Systems and methods for treating vertebral bodies

• US 8,454,663 B2
• Filed: 04/18/2011
• Issued: 06/04/2013
• Est. Priority Date: 08/14/1998
• Status: Expired due to Fees

• Current Assignee: Orthophoenix, LLC (Marathon Patent Group, Inc.)
• Original Assignee: Kyphon SARL (Medtronic Plc)
• Inventors: Boucher, Ryan P., Reiley, Mark A., Scribner, Robert M., Reo, Michael L.
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): HARVEY, JULIANNA NANCY
• Application Number:
  US13/089,210
• Publication Number:
  US 20110196499A1
• Time in Patent Office: 778 Days
• Field of Search: 606 92- 95, 606/279, 606/60, 606/246, 623/17.11
• US Class Current: 606/279
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1662 for particular parts of the body
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• 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 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• 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 17/8819 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 17/8855 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 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• 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 2090/034 : abutting on parts of the device itself
• CPC Class Codes: A61B 2090/062 : penetration depth
• CPC Class Codes: A61B 2090/3933 : Liquid markers
• CPC Class Codes: A61B 2090/3937 : Visible markers
• 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: A61B 90/90 : Identification means for patients or instruments, e.g. tags
• 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 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• 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 2002/30581 : having a pocket filled with fluid, e.g. liquid
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2002/4685 : by means of vacuum
• 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

Systems and methods treat at least two vertebral bodies in a spinal column. The systems and methods make use of first and second tool assemblies operable to treat an interior region of, respectively, a first vertebral body and a second vertebral body in the spinal column. The systems and methods provide directions for operating the first and second tool assemblies to treat the first and second vertebral bodies, at least for a portion of time, concurrently.

Claims

1. A method for treating a vertebral body, the method comprising:

creating an access passage to an interior volume of the vertebra through a pedicle of the vertebral body, wherein creating the access passage comprises placing a cannula in contact with the pedicle;

inserting an expandable structure into the interior volume of the vertebra through the access passage, the expandable structure including an interior tube having an interior lumen that passes through the expandable structure;

expanding the expandable structure to compact cancellous bone and create a laterally offset cavity in the interior volume of the vertebra by delivering an inflation fluid into the expandable structure;

passing fluid through the interior lumen to flush a distal region of the expandable structure and aspirate an interior of the vertebral body; and

introducing a first volume of filling material into the laterally offset cavity.

2. The method of claim 1, wherein creating the access passage comprises placing a cannula in contact with the pedicle.

3. The method of claim 1, wherein the interior tube defines an inner lumen sized to receive a stiffening stylet.

4. The method of claim 1, wherein a stiffening stylet is movably positioned within the catheter tube.

5. The method of claim 1, wherein expanding the expandable structure further causes displacement of cortical bone of the vertebra.

6. The method of claim 1, further comprising:

creating a second access passage to the interior volume of the vertebra through a second pedicle of the vertebral body;

inserting a second expandable structure into the interior volume of the vertebra through the second access passage;

expanding the second expandable structure to compact cancellous bone and create a second laterally offset cavity in the interior volume of the vertebra; and

introducing a second volume of filling material into the second laterally offset cavity.

7. The method of claim 6, wherein the laterally offset cavity and the second laterally offset cavity possess substantially the same volume and geometry.

8. The method of claim 6, wherein the laterally offset cavity defines a first volume,

wherein the second laterally offset cavity defines a second volume, and

wherein the second volume is different than the first volume.

9. The method of claim 6, wherein the laterally offset cavity defines a first geometry, wherein the second laterally offset cavity defines a second geometry, and wherein the second geometry is different than the first geometry.

10. The method of claim 6, wherein the laterally offset cavity and the second laterally offset cavity are separated by a region of cancellous bone.

11. A method for treating a vertebral body, the method comprising:

creating an access passage to an interior volume of the vertebra through only a single pedicle of the vertebra by placing a cannula in contact with the single pedicle of the vertebra;

inserting an expandable structure into the interior volume of the vertebra through the access passage, wherein inserting the expandable structure comprises advancing the expandable structure through the cannula, the expandable structure including an interior tube having an interior lumen that passes through the expandable structure;

expanding the expandable structure to compact cancellous bone and create a single laterally offset cavity in the interior volume of the vertebra and causes displacement of cortical bone of the vertebra;

passing fluid through the interior lumen to flush a distal region of the expandable structure and aspirate an interior of the vertebral body; and

introducing a filling material into the single laterally offset cavity.

12. The method of claim 11, wherein expanding the expandable structure comprises delivering an inflation fluid to the expandable structure through an inner lumen of a catheter.

13. The method of claim 12, wherein a stiffening stylet is positioned at least partially within the inner lumen.

14. The method of claim 13, wherein an inner tube is positioned within the inner lumen, and wherein the inner tube defines an interior lumen sized to receive the stiffening stylet.

15. The method of claim 14, wherein the inner tube passes through the expandable structure.