CN102958456B - 用于治疗椎骨骨折的系统 - Google Patents

用于治疗椎骨骨折的系统 Download PDF

Info

Publication number
CN102958456B
CN102958456B CN201180032469.8A CN201180032469A CN102958456B CN 102958456 B CN102958456 B CN 102958456B CN 201180032469 A CN201180032469 A CN 201180032469A CN 102958456 B CN102958456 B CN 102958456B
Authority
CN
China
Prior art keywords
working end
sleeve pipe
axle
handle
temperature sensing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201180032469.8A
Other languages
English (en)
Other versions
CN102958456A (zh
Inventor
亚伦·杰曼
约翰·H·沙达克
恰巴·特鲁开
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Dfine Inc
Original Assignee
Dfine Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dfine Inc filed Critical Dfine Inc
Priority to CN201510810875.2A priority Critical patent/CN106618669B/zh
Publication of CN102958456A publication Critical patent/CN102958456A/zh
Application granted granted Critical
Publication of CN102958456B publication Critical patent/CN102958456B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1642—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for producing a curved bore
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1631—Special drive shafts, e.g. flexible shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8819—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer proximal part, e.g. cannula handle, or by parts which are inserted inside each other, e.g. stylet and cannula
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1644—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00089—Thermal conductivity
    • A61B2018/00101—Thermal conductivity low, i.e. thermally insulating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00339—Spine, e.g. intervertebral disc
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00565—Bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589—Coagulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00714—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • A61B2018/143—Needle multiple needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • A61B2018/1432—Needle curved
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1435—Spiral
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1497—Electrodes covering only part of the probe circumference
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/007—Auxiliary appliance with irrigation system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007—Aspiration

Abstract

一种移动骨或其他硬组织从而在组织内形成腔的方法和装置。其中，所述方法和装置依靠驱动机构来提供所述装置的移动从而形成改善所述组织移动的剖面。该方法和装置还允许在骨中生成用于插入骨接合剂或其他填充物的路径或腔来治疗骨折或骨中的其他情况。本发明所述的方法和装置的相关特征可以被用于骨或硬组织中的任何区域，其中所述组织或骨被移位以界定孔或腔，而不是在例如钻孔或切除的过程中从体内被取出。

