US20070118143A1 - Systems and methods for reducing fractured bone using a fracture reduction cannula - Google Patents

Systems and methods for reducing fractured bone using a fracture reduction cannula Download PDF

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Publication number
US20070118143A1
US20070118143A1 US11637396 US63739606A US2007118143A1 US 20070118143 A1 US20070118143 A1 US 20070118143A1 US 11637396 US11637396 US 11637396 US 63739606 A US63739606 A US 63739606A US 2007118143 A1 US2007118143 A1 US 2007118143A1
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Prior art keywords
cannula
bone
circumferential opening
distal end
expandable structure
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Abandoned
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US11637396
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Christopher Ralph
Richard Layne
Paul Sand
Robert Scribner
Mark Reiley
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Orthophoenix LLC
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Medtronic Spine LLC
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    • 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
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1686Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hand or wrist
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3472Trocars; Puncturing needles for bones, e.g. intraosseus injections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3468Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
    • 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
    • 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
    • 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
    • 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
    • A61F2/30Joints
    • 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
    • A61F2/4601Special 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

Abstract

Systems and methods provide for the fixation of osteoporotic and non-osteoporotic long bones, especially Colles' fractures. A cannula having a circumferential opening is inserted into cancellous bone and directed such that the circumferential opening faces the fracture. The cannula is further adapted to receive an expandable structure, the expandable structure being inserted through the cannula until it is in registration with the circumferential opening. The expandable structure is expanded through the circumferential opening into cancellous bone and toward the fracture. The expansion of the expandable structure through the circumferential opening toward the fracture causes compression of cancellous bone and moves fractured cortical bone, thus creating a cavity proximal to the fracture. The cavity is then filled with a flowable bone filling material and the material allowed to harden.

