JP2012504432A - 椎骨骨折の治療に使用するシステム - Google Patents
椎骨骨折の治療に使用するシステム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1604—Chisels; Rongeurs; Punches; Stamps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1642—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for producing a curved bore
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8816—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the conduit, e.g. tube, along which fluid flows into the body or by conduit connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8819—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer proximal part, e.g. cannula handle, or by parts which are inserted inside each other, e.g. stylet and cannula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00982—General structural features
- A61B2017/00986—Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
Abstract
Description
Claims (48)
- 椎体を治療するための医療デバイスであって、
作動部を有するハンドルと、
第2のスリーブ内で同心円状に位置する第1のスリーブと、該第2のスリーブの周囲で同心円状に位置する第3のスリーブとを備える、シャフトであって、線形構成と関節構成との間を移動することが可能な作業端を備える遠位部を有する、シャフトであって、該関節構成は、単一面に限定され、各スリーブは、該関節構成に該作業端の偏向を限定するように、一連のスロットまたは切り込みを備え、該それぞれの一連のスロットまたは切り込みは、隣接するスリーブ内で半径方向にオフセットされる、シャフトと、
該作業端の遠位端に位置する鋭い先端であって、該椎体内の骨を貫通するように適合される、鋭い先端と
を備える、医療デバイス。 - 前記第1のスリーブは、前記第1および前記第2のスリーブの相対的軸方向運動が、前記作業端に前記関節構成を帯びさせるように、前記作業端で前記第2のスリーブに取り付けられる、請求項1に記載の医療デバイス。
- 前記第2のスリーブは、前記作業端で前記第3のスリーブに取り付けられる、請求項1に記載の医療デバイス。
- 閾値力に達すると、前記作動部が前記第1のスリーブを係脱するように、前記作動部と前記第1のスリーブとの間で結合される力制限アセンブリをさらに備える、請求項1に記載の医療デバイス。
- 前記力制限機構は、前記第1の構成から前記第2の構成に向かって前記作業端を移動させるときに、骨に適用される力を制限するように適合される、請求項4に記載の医療デバイス。
- 前記第1のスリーブを通って延在する、少なくとも1つのバネ要素をさらに備え、前記バネ要素は、前記シャフトに取り付けられ、前記作業端に弛緩状態で前記線形構成を帯びさせる、請求項1に記載の医療デバイス。
- 前記少なくとも1つのバネ要素は、複数のバネ要素を備える、請求項6に記載の医療デバイス。
- 前記第2の構成は、複数の関節構成を備える、請求項1に記載の医療デバイス。
- 前記第3のスリーブは、前記ハンドル機構によって発生するトルクまたは回転力を制限するように、道具の中間部で終端する、請求項1に記載の医療デバイス。
- 前記第3のスリーブは、前記ハンドル部まで延在する、請求項1に記載の医療デバイス。
- 前記第3のスリーブ上の前記スロットまたは切り込みは、湾曲構成の内面が固体であるように、前記湾曲構成の方向から外側に向く前記第3のスリーブの外面上に位置する、請求項1に記載の医療デバイス。
- 前記第1のスリーブは、前記ハンドルの前記作動部の回転が、前記第1のスリーブの軸方向運動を引き起こして、前記作業端を前記関節構成に変形させるように、前記ハンドルの前記作動部に連結される、請求項1に記載の医療デバイス。
- 前記ハンドルは、衝撃力を受容するよう構成され、骨に対する前記鋭い先端の抵抗は、前記作業端に前記湾曲構成を帯びさせる、請求項1に記載の医療デバイス。
- 前記シャフトおよび前記作業端を通って延在する管腔をさらに備える、請求項1に記載の医療デバイス。
- 前記鋭い先端は、固体であり、前記管腔は、前記鋭い先端の近位で終端される、請求項14に記載の医療デバイス。
- 管腔に流動的に連結される骨セメント材料の供給源をさらに備え、前記骨セメント材料は、前記管腔を通過して前記作業端で退出することができる、請求項14に記載の医療デバイス。
- 前記管腔は、骨セメント材料が前記遠位端の近位で退出するように、前記シャフトの壁の側面開口内で終端する、請求項16に記載の医療デバイス。
- 前記管腔は、潤滑性ポリマー材料を含む表面を含む、請求項14に記載の医療デバイス。
- 前記ポリマー材料は、TEFLON(登録商標)、ポリテトラフルロエチレン(PTFE)、FEP(フッ素化エチレンプロピレン)、ポリエチレン、ポリアミド、ECTFE(エチレンクロロトリフルオロエチレン)、ETFE、PVDF、ポリ塩化ビニル、およびシリコーンのうちの少なくとも1つである、請求項18に記載の医療デバイス。
- 前記第1のスリーブ上の少なくとも前記一連のスロットまたは切り込みは、均一な幅を有する、請求項1に記載の医療デバイス。
- 前記第2のスリーブ上の少なくとも前記一連のスロットまたは切り込みは、均一な幅を有する、請求項1に記載の医療デバイス。