Description

用于治疗椎骨骨折的系统
技术领域
本发明涉及用于在椎骨中生成路径或腔以接收骨接合剂从而治疗椎骨压折的医疗装置和系统。本发明所述的方法和装置的相关特征可以用于骨或硬组织中的任何区域，其中所述组织或骨被移位以界定钻孔或腔，而不是在例如钻孔或切除的过程中从体内被取出。此外，本发明还公开了用于切除或凝固组织的方法和装置，包括但不限于在椎骨和/或皮质骨中切除肿瘤组织。
发明内容
本发明所述的方法和装置涉及在骨或其他硬组织中改进地形成腔，其中所述腔是通过所述组织的移位而形成的。在第一示例中，根据本发明的方法包括治疗椎体或其他骨结构。在一个变型中，该方法包括:提供具有被设置为用于穿入椎骨的锋利尖端的伸长工具，该工具具有从近端延伸到其工作端的轴，其中所述工作端包括至少一个共心地设置于第二套管内的第一套管和一个围绕第二套管共心地设置的第三套管，其中每一个套管包含一系列槽或凹口以限制所述工作端至单一平面内的第一曲线配置的偏移，并且其中，各个系列的槽或凹口在每一个套管内径向偏置；推进所述工作端穿入椎骨；通过在轴向方向上相对于第二套管平移第一套管，将所述工作端从直线配置移动到曲线配置；以及在骨内曲线配置中移动所述工作端以在其中产生一个腔。相对于第二套管平移第一套管可以包括:在轴向方向上移动一个套管或者两个套管。另外的变型包括:在旋转方向上移动一个或两个套管从而在各套管间产生相对轴向位移。
在另外的变型中，本装置包括可以通过机械移动硬组织和/或应用治疗能量切除或凝固组织来治疗硬组织（例如在椎体中）的医疗骨凿装置。例如，一个所述变型包括被连接到电源上的骨凿型装置，并且还包括手柄，所述手柄具有致动部和用于将所述骨凿装置电连接到所述电源上的连接器；所述变型还包括：轴，所述轴包括共心地设置在第二套管内的第一套管，所述轴具有包括工作端的远侧部，所述工作端可以在直线配置和铰接配置间移动，其中，所述铰接配置被限制在单一平面内，并且其中每一个套管包括一系列槽或凹口以限制所述工作端至所述铰接配置的偏移，其中各个系列的槽或凹口在相邻的套管内径向偏置，其中所述轴的第一导电部可电连接到所述电源的第一极；位于所述工作端的第一套管的末端处的锋利尖端，所述锋利尖端适于穿入椎体内的骨中，其中，所述末端可连接到所述电源的第二极，使得当接通时，电流在所述末端的一部分和所述轴之间流动；使第一套管和第一导电部电绝缘的非导电层；并且其中所述轴和锋利尖端具有足够的裂断强度，使得施加在柄上的冲击力引起所述轴的所述远端部和所述末端机械移动所述硬组织。所述电源可以连接到外套管（本发明讨论的第二或第三套管）。
本发明公开的方法的另一个变型可以包括将电极间的能量应用到所述装置上从而切除组织（例如肿瘤）或在组织内执行其他电外科或映像步骤。在一个用于治疗椎体的所述示例中，该方法可以包括提供具有被设置为用于穿入椎骨的锋利尖端的伸长工具，该工具具有从其近端延伸至其工作端的轴，其中所述工作端包括至少一个共心地设置在第二套管内的第一套管，其中，每一个套管包括一系列槽或凹口以限制所述工作端至单一平面内的第一曲线配置的偏移，并且其中各个系列的槽或凹口在相邻的套管内径向偏置，其中第一套管的第一导电部电连接到电源的第一极；推进所述工作端穿入椎骨；通过在轴向方向上相对于第二套管平移第一套管，将所述工作端从直线配置移动到曲线配置；以及使用在第一导电部和电连接到所述电源的第二极的回流电极之间的能量来切除或凝固椎体内的一个区域。
在所述方法的变型中，将所述工作端从直线配置移动到曲线配置可以包括：移动所述工作端，以使其移动穿过多个曲线配置。
在另外的变型中，将所述工作端从直线配置移动到曲线配置可以包括：致动一手柄机构，从而将所述工作端从直线配置移动到曲线配置。如在本发明中所述地，所述手柄机构可以轴向和/或旋转移动。
在一个变型中，致动所述手柄机构，使得所述工作端移动到第一曲线构造而不会扭曲第三套管。
在另外的变型中，所述骨凿或工具的工作端是弹簧偏置的，以呈现所述直线配置。
通过向所述伸长工具施加驱动力或冲击力，所述工作端可以从直线配置移动到曲线配置，其中，穿入皮质骨使得所述工作端从直线配置移动到曲线配置。例如，由于向所述工作端施加了捶打或冲击力，所述锋利尖端紧靠着骨的相互作用使得所述工作端呈现铰接和/或曲线配置。其中，所述工具进一步的轴向运动引起骨压缩并形成了腔。
所述方法还可以包括使用一个或更多个插管来将所述工具引入目标区域。所述插管可以使所述工具保持笔直或直线配置，直到所述工具移出所述插管或直到所述插管从所述工具上缩回。
如上所述，一旦形成所述腔，所述方法还可以包括向所述腔中插入填充材料或其他物质。所述填充材料可以经由所述工具或者经由单独的插管或导管传送。
本发明还包括用于在骨或硬组织中形成腔的装置的变型。所述变型包括用于治疗椎体或其他所述结构的装置。在一个变型中，该装置包括：具有致动部的手柄；轴，其包括共心地设置于第二套管内的第一套管和围绕第二套管共心地设置的第三套管，所述轴具有包括工作端的远端部，所述工作端可以在直线配置和铰接配置间移动，其中第二铰接配置被限制在单一平面内，并且其中每一个套管包括一系列槽或凹口以限制所述工作端至所述铰接配置的偏移，其中各个系列的槽或凹口在每一个套管内径向偏置；以及设置于所述工作端的末端处的尖端，所述尖端适于在椎体内穿入椎骨中。
在一个变型中，本发明所述的装置可以包括在所述工作端将第一套管附着在第二套管上的配置，使得第一套管的近端运动引起所述工作端呈现铰接配置。所述套管可以在其任何部分处经由机械固定装置（例如销或其他固定装置）、粘合剂或一个或多个焊接点沿着其长度而附着。在一些变型中，所述套管的固定发生在工作端，使得内套管或第一套管的运动引起所述工作端呈现曲线配置。在一些情况下，第三套管可以被附着到所述工作端外，只要第一和第二套管铰接，第三套管仍然铰接。
本发明所述的装置可以可选地包括连接在所述致动部和第一套管间的限力组件，使得一旦达到阈值力，所述致动部与第一套管分离。在一个变型中，所述限力机构适于限制当所述工作端从第一配置向着第二配置移动时施加在骨上的力。
在另外的变型中，用于在骨或硬组织中形成腔的装置可以包括一个或多个延伸通过第一套管的弹簧部件，其中所述弹簧部件被附着在所述轴上（在第一、第二或第三套管内或围绕第一、第二或第三套管）。所述弹簧部件在松开的状态下使得所述工作端呈现直线配置。
在另外的变型中，该装置可以包括外套管或第三套管，其中所述槽或凹口（其允许偏移）被设置在第三套管的外表面上。所述外表面典型地是从曲线配置的方向面向外的表面。所述配置允许内表面（位于弯曲部的内侧的表面）是光滑的。因此，如果将所述装置从组织或插管或其他插管器内收回，所述曲线内部的光滑表面最小化了所述装置被卡在插管或其他任何结构的开口处的可能性。
所述装置的变型可以包括一个或多个在所述轴和工作端间延伸的内腔。这些内腔可以在所述装置的末端处或穿过所述装置的壁上的侧开口而退出。所述内腔可以包括包含有光滑聚合材料的表面。例如，所述材料可以包括任何具有低摩擦特性的生物兼容性材料（例如聚四氟乙烯（PTFE）、FEP(氟化乙丙烯)、聚乙烯、聚酰胺，ECTFE（乙烯-三氟氯乙烯共聚物）、ETFE、PVDF、聚氯乙烯和硅树脂）。
如本发明所述地，所述装置可以包括任何数量的配置以防止相邻套管间的旋转，但是允许所述各套管间的轴向运动。例如，所述套管可以经由销/槽或键/键槽配置而机械地连接。在一个另外的变型中，所述套管可以是非圆形的以防止旋转。
在一个另外的变型中，本发明包括各种包含有本发明所述的装置和填充材料（例如骨接合剂或其他骨填充材料）的套件。
上述接入装置和步骤的变型包括各个实施方式的特征或各个实施方式本身的各种可能的组合。
本发明所述的方法、装置和系统可以与以下专利申请和临时申请相结合，其每一个申请的全文通过引用并入本发明中：2008年9月30日提交的美国专利申请61/194,766；2008年10月10日提交的美国专利申请61/104,380；2010年4月8日提交的美国专利申请61/322,281；2009年9月30日提交的美国专利申请12/571,174；2009年9月30日提交的PCT申请PCT/US2009/059113；2009年10月13日提交的美国申请12/578,455。
附图说明
图1是本发明的骨凿的平面图。
图2是图1的骨凿的侧视图。
图3是图1的骨凿的截面图。
图4是图1的骨凿的手柄的放大截面图。
图5是图1的骨凿的工作端的放大截面图。
图6A是图5的工作端在直线配置中的截面图。
图6B是图5的工作端在曲线配置中的截面图。
图7A-7C是使用图1的骨凿的方法的示意性截面图。
图8是骨凿工作端的另一个实施方式。
图9是骨凿工作端的另一个实施方式。
图10是具有外套管的骨凿的另一个变型。
图11是图10的骨凿的工作端的剖视图。
图12A是工作端的另一个实施方式沿图11中12A-12A线的截面图。
图12B和12C例示了防止相邻套管间旋转的另外的变型。
图13是与图11中工作端相似的另一个工作端的实施方式的截面图。
图14是图13的工作端的剖视透视图。
图15例示了本发明所述的骨凿的一个变型，所述骨凿在所述装置的尖端上具有电极并且在所述轴上具有另外的电极。
图16例示了如在图15中所示的骨凿装置在被推进入椎体后的状态且电流在电极间流动。
图17例示了本发明所述装置的一个变型，其还包括用于在所述装置的工作端提供能量的连接器。
图18A和18B例示了具有如本发明所述的锋利尖端的装置，其中所述锋利尖端可从轴的远端推进。
图19例示了如在图18B中所示装置的截面图并且还例示了设置在装置上的温度传感部件。
图20例示了装置的一个变型，其中内套管从所述装置延伸，并且其中在内套管的延伸部和所述轴之间施加电流以治疗组织。
图21例示了如本发明所述装置的一个变型，其还包括由所述装置的工作端携带的可延伸的螺旋电极。
图22A和22B例示了图21的装置，其具有在非延伸位置和延伸位置中的螺旋电极。
图23例示了图21的装置在椎体内的工作端，所述工作端具有将RF能量传送给组织的螺旋电极，以用于切除或其他治疗。
图24例示了可替换的铰接式切除装置，其包括工作端，所述工作端包括在铰接式工作端的外半径上的具有相反极性的电极表面。
图25例示了图24中的铰接式工作端，其向椎体内的组织释放RF能量，其中，一绝缘表面从椎管处引导能量。
图26例示了可替换的铰接式装置，其具有工作端，所述工作端包括从铰接式工作端的外半径延伸的多个可延伸电极。
图27例示了图26中的铰接式工作端，其在椎体中向组织施加RF能量，其中，多个延伸电极从椎管处引导能量。
图28例示了可替换的铰接式切除装置，其具有工作端，所述工作端包括具有相反极性的电极表面以及可连接至装置中内腔的绝缘流体媒质或胶质。
图29例示了图28中的铰接式工作端，其在椎体中向组织施加能量，其中，绝缘胶质从椎管处引导能量。
具体实施方式
参照图1-5，示出了装置或骨凿100，其被配置为进入椎体的内部，并且在椎骨的松质骨中形成路径来接收骨接合剂。在一个实施方式中，所述装置被配置为具有延伸部或构件105，以用于引导穿过椎弓根，并且其中延伸构件105的工作端110可以被逐步地致动，以弯曲成选择的角度和/或旋转，从而在椎体中线的方向上形成弯曲的路径和腔。所述装置可以被收回并且骨填充材料可以被引导穿过骨接合剂注射插管。可选地，随着之后穿过所述装置的内腔112而注射接合剂，所述装置100自身可以被用作接合剂注射器。
在一个实施方式中，所述装置100包括被连接到所述延伸构件105的近端的手柄115。所述延伸构件105包括第一（外）套管120和第二（内）套管122的组件，且第一套管120具有近端124和远端126。第二套管122具有近端134和远端136。如下面将描述地，所述延伸构件105被连接到所述手柄115，以允许医生驱动所述延伸构件105进入骨内且同时致动所述工作端110进入铰接或曲线配置（见图6）。所述手柄115可以由聚合物、金属或任何其他适合经受用于驱动所述组件进入骨中（例如，经由在所述手柄115上使用锤子或相似的装置）的捶打或冲击力的材料制造。所述内套管和外套管由适合的金属合金制造，例如不锈钢或NiTi。所述内套管和外套管的壁厚在约0.005”至0.010”的范围内且所述外套管的外直径在约2.5毫米至5.0毫米的范围内。
参照图1、3和4，所述手柄115包括第一握持部140和表示为142的第二致动部。如下面将描述地，所述握持部140被连接到第一套管120。如下面将描述地，所述致动部142被可操作地连接到第二套管122。所述致动部142可相对于所述握持部140旋转，并且所述握持部140的一个或多个塑料弯曲片145被配置为使凹口146啮合在旋转的致动部142中，从而提供触觉指示并将所述柄部140和142临时锁定在特定旋转角度中。因此所述弯曲片145与所述凹口146啮合或脱离，从而允许所述手柄部和连接在其上的各个套管的棘轮作用（旋转和锁定）。
在任一套管中的槽或凹口可包括沿着所述工作端长度的均匀宽度或变化宽度。可选地，可以在某一区域内选择所述宽度以实现特定的弯曲轮廓。在其他变型中，所述宽度可以沿工作端增加或减少从而形成具有变化半径的曲线。很明显，应理解的是，任何数量的变型都落入本发明的范围之内。
图4是手柄的截面图，其示出了用于相对于第一外套管120致动第二内套管122的机构。所述手柄115的所述致动部142被配置为表示为150的、与所述手柄的握持部140上的突出螺纹149配合的快锁螺旋槽。因此，可以理解的是，所述致动部142的旋转将移动该部到表示为150（透视图）的位置处。在一个实施方式中，当所述致动部142是以选定的、从约45°至720°或从约90°至360°的量旋转时，内套管122近似相对于所述握持部140和外套管120被提升，从而致动所述工作端110。从图4中可以看出，所述致动部142与被焊接到内套管122的近端132的凸缘152啮合。所述凸缘152通过设置于凸缘152和插入所述手柄的握持部140内的金属轴承表面155之间的球轴承组件154被提升。因此，致动部142的旋转可以提升内套管122而不会在所述内套管上引起扭曲。
现在参照图5、6A和6B，可以看出，通过都可以在很小的半径内弯曲的、外套管120与内套管122的远端部的开槽部的配合，所述延伸构件105的工作端110被铰接。外套管120内具有多个槽或凹口162，其可以相对于套管的轴垂直或成角度。内套管122具有多个表示为164的槽或凹口，其可以位于组件相对于外套管120内槽162的相对侧。外套管和内套管在被表示为焊点160的远侧区域焊接在一起。因此可以理解的是，当内套管122在近端方向上平移时，外套管将如图6B所示被弯曲。可以理解的是，通过以选择的量旋转所述致动手柄部142，所述工作端可以被铰接到选定的角度。
图4、5、6A和6B还例示了所述装置的其他部件，其包括具有近端171和凸缘172的弹性扁线构件170，其中该凸缘172与内筒122的凸缘152的近侧相啮合。至少所述扁线构件170的远端部174在焊点175处被焊接到内套管。所述扁线构件由此提供了安全特性，以在所述内套管的一个槽164失灵时保持所述工作端。
所述装置的另一个安全特性包括扭矩限制器和释放系统，该释放系统允许整个手柄组件115自由旋转——例如，如图6B所示，如果当医生旋转手柄并且当所述工作端啮合在坚固的松质骨中时所述工作端110是铰接的。参照图4，所述手柄115的握持部142与被固定到外套管120的近端124的衬圈180相啮合。所述衬圈180还包括凹口185，各凹口185由该衬圈180径向地间隔开并且与球构件186啮合，该球构件186被弹簧188推入凹口185中。以选择的力，例如在大于约0.5英寸磅但小于约7.5英寸磅、5.0英寸磅或2.5英寸磅的范围内的扭矩，所述手柄115的旋转克服了预定的限制。当扭矩限制器组件处于其锁定位置时，所述球轴承186受迫进入衬圈180中的一个凹口185内。当过多的扭矩被施加到手柄和外套管上时，所述球轴承186与凹口185脱离，这使得衬圈180转动，然后球轴承186在下一个凹口处再次啮合，释放在从0.5英寸磅至7.5英寸磅的范围内的扭矩。
参照图6A和6B，可以理解的是，内套管122在其远端部的一侧上被弱化，使得内套管122在任意方向上弯曲，但受限于凹口在外套管120中的位置。任一铰接配置的曲率是由凹口的间距和各个凹口的顶部的间距控制的。所述内套管122也具有用于穿入椎体的皮质骨中的带斜面的尖端。内套管或者外套管中任意一个都可以形成所述末端。
参照图7A-7C，在所述装置的使用的一个变型中，医生轻敲或以其他方式驱动探针200和插管器套管205进入椎体206，典型地直到探针尖端208进入向着皮质骨210的椎体前部的1/3处（图7A）。此后，所述探针200被移除并且套管205向近端移动（图7B）。从图7B中可以看出，所述工具或骨凿100是穿过插管器套管205插入的，并且在一系列如上所述的步骤中是铰接的。当施加驱动力、并且可选地施加旋转力到手柄115上以推进所述工作端穿过松质骨212来形成路径或腔215时，所述工作端110可以是间歇性地铰接的。然后轻敲所述工具来进一步驱动所述工作端110使其到达、朝向或越过椎骨的中线。可选地，医生可以铰接所述工作端110，并且进一步驱动和旋转所述工作端，直到图像显示出工作端100已经形成具有最佳配置的腔215。此后，如图7C所示，随着延伸构件已从椎体206中被收回，医生颠倒顺序并且逐步地伸直所述工作端110。然后，医生可以将骨接合剂注射器220插入到由骨凿100形成的路径或腔215中。图7C例示了正由骨接合剂源225注射诸如PMMA接合剂的骨接合剂222。
在另外的实施方式中（未示出），所述装置100可以具有手柄115，该手柄具有用于连接骨接合剂注射器的鲁尔接头配件，并且所述骨接合剂可以经由所述装置的内腔112注射。在图9的实施方式中，所述内腔可以具有光滑的表面层或聚合物衬里250，从而当骨接合剂流经腔时确保对骨接合剂的最小阻力。在一个实施方式中，所述表面或衬里250可以是氟化聚合物，例如或聚四氟乙烯（PTFE）。可以使用其他合适的氟聚合物树脂，例如FEP和PFA。也可以使用其他材料，例如FEP(氟化乙丙烯)、ECTFE（乙烯-三氟氯-乙烯共聚物）、ETFE、聚乙烯、聚酰胺、PVDF、聚氯乙烯和硅树脂。本发明的范围可以包括提供具有小于0.5、小于0.2或小于0.1的静态摩擦系数的聚合材料。
图9还示出了可被配置为具有表示为255的外部柔性套管的延伸构件或轴105。所述柔性套管可以是公知的生物兼容性材料，例如，所述套管可以包括前一段所述的任何材料。
从图9中还可以看出，在所述装置100的一个变型中，所述工作端110可以被配置为：在表示为260的长度上，基本上以光滑的曲线弯曲。所述工作端100的铰接度可以是至少45°、90°、135°或如265所示的为至少180°（图9）。在另外的变型中，外套管120和内套管120的槽可以改变，从而生产具有在所述装置100的长度260内变化的曲率半径的装置。
在本发明的其他实施方式中，内套管可相对于外套管被弹簧加载，以这样的方式，允许在直线方向上以选定程度的力拉伸工作端时使所述工作端伸直。这个特征允许医生从椎体部分地或整体地收回所述组件而无需进一步旋转手柄115的致动部142。在一些变型中，可以使用限力器，从而允许将小于约10英寸磅的力施加到骨上。
