Apparatus and method for fixation of osteoporotic bone

• US 6,395,007 B1
• Filed: 03/14/2000
• Issued: 05/28/2002
• Est. Priority Date: 03/16/1999
• Status: Expired due to Term

• Current Assignee: Zimmer Biomet Spine, Inc. (Zimvie Incorporated)
• Original Assignee: American Osteomedix, Inc.
• Inventors: Major, Eric, Bhatnagar, Mohit
• Primary Examiner(s): Smith, Jeffrey A.
• Application Number:
  US09/525,008
• Time in Patent Office: 805 Days
• Field of Search: 606/86,92,93,94,213 604/48,500,506,522,230,122,219,57,59,60
• US Class Current: 606/94
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• 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 17/8819 characterised by the introducer proximal part, e.g. cannula handle, or by parts which are inserted inside each other, e.g. stylet and cannula A61B17/8825 takes precedence
• 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 17/8827 with filtering, degassing, venting or pressure relief means
• 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: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• 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 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/4627 with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4635 using minimally invasive surgery
• CPC Class Codes: A61F 2002/4677 using a guide wire
• CPC Class Codes: A61F 2310/00353 Bone cement, e.g. polymethylmethacrylate or PMMA

Abstract

A surgical apparatus and method of use in osteoplasty and other methods of injecting materials into a subject for medical purposes. The present invention particularly relates to the surgical treatment of traumatic, pathogenic, or osteoporotic bone conditions of the human and other animal body systems and more particularly, to an apparatus and method for injection of a material into a lesion of a vertebral body or other bony structure.

Claims

1. An injection device comprising:

a delivery cannulae having a proximal end and a distal end, which are connected by a cannulae body, and a lumen capable of acting as a material conduit, said lumen passing from said proximal end through said distal end;

an elongated plunger, said plunger being sized and configured to slidably pass through said lumen so as to force said injectable material through said lumen while permitting air from said lumen to escape proximally past said plunger;

a removable handle configured for secure attachment to said proximal end of said delivery cannulae, said delivery cannulae being equipped with a handle retention member integrally formed in said proximal end of said delivery cannulae.

2. An injection device according to claim 1, further comprising:

an elongated guide wire, said guide wire having a first end and a second end connected by an elongated guide wire body, said first end being configured with a taper, said taper being capable of breaching cortical bone sufficient to form a channel through said cortical bone; and

an aligning cannulae having a gripping end and a tapered end, said aligning cannulae being sized and configured to slidably pass circumferentially over said guide wire and said delivery cannulae being sized and configured to slidably pass circumferentially over said aligning cannulae.

3. An injection device according to claim 2, wherein said guide wire comprises graduated indicia on said guide wire body.

4. An injection device according to claim 2, wherein said delivery cannulae comprises graduated indicia on said cannulae body.

5. An injection device according to claim 2, wherein said plunger comprises a first end having a gripping member, said first end being connected by a plunger body to a second end having a blunt smooth tip, said gripping member comprising a swivel joint axially aligned with said plunger.

6. An injection device according to claim 2, wherein said second end of said guide wire comprises a gripping member.

7. An injection device according to claim 2, wherein said aligning cannulae comprises a textured surface on said gripping end.

8. An injection device according to claim 2, wherein said delivery cannulae comprises a securing edge on said distal end.

9. An injection device according to claim 2, wherein said plunger comprises a plunger gripping member connected by a plunger body to a blunt smooth tip end.

10. An injection device according to claim 2, wherein said guide wire comprises an attached longitudinally aligned Luer lock connector.

11. An injection device according to claim 10, wherein said handle comprises a Luer lock configured to releasably engage said Luer lock connector of said guide wire, said handle further comprising a longitudinally aligned lumen opening at each end of said handle.

12. An injection device according to claim 2, wherein said device is formed of materials selected from the group consisting of stainless steel, anodized aluminum, thermoplastics and glass.

13. An injection device according to claim 2, wherein said delivery cannulae lumen comprises multiple lumens.

14. An injection device according to claim 1, further comprising:

an elongated guide wire, said guide wire having a first end and a second end connected by an elongated guide wire body, and said first end being configured with a taper, said taper being capable of breaching cortical bone sufficient to form a channel through said cortical bone, wherein said delivery cannulae is sized and configured to slidably pass circumferentially over said guide wire.

15. A kit for introducing an injectable material into a subject, the kit comprising:

an injection device according to claim 1; and

an injectable material selected from the group consisting of bone cement, antibiotics, whole cellular implants, natural products of cells, recombinant nucleic products and protein products of recombinant cells.

16. A kit according to claim 15, wherein said injectable material is polymethylmethacrylate.

17. An injection device in combination with an injectable material comprising:

an elongated guide wire, said guide wire having a first end and a second end connected by an elongated guide wire body, and said first end being configured with a taper, said taper being capable of breaching cortical bond sufficient to form a channel through said cortical bone;

an aligning cannulae having a gripping end and a tapered end, said aligning cannulae being sized and configured to slidably pass circumferentially over said guide wire;

a delivery cannulae having a proximal end and a distal end, which are connected by a cannulae body; and

a lumen capable of acting as a material conduit, said lumen passing from said proximal end through said distal end, said delivery cannulae being sized and configured to slidably pass circumferentially over said aligning cannulae;

an elongated plunger, said plunger being sized and configured to slidably pass through said lumen so as to force said injectable material through said lumen while permitting air from said lumen to escape proximally past said plunger;

a removable handle configured for secure attachment to said proximal end of said delivery cannulae, said delivery cannulae being equipped with a handle retention member integrally formed in said proximal end of said delivery cannulae; and

an injectable material provided to said lumen of said delivery cannulae, said injectable material being of a consistency such that upon controlled movement of said plunger, said injectable material will flow through said lumen.

