WO2011082499A1 - Canule et ensemble d'injection de ciment osseux - Google Patents

Canule et ensemble d'injection de ciment osseux Download PDF

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Publication number
WO2011082499A1
WO2011082499A1 PCT/CH2010/000007 CH2010000007W WO2011082499A1 WO 2011082499 A1 WO2011082499 A1 WO 2011082499A1 CH 2010000007 W CH2010000007 W CH 2010000007W WO 2011082499 A1 WO2011082499 A1 WO 2011082499A1
Authority
WO
WIPO (PCT)
Prior art keywords
cannula
bone
outer tube
hole
shaft
Prior art date
Application number
PCT/CH2010/000007
Other languages
English (en)
Inventor
Markus Windolf
Original Assignee
Ao Technology Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ao Technology Ag filed Critical Ao Technology Ag
Priority to PCT/CH2010/000007 priority Critical patent/WO2011082499A1/fr
Publication of WO2011082499A1 publication Critical patent/WO2011082499A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8816—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the conduit, e.g. tube, along which fluid flows into the body or by conduit connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8827—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with filtering, degassing, venting or pressure relief means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8897—Guide wires or guide pins

Definitions

  • the invention relates to a cannula according to the preamble of claim 1 , to a kit for irrigating bone tissue and subsequent injection of bone cement according to the preamble of claim 13 or 17, to a method for augmenting an implant for an improved fracture fixation according to the preamble of claim 21 as well as to a method for irrigation of bone tissue and subsequent injection of a bone cement according to the preamble of claim 24.
  • the augmentation of implants for improved fracture fixation in osteoporotic bone has a high potential to significantly enhance the implant anchorage.
  • screws or blades used at the proximal femur may be augmented with bone cement in highly osteoporotic cases.
  • the augmentation is often performed through the cannulation of the implant after its insertion in the bore hole in the bone.
  • a guide wire which usually has been previously inserted for guiding a surgical tool e.g. a drill bit for drilling a bore hole in the bone and the implant has then to be removed.
  • the guide wire has perforated into the joint leaving a channel between the femoral head and the articulation surfaces. This problem of bone cement advancing into the joint is not yet solved.
  • An irrigation procedure is often applied in order to prepare the bone tissue prior to the bone cement insertion.
  • an irrigation procedure of vertebral bodies prior to bone cement injection has been proven to be beneficial in terms of reduction of the injection forces, increase of the maximum bone cement volume and removal of fat for preventing fat embolisms.
  • a cannula for introducing a bone cement mixture is known from US-A 2009/0157085 MELSHEIMER.
  • a lumen is formed through the cannula for advancing the bone cement mixture to the distal portion of the cannula.
  • the distal portion of the cannula is provided with a tip member and with a side aperture proximal to said tip member.
  • the tip member directs the advancement of the bone cement mixture through the side aperture while preventing advancement of the bone cement mixture axially through the distal end of the cannula.
  • this known cannula comprises a proximal portion with an enlarged diameter so that the cannula could not be used as a guide wire for a surgical instrument, tool or an implant.
  • Another object of the invention is to provide a kit for irrigation of bone tissue and simultaneous removal of irrigation fluid and subsequent insertion of bone cement.
  • a further object of the invention is to provide a method for irrigation of bone tissue with simultaneous removal of irrigation fluid and subsequent insertion of bone cement by using a kit according to the invention.
  • Yet another object of the invention is to provide a method for augmenting an implant by using the cannula according to the invention.
  • the invention solves the posed problem with a cannula displaying the features of claim 1 , with a kit for irrigating bone tissue and subsequent injection of bone cement displaying the features of claim 13 or 17, to a method for augmenting an implant for an improved fracture fixation displaying the features of claim 21 as well as to a method for irrigation of bone tissue and subsequent injection of a bone cement displaying the features of claim 24.
  • the cannula according to the invention can be used as a guide wire for a surgical instrument or tool or for an implant;
  • a liquid jet irrigation through the cannula can be performed in a bone portion to prepare the bone tissue for a subsequent application of bone cement;