Description

    RELATED APPLICATIONS
  • This application is a divisional of co-pending application Ser. No. 10/001,937 filed 25 Oct. 2001 which is a Continuation-in-part of application Ser. No. 09/804,107 filed 12 Mar. 2001 (now U.S. Pat. No. 6,613,054), which is a divisional of application Ser. No. 09/134,323 filed 14 Aug. 1998 (now U.S. Pat. No. 6,241,734). This application also claims the benefit of provisional application Ser. No. 60.243,194 filed 25 Oct. 2000.
  • FIELD OF THE INVENTION
  • This invention relates to the treatment of bone conditions of the human and other animal body systems and, more particularly, to systems and methods for correcting such conditions.
  • BACKGROUND OF THE INVENTION
  • Bone fractures, particularly osteoporotic bone fractures, are common in older adults. Due to the nature of osteoporotic bone, standard methods of fracture fixation yield unsatisfactory results. Such methods cannot adequately place the broken fragments back to their pre-fracture state. For instance, with a non- osteoporotic bone fracture, common practice includes inserting rods, pins and/or screws into the bone in order to reduce the fracture and/or fix the fracture fragments to plates. Osteoporotic bone generally cannot support such a method. Another common method for non-osteoporotic bone fractures involves maintaining the bone in a cast for several weeks. Osteoporotic bone that has suffered a crush fracture, such as a Colles' fracture of the distal radius, will not heal properly if placed in a cast; the bone mechanics are altered such that the bone is shortened and/or subsides. Yet another non-osteoporotic fracture reduction method involves using an external fixation device. However, when used in elderly patients, the fixation pins may not remain within the weakened bone. Moreover, such a device typically increases the likelihood of infection at the treatment site. Further, because casts and/or an external fixation devices must be left in place for several weeks in order for the bone to heal, the lack of joint movement in the affected area often results in painful arthritis in the immobilized joints of the elderly patient.
  • Even where osteoporosis is not present, it is typically necessary to immobilize a fractured bone to allow the bone to properly heal. This often requires immobilization of the joints adjacent to the fractured bone—often for extended periods of time. However, such immobilization often causes the joints to degenerate over time. Often, such treatment can result in temporary or permanent loss of joint motion. At the very least, such immobilization of the joints requires extensive and often painful rehabilitation for an individual to recover the full range of their joint motion.
  • SUMMARY OF THE INVENTION
  • Because of the problems associated with treating distal radius fractures such as Colles' fractures, and other bone fractures similar thereto, there is a need for a method and apparatus that will improve the existing protocol for treating such fractures such as reducing the pain resulting from the fracture fixation method used, reducing the chance that an infection will occur at the site, improving the likelihood that the fracture will heal properly and minimizing degeneration of the adjacent joints and allows for sooner resumption of activity. The present invention provides apparatus and a method of fracture reduction which satisfies this need.
  • This invention provides a system that fixes or reduces osteoporotic and non-osteoporotic fractures in human and other animal body systems. Moreover, by immediately reducing and/or reinforcing the fractured bone, thereby rendering the bone capable of bearing limited loads, the present system promotes healing of the fractured bone while minimizing degeneration of the adjacent joints. It is particularly well suited for fractures of long bones such as the human distal radius.
  • One aspect of the invention provides a tool for establishing a percutaneous path into bone. The tool is a cannula having a side wall defining an internal bore aligned along an axis. The cannula has a distal end. A circumferential opening is defined in the side wall. The circumferential opening has a distal terminus. The circumferential opening extends partially about the side wall and is elongated along the axis. The circumferential opening is adapted to accommodate passage of an expandable structure from within the bore. In one embodiment, the bore is solid between the distal terminus of the circumferential opening and the distal end of the cannula.
  • In an alternate embodiment of the above described tool, the bore is open between the distal terminus of the circumferential opening and the distal end of the cannula. The cannula has a distal opening in the distal end communicating with the bore. The opening in the distal end can accommodate passage of a guide pin.
  • In an alternate embodiment of the above described tool, the cannula desirably has a surface on its distal end to anchor the distal end in bone.
  • Another aspect of the invention provides an assembly for treating bone, including a cannula as described above. The cannula has a distal opening in the distal end communicating with the bore. The opening in the distal end can accommodate passage of a guide pin. The assembly also includes an expandable structure. The expandable structure is adapted for insertion through bone into the cannula and expansion through the circumferential opening.
  • Another aspect of the invention provides an assembly for treating bone, including a cannula as described above. Desirably, the bore is solid between the distal terminus of the circumferential opening and the distal end of the cannula. The assembly also includes an expandable structure. The expandable structure is adapted for insertion through bone into the cannula and expansion through the circumferential opening.
  • Another aspect of the invention provides an assembly for treating bone, including a cannula as described above. Desirably, the cannula has a surface on its distal end to anchor the distal end in bone. The assembly also includes an expandable structure. The expandable structure is adapted for insertion through bone into the cannula and expansion through the circumferential opening.
  • Another aspect of the invention provides an assembly as described above. Desirably, the expandable structure has radio opaque markers. The markers allow one to locate the expandable structure within a circumferential opening in a cannula.
  • Another aspect of the invention provides a method for treating bone. The method includes providing a cannula and inserting the cannula into cancellous bone. The method also includes inserting an expandable structure through the cannula until the structure is in registration with a circumferential opening in the cannula. The method further includes expanding the expandable structure through the circumferential opening into contact with cancellous bone.
  • Another aspect of the invention provides a method for treating bone, including a step of expanding an expandable structure. The expansion compacts cancellous bone.
  • Another aspect of the invention provides a method for treating bone, including a step of compacting cancellous bone. The compaction of cancellous bone forms a cavity.
  • Another aspect of the invention provides a method for treating bone, including a step of conveying a material into a cavity.
  • Another aspect of the invention provides a method for treating bone, including a step of expanding an expandable structure such that the expansion moves fractured cortical bone.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is an anatomic view that shows bones of a human forearm;
  • FIG. 2 is an anatomic view that shows bones of the forearm including an ulna and a fractured distal radius;
  • FIG. 3 is an enlarged section view of the distal radius showing cancellous bone and cortical bone in a fractured condition;
  • FIG. 4 is a plane view showing a kit containing a system of instruments used to treat bones and that embodies features of the invention;
  • FIG. 5 is a perspective view of an obturator instrument that is contained in the kit shown in FIG. 4;
  • FIG. 6 is a perspective view of a percutaneous cannula that is contained in the kit shown in FIG. 4;
  • FIG. 7 is a perspective view of a drill bit instrument that is contained in the kit shown in FIG. 4;
  • FIG. 8 is a perspective view of a fracture reduction cannula that is contained in the kit shown in FIG. 4, showing a distal end, a proximal end, and a circumferential opening;
  • FIG. 8A is a perspective view of an alternate embodiment of a fracture reduction cannula constructed in accordance with the teachings of the present invention;
  • FIG. 8B is a perspective view of another alternate embodiment of a fracture reduction cannula constructed in accordance with the teachings of the present invention;
  • FIG. 9 is a side view of the fracture reduction cannula of FIG. 8 showing an end interior bore therethrough;
  • FIG. 10 a is an enlarged view of the distal end of the fracture reduction cannula, the distal end being solid;
  • FIG. 10 b is an enlarged view of the distal end of the fracture reduction cannula of FIG. 8, the distal end being open to accommodate passage of a guide pin;
  • FIG. 11 is a perspective view of an instrument carrying an expandable structure, the instrument being contained in the kit shown in FIG. 4;
  • FIG. 12 is an enlarged perspective view of an instrument, showing the expandable structure in an unexpanded state and, in broken lines, the expandable structure in an expanded state;
  • FIG. 13 is a perspective view of a tamp that is contained in the kit shown in FIG. 4;
  • FIG. 14 is a perspective view of a handle that is contained in the kit shown in FIG. 4; showing recesses therein;
  • FIG. 15 is a perspective view showing the obturator instrument inserted into the handle, the handle being grasped by a hand;
  • FIG. 15 a is a side section view showing the obturator instrument inserted into the handle and advanced to the distal radius;
  • FIG. 16 is a side section view showing the percutaneous cannula inserted over the obturator instrument and advanced to the distal radius;
  • FIG. 17 is a side section view showing the drill bit instrument within the percutaneous cannula and advanced to the distal radius, and further showing the distal radius fracture and cancellous bone;
  • FIG. 18 is a side section view showing the fracture reduction cannula within the percutaneous cannula and advanced into the cancellous bone of the distal radius, and further showing the circumferential opening facing the fracture;
  • FIG. 19 is an enlarged view showing the fracture reduction cannula seated within cortical bone;
  • FIG. 20 is an enlarged view showing the fracture reduction cannula seated within cortical bone and containing the unexpanded expandable structure;
  • FIG. 21 is an enlarged view showing the fracture reduction cannula seated within cortical bone, containing the expanded expandable structure, and compressing cancellous bone and/or moving cortical bone;
  • FIG. 21A is an enlarged view showing a fracture reduction cannula seated within cortical bone, with the expanded expandable structure compressing cancellous bone and/or moving cortical bone and creating a cavity which extends across a fracture line in the targeted bone;
  • FIG. 22 is an enlarged view showing the fracture reduction cannula seated within cortical bone and containing the expanded expandable structure, showing compressed cancellous bone, displaced cortical bone, and a reduced fracture, and further showing a pin placed through the distal radius and into the ulna;
  • FIG. 22A is an enlarged view showing a fracture reduction cannula seated within cortical bone and containing the expanded expandable structure, showing compressed cancellous bone, displaced cortical bone, a reduced fracture, and a cavity extending across a fracture line in the cortical bone, and further showing a pin placed through the distal radius and into the ulna;
  • FIG. 23 is a top view showing a patient's forearm on a rolled towel, with horizontal finger traps on the patient's fingers, the instrument inserted through the handle and into the percutaneous cannula, with the fraction reduction cannula hidden from view, and the pin inserted into the patient's wrist;
  • FIG. 24 is an enlarged view showing a cavity created by expansion of the expandable structure in the distal radius, the pin in place, the fracture reduction cannula, and the cavity ready to receive a bone filling material;.
  • FIG. 25 is an enlarged view showing the filling material beginning to fill the cavity;
  • FIG. 26 is an enlarged view showing the tamp urging the filling material fully into the cavity;
  • FIG. 27 is an enlarged view showing the filled cavity with the fracture reduction cannula and tamp removed; and
  • FIG. 28 is an enlarged view showing an alternate embodiment of the fracture reduction cannula with a guide pin placed therethrough.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • The invention may be embodied in several forms without departing from its spirit or essential characteristics. The scope of the invention is defined in the appended claims, rather than in the specific description preceding them. All embodiments that fall within the meaning and range of equivalency of the claims are therefore intended to be embraced by the claims.
  • The preferred embodiment describes improved systems and methods that embody features of the invention in the context of treating bones. This is because the new systems and methods are advantageous when used for this purpose. However, aspects of the invention can be advantageously applied for diagnostic or therapeutic purposes in other areas of the body.
  • The new systems and methods will be more specifically described in the context of the treatment of long bones such as the human distal radius. Of course, other human or animal bone types can be treated in the same or equivalent fashion.
  • I. Anatomy of the Radius
  • The human forearm consists of two bones, the radius and the ulna. As shown in FIGS. 1 and 2, the radius 20 is a long bone that is situated on the thumb side of the forearm, while the ulna 26 is located at the little finger side. The radius 20 lies side by side with the ulna 26, and it exceeds the ulna 26 both in length and in size.
  • The upper, or proximal end 22 of the radius 20 is small and articulates with a part of the elbow joint, including the proximal ulna 28. The distal end 24 of the radius 20 is large and articulates with two bones of the wrist, or carpus, known as the lunate 21 and scaphoid 27 bones. The inner, or medial side 25 of the distal radius 24 contains an ulnar notch 32 that articulates with the ulna 26.
  • II. Bone Fractures
  • The systems and methods of the present invention are especially suited for treating fractures of long bones. One type of bone fracture that may be so treated is known as a Colles' fracture or transverse wrist fracture. As shown in FIG. 2, such a fracture 34 generally occurs less than one inch from the distal end 24 of the radius 20. Colles' fractures are commonly noted in children and the elderly where the person tries to break or stop a fall by using his or her hands and arms. Colles' fractures in children are often associated with sports such as skateboarding and in-line skating. In the elderly, Colles' fractures are commonly caused by osteoporosis and/or in connection with a fall.
  • Osteoporosis is a disease of the bone that is most commonly found in the middle-aged and elderly, particularly women. It is characterized by a gradual loss of a type of bone tissue known as cancellous bone 36. As shown in FIG. 3, cancellous bone 36, also referred to as trabecular bone, is a spongy bone tissue located within the harder outer or cortical bone. Cancellous bone 36 comprises most of the bone tissue of the extremities of long bones such as the radius 20.
  • In contrast to cancellous bone 36, cortical bone 38 tissue is much harder and denser. Cortical bone 38 is layered over cancellous bone 36, and provides a protective layer and support for long bones such as the radius 20, as shown in FIGS. 1 and 2. At the ends of such bones, however, the cortical bone 38 layer becomes thinner. Where osteoporosis has significantly weakened the cancellous bone 36, such regions at the ends of long bones become especially prone to fracture and/or collapse.
  • It may be indicated, due to disease or trauma, to reduce fractured cortical bone 38 and/or compress cancellous bone 36 within long bones such as the radius 20. The compression, for example, can be used to form an interior cavity 35, which receives a filling material 99, e.g., a flowable material that sets to a hardened condition, such as poly(methylmethacrylate), as well as a medication, or combinations thereof, to provide improved interior support for cortical bone 38 or other therapeutic functions, or both. The compaction of cancellous bone 36 also exerts interior force upon cortical bone 38, making it possible to elevate or push broken and compressed bone back to or near its original pre-fracture, or other desired, condition.
  • III. The Instruments
  • FIG. 4 shows instruments, arranged as a kit 200, which are usable in association with each other to reduce fractured bone. The number and type of instruments can vary. FIG. 4 shows seven representative instruments, each having a different size and function.
  • In FIG. 4, the kit 200 includes an obturator instrument 12 for penetrating soft tissue and bone; a percutaneous cannula 14 that functions as a guide sheath; a drill bit instrument 16 that is used for drilling into bone; a fracture reduction cannula 18 used in reducing fractures and that is inserted into bone and designed to receive an expandable structure; a bone compaction instrument 80 that functions to deliver a filling material 99 into a cavity 35 in bone and that carries an expandable structure 86 that may be expanded in bone; a tamp 81 functions to urge residual bone filling material into bone; and a handle 13 with recesses that receives instruments 12, 14, 16 and 18.
  • Instruments 12, 14, 16, and 18 share some common features, although they are intended, in use, to perform different functions. Instruments 12, 14, 16, and 18 each comprise an elongated, cylindrical body 40 having a proximal end 42 and a distal end 44. Instruments 12, 14, 16, and 18 are each made of a rigid, surgical grade plastic or metal material.
  • A. The Obturator Instrument
  • The first instrument 12 functions as an obturator. As shown in FIG. 5, its distal end 44 is tapered to present a penetrating surface 50. In use, the surface 50 is intended to penetrate soft tissue and/or bone in response to pushing or twisting forces applied by the physician at the proximal end 42. In a preferred embodiment, the proximal end 42 of the obturator instrument 12 mates with a handle 13, to be described in detail later.
  • The proximal end 42 of the obturator instrument 12 presents a flanged surface 52. The flanged surface 52 is designed to fit securely into a recess in the handle 13, such that pushing or twisting forces applied to the proximal end 42 of the obturator 12 instrument will not displace the obturator instrument 12. The flanged surface 52 tapers from a larger outer diameter to a smaller outer diameter in the direction of the proximal end 42. The flanged surface 52 includes an array of circumferentially spaced teeth 54 with intermediate flutes 56.
  • An interior bore 60 extends through the obturator instrument 12 from the distal end 44 to the proximal end 42. Desirably, the interior bore 60 is sized to accommodate a conventional surgical guide pin 108 component to aid in its deployment, as will be described in greater detail later.
  • The obturator instrument 12 has an outer surface 142 that is sized such that one may slide a percutaneous cannula 14 over the obturator instrument 12 as described below.
  • B. The Percutaneous Cannula
  • The second instrument 14 functions as a percutaneous cannula or guide sheath. It also serves to protect soft tissue and nerves, ligaments, muscle and vasculature from the use of a drill bit instrument 16, which will be described in greater detail later.
  • As shown in FIG. 6, the percutaneous cannula 14 is somewhat larger in diameter than, and is not as long as, the obturator instrument 12. In one embodiment, the cannula 14 is approximately 2 inches long, although it could be various other lengths, depending upon the thickness of the patient's soft tissue at the surgical site. Desirably, the percutaneous cannula 14 is made of metal, and contains markings 120 along its outer surface 142 to indicate the depth at which it is placed into a patient's distal radius 24.
  • The proximal end 42 of the percutaneous cannula 14 presents a tapered flange 52, as FIG. 6 shows. The flanged surface 52 is designed to fit securely into a recess in the handle 13, such that forces applied to the proximal end 42 of the percutaneous cannula 14 will not displace the percutaneous cannula 14. The tapered flange 52 changes from a larger diameter to a smaller diameter in the direction of the proximal end 42. The tapered flange 52 of the percutaneous cannula 14 also includes an array of circumferentially spaced teeth 54 with intermediate flutes 56. The form and orientation of the teeth 54 and flutes 56 on the percutaneous cannula 14 correspond to the form and orientation of teeth 54 and flutes 56 on the fracture reduction cannula 18.
  • As shown in FIG. 6, the percutaneous cannula 14 includes an interior bore 60 that extends from its distal end 44 to its proximal end 42. Desirably, the interior bore 60 is sized to accept the obturator instrument 12. The size of the interior bore 60 permits a physician to slide and rotate the percutaneous cannula 14 relative to the obturator instrument 12, and vice versa, as will be described in greater detail later.
  • The distal end 44 of the percutaneous cannula 14 presents an end surface 62. Desirably, the surface of the distal end 44 is designed to penetrate soft tissue. In use, the end surface 62 of the percutaneous cannula 14 is intended to penetrate soft tissue surrounding the obturator instrument 12, in response to pushing or twisting forces applied at the proximal end 42. If desired, the end surface 62 can incorporate one or more teeth (not shown) which anchor the cannula 14 to the surface of the targeted bone.
  • C. The Drill Bit Instrument
  • The third instrument functions as a drill bit. As shown in FIG. 7, The drill bit instrument 16 has generally the same physical dimensions as the obturator instrument 12. Like the obturator instrument 12, the drill bit instrument 16 is intended, in use, to fit for sliding and rotational movement within the interior bore 60 of the percutaneous cannula 14.
  • The distal end 44 of the drill bit instrument 16 includes machined cutting edges 64, as shown in FIG. 7. In use, the cutting edges 64 are intended to penetrate hard tissue in response to rotation and longitudinal load forces applied at the proximal end 42 of the drill bit instrument 16.
  • As further shown in FIG. 7, the proximal end 42 presents a tapered flange 52, substantially identical to the flange 52 on the obturator instrument 12, as FIG. 5 shows. The flanged surface 52 is designed to fit securely into a recess in the handle 13, such that forces applied to the proximal end 42 of the drill bit instrument 14 will not displace the drill bit instrument 14. Like the obturator instrument 12, the tapered flange 52 changes from a larger diameter to a smaller diameter in the direction of the proximal end 42. The tapered flange 52 of the drill bit instrument 16 also includes an array of circumferentially spaced teeth 54 with intermediate flutes 56. The form and orientation of the teeth 54 and flutes 56 on the drill bit instrument 16 correspond to the form and orientation of the teeth 54 and flutes 56 on the obturator instrument 12.
  • D. The Fracture Reduction Cannula
  • The fourth instrument functions as a fracture reduction cannula 18. As shown in FIG. 8, the fracture reduction cannula 18 is somewhat smaller in diameter than, and is longer than, the percutaneous cannula 14. In one embodiment, the fracture reduction cannula 18 is approximately 3 M inches in length, although it could be various other lengths depending on the size of the patient and the desired location within the targeted bone. Like both the obturator instrument 12 and the drill bit instrument 16, the fracture reduction cannula 18 is intended, in use, to fit for sliding and rotational movement within the interior bore 60 of the percutaneous cannula 14.
