Expandable bone implant

• US 9,925,055 B2
• Filed: 05/25/2016
• Issued: 03/27/2018
• Est. Priority Date: 05/08/2009
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Schaller, Konrad, Lechmann, Beat, Frigg, Robert
• Primary Examiner(s): JOHANAS, JACQUELINE T
• Application Number:
  US15/164,762
• Publication Number:
  US 20160262904A1
• Time in Patent Office: 671 Days
• CPC Class Codes: A61B 17/149 Chain, wire or band saws
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/7097 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 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/46 Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• 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 2002/30593 hollow
• CPC Class Codes: A61F 2002/30953 using a remote computer network, e.g. Internet
• CPC Class Codes: A61F 2002/4625 with relative movement between parts of the instrument during use
• CPC Class Codes: A61F 2002/4635 using minimally invasive surgery

Abstract

An expandable implant includes an implant body defining an internal void, the implant body including a plurality of interconnected linkages. A first plurality of the linkages has an expansion characteristic that is different from a second plurality of the linkages. An expandable bladder is sized to be disposed in the internal void. The bladder defines a bore configured to receive an expansion material, such that the expansion material applies an expansion force against the bladder, which thereby applies the expansion force against the implant body so as to cause the first linkage to expand greater than the second linkage. The expandable implant can be placed in a fracture location so as to restore height to a fractured target bone.

Claims

1. A method of restoring height to a fractured target bone, the method comprising:

positioning a distal end of a cannulated body adjacent a target bone, the cannulated body being substantially straight and having a proximal end spaced from the distal end;

inserting an opening device through the cannulated body such that a distal end of the opening device extends distally beyond the distal end of the cannulated body and into the target bone, the opening device defining a cannula, the distal end of the opening device having a cutting member, wherein a distal portion of the opening device located proximate the cutting member is substantially axially straight while located within the cannulated body and is axially curved after extending beyond the distal end of the cannulated body;

engaging bone material within the target bone with the cutting member in a manner forming a curved guide path within the target bone; and

inserting an expandable implant through the cannulated body and through the cannula of the opening device and along the curved guide path within the target bone, wherein a central axis of the expandable implant is curved while the expandable implant is positioned along the curved guide path.

2. The method of claim 1, wherein:

the cannulated body is a first cannulated body, the distal end of the cannulated body is a first distal end of the first cannulated body, and the positioning step comprises positioning the first distal end of the first cannulated body adjacent the target bone at a first location of the target bone; and

the method further comprises positioning a second distal end of a second cannulated body adjacent the target bone at a second location of the target bone, the second cannulated body being substantially straight and having a second proximal end spaced from the second distal end, the second location spaced from the first location.

3. The method of claim 2, wherein:

the opening device is a first opening device; and

the method further comprises inserting a second opening device through the second cannulated body such that a distal end of the second opening device extends distally beyond the second distal end of the second cannulated body and into the target bone, the second opening device defining a cannula, the distal end of the second opening device having a second cutting member, wherein a distal portion of the second opening device located proximate the second cutting member is substantially straight while located within the second cannulated body and is curved after extending beyond the second distal end of the second cannulated body.

4. The method of claim 3, further comprising abutting the distal ends of the first and second opening devices within the target bone.

5. The method of claim 4, wherein inserting the expandable implant further comprises inserting the expandable implant through the first cannulated body and through the cannula of the first opening device and into the cannula of the second opening device.

6. The method of claim 5, further comprising:

withdrawing the first opening device proximally from the first cannulated body; and

withdrawing the second opening device proximally from the second cannulated body.

7. The method of claim 6, further comprising:

applying an expansion force to the expandable implant; and

expanding the expandable implant in a direction perpendicular to the central axis of the expandable implant responsive to the expansion force, wherein the central axis of the expandable implant is curved after the expanding step.

8. The method of claim 4, further comprising inserting a cutting device through the cannulas of the first and second opening devices and through the distal portions of the first and second opening devices.

9. The method of claim 8, further comprising:

at least partially withdrawing the first opening device from the first cannulated body;

at least partially withdrawing the second opening device from the second cannulated body; and

exposing at least a portion of the cutting device to the target bone along the curved guide path between the first and second distal ends of the respective first and second cannulated bodies.