- 前記第3のスリーブ上の少なくとも前記一連のスロットまたは切り込みは、均一な幅を有する、請求項1に記載の医療デバイス。
- 前記第1のスリーブ上の前記一連のスロットまたは切り込みは、幅が変化する、請求項1に記載の医療デバイス。
- 前記第2のスリーブ上の前記一連のスロットまたは切り込みは、幅で変化する、請求項1に記載の医療デバイス。
- 前記第3のスリーブ上の前記一連のスロットまたは切り込みは、幅が変化する、請求項1に記載の医療デバイス。
- 前記第1、第2、および第3のスリーブは、相互に対して回転することを妨げられる、請求項1に記載の医療デバイス。
- 前記スリーブは、非円形断面形状を備える、請求項26に記載の医療デバイス。
- 前記第1、第2、または第3のスリーブのうちの少なくとも1つは、キーを備え、前記第1、第2、または第3のスリーブのうちの少なくとも1つは、キー溝を備える、請求項26に記載の医療デバイス。
- 請求項1から28のうちのいずれかに記載のデバイスと、
骨充填材料と
を備える、キット。 - 椎体を治療する方法であって、
椎骨内への貫通のために構成される鋭い先端を有する、細長い道具を提供するステップであって、前記道具は、近位端からその作業端まで延在する軸を有し、前記作業端は、少なくとも1つの第2のスリーブ内で同心円状に位置する第1のスリーブと、前記第2のスリーブの周囲で同心円状に位置付する第3のスリーブとを備え、各スリーブは、単一面内の第1の湾曲構成に前記作業端の偏向を制限するように、一連のスロットまたは切り込みを備え、前記それぞれの一連のスロットまたは切り込みは、隣接するスリーブ内で半径方向にオフセットされる、ステップと、
椎骨を通して前記作業端を前進させるステップと、
軸方向に、前記第2のスリーブに対して前記第1のスリーブを平行移動させることによって、前記作業端を線形構成から湾曲構成に移動させるステップと、
その中に空洞を作成するために、前記骨内で前記湾曲構成の前記作業端を移動させるステップと
を含む、方法。 - 前記第2のスリーブに対して前記第1のスリーブを移動させるステップは、前記軸方向に平行移動させるように、前記第1のスリーブおよび前記第2のスリーブを相互に対して相対的に回転させるステップを含む、請求項30に記載の方法。
- 前記作業端を前記線形構成から前記湾曲構成に移動させるステップは、前記作業端を、複数の湾曲構成を通して移動させるステップを含む、請求項30に記載の方法。
- 前記作業端を線形構成から前記湾曲構成に移動させるステップは、前記作業端を前記線形構成から前記湾曲構成に移動させるように、ハンドル機構を作動させるステップを含む、請求項30に記載の方法。
- 前記第3のスリーブは、前記ハンドル機構によって発生するトルクまたは回転力を制限するように、前記道具の中間部で終端する、請求項33に記載の方法。
- 前記ハンドル機構の作動は、前記第3のスリーブにトルクを与えることなく、前記第1の湾曲構成への前記作業端の移動を引き起こす、請求項33に記載の方法。
- 前記作業端は、前記線形構成を帯びるようにバネ付勢される、請求項30に記載の方法。
- 前記作業端を前記線形構成から前記湾曲構成に移動させるステップは、前記細長い道具に駆動力を適用するステップを含み、前記骨内の貫通は、前記作業端を前記線形構成から前記湾曲構成に移動させる、請求項30に記載の方法。
- 前記第3のスリーブ上の前記スロットまたは切り込みは、前記湾曲構成の内面が固体であるように、前記湾曲構成の方向から外側に向く前記第3のスリーブの外面上に位置する、請求項30に記載の方法。
- 前記作業端を前記線形構成から前記湾曲構成に移動させるステップは、骨に適用される力の量を制限するように、力制限構造を前記道具内に提供することによって、前記作業端によって骨に適用される力の量を制限するステップを含む、請求項30に記載の方法。
- 捻転力を前記道具の一部分に適用するステップをさらに含み、前記力制限構造は、捻転力の量を7.5in*lbs未満に制限する、請求項30に記載の方法。
- 椎骨を通して前記作業端を前進させるステップは、海綿骨を通して前記作業端を前進させるステップを含む、請求項30に記載の方法。
- 椎骨を通して前記作業端を前進させるステップは、皮質骨を通して前記作業端を前進させるステップを含む、請求項30に記載の方法。
- 前記作業端を前記線形構成から前記湾曲構成に移動させるステップは、前記鋭い先端における前記骨の抵抗を可能にして、前記作業端を線形構成から前記湾曲構成に移動させるように、前記道具に衝撃力を適用するステップを含む、請求項30に記載の方法。
- 前記衝撃力を適用し続けることによって、前記湾曲構成に曲率を増加させるステップをさらに含む、請求項43に記載の方法。
- 前記作業端が、カニューレの中にある間に前記線形構成のままであり、前記カニューレの外へ前進させられた後に、前記湾曲構成に移動するように、前記カニューレを通して前記道具を挿入するステップをさらに含む、請求項30に記載の方法。
- 骨充填材料を前記空洞内に導入するステップをさらに含む、請求項30に記載の方法。
- 前記骨充填材料を導入するステップは、前記道具を通して前記骨充填材料を注射するステップを含む、請求項46に記載の方法。
- 前記骨充填材料を導入するステップは、前記道具を除去し、カニューレを通して前記骨充填材料を注射するステップを含む、請求項46に記載の方法。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US19476608P | 2008-09-30 | 2008-09-30 | |
US61/194,766 | 2008-09-30 | ||
US10438008P | 2008-10-10 | 2008-10-10 | |
US61/104,380 | 2008-10-10 | ||
PCT/US2009/059113 WO2010039894A1 (en) | 2008-09-30 | 2009-09-30 | System for use in treatment of vertebral fractures |
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JP2014007042A Division JP6118276B2 (ja) | 2008-09-30 | 2014-01-17 | 椎骨骨折の治療に使用するシステム |