  • The proximal end 42 of the fracture reduction cannula 18 presents a flanged surface 52. The flanged surface 52 is designed to fit securely into a recess in the handle 13, such that pushing or twisting forces applied to the proximal end 42 of the obturator 12 instrument will not displace the fracture reduction cannula 18. Like the percutaneous cannula 14, the flanged surface 52 of the fracture reduction cannula 18 tapers from a larger outer diameter to a smaller outer diameter in the direction of the proximal end 42. The flanged surface 52 includes an array of circumferentially spaced teeth 54 with intermediate flutes 56.
  • The fracture reduction cannula 18 is sized to fit within the interior bore 60 of the percutaneous cannula 14. The size of the interior bore 60 permits a physician to slide and rotate the fraction reduction cannula relative to percutaneous cannula 14, and vice versa, as will be described in greater detail later.
  • As further shown in FIG. 8, the fracture reduction cannula 18 includes a side wall 66 that defines an interior bore 68 that extends from the distal end 44 of the fracture reduction cannula 18 to its proximal end 42. The interior bore 68 is adapted to allow passage of, among other things, an expandable structure 86. In a preferred embodiment, the distal end 44 of the interior bore 68 is solid, as shown in FIG. 10 a. In an alternate embodiment, the distal end 44 of the bore 68 is not solid, but rather, it is open to accommodate passage of an instrument such as a guide pin 108, as shown in FIG. 10 b. As another alternative, the distal end of the bore 68 could be hollow, such that a portion of the expandable structure could extend into the distal end 44 of the cannula 18.
  • The fracture reduction cannula 18 further includes a circumferential opening 70 in the side wall 66. In one embodiment, the circumferential opening 70 extends approximately one-half inch in length along its longitudinal axis, although the size of this opening could vary depending upon the dimensions of the targeted bone and the size of the expandable structure. The circumferential opening 70 is sized to accommodate an expandable structure 86. The circumferential opening 70 desirably also allows a filling material 99 to be placed near and/or into the fracture site.
  • FIG. 8A depicts one alternate embodiment of a fracture reduction cannula 18A constructed in accordance with the teachings of the present invention. Because many of the disclosed components are similar to those previously described, like reference numerals will be used to denote similar components. In this embodiment, the distal end 44A of the cannula 18A is not solid, but rather extends along the side wall 66A, with one or more longitudinally extending teeth 120 disposed at the distal end 44A.
  • E. The Handle
  • The handle 13, which can be made from a molded or cast rigid plastic or metal material, is more fully described in U.S. application Ser. No. 09/014,229, filed on Jan. 27, 1998, the disclosure of which is incorporated herein by reference. As shown in FIG. 14, the handle has a smooth upper side 17. Its lower side 29 contains recesses 15 and 19. The flanged surfaces of the obturator instrument 12, the drill bit instrument 16, the percutaneous cannula 14, and the fracture reduction cannula 18 mate with the handle 13. Recess 15 is adapted to accept the obturator 12 and the drill bit instrument 16 while recess 19 is adapted to accept the fracture reduction cannula 18. If desired, another recess can be provided (not shown) sized to accept the percutaneous cannula 14 in a similar manner.
  • F. The Bone Compaction and/or Displacement Instrument
  • FIG. 11 shows an instrument 80 for accessing bone for the purpose of compacting cancellous bone 36 and/or displacing cortical bone 38. The instrument 80, and instructions for assembling same, are more fully set out in U.S. application Ser. No. 09/420,529, filed on Oct. 19, 1999, incorporated herein by reference.
  • The instrument 80 includes a catheter tube assembly 82, as shown in FIG. 11. The distal end 84 of the catheter tube assembly 82 carries an expandable structure 86. In use, the expandable structure 86 is deployed and expanded inside bone, e.g., in the radius 20 as shown in FIGS. 20, 21, and 22, to compact cancellous bone 36 and/or displace cortical bone 38, as will be described later.
  • As further shown in FIG. 11, the instrument 80 includes an outer catheter body 88, and an inner catheter body 90 which extends through the outer catheter body 88. The proximal ends 92 of the outer 88 and inner 90 catheter bodies are coupled to a y-shaped adaptor/handle 94. The y-shaped adaptor/handle 94 carries a first port 96 and a second port 98 at its proximal end 92. The first port 96 is adapted to be coupled with an inflation syringe 101, the syringe 101 in the present case being used to deliver a pressurized liquid into the expandable structure 86. The second port 98 is adapted for insertion of a stiffening stylet (not shown) to facilitate. insertion of the distal end 84 of the instrument 80.
  • As FIG. 11 shows, the expandable structure 86 is coupled at its proximal end 95 to the distal end 93 of the outer catheter body 88. Likewise, the expandable structure 86 is coupled at its distal end 87 to the distal end 84 of the inner catheter body 90.
  • The outer catheter body 88 defines an interior bore, through which the inner catheter body 90 extends. The interior bore, in use, conveys a pressurized liquid, e.g., a radio-opaque solution such as CONRAY® solution, or another fluid into the expandable structure 86 to expand it.
  • The material from which the expandable structure 86 is made should possess various physical and mechanical properties to optimize its functional capabilities to compact cancellous bone 36, and to move cortical bone 38. Desirably, the expandable structure 86 has the capability to move cortical bone 38 from a fractured condition to a pre-fractured or other desired condition, or both. The three most important properties of expandable structure 86 are the ability to expand its volume; the ability to deform in a desired way when expanding and assume a desired shape inside bone; and the ability to withstand abrasion, tearing, and puncture when in contact with cancellous bone 36.
  • The desired properties for the structure material, and the description for creating a pre-formed structure, are more fully set out in U.S. application Ser. No. 09/420,529, filed on Oct. 19, 1999.
  • As shown in FIG. 11, the expandable structure 86 carries radio-opaque markers 91 located at a distal end 102 and at a proximal end 104 of segmented shaped regions 100 of the expandable structure 86. The radio opaque markers 91 function to indicate, under fluoroscopic or other real-time monitoring, the location of the segmented shaped regions 100 in relation to the circumferential opening 70 of the fracture reduction cannula 18.
  • FIG. 12 illustrates the expandable structure in a collapsed state (solid lines) and an expanded state (broken lines).
  • G. The Pin
  • One or more conventional smooth Steinman pins 130 or Kirschner (“K”) wires may be provided to assist in aligning and/or stabilizing fracture fragments, as will be described in greater detail later.
  • H. The Filling Material Instruments
  • The filling material 99 instruments include a tamp 81 as shown in FIG. 13, and a standard syringe. The filling material 99 is introduced through the syringe and into the fracture reduction cannula 18. Residual filling material 99 may be urged through the fracture reduction cannula 18 by employing the tamp 81, as will be described in greater detail later.
  • I. The Kit
  • As shown in FIG. 4, a kit 200 is provided, including instruments 12, 13, 14, 16, 18, 80, and 81. The kit 200 and the instruments contained therein are sterile and are sealed until an instance of use.
  • IV. Illustrative use of the System
  • The size and shape of the access tools and/or expandable structure(s) 86 to be used, and the amount of bone to be moved, are desirably selected by the physician, taking into account the morphology and geometry of the site to be treated. The shape of the joint, the bones and soft tissues involved, and the local structures that could be harmed if moved inappropriately, are generally understood by medical professionals using textbooks of human anatomy along with their knowledge of the site and its disease and/or injury. The physician is also desirably able to select the desired shape and size of the expandable structure 86, the cavity 35 and their placement based upon prior analysis of the morphology of the targeted bone and joint using, for example, plain film x-ray, fluoroscopic x-ray, or MRI or CT scanning. The shape, size and placement are desirably selected to optimize the strength and ultimate bonding of the fracture relative to the surrounding bone and/or tissue of the joint.
  • In a typical procedure, a patient is placed under local anesthesia, although general anesthesia may instead be employed. Where a fracture 34 is that of a distal radius 24, a physician makes an incision of approximately one (1) centimeter on the radial aspect of the distal radius 24. In an alternate embodiment, one may access the distal radius 24 by an approach through the ulna 26. The distance between the incision and the fracture 34 is approximately 0.5 centimeter. Of course, while the present procedure is described in the context of a minimally invasive surgery, various other surgical approaches, including percutaneous, subcutaneous, non-open, partially open and/or completely open surgical approaches may be utilized in accordance with the teachings of the present invention.
  • After making the incision, the physician spreads the soft tissue by using a small clamp designed to avoid injury to nearby nerves, muscles, and vasculature. The physician then acquires the obturator instrument 12 and the handle 13. The obturator instrument 12 may have at its proximal end 42 a flanged surface 52 that mates with a recess 15 within the handle 13. Use of the handle 13 with the obturator instrument 12 will produce axial as well as radial movement, as shown in U.S. application Ser. No. 09/014,229, filed on Jan. 27, 1998. The physician then fits the proximal end 42 of the obturator instrument 12 into recess 15 in the handle 13, as shown in FIG. 15.
  • The physician next twists the handle 13 while applying longitudinal force to the handle 13. In response, the tapered surface of the obturator instrument 12 rotates and penetrates soft tissue through the incision, as shown in FIG. 15 a. The physician may also tap the handle 13, or otherwise apply appropriate additional longitudinal force to the handle 13, to advance the obturator instrument 12 through soft tissue.
  • Under fluoroscopic monitoring or other real-time monitoring, the physician advances the obturator instrument 12 through soft tissue down to the distal radius 24, as FIG. 15 a shows. The obturator instrument 12 is inserted distal to proximal from the radial side of the radius 20 to the ulnar side of the radius 20. The obturator instrument 12 is introduced into the radius 20. Desirably, the obturator instrument 12 is introduced at an angle between minus 10 degrees and 45 degrees to the radio-carpal joint. More desirably, the obturator instrument 12 is introduced at an angle between zero degrees and 30 degrees to the radio-carpal joint. Most desirably, the obturator instrument 12 is introduced at an angle equal to the angle of the radio-carpal joint, i.e., approximately 23 degrees. Of course, if desired, the physician may utilize various other approach paths to access the bone, including a dorsal approach.
  • The physician next removes the handle 13 from the obturator instrument 12 and places the proximal end 42 of the percutaneous cannula 14 in a recess 19 in the handle 13. The physician slides the percutaneous cannula 14 over the obturator instrument 12, distal end 44 first. The physician then twists the handle 13 while applying longitudinal force to the handle 13, in order to seat the percutaneous cannula 14 against and/or into the external cortical bone 38, as shown in FIG. 16. Once the percutaneous cannula 14 is seated in the cortical bone 38, the obturator instrument 12 is removed, proximal end 42 first.
  • In an alternate embodiment, instead of using the obturator instrument 12 to access external cortical bone 38, the physician may instead insert a conventional spinal needle, the needle having an outer sheath and a stylus, into the bone. Upon puncturing the bone, the physician removes the stylus and inserts a guide pin 108 through the outer sheath. The sheath is then removed and the fracture reduction cannula 18 is deployed over the guide pin 108. The physician then fits the proximal end 42 of the percutaneous cannula 14 into a recess 19 in the handle 13 and slides the assembly, distal end 44 first, over the fracture reduction cannula 18, as shown in FIG. 28. Subsequently, the guide pin 108 is removed, proximal end first.
  • After removing the obturator instrument 12, or the guide pin 108 as in the case of the alternate embodiment described above, the handle 13 is removed from the percutaneous cannula 14. As shown in FIG. 15, the proximal end 42 of a drill bit instrument 16 is then placed in a recess in the handle 13. The preferred size of the drill bit 16 is 3.2 millimeters. The physician slides the drill bit assembly distal end 44 first through the bore 60 of the percutaneous cannula 14. Using manual pressure, the drill bit instrument 16 is advanced down to and into the distal radius 24. As an alternate embodiment, instead of using manual pressure, the physician could connect the proximal end 42 of the drill bit instrument 16 to a conventional motor-driven drill. The physician directs the drill bit instrument 16 to penetrate the cortical bone 38 and the cancellous bone 36 of the distal radius 24, as shown in FIG. 17.
  • After drilling through cortical bone 38 and into cancellous bone 36, the physician removes the drill bit instrument 16 from the handle 13. The fracture reduction cannula 18 is then inserted, distal end 44 first, into the bore of the percutaneous cannula 14, as shown in FIG. 18. The distal end 44 of the fracture reduction cannula 18 extends beyond the distal end 44 of the percutaneous cannula 14. In an alternate embodiment, the physician may at this point remove the percutaneous cannula 14, leaving only the fracture reduction cannula 18 in place. In one embodiment, it is preferred to employ a fracture reduction cannula 18 that has screw threads 71 on its distal end 44 as shown in FIG. 9, thereby enabling the fracture reduction cannula 18 to be anchored to an interior surface of cortical bone 38 in response to rotation of the fracture reduction cannula 18, e.g., by using the handle 13. In an alternative embodiment (see FIG. 8B), the physician may employ a fracture reduction cannula 18 that has a blunt, tapered distal end 44 instead of screw threads 71 on the distal end 44. If such a fracture reduction cannula 18 is employed, the physician may choose to drill a hole in cortical bone 38 in which to seat the blunt, tapered distal end 44. Desirably, if the distal end 44 is blunt and tapered, the fracture reduction cannula 18 may be adapted to rotate independently from the distal end 44. As another alternative, a cannula 18A as depicted in FIG. 8A could be inserted into the targeted bone as previously described, with the teeth 120 anchoring the distal end 44A of the cannula 18A to the cortical wall (not shown) of the targeted bone region. With this embodiment, it would not be necessary to drill a hole through the cortical wall to anchor the distal end 44 a of the cannula 18A.
  • In another embodiment, the access path can be made directly through the one or more fracture lines in the targeted bone. Such an arrangement minimizes trauma to the fractured bone (by reducing additional damage to healthier sections of the bone) and permits the creation of a cavity 35 which extends to each side of the fracture line.
  • The fracture reduction cannula 18 is placed into the cancellous bone 36 of the distal radius 24 such that the circumferential opening 70 is facing towards the fracture, as shown in FIG. 18. The fracture reduction cannula 18 is checked radiologically to ensure that the circumferential opening 70 is contained entirely within the cancellous bone 38 of the radius 20. In one embodiment, one or more markings (not shown) can be provided on the proximal end 42 of the cannula 18, allowing the physician to visually gauge the orientation of the cannula 18. In one embodiment, the fracture reduction cannula 18 is approximately 3 to 4 inches in length.
  • The physician can now acquire the catheter tube assembly 82 for placement into the bore 68 of the fracture reduction cannula 18. In one embodiment, the uninflated expandable structure 86 carried by the catheter tube measures 12 millimeters in length from its proximal end to its distal end, although structures 86 of varying lengths could be used, including expandable structures 86 of 15 mm or 20 mm, depending upon the size of the patient, the size and location of the fracture 34, the size of the opening 70 and the cavity 35 size and shape and/or displacement of bone desired. The catheter tube assembly 82 is now introduced into the bore 68 of the fracture reduction cannula 18.
  • The physician guides the catheter tube assembly 82 through the fracture reduction cannula 18 until the expandable structure 86 enters and lies adjacent to the circumferential opening 70 of the fracture reduction cannula 18, as shown in FIG. 20. In one embodiment, the distal end 44 of the fracture reduction cannula 18 is solid, as shown in FIG. 9, thus preventing an expandable structure 86 from emerging from the distal end 44 of the fracture reduction cannula 18. The placement of the expandable structure 86 within the circumferential opening 70 can be determined by radio opaque markers 91 located on the expandable structure 86, as shown in FIG. 11. The expandable structure 86 is passed into bone through the fracture reduction cannula 18 in a normally collapsed and non-inflated condition. The expandable structure 86 is now aligned with cancellous bone 36.
  • The physician, after verifying that the expandable structure 86 is adjacent the circumferential opening 70, conveys a pressurized fluid, such as a radio opaque fluid, through the catheter tube assembly 82 and into the expandable structure 86. The expandable structure 86 now expands into cancellous bone 36, as shown in FIG. 21. The fracture reduction cannula 18 desirably directs the expanding structure 86 towards the fracture 34. Progress of the expandable structure 86 is evaluated both on A-P, or anterior-posterior, and lateral x-rays. Preferably, the A-P x-ray is used until the distal end 24 of the radius 20 begins to move, at which point both A-P and lateral views are obtained. The pressurized fluid is used to inflate the expandable structure 86 and expand it through the circumferential opening 70 in order to compress cancellous bone 36 and/or displace cortical bone 38. The expandable structure 86 will desirably form an interior cavity 35 in the cancellous bone 36, as shown in FIG. 24. Desirably, the compressed cancellous bone 36 will seal any fractures 34 and/or cracks in the targeted bone through which the filling material 99, to be described later, can flow out of the targeted treatment area.
  • The compression of cancellous bone 36, as shown in FIG. 22, can also exert an interior force upon the surrounding cortical bone 38. The interior force will elevate or push broken and compressed bone back to or near its original pre-fracture, or other desired, condition. Once the fracture 34 is well aligned, it is preferred to introduce one or more smooth “Steinman” pins 130 or K-wires proximal to the joint surface of the radius 20 and distal to the inflated expandable structure 86. The pins 130 can be placed across the distal end 24 of the radius 20 and into the distal ulna 30, as shown in FIGS. 22 and 24-27. Alternatively, the pin(s) 130 can be secured into the radius 20 without penetrating the ulna 26. The pin 130 desirably prevents the fracture 34 from displacing upon further manipulation of the wrist and/or contraction of the expandable structure 86. If desired, additional pins 130 can be used to manipulate and/or secure other cortical bone fragments, or can be used to further secure a single bone fragment.
  • In one or more alternate embodiments, the pins 130 can be introduced once a bone fragment has been displaced to a prior position, but prior to completion of the inflation steps. For example, where inflation of the balloon displaces a fragment to a desired position, but addition cavity creation is desired, the fragment may be secured in position using one or more pins 130, and then the balloon can be further inflated to create a larger cavity 35 and/or compress additional cancellous bone 36.
  • As shown in FIG. 23, in one preferred embodiment, the patient's fingers of the affected arm can be placed in horizontal finger traps 132, with the patient's palm facing the treatment table. A rolled towel 133 may be placed under the patient's wrist. By grasping the finger traps 132 and gently pulling on them, the physician can extend the patient's arm and thus reduce any pressure that may be exerted at the fracture site. This approach potentially allows for an improved correction of the volar tilt (15 degrees) of the distal radius 24. If desired, this can be accomplished prior to, during or after fracture reduction has been accomplished.
  • Once the interior cavity 35 is formed and any desired pins 130 set in place, the expandable structure 86 is collapsed and the catheter tube assembly 82, with the collapsed expandable structure 86, is removed. As shown in FIG. 27, the cavity 35 is now in a condition to receive a filling material 99 through the fracture reduction cannula 18. The filling material 99 can be any of a number of available bone filling materials, which include, but are not limited to, resorbable and/or remodelable bone cements, calcium phosphates, allograft tissue, autograft tissue, poly(methylmethacrylate) or Norian SRS□ bone matrix. The filling material may be introduced into the fracture reduction cannula by means of a syringe (not shown). The filling material 99 progresses through the fracture reduction cannula 18 and into the circumferential opening 70 of the fracture reduction cannula 18. The filling material 99 desirably provides improved interior structural support for cortical bone 38. Desirably, the filling material 99 extends proximal to any cortical defects created by the drill bit instrument 16 and by the fracture reduction cannula 18. In one embodiment, approximately two (2) to seven (7) cubic centimeters of filling material 99 can be injected into the cavity 35.
  • After the filling material 99 is introduced, a tamp 81 may be inserted into the fracture reduction cannula 18 as shown in FIG. 26, for the purpose of urging residual filling material 99 into the interior cavity 35. Tamping of the filling material 99 may also cause the material to interdigitate into the surrounding cancellous bone 36, further supporting the cancellous 36 and cortical bone 38. The fracture reduction cannula 18 and (if still present) the percutaneous cannula 14 are removed. If desired, any void remaining subsequent to removal of the cannula 18 can be filled with filling material 99. The patient should be kept immobile for ten to fifteen minutes. After the immobilization, the pin(s) 130 and finger traps 132 can be removed and the hand of the patient is checked for motion. The entry site is covered with appropriate antibiotics and an adhesive strip is applied.
  • FIGS. 21A and 22A depict an alternate embodiment in which the expandable structure 86 is expanded within the fractured bone to create a cavity 35 which extends across at least one fracture line in the bone. In this embodiment, the filling material 99 ultimately introduced into the cavity 35 can extend across the fracture line and desirably interdigitate into the cancellous bone of the fragmented section(s). This will desirably anchor the fractured sections to the bone, thereby permitting the bone to undergo significant distractive and/or torsional loading without slippage along the fracture line(s) and/or subsequent re-fracture of the treated bone.
  • If desired, the disclosed systems and methods could be used with equal utility in reducing and/or reinforcing fractures in bones of younger individuals and/or individuals not having osteoporosis. In such patients, the present systems and methods would allow for an immediate resumption of activity, reducing the opportunity for degradation of adjacent joints and promoting healing of the fracture.
  • The features of the invention are set forth in the following claims.

