US20030032963A1 - Devices and methods using an expandable body with internal restraint for compressing cancellous bone - Google Patents

Devices and methods using an expandable body with internal restraint for compressing cancellous bone Download PDF

Info

Publication number
US20030032963A1
US20030032963A1 US10044843 US4484302A US2003032963A1 US 20030032963 A1 US20030032963 A1 US 20030032963A1 US 10044843 US10044843 US 10044843 US 4484302 A US4484302 A US 4484302A US 2003032963 A1 US2003032963 A1 US 2003032963A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
balloon
bone
body
fig
cancellous
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10044843
Inventor
Paul Reiss
Cesar Ico
Karen Talmadge
Mark Reiley
Arie Scholten
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Orthophoenix LLC
Original Assignee
Medtronic Spine LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/0233Pointed or sharp biopsy instruments
    • A61B10/025Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7097Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7233Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7258Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7275Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with expanding cylindrical parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/885Tools for expanding or compacting bones or discs or cavities therein
    • A61B17/8852Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc
    • A61B17/8855Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc inflatable, e.g. kyphoplasty balloons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90Identification means for patients or instruments, e.g. tags
    • A61B90/94Identification means for patients or instruments, e.g. tags coded with symbols, e.g. text
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/441Joints for the spine, e.g. vertebrae, spinal discs made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4601Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1002Balloon catheters characterised by balloon shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1006Balloons formed between concentric tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1009Balloons anchored to a disc or plate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02Dilators made of swellable material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802Equipment for handling bone cement or other fluid fillers
    • A61B17/8805Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/0233Pointed or sharp biopsy instruments
    • A61B10/025Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
    • A61B2010/0258Marrow samples
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00539Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • A61B2017/0256Joint distractors for the spine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B2050/005Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover
    • A61B2050/0065Peelable cover
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/30Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments
    • A61B2050/3015Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments transparent
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/30Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments
    • A61B50/33Trays
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2/2846Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3601Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/389Tibial components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2817Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2825Femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2825Femur
    • A61F2002/2828Femoral head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2825Femur
    • A61F2002/2832Femoral neck
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2835Bone graft implants for filling a bony defect or an endoprosthesis cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2853Humerus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2871Radius
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2892Tibia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30113Rounded shapes, e.g. with rounded corners circular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30113Rounded shapes, e.g. with rounded corners circular
    • A61F2002/30115Rounded shapes, e.g. with rounded corners circular circular-O-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30125Rounded shapes, e.g. with rounded corners elliptical or oval
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30131Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30133Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/302Three-dimensional shapes toroidal, e.g. rings
    • A61F2002/30204Three-dimensional shapes toroidal, e.g. rings toric
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30224Three-dimensional shapes cylindrical
    • A61F2002/30225Flat cylinders, i.e. discs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30224Three-dimensional shapes cylindrical
    • A61F2002/30228Cylinders of elliptical or oval basis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30242Three-dimensional shapes spherical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30242Three-dimensional shapes spherical
    • A61F2002/30245Partial spheres
    • A61F2002/30247Hemispheres or half-spheres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30252Three-dimensional shapes quadric-shaped
    • A61F2002/30253Three-dimensional shapes quadric-shaped ellipsoidal or ovoid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30285Three-dimensional shapes rugby-ball-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30288Three-dimensional shapes bottle-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30308Three-dimensional shapes banana-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30311Three-dimensional shapes doughnut-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30313Three-dimensional shapes pear-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30462Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30462Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable
    • A61F2002/30464Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable using bands, belts or straps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30581Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30581Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid
    • A61F2002/30586Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid having two or more inflatable pockets or chambers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30599Special structural features of bone or joint prostheses not otherwise provided for stackable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30682Means for preventing migration of particles released by the joint, e.g. wear debris or cement particles
    • A61F2002/30686Devices for removing particulate debris from prosthetic joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30907Nets or sleeves applied to surface of prostheses or in cement
    • A61F2002/30909Nets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3609Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611Heads or epiphyseal parts of femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3609Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625Necks
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4059Humeral shafts
    • A61F2002/4062Proximal or metaphyseal parts of shafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4212Tarsal bones
    • A61F2002/4215Lateral row of tarsal bones
    • A61F2002/4217Calcaneum or calcaneus or heel bone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4601Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
    • A61F2002/4602Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity for compacting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4627Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4635Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4635Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
    • A61F2002/4636Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery through the hip femoral neck
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4685Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by means of vacuum
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0075Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0006Rounded shapes, e.g. with rounded corners circular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0008Rounded shapes, e.g. with rounded corners elliptical or oval
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0013Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0015Kidney-shaped, e.g. bean-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0065Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0069Three-dimensional shapes cylindrical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0071Three-dimensional shapes spherical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0073Quadric-shaped
    • A61F2230/0076Quadric-shaped ellipsoidal or ovoid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063Nested prosthetic parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures
    • A61F2310/00293Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00353Bone cement, e.g. polymethylmethacrylate or PMMA
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389The prosthesis being coated or covered with a particular material
    • A61F2310/0097Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1059Balloon catheters with special features or adapted for special applications having different inflatable sections mainly depending on the response to the inflation pressure, e.g. due to different material properties
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1072Balloon catheters with special features or adapted for special applications having balloons with two or more compartments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00Anatomical parts of the body
    • A61M2210/02Bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00Anatomical parts of the body
    • A61M2210/10Trunk
    • A61M2210/1003Spinal column
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1011Multiple balloon catheters