在图8所示的其他实施方式中，所述工作端110配置有尖端240，在被驱动进入骨中时，该尖端240偏转到表示为240’的位置处。所述尖端240通过弹性构件242被连接到套管组件，弹性构件242为例如诸如不锈钢或NiTi的弹性金属。已经发现，所述尖端240的弯曲引起其远端表面区域与松质骨啮合，从而协助工作端110在被锤入骨中时偏转。
在本发明的另一个实施方式中（未示出），致动手柄可以包括用于致动工作端的次级（或可选）机构。该机构可以包括具有棘轮的可捶打构件，使得锤的每一次轻敲都可以推进组件并且逐步地驱使工作端进入曲线配置。本领域中已知的棘轮机构可以将所述组件保持在多个铰接配置中的每一个配置中。为了伸直所述延伸构件105从而将其从所述椎体中撤出，可以释放所述棘轮。
图10和11例示了骨治疗装置400的另一个变型，其具有手柄402和延伸到工作端410的延伸构件405，与图1至6B中的具有相似构造。如上所述地，使用第一（外）凹口套管120和相配合的第二（内）凹口套管122来操作所述装置400。但是，在图10和11中所示的变型还包括位于第一套管120和第二套管122外的、同轴的第三凹口套管420。如在图11中以265所表示的，在工作端410处的套管420中的槽或凹口允许套管偏转。
图10还示出了治疗装置400，其包括鲁尔接头配件412，该鲁尔接头配件允许装置402被连接到填充材料源（例如骨填充物或骨接合剂材料）。所述鲁尔接头可以从手柄402移动，从而允许如上所述地向手柄上施加冲击力。此外，所述鲁尔接头配件402可以设置在手柄的致动部上、手柄的固定部上或甚至沿着套管设置。在任何情况下，所述装置400的变型允许将填充材料与延伸通过套管（或在相邻的套管间延伸）的内腔连接，从而在工作端410沉积填充材料。如箭头416所示，填充材料可以经由套管的远端沉积（其中，锋利尖端是坚固的）或经由套管侧壁的开口沉积。很明显地，所述配置的变型落入本领域技术人员公知的范围内。
在一些变型中，第三凹口套管420配置有平滑（无凹口）表面424，该表面面向内部地设置在铰接式工作端（图11）上，使得固体表面形成工作端410的弯曲部的内部。所述平滑表面424允许收回伸入到插管或插管器205内部的装置110而不会造成使槽或凹口被卡在插管205内的风险（参见例如图7B）。
如图10-11所示，第三（最外侧）套管420可以从延伸构件405的中间位置延伸到工作端410的远端。但是，所述装置的变型包括延伸到手柄402处的第三套管420。但是第三套管420典型地不连接到手柄402，使得由手柄402产生的任何旋转力或扭矩都不会直接被传送给第三套管420。
在一个变型中，第三套管420只在一个轴向位置上被连接到第二套管120。在图11例示的示例中，第三套管420在工作端410的远端处通过焊点428附着到第二套管420。但是所述焊点或其他附着工具（例如，销、键/键槽、突起等）可以设置在套管420的中间部分上。所述套管420可以由任何生物兼容性材料制造。例如，在一个变型中，第三套管是由直径为3.00毫米且壁厚为0.007”的不锈钢材料制成。第一、第二和第三套管的尺寸允许各套管间的滑动配合。
图12A是延伸构件405的与图10-11中例示的相似的另一个变型的截面图。但是，由图12A例示的变型包括同轴的可滑动套管（两个或三个套管装置）的非圆形配置。所述配置限制了或防止了各套管间的旋转，并且允许医生向骨施加更大的力以形成腔。虽然图12A例示了椭圆形配置，但任何非圆形的形状都落入本发明的范围之内。例如，如图12B和12C所示，横截面的形状可以包括正方形、多边形或其他径向键配置。如图12C所示，所述套管可包括键407和接收键槽409，以防止套管的旋转，但是允许各套管的相对或轴向滑动。所述键可以包括在接收键槽内滑动的任何突起或构件。另外，在各个套管的外部或内部，所述键可以包括销或任何凸出的突起。在这个示例中，只例示了第一套管122和第二套管120。但是，任何套管都可配置有键/键槽。防止套管间的旋转提升了向铰接式工作端处的骨施加力的能力。
图13-14例示了骨凿装置工作端410的另一个变型。在这个变型中，所述工作端410包括一个或多个平板弹簧部件450、460a、460b、460c、460d，以阻止所述组件的各套管间的相对旋转，从而允许从铰接式工作端向松质骨施加更大的旋转力。所述弹簧部件还迫使工作端组件进入直线配置。为了铰接套管，如上所述地向手柄施加旋转力，一旦旋转力撤除，所述弹簧部件迫使工作端进入直线配置。如图13所示，一个或多个所述弹簧部件可以延伸通过所述套管，从而附着到手柄上以防止旋转。此外，平板弹簧部件450的远端454通过焊点455固定到套管组件上。因此，弹簧部件在每一端部上被固定，从而防止其旋转。可选的变型包括一个或多个在套管的中部处附着到内套管组件上的弹簧部件。
如图13-14所示，骨凿的变型可以包括任何数量的弹簧部件460a-460d。所述另外的弹簧部件460a-460d可以在其近端或远端中的任一端处被焊接到相邻的部件或套管上，从而允许所述部件充当片簧。
在另外的变型中，如图15所示，骨凿装置可以包括一个或多个电极310、312。在所述具体示例中，所述装置300包括间隔开的具有相反的极性的电极，从而以双极方式运行。但是，所述装置可以包括单极配置。此外，一个或多个电极可以被连接到电源的单独通路上，使得电极可以根据需要被通电。上述装置的任何变型都可以配置有一个或多个本发明的中所述的电极。
图16例示了如上所述地被推入到体内之后的骨凿装置300。如线315所例示的，电流在电极间流动，当需要时，医生可以在电极310和312之间实施RF电流，从而在椎体（或其他硬组织）的骨结构内施加凝固或切除能量。虽然图16例示了RF电流315在电极310和312之间流动，所述装置的变型可以包括沿着所述装置的多个电极，从而提供合适的治疗能量。此外，电极可以与骨凿的一端间隔开，而不是如电极310所示地设置在锋利尖端上。在一些变型中，电源被连接到锋利尖端的内部或第一套管的其他工作端。在只具有两个套管的变型中，电源的第二极被连接到第二套管（即所述装置的外部），以形成回流电极。但是，在具有三个套管的变型中，可选地，电源可以被连接到第三外套管。在另外的变型中，第二和第三套管都可以充当回流电极。但是，在那些单极的装置中，所述回流电极将被放置在体外大面积的皮肤上。
图17至20例示了铰接式探针或骨凿装置500的另一个变型。在所述变型中，所述装置500包括工作端505，该工作端携带有一个或多个可以被用于引导电流从其穿过的RF电极。因此，所述装置可以被用于感应组织的阻抗、定位神经或简单地向组织施加电外科能量来凝固或切除组织。在一种可能的应用中，所述装置500可以向肿瘤或脊骨中的其他组织提供切除能量以及形成腔。
图17、18A、18B和19例示了装置500的变型，其具有连接到轴组件510的手柄部506，所述轴组件510沿着轴512延伸到铰接式工作端505。所述铰接式工作端505可以是如上所述地可致动的。另外，图17示出了手柄部件514a可以相对于手柄部件514b旋转，从而引起在第一外套管520和第二内套管522（图19）之间的相对轴向运动，从而引起套管组件的开槽的工作端如上所述地铰接。图19的工作端505示出了两个套管520和522，其是可致动的，从而铰接所述工作端，但是应理解的是，如上所述，可以增加第三外铰接套管。在一个变型中，通过在1/4转和3/4转之间旋转手柄部件514a，可以以90°铰接所述铰接式工作端。所述旋转中的手柄部件514a可包括在不同旋转位置中的棘爪，从而将工作端受控地锤入骨中。例如，所述棘爪可以设置在每旋转45°的位置处或者可设置在其他任何旋转增量处。
图17例示了RF生成器530A和RF控制器530B，其可通过表示为536的插塞式连接器连接到手柄部件514a中的电连接器532。所述RF生成器是电外科切除领域中的已知类型。外套管520包括表示为540A(+)的第一极性电极。但是，本装置可以采用任何能量形态。
图18A和18B还例示了用于在硬组织中形成腔的装置的工作端的另一个变型。如例示地，装置500可以包括中心可延伸套管550，其具有可从第一和第二套管520和522（图19）的组件的通道554轴向延伸的锋利尖端552。所述套管550还可以包括表示为540B（-）的第二极性电极。很明显地，第一和第二电极彼此间将是电绝缘的。在一个变型中，并且如图19所示，所述套管组件可以携带有薄套管555或例如PEEK的绝缘聚合物涂层，以使得第一极性电极540A(+)与第二极性电极540B(-)电绝缘。可通过旋转所述手柄部件514a（图17）的承击面上的按钮558而展开所述电极。中心套管550的延伸度数可以可选地由手柄上的滑片557表示。在例示的变型中，所述滑片设置在手柄部件514a（图17）的任意一侧上。套管550可以被配置为向远侧延伸，越过套管组件520和522约5至15毫米的距离。
参照图19，所述中心可延伸套管550可以在至少一个其远端部处具有一系列槽，以允许其与第一和第二套管520和522的组件相配合而弯曲。在图18B所示的实施方式中，所述中心套管550可以可选择地包括远端部，该远端部不包含任何槽。但是，另外的变型在套管的远端部处包括槽。
图19还例示了电绝缘衬圈560，其延伸长度A，从而轴向地分隔第一极性电极540A(+)和第二极性电极540B(-)。所述轴向长度A可以是约0.5至10毫米，并且通常是1至5毫米。所述衬圈可以是陶瓷或耐温聚合物。
图19还例示了在电极套管550的中心的内腔内延伸的聚合物套管565。所述聚合物套管565可以向工作端提供盐水滴注或其他流体和/或可被用于在使用中从工作端吸气。所述套管550的远端部中可以包括一个或多个端口566，以用于从所述位置传送流体或吸气。
在所有其他方面中，骨凿系统500可以被驱动进入骨中并且如上所述地被铰接。如本领域公知地，电极540A和540B被可操作地连接到射频生成器，从而向组织提供凝固或切除用的电外科能量。从图20中可以看出，如线575所示地，RF电流575例示在电极540A和540B间的路径中，表示为线575。与本发明所述装置一起使用的RF生成器530A和控制器530B可以包括任何数量的电源设置，从而控制定向凝固或定向切除区域的大小。例如，所述RF生成器和控制器可以具有低（5瓦特）、中（15瓦特）和高（25瓦特）功率设置。所述控制器530B可以具有控制算法，其监视电极的温度并且改变电源输入，从而保持恒定的温度。至少一个温度传感部件（例如热电偶）可以被设置在所述装置的不同部件上。例如，如图19所示，温度传感部件577可以被设置在套管550的尖端的末端处，而第二温度传感部件578可以设置在末端的近端处，从而在使用RF能量的过程中向操作者提供温度反馈来表示被切除的组织的区域。在一个示例中，第二温度传感部件被设置在距离所述末端约15至20毫米的位置。
图21例示了具有RF切除特征的铰接式骨凿600的另一个变型。所例示的骨凿600的变型可以类似于图17-18B的骨凿。在这个变型中，骨凿600可以如上所述地具有被连接到轴组件610的手柄602。所述工作端610仍然具有在图21中表示为615的可延伸组件，其可以通过相对于柄602旋转手柄部622而延伸。所述骨凿可以如上所述地通过相对于手柄602旋转手柄部620而被铰接。
图22A-22B是图21的工作端610在第一非延伸配置（图22A）和第二延伸配置（图22B）中的视图。从图22A-22B中可以看出，延伸部615包括轴向轴624和可轴向收缩或伸展的螺旋弹簧部件625。在一个实施方式中，所述轴可以是管构件，其具有流动地连接到内腔628中的端口626。在一些变型中，所述端口可将流体携带到工作端或可从工作端抽吸流体。
在图22A-22B中，可以看出，轴向轴624、螺旋弹簧部件625和锋利尖端630一起包括如上所述的第一极性电极（+），其连接到电源530A和控制器530B。绝缘体632将所述螺旋弹簧电极625与更多包括相反极性电极640（-）的套管的近端部间隔开。RF电极可以如上所述（参见图20）地用来切除组织或向组织传送能量。
在一个变型中，延伸部615可以从2毫米、3毫米、4毫米或5毫米的弹簧压缩长度延伸到6毫米、7毫米、8毫米、9毫米10毫米或更长的弹簧拉伸长度。在图22B的工作端实施方式615中，所述弹簧可以包括扁平矩形线，其协助将弹簧625围绕轴624共心设置，但通过使矩形线的扁平表面定向为堆叠状，仍可以将整个长度压缩至很短。但是，其他变型也落入本发明所述变型的范围之内。
使用弹簧625作为电极显著地改善了能量传送。所述弹簧（i）显著增加了电极表面积且（ii）非常显著地增加了由提供了边缘的矩形线所提供的相对尖锐的边缘的长度。因为所述边缘提供了小的表面积，RF电流的密度或强度在边缘处更大，并且允许RF电流跃变或形成电弧。本发明的这两个方面——增加的电极表面积和增加的电极边缘长度——都允许更快地切除组织。
在本发明的一个方面中，在上述弹簧电极的长度上，弹簧电极625的表面积可以是至少40平方毫米，至少50平方毫米，或至少60平方毫米。
在本发明的另一方面中，在上述弹簧电极的长度上，矩形钢丝弹簧的4个边缘的总长度可以大于50毫米、大于100毫米或大于150毫米。
在用于测试的一个示例中，骨凿600（如图21-22B所示）配置有压缩长度为1.8毫米且拉伸长度为7.5毫米的螺旋弹簧。在所述实施方式中，当拉伸时，弹簧电极625的表面积是64.24平方毫米并且电极边缘的总长度是171.52毫米（4个边缘，每个长42.88毫米）。
如图22B所示，在对比测试中，将不具有螺旋电极的第一骨凿与具有螺旋电极的第二骨凿600进行对比。所述装置在不同的功率水平和不同的能量传送间隔下被评估，以确定切除量。除了螺旋弹簧电极外，这些装置的工作端具有相似的尺寸。在下表A中，RF能量是在5瓦特的低功率设置下被传送的。从表A中可以看出，在120秒的治疗间隔和5W的功率下，具有螺旋电极的工作端的切除量是不具有螺旋电极的工作端的切除量的3倍快（1.29cc比.44cc）。
表A（5W）
表B（15W）
在高于15瓦特的功率水平下评估相同的第一骨凿500（图18B）和具有螺旋电极（图22B）的第二骨凿600的另一个对比测试。从表B可以看出，在25秒的治疗间隔和15W功率的RF能量下，具有螺旋电极的工作端的切除量又是不具有螺旋电极的工作端的切除量的3倍快（1.00cc比0.37cc）。在表B中，不具有螺旋电极的装置在60秒结束前受阻，所以无法提供数据。测试显示，螺旋电极非常适合切除任何类型的组织或肿瘤，在60秒的时间内可以切除1.63cc的组织。
图23示意性地例示了在椎体中使用骨凿600，其中，电极625和640之间的RF电流切除了表示为640的组织。
图24例示了铰接式骨凿700的另一个变型，该铰接式骨凿700具有提供RF能量的能力。所述装置的一些变型可被制备为与图17-18B中的骨凿类似。在一个变型中，轴组件705类似于先前示例，其中，工作端710携带有可延伸部件725，该可延伸部件725携带有在图24中表示为727的电极表面。可延伸部件725可通过设置在轴组件705中的内腔中的柔性套管722的延伸而致动。例如，所述柔性套管722和可延伸部件725可通过旋转如上所述的手柄机构而延伸。如前所述地，可通过相对于第二手柄部分旋转第一手柄部分来铰接所述骨凿。
仍参考图24，可延伸电极727可被连接至电源530A的第一极，且轴725可包括具有相反极性的电极表面740，该电极表面740连接至电源530A第二极。一绝缘体衬圈分隔第一和第二极性电极表面727和740。在一些变型中，所述衬圈携带有绝缘涂层或由绝缘材料制备。如图24中所见，可延伸部件725的面向后部的表面携带有电绝缘体744，该电绝缘体744包括但不限于油漆、涂层、磁带、聚合物、陶瓷等。进一步地，铰接轴705的内部半径携带有电绝缘体745，该电绝缘体745也可为油漆、涂层、磁带、聚合体部件、陶瓷等。
图25例示了图24中的铰接式工作端，其在椎体中向组织释放RF能量，其中绝缘表面744和745在装置的相对侧上引导对组织的加热，使得能量从椎管748导出。在一些变型中，所述能量是在表示为750的切除区域处产生的。然而，不论是切除还是不切除，本发明所描述的装置包括任何种类的能量传递。
图26例示了具有RF切除功能的铰接式骨凿800的另一实施方式。在一实施方式中，轴组件805类似于先前具有工作端810的实施例，该工作端810携带有多个可延伸电极825，该多个可延伸电极825可通过手柄中的致动机构而延伸。如前所述地，通过相对于第二手柄部分旋转第一手柄部分来铰接所述骨凿。可延伸电极825与轴电极840如前所述地相配合，并通过绝缘套管832与轴电极840分离。图26中的实施方式进一步在轴的内部半径上携带有轴向延伸的绝缘体845。
总的来说，图26的骨凿800包括：手柄，其具有用于将装置电连接至电源的连接器；轴805，其具有从手柄延伸至工作端810的轴线，其中，所述轴的第一导电部可电连接至RF电源的第一极；多个可延伸电极部件825，其可从所述轴延伸，其中，所述可延伸部件825可连接至电源的第二极，使得在接通时，电流在可延伸部件和轴之间流动，以及其中，所述可延伸部件相对于轴805的轴线径向不对称。
图27例示了图26中的铰接式工作端，其在椎体中向组织施加能量，其中，多个延伸电极825在与椎管748间隔开的区域850中传递能量。
图28例示了具有RF切除功能的可替换的铰接式切除装置900。在一实施方式中，轴或延伸部件905包括两个组件。一个组件910可为前述实施方式中的铰接式组件或可为NiTi套管，其延伸至工作端910并携带有可延伸电极925，可通过手柄中的致动机构来延伸所述可延伸电极925。所述延伸部件的第二组件930包括柔性聚合物套管或者NiTi套管，其内具有内腔，所述内腔用于将流体媒质携带至工作端910中的出口932。电极925和940如前所述地起作用。
图28的实施方式包括电绝缘和/或热绝缘的胶质流体965的源960，可在组织部位中注射胶质流体965，从而保护选定的组织不被切除。总的来说，本发明的骨凿包括：手柄，其具有用于将骨凿装置电连接至电源的连接器；轴，其从手柄延伸至工作端，其中，所述轴的第一和第二导电部分可连接至电源的第一和第二极，并且所述轴中的内腔可连接至绝缘的可流动媒质源。
图29例示了图28中的铰接式工作端，其在椎体中施加RF能量以切除组织，其中，注射绝缘胶质以保护椎管748，进而生成远离椎管的切除区域950。
尽管以上详细描述了本发明的具体实施方式，但应理解的是，本说明书仅出于例示的目的且本发明的上述说明并不详尽。仅出于方便，本发明的具体特征在一些图中示出而没有在其他图中示出，并且任何特征都可以和根据本发明的其他特征相结合。对于本领域的技术人员来说明显的是，可以做出多种变型和改变，所述改变和变型旨在落入本发明权利要求的范围之内。独立权利要求例示的具体特征可以被组合并且也落入本发明的范围之内。本发明还包括参照其他独立权利要求而可选地以多项从属权利要求形式撰写的从属权利要求的实施方式。

