Systems for treating a vertebral body

• US 8,758,349 B2
• Filed: 10/13/2009
• Issued: 06/24/2014
• Est. Priority Date: 10/13/2008
• Status: Active Grant

• Current Assignee: Dfine Incorporated (Merit Medical Systems, Inc.)
• Original Assignee: Dfine Incorporated (Merit Medical Systems, Inc.)
• Inventors: Germain, Aaron, Truckai, Csaba
• Primary Examiner(s): Yang, Andrew
• Assistant Examiner(s): Jones, Diana S
• Application Number:
  US12/578,455
• Publication Number:
  US 20100211076A1
• Time in Patent Office: 1,715 Days
• Field of Search: 606/39, 606/40, 606/45, 606 48- 50, 606 79- 85, 606 92- 95, 606/167, 606/170, 606/171, 606/180, 606/184, 606/185, 606/186, 606/279, 606/246
• US Class Current: 606/86.R
• 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 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• 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 17/8811 characterised by the introducer tip, i.e. the part inserted into or onto the bone
• 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 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2018/00101 low, i.e. thermally insulating
• CPC Class Codes: A61B 2018/00339 Spine, e.g. intervertebral disc
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00714 : Temperature
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1475 : Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2018/1497 : Electrodes covering only part of the probe circumference

Abstract

Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Claims

1. A method of treating a vertebral body, comprising:

providing an elongate tool having a sharp tip configured for penetration into vertebral tissue, the tool having an axis extending from a proximal end to a working end thereof, where the working end comprises at least a first sleeve concentrically located within a second sleeve, where the first sleeve has a weakened section on a single side comprising a first series of slots or notches, and the second sleeve has a weakened section on a single side comprising a second series of slots or notches, where the first and second series of slots or notches limit deflection of the working end to a first curved configuration in a single plane and where the first and second series of slots or notches are radially offset from each other, where a first conductive portion of the first sleeve is electrically coupled to a first pole of a power supply;

advancing the working end through vertebral tissue;

causing the working end to move from a linear configuration to a curved configuration by translating the first sleeve relative to the second sleeve in an axial direction; and

applying energy between the first conductive portion and a return electrode electrically coupled to a second pole of the energy supply to ablate or coagulate a region within the vertebral body.

2. The method of claim 1, further comprising moving the working end in the curved configuration within the vertebral tissue by applying an impact force on the handle create a cavity therein by mechanically displacing vertebral tissue.

3. The method of claim 1, where applying energy comprises advancing an extension portion of the first sleeve distally from the second sleeve such that applying energy comprises causing current to flow between the extension portion of the first sleeve and the return electrode.

4. The method of claim 3, further comprising applying a fluid through the first sleeve through one or more ports in the extension portion of the first sleeve.

5. The method of claim 1, where the return electrode is located on an exterior portion of the second sleeve.

6. The method of claim 1, where translating the first sleeve relative to the second sleeve comprises relatively rotating the first sleeve and the second sleeve to each other to translate in the axial direction.

7. The method of claim 1, further comprising a third sleeve located concentrically about the second sleeve, the third sleeve having a series of slots or notches to limit deflection of the working end to the first curved configuration in the single plane, and where the return electrode is located on an exterior portion of the third sleeve.

8. The method of claim 7, where the third sleeve ends at an intermediate portion of the tool to limit torque or rotational forces generated by the handle mechanism.

9. A method of treating a vertebral body, comprising:

providing an elongate tool having a sharp tip configured for penetration into vertebral tissue, the tool having an axis extending from a proximal end to a working end thereof, where the working end comprises at least a first sleeve concentrically located within a second sleeve, where each sleeve comprises a series of slots or notches to limit deflection of the working end to a first curved configuration in a single plane and where the respective series of slots or notches are radially offset in adjacent sleeves, where a first conductive portion of the first sleeve is electrically coupled to a first pole of a power supply and a third sleeve located concentrically about the second sleeve, the third sleeve having, a series of slots or notches to limit deflection of the working end to the first curved configuration in the single plane;

advancing the working end through vertebral tissue;

causing the working end to move from a linear configuration to a curved configuration by translating the first sleeve relative to the second sleeve in an axial direction; and

applying energy between the first conductive portion and a return electrode electrically coupled to a second pole of the energy supply to ablate or coagulate a region within the vertebral body and where the return electrode is located on an exterior portion of the third sleeve.

10. The method of claim 9, where the third sleeve ends at an intermediate portion of the tool to limit torque or rotational forces generated by the handle mechanism.

11. The method of claim 9, further comprising moving the working end in the curved configuration within the tissue by applying an impact force on the handle create a cavity therein by mechanically displacing tissue.

12. The method of claim 9, where applying energy comprises advancing, an extension portion of the first sleeve distally from the second sleeve such that applying energy comprises causing current to flow between the extension portion of the first sleeve and the return electrode.

13. The method of claim 12, further comprising applying a fluid through the first sleeve through one or more ports in the extension portion of the first sleeve.

14. The method of claim 9, where the return electrode is located on an exterior portion of the second sleeve.

15. The method of claim 9, where translating the first sleeve relative to the second sleeve comprises relatively rotating the first sleeve and the second sleeve to each other to translate in the axial direction.