Claims (14)

  1. 1. A tool for establishing a percutaneous path into bone comprising:
    a cannula having a side wall defining an internal bore aligned along an axis, the cannula having a distal end;
    a circumferential opening in the side wall, the circumferential opening having a distal terminus, and the circumferential opening extending partially about the side wall and being elongated along the axis and adapted to accommodate passage of an expandable structure from within the bore; and
    the bore being solid between the distal terminus of the circumferential opening and the distal end of the cannula.
  2. 2. A tool for establishing a percutaneous path into bone comprising:
    a cannula having a side wall defining an internal bore aligned along an axis, the cannula having a distal end;
    a distal opening in the distal end communicating with the bore to accommodate passage of a guide pin; and
    a circumferential opening in the side wall, the circumferential opening extending partially about the side wall and being elongated along the axis and adapted to accommodate passage of an expandable structure from within the bore.
  3. 3. A tool for establishing a percutaneous path into bone comprising:
    a cannula having a side wall defining an internal bore aligned along an axis, the cannula having a distal end;
    a circumferential opening in the side wall, the circumferential opening extending partially about the side wall and being elongated along the axis and adapted to accommodate passage of an expandable structure from within the bore; and
    a surface on the distal end of the cannula to anchor the distal end in bone.
  4. 4. A tool as in claim 3, wherein the circumferential opening has a distal terminus; and
    the bore being solid between the distal terminus of the circumferential opening and the distal end of the cannula.
  5. 5. A tool as in claim 3, wherein the cannula has a distal opening in the distal end communicating with the bore to accommodate passage of a guide pin.
  6. 6. An assembly for treating bone comprising:
    a cannula having a side wall defining an internal bore aligned along an axis, the cannula having a distal end;
    a distal opening in the distal end communicating with the bore to accommodate passage of a guide pin;
    a circumferential opening in the side wall extending partially about the side wall and being elongated along the axis and adapted to accommodate passage of an expandable structure from within the bore; and
    an expandable structure adapted for insertion through bone into the cannula and expansion through the circumferential opening.
  7. 7. An assembly for treating bone comprising:
    a cannula having a side wall defining an internal bore aligned along an axis, the cannula having a distal end;
    a circumferential opening in the side wall, the circumferential opening having a distal terminus, and the circumferential opening extending partially about the side wall and being elongated along the axis and adapted to accommodate passage of an expandable structure from within the bore;
    the bore being solid between the distal terminus of the circumferential opening and the distal end of the cannula; and
    an expandable structure adapted for insertion through bone into the cannula and expansion through the circumferential opening.
  8. 8. An assembly for treating bone comprising:
    a cannula having a side wall defining an internal bore aligned along an axis, the cannula having a distal end;
    a circumferential opening in the side wall, the circumferential opening having a distal terminus, and the circumferential opening extending partially about the side wall and being elongated along the axis and adapted to accommodate passage of an expandable structure from within the bore;
    a surface on the distal end of the cannula to anchor the distal end in bone; and
    an expandable structure adapted for insertion through bone into the cannula and expansion through the circumferential opening.
  9. 9. An assembly as set forth in claim 6 or 7 or 8, wherein the expandable structure has radio opaque markers for locating the structure within the circumferential opening.
  10. 10. A method for treating bone comprising the steps of:
    providing a cannula as defined in claim 1 or 2 or 3;
    inserting the cannula into cancellous bone;
    inserting an expandable structure through the cannula into registration with the circumferential opening; and
    expanding the expandable structure through the circumferential opening into contact with cancellous bone.
  11. 11. A method according to claim 10, wherein the step of expanding the expandable structure compacts cancellous bone.
  12. 12. A method according to claim 11, wherein the compaction of cancellous bone forms a cavity.
  13. 13. A method according to claim 12 and further including the step of conveying a material into the cavity.
  14. 14. A method according to claim 10 wherein the step of expanding the expandable structure moves fractured cortical bone.
US11637396 1998-08-14 2006-12-12 Systems and methods for reducing fractured bone using a fracture reduction cannula Abandoned US20070118143A1 (en)

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US09134323 US6241734B1 (en) 1998-08-14 1998-08-14 Systems and methods for placing materials into bone
US24319400 true 2000-10-25 2000-10-25
US09804107 US6613054B2 (en) 1998-08-14 2001-03-12 Systems and methods for placing materials into bone
US10001937 US7153306B2 (en) 2000-10-25 2001-10-25 Systems and methods for reducing fractured bone using a fracture reduction cannula
US11637396 US20070118143A1 (en) 1998-08-14 2006-12-12 Systems and methods for reducing fractured bone using a fracture reduction cannula

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US11637396 US20070118143A1 (en) 1998-08-14 2006-12-12 Systems and methods for reducing fractured bone using a fracture reduction cannula
US11789639 US7927339B2 (en) 1998-08-14 2007-04-25 Systems and methods for reducing fractured bone using a fracture reduction cannula with a side discharge port
US12961690 US8454620B2 (en) 1998-08-14 2010-12-07 Systems and methods for reducing fractured bone using a fracture reduction cannula with a side discharge port

