Devices and methods for vertebrostenting

• US 9,566,101 B2
• Filed: 01/15/2010
• Issued: 02/14/2017
• Est. Priority Date: 12/15/2006
• Status: Active Grant

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Globus Medical, Inc.
• Inventors: Crainich, Lawrence, Sennett, Andrew R., Trabka, Joseph
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US12/688,418
• Publication Number:
  US 20100121332A1
• Time in Patent Office: 2,587 Days
• Field of Search: 606 79- 85, 606/86.R, 606167-169, 606171-172, 606/175, 606300-321, 600139-152
• US Class Current: 1/1
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1671 for the spine
• 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 17/8808 with sealing collar for bone cavity
• 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 17/885 Tools for expanding or compacting bones or discs or cavities therein A61B17/8805, A61B17/7097 take precedence
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855

Abstract

The invention relates to a method of creating a curvilinear cavity within a vertebral body or other body structure. The invention also relates to devices that may be used to perform the steps to create the curvilinear cavity. One such device is a curved drill including a spring assembly that controls the curvature of the drill. The spring assembly can cooperate with a feed screw to assist in curving the drill. The curved drill can be provided through a cannula.

Claims

1. A method of forming a curvilinear void in bony structure, the method comprising the steps of:

accessing a bony structure with a cannula;

inserting a distal end of a drill device through the cannula and into the bony structure, the drill device comprising a flexible drill shaft assembly, wherein the flexible drill shaft assembly comprises a handle having a rotatable element and a handle spring, a drill shaft affixed to a feed screw, a compression spring, a band retention element, and a lever and cam sub assembly comprising a drill cam and a cam pusher assembly for varying a force used to apply a curvature to a distal end of the flexible drill shaft assembly, wherein the drill cam comprises an outer surface wall and an inner surface wall, wherein the outer surface wall is in contact with the cam pusher assembly, and the band retention element is positioned outside of the drill cam, wherein the lever has a first position pointing toward the compression spring that is against the handle and a second position that is away from the handle, wherein when the lever is in the second position away from the handle the compression spring is under greater compression than when the lever is in the first position against the handle, further wherein when the lever is in the second position the drill cam is pivoted and forces the cam pusher assembly toward the compression spring;

manipulating the distal end of the drill device to create a curvilinear void in the bony structure; and

removing the distal end of the drill device from the cannula,

wherein the flexible drill shaft assembly further comprises a sharp cutting tip, a band coupled at a distal end proximate to the cutting tip and at a proximal end to the compression spring, a flexible rotatable drive shaft coupled to the tip, and a flexible, moveable and non-rotatable housing.

2. The method of claim 1, wherein the step of manipulating of the distal end of the drill device comprises a simultaneous rotation and curvilinear translation of the distal end of the drill device.

3. The method of claim 1, wherein the cannula is straight.

4. The method of claim 1, wherein the step of manipulating the distal end of the drill device comprises inducing a curvature in the distal end of the flexible drill shaft assembly.

5. The method of claim 1, further comprising the step of:

moving the lever to the first position to reduce the force on the distal end of the flexible drill shaft assembly prior to removing the distal end of the drill device from the cannula.

6. The method of claim 1, wherein the flexible drill shaft assembly further comprises a sharp cutting tip, a band coupled at a distal end proximate to the cutting tip and at a proximal end to the compression spring, a flexible rotatable drive shaft coupled to the tip, and a flexible, moveable and non-rotatable housing.

7. The method of claim 1, wherein the drilling device further comprises a locking feature.

8. The method of claim 7, further comprising the steps of:

locking the drill device into the cannula using the locking feature prior to forming the void; and

unlocking the drill device from the cannula after forming the void and prior to removing the distal end of the drill device.

9. The method of claim 1, wherein the drill device is manipulated in response to a rotation of an element at a proximal end of the drill device.

10. The method of claim 1, wherein the second position is substantially perpendicular to the first position.

11. The method of claim 1, wherein the drill cam comprises a first outer radius and a second outer radius that is different than the first outer radius.

12. The method of claim 11, wherein the second outer radius is larger than the first outer radius.

13. The method of claim 12, wherein the drill cam has a first end and a second end, the first end includes the second outer radius and a portion of the lever is attached to the second end of the drill cam.

14. The apparatus of claim 1, wherein the handle includes a retaining pin and a drive shaft, wherein the retaining pin anchors a proximal end of the drive shaft to the handle.

15. The apparatus of claim 14, wherein the retaining pin is positioned between the cam and the band retention element.

16. The apparatus of claim 1, wherein the handle includes a feed nut threaded onto the feed screw, the compression spring is positioned between the feed screw and the band retention element, and the feed nut has a locking flange configured to releasably lock the handle to the cannula.

17. The apparatus of claim 1, wherein the flexible shaft assembly includes a key component located on an outer surface of a slotted tube, wherein the key component slidably mates with a slot in the cannula to lock the orientation of the drill device relative to the cannula.

18. A method of forming a curvilinear void in bony structure, the method comprising the steps of:

accessing a bony structure with a cannula;

inserting a distal end of a drill device into the bony structure, the drill device comprising a flexible drill shaft assembly, wherein the flexible drill shaft assembly comprises a handle having a rotatable element and a handle spring, a drill shaft affixed to a compression spring, a band retention element, and a lever and cam sub assembly for varying a force used to apply a curvature to a distal end of the flexible drill shaft assembly, wherein the cam sub assembly comprises a drill cam and a cam pusher assembly, wherein the drill cam comprises an outer surface wall and an inner surface wall, wherein the outer surface wall is in contact with the cam pusher assembly, and the band retention element is positioned outside of the drill cam, wherein the lever has a first position pointing toward the compression spring that is against the handle and a second position that is away from the handle, wherein when the lever is in the second position away from the handle the compression spring is under greater compression than when the lever is in the first position against the handle, further wherein when the lever is in the second position the drill cam is pivoted and forces the cam pusher assembly toward the compression spring; and

manipulating the distal end of the drill device to create a curvilinear void in the bony structure,

wherein the flexible drill shaft assembly includes a key component located on an outer surface of a slotted tube, wherein the key component slidably mates with a slot in the cannula to lock the orientation of the drill device relative to the cannula.

19. The method of claim 18, wherein the force at the first position is less than the second position of the lever.

20. The method of claim 18, wherein the force used to apply a curvature is applied to the distal end of the flexible shaft assembly by a band connected at a proximal end to the band retention element and at a distal portion of the flexible drill shaft assembly.