  • the cannula allows to replace a guide wire used for placing a bone cement injection device or an implant or tool
  • the injection of bone cement can be performed without removing the cannula so that after injection of the bone cement an implant can be inserted over the cannula into the cement volume or an implant can be inserted prior to bone cement application (e.g. a perforated blade for the proximal femur);
  • the cannula can be used for injection of bone cement so that an advancement of bone cement into the articulation area cannot occur because of blocking the channel with the cannula;
  • the cannula can be advanced through the bone tissue without the need of additional drilling tools
  • the cannula can be used as a drill bit
  • the cannula can be used as a probe for assessing bone quality.
  • Said coupling portion of said cannula can be configured, e.g. as a cone for an attachment of a syringe, jet irrigation device or comparable tool. If said coupling portion has a non-circular cross-section said diameter is to be interpreted as the diameter of the circular cylindrical envelope.
  • said coupling portion has a length C measured from said proximal end of said cannula wherein the ratio C / L between said length C and said overall length L of said cannula amounts to maximum 0.1 , preferably maximum 0.05.
  • said tip portion comprises a coaxial core and a fixation structure radially protruding from said core suitable to anchor said cannula in a bone.
  • said fixation structure is formed by at least one blade or a lamella extending transversely to said central axis.
  • a so configured fixation structure allows a firm anchorage of the cannula in the bone.
  • said fixation structure is a helical blade, or a helical lamella or an external thread.
  • the cannula can then be inserted in the bone in a screw-like manner.
  • the diameter of the tip portion including the fixation structure can be equal or greater than the diameter of the shaft of the cannula.
  • said fixation structure can comprise two or more blades or lamellae which are offset relative to each other in a direction parallel to said central axis.
  • said tip portion comprises a tip which is terminally arranged at said distal end of said cannula and which comprises a plurality of cutting edges.
  • the tip can be configured as a pyramid like spike including three or four cutting edges or can be configured as a drill tip.
  • the aforementioned configuration of the tip of the cannula allows the advantage that the cannula can be advanced into the bone without the need of additional drilling tools. Furthermore, the cannula can be used as a drill.
  • said length A is maximum 30 mm, preferably maximum 8 mm.
  • said at least one radial perforation is located within an axial range with a length B measured from said front end of said shaft wherein the ratio between said length B and said overall length L is maximum 0.5 , preferably maximum 0.038 .
  • said tip portion is self-drilling.
  • the tip portion can comprise a terminal section configured as a drill bit. Additionally, the tip can comprise an axial opening.
  • said fixation structure is self-cutting.
  • said tip portion axially closes said lumen in said shaft. Further, said tip is preferably acuminated.
  • Said shaft can be prismatical or cylindrical, preferably circular cylindrical.
  • a circular cylindrical shape offers the advantage that the cannula can be used as a guide wire for an instrument, tool or an implant.
  • said cannula comprises a plurality of perforations.
  • Said perforations are arranged angularly symmetrically or angularly asymmetrically when viewed in cross sections orthogonal to said central axis.
  • Said perforations can be arranged in a plurality of planes orthogonal to said central axis, preferably with a parallel orientation with each other. This configuration allows the advantage that a directed irrigation is possible by turning the cannula towards a desired direction.
  • Said perforations can be staggeredly arranged.
  • the outer diameter of said cannula is maximum 8 mm, preferably maximum 3.5 mm.
  • said shaft has a constant diameter ds and a smooth surface between said coupling portion and said front end of said shaft.
  • the advantage achieved by the kit for irrigating bone tissue and subsequent injection of bone cement according to the invention is essentially to be seen therein that the cannula can slide and rotate within the outer tube in order to adjust the direction and position of the jet lavage.
  • the difference between the inner width D, of the through hole and the outer diameter ds of the cannula is preferably in a range between 0.2 mm and 4 mm, and typically 0.9 mm.
  • the outer diameter of the cannula is 2.6 mm and the diameter of the through hole is 3.5 mm.
