Patent Publication Number: US-2022218411-A1

Title: Devices, systems, and methods facilitating nerve ablation

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of, and priority to, U.S. Provisional Patent Application No. 63/135,075, filed on Jan. 8, 2021, the entire contents of which are hereby incorporated herein by reference. 
    
    
     FIELD 
     The present disclosure relates generally to surgical devices, systems, and methods and, more particularly, to devices, systems, and methods facilitating nerve ablation, e.g., posterior ablation of the basivertebral nerve. 
     BACKGROUND 
     Back pain is a very common health problem. Low back pain, in particular, is a serious medical and social problem that is the most expensive occupational disorder in the United States and the leading cause of disability worldwide. Low back pain may be, for example, vertebrogenic, meaning the pain arises from problems within the vertebral bodies, or may be discogenic, meaning the pain arises from problems within the spinal discs. Vertebrogenic and discogenic pain may be caused by degenerative disease, metastases, and/or other conditions. 
     The basivertebral nerve of a vertebral body enters the posterior vertebral body via the basivertebral foramen and branches near the center of the vertebral body to innervate the superior and inferior endplates of the vertebral body. The basivertebral nerve has been found to transmit pain signals. Accordingly, ablating the basivertebral nerve is one potential avenue for alleviating vertebrogenic and/or discogenic low back pain. 
     SUMMARY 
     As used herein, the term “distal” refers to the portion that is being described which is farther from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator. Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, are meant to encompass variations, e.g., manufacturing tolerances, material tolerances, use and environmental tolerances, measurement variations, and/or other variations, up to and including plus or minus 10 percent. Further, any or all of the aspects described herein, to the extent consistent, may be used in conjunction with any or all of the other aspects described herein. 
     Provided in accordance with aspects of the present disclosure is an ablation device including a handle, an elongated body extending distally from the handle, and an end effector assembly selectively deployable relative to the elongated body. The end effector assembly includes a shaft and a plurality of electrode tines. The shaft has a curved configuration along at least a portion of a length thereof defining an inside portion and an outside portion. The shaft is adapted to connect to a source of Radio Frequency (RF) energy. The plurality of electrode tines is spaced-apart along the shaft and extends from the inside portion thereof. Each electrode tine of the plurality of electrode tines is adapted to connect to the source RF energy. At least one electrode tine of the plurality of electrode tines and the shaft are configured to conduct RF energy therebetween and through tissue to treat tissue. 
     In an aspect of the present disclosure, each electrode tine of the plurality of electrode tines includes a tissue-penetrating tip. 
     In another aspect of the present disclosure, at least two electrode tines of the plurality of electrode tines are configured to conduct RF energy therebetween. 
     In still another aspect of the present disclosure, the plurality of electrode tines is selectively extendable relative to the shaft. 
     In yet another aspect of the present disclosure, each electrode tine of the plurality of electrode tines defines a curved configuration and is curved in a similar direction as the shaft. 
     In still yet another aspect of the present disclosure, at least one cooling lumen extends through the shaft. The at least one cooling lumen is configured to receive cooling fluid to cool at least a portion of the shaft. 
     In another aspect of the present disclosure, the shaft is resiliently biased towards the curved configuration and is resiliently flexible from a substantially linear configuration, corresponding to a retracted position of the end effector assembly relative to the elongated body, to the curved configuration, corresponding to a deployed position of the end effector assembly relative to the elongated body. 
     Another ablation device provided in accordance with aspects of the present disclosure includes a handle, an elongated body extending distally from the handle, and an end effector assembly selectively deployable relative to the elongated body. The end effector assembly includes a tongue, a plurality of electrodes, and an insulating layer. The tongue has a curved configuration along at least a portion of a length thereof defining an inside portion and an outside portion. The tongue defines a curved transverse cross-sectional configuration defining a concave side and a convex side. The concave side corresponds to the inside portion and the convex side corresponds to the outside portion. The tongue is adapted to connect to a source of Radio Frequency (RF) energy. The plurality of electrodes is spaced-apart along the tongue and disposed on the concave side of the tongue. Each electrode of the plurality of electrodes is adapted to connect to the source RF energy. The insulating layer is disposed on the convex side of the tongue. At least one electrode of the plurality of electrodes and the tongue are configured to conduct RF energy therebetween and through tissue to treat tissue. 
     In an aspect of the present disclosure, at least two electrodes of the plurality of electrodes are configured to conduct RF energy therebetween. 
     In another aspect of the present disclosure, the tongue is resiliently biased towards the curved configuration and is resiliently flexible from a substantially linear configuration, corresponding to a retracted position of the end effector assembly relative to the elongated body, to the curved configuration, corresponding to a deployed position of the end effector assembly relative to the elongated body. 
