Methods for placing materials into bone

• US 20070093847A1
• Filed: 11/15/2006
• Published: 04/26/2007
• Est. Priority Date: 08/14/1998
• Status: Abandoned Application

• Current Assignee: Orthophoenix, LLC (Marathon Patent Group, Inc.)
• Original Assignee: Kyphon Incorporated (Medtronic Plc)
• Inventors: Boucher, Ryan, Reo, Michael, Scribner, Robert, Reiley, Mark
• Application Number:
  US11/599,904
• Publication Number:
  US 20070093847A1
• 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
• CPC Class Codes: A61B 2017/00867 shape memory effect
• 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

A cannula is positioned to establish a subcutaneous access path into a cancellous bone. A bone filling material is conveyed into the cancellous bone with a tamping instrument configured to be manipulated independent of the cannula. The bone filling material is compacted with the tamping instrument.

Claims

1. A method comprising

positioning a cannula to establish a subcutaneous access path into a cancellous bone,

conveying a bone filling material into the cancellous bone with a tamping instrument configured to be manipulated independent of the cannula, and

compacting the bone filling material with the tamping instrument.

2. A method according to claim 1

further comprising placing the bone filling material into the cannula prior to conveying the bone filling material into the cancellous bone.

3. A method according to claim 1

wherein the bone filling material comprises a bone cement.

4. A method according to claim 1

wherein the tamping instrument comprises a nozzle.

5. A method according to claim 1

wherein the bone filling material being conveyed into the cancellous bone through the nozzle.

6. A method according to claim 1

wherein the bone filling material comprises a bone cement.

7. A method according to claim 1

further comprising advancing a tamping terminus on the tamping instrument inside the cannula to urge the bone filling material contained in the cannula into the cancellous bone.

8. A method according to claim 7

further including visualizing advancement of the tamping instrument relative to the cannula.

9. A method according to claim 8

wherein visualization includes observing a radiopaque marker carried by the tamping instrument.

10. A method according to claim 8

wherein visualization includes observing a visible marking on the tamping instrument.

11. A method according to claim 8

wherein visualization includes observing when the tamping terminus is aligned with a distal end of the cannula.

18. A method according to claim 1 or 12 further including manipulating a delivery device to convey the bone filling material into the cannula.

19. A method according to claim 1 or 12

wherein the bone filling material includes as least one of bone cement, autograft material, allograft material, calcium carbonate, demineralized bone matrix material, or calcium phosphate.

20. A method according to claim 1 or 12

further including advancing, independent of the tamping instrument, an additional instrument in the cannula.

21. A method according to claim 20

further including manipulating the additional instrument to compress cancellous bone.

22. A method according to claim 20

further including manipulating the additional instrument to form a cavity in cancellous bone.

23. A method according to claim 22

wherein advancing the tamping terminus in the cannula urges the bone filling material into the cavity.

24. A method according to claim 20

further including manipulating the additional instrument to move fractured cortical bone.

25. A method according to claim 20

wherein the additional instrument that is provided includes an expandable body.

26. A method according to claim 25

wherein the expandable body expands by inflation.

27. A method according to claim 25

wherein the expandable body comprises a balloon.

43. A method according to claim 1 or 12 or 28

wherein the tamping instrument is sized and configured to substantially fill the cannula that is provided.

44. A method according to claim 1 or 12 or 28

wherein the tamping instrument has a substantially constant diameter along its length.

45. A method according to claim 1 or 12 or 28

wherein the tamping instrument has an essentially blunt tamping terminus.

46. A method according to claim 1 or 12 or 28

wherein the tamping instrument has a length that is greater than a length of the cannula that is provided.

47. A method according to claim 1 or 12 or 28

wherein the tamping instrument is generally rigid.

48. A method according to claim 1 or 12 or 28

wherein the tamping instrument is generally flexible.

49. A method according to claim 1 or 12 or 28

wherein at least one of the cannula and tamping instrument comprises plastic.

12. A method comprising

inserting a cannula into a patient'"'"'s body to establish a subcutaneous access path through a soft tissue into a cancellous bone,

providing a tamping instrument that can be manipulated independent of the cannula, the tamping instrument having a tamping terminus,

advancing the tamping terminus in the cannula to urge a bone filling material into cancellous bone, and

compacting the bone filling material with the tamping instrument.

13. A method according to claim 12

further comprising visualizing manipulation of the tamping instrument relative to the cannula.