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US11789639 Active 2020-02-09 US7927339B2 (en) 1998-08-14 2007-04-25 Systems and methods for reducing fractured bone using a fracture reduction cannula with a side discharge port
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Cited By (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070255287A1 (en) * 2006-04-26 2007-11-01 Illuminoss Medical, Inc. Apparatus and methods for reinforcing bone
US20080039854A1 (en) * 2006-04-26 2008-02-14 Illuminoss Medical, Inc. Apparatus and methods for delivery of reinforcing materials to bone
US20080125784A1 (en) * 2006-11-10 2008-05-29 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20090048629A1 (en) * 2007-08-14 2009-02-19 Illuminoss Medical, Inc. Apparatus and methods for attaching soft tissue to bone
US20090054900A1 (en) * 2006-11-10 2009-02-26 Illuminoss Medical, Inc. Systems and Methods for Internal Bone Fixation
US20090299327A1 (en) * 2008-06-02 2009-12-03 Lorna Vista Medical, Inc. Inflatable medical devices
US20100265733A1 (en) * 2009-04-06 2010-10-21 Illuminoss Medical, Inc. Attachment System for Light-Conducting Fibers
US20110264098A1 (en) * 2010-02-26 2011-10-27 Cobbs Charles S Minimally invasive systems, devices, and surgical methods for performing arthrodesis in the spine
WO2012134664A2 (en) * 2011-03-31 2012-10-04 Warsaw Orthopedic, Inc. Injection needle for fractures
US20120316565A1 (en) * 2008-02-27 2012-12-13 Ilion Medical Llc Tools for performing less invasive orthopedic joint procedures
US8403968B2 (en) 2007-12-26 2013-03-26 Illuminoss Medical, Inc. Apparatus and methods for repairing craniomaxillofacial bones using customized bone plates
US8512338B2 (en) 2009-04-07 2013-08-20 Illuminoss Medical, Inc. Photodynamic bone stabilization systems and methods for reinforcing bone
US8684965B2 (en) 2010-06-21 2014-04-01 Illuminoss Medical, Inc. Photodynamic bone stabilization and drug delivery systems
US8827981B2 (en) 2007-11-16 2014-09-09 Osseon Llc Steerable vertebroplasty system with cavity creation element
US8870965B2 (en) 2009-08-19 2014-10-28 Illuminoss Medical, Inc. Devices and methods for bone alignment, stabilization and distraction
US8936644B2 (en) 2011-07-19 2015-01-20 Illuminoss Medical, Inc. Systems and methods for joint stabilization
US8939977B2 (en) 2012-07-10 2015-01-27 Illuminoss Medical, Inc. Systems and methods for separating bone fixation devices from introducer
US9119639B2 (en) 2011-08-09 2015-09-01 DePuy Synthes Products, Inc. Articulated cavity creator
US9144442B2 (en) 2011-07-19 2015-09-29 Illuminoss Medical, Inc. Photodynamic articular joint implants and methods of use
US9179959B2 (en) 2010-12-22 2015-11-10 Illuminoss Medical, Inc. Systems and methods for treating conditions and diseases of the spine
US9220554B2 (en) 2010-02-18 2015-12-29 Globus Medical, Inc. Methods and apparatus for treating vertebral fractures
US9427289B2 (en) 2007-10-31 2016-08-30 Illuminoss Medical, Inc. Light source
US9439693B2 (en) 2013-02-01 2016-09-13 DePuy Synthes Products, Inc. Steerable needle assembly for use in vertebral body augmentation
CN106137335A (en) * 2016-07-15 2016-11-23 于海龙 Percutaneous puncture device for thoracolumbar spines and use method of device
US9510885B2 (en) 2007-11-16 2016-12-06 Osseon Llc Steerable and curvable cavity creation system
US9592119B2 (en) 2010-07-13 2017-03-14 C.R. Bard, Inc. Inflatable medical devices
US9687281B2 (en) 2012-12-20 2017-06-27 Illuminoss Medical, Inc. Distal tip for bone fixation devices
US9808346B2 (en) 2003-03-10 2017-11-07 Ilion Medical, Inc. Sacroiliac joint immobilization
US10149764B2 (en) 2017-10-02 2018-12-11 Ilion Medical, Inc. Sacroiliac joint immobilization