Claims (13)

1.一种用于治疗硬组织的医疗装置，该装置包括：
手柄，其具有用于电连接到电源的连接器；
轴，其从所述手柄延伸至工作端，其中，所述轴的第一导电部可电连接到所述电源的第一极；以及
可延伸部件，其可从所述轴延伸；
其中，所述可延伸部件可连接到所述电源的第二极，使得当接通时，电流在所述可延伸部件和所述轴之间流动；其中，所述轴的所述工作端被配置为在单独的平面内铰接从而形成铰接配置；
致动机构可操作地连接至所述手柄，所述致动机构被配置为使所述工作端变形为并保持在所述铰接配置，其中所述工作端被配置为在施加驱动力时保持在铰接配置使得工作端的铰接配置创建空腔；以及
其中，所述工作端的轴向延伸表面部分包括电绝缘体，从而控制电流流动，并在所述装置相对所述电绝缘体的一侧上引导对组织的加热。
2.根据权利要求1所述的医疗装置，其中，可延伸部件包括轴向延伸表面部分，所述轴向延伸表面部分包括所述电绝缘体。
3.根据权利要求1-2中任一项所述的医疗装置，其中，所述电绝缘体设置在所述铰接形状的内部半径上。
4.根据权利要求1-2中任一项所述的医疗装置，其中，所述手柄被配置为接收冲击力从而使所述工作端穿入骨中。
5.根据权利要求1-2中任一项所述的医疗装置，该装置还包括内腔，其位于所述轴内且可连接至绝缘可流动媒质的源。
6.根据权利要求5所述的医疗装置，其中，所述绝缘可流动媒质包括电绝缘体或热绝缘体或胶质。
7.根据权利要求1所述的医疗装置，该装置还包括至少一个温度传感部件。
8.根据权利要求7所述的医疗装置，其中，所述至少一个温度传感部件包括第一温度传感部件和与所述第一温度传感部件的近端间隔开的第二温度传感部件；其中，
所述第一温度传感部件设置在所述可延伸部件的末端处；或
所述第二温度传感部件设置在所述轴处。
9.根据权利要求7所述的医疗装置，其中，所述至少一个温度传感部件包括第一温度传感部件和与所述第一温度传感部件的近端间隔开的第二温度传感部件；其中，在应用由所述电源提供的能量的过程中，所述第一和第二温度传感部件提供反馈来指示被切除的组织的区域。
10.一种用于治疗椎体的医疗骨凿装置，该装置包括：
手柄，其具有用于将所述骨凿装置电连接到电源的连接器；
轴，其具有从所述手柄延伸至工作端的轴线，其中，所述轴的第一导电部可电连接到所述电源的第一极；
致动机构可操作地连接至所述手柄，所述致动机构被配置为使所述工作端变形为并保持在铰接配置，其中所述工作端被配置为在施加驱动力时保持在铰接配置使得工作端的铰接配置创建空腔；以及多个可延伸部件，其可从所述轴延伸；
其中，所述可延伸部件可连接到所述电源的第二极，使得当接通时，电流在所述可延伸部件和所述轴之间流动；以及
其中，所述可延伸部件相对于所述轴的轴线径向不对称。
11.根据权利要求10所述的医疗装置，其中，所述可延伸部件从所述铰接形状的外部半径延伸。
12.根据权利要求10-11中任一项所述的医疗装置，其中，所述可延伸部件的数量在从2至10的范围内。
13.根据权利要求10-11中任一项所述的医疗装置，其中，所述可延伸部件从所述轴延伸少于10mm。
CN201180032469.8A 2010-04-29 2011-04-29 用于治疗椎骨骨折的系统 Active CN102958456B (zh)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201510810875.2A CN106618669B (zh) 2010-04-29 2011-04-29 用于治疗椎骨骨折的系统

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US32939410P 2010-04-29 2010-04-29
US61/329,394 2010-04-29
PCT/US2011/034628 WO2011137377A1 (en) 2010-04-29 2011-04-29 System for use in treatment of vertebral fractures

Related Child Applications (1)

Application Number Title Priority Date Filing Date
CN201510810875.2A Division CN106618669B (zh) 2010-04-29 2011-04-29 用于治疗椎骨骨折的系统

Publications (2)

Publication Number Publication Date
CN102958456A CN102958456A (zh) 2013-03-06
CN102958456B true CN102958456B (zh) 2015-12-16

Family

ID=44861936

Family Applications (2)

Application Number Title Priority Date Filing Date
CN201180032469.8A Active CN102958456B (zh) 2010-04-29 2011-04-29 用于治疗椎骨骨折的系统
CN201510810875.2A Active CN106618669B (zh) 2010-04-29 2011-04-29 用于治疗椎骨骨折的系统

Family Applications After (1)

Application Number Title Priority Date Filing Date
CN201510810875.2A Active CN106618669B (zh) 2010-04-29 2011-04-29 用于治疗椎骨骨折的系统

Country Status (5)

Country Link
US (3) US9125671B2 (zh)
EP (1) EP2563233B1 (zh)
CN (2) CN102958456B (zh)
BR (1) BR112012027708B1 (zh)
WO (1) WO2011137377A1 (zh)

Families Citing this family (58)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8361067B2 (en) 2002-09-30 2013-01-29 Relievant Medsystems, Inc. Methods of therapeutically heating a vertebral body to treat back pain
US7258690B2 (en) 2003-03-28 2007-08-21 Relievant Medsystems, Inc. Windowed thermal ablation probe
US6907884B2 (en) 2002-09-30 2005-06-21 Depay Acromed, Inc. Method of straddling an intraosseous nerve
US10028753B2 (en) 2008-09-26 2018-07-24 Relievant Medsystems, Inc. Spine treatment kits
AU2009296474B2 (en) 2008-09-26 2015-07-02 Relievant Medsystems, Inc. Systems and methods for navigating an instrument through bone
WO2010039894A1 (en) * 2008-09-30 2010-04-08 Dfine, Inc. System for use in treatment of vertebral fractures
US8758349B2 (en) 2008-10-13 2014-06-24 Dfine, Inc. Systems for treating a vertebral body
US20100298832A1 (en) 2009-05-20 2010-11-25 Osseon Therapeutics, Inc. Steerable curvable vertebroplasty drill
US10058336B2 (en) 2010-04-08 2018-08-28 Dfine, Inc. System for use in treatment of vertebral fractures
WO2011137357A1 (en) 2010-04-29 2011-11-03 Dfine, Inc. System for use in treatment of vertebral fractures
US9526507B2 (en) 2010-04-29 2016-12-27 Dfine, Inc. System for use in treatment of vertebral fractures
WO2011137377A1 (en) * 2010-04-29 2011-11-03 Dfine, Inc. System for use in treatment of vertebral fractures
CA2818876C (en) 2010-11-22 2018-10-02 Dfine, Inc. System for use in treatment of vertebral fractures
ES2610079T3 (es) 2011-01-31 2017-04-25 St. Jude Medical, Inc. Herramienta para el ajuste de un dispositivo anatómico protésico
US10028834B2 (en) 2011-01-31 2018-07-24 St. Jude Medical, Inc. Adjustable prosthetic anatomical device holder and handle for the implantation of an annuloplasty ring
ES2689564T3 (es) * 2011-01-31 2018-11-14 St. Jude Medical, Llc Herramienta de ajuste para un dispositivo protésico
ES2864589T3 (es) 2011-04-12 2021-10-14 Thermedical Inc Dispositivos para la terapia de conformación en la ablación mejorada con fluido
WO2013101772A1 (en) 2011-12-30 2013-07-04 Relievant Medsystems, Inc. Systems and methods for treating back pain
US8591507B2 (en) 2012-03-27 2013-11-26 Dfine, Inc. Methods and systems for use in controlling tissue ablation volume by temperature monitoring
ES2601657T3 (es) 2012-06-20 2017-02-15 Stryker Corporation Sistemas para manipulación de tejido descentrado
US10022176B2 (en) 2012-08-15 2018-07-17 Thermedical, Inc. Low profile fluid enhanced ablation therapy devices and methods
US10588691B2 (en) 2012-09-12 2020-03-17 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
EP2914186B1 (en) 2012-11-05 2019-03-13 Relievant Medsystems, Inc. Systems for creating curved paths through bone and modulating nerves within the bone
US9918766B2 (en) 2012-12-12 2018-03-20 Dfine, Inc. Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement
US9717551B2 (en) * 2013-02-21 2017-08-01 Carefusion 2200, Inc. Intravertebral tissue ablation device and method
US9033972B2 (en) 2013-03-15 2015-05-19 Thermedical, Inc. Methods and devices for fluid enhanced microwave ablation therapy
US9610396B2 (en) 2013-03-15 2017-04-04 Thermedical, Inc. Systems and methods for visualizing fluid enhanced ablation therapy
US20140276791A1 (en) * 2013-03-15 2014-09-18 Medtronic Ardian Luxembourg S.A.R.L. Treatment Device With Electrode Contact Surface Configured for Enhancing Uniformity of Electrical Energy Distribution and Associated Devices and Methods
US10548663B2 (en) 2013-05-18 2020-02-04 Medtronic Ardian Luxembourg S.A.R.L. Neuromodulation catheters with shafts for enhanced flexibility and control and associated devices, systems, and methods
US9724151B2 (en) 2013-08-08 2017-08-08 Relievant Medsystems, Inc. Modulating nerves within bone using bone fasteners
CA2927436C (en) 2013-10-15 2022-04-26 Stryker Corporation Device for creating a void space in living tissue, the device including a handle with a control knob that can be set regardless of the orientation of the handle
EP3122233B1 (en) * 2014-03-28 2018-10-24 Spiration, Inc. D.B.A. Olympus Respiratory America System for predictable deployment of a medical device
EP3193759B1 (en) * 2014-09-05 2023-08-02 Apyx Medical Corporation Electrosurgical snare device
US9901392B2 (en) 2015-05-11 2018-02-27 Dfine, Inc. System for use in treatment of vertebral fractures
US11039879B2 (en) 2015-10-20 2021-06-22 Gyrus Acmi, Inc. Ablation device
JP6419099B2 (ja) * 2016-01-20 2018-11-07 日本ライフライン株式会社 焼灼用針装置、高周波焼灼治療システムおよび化学焼灼治療システム
EP3419714A4 (en) * 2016-02-26 2019-09-25 Neuronano AB METHOD FOR PROVIDING AN IMPLANTATION SITE IN A SOFT TISSUE
US9743984B1 (en) 2016-08-11 2017-08-29 Thermedical, Inc. Devices and methods for delivering fluid to tissue during ablation therapy
IL247684A0 (en) * 2016-09-07 2017-01-31 Waismed Ltd Tube for use in intraosseous injections
WO2018058126A1 (en) * 2016-09-26 2018-03-29 Klsmc Instruments, Llc Arthroscopic drill blade and arthroscopic drill access system made therefrom
US11207081B2 (en) 2016-10-21 2021-12-28 University Of Louisville Research Foundation, Inc. Systems and methods for intramedullary preparations
JP2019534130A (ja) 2016-10-27 2019-11-28 ディーファイン，インコーポレイティド セメント送達チャネルを有する関節接合型骨刀
WO2018097992A2 (en) 2016-11-22 2018-05-31 Dfine, Inc. Swivel hub
US11116570B2 (en) 2016-11-28 2021-09-14 Dfine, Inc. Tumor ablation devices and related methods
WO2018107036A1 (en) 2016-12-09 2018-06-14 Dfine, Inc. Medical devices for treating hard tissues and related methods
WO2018129180A1 (en) 2017-01-06 2018-07-12 Dfine, Inc. Osteotome with a distal portion for simultaneous advancement and articulation
WO2019178180A1 (en) * 2018-03-13 2019-09-19 Meditrina, Inc. Endoscope and method of use
US11083871B2 (en) 2018-05-03 2021-08-10 Thermedical, Inc. Selectively deployable catheter ablation devices
US11918277B2 (en) 2018-07-16 2024-03-05 Thermedical, Inc. Inferred maximum temperature monitoring for irrigated ablation therapy
CN109199524B (zh) * 2018-10-17 2020-04-24 郑州大学第一附属医院 胸腔镜下肋骨切割器
EP3876856A4 (en) 2018-11-08 2022-10-12 Dfine, Inc. TUMORABLATION DEVICE AND RELATED SYSTEMS AND METHODS
WO2020219392A2 (en) * 2019-04-24 2020-10-29 Stryker Corporation Systems and methods for off-axis augmentation of a vertebral body
CA3150339A1 (en) 2019-09-12 2021-03-18 Brian W. Donovan TISSUE MODULATION SYSTEMS AND METHODS
EP3892215B1 (en) * 2020-04-09 2023-10-11 Biedermann Technologies GmbH & Co. KG Surgical instrument
US11259695B2 (en) 2020-07-21 2022-03-01 Meditrina, Inc. Endoscope and method of use
WO2022066743A2 (en) * 2020-09-22 2022-03-31 Stryker Corporation Systems and methods for augmentation of a vertebral body
WO2023076667A1 (en) * 2021-10-29 2023-05-04 Vanderbilt University Agonist-antagonist tube steerable instrument with serpentine beam elements
CN114469319B (zh) * 2021-12-22 2024-04-05 大连医科大学 药物冲洗型纳米截肢锯

