Bone treatment systems and methods

• US 20060264965A1
• Filed: 11/04/2005
• Published: 11/23/2006
• Est. Priority Date: 11/05/2004
• Status: Active Grant

• Current Assignee: Dfine Incorporated (Merit Medical Systems, Inc.)
• Original Assignee: Dfine Incorporated (Merit Medical Systems, Inc.)
• Inventors: Shadduck, John H., Truckai, Csaba
• Granted Patent: US 8,048,083 B2
• Time in Patent Office: Days
• US Class Current: 606/92
• CPC Class Codes: A61B 17/7098 wherein the implant is permeable or has openings, e.g. fenestrated screw hollow surgical screws A61B17/864

Abstract

Methods and instruments for treating an osteoporotic vertebral body or for treating a vertebral compression fracture. An exemplary method includes introducing an open knit structure together with a bone cement into a bone wherein the knit structure extends substantially throughout the interior of the cement volume. In one aspect of the invention, the bone cement volumes cures with the filament structure reinforcing the cement. In another aspect of the invention, the open knit structure is configured to direct flows of bone cement to apply forces for reducing a vertebral compression fracture. In another aspect of the invention, the system provides bone cement flows that extend through the knit structure thus allowing the cement to fully interdigitate with the cancellous bone.

Claims

1-37. -37. (canceled)

38. A method of directing a flow of a bone fill material in a bone, comprising:

providing a knit structure configured for extending throughout the interior of a volume of bone cement, the knit structure comprising filaments with openings therebetween; and

introducing the knit structure and a volume of bone cement into a bone;

wherein openings in the knit structure at least partly directs flows of the bone cement.

39. The method of claim 38 wherein providing a knit structure includes providing non-uniform dimension openings.

40. The method of claim 39 wherein flows of bone cement are increased through larger openings and the flows of bone cement are decreased through smaller openings.

41. The method of claim 38 wherein the knit structure is configured to provide reinforcing means by extending throughout the volume of bone cement.

42. The method of claim 38 wherein the knit structure is configured for directing flows to reduce a fracture.

43. The method of claim 38 wherein the knit structure is configured for asymmetrically directing the flows of the volume of bone cement.

44. A method of reducing a fracture in a bone, comprising:

introducing a flowable material and a flow-directing knit structure into an interior of a bone;

wherein openings in the knit structure selectively direct flows to thereby retract cortical bone.

45. The method of reducing a fracture of claim 44 wherein the flowable material and the knit structure are introduced into cancellous bone.

46. The method of reducing a fracture of claim 44 wherein the flowable material and the knit structure are introduced into a vertebra.

47. The method of reducing a fracture of claim 44 wherein the introducing step moves a vertebral endplate.

48. A method of treating a bone, comprising the steps of:

providing a knit structure configured for permitting a flow of bone cement therethrough;

introducing a volume of bone cement and the knit structure into a bone; and

transmitting energy to the knit structure thereby heating at least portion of the knit structure and bone cement.

49. The method of claim 48 wherein transmitting energy modifies the viscosity of the bone cement.

50. The method of claim 48 wherein transmitting energy increases the viscosity of the bone cement.

51. The method of claim 48 wherein transmitting energy is provided by at least one of ultrasound energy delivery;

radiofrequency energy delivery, resistive heating, a light energy delivery, microwave energy delivery source, and inductive heating.

52. The method of claim 48 wherein the volume of bone cement and the knit structure are introduced into cancellous bone of a vertebra.

53. The method of claim 48 wherein the introducing step reduces a fracture.

54. A system for reducing a vertebral fracture, comprising:

a knit structure configured for expandable extension substantially throughout the interior of an injected volume of bone cement; and

an introducer for introducing the knit structure and bone cement into a vertebra.

55. The system for reducing a vertebral fracture of claim 54 wherein the knit structure has non-uniform openings between filaments of the knit structure.

56. The system for reducing a vertebral fracture of claim 55 wherein the filaments are metal.

57. The system for reducing a vertebral fracture of claim 55 wherein the filaments are at least one of titanium, stainless steel and tungsten.

58. The system for reducing a vertebral fracture of claim 55 wherein the filaments are at least partly of a polymer.

59. The system for reducing a vertebral fracture of claim 55 wherein the filaments are at least partly of a conductive polymer.

60. The system for reducing a vertebral fracture of claim 54 further comprising an energy source coupled to the knit structure, the energy source selected from the group of radiofrequency energy sources, resistive heating sources, light energy sources, ultrasound energy sources, microwave energy sources and inductive heating sources.

62. The system for reducing a vertebral fracture of claim 54 wherein the knit structure comprises at least one of knitted filaments, braided filaments, woven filaments and entangled filaments.

63. A system for treating a bone, comprising:

an open knit structure at least partly of conductive filaments configured for extension in cross section by the flow of bone cement therethrough; and

a radiofrequency source coupled to the open knit structure.

64. The system of claim 63 wherein the open knit structure is coupled to a first pole of the radiofrequency source.

65. The system of claim 63 wherein first and second portions of the open knit structure are coupled to respective first and second poles of the radiofrequency source.

66. The system of claim 65 wherein said first and second portions of the open knit structure are of conductive filaments.

67. The system of claim 65 wherein said first and second portions of the open knit structure are coupled by an intermediate portion of non-conductive filaments.