Abstract

Devices and methods compress cancellous bone. In one arrangement, the devices and methods make use of an expandable body that includes an internal restraint coupled to the body. The internal restraint directs expansion of the body. In one arrangement, a method for treating bone inserts the device having the internal restraint inside bone and causes directed expansion of the body in cancellous bone. Cancellous bone is compacted by the directed expansion.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • [0001]
    This application claims the benefit of application Attorney Docket No. 1759.2570-CIP6 (Express Mail No. EL889147179US), filed Oct. 24, 2001, and entitled “Devices and Methods using an Expandable Body with Internal Restraint for Compressing Cancellous Bone.”
  • FIELD OF THE INVENTION
  • [0002]
    This invention relates to the treatment of bone conditions in human and other animals.
  • BACKGROUND OF THE INVENTION
  • [0003]
    When cancellous bone becomes diseased, for example, because of osteoporosis, avascular necrosis, or cancer, the surrounding cortical bone becomes more prone to compression fracture or collapse. This is at least in part because the cancellous bone no longer provides interior support for the surrounding cortical bone. The bone disease may also affect the strength and integrity of the surrounding cortical bone, further disposing the bone to fracture and/or collapse.
  • [0004]
    There are 2 million fractures each year in the United States, of which about 1.3 million are caused by osteoporosis alone. There are also other bone diseases involving infected bone, poorly healing bone, or bone fractured by severe trauma. Moreover, the use of various drugs, such as steroids, tobacco and/or the excessive intake of alcohol, can significantly degrade bone quality. Any of these conditions, if not successfully addressed, can result in fracture and/or collapse of bone, causing deformities, chronic complications, and an overall adverse impact upon the quality of life.
  • [0005]
    U.S. Pat. Nos. 4,969,888 and 5,108,404 disclose apparatus and methods for the fixation of fractures or other conditions of human and other animal bone systems, both osteoporotic and non-osteoporotic. Among other inventions, these patents disclose devices and methods that employ an expandable body to compress cancellous bone and/or create an interior cavity within the targeted bone. The cavity receives a filling material, which hardens and provides renewed interior structural support for cortical bone.
  • [0006]
    The better and more efficacious treatment of bone disease that these patents promise can be more fully realized with improved systems and methods for making and deploying expandable bodies in bone.
  • SUMMARY OF THE INVENTION
  • [0007]
    One aspect of the invention provides devices and methods for compressing cancellous bone. In one arrangement, the devices and methods make use of an expandable body that includes an internal restraint coupled to the body. The internal restraint directs expansion of the body. In one arrangement, a method for treating bone inserts the device having the internal restraint inside bone and causes directed expansion of the body in cancellous bone. Cancellous bone is compacted by the directed expansion.
  • [0008]
    Another aspect of the invention provides devices and methods for compacting cancellous bone. In one arrangement, the devices and methods make use of a body adapted to be inserted into bone and undergo expansion in cancellous bone to compact cancellous bone. The body includes material that, during the expansion in cancellous bone, applies a force capable of moving fractured cortical bone, and further includes an interior membrane to constrain the expansion in cancellous bone. In one arrangement, a method for treating bone inserts the device having the internal membrane inside bone and causes restrained expansion of the body in cancellous bone. Cancellous bone is compacted by the restrained expansion.
  • [0009]
    Features and advantages of the invention are set forth in the following Description and Drawings, as well as in the appended Claims.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0010]
    [0010]FIG. 1 is a perspective view of a first embodiment of a balloon constructed in accordance with the teachings of the present invention, the embodiment being in the shape of a stacked doughnut assembly;
  • [0011]
    [0011]FIG. 2 is a vertical section through the balloon of FIG. 1 showing the way in which the doughnut portions of the balloon of FIG. 1 fit into a cavity of a vertebral body;
  • [0012]
    [0012]FIG. 3 is a schematic view of another embodiment of the balloon of the present invention showing three stacked balloons and string-like restraints for limiting the expansion of the balloon in various directions of inflation;
  • [0013]
    [0013]FIG. 4 is a top plan view of a spherical balloon having a cylindrical ring surrounding the balloon;
  • [0014]
    [0014]FIG. 5 is a vertical section through the spherical balloon and ring of FIG. 4;
  • [0015]
    [0015]FIG. 6 shows an oblong-shaped balloon with a catheter extending into the central portion of the balloon;
  • [0016]
    [0016]FIG. 6A is a perspective view of one way in which a catheter can be arranged relative to the inner tubes for inflating the balloon of FIG. 6;
  • [0017]
    [0017]FIG. 7 is a suction tube and a contrast injection tube for carrying out the inflation of the balloon and removal of debris caused by expansion from the balloon itself;
  • [0018]
    [0018]FIG. 8 is a vertical section through a balloon after it has been deflated and as it is being inserted into the vertebral body of a human;
  • [0019]
    [0019]FIG. 9 and 9A are side elevational view of a cannula showing how the protective sleeve or guard member can expand when leaving the cannula;
  • [0020]
    [0020]FIG. 10 is a perspective view of another embodiment of a balloon of the present invention formed in the shape of a kidney bean;
  • [0021]
    [0021]FIG. 11 is a perspective view of the vertebral bone showing the kidney shaped balloon of FIG. 10 inserted in the bone and expanded;
  • [0022]
    [0022]FIG. 12 is a top view of a kidney shaped balloon formed of several compartments by a heating element or branding tool;
  • [0023]
    [0023]FIG. 13 is a cross-sectional view taken along line 13-13 of FIG. 12 but with two kidney shaped balloons that have been stacked;
  • [0024]
    [0024]FIG. 14 is a view similar to FIG. 11 but showing the stacked kidney shaped balloon of FIG. 13 in the vertebral bone;
  • [0025]
    [0025]FIG. 15 is a top view of a kidney balloon showing outer tufts holding inner strings in place interconnecting the top and bottom walls of the balloon;
  • [0026]
    [0026]FIG. 16 is a cross-sectional view taken along line 16-16 of FIG. 15;
  • [0027]
    [0027]FIG. 17A is a dorsal view of a humpback banana balloon in a right distal radius;
  • [0028]
    [0028]FIG. 17B is a cross-sectional view of FIG. 17A taken along line 17B-17B of FIG. 17A;
  • [0029]
    [0029]FIG. 18 is a spherical balloon with a base in a proximal humerus viewed from the front (anterior) of the left proximal humerus;
  • [0030]
    [0030]FIG. 19A is the front (anterior) view of the proximal tibia with the elliptical cylinder balloon introduced beneath the medial tibial plateau;
  • [0031]
    [0031]FIG. 19B is a three-quarter view of the balloon of FIG. 19A;
  • [0032]
    [0032]FIG. 19C is a side elevational view of the balloon of FIG. 19A;
  • [0033]
    [0033]FIG. 19D is a top plan view of the balloon of FIG. 19A;
  • [0034]
    [0034]FIG. 20 is a spherically shaped balloon for treating avascular necrosis of the head of the femur (or humerus) as seen from the front (anterior) of the left hip;
  • [0035]
    [0035]FIG. 20A is a side view of a hemispherically shaped balloon for treating avascular necrosis of the head of the femur (or humerus);
  • [0036]
    [0036]FIG. 21 is a balloon for preventing and/or treating hip fracture as seen from the anterior (front) of the left hip;
  • [0037]
    FIGS. 22A-C are schematic illustrations of a representative method and system for delivering a therapeutic substance to a bone according to the present invention; and
  • [0038]
    [0038]FIG. 23 is another embodiment of an expandable structure incorporating an internal expansion restraint;
  • [0039]
    FIGS. 24A-C are cross-sectional views of the expandable structure of FIG. 23 undergoing expansion in air;
  • [0040]
    [0040]FIG. 25A is a front view of another embodiment of an expandable structure for use in compressing cancellous bone and/or displacing cortical bone;
  • [0041]
    [0041]FIG. 25B is a side view of the structure of FIG. 25A;
  • [0042]
    [0042]FIG. 25C is a perspective view of the structure of FIG. 25A; and
  • [0043]
    [0043]FIG. 26A is side view of a cavity forming device carrying an expandable structure of the type shown in FIGS. 23 and 24A to 24C ;
  • [0044]
    [0044]FIG. 26B is a perspective view of the distal end of the cavity forming device shown in FIG. 26A, showing the assembly of the proximal end of the expandable structure to the distal end of the outer catheter body of the device;
  • [0045]
    [0045]FIG. 26C is a perspective view of the distal end of the cavity forming device shown in FIG. 26A, after the proximal and distal ends of the expandable structure have been secured, respectively, to the distal end of the outer catheter body and the distal end of the inner catheter body of the device;
  • [0046]
    [0046]FIG. 27 is another embodiment of an expandable structure; and
  • [0047]
    [0047]FIG. 28 is a side view of the distal tip of a cavity-forming device.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • [0048]
    I. Balloons for Anatomical Structures
  • [0049]
    The present invention is directed to a balloon that can be used to treat bones predisposed to fracture or collapse. These balloons comprise one or more inflatable balloon bodies for insertion into said bone. The body has a preferred shape and size when substantially inflated sufficient to compress at least a portion of the inner cancellous bone to create a cavity in the cancellous bone and/or to restore the original position of the outer cortical bone, if fractured or collapsed. In various embodiments, the balloon body is restrained to create said preferred shape and size so that the fully inflated balloon body is desirably inhibited from applying substantial pressure to a single point on the inner surface of the outer cortical bone if said bone is unfractured or uncollapsed.
  • [0050]
    In addition to the shape of the inflatable device itself, another important aspect is the construction of the wall or walls of the balloon such that the proper inflation of the balloon body is achieved to provide for optimum compression of the cancellous bone. The material of the balloon is also desirably chosen so the balloon can be inserted quickly and easily into a bone through a cannula, yet can also withstand high pressures when inflated. For example, the material could be chosen to facilitate folding of the balloon. Alternatively, the material could desirably allow plastic, elastic and/or semi-elastic deformation of the balloon during inflation. The material will also desirably resist abrasion and/or puncture of the balloon when in contact with cortical and/or cancellous bone during introduction and inflation of the balloon. The balloon can also include optional ridges or indentations which are imparted to the cavity, desirably remaining in the cavity walls after the balloon has been removed, to enhance the stability of the bone void filler. Also, the inflatable device can be made to have an optional, built-in suction catheter. This may be used to remove any fat or fluid extruded from the bone during balloon inflation in the bone. Also, the balloon body can be protected from puncture (by the surrounding bone or cannula) by being covered while inside the cannula and/or bone with an optional protective sleeve of suitable materials, such as Kevlar® fiber products or polyethylene tetraphthalate (PET) or other polymer or substance that can protect the balloon. This covering material may also provide the additional advantage of reducing friction between the balloon and cannula, or it can incorporate a lubricating material, such as silicone, to reduce friction. One important purpose of the inflatable device, therefore, is the forming or enlarging of a cavity or passage in a bone, especially in, but not limited to, vertebral bodies.
  • [0051]
    In one aspect, the invention provides an improved balloon-like inflatable device for use in carrying out a surgical protocol of cavity formation in bones to enhance the efficiency of the protocol, to minimize the time required to performing the surgery for which the protocol is designed, and to improve the clinical outcome. If desired, these balloons may approximate the inner shape of the bone they are inside of in order to maximally compress cancellous bone. They may also have additional design elements to achieve specific clinical goals. In various embodiments, they are made of inelastic, semi-elastic, elastomeric or plastically deformable materials and kept in their defined configurations when inflated, by various restraints, including, but not limited to, use of inelastic, semi-elastic, elastomeric or plastically deformable materials in conjunction with the balloon body, seams in the balloon body created by bonding or fusing separate pieces of material together, or by fusing or bonding together opposing sides of the balloon body, woven material bonded inside or outside the balloon body, strings or bands placed at selected points in the balloon body, and stacking balloons of similar or different sizes or shapes on top of each other by gluing or by heat fusing them together. Optional ridges or indentations created by the foregoing structures, or added on by bonding additional material, can increase stability of the bone void filler. The ridges or indentations may also help keep the bone filler material in a desired position during subsequent loading and/or healing of the treated bone. Optional suction devices, preferably placed so that if at least one such device is located approximate the lowest point of the cavity being formed, will desirably allow the cavity to be cleaned and/or permit fluid or solids to be removed from and/or introduced into the cavity before filling.
  • [0052]
    Among the various embodiments of the present invention are the following:
  • [0053]
    1. A doughnut (or torus) shaped balloon with an optional built-in suction catheter to remove fat and other products extruded during balloon expansion.
  • [0054]
    2. A balloon with a spherical outer shape surrounded by a ring-shaped balloon segment for body cavity formation.
  • [0055]
    3. A balloon which is kidney bean shaped in configuration. Such a balloon can be constructed in a single layer, or several layers stacked on top of each other. This embodiment can also be a square or a rectangle instead of a kidney bean.
  • [0056]
    4. A spherically shaped balloon approximating the size of the head of the femur (i.e. the proximal femoral epiphysis). Such a balloon can also be a hemisphere.
  • [0057]
    5. A balloon in the shape of a humpbacked banana or a modified pyramid shape approximating the configuration of the distal end of the radius (i.e. the distal radial epiphysis and metaphysis).
  • [0058]
    6. A balloon in the shape of a cylindrical ellipse to approximate the configuration of either the medial half or the lateral half of the proximal tibial epiphysis. Such a balloon can also be constructed to approximate the configuration of both halves of the proximal tibial epiphysis.
  • [0059]
    7. A balloon in the shape of a sphere on a base to approximate the shape of the proximal humeral epiphysis and metaphysis with a plug to compress cancellous bone into the diaphysis, sealing it off. Such an embodiment can also be a cylinder.
  • [0060]
    8. A balloon in the shape of a boomerang to approximate the inside of the femoral head, neck and lesser trochanter, allowing a procedure to prevent hip fracture.
  • [0061]
    9. A balloon in the shape of a cylinder to approximate the size and shape of the inside of the proximal humerus or of the distal radius.
  • [0062]
    10. A balloon in the shape of a peanut or hourglass with an internal membrane. to constrain expansion preferentially along one or more axes.
  • [0063]
    11. A balloon in the shape of a disk.
  • [0064]
    12. A balloon device with an optional suction device.
  • [0065]
    13. Protective sheaths to act as puncture guard members optionally covering each balloon inside its catheter.
  • [0066]
    The present invention, therefore, provides improved, inflatable devices for creating or enlarging a cavity or passage in a bone wherein the devices are inserted into the bone. In various embodiments, the configuration of each device can be defined by the surrounding cortical bone and adjacent internal structures, and is designed to occupy up to 70-90% of the volume of the inside of the bone, although balloons that are as small as about 40% (or less) and as large as about 99% are workable for fractures. In various other embodiments, the inflated balloon size may be as small as 10% of the cancellous bone volume of the area of bone being treated, such as for the treatment of avascular necrosis and/or cancer, due to the localized nature of the fracture, collapse and/or treatment area. The fully expanded size and shape of the balloon is desirably regulated by material in selected portions of the balloon body whose resistance to expansion creates a restraint as well as by either internal or external restraints formed in the device including, but not limited to, mesh work, webbing, membranes, partitions or baffles, a winding, spooling or other material laminated to portions of the balloon body, continuous or non-continuous strings across the interior of the balloon held in place at specific locations by bonding to the inside of the balloon (by glue, welding, etc.) or by threading these strings through to the outside, and seams in the balloon body created by bonding two pieces of body together or by bonding opposing sides of a body through glue or heat. Aside from the use of different materials, the objectives of the present invention could similarly be accomplished by utilizing different thicknesses of materials to regulate the expansion of the balloon body. Moreover, the use of similar materials of differing elasticity, for example a polyurethane plastic balloon having discrete sections that are cross-linked by gamma radiation exposure and which are thus less prone to expansion, could accomplish the objectives of the present invention as well.
  • [0067]
    Spherical portions of balloons may be restrained by using inelastic, semi-elastic, elastic and elastomeric materials in the construction of the balloon body, or may be additionally restrained as just described. The material of the balloon can be a non-elastic material, such as polyethylene tetraphthalate (PET), nylon, Kevlar® or other patented or nonpatented medical balloon materials. It can also be made of semi-elastic materials, such as silicone, rubber, thermoplastic rubbers and elastomers or elastic materials such as latex or polyurethane, if appropriate restraints are incorporated. The restraints can be continuous or made of discrete elements of a flexible, inelastic high tensile strength material including, but not limited to, the materials described in U.S. Pat. No. 4,706,670, which is incorporated herein by reference. The thickness of the balloon wall is typically in the range of {fraction (2/1000)}ths to {fraction (25/1000)}ths of an inch, although other thicknesses that can withstand increased pressures, such as 250-400 psi or greater, even up to 500, 1000 or 2000 psi, may be used.
  • [0068]
    One important goal of percutaneous vertebral body augmentation of the present invention is to provide a balloon which can create a cavity inside the vertebral body whose configuration is optimal for supporting the bone. Another important goal is to move the top and bottom of the vertebral body (otherwise known as the upper and lower end plates) toward a more normal anatomical position to restore height where possible. Both of these objectives, however, are desirably achieved without significantly altering the outer dimensions of the sides of the vertebral body, either by fracturing the cortical sidewalls of the vertebral body or by moving already fractured bone in the sidewalls.
  • [0069]
    The present invention satisfies these goals through the design of inflatable devices to be described. Inflating such a device desirably creates a cavity within the calcium-containing soft cancellous bone (such as by compressing the cancellous bone) and/or desirably displaces surrounding cortical bone towards a more normal anatomical position.
  • [0070]
    In one embodiment, the balloon body desirably recreates the shape of the inside of an unfractured vertebral body, and optimally grows no more than a maximum of 70 to 90% of the inner volume. The balloons of these embodiments are inelastic, He designed such that maximally inflating them will desirably recreate the predetermined shape and size. However, conventional balloons become spherical when inflated. Spherical shapes do not typically permit the hardened bone void filler to support the spine adequately, because they can create a generally spherical cavity which, when filled with filler material, makes single points of contact on the vertebral body surfaces (the equivalent of a circle inside a square, or a sphere inside a cylinder). In contrast, various embodiments of the balloons of the present invention more generally recreate the flat surfaces of the vertebral body by incorporating restraints that maintain the balloon in desired shapes. These desired shapes create cavities which, when filled with filler material, desirably distribute the load transferred from the vertebral body surfaces to the bone void fillers, which ultimately strengthens the spine. In addition, the volume of bone void filler that fills these cavities desirably creates a thick mantle of cement (for example a thickness of 4 mm or greater), which increases the compressive strength of the filler material. Another useful feature of various embodiments is the incorporation of ridges in the balloons which can leave one or more imprints in the walls of the cavity created within the compressed cancellous bone. The resulting bone void filler “fingers” which will ultimately fill these imprints can provide enhanced stability, and reduce the opportunity for the filler material to shift or displace within the vertebral body under compressive loading of the spine.
  • [0071]
    Balloons which can optimally compress cancellous bone in vertebral bodies include the balloons listed as balloon types 1-3, 10 and 12 above. Some of these balloons are desirably configured to approximate the shape of the vertebral body. Since the balloon can be chosen to occupy less than the total inner volume (prior to fracture) of the targeted vertebral body, inflation of the balloon will desirably not exert undue pressure on the surrounding cortical sidewalls of the vertebral body (the sidewalls of the vertebral body will desirably not be expand beyond their existing size—either fractured or unfractured). However, since the upper and lower end plates of the vertebral body are typically depressed in a compression fracture, and the balloon can be approximately the height of an unfractured vertebral body, inflation of the balloon can move the top and bottom end plates back towards their pre-fractured position and/or orientation. Moreover, a plurality of individual balloons can be utilized inside the vertebral body, such as by being stacked, and stacks containing any of the disclosed balloon types can be mixed in shape and/or size to provide greater flexibility and/or control.
  • [0072]
    A primary goal of percutaneous femoral (or humeral) head augmentation (balloon type 4), percutaneous distal radius augmentation (balloon type 5), percutaneous proximal tibial augmentation (balloon type 6), and percutaneous proximal humeral augmentation (balloon type 7) is to create a cavity whose configuration is optimal to support the bone to be treated. Another important goal is to compress avascular (or aseptic) necrotic bone or to support avascular necrotic bone. Yet another important goal is to help realign the fracture fragments. These goals are generally achieved by exerting pressure primarily on the cancellous bone which may be transferred to the surrounding cortical bone. Pressure directly on a small section of the cortical bone could conceivably cause worsening of the fracture, which, while not precluded, is desirably avoided. The design of various embodiments of the inflatable devices approximates the shape of the bone to be treated. The approximate volume of the cavity made by the inflatable device(s) can be as much as 70 to 90% of the volume of the bone to be treated. In the case of avascular necrosis, depending upon the extent of the avascular necrosis, a smaller or larger cavity inside bone will be formed. In some cases, if the area of avascular necrosis is small, a small balloon will be utilized which might create a cavity only 10 to 15% of the total volume. If larger areas are involved with avascular necrosis, then one or more larger balloons could be utilized which might create a much larger cavity, including cavities as large as 80 to 90% of the volume of the bone (or greater). The present invention satisfies these goals through the design of the inflatable devices to be described.
  • [0073]
    For example, percutaneous hip augmentation (as shown in connection with balloon type 8) is designed to prevent and/or treat hip fracture by compacting weak cancellous bone in the femur where hip fractures occur and replacing it with an appropriate supporting material. The present invention satisfies this goal through the design of the inflatable devices to be described.
  • [0074]
    The present invention discloses improved systems for deployment in bone comprising structures adapted to assume expanded geometries having a desired configuration when used. These expandable structures include material that allows the structure to differentially expand when under internal pressure. These structures, when in use, are able to expand preferentially along one or more axes so as to deliver a greater force and/or displacement of cancellous bone towards one direction versus another. Furthermore, such structures, when distended, can generally match the geometry of the interior bone space in which the structure is deployed, if desired. For example, such structures could optimally expand to a desired shape rather than simply towards areas of lowest bone density, i.e. expansion of the structure is can be controlled even when encountering areas in the bone of varying resistance.
  • [0075]
    Moreover, the exposure of the expandable structure to cancellous bone also typically requires materials having significant resistance to surface abrasion, puncture and/or tensile stresses. For example, structures incorporating elastomer materials, e.g., polyurethane, which have been preformed to a desired shape, e.g., by exposure to heat and pressure, can undergo controlled expansion and further distention in cancellous bone, without failure, while exhibiting resistance to surface abrasion and puncture when contacting cancellous bone.
  • [0076]
    The present invention further discloses inflatable devices that have one or more biased directions of inflation. For example, inflatable devices having reduced lateral growth may provide improved fracture reduction because such devices can exert a greater vertical force and/or displacement within the treated bone. Such inflatable devices may also protect the lateral and anterior/posterior sidewalls of the vertebral body by minimizing expansion towards these sidewalls and directing expansion to a greater degree along the longitudinal axis of the spine. In situations where a surgical procedure is terminated when the inflatable device contacts a lateral cortical wall of the targeted bone, such biased expansion could permit improved fracture reduction prior to reaching this procedure endpoint.
  • [0077]
    Due to the nature of the injury, disease or other treatments, as well as the health and age of the patient suffering from these injuries, it may be preferable to treat a bone with the devices of this invention during an open or semi-open surgical procedure. In addition, a goal of the surgery may be to replace the diseased or injured bone with materials (such as bone fillers or certain drugs) which do not flow, and which thus are not well suited for a more minimally invasive procedure.
  • [0078]
    A. Balloons for Vertebral Bodies
  • [0079]
    A first embodiment of the balloon (FIG. 1) constructed in accordance with the teachings of the present invention is broadly denoted by the numeral 10 and includes a balloon body 11 having a pair of hollow, inflatable parts 12 and 14 comprised of flexible material, including (but not limited to) non-elastic materials such as PET, mylar or Kevlar®, elastic materials such as polyurethane, latex or rubber, semi-elastic materials such as silicone, or other materials. Parts 12 and 14 have a suction tube 16 therebetween for drawing fats and other debris by suction into tube 16 for transfer to a remote disposal location. Catheter 16 has one or more suction holes so that suction may be applied to the open end of tube 16 from a suction source (not shown).
  • [0080]
    In this embodiment, the parts 12 and 14 are connected together by an adhesive which can be of any suitable type for adhering such materials as well as by bonding, i.e. thermal bonding (laser, radio-frequency (RF)/induction, heated dies), ultrasonic welding, solvent bonding, etc. Parts 12 and 14 are doughnut-shaped as shown in FIG. 1 and have tubes 18 and 20 which communicate with and extend away from the parts 12 and 14, respectively, to a source of inflating fluid under pressure (not shown). The inflating fluid is preferably a liquid. The liquid inflates the balloon 10, particularly parts 12 and 14 thereof after the balloon has been inserted in a collapsed condition (FIG. 8) into a bone to be treated, such as a vertebral bone 22 in FIG. 2. The above-mentioned U.S. Pat. Nos. 4,969,888 and 5,108,404, which are incorporated herein by reference, disclose the use of a guide pin and cannula for inserting the balloon into bone to be treated when the balloon is deflated and has been inserted into a tube and driven by the catheter into the cortical bone where the balloon is inflated.
  • [0081]
    [0081]FIG. 8 shows a deflated balloon 10 being inserted through a cannula 26 into bone. The balloon in cannula 26 is deflated and is forced through the cannula by exerting manual force on the catheter 21 which extends into a passage 28 extending into the interior of the bone. The catheter is slightly flexible but is sufficiently rigid to allow the balloon to be forced into the interior of the bone where the balloon is then inflated by directing fluid into the tube 88 whose outlet ends are coupled to respective parts 12 and 14.
  • [0082]
    In use, the balloon 10 is initially deflated and, after the bone to be filled with the balloon has been prepared to receive the balloon (such as by punching, drilling or otherwise displacing a small amount of the cancellous bone directly beyond the opening of the cannula), the deflated balloon is advanced into the bone in a collapsed condition through the cannula 26. (The bone is shown in FIG. 2.) In this embodiment, the balloon is oriented preferably in the bone such that the balloon expansion permits minimum pressure to be exerted on the cortical bone if there were no fracture or collapse of the bone. Where such fracture or collapse has not occurred, such pressure would desirably compress the bone marrow and/or cancellous bone against the inner wall of the cortical bone, thereby compacting the bone marrow of the bone to be treated and to further enlarge the cavity in which the bone marrow is to be replaced by a biocompatible, flowable bone material.
  • [0083]
    The balloon is inflated to compact the bone marrow and/or cancellous bone in the cavity and, after compaction of the bone marrow and/or cancellous bone, the balloon is deflated and removed from the cavity. While inflation of the balloon and compaction occurs, fats and other debris may be removed from the space between and around parts 12 and 14 by applying a suction force to catheter tube 16, if desired. Following this, and following the compaction of the bone marrow, the balloon is deflated and pulled out of the cavity by applying a manual pulling force to the catheter tube 21.
  • [0084]
    Another embodiment of an inflatable device constructed in accordance with the teachings of the present invention is broadly denoted by the numeral 60 and is shown in FIGS. 4 and 5. The balloon 60 includes a central spherical part 62 which is hollow and which receives an inflating liquid under pressure through a tube 64. The spherical part is provided with a spherical outer surface 66 and has an outer periphery which is surrounded substantially by a ring shaped part 68 having tube segments 70 for inflation of part 68. A pair of passages 69 interconnect parts 62 and 68. A suction tube segment 72 draws liquid and debris from the bone cavity being formed by the balloon 60.
  • [0085]
    Provision can be made for a balloon sleeve 71 for the balloon 60 as well as for all balloons disclosed herein. A balloon sleeve 71 (FIG. 9) is shiftably mounted in an outer tube 71 a and can be used to insert the balloon 60 when deflated into a cortical bone. The sleeve 71 has resilient fingers 71 b which bear against the interior of the entrance opening 71 c of the vertebral bone 22 (FIG. 9A) to prevent rearing or bunching of the balloon 60. Upon removal of the balloon sleeve, liquid under pressure will be directed into the tube 64 which will inflate parts 62 and 68 so as to compact the bone marrow within the cortical bone. Following this, the balloon 60 is deflated and removed from the bone cavity.