Family Cites Families (517)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2688329A (en) 1953-03-19 1954-09-07 American Cystoscope Makers Inc Catheter
US3140623A (en) 1961-08-29 1964-07-14 Pendleton Tool Ind Inc Predetermined torque release wrench
US3228400A (en) 1962-12-03 1966-01-11 Thomas A Armao Cryogenic capsule probes
US3503385A (en) 1965-09-27 1970-03-31 Cordis Corp Guidable catheter assembly and manipulator therefor
US3625200A (en) 1969-08-26 1971-12-07 Us Catheter & Instr Corp Controlled curvable tip member
DE1953835B2 (de) 1969-10-25 1972-02-24 Linde Ag, 6200 Wiesbaden Kryochirurgisches geraet
US3664344A (en) 1970-09-15 1972-05-23 Brymill Corp Tyned cryosurgical probe
US3908637A (en) 1974-04-22 1975-09-30 Louis W Doroshow Rigid urethral instrument
DE2501683C3 (de) 1975-01-17 1979-11-29 Ernst Leitz Wetzlar Gmbh, 6300 Wetzlar Polymeres Verbundmaterial für prothetische Zwecke und Verfahren zu seiner Herstellung
US4033331A (en) 1975-07-17 1977-07-05 Guss Stephen B Cardiac catheter and method of using same
US4900303A (en) 1978-03-10 1990-02-13 Lemelson Jerome H Dispensing catheter and method
EP0006414B1 (de) 1978-06-29 1984-10-10 Osteo Ag Mit Kohlenstoffasern verstärkter Knochenzement
US4276880A (en) 1978-09-14 1981-07-07 Oscar Malmin Cannula and process
US4294251A (en) 1978-10-17 1981-10-13 Greenwald A Seth Method of suction lavage
US4236520A (en) 1978-12-04 1980-12-02 Anderson Mark L Fluid drain or injection tube for an animal's udder
DE2944710A1 (de) 1979-11-06 1981-05-07 Christos Dr. Dimakos Vorrichtung zum entfernen einer knochenzementroehre bei einer reimplantation eines kuenstlichen oberschenkelhalskopfes
DE2949368A1 (de) 1979-12-07 1981-06-11 Hilti AG, 9494 Schaan Geraet zum abgeben von ein- oder mehrkomponentenmassen
US4411266A (en) 1980-09-24 1983-10-25 Cosman Eric R Thermocouple radio frequency lesion electrode
US5017627A (en) 1980-10-09 1991-05-21 National Research Development Corporation Composite material for use in orthopaedics
US4337773A (en) 1980-10-20 1982-07-06 Raftopoulos Demetrios D Method of and device for placing a barrier in a cavity provided in a bone shaft
US4578061A (en) 1980-10-28 1986-03-25 Lemelson Jerome H Injection catheter and method
US4719968A (en) 1981-01-15 1988-01-19 Speros Phillip C Heat exchanger
US4399814A (en) 1981-04-27 1983-08-23 Massachusetts Institute Of Technology Method and apparatus for pressure-coated bones
US4473077A (en) 1982-05-28 1984-09-25 United States Surgical Corporation Surgical stapler apparatus with flexible shaft
US4595006A (en) 1982-08-16 1986-06-17 Burke Dennis W Apparatus for cemented implantation of prostheses
US4456017A (en) 1982-11-22 1984-06-26 Cordis Corporation Coil spring guide with deflectable tip
DE3325111A1 (de) 1983-07-12 1985-01-24 Merck Patent Gmbh, 6100 Darmstadt Implantationsmaterialien
US4722948A (en) 1984-03-16 1988-02-02 Dynatech Corporation Bone replacement and repair putty material from unsaturated polyester resin and vinyl pyrrolidone
CA1227902A (en) 1984-04-02 1987-10-13 Raymond G. Tronzo Fenestrated hip screw and method of augmented internal fixation
US4619263A (en) 1984-05-30 1986-10-28 Advanced Cardiovascular Systems, Inc. Adjustable rotation limiter device for steerable dilatation catheters
US4586923A (en) 1984-06-25 1986-05-06 Cordis Corporation Curving tip catheter
US5114414A (en) 1984-09-18 1992-05-19 Medtronic, Inc. Low profile steerable catheter
US4888366A (en) 1984-10-24 1989-12-19 Collagen Corporation Inductive collagen-based bone repair preparations
US5246457A (en) 1985-03-28 1993-09-21 Collagen Corporation Xenogeneic collagen/mineral preparations in bone repair
US4668295A (en) 1985-04-25 1987-05-26 University Of Dayton Surgical cements
US4625722A (en) 1985-05-03 1986-12-02 Murray William M Bone cement system and method
US4742817A (en) 1985-05-15 1988-05-10 Olympus Optical Co., Ltd. Endoscopic apparatus having a bendable insertion section
CH667209A5 (de) 1985-07-02 1988-09-30 Sulzer Ag Medizinische depotsonde.
US4641654A (en) 1985-07-30 1987-02-10 Advanced Cardiovascular Systems, Inc. Steerable balloon dilatation catheter assembly having dye injection and pressure measurement capabilities
US4846814A (en) 1986-01-16 1989-07-11 Sherwood Medical Company Non-whip catheter
US4795602A (en) 1986-03-19 1989-01-03 Pretchel David A Two pin shunt and molding method
DE3613213A1 (de) 1986-04-18 1987-10-22 Merck Patent Gmbh Tricalciumphosphat fuer implantationsmaterialien
US4747840A (en) 1986-09-17 1988-05-31 Ladika Joseph E Selective pulmonary arteriograph catheter
US5085861A (en) 1987-03-12 1992-02-04 The Beth Israel Hospital Association Bioerodable implant composition comprising crosslinked biodegradable polyesters
US4843112A (en) 1987-03-12 1989-06-27 The Beth Israel Hospital Association Bioerodable implant composition
US4748969A (en) 1987-05-07 1988-06-07 Circon Corporation Multi-lumen core deflecting endoscope
US4898156A (en) 1987-05-18 1990-02-06 Mitek Surgical Products, Inc. Suture anchor
US4784638A (en) 1987-09-17 1988-11-15 Neurodynamics, Inc. Angled hole ventricular catheter and method of making same
US4865586A (en) 1987-09-21 1989-09-12 Martha Hedberg Suction stylet for endotracheal intubation
CN88203061U (zh) * 1988-02-05 1988-11-23 黄传诗 脏器穿刺针
IT1234978B (it) 1988-06-01 1992-06-09 Tecres Spa Miscela cementifera a due fasi, particolarmente adatta per usi ortopedici.
US4961731A (en) 1988-06-09 1990-10-09 Sherwood Medical Company Angiographic catheter with balanced dye injection openings
US7431722B1 (en) 1995-02-27 2008-10-07 Warsaw Orthopedic, Inc. Apparatus including a guard member having a passage with a non-circular cross section for providing protected access to the spine
US5088991A (en) 1988-07-14 1992-02-18 Novoste Corporation Fuseless soft tip angiographic catheter
US4998923A (en) 1988-08-11 1991-03-12 Advanced Cardiovascular Systems, Inc. Steerable dilatation catheter
US5156606A (en) 1988-10-11 1992-10-20 Zimmer, Inc. Method and apparatus for removing pre-placed prosthetic joints and preparing for their replacement
US5264214A (en) 1988-11-21 1993-11-23 Collagen Corporation Composition for bone repair
US5296026A (en) 1988-12-02 1994-03-22 Monroe Eugene A Phosphate glass cement
US4982730A (en) 1988-12-21 1991-01-08 Lewis Jr Royce C Ultrasonic wound cleaning method and apparatus
US4963151A (en) 1988-12-28 1990-10-16 Trustees Of The University Of Pennsylvania Reinforced bone cement, method of production thereof and reinforcing fiber bundles therefor
US5372587A (en) 1989-01-09 1994-12-13 Pilot Cariovascular Systems, Inc. Steerable medical device
US5480382A (en) 1989-01-09 1996-01-02 Pilot Cardiovascular Systems, Inc. Steerable medical device
US4969888A (en) 1989-02-09 1990-11-13 Arie Scholten Surgical protocol for fixation of osteoporotic bone using inflatable device
US4969870A (en) 1989-06-07 1990-11-13 The Regents Of The University Of California Method and apparatus for intraosseous infusions
US5049137A (en) 1989-09-08 1991-09-17 Thompson Jeffrey E Prepackaged syringe and catheter apparatus for deep administration of a fluid, and method of making same
US4961730A (en) 1989-09-29 1990-10-09 Poncy George W Hypodermic syringe with sliding cap
US5196201A (en) 1989-10-20 1993-03-23 Bioapatite Ab Implant material composition, preparation thereof as well as uses thereof and implant product obtainable therefrom
US5295980A (en) 1989-10-30 1994-03-22 Ersek Robert A Multi-use cannula system
US5059193A (en) 1989-11-20 1991-10-22 Spine-Tech, Inc. Expandable spinal implant and surgical method
US5116305A (en) 1990-02-01 1992-05-26 Abiomed, Inc. Curved intra aortic balloon with non-folding inflated balloon membrane
US5152744A (en) 1990-02-07 1992-10-06 Smith & Nephew Dyonics Surgical instrument
US5197971A (en) 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
US5454365A (en) 1990-11-05 1995-10-03 Bonutti; Peter M. Mechanically expandable arthroscopic retractors
US5092891A (en) 1990-03-08 1992-03-03 Kummer Frederick J Cement plug for the medullary canal of a bone and coacting tool for installing same
NL9000833A (nl) 1990-04-09 1991-11-01 Cordis Europ Angiografie-catheter.
US5266248A (en) 1990-05-10 1993-11-30 Torao Ohtsuka Method of producing hydroxylapatite base porous beads filler for an organism
US5103804A (en) 1990-07-03 1992-04-14 Boston Scientific Corporation Expandable tip hemostatic probes and the like
US6080801A (en) 1990-09-13 2000-06-27 Klaus Draenert Multi-component material and process for its preparation
ZA917281B (en) 1990-09-26 1992-08-26 Cryomedical Sciences Inc Cryosurgical instrument and system and method of cryosurgery
DE4033343A1 (de) 1990-10-19 1992-04-23 Draenert Klaus Werkstoff als ausgangsmaterial zur herstellung von knochenzement und verfahren zu seiner herstellung
US5147334A (en) 1991-01-02 1992-09-15 Moss James P Catheter for cholangiography
US5231989A (en) 1991-02-15 1993-08-03 Raychem Corporation Steerable cannula
AU660444B2 (en) 1991-02-15 1995-06-29 Ingemar H. Lundquist Torquable catheter and method
US5161715A (en) 1991-03-25 1992-11-10 Giannuzzi Anthony C Double-barreled epoxy injection gun
US5368598A (en) 1991-04-19 1994-11-29 Hasson; Harrith M. Method of manipulating an uterus using a bendable manipulator
US5188619A (en) 1991-04-24 1993-02-23 Gene E. Myers Enterprises, Inc. Internal thoractic artery catheter
US5112303A (en) 1991-05-02 1992-05-12 Pudenz-Schulte Medical Research Corporation Tumor access device and method for delivering medication into a body cavity
US5356629A (en) 1991-07-12 1994-10-18 United States Surgical Corporation Composition for effecting bone repair
US5211631A (en) 1991-07-24 1993-05-18 Sheaff Charles M Patient warming apparatus
US5308342A (en) 1991-08-07 1994-05-03 Target Therapeutics, Inc. Variable stiffness catheter
US5285795A (en) 1991-09-12 1994-02-15 Surgical Dynamics, Inc. Percutaneous discectomy system having a bendable discectomy probe and a steerable cannula
US5697909A (en) 1992-01-07 1997-12-16 Arthrocare Corporation Methods and apparatus for surgical cutting
US5697281A (en) 1991-10-09 1997-12-16 Arthrocare Corporation System and method for electrosurgical cutting and ablation
US5662680A (en) 1991-10-18 1997-09-02 Desai; Ashvin H. Endoscopic surgical instrument
US5891095A (en) 1993-05-10 1999-04-06 Arthrocare Corporation Electrosurgical treatment of tissue in electrically conductive fluid
US5681282A (en) 1992-01-07 1997-10-28 Arthrocare Corporation Methods and apparatus for ablation of luminal tissues
US5284128A (en) 1992-01-24 1994-02-08 Applied Medical Resources Corporation Surgical manipulator
US5336699A (en) 1992-02-20 1994-08-09 Orthopaedic Research Institute Bone cement having chemically joined reinforcing fillers
ATE269371T1 (de) 1992-02-28 2004-07-15 Cohesion Tech Inc Injektierbare, keramische verbindungen sowie verfahren zu deren herstellung und anwendung
US5269750A (en) 1992-06-22 1993-12-14 Stryker Corporation Tip unit for fluid transfer surgical handpiece
US5342299A (en) 1992-07-06 1994-08-30 Catheter Imaging Systems Steerable catheter
US5334626A (en) 1992-07-28 1994-08-02 Zimmer, Inc. Bone cement composition and method of manufacture
US5343877A (en) 1992-09-09 1994-09-06 University Of Iowa Research Foundation Orthopedic implant and method
US5380307A (en) 1992-09-30 1995-01-10 Target Therapeutics, Inc. Catheter with atraumatic drug delivery tip
US5549542A (en) 1992-11-17 1996-08-27 Life Medical Technologies, Inc. Deflectable endoscope
FR2697995B1 (fr) 1992-11-19 1994-12-30 Celsa Lg Dispositif amovible de filtration sanguine, à rigidité variable, implantable dans le corps d'un patient et autorisant l'injection d'un produit traitant.
US5389073A (en) 1992-12-01 1995-02-14 Cardiac Pathways Corporation Steerable catheter with adjustable bend location
US5282821A (en) 1993-01-26 1994-02-01 Donahue John R Adjustable surgical instrument
US5620447A (en) 1993-01-29 1997-04-15 Smith & Nephew Dyonics Inc. Surgical instrument
US5833692A (en) 1993-01-29 1998-11-10 Smith & Nephew, Inc. Surgical instrument
DE69433774T2 (de) 1993-02-19 2005-04-14 Boston Scientific Corp., Natick Chirurgischer extraktor
US5378234A (en) 1993-03-15 1995-01-03 Pilot Cardiovascular Systems, Inc. Coil polymer composite
US5531715A (en) 1993-05-12 1996-07-02 Target Therapeutics, Inc. Lubricious catheters