  • the channel between the outer peripheral wall of said cannula and the inner wall of said outer tube can be used for either:
  • the assembly of said sleeve and said cannula may be used as follows: D) insertion of irrigation fluid via the lumen of said cannula;
  • said outer tube comprises a lateral aperture.
  • the advantage can be achieved that the bone cement will mainly advance through the lateral aperture because the axial way will be blocked by compacted bone tissue.
  • An advantage of an axially open outer lumen is the possible motion between the cannula and the outer tube at the tip. If e.g. blood cloths block the channel during suction, a short movement of the assembly could remove this blockage.
  • the outer tube can comprise two or more lateral openings.
  • said kit further comprises an inner tube axially displaceably arranged in said through hole of said outer tube and comprising a central through bore for rotatively and slideably receiving said cannula.
  • said kit further comprises an adaptor with a through opening with an enlarged section connectable to said outer tube in fluid communication with said through hole of said outer tube and having an aspiration port in fluid connection with said through opening.
  • an irrigation of the bone tissue can be performed through the cannula and the suction of the flushing fluid can be realized via the channel in-between the cannula and the bone cement injection sleeve;
  • the method for augmenting an implant for an improved fracture fixation further comprises the step of measuring the bone quality before injecting a bone cement through said lumen in said cannula.
  • the cannula is clamped on its outer surface by the standard guide wire insertion clamp which is normally attached to a power tool.
  • the electric current consumption of the power tool during insertion might then provide information about the bone quality. Otherwise a torque measurement means could be attached instead of the power tool.
  • the method further comprises the step of irrigating the bone tissue surrounding said cannula by pressing a washing liquid through said lumen of said cannula before injecting a bone cement through said lumen in said cannula. No suction of the washing liquid is required because the removed fat volume is low in case of an application of the cannula for augmentation of an implant.
  • Fig. 1 illustrates a longitudinal section of an embodiment of the cannula according to the invention
  • Fig. 2 illustrates a front view of the embodiment of the cannula according to fig. 1 ;
  • Fig. 3 illustrates a front view of a further embodiment of the cannula according to the invention
  • Fig. 4 illustrates a longitudinal section of an embodiment of the kit according to the invention
  • Fig. 5 illustrates a longitudinal section of another embodiment of the kit according to the invention
  • Fig. 6 illustrates a longitudinal section of an adaptor used with an embodiment of the kit according to the invention
  • Fig. 7 illustrates a perspective view of the adaptor of fig. 6.
  • An embodiment of the cannula 1 is illustrated in figs. 1 and 2 wherein said cannula 1 comprises a cylindrical shaft 11 , a tip portion 14 and a coupling portion 15.
  • Said cannula 1 has an overall length L, a central axis 6, a proximal end 3 and a distal end 4.
  • Said shaft 11 has a smooth peripheral surface and comprises a rear end 18, a front end 19 and a lumen 2 extending between said rear end 17 and said front end 19. Further, said shaft 11 includes a plurality of radial perforations 7.
  • Said coupling portion 15 has a length C, is cylindrically shaped and terminally arranged at said proximal end 3 of said cannula 1 so that a surgical tool or instrument can be connected to said cannula 1.
  • Said shaft 11 has a constant diameter ds between said coupling portion 15 and said front end 19 and said coupling portion 15 has a diameter dc which is equal to said diameter ds of said shaft 11.
  • Said tip portion 14 extends from said front end 19 of said shaft 11 coaxially to said central axis 6 and comprises an acuminated tip 5 which is configured as a pyramid-like spike with four cutting edges 12 (fig. 2) which are arranged at equal angles with respect to each other measured about said central axis 6.
  • said tip portion 14 is solid so that said cannula 1 is axially closed at said front end 19 of said shaft 11.
  • Said tip portion 14 extends over an axial length A and comprises an external thread 17.
  • Said external thread forms a fixation means with a coaxial core 13 and a fixation structure 9 radially protruding from said core 13 so that said cannula 1 can be firmly anchored in a bone.
  • the outer diameter of said tip portion 14 is equal to the diameter ds of said shaft 1 1.