     In still another aspect of the present disclosure, a user interface is disposed on the handle and includes a first control for selectively deploying the end effector assembly relative to the elongated body and a second control for selectively activating the supply of energy to the at least one electrode and the tongue. 
     In aspects of the present disclosure, the elongated body is resiliently flexible and/or defines a tissue-penetrating tip. 
     A method of ablating tissue provided in accordance with aspects of the present disclosure includes inserting an elongated body into a vertebral body of a patient anteriorly of a basivertebral nerve, deploying an end effector assembly from the elongated body such that a base electrode of the end effector assembly is positioned anteriorly of a basivertebral nerve with a plurality of electrodes of the end effector assembly facing posteriority towards the basivertebral nerve, and conducting RF energy between at least one electrode of the plurality of electrodes and the base electrode causing the RF energy to be conducted through the cancellous bone containing the basivertebral nerve to ablate the basivertebral nerve. 
     In an aspect of the present disclosure, deploying the end effector assembly orients the plurality of electrodes substantially radially inwardly towards the basivertebral nerve. 
     In another aspect of the present disclosure, deploying the end effector assembly includes penetrating the basivertebral nerve with at least one electrode of the plurality of electrodes. 
     In yet another aspect of the present disclosure, deploying the end effector assembly orients an insulating layer disposed on the base electrode on an anterior side of the base electrode to inhibit energy conduction anteriorly. 
     In still another aspect of the present disclosure, the method further includes circulating cooling fluid through a portion of the base electrode to promote energy conduction posteriorly. 
     In still yet another aspect of the present disclosure, conducting RF energy further includes conducting RF energy between at least two electrodes of the plurality of electrodes. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
       The above and other aspects and features of the present disclosure will become more apparent in view of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements. 
         FIG. 1  is a side view of a surgical system provided in accordance with the present disclosure including an ablation device, an introducer, and a generator; 
         FIG. 2  is a side view of a distal portion of the ablation device of  FIG. 1  with an end effector assembly thereof disposed in a deployed position; 
         FIG. 3  is a transverse, cross-sectional view of the end effector assembly of  FIG. 2 , taken across section line “3-3” of  FIG. 2 ; 
         FIG. 4  is a transverse cross-section of a vertebral body including the end effector assembly of  FIG. 2  positioned therein for ablating a basivertebral nerve; 
         FIG. 5  is a top view of a user interface of a handle of the ablation device of  FIG. 1 ; 
         FIG. 6  is a front view of the generator of  FIG. 1 ; 
         FIG. 7  is a side view of a distal end of the ablation device of  FIG. 1  including another end effector assembly in accordance with the present disclosure, wherein the end effector assembly is disposed in a deployed position; 
         FIG. 8  is a transverse cross-section of a vertebral body including the end effector assembly of  FIG. 7  positioned therein for ablating a basivertebral nerve; and 
         FIG. 9  is a schematic illustration of a robotic surgical system configured for use in accordance with the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
       FIG. 1  illustrates a surgical system in accordance with the present disclosure shown generally identified by reference numeral  10 . Surgical system  10  may be configured to facilitate nerve ablation, e.g., posterior ablation of the basivertebral nerve, as detailed below, although it is also contemplated that surgical system  10  be utilized to facilitate treatment of other tissue structures and/or at other anatomical locations. Surgical system  10  generally includes an ablation device  100 , an introducer  200 , and a generator  300 . In some configurations, introducer  200  is omitted and ablation device  100  itself functions as the introducer. Additional or alternative components of system  10  are also contemplated such as, for example, a stylet, guidewire, trocar, etc. 
     Ablation device  100  includes a handle  110 , an elongated body  120  extending distally from handle  110 , an end effector assembly  130  selectively deployable from a distal end portion of elongated body  120 , a user interface  150  disposed on handle  110 , and a cable  160  extending proximally from handle  110  to enable connection of ablation device  100  with generator  300 . Handle  110  is configured to facilitate grasping and manipulation by a user and, as noted above, includes user interface  150  disposed thereon to enable user-controlled actuation and activation of ablation device  100 , as detailed below. Although handle  110  is shown defining a pencil-grip configuration, other suitable handle configurations are also contemplated such as, for example, a pistol-grip, a plunger-grip, etc. 