US5628771A (en) 1993-05-12 1997-05-13 Olympus Optical Co., Ltd. Electromagnetic-wave thermatological device
JPH0751379A (ja) 1993-06-24 1995-02-28 Cardiovascular Dynamics Inc 注入カテーテル及び脈管内部位処置方法並びにカテーテル製造方法
US5860974A (en) 1993-07-01 1999-01-19 Boston Scientific Corporation Heart ablation catheter with expandable electrode and method of coupling energy to an electrode on a catheter shaft
US5571088A (en) 1993-07-01 1996-11-05 Boston Scientific Corporation Ablation catheters
US5431639A (en) 1993-08-12 1995-07-11 Boston Scientific Corporation Treating wounds caused by medical procedures
US5616121A (en) 1993-08-17 1997-04-01 Mckay; Douglas W. Method for alleviating pain in a wound
US5431168A (en) 1993-08-23 1995-07-11 Cordis-Webster, Inc. Steerable open-lumen catheter
US5449351A (en) 1993-09-09 1995-09-12 Zohmann; Walter A. Atraumatic needle for lumbar puncture
US5385563A (en) 1993-09-14 1995-01-31 The Kendall Company Urodynamic catheter
US5360416A (en) 1993-09-30 1994-11-01 Sherwood Medical Company Thin-walled anesthesia needles
WO1995010225A1 (en) 1993-10-15 1995-04-20 Ep Technologies, Inc. Multiple electrode element for mapping and ablating
US6001093A (en) 1993-10-15 1999-12-14 Ep Technologies, Inc. Systems and methods for creating long, thin lesions in body tissue
US5599345A (en) 1993-11-08 1997-02-04 Zomed International, Inc. RF treatment apparatus
US5458597A (en) 1993-11-08 1995-10-17 Zomed International Device for treating cancer and non-malignant tumors and methods
US5449301A (en) 1993-11-17 1995-09-12 Berg Technology, Inc. Shunt connector
US5514137A (en) 1993-12-06 1996-05-07 Coutts; Richard D. Fixation of orthopedic devices
US7044954B2 (en) 1994-01-26 2006-05-16 Kyphon Inc. Method for treating a vertebral body
US6241734B1 (en) 1998-08-14 2001-06-05 Kyphon, Inc. Systems and methods for placing materials into bone
US20030032963A1 (en) 2001-10-24 2003-02-13 Kyphon Inc. Devices and methods using an expandable body with internal restraint for compressing cancellous bone
US6248110B1 (en) 1994-01-26 2001-06-19 Kyphon, Inc. Systems and methods for treating fractured or diseased bone using expandable bodies
US7166121B2 (en) 1994-01-26 2007-01-23 Kyphon Inc. Systems and methods using expandable bodies to push apart cortical bone surfaces
ES2287635T3 (es) 1994-01-26 2007-12-16 Kyphon Inc. Dispositivo inflamable mejorado para uso en metodos quirurgicos relacinados a la fijacion de hueso.
US20060100635A1 (en) 1994-01-26 2006-05-11 Kyphon, Inc. Inflatable device for use in surgical protocol relating to fixation of bone
US6716216B1 (en) 1998-08-14 2004-04-06 Kyphon Inc. Systems and methods for treating vertebral bodies
US5571189A (en) 1994-05-20 1996-11-05 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
US5514130A (en) 1994-10-11 1996-05-07 Dorsal Med International RF apparatus for controlled depth ablation of soft tissue
US5858003A (en) 1994-10-20 1999-01-12 Children's Medical Center Corporation Systems and methods for promoting tissue growth
US5554114A (en) 1994-10-20 1996-09-10 Micro Therapeutics, Inc. Infusion device with preformed shape
US5779688A (en) 1994-10-28 1998-07-14 Intella Interventional Systems, Inc. Low profile balloon-on-a-wire catheter with shapeable and/or deflectable tip and method
US5489275A (en) 1994-11-14 1996-02-06 Ep Technologies, Inc. Identification ring for catheter
AU4242996A (en) 1994-11-23 1996-06-17 Navarre Biomedical, Ltd. Flexible catheter
US5535922A (en) 1994-11-29 1996-07-16 Tah Industries, Inc. Caulking gun dispensing module for multi-component cartridge
CA2209633C (en) 1995-01-04 2008-04-22 Advanced Cardiovascular Systems, Inc. Catheter shaft with an oblong transverse cross section
GB0102529D0 (en) 2001-01-31 2001-03-21 Thales Optronics Staines Ltd Improvements relating to thermal imaging cameras
US6291547B1 (en) 1995-02-08 2001-09-18 Materials Evolution And Development Usa Inc. Bone cement compositions comprising fused fibrous compounds
US6409722B1 (en) 1998-07-07 2002-06-25 Medtronic, Inc. Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue
US5947964A (en) 1995-03-03 1999-09-07 Neothermia Corporation Methods and apparatus for therapeutic cauterization of predetermined volumes of biological tissue
US6106524A (en) 1995-03-03 2000-08-22 Neothermia Corporation Methods and apparatus for therapeutic cauterization of predetermined volumes of biological tissue
US6312428B1 (en) 1995-03-03 2001-11-06 Neothermia Corporation Methods and apparatus for therapeutic cauterization of predetermined volumes of biological tissue
US5571085A (en) 1995-03-24 1996-11-05 Electro-Catheter Corporation Steerable open lumen catheter
US6602248B1 (en) * 1995-06-07 2003-08-05 Arthro Care Corp. Methods for repairing damaged intervertebral discs
US5741320A (en) 1995-05-02 1998-04-21 Heart Rhythm Technologies, Inc. Catheter control system having a pulley
US6575969B1 (en) 1995-05-04 2003-06-10 Sherwood Services Ag Cool-tip radiofrequency thermosurgery electrode system for tumor ablation
US6280413B1 (en) 1995-06-07 2001-08-28 Medtronic Ave, Inc. Thrombolytic filtration and drug delivery catheter with a self-expanding portion
US7179255B2 (en) * 1995-06-07 2007-02-20 Arthrocare Corporation Methods for targeted electrosurgery on contained herniated discs
GB9600377D0 (en) * 1996-01-09 1996-03-13 Gyrus Medical Ltd Electrosurgical instrument
US5725568A (en) 1995-06-27 1998-03-10 Scimed Life Systems, Inc. Method and device for recanalizing and grafting arteries
EP0840572B1 (en) 1995-07-18 2004-10-27 Garland U. Edwards Flexible shaft
US5681289A (en) 1995-08-14 1997-10-28 Medicinelodge Inc. Chemical dispensing system
US5810804A (en) 1995-08-15 1998-09-22 Rita Medical Systems Multiple antenna ablation apparatus and method with cooling element
US5637091A (en) 1995-08-31 1997-06-10 Hakky; Said I. Collapsible catheter
US5620467A (en) 1995-10-10 1997-04-15 Incontrol, Inc. Implantable atrial defibrillator having cardioverting output voltage limiting for simulating larger storage capacitors
IL151563A0 (en) 1995-10-13 2003-04-10 Transvascular Inc A longitudinal compression apparatus for compressing tissue
US5776193A (en) 1995-10-16 1998-07-07 Orquest, Inc. Bone grafting matrix
US6073051A (en) 1996-08-13 2000-06-06 Oratec Interventions, Inc. Apparatus for treating intervertebal discs with electromagnetic energy
US6283960B1 (en) 1995-10-24 2001-09-04 Oratec Interventions, Inc. Apparatus for delivery of energy to a surgical site
US5624396A (en) 1995-10-30 1997-04-29 Micro Therapeutics, Inc. Longitudinally extendable infusion device
US5709697A (en) 1995-11-22 1998-01-20 United States Surgical Corporation Apparatus and method for removing tissue
US7270661B2 (en) 1995-11-22 2007-09-18 Arthocare Corporation Electrosurgical apparatus and methods for treatment and removal of tissue
US5833632A (en) 1995-12-07 1998-11-10 Sarcos, Inc. Hollow guide wire apparatus catheters
US20030069522A1 (en) * 1995-12-07 2003-04-10 Jacobsen Stephen J. Slotted medical device
US5860952A (en) 1996-01-11 1999-01-19 C. R. Bard, Inc. Corporeal access tube assembly and method
US5885258A (en) 1996-02-23 1999-03-23 Memory Medical Systems, Inc. Medical instrument with slotted memory metal tube
US6228052B1 (en) 1996-02-29 2001-05-08 Medtronic Inc. Dilator for introducer system having injection port
US5695513A (en) 1996-03-01 1997-12-09 Metagen, Llc Flexible cutting tool and methods for its use
US5735829A (en) 1996-03-22 1998-04-07 Cherian; George Intercostal anesthetic infusion catheter
US6110155A (en) 1996-04-30 2000-08-29 Medtronic, Inc. Anti-inflammatory-agent-loaded catheter and method for preventing tissue fibrosis
EP0837716A1 (en) 1996-05-06 1998-04-29 Thermal Therapeutics, Inc. Transcervical intrauterine applicator for intrauterine hyperthermia
US5700157A (en) 1996-06-05 1997-12-23 D-Link Corporation Electric jack with display means
US5681317A (en) 1996-06-12 1997-10-28 Johnson & Johnson Professional, Inc. Cement delivery system and method
US6312454B1 (en) 1996-06-13 2001-11-06 Nitinol Devices & Components Stent assembly
US6136885A (en) 1996-06-14 2000-10-24 3M Innovative Proprerties Company Glass ionomer cement
GB2314274A (en) 1996-06-20 1997-12-24 Gyrus Medical Ltd Electrode construction for an electrosurgical instrument
US6066176A (en) 1996-07-11 2000-05-23 Oshida; Yoshiki Orthopedic implant system
US5820592A (en) 1996-07-16 1998-10-13 Hammerslag; Gary R. Angiographic and/or guide catheter
US6726684B1 (en) * 1996-07-16 2004-04-27 Arthrocare Corporation Methods for electrosurgical spine surgery
US7104986B2 (en) 1996-07-16 2006-09-12 Arthrocare Corporation Intervertebral disc replacement method
DE69727816T2 (de) 1996-07-18 2004-08-05 Implant Innovations, Inc., Palm Beach Gardens Motorisch angetriebene osteotomiewerkzeuge zum verdichten von knochengewebe
GB9616267D0 (en) 1996-08-02 1996-09-11 Ranier Ltd Balloon catheter
US6126682A (en) 1996-08-13 2000-10-03 Oratec Interventions, Inc. Method for treating annular fissures in intervertebral discs
US6280473B1 (en) 1996-08-19 2001-08-28 Macropore, Inc. Resorbable, macro-porous, non-collapsing and flexible membrane barrier for skeletal repair and regeneration
US5905000A (en) 1996-09-03 1999-05-18 Nanomaterials Research Corporation Nanostructured ion conducting solid electrolytes
US5855577A (en) 1996-09-17 1999-01-05 Eclipse Surgical Technologies, Inc. Bow shaped catheter
US6953594B2 (en) 1996-10-10 2005-10-11 Etex Corporation Method of preparing a poorly crystalline calcium phosphate and methods of its use
US5891027A (en) 1996-10-21 1999-04-06 Irvine Biomedical, Inc. Cardiovascular catheter system with an inflatable soft tip
US7052493B2 (en) 1996-10-22 2006-05-30 Epicor Medical, Inc. Methods and devices for ablation
EP1459692A1 (en) 1996-10-23 2004-09-22 Oratec Interventions, Inc. Method and apparatus for treating intervertebral discs
US5800408A (en) 1996-11-08 1998-09-01 Micro Therapeutics, Inc. Infusion device for distributing infusate along an elongated infusion segment
US5902839A (en) 1996-12-02 1999-05-11 Northwestern University Bone cement and method of preparation
US5914356A (en) 1996-12-06 1999-06-22 Orthovita, Inc. Bioactive load bearing bone bonding compositions
US6332880B1 (en) 1996-12-19 2001-12-25 Ep Technologies, Inc. Loop structures for supporting multiple electrode elements
US6146355A (en) 1996-12-30 2000-11-14 Myelotec, Inc. Steerable catheter
US6030360A (en) 1996-12-30 2000-02-29 Biggs; Robert C. Steerable catheter
US6013591A (en) 1997-01-16 2000-01-11 Massachusetts Institute Of Technology Nanocrystalline apatites and composites, prostheses incorporating them, and method for their production
US5931829A (en) 1997-01-21 1999-08-03 Vasca, Inc. Methods and systems for establishing vascular access
JP3527378B2 (ja) 1997-01-31 2004-05-17 テルモ株式会社 造影用カテーテル
EP1006908A2 (en) 1997-02-12 2000-06-14 Oratec Interventions, Inc. Concave probe for arthroscopic surgery
IL128261A0 (en) 1999-01-27 1999-11-30 Disc O Tech Medical Tech Ltd Expandable element
ES2302349T3 (es) 1997-03-07 2008-07-01 Disc-O-Tech Medical Technologies, Ltd. Sistemas para la estabilizacion, fijacion y reparacion osea y vertebral percutaneas.
US6063078A (en) 1997-03-12 2000-05-16 Medtronic, Inc. Method and apparatus for tissue ablation
US5847046A (en) 1997-03-12 1998-12-08 United States Surgical Corporation Biodegradable bone cement
US5876373A (en) 1997-04-04 1999-03-02 Eclipse Surgical Technologies, Inc. Steerable catheter
US6524296B1 (en) 1997-04-17 2003-02-25 Medtronic, Inc. Vessel cannula having properties varying along the axial length
US6165166A (en) 1997-04-25 2000-12-26 Schneider (Usa) Inc. Trilayer, extruded medical tubing and medical devices incorporating such tubing
US5810867A (en) 1997-04-28 1998-09-22 Medtronic, Inc. Dilatation catheter with varied stiffness
US5849028A (en) 1997-05-16 1998-12-15 Irvine Biomedical, Inc. Catheter and method for radiofrequency ablation of cardiac tissue
US6428894B1 (en) 1997-06-04 2002-08-06 International Business Machines Corporation Tunable and removable plasma deposited antireflective coatings
US5972015A (en) 1997-08-15 1999-10-26 Kyphon Inc. Expandable, asymetric structures for deployment in interior body regions
US5851212A (en) 1997-06-11 1998-12-22 Endius Incorporated Surgical instrument