  • [0086]
    [0086]FIGS. 6 and 6A show views of a modified doughnut shape balloon 80 of the type shown in FIGS. 1 and 2, with one difference being the doughnut shapes of the balloon 80 are not stitched onto one another. In FIG. 6, the balloon 80 has a pear-shaped outer convex surface 82 which is made up of a first hollow part 84 and a second hollow part 85. A tube 88 is provided for directing liquid into the two parts along branches 90 and 92 to inflate the parts after the parts have been inserted into the medullary cavity of a bone. A catheter tube 16 is inserted into the space 96 between two parts of the balloon 80. An adhesive bonds the two parts 84 and 85 together at the interface thereof.
  • [0087]
    [0087]FIG. 6A shows one way in which the catheter tube 16 is inserted into the space or opening 96 between the two parts of the balloon 80.
  • [0088]
    [0088]FIG. 7 shows the tube 88 of which, after directing inflating liquid into the balloon 80, can inject contrast material into the balloon 80 so that x-rays can be taken of the balloon with the inflating material therewithin to determine the proper placement of the balloon. Alternatively, the inflation liquid could comprise a radiopaque inflation liquid, such as Conray® contrast medium (commercially available from Mallinckrodt Inc. of St. Louis, Mo.), such that inflation and visualization can be done currently, allowing monitoring of the balloon position and condition during the inflation step. Tube 16 is also shown in FIG. 6, it being attached in some suitable manner to the outer side wall surface of tube 88.
  • [0089]
    Still another embodiment of the invention is shown in FIG. 3, which is similar to FIG. 1 (although one difference it that it is not a doughnut) and includes an inflatable device 109 having three balloon units 110, 112 and 114 which are inflatable and which have string-like restraints 117 which limit the expansion of the balloon units in a direction transverse to the longitudinal axes of the balloon units. If desired, the restraints can comprise the same or a similar material as the balloon, or the restraints can comprise a material having a reduced, little or no substantial expansion capability.
  • [0090]
    A tube system 115 can be provided to direct liquid under pressure into the balloon units 110, 112 and 114 so that liquid can be used to inflate the balloon units when placed inside the bone in a deflated state. Following the proper inflation and compaction of the bone marrow, the balloon(s) can be removed by deflating it/them and pulling it/them outwardly of the bone being treated. The restraints desirably keep the opposed sides 77 and 79 substantially flat and parallel with respect to each other.
  • [0091]
    In FIG. 10, another embodiment of the inflatable balloon is shown. The device comprises a kidney shaped balloon body 130 having a pair of opposed kidney shaped side walls 132 which are adapted to be collapsed and to cooperate with a continuous end wall 134 so that the balloon 130 can be forced into a bone 136 shown in FIG. 11. A tube 138 is used to direct inflating liquid into the balloon to inflate the balloon and cause it to assume the dimensions and location shown in the vertebral body 136 in FIG. 11. The balloon 130 will desirably compress the cancellous bone if there is no fracture or collapse of the cortical bone. The restraints for this action are principally due to the side and end walls of the balloon.
  • [0092]
    [0092]FIG. 12 shows a balloon 140 which is also kidney shaped and has a tube 142 for directing an inflatable liquid into the tube for inflating the balloon. The balloon is initially formed in a single chamber bladder but the bladder can subsequently be branded and/or melted along curved lines or strips 141 to form attachment lines 144 which take the shape of side-by-side compartments 146 which are kidney shaped as shown in FIG. 13. The branding desirably causes a welding and/or bonding of the two sides of the bladder—the material can be standard medical balloon material, which is typically plastic that can be formed and/or bonded using heat.
  • [0093]
    [0093]FIG. 14 is a perspective view of a vertebral body 147 containing the balloon of FIG. 12, showing a double stacked balloon 140 when it is inserted in vertebral bone 147.
  • [0094]
    [0094]FIG. 15 is a view similar to FIG. 10 except that tufts 155, which can be string-like restraints or other structures between the opposing inner walls of the balloon, extend between and are connected to the side walls 152 of the inflatable device 150 and limit the expansion of the side walls with respect to each other. In this embodiment, the tufts desirably render the side walls generally parallel with each other. Of course, tufts which merely limit and/or reduce the displacement between opposing walls of the balloon will similarly accomplish various objectives of the present invention to some degree. Tube 88 is used to fill the kidney shaped balloon with an inflating liquid in the manner described above.
  • [0095]
    The dimensions for a vertebral body balloon can vary across a broad range, depending upon the size, location, and condition of the targeted vertebral body as well as the objectives of the treatment. For example, the height (H, FIG. 11) of a vertebral body balloon for both lumbar and thoracic vertebral bodies can typically range from 0.5 cm to 3.5 cm. The anterior to posterior (A, FIG. 11) vertebral body balloon dimensions for both lumbar and thoracic vertebral bodies can typically range from 0.5 cm to 3.5 cm. The side to side (L, FIG. 11) vertebral body dimensions from thoracic vertebral bodies will often range from 0.5 cm to 3.5 cm. The side to side vertebral body dimensions for lumbar vertebral bodies will typically range from 0.5 cm to 5.0 cm. Of course, depending upon the objectives of the treatment and the actual dimensions of the patient's bones, the use of balloons having larger or smaller dimension than these disclosed ranges may be appropriate.
  • [0096]
    The eventual selection of the appropriate balloon for, for instance, a given vertebral body is based upon several factors. One major factor affecting the choice of balloon size is the objectives of the treatment. For example, if the principal treatment objective is simply the repair and/or augmentation of a collapsed vertebral body, then the appropriate balloon size (and desired cavity size) may be a balloon which approximates the size of the interior of the vertebral body in an unfractured and/or uncollapsed condition. Alternatively, two or more balloons could be used concurrently within a single vertebral body, which together create a desired size cavity within the vertebral body. As another alternative, if the objective of treatment is more localized within the bone, such as the creation of a smaller cavity to augment and/or repair a smaller section of the bone, then the use of a smaller balloon size (and desired cavity size) may be desirous.
  • [0097]
    Similarly, where the cancellous bone is relatively strong and/or resistant to compression, the use of a smaller balloon may be warranted to accomplish the objective of displacing cortical bone (to reduce the fracture) without significantly compressing the cancellous bone (thus creating a smaller cavity). Moreover, smaller balloons may also be suited for use in the treatment of bone tumors, etc., where the balloon can be used to create a small cavity adjacent to the tumor—this small cavity will simplify the use of other minimally invasive tools to directly visualize the treatment area as well as morselize and/or excise the tumor from the bone.
  • [0098]
    The anterior-posterior (A-P) balloon dimension is measured from the internal cortical wall of the anterior cortex to the internal cortical wall of the posterior cortex of the vertebral body. In general, for augmentation and/or reinforcement of a collapsed vertebral body, the appropriate A-P balloon dimension will often be approximately 5 to 7 millimeters less than this measurement.
  • [0099]
    The appropriate side to side balloon dimensions for a given vertebral body is selected from the CT scan or from a plain film x-ray view of the vertebral body to be treated. The side to side distance can be measured from the internal cortical walls of the side of the vertebral bone. In one embodiment, the appropriate side to side balloon dimension may be 5 to 7 millimeters less than this measurement. In alternate embodiments, the appropriate side to side balloon dimensions may be significantly smaller, such as where multiple balloons are introduced into a single vertebral body or where the displacement of cortical bone is a primary objective of the treatment. In general, lumbar vertebral bodies tend to be much wider in their side to side dimension than in their A-P dimension. In contrast, thoracic vertebral bodies are typically approximately equal in their the side to side dimensions and their A-P dimensions.
  • [0100]
    The height dimensions of the appropriate vertebral body balloon for a given vertebral body may be chosen by the CT scan or x-ray views of the vertebral bodies above and below the vertebral body to be treated. The height of the vertebral bodies above and below the vertebral body to be treated can be measured and averaged. This average may be used to determine the appropriate height dimension of the chosen vertebral body balloon. Of course, as previously mentioned, various other balloon sizes may be desirous based upon the objectives of the treatment, as well as the actual patient's anatomy.
  • [0101]
    B. Balloons for Long Bones
  • [0102]
    Long bones which can be treated with the use of balloons of the present invention include (but are not limited to) the distal radius (larger arm bone at the wrist), the proximal tibial plateau (leg bone just below the knee), the proximal humerus (upper end of the arm at the shoulder), and the proximal femoral head (leg bone in the hip).
  • [0103]
    C. Distal Radius Balloon
  • [0104]
    For the distal radius, one embodiment of a balloon 160 is shown in the distal radius 152 has a shape which approximates a pyramid but more closely can be considered the shape of a humpbacked banana in that it substantially fills the interior of the space of the distal radius to force cancellous bone 154 against the inner surface 156 or cortical bone 158.
  • [0105]
    The balloon 160 has a lower, conical portion 159 which extends downwardly into the hollow space of the distal radius 152, and this conical portion 159 increases in cross section as a central distal portion 161 is approached. The cross section of the balloon 160 is shown at a central location (FIG. 17B) and this location is near the widest location of the balloon. The upper end of the balloon, denoted by the numeral 162, converges to the catheter 88 for directing a liquid into the balloon for inflating the same to compress the cancellous bone and/or force the cancellous bone against the inner surface of the cortical bone. The shape of the balloon 160 is desirably predetermined and can be restrained by tufts formed by string restraints 165, as well as various other types of restraints described herein. These restraints are optional and provide additional strength to the balloon body 160, but are not absolutely required to achieve the desired configuration. The balloon is placed into and taken out of the distal radius in the same manner as that described above with respect to the vertebral bone.
  • [0106]
    The dimensions of the distal radius balloon vary as follows:
  • [0107]
    The proximal end of the balloon (i.e. the part nearest the elbow) is cylindrical in shape and will vary from 0.5×0.5 cm to 1.8×1.8 cm.
  • [0108]
    The length of the distal radius balloon will vary from 1.0 cm to 12.0 cm.
  • [0109]
    The widest medial to lateral dimension of the distal radius balloon, which occurs at or near the distal radio-ulnar joint, will measure from 1.0 cm to 2.5 cm.
  • [0110]
    The distal anterior-posterior dimension of the distal radius balloon will vary from 0.5 cm to 3.0 cm.
  • [0111]
    In an alternate embodiment also suited for use in treating a distal radius fracture, a balloon can take the shape of a toroidal or disk-like shape, such as shown in FIGS. 25A-25C.
  • [0112]
    D. Proximal Humerus Fracture Balloon
  • [0113]
    The selection of the appropriate balloon size to treat a given fracture of the distal radius will often depend on the radiological size of the distal radius and the location of the fracture, as well as the treatment goals.
  • [0114]
    In the case of the proximal humerus 169, one embodiment of a balloon 166 shown in FIG. 18 is spherical and has a base design. It can optimally compact the cancellous bone 168 in a proximal humerus 169. A mesh 170, embedded, laminated and/or wound, may be used to form a neck 172 on the balloon 166, and a second mesh 170 a may be used to conform the bottom of the base 172 a to the shape of the inner cortical wall at the start of the shaft. These restraints provide additional strength to the balloon body, but the configuration can be achieved through various methods, including molding of the balloon body or various other restraints described herein. This embodiment desirably compresses the cancellous bone to create a compacted region surrounding the balloon 166 as shown in FIG. 18. The cortical bone 173 is desirably relatively wide at the base 174 and is thin-walled at the upper end 175. The balloon 166 has a feed tube 177 into which liquid under pressure is forced into the balloon to inflate it to compact the cancellous bone in the proximal humerus. The balloon is inserted into and taken out of the proximal humerus in the same manner as that described above with respect to the vertebral bone.
  • [0115]
    In this embodiment, the dimensions of the proximal humerus fracture balloon vary as follows:
  • [0116]
    The spherical end of the balloon will vary from 1.0×1.0 cm to 3.0×3.0 cm.
  • [0117]
    The neck of the proximal humeral fracture balloon will vary from 0.8×0.8 cm to 3.0×3.0 cm.
  • [0118]
    The width of the base portion or distal portion of the proximal humeral fracture balloon will vary from 0.5×0.5 cm to 2.5×2.5 cm.
  • [0119]
    The length of the balloon will vary from 4.0 cm to 14.0 cm.
  • [0120]
    The selection of the appropriate balloon to treat a given proximal humeral fracture depends on the radiologic size of the proximal humerus and the location of the fracture as well as the treatment goals.
  • [0121]
    E. Proximal Tibial Plateau Fracture Balloon
  • [0122]
    The tibial fracture is shown in FIG. 19A in which one embodiment of a balloon 180 is placed in one side 182 of a tibia 183. Desirably, the balloon, when inflated, compacts the cancellous bone in the layer 184 surrounding the balloon 180. A cross section of this embodiment of a balloon is shown in FIG. 19C wherein the balloon has a pair of opposed sides 185 and 187 which are interconnected by restraints 188 which can be in the form of strings or flexible members of any suitable construction. In this embodiment, the restraints desirably maintain the sides 185 and 187 substantially parallel with each other and non-spherical. A tube 190 is coupled to the balloon 180 to direct inflation liquid into and out of the balloon. The ends of the restraints are shown in FIGS. 19B and 19D and denoted by the numeral 191. The balloon is inserted into and taken out of the tibia in the same manner as that described above with respect to the vertebral bone. FIG. 19B shows a substantially circular configuration for the balloon; whereas, FIG. 19D shows a substantially elliptical version of the balloon.
  • [0123]
    The dimensions of this embodiment of a proximal tibial plateau fracture balloon vary as follows:
  • [0124]
    The thickness or height of the balloon will vary from 0.5 cm to 5.0 cm.
  • [0125]
    The anterior-posterior (front to back) dimension will vary from 1.0 cm to 6.0 cm.
  • [0126]
    The side to side (medial to lateral) dimension will vary from 1.0 cm to 6.0 cm.
  • [0127]
    The selection of the appropriate balloon to treat a given tibial plateau fracture will depend on the radiological size of the proximal tibial and the location of the fracture, as well as the treatment goals.
  • [0128]
    F. Femoral Head Balloon
  • [0129]
    In the case of the femoral head, one embodiment of a balloon 200 is shown as having been inserted inside the cortical bone 202 of the femoral head which is thin at the outer end 204 of the femur and which can increase in thickness at the lower end 206 of the femur. The cortical bone surrounds the cancellous bone 207 and this bone is desirably compacted by the inflation of the balloon 200. The tube for directing liquid for inflation purposes into the balloon is denoted by the numeral 209. It extends along the femoral neck and is directed into the femoral had which is generally spherical in configuration. FIG. 20A shows that the balloon, denoted by the numeral 200 a, can be hemispherical as well as spherical, as shown in FIG. 20. The balloon 200 is inserted into and taken out of the femoral head in the same manner as that described with respect to the vertebral bone. The hemispherical shape is maintained in this example by bonding overlapping portions of the bottom, creating pleats 200 b as shown in FIG. 20A.
  • [0130]
    The dimensions of the femoral head balloon may vary as follows—the diameter of the femoral head balloon will vary from 1.0 cm to up to 4.5 cm or greater. The appropriate size of the femoral head balloon to be chosen depends on the radiological or CT scan size of the head of the femur and the location and size of the avascular necrotic bone. The dimensions of the hemispherical balloon are similar to those of the spherical balloon, except that approximately one half of the balloon is provided.
  • [0131]
    G. Prevention of Hip Fracture
  • [0132]
    [0132]FIG. 21 illustrates one embodiment of a “boomerang” balloon 210 adapted for preventing and/or treating hip fracture. When inflated, the “boomerang” balloon 210 is a cylinder which gradually bends in the middle, like a boomerang, and extends from about 0.5 cm from the end of the femoral head 211 through the femoral neck 212 and down into the proximal femoral diaphysis 213 about 5-7 cm past the lesser trochanter 214. This embodiment of a balloon 210 preferably maintains its shape by rings of inelastic material (215 is one of them) held closer together on one side by attachment to a shorter inelastic band 216 running the length of the side of balloon and further apart by attachment to a longer inelastic band 217 bonded on the opposite side, although various other restraints disclosed herein would also suffice.
  • [0133]
    After and prior to inflation, the balloon 210 may be folded back (shown in dotted lines at 218) against the inflation tube 219. Prior to inflation, the balloon 210 can also be rolled up and held against the inflation tube with loose attachments that break when the balloon is inflated. To insert the balloon on its inflation tube into the hip, the surgeon can use a power drill under radiographic guidance to create a cavity 220 that is usually 4-6 mm wide starting at the lateral femoral cortex 221 and proceeding into the femoral head 211. Inflation of the balloon 210 into the greater trochanteric region 222 instead of down the femoral diaphysis 213 is less desirable and is typically avoided by proper choices in the shape of the balloon as well as by its placement and correct orientation (the deflated balloon desirably facing the lesser trochanter) After the balloon 210 has been inflated within the cavity 220 (see the dotted lines in FIG. 21), the predetermined size and shape of the balloon biases the proximal portion of the balloon downward into the lesser trochanter. Optionally, a second cavity can be drilled down into the diaphysis, starting from the same entry point or from the other side.
  • [0134]
    Patients with bone density in the hip below a threshold value are at increased risk of hip fracture, and lower densities create greater risk. Patient selection may be done through a bone density scan or other methods of determining bone quality well known in the art. Such selection could also result from a previous and/or concurrent fracture of the other hip, or some other type and/or location of osteoporotic fracture. The balloon length can be chosen by the surgeon to extend about 0.5 cm from the end of the femoral head, through the femoral neck and into the proximal femoral diaphysis, usually about 4-8 cm below the lesser trochanter. The balloon diameter can be chosen by measuring the inner cortical diameter of the femoral neck (the most narrow area) and subtracting 0.5 cm. The preferred dimensions of the “boomerang” balloon are a total length of 10-20 cm and a diameter of 1.0-2.5 cm. (A “humpback banana” balloon with appropriate length may also be useful in hip fracture prevention, where the “humpback” width does not exceed the desired femoral neck dimensions.)
  • [0135]
    Patients having the lowest bone densities in the femoral head may require greater compacting in the femoral head, which may, for example, be provided by using two balloons, one after the other: the “boomerang” followed by the femoral head balloon (inserted at the same point and expanded prior to inserting any supporting material.) Alternatively, the “boomerang” balloon may be adapted to have a distal portion that approximates the shape of the femoral head balloon.
  • [0136]
    The various balloons described herein could also be used in conjunction with the replacement of various structures within human and animal bodies. For example, the balloons described herein could be used to compress cancellous bone in a femur in preparation for the implantation of an artificial hip stem. Similarly, the balloons described herein could be used in conjunction with various other joint replacement procedures, including artificial knee and ankle joints.
  • [0137]
    H. All Balloons
  • [0138]
    It should be understood that the various embodiments of balloons disclosed herein are by no means limited in their utility to use in a single treatment location within the body. Rather, while each embodiment may be disclosed in connection with an exemplary treatment location, these embodiments can be utilized in various locations within the human body, depending upon the treatment goals as well as the anatomy of the targeted bone. For example, the embodiment of a balloon previously disclosed as useful in treating a fracture of the distal radius could similarly be used in the treatment of fractures in various other areas within the body, including but not limited to fractures and/or impending fractures of the femur, the radius, the ulna, the tibia, the humerus, the calcaneus or the spine. Similarly, the various other disclosed embodiments can be utilized throughout the body, with varying results depending upon treatment goals and/or the anatomy of the targeted bone.
  • [0139]
    II. The Inflatable Device
  • [0140]
    A. Complex Expandable Structures
  • [0141]
    Sometimes it can be difficult to achieve a desired uniformity and area of compaction within a given cancellous bone region using an expandable body having a single expansion region. FIG. 27 shows a complex preformed structure 280 which includes expanded segmented regions 282 and 284 spaced along its length. The structure 280 provides a longer profile along which volume can be increased.
  • [0142]
    The complex expandable structure is created by extruding or molding a tube 286 of polyurethane plastic or other elastomer material. In a preferred embodiment, the tube is comprised of polyurethane plastic material. The tube has a normal extruded wall thickness (T5) and a normal extruded outside diameter (D5) (as shown in FIG. 27).
  • [0143]
    The segmented shaped regions 282 and 284 are created by exposing an intermediate region of the tube to heat, positive interior pressure and/or stretching inside a fixture or mold (not shown). In one embodiment, the fixture could possess two cavity regions separated by a reduced diameter region or intermediate channel. The cavity regions and the channel can be exposed to a source of heat, to soften the material of the region. When heat-softened (in the manner previously described), the interior of the tube 286 is stretched and subjected to positive pressure from a source. The material in the region 288 will desirably expand or extend within the cavities and the channel.
  • [0144]
    Once cooled and removed from the fixture, the structure 280 can be attached to the distal end of an outer catheter tube 250. (See FIG. 28.) The structure of the outer catheter tube 250 (as well as the inner catheter tube 258) can vary, and the outer catheter tube 250 can comprise various flexible materials, including medical grade plastic materials like vinyl, polyethylenes, ionomer, polyurethane, and polytetrapthalate (PET) as well as less flexible materials such as Kevlar®, PEBAXT™, stainless steel, nickel-titanium alloys, and other metals and/or ceramics. The outer catheter tube 250 desirably incorporates an interior bore 260, into which an inner catheter tube 258 extends. It should be appreciated that the outer catheter tube 250 can have one or more interior lumens. In the illustrated embodiment, the inner catheter tube 258 extends through the interior bore 260 and beyond the distal end 254 of the catheter tube 250. A distal end region of the structure 280 is secured to the to the distal end region 254 of the outer catheter tube 250, while a proximal end region of the structure 280 is secured to the distal end region 262 of the inner catheter tube 258. The end regions can be secured, e.g., using adhesive or thermal bonding, etc.
  • [0145]
    The structure 280 possesses, in an open air environment, a normal expanded shape, having diameter D7 (shown in phantom lines of FIG. 27). The normal shape and diameter D7 for the regions 282 and 284 generally correspond with the shape and dimension of the cavities, respectively.
  • [0146]
    When an interior vacuum is drawn, removing air and/or fluid from the structure 280, the structure 280 assumes a substantially collapsed, and not inflated, geometry, shown as lines D6 in FIG. 27. Due to the application of heat and pressure upon the intermediate region 288, the diameter D6 for each region 282 and 284 is larger than the normally extruded or molded outside diameter D5 of the original extruded tube.
  • [0147]
    The regions 282 and 284 are separated by a tubular neck 298, which segments the structure 280 into two expandable regions 282 and 284. When substantially collapsed under vacuum or not inflated, the structure 280 exhibits a low profile, ideal for the insertion into and/or removal from the targeted cancellous bone region.
  • [0148]
    The introduction of fluid volume back into the tube 286 will cause each region 282 and 284 to return from the collapsed diameter D6 to the normal, enlarged, but not distended, geometry, having the shape and diameter shown in phantom lines D7 in FIG. 27.
  • [0149]
    In the illustrated embodiment, the first and second shaped regions 282 and 284 have generally the same radius of expansion and thus the same non-distended shape and diameter D7. Alternatively, each region 282 and 284 can have a different radius of expansion, and thus a different non-distended shape and diameter. Regardless, when in the normal, non-distended diameter D7, the material of the structure 280 in the region 288 is not significantly stretched or stressed, because the regions 282 and 284 have been expanded in a stress-relieved condition into these geometries in the cavities.
  • [0150]
    As before explained in conjunction with the structure, the regions 282 and 284 can be shaped by heat and/or interior pressure within different cavities to assume different geometry's, e.g., cylindrical or elliptical geometry, or a non-spherical, non-cylindrical, or non-elliptical geometry, with either uniform or complex curvature, and in either symmetric or asymmetric forms. Of course, more than two segmented regions 282 and 284 can be formed along the length of the tube. In addition, the normally expanded shape characteristics of the structure can be achieved by other techniques. For example, and not by way of limitation, the structure can be formed by dipping, lost wax casting, or injection molding.
  • [0151]
    Each shaped region 282 and 284 possesses a minimum wall thickness (designated T7 in FIG. 27) when in the normally enlarged but not distended geometry D7. Due to expansion of heat-softened material under pressure in the cavities, the wall thickness is not uniform, i.e., T7 is less than the normal extruded or molded wall thickness T5 of the tube. The minimum wall thickness T7 for the regions 282 and 284 can be the same or different.
  • [0152]
    When in the enlarged, but not distended geometry, the neck region 298 has an outside diameter (designated D9 in FIG. 27), which is equal to or greater than the normal extruded or molded diameter D5 of the tube. The size of the channel in the fixture determines the magnitude of the diameter D9. Due to expansion of heat-softened material in the adjacent regions 282 and 284 under pressure in the cavities, the neck region 298 (which expands under pressure in the channel) has a wall thickness (designated T9 in FIG. 27) which is less than or equal to the normal extruded or molded wall thickness TS of the tube 286, but still greater than the minimum wall thickness T7 of either fully shaped region 282 or 284.
  • [0153]
    The formed complex structure 280 thus possesses regions of non-uniform minimum wall thickness along its length; that is, T5≧T9≧T7. The formed complex structure 280 also provides multiple expandable regions 282 and 284 of the same or different enlarged outside diameters (D7), segmented by a neck region 298, in which D6>D5; D7>D6; and D7>D9.
  • [0154]
    By continuing to apply fluid volume at a constant pressure at a threshold amount P(t), and thereby increasing the volume within the structure 280, the shaped regions 282 and 284 of the structure 280 will continue to enlarge beyond diameter D7 to a distended shape and geometry, designated D8 in FIG. 27. The wall thickness T7 further decreases and approaches T8. As the regions 282 and 284 approach diameter D8, the diameter D9 of the neck region 298 will likewise increase toward diameter D10, as FIG. 27 shows, providing more uniform, elongated surface contact with cancellous bone.
  • [0155]
    Enlargement of the structure 280 beyond diameter D7 stretches the material in the regions 282, 284 and 298 beyond their stress-relieved condition, although the distended geometry of the regions 282 and 284 will, in important respects, maintain the preformed shape dictated by the cavities.
  • [0156]
    The degree of stretching at a substantially constant incremental pressure condition can be tailored to achieve a desired, fully distended diameter D8. The final, fully distended diameter D8 can be selected to match the dimensions of the targeted cancellous bone region. The controlled stretching of the segmented regions 282 and 284 in tandem can provide an equal volume compression of cancellous bone with a major diameter that is less than a single non-segmented region (i.e., one without the neck region 298). Stated another way, segmented regions 282 and 284, when expanded to a given inflation volume, have a diameter less than a sphere expanded to an equal inflation volume.
  • [0157]
    While expanding in the region between D7 and D8, the structure 280, when inside bone, assumes an increasingly larger surface area and volume, thereby compacting surrounding cancellous bone. Inflation in cancellous bone may occur at the same threshold pressure P(t) as outside bone. However, an increase in the threshold pressure P(t) inside bone is typically required, due to the density of the cancellous bone and resistance of the cancellous bone to compaction.
  • [0158]
    B. Assembly of an Expandable Balloon Device with an Internal Membrane
  • [0159]
    [0159]FIGS. 23 and 24A-24C depict cross-sectional views of another alternate embodiment of a cavity-forming device constructed in accordance with the teachings of the present invention. Because many of the features of this embodiment are similar to those described in connection with the previous embodiment, like reference numerals will be used to describe similar components.
  • [0160]
    In this embodiment the cavity-forming device incorporates a balloon 300 comprising a section of dual lumen tubing having an outer wall 310 and an internal membrane 320. The balloon 300 will desirably comprises a material that is commonly used for balloon catheters including, but not limited to, polyethylene, mylar, rubber or polyurethane. Even more desirably, the balloon 300 will comprise an elastomer material, which also possess the capability of being preformed, i.e., to acquire a desired shape by exposure, e.g., to heat and pressure, e.g., through the use of conventional thermoforming, blow molding and/or dip coating techniques. Candidate materials that meet this criteria include polyurethane, silicone, thermoplastic rubber, nylon, and thermoplastic elastomer materials.
  • [0161]
    In the illustrated embodiment, the balloon 300 comprises TEXIN® 5290 polyurethane plastic material (commercially available from Bayer Corp.). This material can be processed and extruded in a tubular shape, which can then be cut into individual lengths for further processing. The balloon 300 can be formed by exposing a cut tube length to heat and then enclosing the heated tube within a mold while positive interior pressure is applied to the tube length. For example, one embodiment of a balloon can be formed by heating a length of extruded tubing (incorporating an internal membrane 320) to 320° F. for approximately 220 seconds, and then stretching the tubing by 10 mm while the tubing is blown at 10 psi in a mold for 45 seconds. The mold can of course be part of a conventional balloon forming machine