Families Citing this family (167)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030229372A1 (en) * 1994-01-26 2003-12-11 Kyphon Inc. Inflatable device for use in surgical protocols relating to treatment of fractured or diseased bone
DE69535492D1 (en) * 1994-01-26 2007-06-14 Kyphon Inc Improved inflatable device for use in surgical methods for fixing bone
US6248110B1 (en) * 1994-01-26 2001-06-19 Kyphon, Inc. Systems and methods for treating fractured or diseased bone using expandable bodies
US20060100635A1 (en) * 1994-01-26 2006-05-11 Kyphon, Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US20070282443A1 (en) * 1997-03-07 2007-12-06 Disc-O-Tech Medical Technologies Ltd. Expandable element
US6726691B2 (en) * 1998-08-14 2004-04-27 Kyphon Inc. Methods for treating fractured and/or diseased bone
JP2004535249A (en) * 1998-10-26 2004-11-25 エクスパンディング オーソペディクス インコーポレーテッド Expandable orthopedic equipment
US7815649B2 (en) * 2000-04-07 2010-10-19 Kyphon SÀRL Insertion devices and method of use
US8622739B2 (en) 2001-05-09 2014-01-07 Ben-Zion Karmon Method for enlarging a jaw bone using a hollow dental implant having a side perforation
US7771482B1 (en) 2000-05-09 2010-08-10 Ben-Zion Karmon Method for tissue expansion and regeneration using bioresorbable inflatable devices
DE60140558D1 (en) * 2000-10-25 2009-12-31 Kyphon S A R L Systems for reposition of broken bone by means of a cannula to the repositioning of bone fractures
US6419490B1 (en) * 2001-01-30 2002-07-16 Arthur Kitchings Weathers, Jr. Grooved intraosseous dental drill bit
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
EP1560546A2 (en) * 2002-11-12 2005-08-10 Regenex Ltd. Expandable devices and methods for tissue expansion, regenerationand fixation
US6730095B2 (en) * 2002-06-26 2004-05-04 Scimed Life Systems, Inc. Retrograde plunger delivery system
US7135027B2 (en) * 2002-10-04 2006-11-14 Baxter International, Inc. Devices and methods for mixing and extruding medically useful compositions
FR2848413B1 (en) * 2002-12-11 2005-07-29 Fixano Plate osteosynthesis for the osteosynthesis of small neighboring bones each other
WO2004073563A3 (en) 2003-02-14 2004-12-16 Depuy Spine Inc In-situ formed intervertebral fusion device
ES2545328T3 (en) 2003-03-14 2015-09-10 Depuy Spine, Inc. Hydraulic injection device in percutaneous vertebroplasty bone cement
CN100450452C (en) 2003-03-25 2009-01-14 矫正医学技术有限公司 Hybrid interlocking proximal femoral fracture fixation
US8066713B2 (en) 2003-03-31 2011-11-29 Depuy Spine, Inc. Remotely-activated vertebroplasty injection device
US20040220672A1 (en) * 2003-05-03 2004-11-04 Shadduck John H. Orthopedic implants, methods of use and methods of fabrication
US9918767B2 (en) 2005-08-01 2018-03-20 DePuy Synthes Products, Inc. Temperature control system
US9381024B2 (en) 2005-07-31 2016-07-05 DePuy Synthes Products, Inc. Marked tools
US8415407B2 (en) * 2004-03-21 2013-04-09 Depuy Spine, Inc. Methods, materials, and apparatus for treating bone and other tissue
US20050010231A1 (en) * 2003-06-20 2005-01-13 Myers Thomas H. Method and apparatus for strengthening the biomechanical properties of implants
CA2537048C (en) * 2003-09-03 2010-01-12 Kyphon Inc. Devices for creating voids in interior body regions and related methods
WO2005030034A3 (en) 2003-09-26 2006-05-26 Depuy Spine Inc Device for delivering viscous material
US7160245B2 (en) * 2003-11-17 2007-01-09 Virginijus Burneikis Method and device for umbilicus protection during abdominal surgery
US7524103B2 (en) * 2003-11-18 2009-04-28 Boston Scientific Scimed, Inc. Apparatus for mixing and dispensing a multi-component bone cement
US7789912B2 (en) * 2004-01-08 2010-09-07 Spine Wave, Inc. Apparatus and method for injecting fluent material at a distracted tissue site
US7641664B2 (en) * 2004-02-12 2010-01-05 Warsaw Orthopedic, Inc. Surgical instrumentation and method for treatment of a spinal structure
US8360629B2 (en) 2005-11-22 2013-01-29 Depuy Spine, Inc. Mixing apparatus having central and planetary mixing elements
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
US20080255560A1 (en) * 2004-05-21 2008-10-16 Myers Surgical Solutions, Llc Fracture Fixation and Site Stabilization System
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
CN101065080A (en) 2004-07-30 2007-10-31 光碟-O-特克医学科技有限公司 Methods, materials and apparatus for treating bone and other tissue
US20060085009A1 (en) * 2004-08-09 2006-04-20 Csaba Truckai Implants and methods for treating bone
US8038682B2 (en) * 2004-08-17 2011-10-18 Boston Scientific Scimed, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20080319445A9 (en) * 2004-08-17 2008-12-25 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20060106459A1 (en) * 2004-08-30 2006-05-18 Csaba Truckai Bone treatment systems and methods
EP1793769A4 (en) * 2004-09-02 2009-06-24 Crosstrees Medical Inc Device and method for distraction of the spinal disc space
US8048083B2 (en) 2004-11-05 2011-11-01 Dfine, Inc. Bone treatment systems and methods
US20060100706A1 (en) * 2004-11-10 2006-05-11 Shadduck John H Stent systems and methods for spine treatment
US7682378B2 (en) 2004-11-10 2010-03-23 Dfine, Inc. Bone treatment systems and methods for introducing an abrading structure to abrade bone
US8562607B2 (en) 2004-11-19 2013-10-22 Dfine, Inc. Bone treatment systems and methods
US20060122614A1 (en) * 2004-12-06 2006-06-08 Csaba Truckai Bone treatment systems and methods
US7717918B2 (en) * 2004-12-06 2010-05-18 Dfine, Inc. Bone treatment systems and methods
US9066769B2 (en) 2005-08-22 2015-06-30 Dfine, Inc. Bone treatment systems and methods
US7678116B2 (en) 2004-12-06 2010-03-16 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
US8070753B2 (en) 2004-12-06 2011-12-06 Dfine, Inc. Bone treatment systems and methods
US20060241673A1 (en) * 2005-04-21 2006-10-26 Zadini Filiberto P Subcision device
US9060820B2 (en) 2005-05-18 2015-06-23 Sonoma Orthopedic Products, Inc. Segmented intramedullary fracture fixation devices and methods
US8961516B2 (en) * 2005-05-18 2015-02-24 Sonoma Orthopedic Products, Inc. Straight intramedullary fracture fixation devices and methods
US7955339B2 (en) * 2005-05-24 2011-06-07 Kyphon Sarl Low-compliance expandable medical device
KR20080047357A (en) * 2005-07-07 2008-05-28 크로스트리스 메디칼, 인코포레이티드 Devices and methods for the treatment of bone fracture
US8366773B2 (en) 2005-08-16 2013-02-05 Benvenue Medical, Inc. Apparatus and method for treating bone
US7666227B2 (en) 2005-08-16 2010-02-23 Benvenue Medical, Inc. Devices for limiting the movement of material introduced between layers of spinal tissue
US8998923B2 (en) 2005-08-31 2015-04-07 Spinealign Medical, Inc. Threaded bone filling material plunger
US20070233148A1 (en) 2005-09-01 2007-10-04 Csaba Truckai Systems and methods for delivering bone fill material and controlling the temperature thereof
US9358033B2 (en) 2005-09-07 2016-06-07 Ulthera, Inc. Fluid-jet dissection system and method for reducing the appearance of cellulite
US9011473B2 (en) 2005-09-07 2015-04-21 Ulthera, Inc. Dissection handpiece and method for reducing the appearance of cellulite
US9358064B2 (en) 2009-08-07 2016-06-07 Ulthera, Inc. Handpiece and methods for performing subcutaneous surgery
US8518069B2 (en) 2005-09-07 2013-08-27 Cabochon Aesthetics, Inc. Dissection handpiece and method for reducing the appearance of cellulite
US9248317B2 (en) 2005-12-02 2016-02-02 Ulthera, Inc. Devices and methods for selectively lysing cells
EP1968505A4 (en) * 2005-11-23 2011-12-28 Crosstrees Medical Inc Devices and methods for the treatment of bone fracture
US7901409B2 (en) 2006-01-20 2011-03-08 Canaveral Villegas Living Trust Intramedullar devices and methods to reduce and/or fix damaged bone
US20070233250A1 (en) * 2006-02-07 2007-10-04 Shadduck John H Systems for treating bone
US20070213822A1 (en) 2006-02-14 2007-09-13 Sdgi Holdings, Inc. Treatment of the vertebral column
WO2007093192A8 (en) * 2006-02-16 2008-07-17 Valerie Gangji Surgical boring tool set
US7922690B2 (en) * 2006-02-22 2011-04-12 Michael Plishka Curable material delivery device
US20080003255A1 (en) 2006-05-10 2008-01-03 Synthes (Usa) Method for augmenting, reducing, and repairing bone with thermoplastic materials
US20090198237A1 (en) * 2006-05-10 2009-08-06 David Downey Method for augmenting, reducing, and repairing bone with thermoplastic materials
WO2007139758A3 (en) 2006-05-22 2008-10-30 Charanpreet S Bagga Delivery of multicomponent compositions
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
US8617219B2 (en) * 2006-07-31 2013-12-31 T.A.G. Medical Devices—Agriculture Cooperative Ltd. Arthroscopic bone transplanting procedure, and medical instruments useful therein
WO2008020896B1 (en) 2006-08-07 2008-05-08 Strathmore Ind Inc Bone tamp apparatus and method
CA2663447A1 (en) 2006-09-14 2008-03-20 Depuy Spine, Inc. Polymeric bone cement and methods of use thereof
US20080091207A1 (en) * 2006-10-13 2008-04-17 Csaba Truckai Bone treatment systems and methods
EP2091818B1 (en) 2006-10-19 2016-06-08 DePuy Spine, Inc. Fluid delivery system and related method
WO2008073190A3 (en) * 2006-11-03 2009-08-13 Kyphon Sarl Materials and methods and systems for delivering localized medical treatments
US7931651B2 (en) 2006-11-17 2011-04-26 Wake Lake University Health Sciences External fixation assembly and method of use
WO2008064346A3 (en) 2006-11-22 2008-12-11 Sonoma Orthopedic Products Inc Fracture fixation device, tools and methods
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
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
EP2124777A4 (en) 2007-02-21 2013-06-05 Benvenue Medical Inc Devices for treating the spine
JP5371107B2 (en) 2007-02-21 2013-12-18 ベンベニュー メディカル, インコーポレイテッド Device for spine treatment
CA2678517A1 (en) * 2007-03-12 2008-09-18 Kieran P. Murphy Method and kit for intra osseous navigation and augmentation of bone
CA2678911A1 (en) 2007-03-22 2008-09-25 Novalign Orthopaedics, Inc. Segmented intramedullary structure
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
US20080262383A1 (en) * 2007-04-17 2008-10-23 Needletech Products, Inc. Needle assembly with separable handle
WO2008137428A3 (en) 2007-04-30 2009-11-12 Dfine, Inc. Bone treatment systems and methods
US7885793B2 (en) 2007-05-22 2011-02-08 International Business Machines Corporation Method and system for developing a conceptual model to facilitate generating a business-aligned information technology solution
US8672954B2 (en) * 2007-05-30 2014-03-18 T.A.G. Medical Devices—Agriculture Cooperative Ltd. Piercing implement particularly useful as a medical implement for piercing body tissue, and method of using such implement for applying a suture to the body tissue
WO2009036466A1 (en) * 2007-09-14 2009-03-19 Crosstrees Medical, Inc. Material control device for inserting material into a targeted anatomical region
US8597301B2 (en) * 2007-10-19 2013-12-03 David Mitchell Cannula with lateral access and directional exit port
US20090105775A1 (en) * 2007-10-19 2009-04-23 David Mitchell Cannula with lateral access and directional exit port
US8556949B2 (en) 2007-11-14 2013-10-15 DePuy Synthes Products, LLC Hybrid bone fixation element and methods of using the same
US20090299282A1 (en) * 2007-11-16 2009-12-03 Osseon Therapeutics, Inc. Steerable vertebroplasty system with a plurality of cavity creation elements
US20090131886A1 (en) 2007-11-16 2009-05-21 Liu Y King Steerable vertebroplasty system
US20090157085A1 (en) * 2007-12-18 2009-06-18 Cook Incorporated Device and method for introducing a bone cement mixture into a damaged bone
WO2009091811A1 (en) 2008-01-14 2009-07-23 Brenzel Michael P Apparatus and methods for fracture repair
US7842040B2 (en) 2008-01-18 2010-11-30 Illuminoss Medical, Inc. Internal bone fixation system with integrated mixer
US20090198243A1 (en) * 2008-02-06 2009-08-06 Melsheimer Jeffry S Device and method for stabilizing a damaged bone with a bone cement mixture
EP2252336B1 (en) 2008-02-28 2014-06-25 Dfine, Inc. Bone treatment systems and methods
US20090222096A1 (en) * 2008-02-28 2009-09-03 Warsaw Orthopedic, Inc. Multi-compartment expandable devices and methods for intervertebral disc expansion and augmentation
KR100923427B1 (en) * 2008-03-12 2009-10-27 한창기전 주식회사 Bone compression equipment for kyphoplasty
WO2009125242A1 (en) 2008-04-08 2009-10-15 Vexim Apparatus for restoration of the spine and methods of use thereof
US9180416B2 (en) 2008-04-21 2015-11-10 Dfine, Inc. System for use in bone cement preparation and delivery
WO2009155319A1 (en) 2008-06-17 2009-12-23 Soteira, Inc. Devices and methods for fracture reduction
US20100030220A1 (en) * 2008-07-31 2010-02-04 Dfine, Inc. Bone treatment systems and methods
US8968322B1 (en) * 2008-08-19 2015-03-03 Marcos V. Masson Method and composition for repair of articular bone fractures
US8777479B2 (en) 2008-10-13 2014-07-15 Dfine, Inc. System for use in bone cement preparation and delivery
WO2010044462A1 (en) * 2008-10-17 2010-04-22 学校法人 聖マリアンナ医科大学 Bone cement injection needle
US8216185B2 (en) * 2008-10-20 2012-07-10 Berger J Lee Cannulated apertured grooved director
US20100160921A1 (en) * 2008-12-19 2010-06-24 Arthrocare Corporation Cancellous bone displacement system and methods of use
ES2659719T3 (en) 2009-03-12 2018-03-19 Vexim Apparatus for bone restoration of the spine
US8535327B2 (en) 2009-03-17 2013-09-17 Benvenue Medical, Inc. Delivery apparatus for use with implantable medical devices
US9060748B2 (en) * 2009-03-18 2015-06-23 Smith & Nephew, Inc. Soft tissue manipulator assembly
US8540723B2 (en) 2009-04-14 2013-09-24 Dfine, Inc. Medical system and method of use
US8652183B1 (en) 2009-07-07 2014-02-18 Mari S Truman Multi-angle orthopedic expansion head fastener
US20110106013A1 (en) * 2009-10-30 2011-05-05 DePuy Mikek, Inc. Dual cannula system and method for partial thickness rotator cuff repair
US8894658B2 (en) 2009-11-10 2014-11-25 Carefusion 2200, Inc. Apparatus and method for stylet-guided vertebral augmentation
US20110118740A1 (en) * 2009-11-10 2011-05-19 Illuminoss Medical, Inc. Intramedullary Implants Having Variable Fastener Placement
US9095393B2 (en) 2012-05-30 2015-08-04 Carefusion 2200, Inc. Method for balloon-aided vertebral augmentation
US8226657B2 (en) 2009-11-10 2012-07-24 Carefusion 207, Inc. Systems and methods for vertebral or other bone structure height restoration and stabilization
US20110112507A1 (en) * 2009-11-10 2011-05-12 Carefusion 207, Inc. Curable material delivery systems and methods
JP2013511357A (en) 2009-11-20 2013-04-04 ニー・クリエイションズ・リミテッド・ライアビリティ・カンパニーKnee Creations,Llc Coordinate mapping system for the joint treatment
WO2011063260A1 (en) 2009-11-20 2011-05-26 Knee Creations, Llc Bone-derived implantable devices for subchondral treatment of joint pain
US8821504B2 (en) 2009-11-20 2014-09-02 Zimmer Knee Creations, Inc. Method for treating joint pain and associated instruments
WO2011063281A1 (en) 2009-11-20 2011-05-26 Knee Creations, Llc Navigation and positioning instruments for joint repair
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
WO2011063240A1 (en) 2009-11-20 2011-05-26 Knee Creations, Llc Implantable devices for subchondral treatment of joint pain
WO2011082499A1 (en) * 2010-01-11 2011-07-14 Ao Technology Ag Cannula and kit for injection of bone cement
US20110178520A1 (en) 2010-01-15 2011-07-21 Kyle Taylor Rotary-rigid orthopaedic rod
CA2823873A1 (en) 2010-01-20 2011-07-28 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
JP2013521880A (en) 2010-03-08 2013-06-13 コンベンタス オーソピディックス, インコーポレイテッド Apparatus and method for securing a bone implant
US9144501B1 (en) 2010-07-16 2015-09-29 Nuvasive, Inc. Fracture reduction device and methods
US8771276B2 (en) 2010-12-01 2014-07-08 Carefusion 2200, Inc. Systems and methods for forming a cavity in, and delivering curable material into, bone
US8439940B2 (en) 2010-12-22 2013-05-14 Cabochon Aesthetics, Inc. Dissection handpiece with aspiration means for reducing the appearance of cellulite
US9999444B2 (en) 2011-03-01 2018-06-19 Orthovita, Inc. Depth controlled Jamshidi needle
US9554840B2 (en) * 2011-04-08 2017-01-31 Kyphon SÀRL Low cost low profile inflatable bone tamp
US8814873B2 (en) 2011-06-24 2014-08-26 Benvenue Medical, Inc. Devices and methods for treating bone tissue
US8454615B2 (en) * 2011-07-05 2013-06-04 Kyphon Sarl Combination directional and non-directional bone tamp
US9848890B2 (en) * 2011-07-15 2017-12-26 Globus Medical, Inc. Devices and methods for the preparation of intervertebral discs
US20130072941A1 (en) * 2011-09-16 2013-03-21 Francisca Tan-Malecki Cement Injector and Cement Injector Connectors, and Bone Cement Injector Assembly
US20140316411A1 (en) * 2011-11-17 2014-10-23 Beth Israel Deaconess Medical Center Systems and methods for minimally invasive fracture reduction and fixation
US20150164567A1 (en) * 2012-01-23 2015-06-18 Universitat Zurich Surgical tool system
US9155578B2 (en) 2012-02-28 2015-10-13 DePuy Synthes Products, Inc. Expandable fastener
CN104582639A (en) 2012-05-29 2015-04-29 Nlt-脊椎有限公司 Laterally deflectable implant
US9149318B2 (en) * 2013-03-07 2015-10-06 Kyphon Sarl Low cost inflatable bone tamp
US9028464B2 (en) 2013-03-08 2015-05-12 Kyphon Saul Bone fracture reduction system and methods of using the same
US10085783B2 (en) 2013-03-14 2018-10-02 Izi Medical Products, Llc Devices and methods for treating bone tissue
US9770278B2 (en) 2014-01-17 2017-09-26 Arthrex, Inc. Dual tip guide wire
US9968373B1 (en) * 2014-02-21 2018-05-15 Surgentec, Llc Handles for needle assemblies
US9814499B2 (en) 2014-09-30 2017-11-14 Arthrex, Inc. Intramedullary fracture fixation devices and methods