     Elongated body  120  extends distally from handle  110  and defines sufficient length to enable a distal end portion of elongated body  120  to be positioned adjacent an internal surgical site, e.g., within a vertebral body, while handle  110  remains externally disposed. Elongated body  120  may include one or more sections that are straight, pre-bent, rigid, flexible, malleable, and/or articulatable. For example, elongated body  120  may define an at least partially flexible configuration wherein a distal section  122  thereof is biased towards a curved configuration, as illustrated in  FIG. 1 , although other configurations are also contemplated. Elongated body  120  may be resiliently flexible from this curved configuration to a substantially linear configuration to enable insertion of elongated body through introducer  200 . In such configurations, upon emergence of elongated body  120  from a distal end of introducer  200 , e.g., within the internal surgical site, the portion of elongated body  120  that extends distally from introducer  200  is thus permitted to resiliently return towards the curved configuration. Elongated body  120  (or a portion thereof) may be formed from nitinol or other suitable shape memory material. 
     With additional reference to  FIG. 2 , elongated body  120  may define a sharpened distal tip  124  to facilitate penetration through tissue such as bone or may define a blunt configuration. End effector assembly  130  is selectively deployable relative to elongated body  120  from a retracted position ( FIG. 1 ), wherein end effector assembly  130  is substantially disposed within elongated body  120 , to a deployed position ( FIG. 2 ), wherein end effector assembly  130  extends distally from elongated body  120 . End effector assembly  130  may be deployed and retracted via a slider  152  of user interface  150 , although other suitable actuators, e.g., triggers, plungers, wheels, etc., are also contemplated. End effector assembly  130  and user interface  150  are described in greater detail below. 
     Referring again to  FIG. 1 , introducer  200  includes a proximal hub  210  and a distal sheath  220  extending distally from proximal hub  210 . Distal sheath  220  includes a tissue-penetrating tip  222  to facilitate insertion of introducer  200  through tissue, e.g., bone, into an internal surgical site. A longitudinal lumen  230  extends through proximal hub  210  and distal sheath  220  to enable insertion of elongated body  120  of ablation device  100  through introducer  200 , distally therefrom, and into the internal surgical site. Distal sheath  220  may include one or more sections that are straight, pre-bent, rigid, flexible, malleable, and/or articulatable. As noted above, in some aspects, introducer  200  is omitted. 
     Generator  300  is configured to provide suitable energy to ablation device  100  for treating, e.g., ablating, tissue therewith. For example, generator  300  may provide Radio Frequency (RF) energy to ablation device  100  for ablating tissue, as detailed below, although other suitable forms of energy, e.g., microwave, ultrasonic, thermal, etc., and/or tissue treatments, are also contemplated. 
     With reference to  FIGS. 2 and 3 , in conjunction with  FIG. 1 , end effector assembly  130  of ablation device  100  includes a base electrode, e.g., tongue  132 , a plurality of electrodes  134  disposed on a first face  133   a  of tongue  132 , and an insulating layer  136  disposed on a second, opposite face  133   b  of tongue  132 . Tongue  132  may be resiliently flexible to enable flexion of tongue  132  between a curved configuration, wherein tongue  132  defines a curvature along at least a portion of a longitudinal length thereof, and a linear configuration, wherein tongue  132  extends substantially linearly along the longitudinal length thereof. The linear configuration of tongue  132  may correspond to the retracted position of end effector assembly  130 . More specifically, with tongue  132  disposed in the linear configuration, end effector assembly  130  is capable of being received within elongated body  120  to define the retracted position ( FIG. 1 ). End effector assembly  130  is deployable from this retracted position to the deployed position ( FIG. 2 ), wherein end effector assembly  130  extends distally from elongated body  120  and is permitted to move to the curved configuration. In some aspects, tongue  132  extends radially outwardly beyond the outer radial dimension of elongated body  120  in the curved configuration. Tongue  132  may be biased towards the curved configuration such that, upon deployment of end effector assembly  130  from elongated body  120 , tongue  132  resiliently returns towards the curved configuration. In the curved configuration, first face  133   a  of tongue  132  (including electrodes  134 ) is disposed on the inside portion of the curve while second face  133   b  of tongue  132  (including insulating layer  136 ) is disposed on the outside portion of the curve. Tongue  132  may define a radiused curvature in the curved configuration. Alternatively, tongue  132  may define another curvature, multiple curvatures, straight portions, angled portions, combinations thereof, etc. in the curved configuration. Tongue  132  (or a portion thereof) may be formed from nitinol or other suitable shape memory material to enable flexion of tongue  132  between the linear and curved configurations. 