  • [0162]
    In the present embodiment, after the balloon is formed the proximal end of the balloon 300 can be attached to the distal end of an outer catheter body 250 and the distal end of the balloon 300 can be attached to the distal end of an inner catheter body 258. The outer and inner catheters may each comprise extruded tubing made, e.g., from TEXIN® polyurethane plastic material, and each can extruded in a tubular shape using, e.g., a screw type extrusion machine, with a GENCA™ head, using suitable screens.
  • [0163]
    In assembling the cavity-forming device, the proximal end of the balloon 300 is desirably bonded to the distal end of an outer catheter body 250, as FIG. 26A shows. In one preferred embodiment (as FIG. 26B shows), a razor blade or other cutting instrument can be used to split approximately 5 mm of the distal end of the outer catheter body 250, creating a pair of slots 360, as best shown by “A” in FIG. 26B. The proximal end of the balloon 300 can then be slid over the distal end of the outer catheter body 250, with the outer wall 310 positioned around the distal tip of the outer catheter body 250 and the internal membrane 320 positioned within the slots 360 (as FIG. 26C shows). To maintain the flow channels (for the inflation fluid) through the outer catheter body 250 and into the balloon 300, a pair of mandrels or inserts (not shown) can be introduced into the outer catheter body and balloon in a manner well known in the art. The distal end of the outer catheter body 250 and the proximal end of the balloon 300 can then be bonded together using various means including heat bonding, adhesives, or the like. After the bond is formed, the mandrels can be removed. Desirably, the splitting of the outer catheter body 250 increases the mechanical strength of the bond between the catheter body 250 and the balloon 300 and permits the balloon to be more securely bonded to the outer catheter body 250, reducing the opportunity for a proximal bond failure of the balloon 300.
  • [0164]
    The distal end of the balloon 300 is also bonded to the distal end of an inner catheter body 258. If desired, the distal end of the inner catheter body 258 may be split in a similar manner to increase the mechanical strength of the distal bond. Desirably, the inner catheter body 258 will extend through the outer catheter body 250 and the balloon 300 along one side the internal membrane 320.
  • [0165]
    As FIG. 26A shows, the proximal end of the outer catheter body 250 can be secured to a distal end of a y-shaped luer fitting 400. The inner catheter body 258 desirably extends through an inner lumen of the luer fitting 400, and may be bonded to a proximal end of the fitting 400. Desirably, an inflation fitting 402 of the y-shaped luer fitting 400 will be in fluid communication with the lumen 404 (see FIG. 26C) formed between the inner and outer catheter bodies 250 and 258, which will in turn be in fluid communication with the interior of the balloon 300, such that an inflation fluid introduced into the inflation fitting 402 will inflate the balloon 300.
  • [0166]
    Desirably (as FIGS. 26A to 26C show), the outer catheter body 250 and/or y-shaped luer fitting 400 will incorporate a marker 406 or other externally viewable indicia which shows a physician the orientation of the internal membrane 320 when the balloon 300 is in a desired position within the patient. Such indicia could include colored markers or stripes 406, indentations and/or protrusions on the outer catheter body 250 or y-shaped luer fitting 400 as well as the orientation of the luer fitting itself. By utilizing such indicia 406, the physician can easily rotate the balloon 300 to a desired orientation within the vertebral body. Because the materials used in constructing medical balloons are typically radio-lucent, it would be difficult to gage the orientation of the internal membrane 320 once the balloon 300 is in position within the targeted bone. Alternatively, or in combination with external indicia 406, the internal membrane 320 could incorporate one or more marker bands or other radiopaque substances 408 (see FIG. 26C) to depict the orientation of the membrane 320 within the targeted vertebral body.
  • [0167]
    Various materials can be selected for the component parts of the cavity-forming device. Furthermore, the dimensions of the component parts of the cavity-forming device can also vary, according to its intended use. It should also be understood that, while one described embodiment incorporates dual lumen tubing, various other embodiments could incorporate other types of multi-lumen tubing (including, but not limited to triple, quadruple, etc., lumen tubing), as well as could incorporate membrane(s) having varying orientations and/or positions within the tubing (e.g., symmetrical or asymmetrical).
  • [0168]
    The following table lists preferred component materials and dimensions, which are well suited for a cavity-forming device (incorporating dual lumen tubing) that can be deployed for use in a vertebral body:
    Component Material Dimension
    Outer catheter Polyurethane Outside Diameter: 0.124″
    body Plastic Inside Diameter: 0.102″
    Inner catheter Polyurethane Outside Diameter: 0.035″
    body Plastic Inside Diameter: 0.025″
    Expandable Structure:
    Extruded Tubing: Polyurethane Outer Diameter: 0.164″
    Plastic Outer Wall Thickness: 0.028″
    Membrane Thickness: 0.030″
    Longitudinal Length 0.600″ to 0.949″
    of Balloon
  • [0169]
    C. Exemplary Performance Features of the Expandable Balloon
  • [0170]
    [0170]FIGS. 24A, 24B and 24C show cross-sectional views of the previously-described embodiment of a balloon 300 during its deployment in air. Desirably, the balloon 300 will expand in a similar fashion within the targeted bone such as a vertebral body.
  • [0171]
    [0171]FIG. 24A depicts a cross-sectional view of the balloon 300 when filled with a small amount of inflation fluid, such that the balloon desirably assumes the approximate size and shape of the mold in which the balloon was previously formed, with minimal stresses experienced by the internal membrane 320. In this condition, the expansion of the balloon is substantially circular in cross-section. Accordingly, the vertical and horizontal dimensions of the cross-section of the expanded balloon 300 are approximately equal, or DX1=DY1.
  • [0172]
    [0172]FIG. 24B depicts the balloon 300 of FIG. 24A when further filled with a pressurized inflation fluid. In this figure, the balloon 300 has assumed a further distended shape, with the wall material of the balloon 300 typically undergoing elastic and/or plastic deformation to assume this enlarged geometry. The balloon 300 desirably does not assume a completely circular cross-sectional shape, principally because the internal membrane resists lateral expansion of the outer walls 310. While some elongation of the internal membrane 320 typically occurs (due to elastic and/or plastic deformation of the membrane), the resulting cross-sectional shape is generally ovoid or somewhat similar to a figure-8. The balloon 300, however, is not as significantly restrained from growing in the vertical direction. This combination of restraints results in a balloon which substantially expands or grows more in the vertical direction than in the horizontal direction. Accordingly, the vertical dimension of the expanded balloon 300 is larger than the horizontal dimension of the balloon 300, or DX2>DY2.
  • [0173]
    [0173]FIG. 24C depicts the balloon 300 of FIGS. 24A and 24B when further filled with a pressurized inflation liquid. In this figure, the balloon 300 has assumed an even more distended shape, with the wall material typically having undergone both elastic and significant plastic deformation in order to assume this enlarged geometry. At this point, the balloon 300 is clearly in a non-circular shape, with the internal membrane 320 significantly resisting lateral growth of the balloon (although some additional elastic stretching and/or plastic deformation of the membrane 320 has likely occurred). Accordingly, the vertical dimension of the expanded balloon 300 is significantly larger than the horizontal dimension of the balloon 300, or DX3>>DY3.
  • [0174]
    For the above-described embodiment, an experimental inflation of the balloon with inflation fluid with volumes of 0 cc to 2 cc and 2 cc to 4 cc produced the following results:
  • [0175]
    0 cc:
  • [0176]
    Balloon Minor diameter (DX1—width): 7.7 mm
  • [0177]
    Balloon Major diameter (DY1—height): 7.7 mm
  • [0178]
    Inflation to 2 cc (Fluid):
  • [0179]
    Balloon Minor diameter (DX2—width): 9.2 mm
  • [0180]
    Increase in minor (horizontal) diameter: 1.5 mm (width)-[19.5% total increase]
  • [0181]
    Balloon Major diameter (DY2—height): 10.9 mm
  • [0182]
    Increase in major (vertical) diameter: 2.2 mm (height)-[28.6% total increase]
  • [0183]
    Inflation to 4 cc (Fluid):
  • [0184]
    Balloon Minor diameter (DX3—width): 12.7 mm
  • [0185]
    Increase in minor (horizontal) diameter: 5 mm (width)-[65% total increase]
  • [0186]
    Balloon Major diameter (DY3—height): 15.4 mm
  • [0187]
    Increase in major (vertical) diameter: 7.7 mm (height)-[100% total increase]
  • [0188]
    In addition to axial growth of the balloon 300 as the balloon expands (as previously described), the longitudinal length of a balloon also tends to increase during inflation. This is because the stresses experienced by the balloon material are typically acting in more than one dimension (resulting in material deformation along more than a single axis), causing the overall longitudinal length of the balloon 300 to expand in response to the increased internal pressure. In the present embodiment, however, the internal membrane 320 also tends to reduce the longitudinal growth of the balloon during inflation. For example, for the previously described embodiment of a balloon 300, a volumetric increase from 2 cc to 4 cc results in a longitudinal length increase for the balloon of only 27.1%. For a similarly constructed balloon that does not incorporate an interior membrane, a volumetric increase from 2 cc to 4 cc results in a longitudinal length increase of 37.1%. Accordingly, the interior membrane 320 of the present invention restrains not only certain aspects of circumferential expansion, but also restrains aspects of longitudinal expansion as well.
  • [0189]
    The internal membrane 320 of the present embodiment also significantly reduces the opportunity for the balloon 300 to experience a complete radial failure and/or fragment within the patient. During a surgical procedure, if the balloon is punctured or torn, the balloon failure may propagate through a significant amount of the balloon material. If this failure propagates around the entire radius of the balloon, then the distal section of the balloon is in danger of becoming completely separated from the proximal end of the balloon, with only the inner catheter body 258 connecting the distal section of the balloon to the cavity-forming device. In such a case, upon removal of the cavity forming device from the patient, it is possible for the inner catheter body 258 to fail, leaving the distal section and any balloon fragments in the patient.
  • [0190]
    The internal membrane 320 of the present embodiment desirably reduces any opportunity for a complete radial failure of the balloon 300, and also significantly reduces the opportunity for balloon fragments to separate from the cavity-forming device. Where the interior membrane 320 joins the expandable wall, the geometry and/or additional thickness of balloon material at this junction 410 (see FIG. 26C) significantly increases the balloon's resistance to fracture at his location. A fracture which propagates towards such a junction 410 will typically be redirected by the junction—typically the fracture will either terminate, will rebound from the junction and/or will be redirected along the junction.
  • [0191]
    In the disclosed embodiment, a radial fracture which propagates towards the junction 410 will generally be redirected towards the longitudinal axis of the balloon 300. Moreover, the interior membrane 320 serves to connect the proximal and distal ends of the balloon 300, which will reinforce the inner catheter body 258 in the unlikely event of a complete radial failure of the balloon. Accordingly, because the present embodiment incorporates at least two longitudinally extending junctions (i.e., the internal membrane 320 of the balloon 300 and the inner catheter body 258 to which the distal end of the balloon 300 is secured), a fracture of this embodiment is unlikely to result in a complete radial tear of the balloon material and/or fragmentation of the cavity forming device.
  • [0192]
    III. Implant Creation and Performance
  • [0193]
    Once the balloon 300 is in a desired position within a targeted bone (in this example a vertebral body), an inflation medium can be introduced into the balloon, which desirably expands the balloon within the targeted bone. The balloon will desirably assume a similar shape within the targeted bone as it would in air, thereby creating a cavity within the bone that is substantially the same shape and size as the inflated balloon. It must be understood, however, that variations in cancellous bone density and quality may distort the final expanded size and shape of the inflated balloon, such that the expanded balloon may be significantly different in size and shape than it would be when expanded in air.
  • [0194]
    While the restraints described herein may not absolutely guarantee that the final shape and size of the balloon (and thus the cavity) will be identical to the shape and size of the balloon in air, the restraints described herein significantly increase the potential for creating an optimally sized and shaped cavity to achieve one or more desired treatment goals. For example, if the desired treatment goal is the reinforcement and/or repair of a targeted vertebral body, a balloon may be chosen that incorporates restraints to maximize vertical growth of the balloon (in this context, the vertical orientation can be assumed to be parallel to the longitudinal axis of the spine) while minimizing horizontal and/or longitudinal growth of the balloon. If desired, this balloon could also incorporate restraints that reduce and/or minimize balloon expansion along its longitudinal axis.
  • [0195]
    Alternatively, a physician may desire a balloon that incorporates restraints to maximize horizontal growth of the balloon (in this context, horizontal growth can be assumed to be transverse to the longitudinal axis of the spine) while minimizing vertical growth of the balloon. Such a balloon (which could simply be the previously described embodiment when rotated 90° about its longitudinal axis) could be used to initially create a cavity extending across substantially the entire vertebral body. After removal of the first balloon, a second balloon (of the same or different design) could subsequently be introduced into the horizontal cavity and expanded. If desired, the second balloon could substantially fill the horizontal cavity prior to inflation (thereby maximizing the surface area of the balloon facing the upper and lower end plates) and, when expanded, could maximize the vertical forces which ultimately act on the endplates of the vertebral body (in an attempt to displace the surrounding cortical bone).
  • [0196]
    If desired, a balloon chosen for treatment of a vertebral body may further incorporate restraints that cause the balloon to expand into an irregular shape. In one embodiment disclosed herein, best shown in FIG. 23, the balloon desirably expands to a “peanut-like” shape when viewed from the side. This embodiment will desirably create a cavity that is similarly “peanut-shaped”, with the cavity essentially comprising a pair of enlarged cavity lobes that are separated by a region of reduced cavity size—in other words, the cavity is dumb-bell shaped. Desirably, the filler material which occupies this cavity will harden, set and/or solidify into an implant having substantially the shape of the cavity into which it was introduced. By forming the implant into this dumb-bell shape, the region of reduced width of the implant will desirably help to anchor the implant within the cancellous bone, thereby reducing the opportunity for the implant to displace along the longitudinal axis of the implant and/or migrate within or outside the treated bone.
  • [0197]
    Furthermore, if desired a balloon used for treatment of a vertebral body could incorporate additional restraints that alter the outer shape of the expanded balloon to further reduce the opportunity and/or tendency of an implant to migrate within and/or outside of a treated bone. For example, in one embodiment described above, the balloon incorporates an internal membrane which desirably causes the expanded balloon to assume an indented or elongated “figure-8” shape in cross-section (see FIG. 24c) . This shape, if formed into the cavity walls and ultimately assumed by the filler material, will desirably create an implant of similar cross-section. By forming the implant into this figure-8 shape, the implant will desirably be anchored within the cancellous bone, thereby reducing the opportunity for the implant to rotate about the longitudinal axis of the implant and/or migrate within or outside the treated bone.
  • [0198]
    In addition to creating a desired shape and size to the cavity, which will desirably act as a mold to bound and shape the filler material, the physician can further customize the shape of the implant in various ways. For example, after the initial cavity formation, but prior to the introduction of the filler material, the physician could use other surgical instruments to alter the shape and/or size of the cavity, such as by removing additional cancellous bone and/or scoring the compressed cancellous bone along the walls of the cavity. Similarly, prior to introducing the filler material the physician could introduce one or more additional balloons into the cavity to alter the existing cavity dimensions and/or create additional cavities of unique and/or desired shape. The physician could alternatively choose to introduce two or more different bone filler materials into a single cavity, with different materials occupying different portions of the cavity and/or being intertwined, mixed or separated in some manner, if desired. In addition, after the filler material has filled the entire cavity, the physician could continue introducing an additional amount of bone filler material, which would desirably cause small amounts of the bone filler material to interdigitate or flow into various gaps and/or cracks in the walls of the cavity, thereby further anchoring the resulting implant within the cancellous bone. For example, the injection of an additional ½ cc, 1 cc or 1½ cc of bone filler material (beyond the volume of the cavity created within the cancellous bone) can significantly increase the interdigitation of bone filler material with the surrounding cancellous bone matrix.
  • [0199]
    IV. Other Uses, Methods and Balloons
  • [0200]
    The cavity created by the balloon can be filled with a medically-appropriate formulation of a drug or a growth factor. As an example of delivering a drug, a typical dose of the antibiotic, gentamicin, to treat a local osteomyelitis (bone infection), is 1 gram (although the therapeutic range for gentamicin can be far greater, from 1 nanogram to 100 grams, depending on the condition being treated and the size of the area to be covered). A medically-suitable gel formulated with appropriate gel materials, such a polyethylene glycol, can contain 1 gram of gentamicin in a set volume of gel, such as 10 cc. A balloon with this volume whose shape and size is appropriate for the site being treated (that is, the balloon desirably will not break the cortical bone when inflated at the chosen site) can be used to compact the infected cancellous bone. This creates a space that can be filled with the antibiotic gel in an open or minimally invasive procedure. This places and holds the required amount of drug right at the site needing treatment, and protects the drug from being quickly washed away by blood or other fluids. Ngt only can the dose be optimized, but additional doses can be applied at later times without open surgery, enhancing the therapeutic outcome. If the required cavity for the optimal drug dose weakens the bone, the bone can be protected from future fractures with a cast or with current internal or external metal or plastic fixation devices. The therapeutic substance put into bone may be acting outside the bone as well. A formulation containing chemotherapeutic agent could be used to treat local solid osteosarcoma or other tumor near that bone.
  • [0201]
    As an alternative, to deliver therapeutic substances, balloons can be dipped in a medical formulation (often a dry powder, liquid or gel) containing a medically-effective amount of any desired antibiotic, bone growth factor or other therapeutic agent to coat the balloon with the above-mentioned substance before it is inserted into a bone being treated. Optionally, the balloon can be wholly or partially inflated with air or liquid before the coating is performed. Optionally, the coated balloon can be dried with air or by other means when the applied formulation is wet, such as a liquid or a gel. The balloon is refolded as required and either used immediately or stored, if appropriate and desired. Coated on the balloon, therapeutic substances can be delivered while cancellous bone is being compressed, or with an additional balloon once the cavity is made.
  • [0202]
    The methods described above can also be used to coat Gelfoam® absorbable gelatin powder or other agents onto the balloon before use. Such agents may also comprise substances that desirably promote coagulation and/or thickening of body fluids. Inflating a Gelfoam-coated balloon inside bone may further fill any cracks in fractured bone not already filled by the compressed cancellous bone.
  • [0203]
    FIGS. 22A-C schematically illustrate one system and method for delivering a therapeutic substance to the bone according to the present invention. As shown in FIG. 22A, an inflated balloon 229 attached to an inflating tube 230 is stabilized with a clip 231 that couples tube 230 to a wire 232. As shown in FIG. 22B, a measured amount of gel formulation containing the desired amount of substance 233 is uniformly dispensed from a container 234, preferably in thin lines 235, onto the outer surface of a balloon 236. As shown in FIG. 22C, the coated balloon 23 is then deflated and allowed to dry until the gel sets. The coated balloon 237 is then ready for packaging for use by the surgeon. Of course, the balloon can also be coated without prior inflation. In addition, the coating substance can be the desired compound alone in its natural state (solid, liquid or gas) or in an appropriate formulation, including a dry powder, an aerosol or a solution. The optional drying time will, of course, depend on the nature of the compound and its formulation.
  • [0204]
    Delivering a therapeutic substance on the outside of the balloon used to compact the bone or with a second (possibly slightly larger) balloon after the bone is compacted, is qualitatively different than putting formulated drug into the cavity. When delivered while compressing the bone, the substance becomes incorporated into the compacted bone. This can serve as a way to instantly formulate a slow release version of the substance. It simultaneously allows the surgeon to fill the cavity with an appropriate supporting material, like acrylic bone cement or biocompatible bone substitute, so no casting or metal fixation is required. Such a combination allows the surgeon, for example, to percutaneously fix an osteoporotic fracture while delivering a desired therapeutic substance (like an antibiotic, bone growth factor or osteoporosis drug) to the site. Thus, casts or metal fixation devices may not be required in such instances.
  • [0205]
    Medically-effective amounts of therapeutic substances are typically defined by their manufacturers or sponsors and are generally in the range of 10 nanograms to 50 milligrams per site, although more or less may be required in a specific case. Typical antibiotics include gentamicin and tobramycin. Typical bone growth factors are members of the bone morphogenetic factor, osteogenic protein, fibroblast growth factor, insulin-like growth factor, and transforming growth factor alpha and beta families. Chemotherapeutic and related agents include compounds such as cisplatin, doxorubicin, daunorubicin, methotrexate, taxol and tamoxifen. Osteoporosis drugs include estrogen, calcitonin, diphosphonates, and parathyroid hormone antagonists.
  • [0206]
    The balloons described in this invention can be used in open surgical procedures at the sites discussed above to provide an improved space for inserting orthopedic implants, bone graft, bone substitutes, bone fillers or therapeutic substances. The size and shape of balloon chosen will be determined depending upon the site being treated as well as the size, shape or amount of material that the surgeon wants to insert into the remaining bone. Square and rectangular balloons can be used at any site for the placement of bone substitutes like hydroxyapatites which are available in those shapes. Balloons would desirably be made to match those predetermined sizes, and the surgeon would chose the balloon to fit the size of material chosen.
  • [0207]
    To insert materials which do not flow into the balloon-made cavity, like hydroxyapatite granules or bone mineral matrix, the surgeon can push them down a tube with a long pin whose diameter is slightly more narrow than the inner diameter of the cannula through procedures in which the minimally-invasive procedure is taking place. During open surgery, the surgeon can approach the bone to be treated as if the procedure is percutaneous, except that here is no skin and other tissues between the surgeon and the bone being treated. This desirably keeps the cortical bone as intact as possible. If the material to be inserted does not flow and should not be pushed into the cavity through a cannula (as in the case of the hydroxyapatite block, because that may result in significant damage to the patient), the surgeon can make the cavity using the “minimally invasive” approach, then punch a hole using standard tools (such as a punch, gouge or rasp) into one side of the cortical bone to allow insertion of the block. This same approach can be used for implanting a metal prosthesis, such as the metal tibial component of a total knee replacement system.
  • [0208]
    Different sizes and/or shapes of balloons may be used at sites not specified above, such as the jaw bones, the midshaft of the arm and leg bones, the cervical vertebral bodies, the foot and ankle bones, the ribs and the like. One of the keys to choosing balloon shape and size in treating or preventing bone fracture is the teaching of this application that, optimally, up to 70-90% (or greater) of the cancellous bone can be compacted in cases where the bone disease causing fracture (or the risk of fracture) is the loss of cancellous bone mass (as in osteoporosis). Compacting less than 70-90% of the cancellous bone at the site being treated could possibly leave an extensive amount of the diseased cancellous bone at the treated site. The diseased cancellous bone could remain weak and later collapse, causing fracture despite treatment. With this principle, the allowed shapes and minimum sizes for any chosen bone are explained and defined.
  • [0209]
    Of course, there are many exceptions to this 70-90% cavity size, as generally described in this specification. One exception is when the bone disease being treated is localized, as in avascular necrosis, where local loss of blood supply is killing bone in a limited area. In that case, the balloons can be smaller, because the disease area requiring treatment is often smaller. A second exception is in the use of the devices to improve insertion of solid materials in defined shapes, like hydroxyapatite and components in total joint replacement. In these cases, the balloon shape and size is generally defined by the shape and size of the material being inserted. Another exception is the delivery of therapeutic substances. In this case, the cancellous bone may or may not be affected. If it is not, some of the cancellous bone can be sacrificed by compacting it to improve the delivery of a drug or growth factor which has an important therapeutic purpose. In this case, the bone with the drug inside is supported while the drug works and then the bone heals through casting or current fixation devices. Another exception can involve the treatment of bone tumors, where the creation of a small cavity in cancellous bone adjacent the tumor could facilitate the minimally invasive manipulation and/or removal of the tumor. Another exception could be where the quality of the cancellous bone is generally good, but the bone has fractured and/or collapsed in some manner. In such a case, the creation of a small cavity within the stronger cancellous bone may displace the cortical bone fragments to a position at or near the fragments, normal anatomic positions without significantly compressing the cancellous bone.
  • [0210]
    Another key to choosing balloon shape and size is one teaching of this invention—that inelastic, elastic and/or semi-elastic balloon restraints can be utilized and that inelastic or semi-elastic balloon materials are often preferred. Such materials can safely and easily prevent the balloon from expanding beyond its predetermined shape and size which can be defined by the limits of the normal dimensions of the outside edge of the cancellous bone (which is inside of the cortical bone). A balloon which expands too much, for example, can create the risk of immediate fracture, so in one embodiment this defines the upper limits of balloon sizes at each site. With many typical angioplasty balloons, surgeons usually rely on monitoring pressure (instead of the balloon design features of this invention) to prevent their balloons from inflating too much. This often requires greater surgical skill than the teachings of the present application, which are to take an X-ray of the site to be treated and measure the important dimensions as described herein. In addition, in bone treatment, relying on pressure can often result in an inferior clinical outcome. The surgeon generally will not know in advance what pressure is required to completely compact the cancellous bone, because this varies depending on the thickness of the cancellous bone and the extent to which it has lost density due to its disease. The surgeon is often likely to under inflate the balloon to avoid the potential consequences of overinflation and/or cortical bone fracture.
  • [0211]
    Another teaching of this application is that, while maximal pressures equally exerted in all directions can typically compress the weakest areas of cancellous bone, the use of restraints in a balloon body will desirably control balloon expansion to some degree. If the balloon design does not incorporate restraints, it may not compress cancellous bone in an optimal manner for reinforcement and/or repair of a fractured vertebral. The shape of the cancellous bone to be compressed, and the local structures that could be harmed if bone were moved inappropriately, are generally understood by medical professionals using textbooks of human skeletal anatomy along with their knowledge of the site and its disease or injury. Ranges of shapes and dimensions are defined by the site to be treated. Precise dimensions for a given patient can be determined by X-ray of the site to be treated, the therapeutic goal and safety constraints at the site. For diseased bone, replacement of most of the cancellous bone may be desired, so a balloon whose shape and size will compress around 70-90% (or greater) of the volume of the cancellous bone in the treated region can be chosen. However, as previously noted balloons that are smaller or larger may be appropriate, particularly where localized bone treatments and/or delivery of a therapeutic substance is the main goal. If desired, the balloon size can be chosen by the desired amount of therapeutic substance, keeping in mind that the balloon should desirably not displace the cortical bone beyond its normal unfractured dimensions.
  • [0212]
    While the new devices and methods have been more specifically described in the context of the treatment of human vertebrae, it should be understood that other human or animal bone types can be treated in the same or equivalent fashion. By way of example, and not by limitation, the present systems and methods could be used in any bone having bone marrow therein, including the radius, the humerus, the vertebrae, the femur, the tibia or the calcaneus. In addition, other embodiments and uses of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. All documents referenced herein are specifically and entirely incorporated by reference. The specification and examples should be considered exemplary only with the true scope and spirit of the invention indicated by the following claims. As will be easily understood by those of ordinary skill in the art, variations and modifications of each of the disclosed embodiments can be easily made within the scope of this invention as defined by the following claims.

