal end of a second probe shaft, a system.

12. The system of claim 11, wherein the first mark and the second mark are opaque bands extending around the drill shaft.

13. The system of claim 11, wherein the first mark and the second mark are translucent bands extending around the drill shaft.

14. The system of claim 11, wherein the first mark and the second mark are elongated, linear, and recessed longitudinally along one side surface of the proximal portion of the drill shaft.

15. The system of claim 14, wherein the first mark and the second mark are elongated, linear, and recessed longitudinally along opposite side surfaces of the proximal portion of the drill shaft.

16. The system of claim 14 or 15, wherein the one side surface or the opposite side surface is defined by being aligned with a main surface of the drill hub.

17. The system of any one of claims 11 to 16, wherein the first mark and the second mark are not circular rings.

18. A system for ablating tissue, an access cannula comprising a cannula hub, a drill comprising a drill hub, a drill shaft extending from the drill hub, a first mark of a first color disposed on the proximal portion of the drill shaft, and a second mark of a second color disposed on the proximal portion of the drill shaft, wherein the first mark and the second mark are elongated, linear, and recessed longitudinally along one side surface of the proximal portion of the drill shaft aligned with a main surface of the drill hub, comprising The drill shaft is configured to be guided through the access cannula to align one of the first mark and the second mark with the cannula hub of the access cannula, and a first distance between a distal edge of the first mark and a distal end of the drill shaft is configured to be equal to a first probe length defined between a first probe hub and a first distal end of a first probe shaft, and a second distance between a distal edge of the second mark and the distal end of the drill shaft is configured to be equal to a second probe length defined between a second probe hub and a second distal end of a second probe shaft, a system.

19. The system according to any one of claims 11 to 18, wherein a length of the first mark defined between a proximal edge and a distal edge of the first mark is greater than a length of the second mark defined between a distal edge and a proximal edge of the second mark.

20. A system for ablating tissue, An access cannula comprising a cannula hub, A drill comprising a drill hub, a drill shaft extending from the drill hub, a first mark of a first color disposed on a proximal portion of the drill shaft, and a second mark of a second color disposed on the proximal portion of the drill shaft, wherein a length of the first mark defined between a proximal edge and a distal edge of the first mark is greater than a length of the second mark defined between a distal edge and a proximal edge of the second mark, Comprising, The drill shaft is configured to be guided through the access cannula to align one of the first mark and the second mark with the cannula hub of the access cannula, and a first distance between a distal edge of the first mark and a distal end of the drill shaft is configured to be equal to a first probe length defined between a first probe hub and a first distal end of a first probe shaft, and a second distance between a distal edge of the second mark and the distal end of the drill shaft is configured to be equal to a second probe length defined between a second probe hub and a second distal end of a second probe shaft, a system.

21. The system according to any one of claims 11 to 20, wherein the drill is configured to create a first tissue path that has a path length insufficient to allow the second emitter on the second probe shaft to be positioned beyond the distal end of the access cannula with the first mark overlapping the cannula hub.

22. The system according to any one of claims 11 to 21, wherein the first mark is a first color, the second mark is a second color different from the first color, and optionally, the first color is blue and the second color is yellow.

23. The system according to any one of claims 11 to 22, wherein the drill further comprises a third mark of a third color disposed on a proximal portion of the drill shaft and a fourth mark of a fourth color disposed on the proximal portion of the drill shaft.

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