Methods for placing materials into bone

• US 20070073307A1
• Filed: 11/15/2006
• Published: 03/29/2007
• Est. Priority Date: 08/14/1998
• Status: Active Grant

• Current Assignee: Kyphon SARL (Medtronic Plc)
• Original Assignee: Kyphon Incorporated
• Inventors: Boucher, Ryan, Reo, Michael, Scribner, Robert, Reiley, Mark
• Granted Patent: US 7,708,742 B2
• Time in Patent Office: Days
• US Class Current: 606/93
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 17/7097 Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants disc prostheses made of inflatable chambers or pockets filled with fluid A61F2/441; replacing the nucleus pulposus A61F2002/444
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 17/8816 characterised by the conduit, e.g. tube, along which fluid flows into the body or by conduit connections
• CPC Class Codes: A61B 17/8822 characterised by means facilitating expulsion of fluid from the introducer, e.g. a screw pump plunger, hydraulic force transmissions, application of vibrations or a vacuum
• CPC Class Codes: A61B 17/8833 Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means
• CPC Class Codes: A61B 17/8855 inflatable, e.g. kyphoplasty balloons
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2050/0065 Peelable cover
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 50/33 Trays
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2310/00353 : Bone cement, e.g. polymethylmethacrylate or PMMA

Abstract

Cancellous bone is accessed through a subcutaneous access path in soft tissue. A cavity is formed in cancellous bone by a cavity forming tool that is advanced through the subcutaneous access path into cancellous bone and manipulated to form the cavity. A measured volume of bone filling material is delivered into the cavity through the subcutaneous access path by a nozzle having an interior bore defining an interior volume sized for containing bone filling material, which is advanced through the subcutaneous access path. A nested instrument is formed while clearing residual bone filling material from the interior bore by an auxiliary tool that can be manipulated independently of the nozzle, which is advanced through the interior bore of the nozzle.

Claims

1. A method comprising

accessing cancellous bone through a subcutaneous access path in soft tissue,

forming a cavity in cancellous bone including providing a cavity forming tool, advancing the cavity forming tool through the subcutaneous access path into cancellous bone, and manipulating the cavity forming tool to form the cavity,

delivering a measured volume of bone filling material into the cavity through the subcutaneous access path including providing a nozzle having an interior bore defining an interior volume sized for containing bone filling material for delivery into the cavity, and advancing the nozzle through the subcutaneous access path, and

forming a nested instrument while clearing residual bone filling material from the interior bore including providing an auxiliary tool that can be manipulated independently of the nozzle, and advancing the auxiliary tool through the interior bore of the nozzle.

5. A method according to claim 1 or 2 or 3

wherein accessing cancellous bone includes providing a cannula.

6. A method according to claim 1 or 2 or 3

wherein the void forming tool that is provided comprises an expandable body.

7. A method according to claim 6

wherein the expandable body, when expanded, assumes a non-spherical shape.

8. A method according to claim 1 or 2 or 3

wherein the nozzle that is provided comprises an elongate tube.

9. A method according to claim 1 or 2 or 3

further including manipulating a delivery device to conduct bone filling material into the nozzle.

10. A method according to claim 1 or 2 or 3

wherein the nozzle that is provided has a length and includes measured markings along the length.

11. A method according to claim 1 or 2 or 3

wherein the auxiliary tool that is provided comprises an elongate body.

12. A method according to claim 1 or 2 or 3

wherein the nozzle that is provided is made from a generally flexible material.

13. A method according to claim 1 or 2 or 3

wherein the nozzle that is provided is made from a generally rigid material.

14. A method according to claim 1 or 2 or 3

wherein the bone filling material comprises at least one of a flowable material that hardens to a rigid state, a bone cement, autograft material, allograft material, calcium carbonate, demineralized bone matrix material, and calcium phosphate.

15. A method according to claim 1 or 2 or 3

wherein the cavity forming tool that is provided includes an expandable body.

16. A method according to claim 15

wherein the expandable body expands by inflation.

17. A method according to claim 15

wherein the expandable body comprises a balloon.

18. A method according to claim 1 or 2 or 3

wherein manipulating the cavity forming tool compresses cancellous bone.

19. A method according to claim 1 or 2 or 3

wherein manipulating the cavity forming tool moves fractured cortical bone.

20. A method according to claim 1 or 2 or 3

wherein the cavity forming tool that is provided includes an elongate member sized and configured to pass through the access path.

21. A method according to claim 20

wherein the elongate member comprises a catheter.

2. A method comprising

accessing cancellous bone through a subcutaneous access path in soft tissue, forming a cavity in cancellous bone including providing a cavity forming tool, advancing the cavity forming tool through the subcutaneous access path into cancellous bone, and manipulating the cavity forming tool to form the cavity,

delivering a measured volume of bone filling material into the cavity through the subcutaneous access path including providing a nozzle having an interior bore defining an interior volume sized for containing bone filling material for delivery into the cavity, and advancing the nozzle through the subcutaneous access path, and

forming a nested instrument while clearing residual bone filling material from the interior bore including providing an auxiliary tool that can be manipulated independently of the nozzle, and advancing the auxiliary tool through the interior bore of the nozzle to substantially fully occupying the entire interior bore.

3. A method comprising

accessing cancellous bone through a subcutaneous access path in soft tissue, forming a cavity in cancellous bone including providing a cavity forming tool, advancing the cavity forming tool through the subcutaneous access path into cancellous bone, and manipulating the cavity forming tool to form the cavity,

delivering a measured volume of bone filling material into the cavity through the subcutaneous access path including providing a nozzle having an interior bore defining an interior volume sized for containing bone filling material for delivery into the cavity, advancing the nozzle through the subcutaneous access path, and

forming a nested instrument sized for occupying the subcutaneous access path. including providing an auxiliary tool that can be manipulated independently of the nozzle, and advancing the auxiliary tool through the interior bore of the nozzle to substantially fully occupy the entire interior bore while clearing residual bone filling material from the interior bore.

4. A method according to claim 3

further including manipulating the nested instrument in the subcutaneous access path to displace residual bone filling material into the cavity.