Claims (37)

    What is claimed is:
  1. 1. A device for compressing cancellous bone comprising:
    an expandable body including an internal restraint coupled to the body which directs expansion of the body.
  2. 2. A device according to claim 1
    wherein the internal restraint includes an internal membrane.
  3. 3. A device according to claim 1
    wherein the expandable body includes an elongated axis,
    and
    wherein the internal restraint includes an internal membrane that extends transversely of the elongated axis between opposing interior side surfaces of the expandable structure.
  4. 4. A device according to claim 1
    wherein the expandable body includes an elongated axis,
    and
    wherein the internal restraint includes an internal membrane that extends along the elongated axis between opposing end surfaces of the expandable structure.
  5. 5. A device according to claim 1
    wherein the expandable body includes an elongated axis,
    and
    wherein the internal restraint includes an internal membrane that extends in one direction along the elongated axis between opposing end surfaces of the expandable structure and in a second direction transversely of the elongated axis between opposing interior side surfaces of the expandable structure.
  6. 6. A device according to claim 1
    wherein the internal restraint directs expansion of the expandable body more in one direction than in another direction transverse the one direction.
  7. 7. A device according to claim 1
    wherein the expandable body includes an elongated axis,
    wherein the internal restraint constrains expansion of the expandable body along the elongated axis.
  8. 8. A device according to claim 1
    wherein the expandable body includes an elongated axis,
    wherein the internal restraint directs expansion of the expandable body more in one radial direction from the elongated axis than in a second radial direction from the elongated axis.
  9. 9. A device according to claim 8
    wherein the internal restraint constrains expansion of the expandable body along the elongated axis.
  10. 10. A method for treating bone comprising the steps of
    inserting a device as defined in claim 1 inside bone,
    causing directed expansion of the body in cancellous bone, and
    compacting cancellous bone by the directed expansion.
  11. 11. A method according to claim 10
    wherein the directed expansion lifts vertebral end plates.
  12. 12. A method according to claim 10
    wherein the directed expansion lifts tibial plateau depressions.
  13. 13. A method according to claim 10
    wherein the directed expansion lifts proximal humerus depressions.
  14. 14. A method according to claim 10
    wherein the directed expansion lifts cortical bone.
  15. 15. A method according to claim 10
    wherein the step of compacting forms a cavity.
  16. 16. A method according to claim 15
    further including the step of filling the cavity with a material.
  17. 17. A method according to claim 16
    wherein the material comprises bone cement.
  18. 18. A method according to claim 16
    wherein the material comprises synthetic bone substitute.
  19. 19. A method according to claim 16
    wherein the material comprises a flowable material that sets to a hardened condition.
  20. 20. A device for compacting cancellous bone comprising a body adapted to be inserted into bone and undergo expansion in cancellous bone to compact cancellous bone, the body including material that, during the expansion in cancellous bone, applies a force capable of moving fractured cortical bone, and further includes an interior membrane to constrain the expansion in cancellous bone.
  21. 21. A device according to claim 20
    wherein the expandable body includes an elongated axis,
    and
    wherein the internal membrane extends transversely of the elongated axis between opposing interior side surfaces of the expandable structure.
  22. 22. A device according to claim 20
    wherein the expandable body includes an elongated axis,
    and
    wherein the internal membrane extends along the elongated axis between opposing end surfaces of the expandable structure.
  23. 23. A device according to claim 20
    wherein the expandable body includes an elongated axis,
    and
    wherein the internal membrane extends in one direction along the elongated axis between opposing end surfaces of the expandable structure and in a second direction transversely of the elongated axis between opposing interior side surfaces of the expandable structure.
  24. 24. A device according to claim 20
    wherein the internal membrane constrains expansion of the expandable body more in one direction than in another direction transverse the one direction.
  25. 25. A device according to claim 20
    wherein the expandable body includes an elongated axis,
    wherein the internal membrane constrains expansion of the expandable body along the elongated axis.
  26. 26. A device according to claim 20
    wherein the expandable body includes an elongated axis,
    wherein the internal membrane constrains expansion of the expandable body more in one radial direction from the elongated axis than in a second radial direction from the elongated axis.
  27. 27. A device according to claim 26
    wherein the internal membrane constrains expansion of the expandable body along the elongated axis.
  28. 28. A method for treating bone comprising the steps of
    inserting a device as defined in claim 20 inside bone,
    causing constrained expansion of the body in cancellous bone, and
    compacting cancellous bone by the constrained expansion.
  29. 29. A method according to claim 28
    wherein the constrained expansion lifts vertebral end plates.
  30. 30. A method according to claim 28
    wherein the constrained expansion lifts tibial plateau depressions.
  31. 31. A method according to claim 28
    wherein the constrained expansion lifts proximal humerus depressions.
  32. 32. A method according to claim 28
    wherein the constrained expansion lifts cortical bone.
  33. 33. A method according to claim 28
    wherein the step of compacting forms a cavity.
  34. 34. A method according to claim 33
    further including the step of filling the cavity with a material.
  35. 35. A method according to claim 33
    wherein the material comprises bone cement.
  36. 36. A method according to claim 33
    wherein the material comprises synthetic bone substitute.
  37. 37. A method according to claim 33
    wherein the material comprises a flowable material that sets to a hardened condition.
US10044843 2001-10-24 2002-01-11 Devices and methods using an expandable body with internal restraint for compressing cancellous bone Abandoned US20030032963A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US5473601 true 2001-10-24 2001-10-24
US10044843 US20030032963A1 (en) 2001-10-24 2002-01-11 Devices and methods using an expandable body with internal restraint for compressing cancellous bone

Applications Claiming Priority (41)

Application Number Priority Date Filing Date Title
PCT/US1995/001011 WO1995020362A1 (en) 1994-01-26 1995-01-24 Improved inflatable device for use in surgical protocol relating to fixation of bone
CA 2180556 CA2180556C (en) 1994-01-26 1995-01-24 Improved inflatable device for use in surgical protocol relating to fixation of bone
JP52015295A JP3333211B2 (en) 1994-01-26 1995-01-24 As used surgical methods for the treatment of a bone, the expandable device according to the improved
EP19950908122 EP0741547B1 (en) 1994-01-26 1995-01-24 Improved inflatable device for use in surgical protocol relating to fixation of bone
US08659678 US5827289A (en) 1994-01-26 1996-06-05 Inflatable device for use in surgical protocols relating to treatment of fractured or diseased bones
CA 2222144 CA2222144C (en) 1994-01-26 1996-06-06 Expandable devices for treatment of fractured or diseased bone
PCT/US1996/009933 WO1996039970A1 (en) 1994-01-26 1996-06-06 Improved inflatable device for use in surgical protocols relating to treatment of fractured or diseased bone
JP50209497A JP2001520530A (en) 1994-01-26 1996-06-06 Inflatable devices improved used in surgical protocol for the treatment of fractured bone or disease bone
DE1996633286 DE69633286D1 (en) 1994-01-26 1996-06-06 Device with an inflatable balloon for use in the surgical treatment of diseased or fractured bone
EP19960921483 EP0836435B1 (en) 1994-01-26 1996-06-06 Device with an inflatable balloon for use in surgical protocols relating to treatment of fractured or diseased bone
DE1996633286 DE69633286T2 (en) 1994-01-26 1996-06-06 Device with an inflatable balloon for use in the surgical treatment of diseased or fractured bone
EP20040075744 EP1426075A3 (en) 1994-01-26 1996-06-06 Improved inflatable device for use in surgical protocols relating to treatment of fractured or diseased bone
US10044843 US20030032963A1 (en) 2001-10-24 2002-01-11 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US10265922 US7261720B2 (en) 2002-01-11 2002-10-07 Inflatable device for use in surgical protocol relating to fixation of bone
JP2003559380A JP4292081B2 (en) 2002-01-11 2002-10-23 Apparatus and method for cancellous bone compression using an expandable body equipped with internal suppression unit
KR20047010850A KR100959444B1 (en) 2002-01-11 2002-10-23 Device and methods using an expandable body with internal restraint for compressing cancellous bone
DE2002633609 DE60233609D1 (en) 2002-01-11 2002-10-23 Devices for compressing cancellous bone using an expandable body with an inner support
EP20020793920 EP1463464B1 (en) 2002-01-11 2002-10-23 Devices using an expandable body with internal restraint for compressing cancellous bone
DE2002620716 DE60220716D1 (en) 2002-01-11 2002-10-23 Devices for compressing cancellous bone using an expandable body having inner retaining
CN 02828501 CN100464723C (en) 2002-01-11 2002-10-23 A device and a method thereof that can use an expandable body with an internal restraint to compress cancellous bones
PCT/US2002/036320 WO2003059214A3 (en) 2002-01-11 2002-10-23 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
ES02793920T ES2288569T3 (en) 2002-01-11 2002-10-23 Devices using an expandable body with internal restriction to compact cancellous bone.
DE2002620716 DE60220716T2 (en) 2002-01-11 2002-10-23 Devices for compressing cancellous bone using an expandable body having inner retaining
CA 2472594 CA2472594C (en) 2002-01-11 2002-10-23 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
CN 200910006219 CN101548906B (en) 2002-01-11 2002-10-23 Device and method using an expandable body with internal restraint for compressing cancellous bone
EP20070075421 EP1820463B1 (en) 2002-01-11 2002-10-23 Devices using an expandable body with internal restraint for compressing cancellous bone
DE2002625337 DE60225337T2 (en) 2002-01-11 2002-10-24 Inflatable device for use in surgical protocols in relation to the fixation of bone
EP20080075005 EP1913903A3 (en) 2002-01-11 2002-10-24 Inflatable device for use in surgical protocol relating to fixation of bone
EP20020773895 EP1463463B1 (en) 2002-01-11 2002-10-24 Inflatable device for use in surgical protocol relating to fixation of bone
PCT/US2002/034142 WO2003059213A3 (en) 1994-01-26 2002-10-24 Inflatable device for use in surgical protocol relating to fixation of bone
ES02773895T ES2302846T3 (en) 2002-01-11 2002-10-24 inflatable device for use in the surgical protocol to bone fixation.
DE2002625337 DE60225337D1 (en) 2002-01-11 2002-10-24 Inflatable device for use in surgical protocols in relation to the fixation of bone
US10863727 US7241303B2 (en) 1994-01-26 2004-06-08 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US10989733 US20050131267A1 (en) 1995-06-07 2004-11-15 System and method for delivering a therapeutic agent for bone disease
US10990285 US20050131268A1 (en) 1995-06-07 2004-11-15 System and method for delivering a therapeutic agent for bone disease
US10990291 US20050131269A1 (en) 1995-06-07 2004-11-15 System and method for delivering a therapeutic agent for bone disease
JP2004341300A JP2005161047A (en) 1994-01-26 2004-11-25 Improved expandable device employed in surgical protocol regarding treatment of fracture bone or disease bone
PCT/US2005/041257 WO2006053312A1 (en) 1995-06-07 2005-11-14 System and method for delivering a therapeutic agent for bone disease
US11827120 US20080172081A1 (en) 1994-01-26 2007-07-10 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US11895833 US20070299455A1 (en) 2002-01-11 2007-08-28 Inflatable device for use in surgical protocol relating to fixation of bone
US12986995 US20110144688A1 (en) 1994-01-26 2011-01-07 Devices and methods using an expandable body with internal restraint for compressing cancellous bone

Related Parent Applications (3)

Application Number Title Priority Date Filing Date
US09054736 Continuation-In-Part US6240326B1 (en) 1998-04-03 1998-04-03 Language independent building automation architecture for worldwide system deployment
US09754451 Continuation-In-Part US6899719B2 (en) 1994-01-26 2001-01-04 Systems and methods for treating fractured or diseased bone using expandable bodies
US5473601 Division 2001-10-24 2001-10-24

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US10265922 Continuation-In-Part US7261720B2 (en) 2001-10-24 2002-10-07 Inflatable device for use in surgical protocol relating to fixation of bone
US10863727 Continuation US7241303B2 (en) 1994-01-26 2004-06-08 Devices and methods using an expandable body with internal restraint for compressing cancellous bone

Publications (1)

Publication Number Publication Date
US20030032963A1 true true US20030032963A1 (en) 2003-02-13

Family

ID=21934626

Family Applications (6)

Application Number Title Priority Date Filing Date
US10044843 Abandoned US20030032963A1 (en) 2001-10-24 2002-01-11 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US10265922 Active 2022-04-10 US7261720B2 (en) 2001-10-24 2002-10-07 Inflatable device for use in surgical protocol relating to fixation of bone
US10863727 Expired - Lifetime US7241303B2 (en) 1994-01-26 2004-06-08 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US11827120 Abandoned US20080172081A1 (en) 1994-01-26 2007-07-10 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US11895833 Abandoned US20070299455A1 (en) 2001-10-24 2007-08-28 Inflatable device for use in surgical protocol relating to fixation of bone
US12986995 Abandoned US20110144688A1 (en) 1994-01-26 2011-01-07 Devices and methods using an expandable body with internal restraint for compressing cancellous bone

Family Applications After (5)

Application Number Title Priority Date Filing Date
US10265922 Active 2022-04-10 US7261720B2 (en) 2001-10-24 2002-10-07 Inflatable device for use in surgical protocol relating to fixation of bone
US10863727 Expired - Lifetime US7241303B2 (en) 1994-01-26 2004-06-08 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US11827120 Abandoned US20080172081A1 (en) 1994-01-26 2007-07-10 Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US11895833 Abandoned US20070299455A1 (en) 2001-10-24 2007-08-28 Inflatable device for use in surgical protocol relating to fixation of bone
US12986995 Abandoned US20110144688A1 (en) 1994-01-26 2011-01-07 Devices and methods using an expandable body with internal restraint for compressing cancellous bone

Country Status (9)

Country Link
US (6) US20030032963A1 (en)
EP (4) EP1463464B1 (en)
JP (1) JP4292081B2 (en)
KR (1) KR100959444B1 (en)
CN (2) CN100464723C (en)
CA (1) CA2472594C (en)
DE (5) DE60233609D1 (en)
ES (2) ES2288569T3 (en)
WO (1) WO2003059214A3 (en)

Cited By (65)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040267269A1 (en) * 2001-06-01 2004-12-30 Middleton Lance M. Tissue cavitation device and method
US20050043737A1 (en) * 1998-04-06 2005-02-24 Kyphon Inc. Structures for creating cavities in interior body regions
US20050105385A1 (en) * 2003-11-18 2005-05-19 Scimed Life Systems, Inc. Apparatus for mixing and dispensing a multi-component bone cement
US20050131267A1 (en) * 1995-06-07 2005-06-16 Talmadge Karen D. System and method for delivering a therapeutic agent for bone disease
US20050131269A1 (en) * 1995-06-07 2005-06-16 Talmadge Karen D. System and method for delivering a therapeutic agent for bone disease
US6923813B2 (en) 2003-09-03 2005-08-02 Kyphon Inc. Devices for creating voids in interior body regions and related methods
US20050226991A1 (en) * 2004-04-07 2005-10-13 Hossainy Syed F Methods for modifying balloon of a catheter assembly
US20050234425A1 (en) * 2004-04-16 2005-10-20 Innospine, Inc. Spinal diagnostic methods and apparatus
US20060052794A1 (en) * 2004-08-17 2006-03-09 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20060064094A1 (en) * 1998-10-26 2006-03-23 Expanding Orthopedics, Inc. Expandable orthopedic device
WO2006034396A2 (en) * 2004-09-21 2006-03-30 Stout Medical Group, L.P. Balloon and methods of making and using
US20060074433A1 (en) * 2004-08-17 2006-04-06 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20060116689A1 (en) * 2004-06-16 2006-06-01 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of a spinal structure
US20060155296A1 (en) * 2005-01-07 2006-07-13 Celonova Biosciences, Inc. Three-dimensional implantable bone support
US20060184192A1 (en) * 2005-02-11 2006-08-17 Markworth Aaron D Systems and methods for providing cavities in interior body regions
US20070010716A1 (en) * 2005-07-11 2007-01-11 Malandain Hugues F Surgical access device, system, and methods of use
US20070006692A1 (en) * 2005-07-11 2007-01-11 Phan Christopher U Torque limiting device
US20070010845A1 (en) * 2005-07-08 2007-01-11 Gorman Gong Directionally controlled expandable device and methods for use
US20070010848A1 (en) * 2005-07-11 2007-01-11 Andrea Leung Systems and methods for providing cavities in interior body regions
US20070010824A1 (en) * 2005-07-11 2007-01-11 Hugues Malandain Products, systems and methods for delivering material to bone and other internal body parts
US20070010844A1 (en) * 2005-07-08 2007-01-11 Gorman Gong Radiopaque expandable body and methods
US20070055265A1 (en) * 2005-08-16 2007-03-08 Laurent Schaller Devices For Limiting the Movement Of Material Introduced Between Layers Of Spinal Tissue
US20070055276A1 (en) * 2005-07-11 2007-03-08 Edidin Avram A Systems and methods for inserting biocompatible filler materials in interior body regions
US20070055201A1 (en) * 2005-07-11 2007-03-08 Seto Christine L Systems and methods for providing cavities in interior body regions
US20070060933A1 (en) * 2005-07-11 2007-03-15 Meera Sankaran Curette heads
US20070123877A1 (en) * 2005-11-15 2007-05-31 Aoi Medical, Inc. Inflatable Device for Restoring Anatomy of Fractured Bone
US20070198013A1 (en) * 2000-08-11 2007-08-23 Foley Kevin T Surgical instrumentation and method for treatment of the spine
US20070213641A1 (en) * 2006-02-08 2007-09-13 Sdgi Holdings, Inc. Constrained balloon disc sizer
US20070219634A1 (en) * 2004-09-21 2007-09-20 Greenhalgh E S Expandable support device and method of use
US20070260257A1 (en) * 2005-07-11 2007-11-08 Phan Christopher U Surgical device having interchangeable components and methods of use
US20080009876A1 (en) * 2006-07-07 2008-01-10 Meera Sankaran Medical device with expansion mechanism
US20080071356A1 (en) * 2005-04-27 2008-03-20 Stout Medical Group, L.P. Expandable support device and methods of use
US20080086142A1 (en) * 2006-10-06 2008-04-10 Kohm Andrew C Products and Methods for Delivery of Material to Bone and Other Internal Body Parts
US20080114364A1 (en) * 2006-11-15 2008-05-15 Aoi Medical, Inc. Tissue cavitation device and method
US20080183204A1 (en) * 2005-07-14 2008-07-31 Stout Medical Group, L.P. Expandable support device and method of use
US20080234827A1 (en) * 2005-08-16 2008-09-25 Laurent Schaller Devices for treating the spine
US20080243249A1 (en) * 2007-03-30 2008-10-02 Kohm Andrew C Devices for multipoint emplacement in a body part and methods of use of such devices
US20080294167A1 (en) * 2007-05-21 2008-11-27 Brian Schumacher Articulating cavitation device
US20090112214A1 (en) * 2007-10-30 2009-04-30 Hipco, Inc. Device and Method for Hip Distention and Access
US20090149956A1 (en) * 2006-05-01 2009-06-11 Stout Medical Group, L.P. Expandable support device and method of use
EP2114307A2 (en) * 2007-02-07 2009-11-11 N.M.B. Medical Applications Ltd. Bone implant
US20100076445A1 (en) * 2004-02-12 2010-03-25 Warsaw Orthopedic, Inc. Surgical Instrumentation and Method for Treatment of a Spinal Structure
US20100211176A1 (en) * 2008-11-12 2010-08-19 Stout Medical Group, L.P. Fixation device and method
US7824390B2 (en) 2004-04-16 2010-11-02 Kyphon SÀRL Spinal diagnostic methods and apparatus
US7828802B2 (en) 2004-01-16 2010-11-09 Expanding Orthopedics, Inc. Bone fracture treatment devices and methods of their use
US8142462B2 (en) 2004-05-28 2012-03-27 Cavitech, Llc Instruments and methods for reducing and stabilizing bone fractures
US8221420B2 (en) 2009-02-16 2012-07-17 Aoi Medical, Inc. Trauma nail accumulator
US8366773B2 (en) 2005-08-16 2013-02-05 Benvenue Medical, Inc. Apparatus and method for treating bone
US8454617B2 (en) 2005-08-16 2013-06-04 Benvenue Medical, Inc. Devices for treating the spine
US8535380B2 (en) 2010-05-13 2013-09-17 Stout Medical Group, L.P. Fixation device and method
US8535327B2 (en) 2009-03-17 2013-09-17 Benvenue Medical, Inc. Delivery apparatus for use with implantable medical devices
US20140222094A1 (en) * 2011-08-18 2014-08-07 Matthias Militz Expansion device for bone expansion and medical device for bone expansion
US8814873B2 (en) 2011-06-24 2014-08-26 Benvenue Medical, Inc. Devices and methods for treating bone tissue
US8827981B2 (en) 2007-11-16 2014-09-09 Osseon Llc Steerable vertebroplasty system with cavity creation element
US20140303730A1 (en) * 2011-11-30 2014-10-09 Beth Israel Deaconess Medical Center Systems and methods for endoscopic vertebral fusion
US20140309646A1 (en) * 2010-11-12 2014-10-16 Smith & Nephew, Inc. Inflatable, steerable balloon for elevation of tissue within a body
US9050112B2 (en) 2011-08-23 2015-06-09 Flexmedex, LLC Tissue removal device and method
US9149286B1 (en) 2010-11-12 2015-10-06 Flexmedex, LLC Guidance tool and method for use
US9220554B2 (en) 2010-02-18 2015-12-29 Globus Medical, Inc. Methods and apparatus for treating vertebral fractures
US20160199052A1 (en) * 2011-03-28 2016-07-14 Prabhat Kumar Ahluwalia Organ retractor
US9402725B2 (en) 2009-11-30 2016-08-02 DePuy Synthes Products, Inc. Expandable implant
US9510885B2 (en) 2007-11-16 2016-12-06 Osseon Llc Steerable and curvable cavity creation system
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods
US9788963B2 (en) 2003-02-14 2017-10-17 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9861794B2 (en) 2015-10-08 2018-01-09 Cook Medical Technologies Llc Multi chamber medical balloon