     As illustrated in  FIG. 3 , tongue  132  defines a radiused transverse cross-sectional configuration although U-shaped or V-shaped configurations are also contemplated. Tongue  132 , more specifically, in aspects, extends from about 45 degrees to about 135 degrees about the circumference of a circle in transverse cross-section; in other aspects, from about 60 degrees to about 120 degrees about the circumference of a circle in transverse cross-section; or in still other aspects, defines a semi-circle in transverse cross-sectional configuration (extending approximately 90 degrees about the circumference of a circle). First face  133   a  of tongue  132  (including electrodes  134 ) is disposed on the concave side (in cross-section) of tongue  132  while second face  133   b  of tongue  132  (including insulating layer  136 ) is disposed on the convex side (in cross-section) of tongue  132 . 
     Referring again to  FIGS. 2 and 3 , in aspects, tongue  132  (or a portion thereof) is formed from an electrically-conductive material adapted to connect to generator  300  (e.g., via a lead wire (not shown) extending from end effector assembly  130  through elongated body  120 , handle  110 , and cable  160  to generator  300 ). In this manner, tongue  132  may function as a return electrode in a bipolar or monopolar RF circuit while electrodes  134  function as the active electrodes, as detailed below. 
     Electrodes  134  are disposed on first face  133   a  of tongue  132  and longitudinally spaced-apart from one another along at least a portion of the longitudinal length of tongue  132 . Although three electrodes  134  are shown, any suitable number of electrodes e.g., two electrodes  134  or more than three electrodes  134 , are also contemplated. Electrodes  134  are formed from an electrically-conductive material adapted to connect to generator  300  (e.g., via lead wires (not shown) extending from end effector assembly  130  through elongated body  120 , handle  110 , and cable  160  to generator  300 ). Electrodes  134  may be collectively connected to generator  300  (e.g., via a common lead wire) such that electrodes  134  are energizable together, may be independently connected to generator  300  (e.g., via separate lead wires) such that electrodes  134  are independently energizable, or may be connected to generator  300  in one or more groups (e.g., via one or more group lead wires) such that electrodes  134  in a group are energizable together while different groups of electrodes  134  may be energized independently. Electrodes  134  are electrically-insulated from tongue  132 , e.g., via an insulative layer (not shown) disposed therebetween. 
     In aspects, one or more electrodes  134  may function as the active electrode(s) in a bipolar RF circuit while tongue  132  functions as the return electrode. Thus, energy may be conducted between the electrode(s)  134  (charged to a first potential, e.g., a positive “+” potential) and tongue  132  (charged to a second, different potential, e.g., a negative “−” potential) and through tissue to treat, e.g., ablate tissue. Alternatively, one or more electrodes  134  (and/or tongue  132 ) may be charged to the first potential while one or more other electrodes  134  (and/or tongue  132 ) is charged to the second potential (or a third potential) to establish a bipolar RF circuit wherein energy may be conducted between the electrode(s)  134  (and/or tongue  132 ) and the other electrode(s)  134  (and/or tongue  132 ) and through tissue to treat, e.g., ablate tissue. Further still, multipolar configurations are also contemplated such as, for example, a three-phase RF circuit wherein at least three potentials are utilized between the electrodes  134  and/or tongue  132  to enable conduction of energy between any two electrodes  134  energized to different potentials and/or between tongue  132  and any electrode  134  energized to a different potential from tongue  132  and through tissue to treat, e.g., ablate tissue. In aspects, some electrodes  134  and/or tongue  132  may be turned “OFF” in some modes of operation, and/or may be energized sequentially, in alternating fashion, or according to any other suitable pattern. Monopolar RF circuits are also contemplated. Regardless of the particular energization of electrodes  134  and tongue  132 , the energization may be continuous, pulsed, combinations thereof, or in any other suitable manner. Likewise, the intensity and duration of energization may be controlled to achieve a desired tissue treatment, e.g., ablation, while inhibiting collateral damage. Selecting a mode of activation, adjusting activation settings, and/or initiating activation of end effector assembly  130  may be performed via buttons  154  of user interface  150  ( FIG. 1 ) and/or via generator  300  ( FIG. 1 ), as detailed below. 
     With momentary reference to  FIG. 3 , electrodes  134  may define semi-cylindrical configurations (semi-circular transverse cross-sectional configurations); may define a partial cylindrical configuration extending from about 45 degrees to about 135 degrees about the circumference of a cylinder (of a circle in transverse cross-section); or may define a partial cylindrical configuration extending from about 60 degrees to about 120 degrees about the circumference of a cylinder (of a circle in transverse cross-section). U-shaped, V-shaped, or other configurations are also contemplated. Electrodes  134  may be shaped complementary to first face  133   a  of tongue  132  or differently therefrom. Electrodes  134  may protrude beyond the outer dimensions of tongue  132 , e.g., in the facing direction of first face  133   a , may extend to the outer dimensions of tongue  132 , e.g., in the facing direction of first face  133   a , or may be recessed within the outer dimensions of tongue  132 . The electrodes  134  may be similar to one another or different from one another, e.g., defining different lengths, heights, etc. 