Citations (50)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4083369A (en) * 1976-07-02 1978-04-11 Manfred Sinnreich Surgical instruments
US4205683A (en) * 1977-01-07 1980-06-03 Victory Engineering Corporation Adapter for inflating balloon catheter
US4313434A (en) * 1980-10-17 1982-02-02 David Segal Fracture fixation
US4327736A (en) * 1979-11-20 1982-05-04 Kanji Inoue Balloon catheter
US4357716A (en) * 1980-07-09 1982-11-09 Brown Byron L Device and method for cementing a hip prosthesis in a femoral canal
US4494535A (en) * 1981-06-24 1985-01-22 Haig Armen C Hip nail
US4842585A (en) * 1986-12-18 1989-06-27 B. Braun Melsungen Ag Steel cannula for spinal and peridural anaesthesia
US4969888A (en) * 1989-02-09 1990-11-13 Arie Scholten Surgical protocol for fixation of osteoporotic bone using inflatable device
US5100390A (en) * 1990-10-22 1992-03-31 Norma A. Lubeck Lubeck spinal catheter needle
US5102413A (en) * 1990-11-14 1992-04-07 Poddar Satish B Inflatable bone fixation device
US5116305A (en) * 1990-02-01 1992-05-26 Abiomed, Inc. Curved intra aortic balloon with non-folding inflated balloon membrane
US5176683A (en) * 1991-04-22 1993-01-05 Kimsey Timothy P Prosthesis press and method of using the same
US5254091A (en) * 1991-01-08 1993-10-19 Applied Medical Resources Corporation Low profile balloon catheter and method for making same
US5359995A (en) * 1991-02-04 1994-11-01 Sewell Jr Frank Method of using an inflatable laparoscopic retractor
US5380290A (en) * 1992-04-16 1995-01-10 Pfizer Hospital Products Group, Inc. Body access device
US5423850A (en) * 1993-10-01 1995-06-13 Berger; J. Lee Balloon compressor for internal fixation of bone fractures
US5439447A (en) * 1994-02-09 1995-08-08 Baxter International Inc. Balloon dilation catheter with hypotube
US5456267A (en) * 1994-03-18 1995-10-10 Stark; John G. Bone marrow harvesting systems and methods and bone biopsy systems and methods
US5467786A (en) * 1992-12-10 1995-11-21 William C. Allen Method for repairing tears and incisions in soft tissue
US5480400A (en) * 1993-10-01 1996-01-02 Berger; J. Lee Method and device for internal fixation of bone fractures
US5514137A (en) * 1993-12-06 1996-05-07 Coutts; Richard D. Fixation of orthopedic devices
US5545136A (en) * 1993-09-14 1996-08-13 Berger; J. Lee Grooved catheter director apparatus
US5792044A (en) * 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5807329A (en) * 1996-05-07 1998-09-15 Gelman; Martin L. Displaceable catheter device
US5817074A (en) * 1995-10-23 1998-10-06 Racz; Gabor J. Stellate block needle
US5827289A (en) * 1994-01-26 1998-10-27 Reiley; Mark A. Inflatable device for use in surgical protocols relating to treatment of fractured or diseased bones
US5849014A (en) * 1997-03-20 1998-12-15 Johnson & Johnson Professional, Inc. Cement restrictor system and method of forming a cement plug within the medullary canal of a bone
US5865728A (en) * 1991-05-29 1999-02-02 Origin Medsystems, Inc. Method of using an endoscopic inflatable lifting apparatus to create an anatomic working space
US5961499A (en) * 1993-02-04 1999-10-05 Peter M. Bonutti Expandable cannula
US5972015A (en) * 1997-08-15 1999-10-26 Kyphon Inc. Expandable, asymetric structures for deployment in interior body regions
US6036682A (en) * 1997-12-02 2000-03-14 Scimed Life Systems, Inc. Catheter having a plurality of integral radiopaque bands
US6036711A (en) * 1998-02-18 2000-03-14 United States Surgical Corporation Reusable cannula
US6048346A (en) * 1997-08-13 2000-04-11 Kyphon Inc. Systems and methods for injecting flowable materials into bones
US6066154A (en) * 1994-01-26 2000-05-23 Kyphon Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US6066122A (en) * 1999-06-09 2000-05-23 Fisher; John Needle apparatus and method for marking lesions
US6127728A (en) * 1999-06-24 2000-10-03 Lsi Logic Corporation Single reference plane plastic ball grid array package
US6241734B1 (en) * 1998-08-14 2001-06-05 Kyphon, Inc. Systems and methods for placing materials into bone
US6248110B1 (en) * 1994-01-26 2001-06-19 Kyphon, Inc. Systems and methods for treating fractured or diseased bone using expandable bodies
US20020010472A1 (en) * 2000-06-30 2002-01-24 Kuslich Stephen D. Tool to direct bone replacement material
US20020032447A1 (en) * 2000-09-01 2002-03-14 Stuart Weikel Tools and methods for creating cavities in bone
US20020099385A1 (en) * 2000-10-25 2002-07-25 Kyphon Inc. Systems and methods for reducing fractured bone using a fracture reduction cannula
US6440138B1 (en) * 1998-04-06 2002-08-27 Kyphon Inc. Structures and methods for creating cavities in interior body regions
US6468279B1 (en) * 1998-01-27 2002-10-22 Kyphon Inc. Slip-fit handle for hand-held instruments that access interior body regions
US20020173796A1 (en) * 2000-02-16 2002-11-21 Cragg Andrew H. Method and apparatus for spinal augmentation
US6488653B1 (en) * 1999-08-12 2002-12-03 Wilson-Cook Medical Incorporated Dilation balloon having multiple diameters
US20030050702A1 (en) * 2001-09-13 2003-03-13 J - Lee Berger Spinal grooved director with built in balloon and method of using same
US6582446B1 (en) * 1999-05-06 2003-06-24 J. Alexander Marchosky Method and apparatus for percutaneous osteoplasty
US20030130664A1 (en) * 1998-08-14 2003-07-10 Kyphon Inc. Systems and methods for treating vertebral bodies
US6607544B1 (en) * 1994-01-26 2003-08-19 Kyphon Inc. Expandable preformed structures for deployment in interior body regions
US6726691B2 (en) * 1998-08-14 2004-04-27 Kyphon Inc. Methods for treating fractured and/or diseased bone

Family Cites Families (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US600432A (en) * 1898-03-08 Lifter
US556928A (en) * 1896-03-24 Dress-stay
US4005527A (en) 1975-12-22 1977-02-01 Wilson Ralph S Depth gauge
US4684363A (en) * 1984-10-31 1987-08-04 American Hospital Supply Corporation Rapidly inflatable balloon catheter and method
DE3800482A1 (en) 1988-01-11 1989-07-20 List Heinz Juergen Surgical drilling instrument
US4919153A (en) 1988-10-11 1990-04-24 Origin Medsystems, Inc. Method and apparatus for removing pre-placed prosthetic joints and preparing for their replacement
US5601559A (en) 1988-10-24 1997-02-11 Cook Incorporated Intraosseous needle
DE68920589T2 (en) 1988-10-24 1995-05-04 Cook Inc Needle unit for bone interior.
US5484442A (en) 1988-10-24 1996-01-16 Cook Incorporated Intraosseous needle
DE3922044C2 (en) 1989-07-05 1991-05-29 Matthias Dr. 8000 Muenchen De Richter-Turtur
US5013318A (en) 1990-07-31 1991-05-07 Special Devices Incorporated Medical instrument for measuring depth of fastener hold in bone
US5171248A (en) 1991-02-27 1992-12-15 Intermedics Orthopedics, Inc. Medullary caliper
US5320611A (en) * 1993-02-04 1994-06-14 Peter M. Bonutti Expandable cannula having longitudinal wire and method of use
US5468245A (en) 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer
GB9407135D0 (en) 1994-04-11 1994-06-01 Aberdeen University And Plasma Treatment of osteoporosis
JPH0838618A (en) 1994-07-29 1996-02-13 Nippon Zeon Co Ltd Balloon catheter for expanding celom and its production
US5989260A (en) 1994-08-22 1999-11-23 Yao; Meei-Huei Intramedullary nail guide rod with measure scale marked thereon
US5569284A (en) * 1994-09-23 1996-10-29 United States Surgical Corporation Morcellator
US5615690A (en) * 1995-02-15 1997-04-01 Symbiosis Corporation Tissue core biopsy cannula
CA2246434A1 (en) 1996-02-12 1997-08-14 Mentor Urology, Inc. Prostatic tissue expander
US5741261A (en) 1996-06-25 1998-04-21 Sdgi Holdings, Inc. Minimally invasive spinal surgical methods and instruments
US6113604A (en) * 1997-01-14 2000-09-05 Ethicon, Inc. Method and apparatus for fixing a graft in a bone tunnel
US5976105A (en) * 1997-03-05 1999-11-02 Marcove; Ralph C. Intra annular ultrasound disc apparatus and method
JP2001527437A (en) * 1997-03-07 2001-12-25 グローバーマン、オレン System for percutaneous bone and spinal stabilization, fixation and repair
WO1999002214A1 (en) * 1997-07-09 1999-01-21 Tegementa, L.L.C. Interbody device and method for treatment of osteoporotic vertebral collapse
US6004326A (en) * 1997-09-10 1999-12-21 United States Surgical Method and instrumentation for implant insertion
US5997581A (en) 1997-12-29 1999-12-07 Johnson & Johnson Professional, Inc. Hip stem cement spacer
US6395007B1 (en) 1999-03-16 2002-05-28 American Osteomedix, Inc. Apparatus and method for fixation of osteoporotic bone
CA2419196A1 (en) * 2000-08-11 2002-02-21 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of the spine

