Bone treatment systems and methods
First Claim
1. A method of treating an abnormal vertebra, comprising:
- delivering energy to a bone fill material flow that flows through a delivery cannula to alter a viscosity of the bone fill material;
flowing a volume of the bone fill material flow, with a relatively high viscosity of at least about 1,000,000 cps, into a vertebral body under a first set of flow parameters;
interdigitating cancellous bone with at least a portion of the volume of bone fill material, wherein a computer controller controls an energy source to alter the fill material within a delivery cannula to the relatively high viscosity of at least about 1,000,000 cps sufficient to controllably permeate and interdigitate with cancellous bone;
flowing an additional volume of bone fill material with a relatively low viscosity into the vertebral body under a second set of flow parameters, different from the first set of flow parameters that substantially prevents interdigitation of the additional volume of bone fill material with cancellous bone;
applying forces to the cancellous bone and interdigitated fill material about a surface of the interdigitated bone fill material with the additional volume of bone fill material; and
controlling the viscosity of the bone fill material in response to a measured characteristic of the bone fill material flow, wherein the measured characteristic is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume.
2 Assignments
0 Petitions
Accused Products
Abstract
The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.
299 Citations
45 Claims
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1. A method of treating an abnormal vertebra, comprising:
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delivering energy to a bone fill material flow that flows through a delivery cannula to alter a viscosity of the bone fill material; flowing a volume of the bone fill material flow, with a relatively high viscosity of at least about 1,000,000 cps, into a vertebral body under a first set of flow parameters; interdigitating cancellous bone with at least a portion of the volume of bone fill material, wherein a computer controller controls an energy source to alter the fill material within a delivery cannula to the relatively high viscosity of at least about 1,000,000 cps sufficient to controllably permeate and interdigitate with cancellous bone; flowing an additional volume of bone fill material with a relatively low viscosity into the vertebral body under a second set of flow parameters, different from the first set of flow parameters that substantially prevents interdigitation of the additional volume of bone fill material with cancellous bone; applying forces to the cancellous bone and interdigitated fill material about a surface of the interdigitated bone fill material with the additional volume of bone fill material; and controlling the viscosity of the bone fill material in response to a measured characteristic of the bone fill material flow, wherein the measured characteristic is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method of treating an abnormal vertebra, comprising:
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providing a flow source configured to provide bone fill material inflows into an interior of a vertebra through an introducer and a controller configured to control the bone fill material inflows; inflowing the bone fill material in pulses from the flow source into the interior of the vertebra, wherein the pulses of bone fill material flow comprise a first bone fill material flow with relatively high viscosity that interdigitates with cancellous bone and a second bone fill material flow with relatively low viscosity that does not substantially interdigitate with cancellous bone; measuring a characteristic of the bone fill material with a sensor while the bone fill material is inflowing into the vertebra, wherein the characteristic is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume; and controlling the change in viscosity between the pulses of the first bone fill material flow and the second bone fill material flow, at least in part in response to the measured characteristic of the bone fill material, such that the viscosity of the first bone fill material flow is greater than the viscosity of the second bone fill material flow by between about 100% to 1000%. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20)
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21. A method of treating an abnormal vertebra, comprising:
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injecting a first flow of bone fill material into a vertebral body at a first viscosity; interdigitating the first flow of bone fill material with cancellous bone; injecting a second flow of bone fill material into the vertebral body at a second viscosity, lower than the first; and preventing the second flow of bone fill material from interdigitizing with the cancellous bone, wherein the second flow of bone fill material expands the cancellous bone with the interdigitated bone fill material; sensing a characteristic of the flows of bone fill material, wherein the characteristic is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume; and controlling viscosity of the bone fill material through a computer controller and the application of electrical or thermal energy to the bone fill material within a delivery cannula at least in part in response to the sensed characteristic, wherein there is a decrease in viscosity of at least 50% from the first flow to the second flow. - View Dependent Claims (22, 23, 24, 25, 26, 27)
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28. A system for treating an abnormal vertebra comprising:
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an elongated introducer configured for insertion into a vertebra; a source of flowable bone fill material coupled to the introducer, the source configured to provide a pressurized inflow of bone fill material through the introducer; a sensor that provides a measurement of a parameter of the bone fill material, wherein the parameter is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume; and a computer controller configured to control at least one flow parameter of the bone fill material into the vertebra, the computer controller being adjustable between a first setting wherein the inflowing bone fill material has a first flow parameter capable of interdigitating with cancellous bone and a second setting wherein the inflowing bone fill material has a second flow parameter that substantially prevents interdigitation with cancellous bone, the computer controller further configured to control an application of thermal energy directly to the bone fill material, which control is separate from the control of the at least one flow parameter and based at least in part on the measured parameter. - View Dependent Claims (29, 30, 31, 32)
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33. A method for treating a vertebral body, comprising:
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providing a pulsing inflow of bone fill material into the vertebral body; moving at least one of bone marrow, fat and blood within cancellous bone of the vertebral body by delivering the bone fill material at a flow rate that displaces the at least one of bone marrow, fat and blood within the cancellous bone; measuring a characteristic of the bone fill material with a sensor, wherein the characteristic is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume; and controllably applying thermal energy to the inflow of bone fill material, wherein the application of thermal energy is controlled at least in part on the measured characteristic of the bone fill material; wherein the pulses of bone fill material flow comprise relatively higher flow rate flows, having relatively low viscosity, into the interior of the vertebral body alternating with relatively slower flow rate flows, having relatively high viscosity. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40, 41, 42)
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43. A method of treating a vertebral body, comprising:
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providing an inflow of bone fill material into the vertebral body, wherein the inflow of bone fill material comprises relatively higher flow rate flows, having relatively low viscosity, into the interior of the vertebral body alternating with relatively slower flow rate flows, having relatively high viscosity and achieving these viscosities in a delivery cannula prior to inflowing into the vertebral bodies; measuring a characteristic of the inflow of bone fill material, wherein the characteristic is selected from the group consisting of impedance, temperature, pressure, viscosity, flow parameters and volume; controllably applying thermal energy to the inflow of bone fill material, wherein the application of thermal energy is controlled at least in part on the measured characteristic of the bone fill material; displacing at least one of bone marrow, fat, blood and cancellous bone of the vertebral body by delivering the bone fill material at a flow rate that displaces the at least one of bone marrow, fat, blood and cancellous bone; and extracting at least some of the at least one of bone marrow, fat, blood and cancellous bone from the vertebral body. - View Dependent Claims (44, 45)
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Specification