Families Citing this family (208)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050131268A1 (en) * 1995-06-07 2005-06-16 Talmadge Karen D. System and method for delivering a therapeutic agent for bone disease
US5972015A (en) 1997-08-15 1999-10-26 Kyphon Inc. Expandable, asymetric structures for deployment in interior body regions
CA2363254C (en) 1999-03-07 2009-05-05 Discure Ltd. Method and apparatus for computerized surgery
US6899713B2 (en) 2000-06-23 2005-05-31 Vertelink Corporation Formable orthopedic fixation system
US6875212B2 (en) 2000-06-23 2005-04-05 Vertelink Corporation Curable media for implantable medical device
WO2002000126A1 (en) * 2000-06-23 2002-01-03 University Of Southern California Percutaneous vertebral fusion system
US6964667B2 (en) * 2000-06-23 2005-11-15 Sdgi Holdings, Inc. Formed in place fixation system with thermal acceleration
US7569626B2 (en) 2003-06-05 2009-08-04 Dfine, Inc. Polymer composites for biomedical applications and methods of making
US6632235B2 (en) 2001-04-19 2003-10-14 Synthes (U.S.A.) Inflatable device and method for reducing fractures in bone and in treating the spine
JP2005506867A (en) * 2001-10-24 2005-03-10 カッティング エッジ サージカル, インコーポレイテッド Bone in an ultrasound between the surgical implantation
DE10154163A1 (en) 2001-11-03 2003-05-22 Advanced Med Tech An apparatus for raising and stabilizing the spine
DE60310078T2 (en) * 2002-07-09 2007-06-06 AECC ENTERPRISES LTD., Bournemouth A method of image representation of the relative motion of skeletal segments
US20040011532A1 (en) * 2002-07-16 2004-01-22 White Jack D. Combined rod guide and rod rotator device
US9782572B2 (en) 2002-09-30 2017-10-10 Nordson Corporation Apparatus and methods for treating bone structures, tissues and ducts using a narrow gauge cannula system
US20040220672A1 (en) * 2003-05-03 2004-11-04 Shadduck John H. Orthopedic implants, methods of use and methods of fabrication
US7175627B2 (en) * 2003-05-21 2007-02-13 Crosstrees Medical, Inc. Extractable filler for inserting medicine into animal tissue
US7175628B2 (en) * 2003-05-21 2007-02-13 Crosstrees Medical, Inc. Extractable filler for inserting medicine into animal tissue
US7175629B2 (en) * 2003-09-29 2007-02-13 Crosstrees Medical, Inc. Extractable filler for inserting medicine into vertebral body
US8328876B2 (en) 2003-12-31 2012-12-11 Warsaw Orthopedic, Inc. Bone matrix compositions and methods
US8734525B2 (en) 2003-12-31 2014-05-27 Warsaw Orthopedic, Inc. Osteoinductive demineralized cancellous bone
US7789912B2 (en) * 2004-01-08 2010-09-07 Spine Wave, Inc. Apparatus and method for injecting fluent material at a distracted tissue site
US7465318B2 (en) 2004-04-15 2008-12-16 Soteira, Inc. Cement-directing orthopedic implants
US20080132899A1 (en) * 2004-05-17 2008-06-05 Shadduck John H Composite implant and method for treating bone abnormalities
US20060085081A1 (en) * 2004-06-07 2006-04-20 Shadduck John H Implants and methods for treating bone
US7621952B2 (en) * 2004-06-07 2009-11-24 Dfine, Inc. Implants and methods for treating bone
US20060095138A1 (en) * 2004-06-09 2006-05-04 Csaba Truckai Composites and methods for treating bone
FR2871366A1 (en) * 2004-06-09 2005-12-16 Ceravic Soc Par Actions Simpli expandable prosthetic bone implant
US20050278023A1 (en) * 2004-06-10 2005-12-15 Zwirkoski Paul A Method and apparatus for filling a cavity
US20060085009A1 (en) * 2004-08-09 2006-04-20 Csaba Truckai Implants and methods for treating bone
EP1793769A4 (en) * 2004-09-02 2009-06-24 Crosstrees Medical Inc Device and method for distraction of the spinal disc space
US20060229628A1 (en) * 2004-10-02 2006-10-12 Csaba Truckai Biomedical treatment systems and methods
US8048083B2 (en) 2004-11-05 2011-11-01 Dfine, Inc. Bone treatment systems and methods
US7682378B2 (en) * 2004-11-10 2010-03-23 Dfine, Inc. Bone treatment systems and methods for introducing an abrading structure to abrade bone
US20060100706A1 (en) * 2004-11-10 2006-05-11 Shadduck John H Stent systems and methods for spine treatment
US8562607B2 (en) 2004-11-19 2013-10-22 Dfine, Inc. Bone treatment systems and methods
US7722620B2 (en) 2004-12-06 2010-05-25 Dfine, Inc. Bone treatment systems and methods
US7559932B2 (en) * 2004-12-06 2009-07-14 Dfine, Inc. Bone treatment systems and methods
US7678116B2 (en) * 2004-12-06 2010-03-16 Dfine, Inc. Bone treatment systems and methods
US7717918B2 (en) * 2004-12-06 2010-05-18 Dfine, Inc. Bone treatment systems and methods
US20060122614A1 (en) * 2004-12-06 2006-06-08 Csaba Truckai Bone treatment systems and methods
US8070753B2 (en) * 2004-12-06 2011-12-06 Dfine, Inc. Bone treatment systems and methods
US20070078477A1 (en) * 2005-02-04 2007-04-05 Heneveld Scott H Sr Anatomical spacer and method to deploy
WO2006113586A3 (en) 2005-04-15 2007-09-20 Musculoskeletal Transplant Vertebral disc repair
US20060247790A1 (en) * 2005-04-30 2006-11-02 Mckay William F Shaped osteochondral grafts and methods of using same
US7955339B2 (en) * 2005-05-24 2011-06-07 Kyphon Sarl Low-compliance expandable medical device
US8740988B1 (en) * 2005-06-16 2014-06-03 Robert L. Hively Bariatric balloon apparatus
US20070093899A1 (en) * 2005-09-28 2007-04-26 Christof Dutoit Apparatus and methods for treating bone
KR20080047357A (en) * 2005-07-07 2008-05-28 크로스트리스 메디칼, 인코포레이티드 Devices and methods for the treatment of bone fracture
EP1903967A2 (en) * 2005-07-08 2008-04-02 Kyphon Inc. Expandable device and methods for use
EP1909707A2 (en) * 2005-07-11 2008-04-16 Kyphon Inc. Systems and methods for providing prostheses
US20070233148A1 (en) 2005-09-01 2007-10-04 Csaba Truckai Systems and methods for delivering bone fill material and controlling the temperature thereof
CN103251449B (en) 2005-10-13 2016-03-02 斯恩蒂斯有限公司 Drug packaging
CN101365499A (en) 2005-11-01 2009-02-11 骨骼技术股份有限公司 Bone matrix compositions and methods
EP1968505A4 (en) * 2005-11-23 2011-12-28 Crosstrees Medical Inc Devices and methods for the treatment of bone fracture
US20070162132A1 (en) 2005-12-23 2007-07-12 Dominique Messerli Flexible elongated chain implant and method of supporting body tissue with same
US20070233250A1 (en) * 2006-02-07 2007-10-04 Shadduck John H Systems for treating bone
US20070232905A1 (en) * 2006-04-04 2007-10-04 Francis Tom J Unconstrained Balloon Sizer
US8676293B2 (en) 2006-04-13 2014-03-18 Aecc Enterprises Ltd. Devices, systems and methods for measuring and evaluating the motion and function of joint structures and associated muscles, determining suitability for orthopedic intervention, and evaluating efficacy of orthopedic intervention
EP2740423A1 (en) 2006-04-26 2014-06-11 Illuminoss Medical, Inc. Apparatus for delivery of reinforcing materials to a fractured long bone
US7806900B2 (en) * 2006-04-26 2010-10-05 Illuminoss Medical, Inc. Apparatus and methods for delivery of reinforcing materials to bone
CA2650490A1 (en) 2006-04-26 2007-11-08 Illuminoss Medical, Inc. Apparatus and methods for reinforcing bone
US8062337B2 (en) * 2006-05-04 2011-11-22 Warsaw Orthopedic, Inc. Expandable device for insertion between anatomical structures and a procedure utilizing same
US20080027456A1 (en) * 2006-07-19 2008-01-31 Csaba Truckai Bone treatment systems and methods
US9597118B2 (en) * 2007-07-20 2017-03-21 Dfine, Inc. Bone anchor apparatus and method
WO2008013763A3 (en) * 2006-07-25 2008-06-26 Morris L Jacobs Packed demineralized cancellous tissue forms for disc nucleus augmentation, restoration, or replacement and methods of implantation
US8926620B2 (en) 2006-08-25 2015-01-06 Kyphon Sarl Apparatus and methods for use of expandable members in surgical applications
US8043362B2 (en) * 2006-08-25 2011-10-25 Kyphon Sarl Apparatus and methods for use of expandable members in surgical applications
US20080097491A1 (en) * 2006-08-28 2008-04-24 Fred Gobel Tissue to tissue anchoring device and method of using the same
US8137352B2 (en) 2006-10-16 2012-03-20 Depuy Spine, Inc. Expandable intervertebral tool system and method
US7879041B2 (en) 2006-11-10 2011-02-01 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20080114402A1 (en) * 2006-11-10 2008-05-15 Warsaw Orthopedic, Inc. Devices and Methods for Correcting a Spinal Deformity
CA2669129C (en) 2006-11-10 2014-09-16 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20080119729A1 (en) * 2006-11-22 2008-05-22 Copa Vincent G Built-In Balloon Actuator for Urological Device
US8696679B2 (en) 2006-12-08 2014-04-15 Dfine, Inc. Bone treatment systems and methods
US9480485B2 (en) 2006-12-15 2016-11-01 Globus Medical, Inc. Devices and methods for vertebrostenting
US7909873B2 (en) 2006-12-15 2011-03-22 Soteira, Inc. Delivery apparatus and methods for vertebrostenting
US7771476B2 (en) 2006-12-21 2010-08-10 Warsaw Orthopedic Inc. Curable orthopedic implant devices configured to harden after placement in vivo by application of a cure-initiating energy before insertion
US8480718B2 (en) * 2006-12-21 2013-07-09 Warsaw Orthopedic, Inc. Curable orthopedic implant devices configured to be hardened after placement in vivo
US8758407B2 (en) * 2006-12-21 2014-06-24 Warsaw Orthopedic, Inc. Methods for positioning a load-bearing orthopedic implant device in vivo
US8663328B2 (en) * 2006-12-21 2014-03-04 Warsaw Orthopedic, Inc. Methods for positioning a load-bearing component of an orthopedic implant device by inserting a malleable device that hardens in vivo
US9445854B2 (en) 2008-02-01 2016-09-20 Dfine, Inc. Bone treatment systems and methods
US9161798B2 (en) * 2008-02-01 2015-10-20 Dfine, Inc. Bone treatment systems and methods
US20080208260A1 (en) * 2007-02-22 2008-08-28 Csaba Truckai Spine treatment devices and methods
US20080255569A1 (en) * 2007-03-02 2008-10-16 Andrew Kohm Bone support device, system, and method
US20080243122A1 (en) * 2007-03-29 2008-10-02 Kohm Andrew C Apparatuses and methods for bone screw augmentation
WO2008124533A1 (en) * 2007-04-03 2008-10-16 Dfine, Inc. Bone treatment systems and methods
US8062364B1 (en) 2007-04-27 2011-11-22 Knee Creations, Llc Osteoarthritis treatment and device
WO2008137428A3 (en) 2007-04-30 2009-11-12 Dfine, Inc. Bone treatment systems and methods
US7780740B2 (en) * 2007-05-21 2010-08-24 Active Implants Corporation Methods, systems, and apparatus for implanting prosthetic devices into cartilage
EP2167148B1 (en) 2007-06-15 2017-12-27 Warsaw Orthopedic, Inc. Method of treating tissue
US9554920B2 (en) 2007-06-15 2017-01-31 Warsaw Orthopedic, Inc. Bone matrix compositions having nanoscale textured surfaces
EP2167147B1 (en) 2007-06-15 2017-03-29 Warsaw Orthopedic, Inc. Bone matrix compositions and methods
WO2009009684A1 (en) 2007-07-10 2009-01-15 Osteotech, Inc. Delivery system
EP2742913B1 (en) * 2007-08-13 2016-11-09 MicroAire Surgical Instruments, LLC Tissue positioning device
WO2009036466A1 (en) * 2007-09-14 2009-03-19 Crosstrees Medical, Inc. Material control device for inserting material into a targeted anatomical region
US20090099481A1 (en) 2007-10-10 2009-04-16 Adam Deitz Devices, Systems and Methods for Measuring and Evaluating the Motion and Function of Joints and Associated Muscles
ES2446544T3 (en) 2007-10-19 2014-03-10 Warsaw Orthopedic, Inc. Demineralized bone matrix compositions and methods
US20090112210A1 (en) 2007-10-30 2009-04-30 Hipco, Inc. Femoral Neck Support Structure, System, and Method of Use
WO2009059090A1 (en) 2007-10-31 2009-05-07 Illuminoss Medical, Inc. Light source
CA2705709C (en) * 2007-11-16 2016-03-15 Synthes Usa, Llc Porous containment device and associated method for stabilization of vertebral compression fractures
US20090131886A1 (en) 2007-11-16 2009-05-21 Liu Y King Steerable vertebroplasty system
US8403968B2 (en) 2007-12-26 2013-03-26 Illuminoss Medical, Inc. Apparatus and methods for repairing craniomaxillofacial bones using customized bone plates
EP2252336B1 (en) 2008-02-28 2014-06-25 Dfine, Inc. Bone treatment systems and methods
US20090242081A1 (en) * 2008-03-26 2009-10-01 Richard Bauer Aluminum Treatment Composition
WO2009125242A1 (en) 2008-04-08 2009-10-15 Vexim Apparatus for restoration of the spine and methods of use thereof
EP2460477B1 (en) 2008-04-21 2018-04-11 Covidien LP Braid-ball embolic devices and delivery systems
WO2009134686A1 (en) * 2008-04-27 2009-11-05 Loma Vista Medical, Inc. Biological navigation device
US8252013B2 (en) * 2008-04-30 2012-08-28 Kyphon Sarl Expandable surgical access device and methods of use
US20090299401A1 (en) 2008-06-02 2009-12-03 Loma Vista Medical, Inc. Inflatable medical devices
KR20110022568A (en) * 2008-06-02 2011-03-07 신세스 게엠바하 Inflatable interspinous spacer
US8974462B2 (en) * 2008-06-13 2015-03-10 Pivot Medical, Inc. Devices and methods for minimally invasive access into a joint
CA2727791A1 (en) 2008-06-13 2009-12-17 Pivot Medical, Inc. Methods and apparatus for joint distraction
WO2009155319A1 (en) 2008-06-17 2009-12-23 Soteira, Inc. Devices and methods for fracture reduction
CN103655040A (en) * 2008-06-26 2014-03-26 凯希特许有限公司 Stimulation of cartilage formation using reduced pressure treatment
US9179918B2 (en) 2008-07-22 2015-11-10 Covidien Lp Vascular remodeling device
GB0813659D0 (en) 2008-07-25 2008-09-03 Smith & Nephew Fracture putty
US20100030220A1 (en) * 2008-07-31 2010-02-04 Dfine, Inc. Bone treatment systems and methods
CA2739326A1 (en) * 2008-10-10 2010-04-15 Intervalve, Inc. Valvuloplasty catheter and methods
US8777479B2 (en) 2008-10-13 2014-07-15 Dfine, Inc. System for use in bone cement preparation and delivery
WO2010078118A3 (en) * 2008-12-30 2010-10-21 Kci Licensing, Inc. Reduced pressure augmentation of microfracture procedures for cartilage repair
US20100198140A1 (en) * 2009-02-05 2010-08-05 Kevin Jon Lawson Percutaneous tools and bone pellets for vertebral body reconstruction
WO2010093959A9 (en) 2009-02-12 2010-11-25 Osteotech, Inc. Delivery systems, tools, and methods of use
US8591582B2 (en) 2009-02-26 2013-11-26 Depuy International Limited Support structure implant for a bone cavity
GB0903247D0 (en) 2009-02-26 2009-04-08 Depuy Int Ltd Support structure implant for a bone cavity
WO2010103344A1 (en) 2009-03-12 2010-09-16 Vexim Apparatus for bone restoration of the spine and methods of use
US9186181B2 (en) 2009-03-17 2015-11-17 Pivot Medical, Inc. Method and apparatus for distracting a joint
CA2754905A1 (en) * 2009-03-17 2010-09-23 Pivot Medical, Inc. Method and apparatus for distracting a joint, including the provision and use of a novel joint-spacing balloon catheter and a novel inflatable perineal post
US8012155B2 (en) * 2009-04-02 2011-09-06 Zimmer, Inc. Apparatus and method for prophylactic hip fixation
WO2010115138A3 (en) 2009-04-03 2010-11-25 Light Cure, Llc Devices and injectable or implantable compositions for intervertebral fusion
US9344902B2 (en) * 2009-04-03 2016-05-17 Broadcom Corporation Method and system for evaluating deployment of femtocells as part of a cellular network
US8210729B2 (en) 2009-04-06 2012-07-03 Illuminoss Medical, Inc. Attachment system for light-conducting fibers
US8512338B2 (en) 2009-04-07 2013-08-20 Illuminoss Medical, Inc. Photodynamic bone stabilization systems and methods for reinforcing bone
US8911497B2 (en) * 2009-04-09 2014-12-16 DePuy Synthes Products, LLC Minimally invasive spine augmentation and stabilization system and method
US8540723B2 (en) 2009-04-14 2013-09-24 Dfine, Inc. Medical system and method of use
US8562550B2 (en) 2009-05-27 2013-10-22 Linares Medical Devices, Llc Interior and exterior cast assemblies for repairing a bone fracture and including interior inflatable or mechanically expandable inserts as well as exterior wrap around and adhesively secured braces
EP2467098A4 (en) 2009-08-19 2015-07-08 Illuminoss Medical Inc Devices and methods for bone alignment, stabilization and distraction
US8814914B2 (en) * 2009-08-28 2014-08-26 Zimmer Spine, Inc. Fusion method and pedicle access tool
US9138163B2 (en) 2009-09-25 2015-09-22 Ortho Kinematics, Inc. Systems and devices for an integrated imaging system with real-time feedback loop and methods therefor
US8545499B2 (en) * 2009-09-28 2013-10-01 Zimmer, Inc. Expandable intramedullary rod
US8262609B2 (en) * 2009-10-29 2012-09-11 Kyphon Sarl Anterior inflation balloon
JP5711251B2 (en) 2009-11-09 2015-04-30 コヴィディエン リミテッド パートナーシップ Braided ball embolic device features
US8894658B2 (en) 2009-11-10 2014-11-25 Carefusion 2200, Inc. Apparatus and method for stylet-guided vertebral augmentation
US20110112507A1 (en) * 2009-11-10 2011-05-12 Carefusion 207, Inc. Curable material delivery systems and methods
US8226657B2 (en) 2009-11-10 2012-07-24 Carefusion 207, Inc. Systems and methods for vertebral or other bone structure height restoration and stabilization
US9095393B2 (en) 2012-05-30 2015-08-04 Carefusion 2200, Inc. Method for balloon-aided vertebral augmentation
WO2011063240A1 (en) 2009-11-20 2011-05-26 Knee Creations, Llc Implantable devices for subchondral treatment of joint pain
EP2501281A4 (en) 2009-11-20 2017-05-31 Zimmer Knee Creations Inc Coordinate mapping system for joint treatment
US8821504B2 (en) 2009-11-20 2014-09-02 Zimmer Knee Creations, Inc. Method for treating joint pain and associated instruments
US9259257B2 (en) * 2009-11-20 2016-02-16 Zimmer Knee Creations, Inc. Instruments for targeting a joint defect
US8951261B2 (en) 2009-11-20 2015-02-10 Zimmer Knee Creations, Inc. Subchondral treatment of joint pain
WO2011063250A1 (en) * 2009-11-20 2011-05-26 Knee Creations, Llc Implantable devices for subchondral treatment of joint pain
WO2011063260A1 (en) 2009-11-20 2011-05-26 Knee Creations, Llc Bone-derived implantable devices for subchondral treatment of joint pain
WO2011063281A1 (en) 2009-11-20 2011-05-26 Knee Creations, Llc Navigation and positioning instruments for joint repair
US8906032B2 (en) * 2009-11-20 2014-12-09 Zimmer Knee Creations, Inc. Instruments for a variable angle approach to a joint
US8721649B2 (en) 2009-12-04 2014-05-13 Pivot Medical, Inc. Hip joint access using a circumferential wire and balloon
US8926681B2 (en) 2010-01-28 2015-01-06 Covidien Lp Vascular remodeling device
EP2528542A4 (en) 2010-01-28 2013-07-03 Covidien Lp Vascular remodeling device
US8684965B2 (en) 2010-06-21 2014-04-01 Illuminoss Medical, Inc. Photodynamic bone stabilization and drug delivery systems
WO2012009486A3 (en) 2010-07-13 2012-03-22 Loma Vista Medical, Inc. Inflatable medical devices
US9144501B1 (en) 2010-07-16 2015-09-29 Nuvasive, Inc. Fracture reduction device and methods
WO2012064786A1 (en) 2010-11-08 2012-05-18 Pivot Medical, Inc. Method and apparatus for distracting a joint
US20120123481A1 (en) * 2010-11-15 2012-05-17 Lin Chih I Bone fixation device
US20130307955A1 (en) 2010-12-13 2013-11-21 Ortho Kinematics, Inc., Methods, systems and devices for a clinical data reporting and surgical navigation
US9179959B2 (en) 2010-12-22 2015-11-10 Illuminoss Medical, Inc. Systems and methods for treating conditions and diseases of the spine
EP2672900B1 (en) 2011-02-11 2017-11-01 Covidien LP Two-stage deployment aneurysm embolization devices
CN103945780B (en) 2011-02-22 2016-12-07 齐默尔膝部创造物公司 Navigation and positioning system and a guide device for joint repair
US9358372B2 (en) 2011-03-25 2016-06-07 Vention Medical Advanced Components, Inc. Apparatus and methods for accessing and dilating bone structures using a narrow gauge cannula
WO2012134841A1 (en) 2011-03-25 2012-10-04 Orthopaedic International, Inc. Bone compactor
US9089332B2 (en) 2011-03-25 2015-07-28 Covidien Lp Vascular remodeling device
JP5847289B2 (en) 2011-04-07 2016-01-20 ヴェクシム ソシエテアノニム Expandable orthopedic equipment
US9554840B2 (en) * 2011-04-08 2017-01-31 Kyphon SÀRL Low cost low profile inflatable bone tamp
US8728081B2 (en) * 2011-04-29 2014-05-20 Warsaw Orthopedic, Inc. Bone tamp and methods of use
US20120316571A1 (en) 2011-06-10 2012-12-13 Knee Creations, Llc Subchondral treatment of osteoarthritis in joints
US9144442B2 (en) 2011-07-19 2015-09-29 Illuminoss Medical, Inc. Photodynamic articular joint implants and methods of use
WO2013059609A1 (en) 2011-10-19 2013-04-25 Illuminoss Medical, Inc. Systems and methods for joint stabilization
US9119646B2 (en) 2011-08-07 2015-09-01 Zimmer Knee Creations, Inc. Subchondral treatment to prevent the progression of osteoarthritis of the joint
US9138187B2 (en) 2011-08-07 2015-09-22 Zimmer Knee Creations, Inc. Treatment of subchondral bone by biochemical diagnosis to prevent the progression of osteoarthritis of the joint
US8623089B2 (en) 2011-08-07 2014-01-07 Zimmer Knee Creations, Inc. Subchondral treatment of joint pain of the spine
WO2013049448A1 (en) 2011-09-29 2013-04-04 Covidien Lp Vascular remodeling device
CA2851363A1 (en) 2011-10-11 2013-04-18 Shaun B. Hanson Methods and instruments for subchondral treatment of osteoarthritis in a small joint
US20140316411A1 (en) * 2011-11-17 2014-10-23 Beth Israel Deaconess Medical Center Systems and methods for minimally invasive fracture reduction and fixation
WO2013081071A1 (en) * 2011-12-02 2013-06-06 テルモ株式会社 Device for cell transplantation
WO2013096197A1 (en) 2011-12-22 2013-06-27 Depuy Spine, Inc. Length-adjustable vertebral body balloon
US9381683B2 (en) 2011-12-28 2016-07-05 DePuy Synthes Products, Inc. Films and methods of manufacture
US9254157B2 (en) * 2012-02-07 2016-02-09 Kyphon Sarl Bone fracture reduction device and methods using same
US20130238038A1 (en) * 2012-03-07 2013-09-12 Kyphon Sarl Angled inflatable composite balloon and method
US9949755B2 (en) 2012-03-30 2018-04-24 Zimmer Knee Creations, Inc. Surgical access systems, instruments and accessories
US8939977B2 (en) 2012-07-10 2015-01-27 Illuminoss Medical, Inc. Systems and methods for separating bone fixation devices from introducer
EP2892445B1 (en) 2012-09-07 2016-08-24 Zimmer Knee Creations, Inc. Navigation instruments for subchondral bone treatment
US9339294B2 (en) 2012-09-07 2016-05-17 Zimmer Knee Creations, Inc. Instruments for controlled delivery of injectable materials into bone
US9314248B2 (en) 2012-11-06 2016-04-19 Covidien Lp Multi-pivot thrombectomy device
DE102012023042B3 (en) * 2012-11-26 2013-11-28 Spontech Spine Intelligence Group Ag Expandable Cage Interbody Fusion of the lumbar vertebrae
US9687281B2 (en) 2012-12-20 2017-06-27 Illuminoss Medical, Inc. Distal tip for bone fixation devices
US9295571B2 (en) 2013-01-17 2016-03-29 Covidien Lp Methods and apparatus for luminal stenting
US9192420B2 (en) * 2013-01-24 2015-11-24 Kyphon Sarl Surgical system and methods of use
US9149318B2 (en) * 2013-03-07 2015-10-06 Kyphon Sarl Low cost inflatable bone tamp
US9463105B2 (en) 2013-03-14 2016-10-11 Covidien Lp Methods and apparatus for luminal stenting
US9572676B2 (en) 2013-03-14 2017-02-21 DePuy Synthes Products, Inc. Adjustable multi-volume balloon for spinal interventions
US9358120B2 (en) 2013-03-14 2016-06-07 DePuy Synthes Products, Inc. Expandable coil spinal implant
US9585761B2 (en) 2013-03-14 2017-03-07 DePuy Synthes Products, Inc. Angulated rings and bonded foils for use with balloons for fusion and dynamic stabilization
US20140364892A1 (en) * 2013-06-11 2014-12-11 Covidien Lp Restricted Expansion Dissector
US9539041B2 (en) 2013-09-12 2017-01-10 DePuy Synthes Products, Inc. Minimally invasive biomaterial injection system
US9475218B2 (en) 2014-03-21 2016-10-25 General Electric Company Apparatus and method for forming flanges on components
US9700408B1 (en) * 2014-06-04 2017-07-11 Robert T. Sataloff Thyroplasty implant
US20170281250A1 (en) * 2016-04-05 2017-10-05 Warsaw Orthopedic, Inc Spinal implant system and method
DE202016101864U1 (en) * 2016-04-08 2017-07-13 Joline Gmbh & Co. Kg Double balloon catheter
CN106725814A (en) * 2016-12-06 2017-05-31 苏州爱得科技发展股份有限公司 Flat balloon device
CN106983586A (en) * 2017-04-28 2017-07-28 宁波华科润生物科技有限公司 Vertebral body fusion system approaching through minimally invasive pathway