     Referring again to  FIGS. 2 and 3 , insulating layer  136  is formed from an electrically and thermally insulating material and, as noted above, is disposed on second face  133   b  of tongue  132 , on the opposite side of tongue  132  as compared to electrodes  134 . In this manner, insulating layer  136  inhibits the conduction of thermal and electrical energy outwardly from second face  133   b  of tongue  132 . Insulating layer  136  may be coated, adhered, overmolded, or otherwise disposed on second face  133   b  of tongue  132   
     With reference to  FIG. 4 , in use, with end effector assembly  130  disposed in the retracted position, elongated body  120  is inserted into the vertebral body “V” to a position adjacent a basivertebral nerve “BVN,” e.g., adjacent the cancellous bone containing the basivertebral nerve “BVN.” Elongated body  120  may penetrate the vertebral body “V” itself or may be utilized in conjunction with introducer  200  ( FIG. 1 ) to facilitate positioning distal tip  124  of elongated body  120  within the vertebral body “V” and adjacent the basivertebral nerve “BVN,” anteriorly thereof. Once this position has been achieved, end effector assembly  130  is moved to the deployed position such that tongue  132  is positioned anteriorly of and extends at least partially about the basivertebral nerve “BVN” with first face  133   a  thereof (and, thus, electrodes  134 ) facing posteriorly and towards the basivertebral nerve “BVN,” while second face  133   b  of tongue faces anteriorly and away from the basivertebral nerve “BVN.” 
     The curved configuration of tongue  132  along at least a portion of its length enables tongue  132  to partially circumferentially surround the basivertebral nerve “BVN.” In this manner, with end effector assembly  130  disposed in the deployed position, electrodes  134  are substantially oriented radially inwardly towards the basivertebral nerve “BVN.” Once this position has been achieved, electrodes  134  and/or tongue  132  may be energized in any suitable arrangement, pattern, etc., to conduct energy therebetween and through the cancellous bone containing the basivertebral nerve “BVN” to heat and thereby treat, e.g., ablate, the basivertebral nerve “BVN.” In aspects, the basivertebral nerve “BVN” is treated to achieve at least partial denervation, e.g., by ablating at least some of the nerve fibers associated with the basivertebral nerve “BVN.” As the basivertebral nerve “BVN” is heated and, thus, treated, insulating layer  136  protects surrounding tissue structures by confining the thermal and electrical energy from end effector assembly  130  to the posterior direction, e.g., towards the basivertebral nerve “BVN.” 
     In aspects, end effector assembly  130  may be repositioned, e.g., by advancing or retracting elongated body  120 , rotating elongated body  120 , further deploying end effector assembly  130 , or partially retracting end effector assembly  130 , to enable further treatment of the basivertebral nerve “BVN” from a different orientation and/or position. Once treatment is complete, end effector assembly  130  may be returned to the retracted position ( FIG. 1 ) and ablation device  100  removed from the vertebral body “V.” 
     Turning to  FIG. 5 , in conjunction with  FIG. 2 , user interface  150  of handle  110  of ablation device  100  is shown. User interface  150  enables control of end effector assembly  130 , e.g., deployment, setting adjustment, and/or activation of end effector assembly  130 . User interface  150  includes a pair of sliders  152  and a plurality of buttons  154 , although alternative or additional user interface components are also contemplated such as, for example, rocker switches, dials, touch-screen graphical user interfaces (GUI), etc. One or both of sliders  152  may be selectively slidable to deploy and retract end effector assembly  130 , e.g., wherein distal sliding deploys end effector assembly  130  while proximal sliding retracts end effector assembly  130 . In aspects, sliders  152  are associated with an underlying safety switch (not shown) that inhibits activation when end effector assembly  130  is disposed in the retracted position. 
     The buttons  154  may include multi-click buttons wherein the user depresses a button  154  one or more times to make a desired selection; multi-stage buttons (continuous or step-wise) wherein the user depresses a button  154  to a position corresponding to the desired selection; ON-OFF buttons wherein the user depresses and holds a button  154  to maintain an ON condition; and/or other suitable buttons. One or more of buttons  154  may be configured to enable mode selection between various modes of operation. The modes of operation may include, for example: a first mode wherein energy is conducted between the electrodes  134  and tongue  132 ; a second mode wherein energy is conducted between the electrodes  134  themselves (and/or tongue  132 ); and/or one or more third modes of operation wherein energy is conducted between select electrodes  134  and other electrodes and/or tongue  132 . One or more of the buttons  154  may alternatively or additionally be configured, for example, to enable selection of an energy intensity, e.g., LOW power or HIGH power; an energy duration setting, e.g., 1 minute, 2 minutes, or 5 minutes; or an energy profile, e.g., continuous, pulsed, etc. One of the buttons  154  is configured as an activation button, e.g., to initiate and terminate the supply of energy to end effector assembly  130 . The mode of operation, energy intensity, energy profile, and/or energy duration may be selected, for example, based on the needs of the procedure, patient anatomy, placement of the end effector assembly  130 , etc. Pre-set programs including select modes and energy settings are also contemplated and may likewise be activated by one or more of buttons  154 . 