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JP2012504432A true JP2012504432A (ja) | 2012-02-23 |
JP2012504432A5 JP2012504432A5 (ja) | 2014-03-06 |
JP5575777B2 JP5575777B2 (ja) | 2014-08-20 |
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JP2011529386A Active JP5575777B2 (ja) | 2008-09-30 | 2009-09-30 | 椎骨骨折の治療に使用するシステム |
JP2014007042A Active JP6118276B2 (ja) | 2008-09-30 | 2014-01-17 | 椎骨骨折の治療に使用するシステム |
JP2016235597A Active JP6466389B2 (ja) | 2008-09-30 | 2016-12-05 | 椎骨骨折の治療に使用するシステム |
JP2018219159A Pending JP2019022844A (ja) | 2008-09-30 | 2018-11-22 | 椎骨骨折の治療に使用するシステム |
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JP2014007042A Active JP6118276B2 (ja) | 2008-09-30 | 2014-01-17 | 椎骨骨折の治療に使用するシステム |
JP2016235597A Active JP6466389B2 (ja) | 2008-09-30 | 2016-12-05 | 椎骨骨折の治療に使用するシステム |
JP2018219159A Pending JP2019022844A (ja) | 2008-09-30 | 2018-11-22 | 椎骨骨折の治療に使用するシステム |
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US (5) | US8663226B2 (ja) |
EP (1) | EP2364128A4 (ja) |
JP (4) | JP5575777B2 (ja) |
WO (1) | WO2010039894A1 (ja) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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JP2014508576A (ja) * | 2011-01-24 | 2014-04-10 | クラリアンス | 椎体内に湾曲した骨の通路を形成するためのドリル装置 |
JP2015515337A (ja) * | 2012-04-17 | 2015-05-28 | インディアン ウェルズ メディカル インコーポレイテッドIndian Wells Medical,Inc. | 操縦可能なルーメンパンチ |
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JP2015231527A (ja) * | 2014-06-10 | 2015-12-24 | メドス・インターナショナル・エスエイアールエルMedos International SARL | 可変限界設定を用いた逆方向切削器具 |
US11284907B2 (en) | 2014-06-10 | 2022-03-29 | Medos International Sarl | Retro-cutting instrument with adjustable limit setting |
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JP2020508710A (ja) * | 2017-02-28 | 2020-03-26 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | 関節運動する針 |
JP7252894B2 (ja) | 2017-02-28 | 2023-04-05 | ボストン サイエンティフィック サイムド,インコーポレイテッド | 関節運動する針 |
JP7465585B2 (ja) | 2020-09-29 | 2024-04-11 | ディープキュア インコーポレイテッド | 体内の神経を遮断又は調節するための電極装置 |
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JP6118276B2 (ja) | 2017-04-19 |
US20150313614A1 (en) | 2015-11-05 |
US9113974B2 (en) | 2015-08-25 |
JP2014064954A (ja) | 2014-04-17 |
EP2364128A4 (en) | 2013-07-24 |
JP2017074397A (ja) | 2017-04-20 |
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WO2010039894A1 (en) | 2010-04-08 |
US20100082033A1 (en) | 2010-04-01 |
US20140135779A1 (en) | 2014-05-15 |
JP6466389B2 (ja) | 2019-02-06 |
US20170128112A1 (en) | 2017-05-11 |
EP2364128A1 (en) | 2011-09-14 |
US10245092B2 (en) | 2019-04-02 |
JP5575777B2 (ja) | 2014-08-20 |
JP2019022844A (ja) | 2019-02-14 |
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