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3779241A (en) * 1971-10-20 1973-12-18 Ethyl Corp Intrauterine contraceptive device and method for its use
US5514153A (en) * 1990-03-02 1996-05-07 General Surgical Innovations, Inc. Method of dissecting tissue layers

Family Cites Families (86)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2849002A (en) * 1956-03-12 1958-08-26 Vincent J Oddo Haemostatic catheter
US3045677A (en) * 1960-05-03 1962-07-24 American Cystoscope Makers Inc Inflatable balloon catheter
US3154077A (en) * 1962-06-04 1964-10-27 Joseph P Cannon Hemostatic device for anal surgery
DE1906284A1 (en) * 1969-02-08 1970-09-03 Dr Esfandiar Shahrestani Endoprosthesis, particularly for hip joints
US3640282A (en) * 1970-08-06 1972-02-08 Jack M Kamen Tracheal tube with normally expanded balloon cuff
DE2112139B2 (en) * 1971-03-13 1973-02-01 Huelsenfoermiges fastener for the compression-osteosynthesis at roehrenknochenfrakturen
US3850176A (en) * 1972-02-07 1974-11-26 G Gottschalk Nasal tampon
US3889685A (en) * 1973-11-02 1975-06-17 Cutter Lab Tubular unit with vessel engaging cuff structure
US4083369A (en) * 1976-07-02 1978-04-11 Manfred Sinnreich Surgical instruments
US4261339B1 (en) * 1978-03-06 1990-09-25 Datascope Corp
US4327736A (en) * 1979-11-20 1982-05-04 Kanji Inoue Balloon catheter
US4292974A (en) * 1980-01-30 1981-10-06 Thomas J. Fogarty Dilatation catheter apparatus and method
US4313434A (en) * 1980-10-17 1982-02-02 David Segal Fracture fixation
US4338942A (en) * 1980-10-20 1982-07-13 Fogarty Thomas J Dilatation catherter apparatus
US4402307A (en) * 1980-10-31 1983-09-06 Datascope Corp. Balloon catheter with rotatable energy storing support member
US4467790A (en) * 1981-04-13 1984-08-28 Peter Schiff Percutaneous balloon
US4531512A (en) * 1981-06-15 1985-07-30 Datascope Corporation Wrapping system for intra-aortic balloon utilizing a wrapping envelope
US4490421A (en) 1983-07-05 1984-12-25 E. I. Du Pont De Nemours And Company Balloon and manufacture thereof
US4917088A (en) * 1985-05-02 1990-04-17 C. R. Bard, Inc. Balloon dilation probe
US5102390A (en) * 1985-05-02 1992-04-07 C. R. Bard, Inc. Microdilatation probe and system for performing angioplasty in highly stenosed blood vessels
US5104376A (en) * 1985-05-02 1992-04-14 C. R. Bard, Inc. Torsionally rigid balloon dilatation probe
US4706670A (en) 1985-11-26 1987-11-17 Meadox Surgimed A/S Dilatation catheter
US4921483A (en) 1985-12-19 1990-05-01 Leocor, Inc. Angioplasty catheter
US4763654A (en) * 1986-09-10 1988-08-16 Jang G David Tandem independently inflatable/deflatable multiple diameter balloon angioplasty catheter systems and method of use
US4753238A (en) * 1987-01-06 1988-06-28 Advanced Cardiovascular Systems, Inc. Proximal manifold and adapter
EP0274411A3 (en) 1987-01-09 1988-11-30 C.R. Bard, Inc. Thin wall high strength balloon and method of manufacture
US4796629A (en) * 1987-06-03 1989-01-10 Joseph Grayzel Stiffened dilation balloon catheter device
US4848344A (en) * 1987-11-13 1989-07-18 Cook, Inc. Balloon guide
US4963313A (en) 1987-11-30 1990-10-16 Boston Scientific Corporation Balloon catheter
US4906244A (en) 1988-10-04 1990-03-06 Cordis Corporation Balloons for medical devices and fabrication thereof
EP0439202B1 (en) 1989-07-24 1993-09-29 Cordis Corporation Apparatus and method for manufacturing balloons for medical devices
US4938676A (en) 1988-10-04 1990-07-03 Cordis Corporation Apparatus for manufacturing balloons for medical devices
US4983167A (en) * 1988-11-23 1991-01-08 Harvinder Sahota Balloon catheters
US4969888A (en) * 1989-02-09 1990-11-13 Arie Scholten Surgical protocol for fixation of osteoporotic bone using inflatable device
DE69002295D1 (en) 1989-09-25 1993-08-26 Schneider Usa Inc Multilayer extrusion process as gefaessplastik for manufacture of balloons for.
US5116305A (en) * 1990-02-01 1992-05-26 Abiomed, Inc. Curved intra aortic balloon with non-folding inflated balloon membrane
EP0527969A1 (en) 1990-05-11 1993-02-24 SAAB, Mark, A. High-strength, thin-walled single piece catheters
US5163989A (en) * 1990-08-27 1992-11-17 Advanced Cardiovascular Systems, Inc. Method for forming a balloon mold and the use of such mold
US5254091A (en) 1991-01-08 1993-10-19 Applied Medical Resources Corporation Low profile balloon catheter and method for making same
WO1992019440A1 (en) 1991-05-01 1992-11-12 Danforth Biomedical, Inc. Improved balloon catheter of low molecular weight pet
US5766151A (en) * 1991-07-16 1998-06-16 Heartport, Inc. Endovascular system for arresting the heart
JPH05192408A (en) 1991-09-06 1993-08-03 C R Bard Inc Manufacture of expansion balloon
US5295994A (en) * 1991-11-15 1994-03-22 Bonutti Peter M Active cannulas
US5415635A (en) * 1992-07-21 1995-05-16 Advanced Cardiovascular Systems, Inc. Balloon assembly with separately inflatable sections
EP0652787B1 (en) 1992-07-28 2003-02-05 Advanced Cardiovascular Systems, Inc. Low profile catheter with expandable outer tubular member
US5348538A (en) * 1992-09-29 1994-09-20 Scimed Life Systems, Inc. Shrinking balloon catheter having nonlinear or hybrid compliance curve
US5500180A (en) 1992-09-30 1996-03-19 C. R. Bard, Inc. Method of making a distensible dilatation balloon using a block copolymer
EP0621020A1 (en) 1993-04-21 1994-10-26 SULZER Medizinaltechnik AG Intervertebral prosthesis and method of implanting such a prosthesis
US5352199A (en) * 1993-05-28 1994-10-04 Numed, Inc. Balloon catheter
US6248110B1 (en) * 1994-01-26 2001-06-19 Kyphon, Inc. Systems and methods for treating fractured or diseased bone using expandable bodies
CA2180556C (en) 1994-01-26 2007-08-07 Mark A. Reiley Improved inflatable device for use in surgical protocol relating to fixation of bone
DE69534156D1 (en) * 1994-01-26 2005-05-25 Kyphon Inc Improved inflatable device for use in surgical protocols in relation to the fixation of bone
CN1153549C (en) 1997-06-09 2004-06-16 科丰公司 System for treating fractured or diseased bone using expandable bodies
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer
US5387193A (en) * 1994-02-09 1995-02-07 Baxter International Inc. Balloon dilation catheter with hypotube
CA2160487C (en) 1994-02-17 2003-09-23 Lixiao Wang Process improvements for preparing catheter balloons
US5587125A (en) * 1994-08-15 1996-12-24 Schneider (Usa) Inc. Non-coextrusion method of making multi-layer angioplasty balloons
WO1996012516A1 (en) 1994-10-19 1996-05-02 Advanced Cardiovascular Systems, Inc. High strength dilatation balloons
US5620457A (en) 1994-11-23 1997-04-15 Medinol Ltd. Catheter balloon
NL9500468A (en) 1995-03-08 1996-10-01 Cordis Europ Balloon catheter and method for manufacturing the same.
US5645789A (en) 1995-07-20 1997-07-08 Navius Corporation Distensible pet balloon and method of manufacture
WO1997017099A1 (en) 1995-11-06 1997-05-15 C.R. Bard, Inc. Balloon catheter for drug application
DE69611378D1 (en) 1995-11-08 2001-02-01 Scimed Life Systems Inc necking process for balloon manufacture by cold drawing /
NL1001878C2 (en) 1995-12-12 1997-06-17 Cordis Europ A process for the manufacture of a stent and a tubular member, and catheter therefor.
US5843116A (en) 1996-05-02 1998-12-01 Cardiovascular Dynamics, Inc. Focalized intraluminal balloons
US5741282A (en) * 1996-01-22 1998-04-21 The Anspach Effort, Inc. Soft tissue fastener device
DE69727234T2 (en) 1996-07-23 2004-11-11 Scimed Life Systems, Inc., Maple Grove A process for producing high-strength dilatation balloon having a high compliance to the treatment of gastrointestinal damage
US5910101A (en) 1996-08-29 1999-06-08 Advanced Cardiovascular Systems, Inc. Device for loading and centering a vascular radiation therapy source
NL1004162C2 (en) 1996-10-01 1998-04-02 Cordis Europ Balloon catheter for stent placement.
DE19715724C2 (en) * 1997-04-15 1999-10-21 Wilhelm Horkel A device for childbirth and ease childbirth
US6048346A (en) * 1997-08-13 2000-04-11 Kyphon Inc. Systems and methods for injecting flowable materials into bones
US5972015A (en) * 1997-08-15 1999-10-26 Kyphon Inc. Expandable, asymetric structures for deployment in interior body regions
US5938582A (en) * 1997-09-26 1999-08-17 Medtronic, Inc. Radiation delivery centering catheter
WO1999029246A1 (en) 1997-12-08 1999-06-17 Kyphon Inc. Systems and methods using expandable bodies to push apart cortical bone surfaces
US6468279B1 (en) 1998-01-27 2002-10-22 Kyphon Inc. Slip-fit handle for hand-held instruments that access interior body regions
US6440138B1 (en) * 1998-04-06 2002-08-27 Kyphon Inc. Structures and methods for creating cavities in interior body regions
DE69942858D1 (en) * 1998-06-01 2010-11-25 Kyphon S A R L Expandable, preformed structures for folding in regions within the body
US6241734B1 (en) * 1998-08-14 2001-06-05 Kyphon, Inc. Systems and methods for placing materials into bone
US6716216B1 (en) * 1998-08-14 2004-04-06 Kyphon Inc. Systems and methods for treating vertebral bodies
US6152943A (en) * 1998-08-14 2000-11-28 Incept Llc Methods and apparatus for intraluminal deposition of hydrogels
US6200325B1 (en) * 1999-03-31 2001-03-13 Advanced Cardiovascular Systems, Inc. Balloon catheter and stent deploying catheter system
USD439980S1 (en) * 1999-10-19 2001-04-03 Kyphon, Inc. Hand-held surgical instrument
US7081122B1 (en) 1999-10-19 2006-07-25 Kyphon Inc. Hand-held instruments that access interior body regions
WO2001076514A3 (en) 2000-04-05 2002-05-02 Joseph J Basista Methods and devices for treating fractured and/or diseased bone
WO2002030338A1 (en) 2000-10-10 2002-04-18 Vertx, Inc. Method and appartus for treating a vertebral body
WO2002043628A1 (en) * 2000-12-01 2002-06-06 Sabitzer Ronald J Method and device for expanding a body cavity

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3779241A (en) * 1971-10-20 1973-12-18 Ethyl Corp Intrauterine contraceptive device and method for its use
US5514153A (en) * 1990-03-02 1996-05-07 General Surgical Innovations, Inc. Method of dissecting tissue layers