18. An injection device according to claim 17, wherein said injectable material is selected from the group consisting of bone cement, antibiotics, cellular implants, natural products of cells recombinant nucleic acid products, and protein products of recombinant cells.

19. An intraosseous device comprising:

an elongated guide wire, said guide wire having a first end and a second end connected by an elongated guide wire body, and said first end being configured with a taper, said taper being capable of breaching cortical bone sufficient to form a channel through said cortical bone;

an aligning cannulae having a gripping end and a tapered end, said aligning cannulae being sized and configured to slidably pass circumferentially over said guide wire;

a delivery cannulae having a proximal end and a distal end, which are connected by a cannulae body, and a lumen capable of acting as a material conduit, said lumen passing from said proximal end through said distal end, said delivery cannulae being sized and configured to slidably pass circumferentially over said aligning cannulae;

an elongated plunger, said plunger being sized and configured to slidably pass through said lumen so as to force said injectable material through said lumen while permitting air from said lumen to escape proximally past said plunger;

a removable handle configured for secure attachment to said proximal end of said delivery cannulae, said delivery cannulae being equipped with a handle retention member integrally formed in said proximal end of said delivery cannulae.

20. A method of introducing an injectable material into a subject, the method comprising:

introducing a guide wire through the cortical bone of a subject;

introducing an aligning cannulae circumferentially over said guide wire until said aligning cannulae contacts said cortical bone;

introducing a delivery cannulae having a lumen circumferentially over said aligning cannulae until said delivery cannulae contacts said cortical bone;

removing said guide wire and said aligning cannulae from the subject;

infusing an injectable material into said lumen, and infusing said injectable material into the bone of said subject by movement of a plunger, said plunger being sized and configured to force said injectable material through said lumen of said delivery cannulae while permitting air from with said lumen to escape proximally past said plunger.

21. A method according to claim 20, wherein said guide wire introducing step is into the body of a vertebra of the subject via an approach selected from the group consisting of postero-lateral approach, unilateral approach, bilateral approach and lateral intracortical bone penetration approach.

22. A method according to claim 20, wherein said guide wire introducing step is into the body of a vertebra of the subject via a transpedicular approach.

23. An injection device for the injection of an injectable material comprising:

a delivery cannulae having a proximal end and a distal end, which are connected by a cannulae body, and a lumen capable of acting as a material conduit, said lumen passing from said proximal end through said distal end;

a syringe system releasably connected to said delivery cannulae and in fluid communication with said delivery cannulae lumen, said syringe system comprising a lumen and a syringe plunger tip, said syringe plunger tip having at least one air passage and being sized to slidably move within said lumen of said syringe system so as to allow the proximal flow of air past said plunger tip while said plunger tip moves distally with said syringe system to force said injectable material into said delivery cannulae;

a removable handle configured for secure attachment to said proximal end of said delivery cannulae, said delivery cannulae being equipped with a handle retention member integrally formed in said proximal end of said delivery cannulae.

24. An injection device according to claim 23, wherein said syringe system is removably connected to said delivery cannulae by a connector selected from the group consisting of a Luer lock, a bayonet fitting, and a hydraulic quick disconnect fitting.

25. An injection device according to claim 24, wherein said connector is integral with said proximal end of said delivery cannulae and is aligned with the longitudinal axis of said delivery cannulae body.

26. An injection device according to claim 24, wherein said connector of said delivery cannulae is a Luer lock and said handle comprises a Luer lock configured to releasably engage said Luer lock connector of said delivery cannulae, said handle further comprising a longitudinally aligned handle lumen opening at each end of said handle, said handle lumen being in fluid communication with said lumen of said delivery cannulae.

27. An injection device according to claim 26, wherein said handle further comprises a view slot sized and configured to permit viewing of the handle lumen.

28. An injection device according to claim 26, wherein said handle further comprises a first clearance hole passing through said handle perpendicular to said handle lumen, said first clearance hole being sized and configured to slidably receive said guide wire.

29. An injection device according to claim 28, wherein said handle further comprises a second clearance hole passing through said handle perpendicular to said handle lumen, said second clearance hole being sized and configured to slidably receive said aligning cannulae.

30. An injection device according to claim 26, wherein said handle further comprises a removable proximal Luer lock end.

31. An injection device according to claim 23, wherein said syringe system is connected to said delivery cannulae by a flexible conduit.

32. An injection device according to claim 23, wherein said syringe system comprises an automated impelling unit.

33. An injection device according to claim 32, wherein said automated impelling unit being capable of controlling the rate and amount of movement of said syringe plunger tip.

34. An injection device according to claim 33, wherein said automated impelling unit further comprises a pressure sensing unit.

35. A kit for introducing an injectable material into a subject, the kit comprising:

an injection device according to claim 24 and

an injectable material selected from the group consisting of bone cement, antibiotics, whole cellular implants, natural products of cells, recombinant nucleic products and protein products of recombinant cells.

36. A kit according to claim 35, wherein said injectable material is polymethylmethacrylate.