10. The method of claim 9, further comprising:

translating the cutting device back and forth through the first and second cannulated bodies and along the curved guide path; and

cutting bone material with the cutting device during the translating step.

11. The method of claim 3, wherein:

the expandable implant is a first expandable implant; and

the method further comprises;

engaging bone material within the target bone with the second cutting member in a manner forming a second curved guide path within the target bone; and

inserting a second expandable implant through the second cannulated body and through the cannula of the second opening device and along the second curved guide path within the target bone, wherein a central axis of the second expandable implant is curved while the second expandable implant is positioned along the second curved guide path.

12. The method of claim 11, further comprising:

applying a first expansion force to the first expandable implant;

applying a second expansion force to the second expandable implant;

expanding the first expandable implant in a first direction perpendicular to the central axis of the first expandable implant responsive to the first expansion force, wherein the central axis of the first expandable implant is curved after the expanding step; and

expanding the second expandable implant in a second direction perpendicular to the central axis of the second expandable implant responsive to the second expansion force, wherein the central axis of the second expandable implant is curved after the second expanding step.

13. The method of claim 1, wherein the expandable implant including an implant body elongate along the central axis, the implant body having a plurality of linkages connected so as to define at least one annular row of linkages arranged in a plurality of columns, each of the plurality of linkages defining a first side and a second side circumferentially spaced from the first side about the central axis.

14. The method of claim 13, further comprising:

applying an expansion force to the implant body; and

expanding the implant body in a direction perpendicular to the central axis responsive to the expansion force, wherein the central axis is curved after the expanding step.

15. The method of claim 14, wherein:

the plurality of linkages includes at least a first linkage that is disposed in a first one of the columns, and at least a second linkage that is disposed in a second one of the columns; and

the expanding step further comprises;

increasing the distance between the first and second sides of each of the linkages from a first distance to a second distance that is greater than the first distance, and

causing the at least a first linkage to expand to a greater extent than the at least a second linkage in a manner causing asymmetric expansion of the body during the expanding step.

16. The method of claim 1, wherein the target bone is a vertebral body, the method further comprises making a stab incision in soft tissue of a patient at a location adjacent a pedicle of the vertebral body prior to the positioning step, the positioning step includes inserting the distal end of the cannulated body through the incision until the distal end of the cannulated body abuts the pedicle, and inserting the opening device further comprises driving the distal end of the opening device into the pedicle in a manner penetrating cortical bone of the pedicle.

17. The method of claim 16, wherein the engaging step further comprises engaging cancellous bone material within the vertebral body with the cutting member in a manner forming the curved guide path within the cancellous bone material.

18. A method of restoring height to a fractured target bone, the method comprising:

inserting an expandable implant into the target bone, the expandable implant including a body elongate along a central axis in an axial direction, the body having a plurality of linkages connected so as to define at least one annular row of linkages arranged in a plurality of columns, each annular row extending along a row direction that extends about the central axis, each of the linkages defining

     1) a first side,

     2) a second side spaced from the first side along the row direction,

     3) a first end, and

     4) a second end spaced from the first end along the axial direction, wherein an entirety of the first and second ends are curved as they extend from the first side to the second side, and the first and second sides a) extend from the first end to the second end, and b) are orientated substantially parallel to the axial direction during the inserting step, the first and second sides further defining a distance therebetween, the plurality of linkages including at least a first linkage that is disposed in a first one of the columns, and at least a second linkage that is disposed in a second one of the columns, the first one of the columns defining the same number of linkages as the second one of the columns, each of the first and second ones of the columns having a thickness of a single linkage along the row direction, the at least a first linkage sized different than the at least a second linkage;

applying an expansion force to the body, the expansion force

     1) increasing the distance between the first and second sides of each of the linkages from a first distance to a second distance that is greater than the first distance, and

     2) causing the at least a first linkage to expand to a greater extent than the at least a second linkage in a manner causing asymmetric expansion of the body into an expanded configuration where the body is bent such that the central axis is curved more than during the inserting step.

19. The method of claim 18, wherein the expandable implant is substantially cylindrical prior to the applying step.

20. The method of claim 18, wherein the first and second sides are substantially straight and parallel with one another prior to the applying step.