Patent Citations (54)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4083369A (en) * 1976-07-02 1978-04-11 Manfred Sinnreich Surgical instruments
US4205683A (en) * 1977-01-07 1980-06-03 Victory Engineering Corporation Adapter for inflating balloon catheter
US4327736A (en) * 1979-11-20 1982-05-04 Kanji Inoue Balloon catheter
US4357716A (en) * 1980-07-09 1982-11-09 Brown Byron L Device and method for cementing a hip prosthesis in a femoral canal
US4313434A (en) * 1980-10-17 1982-02-02 David Segal Fracture fixation
US4494535A (en) * 1981-06-24 1985-01-22 Haig Armen C Hip nail
US4842585A (en) * 1986-12-18 1989-06-27 B. Braun Melsungen Ag Steel cannula for spinal and peridural anaesthesia
US4969888A (en) * 1989-02-09 1990-11-13 Arie Scholten Surgical protocol for fixation of osteoporotic bone using inflatable device
US5108404A (en) * 1989-02-09 1992-04-28 Arie Scholten Surgical protocol for fixation of bone using inflatable device
US5116305A (en) * 1990-02-01 1992-05-26 Abiomed, Inc. Curved intra aortic balloon with non-folding inflated balloon membrane
US5100390A (en) * 1990-10-22 1992-03-31 Norma A. Lubeck Lubeck spinal catheter needle
US5102413A (en) * 1990-11-14 1992-04-07 Poddar Satish B Inflatable bone fixation device
US5254091A (en) * 1991-01-08 1993-10-19 Applied Medical Resources Corporation Low profile balloon catheter and method for making same
US5359995A (en) * 1991-02-04 1994-11-01 Sewell Jr Frank Method of using an inflatable laparoscopic retractor
US5176683A (en) * 1991-04-22 1993-01-05 Kimsey Timothy P Prosthesis press and method of using the same
US5865728A (en) * 1991-05-29 1999-02-02 Origin Medsystems, Inc. Method of using an endoscopic inflatable lifting apparatus to create an anatomic working space
US5380290A (en) * 1992-04-16 1995-01-10 Pfizer Hospital Products Group, Inc. Body access device
US5467786A (en) * 1992-12-10 1995-11-21 William C. Allen Method for repairing tears and incisions in soft tissue
US5961499A (en) * 1993-02-04 1999-10-05 Peter M. Bonutti Expandable cannula
US5545136A (en) * 1993-09-14 1996-08-13 Berger; J. Lee Grooved catheter director apparatus
US5658310A (en) * 1993-10-01 1997-08-19 Berger; J. Lee Balloon compressor for internal fixation of bone fractures
US5423850A (en) * 1993-10-01 1995-06-13 Berger; J. Lee Balloon compressor for internal fixation of bone fractures
US5480400A (en) * 1993-10-01 1996-01-02 Berger; J. Lee Method and device for internal fixation of bone fractures
US5514137A (en) * 1993-12-06 1996-05-07 Coutts; Richard D. Fixation of orthopedic devices
US6423083B2 (en) * 1994-01-26 2002-07-23 Kyphon Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US6607544B1 (en) * 1994-01-26 2003-08-19 Kyphon Inc. Expandable preformed structures for deployment in interior body regions
US6248110B1 (en) * 1994-01-26 2001-06-19 Kyphon, Inc. Systems and methods for treating fractured or diseased bone using expandable bodies
US6066154A (en) * 1994-01-26 2000-05-23 Kyphon Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US5827289A (en) * 1994-01-26 1998-10-27 Reiley; Mark A. Inflatable device for use in surgical protocols relating to treatment of fractured or diseased bones
US5439447A (en) * 1994-02-09 1995-08-08 Baxter International Inc. Balloon dilation catheter with hypotube
US5456267A (en) * 1994-03-18 1995-10-10 Stark; John G. Bone marrow harvesting systems and methods and bone biopsy systems and methods
US5817074A (en) * 1995-10-23 1998-10-06 Racz; Gabor J. Stellate block needle
US5792044A (en) * 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5807329A (en) * 1996-05-07 1998-09-15 Gelman; Martin L. Displaceable catheter device
US5849014A (en) * 1997-03-20 1998-12-15 Johnson & Johnson Professional, Inc. Cement restrictor system and method of forming a cement plug within the medullary canal of a bone
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
US6280456B1 (en) * 1997-08-15 2001-08-28 Kyphon Inc Methods for treating bone
US6036682A (en) * 1997-12-02 2000-03-14 Scimed Life Systems, Inc. Catheter having a plurality of integral radiopaque bands
US6468279B1 (en) * 1998-01-27 2002-10-22 Kyphon Inc. Slip-fit handle for hand-held instruments that access interior body regions
US6036711A (en) * 1998-02-18 2000-03-14 United States Surgical Corporation Reusable cannula
US6440138B1 (en) * 1998-04-06 2002-08-27 Kyphon Inc. Structures and methods for creating cavities in interior body regions
US6241734B1 (en) * 1998-08-14 2001-06-05 Kyphon, Inc. Systems and methods for placing materials into bone
US6726691B2 (en) * 1998-08-14 2004-04-27 Kyphon Inc. Methods for treating fractured and/or diseased bone
US20030130664A1 (en) * 1998-08-14 2003-07-10 Kyphon Inc. Systems and methods for treating vertebral bodies
US6582446B1 (en) * 1999-05-06 2003-06-24 J. Alexander Marchosky Method and apparatus for percutaneous osteoplasty
US6066122A (en) * 1999-06-09 2000-05-23 Fisher; John Needle apparatus and method for marking lesions
US6127728A (en) * 1999-06-24 2000-10-03 Lsi Logic Corporation Single reference plane plastic ball grid array package
US6488653B1 (en) * 1999-08-12 2002-12-03 Wilson-Cook Medical Incorporated Dilation balloon having multiple diameters
US20020173796A1 (en) * 2000-02-16 2002-11-21 Cragg Andrew H. Method and apparatus for spinal augmentation
US20020010472A1 (en) * 2000-06-30 2002-01-24 Kuslich Stephen D. Tool to direct bone replacement material
US20020032447A1 (en) * 2000-09-01 2002-03-14 Stuart Weikel Tools and methods for creating cavities in bone
US20020099385A1 (en) * 2000-10-25 2002-07-25 Kyphon Inc. Systems and methods for reducing fractured bone using a fracture reduction cannula
US20030050702A1 (en) * 2001-09-13 2003-03-13 J - Lee Berger Spinal grooved director with built in balloon and method of using same

Cited By (69)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9808346B2 (en) 2003-03-10 2017-11-07 Ilion Medical, Inc. Sacroiliac joint immobilization
US20080039854A1 (en) * 2006-04-26 2008-02-14 Illuminoss Medical, Inc. Apparatus and methods for delivery of reinforcing materials to bone
US8348956B2 (en) 2006-04-26 2013-01-08 Illuminoss Medical, Inc. Apparatus and methods for reinforcing bone
US9265549B2 (en) 2006-04-26 2016-02-23 Illuminoss Medical, Inc. Apparatus for delivery of reinforcing materials to bone
US8668701B2 (en) 2006-04-26 2014-03-11 Illuminoss Medical, Inc. Apparatus for delivery of reinforcing materials to bone
US20110009871A1 (en) * 2006-04-26 2011-01-13 Illuminoss Medical, Inc. Apparatus and methods for reinforcing bone
US7806900B2 (en) 2006-04-26 2010-10-05 Illuminoss Medical, Inc. Apparatus and methods for delivery of reinforcing materials to bone
US9724147B2 (en) 2006-04-26 2017-08-08 Illuminoss Medical, Inc. Apparatus for delivery of reinforcing materials to bone
US7811290B2 (en) 2006-04-26 2010-10-12 Illuminoss Medical, Inc. Apparatus and methods for reinforcing bone
US9254156B2 (en) 2006-04-26 2016-02-09 Illuminoss Medical, Inc. Apparatus for delivery of reinforcing materials to bone
US8246628B2 (en) 2006-04-26 2012-08-21 Illuminoss Medical, Inc. Apparatus for delivery of reinforcing materials to bone
US20070255287A1 (en) * 2006-04-26 2007-11-01 Illuminoss Medical, Inc. Apparatus and methods for reinforcing bone
US8906031B2 (en) 2006-11-10 2014-12-09 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20110098713A1 (en) * 2006-11-10 2011-04-28 Illuminoss Medical, Inc. Systems and Methods for Internal Bone Fixation
US7879041B2 (en) 2006-11-10 2011-02-01 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US8906030B2 (en) * 2006-11-10 2014-12-09 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US7811284B2 (en) 2006-11-10 2010-10-12 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20090054900A1 (en) * 2006-11-10 2009-02-26 Illuminoss Medical, Inc. Systems and Methods for Internal Bone Fixation
US8734460B2 (en) * 2006-11-10 2014-05-27 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20080125784A1 (en) * 2006-11-10 2008-05-29 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US9717542B2 (en) 2006-11-10 2017-08-01 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US8366711B2 (en) 2006-11-10 2013-02-05 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US20130066326A1 (en) * 2006-11-10 2013-03-14 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US9433450B2 (en) 2006-11-10 2016-09-06 Illuminoss Medical, Inc. Systems and methods for internal bone fixation
US9050079B2 (en) 2007-08-14 2015-06-09 Illuminoss Medical, Inc. Apparatus and methods for attaching soft tissue to bone
US8523901B2 (en) 2007-08-14 2013-09-03 Illuminoss Medical, Inc. Apparatus and methods for attaching soft tissue to bone
US20090048629A1 (en) * 2007-08-14 2009-02-19 Illuminoss Medical, Inc. Apparatus and methods for attaching soft tissue to bone
US9427289B2 (en) 2007-10-31 2016-08-30 Illuminoss Medical, Inc. Light source
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
US8672982B2 (en) 2007-12-26 2014-03-18 Illuminoss Medical, Inc. Apparatus and methods for repairing craniomaxillofacial bones using customized bone plates
US9005254B2 (en) 2007-12-26 2015-04-14 Illuminoss Medical, Inc. Methods for repairing craniomaxillofacial bones using customized bone plate
US8403968B2 (en) 2007-12-26 2013-03-26 Illuminoss Medical, Inc. Apparatus and methods for repairing craniomaxillofacial bones using customized bone plates
US20120316565A1 (en) * 2008-02-27 2012-12-13 Ilion Medical Llc Tools for performing less invasive orthopedic joint procedures
US9314232B2 (en) * 2008-02-27 2016-04-19 Ilion Medical, Inc Tools for performing less invasive orthopedic joint procedures
US20090299327A1 (en) * 2008-06-02 2009-12-03 Lorna Vista Medical, Inc. Inflatable medical devices
US9186488B2 (en) 2008-06-02 2015-11-17 Loma Vista Medical, Inc. Method of making inflatable medical devices
US9504811B2 (en) 2008-06-02 2016-11-29 Loma Vista Medical, Inc. Inflatable medical devices
US8708955B2 (en) 2008-06-02 2014-04-29 Loma Vista Medical, Inc. Inflatable medical devices
US8210729B2 (en) 2009-04-06 2012-07-03 Illuminoss Medical, Inc. Attachment system for light-conducting fibers
US20100265733A1 (en) * 2009-04-06 2010-10-21 Illuminoss Medical, Inc. Attachment System for Light-Conducting Fibers
US8936382B2 (en) 2009-04-06 2015-01-20 Illuminoss Medical, Inc. Attachment system for light-conducting fibers
US8328402B2 (en) 2009-04-06 2012-12-11 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
US8574233B2 (en) 2009-04-07 2013-11-05 Illuminoss Medical, Inc. Photodynamic bone stabilization systems and methods for reinforcing bone
US8915966B2 (en) 2009-08-19 2014-12-23 Illuminoss Medical, Inc. Devices and methods for bone alignment, stabilization and distraction
US8870965B2 (en) 2009-08-19 2014-10-28 Illuminoss Medical, Inc. Devices and methods for bone alignment, stabilization and distraction
US9125706B2 (en) 2009-08-19 2015-09-08 Illuminoss Medical, Inc. Devices and methods for bone alignment, stabilization and distraction
US9220554B2 (en) 2010-02-18 2015-12-29 Globus Medical, Inc. Methods and apparatus for treating vertebral fractures
US20110264098A1 (en) * 2010-02-26 2011-10-27 Cobbs Charles S Minimally invasive systems, devices, and surgical methods for performing arthrodesis in the spine
US8684965B2 (en) 2010-06-21 2014-04-01 Illuminoss Medical, Inc. Photodynamic bone stabilization and drug delivery systems
US9592119B2 (en) 2010-07-13 2017-03-14 C.R. Bard, Inc. Inflatable medical devices
US9855080B2 (en) 2010-12-22 2018-01-02 Illuminoss Medical, Inc. Systems and methods for treating conditions and diseases of the spine
US10111689B2 (en) 2010-12-22 2018-10-30 Illuminoss Medical, Inc. Systems and methods for treating conditions and diseases of the spine
US9179959B2 (en) 2010-12-22 2015-11-10 Illuminoss Medical, Inc. Systems and methods for treating conditions and diseases of the spine
WO2012134664A3 (en) * 2011-03-31 2013-01-24 Warsaw Orthopedic, Inc. Injection needle for fractures
WO2012134664A2 (en) * 2011-03-31 2012-10-04 Warsaw Orthopedic, Inc. Injection needle for fractures
US8936644B2 (en) 2011-07-19 2015-01-20 Illuminoss Medical, Inc. Systems and methods for joint stabilization
US9254195B2 (en) 2011-07-19 2016-02-09 Illuminoss Medical, Inc. Systems and methods for joint stabilization
US9855145B2 (en) 2011-07-19 2018-01-02 IlluminsOss Medical, Inc. Systems and methods for joint stabilization
US9144442B2 (en) 2011-07-19 2015-09-29 Illuminoss Medical, Inc. Photodynamic articular joint implants and methods of use
US9775661B2 (en) 2011-07-19 2017-10-03 Illuminoss Medical, Inc. Devices and methods for bone restructure and stabilization
US9610083B2 (en) 2011-08-09 2017-04-04 DePuy Synthes Products, Inc. Articulated cavity creator
US9119639B2 (en) 2011-08-09 2015-09-01 DePuy Synthes Products, Inc. Articulated cavity creator
US8939977B2 (en) 2012-07-10 2015-01-27 Illuminoss Medical, Inc. Systems and methods for separating bone fixation devices from introducer
US9687281B2 (en) 2012-12-20 2017-06-27 Illuminoss Medical, Inc. Distal tip for bone fixation devices
US9439693B2 (en) 2013-02-01 2016-09-13 DePuy Synthes Products, Inc. Steerable needle assembly for use in vertebral body augmentation
CN106137335A (en) * 2016-07-15 2016-11-23 于海龙 Percutaneous puncture device for thoracolumbar spines and use method of device
US10149764B2 (en) 2017-10-02 2018-12-11 Ilion Medical, Inc. Sacroiliac joint immobilization

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