     Regardless of the particular configuration of user interface  150 , user interface  150  communicates with generator  300  ( FIG. 1 ), e.g., via one or more lead wires (not shown) extending through cable  160  ( FIG. 1 ) to enable selective activation of end effector assembly  130  and implementation of the selected activation settings. 
     With reference to  FIG. 6 , in conjunction with  FIGS. 1 and 2 , generator  300  includes a display  310 , a plurality of user interface features  320 , e.g., buttons, touch-screen GUIs, switches, etc., and one or more plug ports  330 . Display  310  is configured to display operating parameters, settings, alerts, and/or other information associated with use of ablation device  100 . User interface features  320  enable control of end effector assembly  130 , e.g., deployment, setting adjustment, and/or activation of end effector assembly  130 , in addition to or as an alternative to user interface  150  of ablation device  100 . One of the plug ports  330  is configured to receive a plug (not shown) associated with cable  160  to enable electrical coupling of ablation device  100  with generator  300 . Where additional plug ports  330  are provided, such plug ports  330  may enable connection of auxiliary device(s) and/or other energy-based device(s) to generator  300 . 
     Generator  300  is configured to produce electrosurgical energy, e.g., RF monopolar or bipolar energy, for output to end effector assembly  130  of ablation device  100  for treating, e.g., ablating tissue therewith. Generator  300  may further include feedback circuitry configured to monitor voltage, current, impedance, temperature, etc., and to control energy output based thereon to implement the selected activation settings. 
     Referring to  FIG. 7 , ablation device  100  is shown in a deployed position including another end effector assembly  730  in accordance with the present disclosure. Except as explicitly contradicted below, the features of ablation device  100  detailed above with respect to end effector assembly  130  ( FIGS. 2-4 ) are equally applicable for use with end effector assembly  730  and, thus, may not be repeated hereinbelow for purposes of brevity. 
     End effector assembly  730  is selectively deployable relative to elongated body  120  from a retracted position ( FIG. 1 ), wherein end effector assembly  730  is substantially disposed within elongated body  120 , to a deployed position ( FIG. 7 ), wherein end effector assembly  730  extends distally from elongated body  120 . End effector assembly  730  may be deployed and retracted via a slider  152  of user interface  150  ( FIGS. 1 and 5 ), or any other suitable deployment mechanism. End effector assembly  730  includes a base electrode, e.g., shaft  732 , and a plurality of electrode tines  734  extending from or extendable from shaft  732 . 
     Shaft  732  may define a circular cross-sectional configuration, a polygonal cross-sectional configuration, or any other suitable cross-sectional configuration and may be resiliently flexible to enable flexion of shaft  732  between a curved configuration, wherein shaft  732  defines a curvature along at least a portion of a longitudinal length thereof, and a linear configuration, wherein shaft  732  extends substantially linearly along the longitudinal length thereof. The linear configuration of shaft  732  may correspond to the retracted position of end effector assembly  730 . In the deployed position of end effector assembly  730 , with elongated body  120  no longer constraining shaft  732 , shaft  732  is permitted to move, e.g., under resilient bias, towards the curved configuration. In the curved configuration, electrode tines  734  extend from or are extendable from the inside portion of the curve defined along the length of shaft  732 . Shaft  732  (or a portion thereof) may be formed from nitinol or other suitable shape memory material to enable flexion thereof between the linear and curved configurations. 
     Shaft  732  (or a portion thereof) is formed from an electrically-conductive material adapted to connect to generator  300  (e.g., via a lead wire (not shown) extending from end effector assembly  730  through elongated body  120 , handle  110 , and cable  160  to generator  300  (see  FIG. 1 )). In this manner, shaft  732  may function as a return electrode in a monopolar RF circuit while electrode tines  734  function as the active electrodes, as detailed below. 