  • Said plurality of radial perforations 7 is located within an axial range with a length B measured from said front end 19 of said shaft 11. Further, said radial perforations 7 are located at different distances measured from said front end 19 of said shaft 11 and are arranged at equal angles relative to each other measured orthogonal to said central axis 6 of said cannula 1.
  • the tip portion 14 of fig. 3 differs from the tip portion 14 of fig. 2 only therein that it comprises three cutting edges 12 instead of four cutting edges 12. Similarly, said three cutting edges 12 are arranged at equal angles with respect to each other measured about said central axis 6.
  • Fig. 4 illustrates an embodiment of the kit for irrigating bone tissue and subsequent injection of bone cement
  • the cannula of figs. 1 and 2 and an outer tube 20 with a through hole 21 of diameter D, for injection of bone cement.
  • Said cannula 1 is rotatably and axially displaceably arranged in said through hole 21.
  • said outer tube 20 comprises a lateral aperture 22 wherethrough a bone cement injected through said through hole 21 will mainly advance.
  • the channel 23 between the outer peripheral wall 10 of said cannula 1 and the inner wall 24 of said outer tube 20 can be used for either suction of irrigation fluid, insertion of irrigation fluid or injection of bone cement.
  • Fig. 5 illustrates a further embodiment of the kit which differs from the embodiment of fig. 4 only therein that said kit further comprises an inner tube 25 which is axially displaceably arranged in said through hole 21 of said outer tube 20. Further, said inner tube 25 comprises a central through bore 26 for rotatively and slideably receiving said cannula 1. Said inner tube 25 fits in between said cannula 1 and said outer tube 20.
  • Figs. 6 and 7 illustrate an adaptor 30 to be used in another embodiment of the kit according to the invention.
  • Said adaptor 30 essentially comprises a first end 31 , a second end 32 and a through opening 33 extending between said first and second end 31 , 32.
  • Said through opening 33 has a longitudinal axis 37, a coaxial first section 34 for guiding said cannula 1 and a coaxial second section 35 with a larger diameter which is suitable for fluid connection with the through hole 21 of said outer tube 20 (not shown).
  • An aspiration port 36 is arranged transversely to said longitudinal axis 37 and in fluid connection with said second section 35 of said through opening 33.
  • Said second section 35 of said through opening 33 comprises a female Luer-Lock connector 40 at said second end 32 of said adaptor 30 which is connectable to a male Luer-Lock connector at the rear end 27 of said outer tube 20.
  • a first sealing 38 is arranged between said second end 32 of said connector 30 and said outer tube 20 to provide a fluid tight transition between said adaptor 30 and said outer tube 20.
  • a second sealing 39 is arranged in said first section 34 of said through hole 33 encircling said cannula 1 to provide a fluid tight closing of said through opening 33 towards said first end 31 of said adaptor 30.
  • said aspiration port 36 comprises a fastening means, e.g. in the form of an internal thread 41 to reversibly fix an aspiration tube thereto.
  • said coupling portion 15 of said cannula 1 is configured as a cone 16 tapering towards said proximal end 3 of said shaft 11. Said conical coupling portion is used for an attachment of a jet irrigation device.
  • said adaptor 30 allows to connect an irrigation source (not shown) to the coupling portion 15 of said cannula 1 in such a manner that the irrigation fluid can be pressed through the lumen 2 of said cannula 1.
  • a fluid suction source can be connected to said aspiration port 36 allowing to simultaneously remove the suction fluid from the irrigated bone through said through hole 21 of said outer tube 20 and through said aspiration port 36.
  • the above steps can be performed in a different sequence so that firstly - after having the cannula 1 inserted into a selected portion of a bone - an implant is positioned over said cannula 1 into said bone by using said cannula as a guide wire and secondly a bone cement is injected through lateral perforations in said implant.
  • step b) can be performed before step a) due to safety issues. Many surgeons believe that it is absolutely necessary to firstly insert the implant and then the cement to exclude the case of missing the implant insertion during the hardening time of the cement. This however requires then special implants like a perforated blade or screw.
  • kits In another method for irrigation of bone tissue and subsequent injection of a bone cement, particularly in case of vertebroplasty an embodiment of said kit is used to perform the following steps: 1) inserting said cannula 1 into a selected portion of a bone forming a hole in said bone;