US20020077595A1 (en) 1998-06-15 2002-06-20 Ronald R Hundertmark Endovascular coronary sinus catheter and method of use
US6048346A (en) 1997-08-13 2000-04-11 Kyphon Inc. Systems and methods for injecting flowable materials into bones
US5924976A (en) 1997-08-21 1999-07-20 Stelzer; Paul Minimally invasive surgery device
US5921956A (en) 1997-09-24 1999-07-13 Smith & Nephew, Inc. Surgical instrument
WO1999017672A1 (en) 1997-10-06 1999-04-15 Somnus Medical Technologies, Inc. Electro-surgical instrument with a graphical user interface
US6309420B1 (en) 1997-10-14 2001-10-30 Parallax Medical, Inc. Enhanced visibility materials for implantation in hard tissue
CA2310088C (en) 1997-11-14 2008-12-16 Carl E. Yee Multi-sheath delivery catheter
US6280441B1 (en) 1997-12-15 2001-08-28 Sherwood Services Ag Apparatus and method for RF lesioning
US5997581A (en) 1997-12-29 1999-12-07 Johnson & Johnson Professional, Inc. Hip stem cement spacer
US6251092B1 (en) 1997-12-30 2001-06-26 Medtronic, Inc. Deflectable guiding catheter
US5928239A (en) 1998-03-16 1999-07-27 University Of Washington Percutaneous surgical cavitation device and method
JP2002506672A (ja) * 1998-03-19 2002-03-05 オーレイテック インターヴェンションズ インコーポレイテッド 手術部位にエネルギーを給送するためのカテーテル
AU3203599A (en) 1998-04-01 1999-10-18 Parallax Medical, Inc. Pressure applicator for hard tissue implant placement
US7572263B2 (en) 1998-04-01 2009-08-11 Arthrocare Corporation High pressure applicator
US6440138B1 (en) 1998-04-06 2002-08-27 Kyphon Inc. Structures and methods for creating cavities in interior body regions
JP3360810B2 (ja) 1998-04-14 2003-01-07 ペンタックス株式会社 骨補填材の製造方法
US6106539A (en) 1998-04-15 2000-08-22 Neosurg Technologies Trocar with removable, replaceable tip
US6064902A (en) 1998-04-16 2000-05-16 C.R. Bard, Inc. Pulmonary vein ablation catheter
US6019765A (en) 1998-05-06 2000-02-01 Johnson & Johnson Professional, Inc. Morsellized bone allograft applicator device
US6059739A (en) 1998-05-29 2000-05-09 Medtronic, Inc. Method and apparatus for deflecting a catheter or lead
DE69942858D1 (de) 1998-06-01 2010-11-25 Kyphon S A R L Entfaltbare, vorgeformte strukturen zur auffaltung in regionen innerhalb des körpers
US6719773B1 (en) 1998-06-01 2004-04-13 Kyphon Inc. Expandable structures for deployment in interior body regions
US6706039B2 (en) 1998-07-07 2004-03-16 Medtronic, Inc. Method and apparatus for creating a bi-polar virtual electrode used for the ablation of tissue
US6123702A (en) 1998-09-10 2000-09-26 Scimed Life Systems, Inc. Systems and methods for controlling power in an electrosurgical probe
GB9820369D0 (en) 1998-09-19 1998-11-11 Giltech Ltd Material
US6544215B1 (en) 1998-10-02 2003-04-08 Scimed Life Systems, Inc. Steerable device for introducing diagnostic and therapeutic apparatus into the body
US6592559B1 (en) 1998-12-09 2003-07-15 Cook Incorporated Hollow, curved, superlastic medical needle
CA2360938C (en) 1999-02-02 2008-01-08 Warren Oliver Haggard Controlled release composite
WO2000045870A1 (en) 1999-02-04 2000-08-10 Sdgi Holdings, Inc. Osteogenic paste compositions and uses thereof
US6203507B1 (en) 1999-03-03 2001-03-20 Cordis Webster, Inc. Deflectable catheter with ergonomic handle
US6395007B1 (en) 1999-03-16 2002-05-28 American Osteomedix, Inc. Apparatus and method for fixation of osteoporotic bone
US6770079B2 (en) 1999-03-16 2004-08-03 American Osteomedix, Inc. Apparatus and method for fixation of osteoporotic bone
US6183435B1 (en) 1999-03-22 2001-02-06 Cordis Webster, Inc. Multi-directional steerable catheters and control handles
AU6168699A (en) 1999-03-24 2000-10-09 Parallax Medical, Inc. Non-compliant system for delivery of implant material
US6506217B1 (en) 1999-03-29 2003-01-14 Arnett Facial Reconstruction Courses, Inc. Moldable post-implantation bone filler and method
US6689823B1 (en) 1999-03-31 2004-02-10 The Brigham And Women's Hospital, Inc. Nanocomposite surgical materials and method of producing them
US20040044350A1 (en) 1999-04-09 2004-03-04 Evalve, Inc. Steerable access sheath and methods of use
US6270476B1 (en) 1999-04-23 2001-08-07 Cryocath Technologies, Inc. Catheter
US6352533B1 (en) 1999-05-03 2002-03-05 Alan G. Ellman Electrosurgical handpiece for treating tissue
US6582446B1 (en) 1999-05-06 2003-06-24 J. Alexander Marchosky Method and apparatus for percutaneous osteoplasty
US6478793B1 (en) 1999-06-11 2002-11-12 Sherwood Services Ag Ablation treatment of bone metastases
US6890329B2 (en) 1999-06-15 2005-05-10 Cryocath Technologies Inc. Defined deflection structure
US6479565B1 (en) 1999-08-16 2002-11-12 Harold R. Stanley Bioactive ceramic cement
US6783515B1 (en) 1999-09-30 2004-08-31 Arthrocare Corporation High pressure delivery system
JP4454078B2 (ja) 1999-10-08 2010-04-21 株式会社町田製作所 内視鏡の湾曲管およびその製造方法
US6575919B1 (en) 1999-10-19 2003-06-10 Kyphon Inc. Hand-held instruments that access interior body regions
US7081122B1 (en) 1999-10-19 2006-07-25 Kyphon Inc. Hand-held instruments that access interior body regions
US7641657B2 (en) 2003-06-10 2010-01-05 Trans1, Inc. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US6241710B1 (en) 1999-12-20 2001-06-05 Tricardia Llc Hypodermic needle with weeping tip and method of use
US6599961B1 (en) 2000-02-01 2003-07-29 University Of Kentucky Research Foundation Polymethylmethacrylate augmented with carbon nanotubes
US6383188B2 (en) 2000-02-15 2002-05-07 The Spineology Group Llc Expandable reamer
US6740090B1 (en) 2000-02-16 2004-05-25 Trans1 Inc. Methods and apparatus for forming shaped axial bores through spinal vertebrae
US6740093B2 (en) 2000-02-28 2004-05-25 Stephen Hochschuler Method and apparatus for treating a vertebral body
US6332894B1 (en) 2000-03-07 2001-12-25 Zimmer, Inc. Polymer filled spinal fusion cage
US6447514B1 (en) 2000-03-07 2002-09-10 Zimmer Polymer filled hip fracture fixation device
US6358251B1 (en) 2000-03-21 2002-03-19 University Of Washington Method and apparatus for forming a cavity in soft tissue or bone
AU5113401A (en) 2000-03-31 2001-10-15 Rita Medical Systems Inc Tissue biopsy and treatment apparatus and method
CA2403925C (en) 2000-04-05 2008-09-16 Stx Medical, Inc. Intralumenal material removal systems and methods
US6565588B1 (en) 2000-04-05 2003-05-20 Pathway Medical Technologies, Inc. Intralumenal material removal using an expandable cutting device
ATE318559T1 (de) 2000-04-05 2006-03-15 Kyphon Inc Vorrichtungen zur behandlung von gebrochenen und/oder erkrankten knochen
US6638268B2 (en) 2000-04-07 2003-10-28 Imran K. Niazi Catheter to cannulate the coronary sinus
US7815649B2 (en) 2000-04-07 2010-10-19 Kyphon SÀRL Insertion devices and method of use
EP1272113B1 (en) 2000-04-07 2012-03-21 Kyphon SÀRL Insertion devices
US6869445B1 (en) 2000-05-04 2005-03-22 Phillips Plastics Corp. Packable ceramic beads for bone repair
US6743239B1 (en) 2000-05-25 2004-06-01 St. Jude Medical, Inc. Devices with a bendable tip for medical procedures
ATE308933T1 (de) 2000-06-23 2005-11-15 Cryocath Technologies Inc Vorrichtung zur kryobehandlung
WO2002000143A1 (en) 2000-06-27 2002-01-03 Kyphon Inc. Systems and methods for injecting flowable materials into bones
GB0016516D0 (en) 2000-07-06 2000-08-23 Owen Mumford Ltd Improvements relating to needle protection devices
FR2811538B1 (fr) 2000-07-12 2003-02-07 Spine Next Sa Outil de curetage intervertebral
EP1303236B1 (en) 2000-07-14 2008-12-03 Kyphon SARL Systems for treating vertebral bodies
DE60141653D1 (de) 2000-07-21 2010-05-06 Spineology Group Llc Eine dehnbare, poröse netzbeutel-vorrichtung und seine nutzung in der knochenchirugie
CA2419196A1 (en) 2000-08-11 2002-02-21 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of the spine
US7114501B2 (en) 2000-08-14 2006-10-03 Spine Wave, Inc. Transverse cavity device and method
US6669692B1 (en) 2000-08-21 2003-12-30 Biosense Webster, Inc. Ablation catheter with cooled linear electrode
US6679886B2 (en) 2000-09-01 2004-01-20 Synthes (Usa) Tools and methods for creating cavities in bone
US6808561B2 (en) 2000-10-16 2004-10-26 University Of South Carolina Biocompatible cement containing reactive calcium phosphate nanoparticles and methods for making and using such cement
US20020068929A1 (en) 2000-10-24 2002-06-06 Roni Zvuloni Apparatus and method for compressing a gas, and cryosurgery system and method utilizing same
KR100889416B1 (ko) 2000-10-25 2009-03-20 키폰 에스에이알엘 골절 회복용 캐뉼러를 사용하여 골절된 골을 회복시키기위한 시스템 및 방법
US6916306B1 (en) 2000-11-10 2005-07-12 Boston Scientific Scimed, Inc. Steerable loop structures for supporting diagnostic and therapeutic elements in contact with body tissue
US6576249B1 (en) 2000-11-13 2003-06-10 El Gendler Bone putty and method
US20040087936A1 (en) * 2000-11-16 2004-05-06 Barrx, Inc. System and method for treating abnormal tissue in an organ having a layered tissue structure
US6511471B2 (en) 2000-12-22 2003-01-28 Biocardia, Inc. Drug delivery catheters that attach to tissue and methods for their use
WO2002054941A2 (en) 2001-01-11 2002-07-18 Rita Medical Systems Inc Bone-treatment instrument and method
US7008433B2 (en) 2001-02-15 2006-03-07 Depuy Acromed, Inc. Vertebroplasty injection device
US6648880B2 (en) 2001-02-16 2003-11-18 Cryocath Technologies Inc. Method of using cryotreatment to treat brain tissue
US6375659B1 (en) 2001-02-20 2002-04-23 Vita Licensing, Inc. Method for delivery of biocompatible material
US7544196B2 (en) 2001-02-20 2009-06-09 Orthovita, Inc. System and kit for delivery of restorative materials
DE10108261B4 (de) 2001-02-21 2006-07-20 Ivoclar Vivadent Ag Polymerisierbare Zusammensetzung mit Füllstoff auf der Basis von partikulärem Komposit
US20020115742A1 (en) 2001-02-22 2002-08-22 Trieu Hai H. Bioactive nanocomposites and methods for their use
CN1162187C (zh) 2001-02-22 2004-08-18 华东理工大学 无机骨粘合剂及其在人体硬组织修复中的应用
US6623448B2 (en) 2001-03-30 2003-09-23 Advanced Cardiovascular Systems, Inc. Steerable drug delivery device
US6575978B2 (en) 2001-04-05 2003-06-10 Spineology, Inc. Circumferential resecting reamer tool
US6979312B2 (en) 2001-04-12 2005-12-27 Biotran Corporation, Inc. Steerable sheath catheters
US6837867B2 (en) 2001-04-30 2005-01-04 Biosense Webster, Inc. Steerable catheter with reinforced tip
US6610058B2 (en) 2001-05-02 2003-08-26 Cardiac Pacemakers, Inc. Dual-profile steerable catheter
US7160296B2 (en) 2001-05-10 2007-01-09 Rita Medical Systems, Inc. Tissue ablation apparatus and method
US6484904B1 (en) 2001-05-21 2002-11-26 Tah Industries, Inc. Two-component cartridge system
ITVI20010126A1 (it) 2001-05-30 2002-11-30 Tecres Spa Cemento osseo radiopaco per uso ortopedico nonche' metodo di realizzazione
US6746451B2 (en) 2001-06-01 2004-06-08 Lance M. Middleton Tissue cavitation device and method
US20020188300A1 (en) 2001-06-06 2002-12-12 Arramon Yves P. Cannula system for hard tissue implant delivery
DE10129842C1 (de) 2001-06-15 2003-04-24 Bam Bundesanstalt Matforschung Verfahren zur Herstellung eines bioaktiven Knochenzements und Knochenzement-Kit
US6814734B2 (en) 2001-06-18 2004-11-09 Sdgi Holdings, Inc, Surgical instrumentation and method for forming a passage in bone having an enlarged cross-sectional portion
NL1018438C1 (nl) 2001-07-02 2003-01-08 Baat Medical Engineering B V In- en uitklapbaar gereedschap voor plaatsing in een ruggenwervel.
US6835193B2 (en) 2001-07-10 2004-12-28 Myocardial Therapeutics, Inc. Methods for controlled depth injections into interior body cavities
US6679906B2 (en) 2001-07-13 2004-01-20 Radiant Medical, Inc. Catheter system with on-board temperature probe
US6620162B2 (en) 2001-07-20 2003-09-16 Spineology, Inc. Device for inserting fill material particles into body cavities
CN1835720B (zh) 2001-07-25 2011-09-28 Disc整形外科技术股份有限公司 可变形工具及植入物
JP4345478B2 (ja) 2001-08-08 2009-10-14 株式会社カネカ 拡張カテーテル
JP3603278B2 (ja) 2001-09-06 2004-12-22 理学電機工業株式会社 蛍光ｘ線分析システムおよびそれに用いるプログラム
US20030050644A1 (en) 2001-09-11 2003-03-13 Boucher Ryan P. Systems and methods for accessing and treating diseased or fractured bone employing a guide wire
US6893431B2 (en) 2001-10-15 2005-05-17 Scimed Life Systems, Inc. Medical device for delivering patches
GB0124742D0 (en) 2001-10-16 2001-12-05 Biocomposites Ltd Biodegradable materials
AU2002336694A1 (en) 2001-11-01 2003-05-12 Lawrence M. Boyd Devices and methods for the restoration of a spinal disc
US6913594B2 (en) 2001-12-31 2005-07-05 Biosense Webster, Inc. Dual-function catheter handle