     Electrode tines  734 , as noted above, may extend from or may be extendable from shaft  732 . That is, the fixed ends of electrode tines  734  may be fixed relative to shaft  732  with electrode tines  734  extending therefrom to the free ends thereof. In such configurations, electrode tines  734  are resiliently flexible to enable electrode tines  734  to be collapsed inwardly towards shaft  732  in the retracted position of end effector assembly  730  and to resiliently return to extend outwardly from shaft  732  in the deployed position of end effector assembly  730 . Alternatively, electrode tines  734  may be selectively extendable through tine ports defined within shaft  732 . More specifically, the fixed ends of electrode tines  734  may be coupled to a drive structure (not shown) associated within one of the sliders  152  of user interface  150  (see  FIG. 1 ) such that electrode tines  734  may be selectively deployed from shaft  732 , together with the deployment of end effector assembly  730  from elongated body  120  or independently thereof. Any suitable number of electrode tines  734  may be provided. 
     Electrode tines  734  are spaced-apart from one another along at least a portion of a length of shaft  732  and are disposed on the same side of shaft  732 , e.g., the inside portion thereof. Electrode tines  734  may include tissue-penetrating free ends to facilitate penetration of electrode tines  734  through tissue. Electrode tines  734  may define arcuate, angled, or other suitable configurations. In aspects where electrode tines  734  are arcuate, each electrode tine  734  may be curved in a similar direction, although other configurations are also contemplated. In aspects, electrode tines  734  are curved in a similar direction as shaft  732  in the curved configuration thereof. 
     Electrode tines  734  are formed from an electrically-conductive material adapted to connect to generator  300  (e.g., via lead wires (not shown) extending from end effector assembly  730  through elongated body  120 , handle  110 , and cable  160  to generator  300 ) (see  FIG. 1 ). Electrode tines  734  may be collectively connected to generator  300  ( FIG. 1 ) (e.g., via a common lead wire) such that electrode tines  734  are energizable together, may be independently connected to generator  300  ( FIG. 1 ) (e.g., via separate lead wires) such that electrode tines  734  are independently energizable, or may be connected to generator  300  ( FIG. 1 ) in one or more groups (e.g., via one or more group lead wires) such that electrode tines  734  in a group are energizable together while different groups of electrode tines  734  may be energized independently. Electrode tines  734  are electrically-insulated from shaft  732 , e.g., via suitable insulation (not shown). 
     In aspects, one or more electrode tines  734  may function as the active electrode(s) in a monopolar RF circuit while shaft  732  functions as the return electrode in the monopolar circuit. Thus, energy may be conducted between the electrode tine(s)  734  (charged to a first potential, e.g., a positive “+” potential) and shaft  732  (charged to a second, different potential, e.g., a negative “−” potential) and through tissue to treat, e.g., ablate tissue. Alternatively, one or more electrode tines  734  (and/or shaft  732 ) may be charged to the first potential while one or more other electrode tines  734  (and/or shaft  732 ) is charged to the second potential (or a third potential) to establish a bipolar RF circuit wherein energy may be conducted between the electrode tines  734  (and/or shaft  732 ) and the other electrode tines  734  (and/or shaft  732 ) and through tissue to treat, e.g., ablate tissue. Further still, multipolar configurations are also contemplated such as, for example, a three-phase RF circuit wherein at least three potentials are utilized between the electrode tines  734  and/or shaft  732  to enable conduction of energy between any two electrode tines  734  energized to different potentials and/or between shaft  732  and any electrode tines  734  energized to a different potential from shaft  732  and through tissue to treat, e.g., ablate tissue. In aspects, some electrode tines  734  and/or shaft  732  may be turned “OFF” in some modes of operation, and/or may be energized sequentially, in alternating fashion, or according to any other suitable pattern. 
     In aspects, end effector assembly  730  further includes one or more cooling lumens  736  extending through shaft  732  and coupled to a fluid source  800  (including a pump) to enable circulation of cooling fluid through shaft  732  via cooling lumen(s)  736 . The one or more cooling lumens  736  may be positioned on the inside portion of shaft  732  (in the curved configuration thereof), the outside portion thereof, on both the inside and outside portions, and/or may be centrally located. 
     With additional reference to  FIG. 8 , in use, with end effector assembly  730  disposed in the retracted position, elongated body  120  is inserted into the vertebral body “V” to a position adjacent a basivertebral nerve “BVN,” e.g., adjacent the cancellous bone containing the basivertebral nerve “BVN.” Elongated body  120  may penetrate the vertebral body “V” itself or may be utilized in conjunction with introducer  200  ( FIG. 1 ) to facilitate positioning distal tip  124  of elongated body  120  within the vertebral body “V” and adjacent the basivertebral nerve “BVN,” anteriorly thereof. Once this position has been achieved, end effector assembly  730  is moved to the deployed position such that shaft  732  is positioned anteriorly of and extends at least partially about the basivertebral nerve “BVN” with the inside portion thereof facing posteriorly and towards the basivertebral nerve “BVN.” 