14. A method according to claim 13

wherein visualization includes observing a radiopaque marker carried by the tamping instrument.

15. A method according to claim 13

wherein visualization includes observing a visible marking on the tamping instrument.

16. A method according to claim 13

wherein visualization includes observing when the tamping terminus is aligned with a distal end of the cannula.

17. A method according to claim 12

wherein advancing the tamping instrument includes gripping a handle on the tamping instrument.

28. A method comprising

accessing cancellous bone through a subcutaneous access path in soft tissue, advancing a first instrument into cancellous bone through the subcutaneous access path,

inserting a bone filling material into cancellous bone through the subcutaneous access path including providing a cannula that contains a volume of bone filling material,providing a tamping instrument that can be manipulated independent of the cannula and the first instrument, the tamping instrument having a tamping terminus, and

advancing the tamping terminus in the cannula to urge material contained in the cannula into cancellous bone.

29. A method according to claim 28

further including withdrawing the tamping terminus from the cannula.

30. A method according to claim 28

further including visualizing manipulation of the tamping instrument relative to the cannula.

31. A method according to claim 30

wherein visualization includes observing a radiopaque marker carried by the tamping instrument.

32. A method according to claim 30

wherein visualization includes observing a visible marking on the tamping instrument.

33. A method according to claim 30

wherein visualization includes observing when the tamping terminus is aligned with a distal end of the cannula.

34. A method according to claim 30

wherein visualization includes proving the cannula that is, at least in part, radiopaque.

35. A method according to claim 28

further including manipulating the first instrument.

36. A method according to claim 35

wherein manipulating the first instrument compresses cancellous bone.

37. A method according to claim 35

wherein manipulating of the first instrument forms a cavity in cancellous bone.

38. A method according to claim 37

wherein advancing the tamping terminus in the cannula urges material contained in the cannula into the cavity.

39. A method according to claim 35

wherein manipulating the first instrument moves fractured cortical bone.

40. A method according to claim 28

wherein advancing the tamping instrument includes gripping a handle on the tamping instrument.

41. A method according to claim 28

further including manipulating a delivery device to convey bone filling material into the cannula.

42. A method according to claim 28

wherein the bone filling material includes as least one of bone cement, autograft material, allograft material, calcium carbonate, demineralized bone matrix material, or calcium phosphate.

50. A method according to claim 28

wherein the first instrument that is provided includes an expandable body.

51. A method according to claim 50

wherein the expandable body expands by inflation.

52. A method according to claim 50

wherein the expandable body comprises a balloon.

53. A method comprising inserting a cannula into a patient'"'"'s body to establish a subcutaneous access path into a cancellous bone;

advancing a first instrument into the cancellous bone through the subcutaneous access path;

compressing at least a portion of the cancelous bone and create a cavity in the cancelous bone,

inserting a bone filling material into the subcutaneous access path,

providing a second instrument that can be manipulated independent of the cannula and the first instrument, the second instrument having a tamping terminus, and

advancing the tamping terminus in the cannula to urge the bone filling material into the cavity.

54. A method according to claim 53

further comprising compacting the bone filling material uniformly within the cavity.

55. A method according to claim 53

further comprising advancing the tamping terminus to compact the bone filling material.

56. A method according to claim 53

further including withdrawing the tamping terminus from the cannula.

57. A method according to claim 53

further including visualizing manipulation of the tamping instrument relative to the cannula.

58. A method according to claim 57

wherein visualization includes observing a radiopaque marker carried by the tamping instrument.

59. A method according to claim 57

wherein visualization includes observing a visible marking on the tamping instrument.

60. A method according to claim 57

wherein visualization includes observing when the tamping terminus is aligned with a distal end of the cannula.

61. A method according to claim 53

further comprising manipulating the first instrument to move fractured cortical bone.

62. A method according to claim 53

wherein advancing the tamping instrument includes gripping a handle on the tamping instrument.

63. A method according to claim 53

further including manipulating a delivery device to convey bone filling material into the cannula.

64. A method according to claim 53

wherein the bone filling material includes as least one of bone cement, autograft material, allograft material, calcium carbonate, demineralized bone matrix material, or calcium phosphate.

65. A method according to claim 53

wherein the first instrument comprises an expandable body.

66. A method according to claim 65

wherein the expandable body expands by inflation.

67. A method according to claim 66

wherein the expandable body comprises a balloon.