Methods For Off-Axis Treatment Of A Vertebral Body

A method of manipulating tissue with a system including an access cannula, a steerable assembly comprising a steerable instrument, a control surface coupled to the steering instrument, and a deformable conduit, the method comprising the steps of:

• providing the steerable instrument with a deflectable portion of the steerable instrument removably disposed within a distal portion of the deformable conduit;
• positioning a distal end of the access cannula within cortical bone to provide access to cancellous bone disposed therein;
• directing the deflectable portion of the steering instrument and the distal portion of the deformable conduit to within the access cannula along a longitudinal axis;
• manipulating the control surface with the deflectable portion positioned within the access cannula, wherein the access cannula prevents deflection of the steerable assembly and causes a control element of the steerable instrument to be tensioned;
• and
• advancing the steerable assembly relative to the access cannula, wherein the tension on the control element causes lateral deflection of the deflectable portion of the steering instrument and the distal portion of the deformable conduit to assume a curved configuration within the cancellous bone that is off-axis from the longitudinal axis of the access cannula.

A method of manipulating tissue with a system including an access cannula, a steerable assembly comprising a steerable instrument, a control surface coupled to the steering instrument, a deformable conduit, and a locking mechanism, the method comprising the steps of:

• providing the steerable instrument with a deflectable portion of the steerable instrument removably disposed within a distal portion of the deformable conduit;
• positioning a distal end of the access cannula within cortical bone to provide access to cancellous bone disposed therein;
• directing the deflectable portion of the steering instrument and a distal portion of the deformable conduit to within the access cannula along a longitudinal axis;
• manipulating the control surface with the deflectable portion positioned within the access cannula until engagement of a locking mechanism retains potential energy within the steerable instrument;
• and
• advancing the steerable assembly relative to the access cannula with the locking mechanism engaged such that release of potential energy causes lateral deflection of the deflectable portion of the steering instrument and the distal portion of the deformable conduit to assume a curved configuration within the cancellous bone that is off-axis from the longitudinal axis of the access cannula.