     If not already done so, electrode tines  734  are then extended from shaft  732  in a posterior direction, e.g., from the inside portion of shaft  732 , such that the free ends of electrode tines  734  extend into the basivertebral nerve “BVN.” Thereafter, electrode tines  734  and/or shaft  732  may be energized in any suitable arrangement, pattern, etc., to conduct energy therebetween and through the cancellous bone containing the basivertebral nerve “BVN” to heat and thereby treat, e.g., ablate, the basivertebral nerve “BVN.” In aspects, the basivertebral nerve “BVN” is treated to achieve at least partial denervation, e.g., by ablating at least some of the nerve fibers associated with the basivertebral nerve “BVN.” Cooling, e.g., via circulating cooling fluid through shaft  732 , may be initiated automatically upon energy activation, intermittently during energy activation, independently (user-controlled), or in any other suitable manner. As the basivertebral nerve “BVN” is heated, the cooling of shaft  732  protects surrounding tissue structures by confining the thermal and electrical energy from end effector assembly  730  to the posterior direction, e.g., towards the basivertebral nerve “BVN.” In aspects, the cooling fluid circulates on the inside portion (posterior side) of shaft  732  to facilitate energy conduction in the posterior direction, although other configurations are also contemplated. 
     As an alternative to cooling via circulation of cooling fluid, other cooling mechanisms may be employed such as, for example, passive coolers (heat sinks, heat pipes, fins, etc.) or active coolers (Peltier (thermoelectric) coolers, etc.). 
     In aspects, end effector assembly  730  and, more specifically, electrode tines  734  thereof, may be repositioned for subsequent treatment of the basivertebral nerve “BVN” from a different position and/or orientation. Once treatment is complete, end effector assembly  130  may be returned to the retracted position ( FIG. 1 ) and ablation device  100  removed from the vertebral body “V.” 
     Turning to  FIG. 9 , a robotic surgical system  1000  configured for use in accordance with the present disclosure is shown. Aspects and features of robotic surgical system  1000  not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail. 
     Robotic surgical system  1000  generally includes a plurality of robot arms  1002 ,  1003 ; a control device  1004 ; and an operating console  1005  coupled with control device  1004 . Operating console  1005  may include a display device  1006 , which may be set up in particular to display three-dimensional images; and manual input devices  1007 ,  1008 , by means of which a person, e.g., a surgeon, may be able to telemanipulate robot arms  1002 ,  1003  in a first operating mode. Robotic surgical system  1000  may be configured for use on a patient  1013  lying on a patient table  1012  to be treated in a minimally invasive manner. Robotic surgical system  1000  may further include a database  1014 , in particular coupled to control device  1004 , in which are stored, for example, pre-operative data from patient  1013  and/or anatomical atlases. 
     Each of the robot arms  1002 ,  1003  may include a plurality of members, which are connected through joints, and a mounted device which may be, for example, a surgical tool “ST.” The surgical tools “ST” may include, for example, any of the ablation devices of the present disclosure, the introducer of the present disclosure, an endoscope or other visualization device, etc. More specifically, with respect to the ablation devices detailed herein, the user-activation and actuation components are replaced with robotic inputs to enable a robot to provide the desired activation(s) and actuation(s) similarly as detailed above. That is, in robotic implementations, the ablation devices function similarly according to any of the aspects above except that the ablation devices are directly manipulated, activated, and/or actuated by a robot arm  1002 ,  1003  rather than a human surgeon. 
     Robot arms  1002 ,  1003  may be driven by electric drives, e.g., motors, connected to control device  1004 . The motors, for example, may be rotational drive motors configured to provide rotational inputs to accomplish a desired task or tasks. Control device  1004 , e.g., a computer, may be configured to activate the motors, in particular by means of a computer program, in such a way that robot arms  1002 ,  1003 , and, thus, their mounted surgical tools “ST” execute a desired movement and/or function according to a corresponding input from manual input devices  1007 ,  1008 , respectively. Control device  1004  may also be configured in such a way that it regulates the movement of robot arms  1002 ,  1003  and/or of the motors. 
     Control device  1004 , more specifically, may control one or more of the motors based on rotation, e.g., controlling to rotational position using a rotational position encoder (or Hall effect sensors or other suitable rotational position detectors) associated with the motor to determine a degree of rotation output from the motor and, thus, the degree of rotational input provided. Alternatively or additionally, control device  1004  may control one or more of the motors based on torque, current, or in any other suitable manner. 
     It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques). 
     While several configurations of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular configurations. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.