Cited By (145)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050131267A1 (en) * 1995-06-07 2005-06-16 Talmadge Karen D. System and method for delivering a therapeutic agent for bone disease
US20050131269A1 (en) * 1995-06-07 2005-06-16 Talmadge Karen D. System and method for delivering a therapeutic agent for bone disease
US20070055261A1 (en) * 1998-04-06 2007-03-08 Kyphon Inc. Systems and methods for creating cavities in interior body regions by propagation of energy
US20050043737A1 (en) * 1998-04-06 2005-02-24 Kyphon Inc. Structures for creating cavities in interior body regions
US7670339B2 (en) 1998-10-26 2010-03-02 Expanding Orthopedics, Inc. Expandable orthopedic device
US20060064094A1 (en) * 1998-10-26 2006-03-23 Expanding Orthopedics, Inc. Expandable orthopedic device
US20060084998A1 (en) * 1998-10-26 2006-04-20 Expanding Orthopedics, Inc. Expandable orthopedic device
US20070198013A1 (en) * 2000-08-11 2007-08-23 Foley Kevin T Surgical instrumentation and method for treatment of the spine
US20040267269A1 (en) * 2001-06-01 2004-12-30 Middleton Lance M. Tissue cavitation device and method
US9788963B2 (en) 2003-02-14 2017-10-17 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9925060B2 (en) 2003-02-14 2018-03-27 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9801729B2 (en) 2003-02-14 2017-10-31 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9808351B2 (en) 2003-02-14 2017-11-07 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9814590B2 (en) 2003-02-14 2017-11-14 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9814589B2 (en) 2003-02-14 2017-11-14 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US6923813B2 (en) 2003-09-03 2005-08-02 Kyphon Inc. Devices for creating voids in interior body regions and related methods
US20050240193A1 (en) * 2003-09-03 2005-10-27 Kyphon Inc. Devices for creating voids in interior body regions and related methods
US20050105385A1 (en) * 2003-11-18 2005-05-19 Scimed Life Systems, Inc. Apparatus for mixing and dispensing a multi-component bone cement
US7828802B2 (en) 2004-01-16 2010-11-09 Expanding Orthopedics, Inc. Bone fracture treatment devices and methods of their use
US20100076445A1 (en) * 2004-02-12 2010-03-25 Warsaw Orthopedic, Inc. Surgical Instrumentation and Method for Treatment of a Spinal Structure
US8034088B2 (en) * 2004-02-12 2011-10-11 Warsaw Orthopedic, Inc. Surgical instrumentation and method for treatment of a spinal structure
US20080113081A1 (en) * 2004-04-07 2008-05-15 Abbott Cardiovascular Systems Inc. Methods for Modifying Balloon of a Catheter Assembly
US20050226991A1 (en) * 2004-04-07 2005-10-13 Hossainy Syed F Methods for modifying balloon of a catheter assembly
US20080077117A1 (en) * 2004-04-16 2008-03-27 Kyphon, Inc. Spinal diagnostic methods and apparatus
US7824390B2 (en) 2004-04-16 2010-11-02 Kyphon SÀRL Spinal diagnostic methods and apparatus
US20050234425A1 (en) * 2004-04-16 2005-10-20 Innospine, Inc. Spinal diagnostic methods and apparatus
US7955312B2 (en) 2004-04-16 2011-06-07 Kyphon Sarl Spinal diagnostic methods and apparatus
US7905874B2 (en) 2004-04-16 2011-03-15 Kyphon Sarl Spinal diagnostic methods and apparatus
US20080077172A1 (en) * 2004-04-16 2008-03-27 Kyphon, Inc. Spinal diagnostic methods and apparatus
US7452351B2 (en) * 2004-04-16 2008-11-18 Kyphon Sarl Spinal diagnostic methods and apparatus
US8157786B2 (en) 2004-04-16 2012-04-17 Kyphon Sarl Spinal diagnostic methods and apparatus
US20080021435A1 (en) * 2004-04-16 2008-01-24 Kyphon, Inc. Spinal diagnostic methods and apparatus
US8562634B2 (en) 2004-05-28 2013-10-22 Cavitech, Llc Instruments and methods for reducing and stabilizing bone fractures
US8142462B2 (en) 2004-05-28 2012-03-27 Cavitech, Llc Instruments and methods for reducing and stabilizing bone fractures
US20060116689A1 (en) * 2004-06-16 2006-06-01 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of a spinal structure
US20080319445A9 (en) * 2004-08-17 2008-12-25 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20060074433A1 (en) * 2004-08-17 2006-04-06 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US8038682B2 (en) 2004-08-17 2011-10-18 Boston Scientific Scimed, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20060052794A1 (en) * 2004-08-17 2006-03-09 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US8709042B2 (en) 2004-09-21 2014-04-29 Stout Medical Group, LP Expandable support device and method of use
WO2006034396A3 (en) * 2004-09-21 2006-05-11 E Skott Greenhalgh Balloon and methods of making and using
US20070219634A1 (en) * 2004-09-21 2007-09-20 Greenhalgh E S Expandable support device and method of use
WO2006034396A2 (en) * 2004-09-21 2006-03-30 Stout Medical Group, L.P. Balloon and methods of making and using
US9259329B2 (en) 2004-09-21 2016-02-16 Stout Medical Group, L.P. Expandable support device and method of use
US9314349B2 (en) 2004-09-21 2016-04-19 Stout Medical Group, L.P. Expandable support device and method of use
US20070244485A1 (en) * 2004-09-21 2007-10-18 Greenhalgh E S Expandable support device and method of use
US20060155296A1 (en) * 2005-01-07 2006-07-13 Celonova Biosciences, Inc. Three-dimensional implantable bone support
US20060184192A1 (en) * 2005-02-11 2006-08-17 Markworth Aaron D Systems and methods for providing cavities in interior body regions
US20080071356A1 (en) * 2005-04-27 2008-03-20 Stout Medical Group, L.P. Expandable support device and methods of use
US20070010845A1 (en) * 2005-07-08 2007-01-11 Gorman Gong Directionally controlled expandable device and methods for use
US20070010844A1 (en) * 2005-07-08 2007-01-11 Gorman Gong Radiopaque expandable body and methods
US20070055201A1 (en) * 2005-07-11 2007-03-08 Seto Christine L Systems and methods for providing cavities in interior body regions
US20070010848A1 (en) * 2005-07-11 2007-01-11 Andrea Leung Systems and methods for providing cavities in interior body regions
US20070256527A1 (en) * 2005-07-11 2007-11-08 Phan Christopher U Torque limiting device and methods
US20070010716A1 (en) * 2005-07-11 2007-01-11 Malandain Hugues F Surgical access device, system, and methods of use
US20070068329A1 (en) * 2005-07-11 2007-03-29 Phan Christopher U Curette system
US20070060933A1 (en) * 2005-07-11 2007-03-15 Meera Sankaran Curette heads
US20070010824A1 (en) * 2005-07-11 2007-01-11 Hugues Malandain Products, systems and methods for delivering material to bone and other internal body parts
US8317791B2 (en) 2005-07-11 2012-11-27 Kyphon Sarl Torque limiting device and methods
US20070260257A1 (en) * 2005-07-11 2007-11-08 Phan Christopher U Surgical device having interchangeable components and methods of use
US20070260227A1 (en) * 2005-07-11 2007-11-08 Phan Christopher U Axial load limiting system and methods
US8105236B2 (en) 2005-07-11 2012-01-31 Kyphon Sarl Surgical access device, system, and methods of use
US20070006692A1 (en) * 2005-07-11 2007-01-11 Phan Christopher U Torque limiting device
US8021365B2 (en) 2005-07-11 2011-09-20 Kyphon Sarl Surgical device having interchangeable components and methods of use
US8021366B2 (en) 2005-07-11 2011-09-20 Kyphon Sarl Axial load limiting system and methods
US20070055276A1 (en) * 2005-07-11 2007-03-08 Edidin Avram A Systems and methods for inserting biocompatible filler materials in interior body regions
US20080183204A1 (en) * 2005-07-14 2008-07-31 Stout Medical Group, L.P. Expandable support device and method of use
US9770339B2 (en) 2005-07-14 2017-09-26 Stout Medical Group, L.P. Expandable support device and method of use
US7666227B2 (en) 2005-08-16 2010-02-23 Benvenue Medical, Inc. Devices for limiting the movement of material introduced between layers of spinal tissue
US20070055271A1 (en) * 2005-08-16 2007-03-08 Laurent Schaller Spinal Tissue Distraction Devices
US20070055275A1 (en) * 2005-08-16 2007-03-08 Laurent Schaller Methods for Limiting the Movement of Material Introduced Between Layers of Spinal Tissue
US8961609B2 (en) 2005-08-16 2015-02-24 Benvenue Medical, Inc. Devices for distracting tissue layers of the human spine
US7670375B2 (en) 2005-08-16 2010-03-02 Benvenue Medical, Inc. Methods for limiting the movement of material introduced between layers of spinal tissue
US20100174321A1 (en) * 2005-08-16 2010-07-08 Laurent Schaller Methods of Distracting Tissue Layers of the Human Spine
US8882836B2 (en) 2005-08-16 2014-11-11 Benvenue Medical, Inc. Apparatus and method for treating bone
US7785368B2 (en) 2005-08-16 2010-08-31 Benvenue Medical, Inc. Spinal tissue distraction devices
US20070055265A1 (en) * 2005-08-16 2007-03-08 Laurent Schaller Devices For Limiting the Movement Of Material Introduced Between Layers Of Spinal Tissue
US7670374B2 (en) 2005-08-16 2010-03-02 Benvenue Medical, Inc. Methods of distracting tissue layers of the human spine
US20070055273A1 (en) * 2005-08-16 2007-03-08 Laurent Schaller Methods of Distracting Tissue Layers of the Human Spine
US7955391B2 (en) 2005-08-16 2011-06-07 Benvenue Medical, Inc. Methods for limiting the movement of material introduced between layers of spinal tissue
US7666226B2 (en) 2005-08-16 2010-02-23 Benvenue Medical, Inc. Spinal tissue distraction devices
US7963993B2 (en) 2005-08-16 2011-06-21 Benvenue Medical, Inc. Methods of distracting tissue layers of the human spine
US7967864B2 (en) 2005-08-16 2011-06-28 Benvenue Medical, Inc. Spinal tissue distraction devices
US7967865B2 (en) 2005-08-16 2011-06-28 Benvenue Medical, Inc. Devices for limiting the movement of material introduced between layers of spinal tissue
US8979929B2 (en) 2005-08-16 2015-03-17 Benvenue Medical, Inc. Spinal tissue distraction devices
US20090182386A1 (en) * 2005-08-16 2009-07-16 Laurent Schaller Spinal tissue distraction devices
US8556978B2 (en) 2005-08-16 2013-10-15 Benvenue Medical, Inc. Devices and methods for treating the vertebral body
US20090177207A1 (en) * 2005-08-16 2009-07-09 Laurent Schaller Method of interdigitating flowable material with bone tissue
US8057544B2 (en) 2005-08-16 2011-11-15 Benvenue Medical, Inc. Methods of distracting tissue layers of the human spine
US9044338B2 (en) 2005-08-16 2015-06-02 Benvenue Medical, Inc. Spinal tissue distraction devices
US8808376B2 (en) 2005-08-16 2014-08-19 Benvenue Medical, Inc. Intravertebral implants
US9066808B2 (en) 2005-08-16 2015-06-30 Benvenue Medical, Inc. Method of interdigitating flowable material with bone tissue
US9259326B2 (en) 2005-08-16 2016-02-16 Benvenue Medical, Inc. Spinal tissue distraction devices
US20080234827A1 (en) * 2005-08-16 2008-09-25 Laurent Schaller Devices for treating the spine
US9788974B2 (en) 2005-08-16 2017-10-17 Benvenue Medical, Inc. Spinal tissue distraction devices
US8366773B2 (en) 2005-08-16 2013-02-05 Benvenue Medical, Inc. Apparatus and method for treating bone
US8591583B2 (en) 2005-08-16 2013-11-26 Benvenue Medical, Inc. Devices for treating the spine
US8454617B2 (en) 2005-08-16 2013-06-04 Benvenue Medical, Inc. Devices for treating the spine
US8801787B2 (en) 2005-08-16 2014-08-12 Benvenue Medical, Inc. Methods of distracting tissue layers of the human spine
US20100174375A1 (en) * 2005-08-16 2010-07-08 Laurent Schaller Spinal Tissue Distraction Devices
US9326866B2 (en) 2005-08-16 2016-05-03 Benvenue Medical, Inc. Devices for treating the spine
US20070123877A1 (en) * 2005-11-15 2007-05-31 Aoi Medical, Inc. Inflatable Device for Restoring Anatomy of Fractured Bone
US20070213641A1 (en) * 2006-02-08 2007-09-13 Sdgi Holdings, Inc. Constrained balloon disc sizer
US20090149956A1 (en) * 2006-05-01 2009-06-11 Stout Medical Group, L.P. Expandable support device and method of use
US20080009877A1 (en) * 2006-07-07 2008-01-10 Meera Sankaran Medical device with expansion mechanism
US20080009876A1 (en) * 2006-07-07 2008-01-10 Meera Sankaran Medical device with expansion mechanism
US20080009875A1 (en) * 2006-07-07 2008-01-10 Meera Sankaran Medical device with dual expansion mechanism
US9089347B2 (en) 2006-07-07 2015-07-28 Orthophoenix, Llc Medical device with dual expansion mechanism
US20080086142A1 (en) * 2006-10-06 2008-04-10 Kohm Andrew C Products and Methods for Delivery of Material to Bone and Other Internal Body Parts
US20080114364A1 (en) * 2006-11-15 2008-05-15 Aoi Medical, Inc. Tissue cavitation device and method
EP2114307A4 (en) * 2007-02-07 2013-05-08 Nmb Medical Applic Ltd Bone implant
US20100076503A1 (en) * 2007-02-07 2010-03-25 N.M.B. Medical Applications Ltd Bone implant
EP2114307A2 (en) * 2007-02-07 2009-11-11 N.M.B. Medical Applications Ltd. Bone implant
US9642712B2 (en) 2007-02-21 2017-05-09 Benvenue Medical, Inc. Methods for treating the spine
US8968408B2 (en) 2007-02-21 2015-03-03 Benvenue Medical, Inc. Devices for treating the spine
US20080255624A1 (en) * 2007-03-30 2008-10-16 Gregory Arcenio Methods and devices for multipoint access of a body part
US20080243249A1 (en) * 2007-03-30 2008-10-02 Kohm Andrew C Devices for multipoint emplacement in a body part and methods of use of such devices
US20080294166A1 (en) * 2007-05-21 2008-11-27 Mark Goldin Extendable cutting member
US20090131952A1 (en) * 2007-05-21 2009-05-21 Brian Schumacher Delivery system and method for inflatable devices
US8353911B2 (en) 2007-05-21 2013-01-15 Aoi Medical, Inc. Extendable cutting member
US20080294167A1 (en) * 2007-05-21 2008-11-27 Brian Schumacher Articulating cavitation device
US9750534B2 (en) 2007-10-30 2017-09-05 Hipco, Inc. Device and method for hip distention and access
US8858563B2 (en) * 2007-10-30 2014-10-14 Hipco, Inc. Device and method for hip distention and access
US20090112214A1 (en) * 2007-10-30 2009-04-30 Hipco, Inc. Device and Method for Hip Distention and Access
US8827981B2 (en) 2007-11-16 2014-09-09 Osseon Llc Steerable vertebroplasty system with cavity creation element
US9510885B2 (en) 2007-11-16 2016-12-06 Osseon Llc Steerable and curvable cavity creation system
US20100211176A1 (en) * 2008-11-12 2010-08-19 Stout Medical Group, L.P. Fixation device and method
US8221420B2 (en) 2009-02-16 2012-07-17 Aoi Medical, Inc. Trauma nail accumulator
US8535327B2 (en) 2009-03-17 2013-09-17 Benvenue Medical, Inc. Delivery apparatus for use with implantable medical devices
US9402725B2 (en) 2009-11-30 2016-08-02 DePuy Synthes Products, Inc. Expandable implant
US9220554B2 (en) 2010-02-18 2015-12-29 Globus Medical, Inc. Methods and apparatus for treating vertebral fractures
US8535380B2 (en) 2010-05-13 2013-09-17 Stout Medical Group, L.P. Fixation device and method
US9439705B2 (en) * 2010-11-12 2016-09-13 Smith & Nephew, Inc. Inflatable, steerable balloon for elevation of tissue within a body
US9149286B1 (en) 2010-11-12 2015-10-06 Flexmedex, LLC Guidance tool and method for use
US20140309646A1 (en) * 2010-11-12 2014-10-16 Smith & Nephew, Inc. Inflatable, steerable balloon for elevation of tissue within a body
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods
US9795369B2 (en) * 2011-03-28 2017-10-24 Prabhat Kumar Ahluwalia Organ retractor
US20160199052A1 (en) * 2011-03-28 2016-07-14 Prabhat Kumar Ahluwalia Organ retractor
US8814873B2 (en) 2011-06-24 2014-08-26 Benvenue Medical, Inc. Devices and methods for treating bone tissue
US9314252B2 (en) 2011-06-24 2016-04-19 Benvenue Medical, Inc. Devices and methods for treating bone tissue
US20140222094A1 (en) * 2011-08-18 2014-08-07 Matthias Militz Expansion device for bone expansion and medical device for bone expansion
US9839461B2 (en) * 2011-08-18 2017-12-12 Matthias Militz Expansion device for bone expansion and medical device for bone expansion
US9050112B2 (en) 2011-08-23 2015-06-09 Flexmedex, LLC Tissue removal device and method
US20140303730A1 (en) * 2011-11-30 2014-10-09 Beth Israel Deaconess Medical Center Systems and methods for endoscopic vertebral fusion
US9861794B2 (en) 2015-10-08 2018-01-09 Cook Medical Technologies Llc Multi chamber medical balloon

Also Published As

Publication number Publication date Type
US20040225296A1 (en) 2004-11-11 application
ES2302846T3 (en) 2008-08-01 grant
US20070299455A1 (en) 2007-12-27 application
CA2472594C (en) 2010-06-01 grant
CN1622792A (en) 2005-06-01 application
CN100464723C (en) 2009-03-04 grant
EP1820463A2 (en) 2007-08-22 application
EP1820463A3 (en) 2007-09-05 application
KR20040105702A (en) 2004-12-16 application
JP2005514160A (en) 2005-05-19 application
DE60220716T2 (en) 2007-10-04 grant
DE60220716D1 (en) 2007-07-26 grant
EP1820463B1 (en) 2009-09-02 grant
US20040092948A1 (en) 2004-05-13 application
KR100959444B1 (en) 2010-05-25 grant
WO2003059214A3 (en) 2003-11-13 application
CN101548906B (en) 2012-03-14 grant
EP1463464B1 (en) 2007-06-13 grant
EP1913903A2 (en) 2008-04-23 application
EP1463463A2 (en) 2004-10-06 application
US20080172081A1 (en) 2008-07-17 application
DE60225337D1 (en) 2008-04-10 grant
CA2472594A1 (en) 2003-07-24 application
DE60233609D1 (en) 2009-10-15 grant
JP4292081B2 (en) 2009-07-08 grant
WO2003059214A2 (en) 2003-07-24 application
US7241303B2 (en) 2007-07-10 grant
EP1463463B1 (en) 2008-02-27 grant
US20110144688A1 (en) 2011-06-16 application
DE60225337T2 (en) 2008-05-29 grant
EP1913903A3 (en) 2008-05-07 application
CN101548906A (en) 2009-10-07 application
EP1463464A2 (en) 2004-10-06 application
ES2288569T3 (en) 2008-01-16 grant
US7261720B2 (en) 2007-08-28 grant

Similar Documents

Publication Publication Date Title
EP1011464B1 (en) Systems for percutaneous bone and spinal stabilization, fixation and repair
US7014633B2 (en) Methods of performing procedures in the spine
US5888210A (en) Stem of a femoral component of a hip joint endoprosthesis
US7156861B2 (en) Expandable structures for deployment in interior body regions
US6733533B1 (en) Artificial spinal disc
US7166121B2 (en) Systems and methods using expandable bodies to push apart cortical bone surfaces
US20040260305A1 (en) Device for delivering an implant through an annular defect in an intervertebral disc
US7309338B2 (en) Methods and apparatus for performing therapeutic procedures in the spine
US6706069B2 (en) Spinal grooved director with built in balloon
US7758644B2 (en) Systems and techniques for intravertebral spinal stabilization with expandable devices
US20110046737A1 (en) Method and apparatus for augmenting bone
US7267687B2 (en) Spinal implant and method of use
US20070118143A1 (en) Systems and methods for reducing fractured bone using a fracture reduction cannula
US20040002713A1 (en) Retrograde plunger delivery system
US5108404A (en) Surgical protocol for fixation of bone using inflatable device
US20050209629A1 (en) Resorbable containment device and process for making and using same
US6425923B1 (en) Contourable polymer filled implant
US20050015148A1 (en) Biocompatible wires and methods of using same to fill bone void
US6726691B2 (en) Methods for treating fractured and/or diseased bone
US7204851B2 (en) Method and apparatus for delivering an intervertebral disc implant
US20070093906A1 (en) Nucleus implant and method
US20020026195A1 (en) Insertion devices and method of use
US20070010845A1 (en) Directionally controlled expandable device and methods for use
US20130041472A1 (en) Systems and Methods for Joint Stabilization
US20100023126A1 (en) Resilient arthroplasty device

Legal Events

Date Code Title Description
AS Assignment

Owner name: KYPHON INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:REISS, PAUL;ICO, CESAR;TALMADGE, KAREN D.;AND OTHERS;REEL/FRAME:013292/0745;SIGNING DATES FROM 20020830 TO 20020906

AS Assignment

Owner name: MEDTRONIC SPINE LLC, CALIFORNIA

Free format text: CHANGE OF NAME;ASSIGNOR:KYPHON INC;REEL/FRAME:020993/0042

Effective date: 20080118

Owner name: MEDTRONIC SPINE LLC,CALIFORNIA

Free format text: CHANGE OF NAME;ASSIGNOR:KYPHON INC;REEL/FRAME:020993/0042

Effective date: 20080118

AS Assignment

Owner name: KYPHON SARL, SWITZERLAND

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MEDTRONIC SPINE LLC;REEL/FRAME:021070/0278

Effective date: 20080325

Owner name: KYPHON SARL,SWITZERLAND

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MEDTRONIC SPINE LLC;REEL/FRAME:021070/0278

Effective date: 20080325

AS Assignment

Owner name: ORTHOPHOENIX, LLC, TEXAS

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:KYPHON SARL;REEL/FRAME:035307/0018

Effective date: 20130425