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Fluid Mechanics (AREA)
  • Physics & Mathematics (AREA)
  • Prostheses (AREA)

Abstract

L'invention porte sur une canule (1) ayant une extrémité proximale (3) et une extrémité distale (4), comprenant un arbre (11) avec une lumière (2), une partie de pointe (14) comprenant un bord de coupe (12) et une partie de couplage (15) disposée en bout de ladite extrémité proximale (3), appropriée pour être reliée à un outil ou un instrument chirurgical. Ledit arbre (11) comprend en outre au moins une perforation radiale (7). Ledit arbre (11) a un diamètre constant ds et ladite partie de couplage (15) a un diamètre maximum dc égal ou inférieur audit diamètre ds dudit arbre (11). L'invention porte également sur un ensemble destiné à l'irrigation d'un tissu osseux et à l'injection consécutive de ciment osseux à l'aide de ladite canule et comprenant un tube extérieur (20) comportant un trou traversant (21) pour l'injection du ciment osseux, ladite canule (1) étant disposée de manière déplaçable en rotation et axialement dans ledit trou traversant (21).
PCT/CH2010/000007 2010-01-11 2010-01-11 Canule et ensemble d'injection de ciment osseux WO2011082499A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/CH2010/000007 WO2011082499A1 (fr) 2010-01-11 2010-01-11 Canule et ensemble d'injection de ciment osseux

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2010/000007 WO2011082499A1 (fr) 2010-01-11 2010-01-11 Canule et ensemble d'injection de ciment osseux

Publications (1)

Publication Number Publication Date
WO2011082499A1 true WO2011082499A1 (fr) 2011-07-14

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH2010/000007 WO2011082499A1 (fr) 2010-01-11 2010-01-11 Canule et ensemble d'injection de ciment osseux

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103989502A (zh) * 2014-06-13 2014-08-20 王京生 股骨头坏死钻孔减压钻及其配套用骨水泥增强棒
WO2016028596A1 (fr) * 2014-08-20 2016-02-25 ZynFusion, LLC Système et procédé de fusion vertébrale à effraction minimale
CN105559851A (zh) * 2015-12-21 2016-05-11 武汉康斯泰德科技有限公司 填充型金属骨针

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002034148A2 (fr) * 2000-10-25 2002-05-02 Kyphon Inc. Systemes et procedes de reduction de fracture utilisant une canule de reduction de fracture
US20070142842A1 (en) * 2005-11-18 2007-06-21 Krueger John A Device, system and method for delivering a curable material into bone
WO2007122608A2 (fr) * 2006-04-20 2007-11-01 Depuy Spine, Inc. Kit d'instruments servant à administrer une matière visqueuse de remplissage d'os
US20090157085A1 (en) 2007-12-18 2009-06-18 Cook Incorporated Device and method for introducing a bone cement mixture into a damaged bone
US20090198243A1 (en) * 2008-02-06 2009-08-06 Melsheimer Jeffry S Device and method for stabilizing a damaged bone with a bone cement mixture

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002034148A2 (fr) * 2000-10-25 2002-05-02 Kyphon Inc. Systemes et procedes de reduction de fracture utilisant une canule de reduction de fracture
US20070142842A1 (en) * 2005-11-18 2007-06-21 Krueger John A Device, system and method for delivering a curable material into bone
WO2007122608A2 (fr) * 2006-04-20 2007-11-01 Depuy Spine, Inc. Kit d'instruments servant à administrer une matière visqueuse de remplissage d'os
US20090157085A1 (en) 2007-12-18 2009-06-18 Cook Incorporated Device and method for introducing a bone cement mixture into a damaged bone
US20090198243A1 (en) * 2008-02-06 2009-08-06 Melsheimer Jeffry S Device and method for stabilizing a damaged bone with a bone cement mixture

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103989502A (zh) * 2014-06-13 2014-08-20 王京生 股骨头坏死钻孔减压钻及其配套用骨水泥增强棒
WO2016028596A1 (fr) * 2014-08-20 2016-02-25 ZynFusion, LLC Système et procédé de fusion vertébrale à effraction minimale
US9498348B2 (en) 2014-08-20 2016-11-22 ZynFusion, LLC Minimally invasive spinal fusion system and method
US9924989B2 (en) 2014-08-20 2018-03-27 ZynFusion, LLC Minimally invasive spinal fusion system and method
CN105559851A (zh) * 2015-12-21 2016-05-11 武汉康斯泰德科技有限公司 填充型金属骨针

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