US20030163085A1 (en) 2002-01-16 2003-08-28 Tanner Howard M. Catheter hand-piece apparatus and method of using the same
US6955716B2 (en) 2002-03-01 2005-10-18 American Dental Association Foundation Self-hardening calcium phosphate materials with high resistance to fracture, controlled strength histories and tailored macropore formation rates
US7294127B2 (en) 2002-03-05 2007-11-13 Baylis Medical Company Inc. Electrosurgical tissue treatment method
US8518036B2 (en) 2002-03-05 2013-08-27 Kimberly-Clark Inc. Electrosurgical tissue treatment method
US6896675B2 (en) 2002-03-05 2005-05-24 Baylis Medical Company Inc. Intradiscal lesioning device
US8882755B2 (en) 2002-03-05 2014-11-11 Kimberly-Clark Inc. Electrosurgical device for treatment of tissue
SE0201052D0 (sv) 2002-04-04 2002-04-04 Cerbio Tech Ab Biocompatible cement compositions and method of manufacturing
ATE366123T1 (de) 2002-05-29 2007-07-15 Heraeus Kulzer Gmbh Knochenzementmischung und röntgenkontrastmittel
US20030225432A1 (en) 2002-05-31 2003-12-04 Baptiste Reginald C. Soft tissue retraction device for an endoscopic instrument
WO2003101308A1 (en) 2002-06-04 2003-12-11 Office Of Technology Licensing Stanford University Device and method for rapid aspiration and collection of body tissue from within an enclosed body space
US7166133B2 (en) 2002-06-13 2007-01-23 Kensey Nash Corporation Devices and methods for treating defects in the tissue of a living being
US20040023384A1 (en) 2002-07-31 2004-02-05 Isis Pharmaceuticals Inc. Antisense modulation of G protein-coupled receptor 12 expression
US7029468B2 (en) 2002-06-25 2006-04-18 Enpath Medical, Inc. Catheter assembly with side wall exit lumen and method therefor
US6730095B2 (en) 2002-06-26 2004-05-04 Scimed Life Systems, Inc. Retrograde plunger delivery system
KR100465985B1 (ko) 2002-07-30 2005-01-15 재단법인서울대학교산학협력재단 인공골용 생체활성 복합 세라믹스 조성물 및 그의 제조방법
US7901407B2 (en) 2002-08-02 2011-03-08 Boston Scientific Scimed, Inc. Media delivery device for bone structures
US7393350B2 (en) 2002-08-06 2008-07-01 Erbe Elektromedizin Gmbh Cryo-surgical apparatus and methods
US20040087994A1 (en) 2002-08-29 2004-05-06 Loubert Suddaby Mechanical bone tamping device for repair of osteoporotic bone fractures
US7138442B2 (en) 2002-08-30 2006-11-21 Biomet, Inc. Reduced exothermic bone replacement cement
US6907884B2 (en) 2002-09-30 2005-06-21 Depay Acromed, Inc. Method of straddling an intraosseous nerve
US8613744B2 (en) 2002-09-30 2013-12-24 Relievant Medsystems, Inc. Systems and methods for navigating an instrument through bone
US8361067B2 (en) 2002-09-30 2013-01-29 Relievant Medsystems, Inc. Methods of therapeutically heating a vertebral body to treat back pain
US8808284B2 (en) 2008-09-26 2014-08-19 Relievant Medsystems, Inc. Systems for navigating an instrument through bone
US7066942B2 (en) 2002-10-03 2006-06-27 Wright Medical Technology, Inc. Bendable needle for delivering bone graft material and method of use
US7582309B2 (en) 2002-11-15 2009-09-01 Etex Corporation Cohesive demineralized bone compositions
US7918819B2 (en) 2002-11-15 2011-04-05 Health & Human Services - NIH Variable curve catheter
US6979352B2 (en) 2002-11-21 2005-12-27 Depuy Acromed Methods of performing embolism-free vertebroplasty and devices therefor
US20050251267A1 (en) 2004-05-04 2005-11-10 John Winterbottom Cell permeable structural implant
US6945956B2 (en) 2002-12-23 2005-09-20 Medtronic, Inc. Steerable catheter
SE524494C2 (sv) 2002-12-31 2004-08-17 Doxa Ab Kemiskt bundna biomaterialelement med skräddarsydda egenskaper
US20060024348A1 (en) 2002-12-31 2006-02-02 Doxa Aktiebolag Chemically bonded biomaterial element with tailored properties
US7390298B2 (en) 2003-01-06 2008-06-24 City Of Hope Expandable surgical retractor for internal body spaces approached with minimally invasive incisions or through existing orifices
US20040158237A1 (en) 2003-02-11 2004-08-12 Marwan Abboud Multi-energy ablation station
WO2004071543A1 (en) 2003-02-13 2004-08-26 Synthes Ag Chur Injectable bone-replacement mixture
US6875219B2 (en) 2003-02-14 2005-04-05 Yves P. Arramon Bone access system
AU2004212942A1 (en) 2003-02-14 2004-09-02 Depuy Spine, Inc. In-situ formed intervertebral fusion device
JP2004242936A (ja) 2003-02-14 2004-09-02 Terumo Corp 穿刺針
GB0307834D0 (en) 2003-04-04 2003-05-14 Ta Contrast Ab Composition
US20060206116A1 (en) 2003-05-07 2006-09-14 Yeung Jeffrey E Injection device for the invertebral disc
US7625364B2 (en) 2003-05-27 2009-12-01 Cardia, Inc. Flexible center connection for occlusion device
WO2004109638A1 (ja) 2003-06-06 2004-12-16 Semiconductor Energy Laboratory Co., Ltd. 半導体装置
US8415407B2 (en) 2004-03-21 2013-04-09 Depuy Spine, Inc. Methods, materials, and apparatus for treating bone and other tissue
WO2006011152A2 (en) 2004-06-17 2006-02-02 Disc-O-Tech Medical Technologies, Ltd. Methods for treating bone and other tissue
US7112205B2 (en) 2003-06-17 2006-09-26 Boston Scientific Scimed, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
EP1646332B1 (en) 2003-07-18 2015-06-17 Edwards Lifesciences AG Remotely activated mitral annuloplasty system
US7887557B2 (en) 2003-08-14 2011-02-15 Boston Scientific Scimed, Inc. Catheter having a cutting balloon including multiple cavities or multiple channels
CA2537048C (en) 2003-09-03 2010-01-12 Kyphon Inc. Devices for creating voids in interior body regions and related methods
US7824412B2 (en) 2003-09-05 2010-11-02 Medical Design Instruments LLC Cement/biologics inserter and method for bone-fastener fixation augmentation
US7156843B2 (en) 2003-09-08 2007-01-02 Medtronic, Inc. Irrigated focal ablation tip
US8579908B2 (en) 2003-09-26 2013-11-12 DePuy Synthes Products, LLC. Device for delivering viscous material
US7909833B2 (en) 2003-09-29 2011-03-22 Depuy Acromed, Inc. Vertebroplasty device having a flexible plunger
US7094202B2 (en) 2003-09-29 2006-08-22 Ethicon Endo-Surgery, Inc. Method of operating an endoscopic device with one hand
US7998112B2 (en) 2003-09-30 2011-08-16 Abbott Cardiovascular Systems Inc. Deflectable catheter assembly and method of making same
US7708733B2 (en) 2003-10-20 2010-05-04 Arthrocare Corporation Electrosurgical method and apparatus for removing tissue within a bone body
DE10353919A1 (de) 2003-11-18 2005-07-07 Somatex Medical Technologies Gmbh Injektionspumpe
US20050113836A1 (en) 2003-11-25 2005-05-26 Lozier Antony J. Expandable reamer
EP1708654B1 (en) 2003-12-01 2007-05-09 Broockeville Corporation N.V. A two-component mixing and dispensing device
US8221424B2 (en) 2004-12-20 2012-07-17 Spinascope, Inc. Surgical instrument for orthopedic surgery
US7727232B1 (en) * 2004-02-04 2010-06-01 Salient Surgical Technologies, Inc. Fluid-assisted medical devices and methods
US7351280B2 (en) 2004-02-10 2008-04-01 New York University Macroporous, resorbable and injectible calcium phosphate-based cements (MCPC) for bone repair, augmentation, regeneration, and osteoporosis treatment
US7488322B2 (en) 2004-02-11 2009-02-10 Medtronic, Inc. High speed surgical cutting instrument
US7641664B2 (en) 2004-02-12 2010-01-05 Warsaw Orthopedic, Inc. Surgical instrumentation and method for treatment of a spinal structure
US20060064101A1 (en) 2004-02-12 2006-03-23 Arthrocare Corporation Bone access system
US20050187556A1 (en) 2004-02-25 2005-08-25 Synecor, Llc Universal percutaneous spinal access system
WO2005087974A2 (en) 2004-03-05 2005-09-22 Applied Materials, Inc. Cvd processes for the deposition of amorphous carbon films
US7959634B2 (en) 2004-03-29 2011-06-14 Soteira Inc. Orthopedic surgery access devices
US7507241B2 (en) 2004-04-05 2009-03-24 Expanding Orthopedics Inc. Expandable bone device
US7465318B2 (en) 2004-04-15 2008-12-16 Soteira, Inc. Cement-directing orthopedic implants
US7452351B2 (en) 2004-04-16 2008-11-18 Kyphon Sarl Spinal diagnostic methods and apparatus
US9554691B2 (en) 2004-04-21 2017-01-31 Acclarent, Inc. Endoscopic methods and devices for transnasal procedures
US8163030B2 (en) 2004-05-06 2012-04-24 Degradable Solutions Ag Biocompatible bone implant compositions and methods for repairing a bone defect
AU2004319780A1 (en) 2004-05-19 2005-11-24 Sintea Biotech S.P.A Intravertebral widening device, injection device, and kit and method for kyphoplasty
WO2005122938A1 (en) 2004-06-10 2005-12-29 Arthrocare Corporation Electrosurgical method and apparatus for removing tissue within a bone body
WO2006002430A2 (en) 2004-06-16 2006-01-05 Sdgi Holdings, Inc. Surgical instrumentation for the repair of vertebral bodies
US20050283148A1 (en) 2004-06-17 2005-12-22 Janssen William M Ablation apparatus and system to limit nerve conduction
US20060085009A1 (en) 2004-08-09 2006-04-20 Csaba Truckai Implants and methods for treating bone
US7503920B2 (en) 2004-08-11 2009-03-17 Tzony Siegal Spinal surgery system and method
US20080319445A9 (en) 2004-08-17 2008-12-25 Scimed Life Systems, Inc. Apparatus and methods for delivering compounds into vertebrae for vertebroplasty
US20060106459A1 (en) 2004-08-30 2006-05-18 Csaba Truckai Bone treatment systems and methods
US7396360B2 (en) 2004-09-29 2008-07-08 The Cleveland Clinic Foundation Minimally invasive method and apparatus for fusing adjacent vertebrae
US7559932B2 (en) 2004-12-06 2009-07-14 Dfine, Inc. Bone treatment systems and methods
US20060100706A1 (en) 2004-11-10 2006-05-11 Shadduck John H Stent systems and methods for spine treatment
US7682378B2 (en) 2004-11-10 2010-03-23 Dfine, Inc. Bone treatment systems and methods for introducing an abrading structure to abrade bone
US8663225B2 (en) 2004-11-12 2014-03-04 Medtronic, Inc. Hydrogel bone void filler
US8562607B2 (en) 2004-11-19 2013-10-22 Dfine, Inc. Bone treatment systems and methods
US8583260B2 (en) 2004-12-28 2013-11-12 St. Jude Medical, Atrial Fibrillation Division, Inc. Long travel steerable catheter actuator
DE102005025946A1 (de) 2005-01-26 2006-08-03 Erbe Elektromedizin Gmbh HF-Chirurgieeinrichtung
GB0502384D0 (en) * 2005-02-04 2005-03-16 Instrumedical Ltd Electro-surgical needle apparatus
US20060184192A1 (en) 2005-02-11 2006-08-17 Markworth Aaron D Systems and methods for providing cavities in interior body regions
US7959601B2 (en) 2005-02-14 2011-06-14 Biosense Webster, Inc. Steerable catheter with in-plane deflection
US20060200121A1 (en) 2005-03-03 2006-09-07 Mowery Thomas M Navigable, multi-positional and variable tissue ablation apparatus and methods
JP2006263184A (ja) 2005-03-24 2006-10-05 Gc Corp 骨セメント注入充填方法及び骨セメント注入充填用漏洩防止袋
US7497853B2 (en) 2005-05-05 2009-03-03 Enpath Medical Inc. Deflectable catheter steering and locking system
US20070016130A1 (en) 2005-05-06 2007-01-18 Leeflang Stephen A Complex Shaped Steerable Catheters and Methods for Making and Using Them
US7442190B2 (en) 2005-05-13 2008-10-28 Cryocath Technologies Inc. Contact assessment of balloon catheters
US8187327B2 (en) 2005-05-18 2012-05-29 Kyphon Sarl Selectively-expandable bone scaffold
EP1919375A1 (en) 2005-05-24 2008-05-14 Gary Botimer Expandable surgical reaming tool
US20060276797A1 (en) 2005-05-24 2006-12-07 Gary Botimer Expandable reaming device
EP1922006A2 (en) 2005-05-26 2008-05-21 Smith & Nephew, Inc. Electrothermal intervertebral disc treatment
US20060293687A1 (en) 2005-06-07 2006-12-28 Bogert Roy B Syringe plunger seal
US20070010845A1 (en) 2005-07-08 2007-01-11 Gorman Gong Directionally controlled expandable device and methods for use
EP1909658A2 (en) 2005-07-11 2008-04-16 Kyphon Inc. Systems and methods for providing cavities in interior body regions
US20070006692A1 (en) 2005-07-11 2007-01-11 Phan Christopher U Torque limiting device
US8021366B2 (en) 2005-07-11 2011-09-20 Kyphon Sarl Axial load limiting system and methods
US7794458B2 (en) 2005-07-22 2010-09-14 Boston Scientific Scimed, Inc. Bipolar radio frequency ablation device with retractable insulator
US7670375B2 (en) 2005-08-16 2010-03-02 Benvenue Medical, Inc. Methods for limiting the movement of material introduced between layers of spinal tissue
CN2841051Y (zh) * 2005-08-24 2006-11-29 汤枧根 伞形治疗电极
US20070067034A1 (en) 2005-08-31 2007-03-22 Chirico Paul E Implantable devices and methods for treating micro-architecture deterioration of bone tissue
US20070162043A1 (en) 2005-09-01 2007-07-12 Csaba Truckai Methods for sensing retrograde flows of bone fill material
KR101270876B1 (ko) 2005-09-09 2013-06-07 아그노보스 헬스케어 엘엘씨 복합 골이식 대용 시멘트 및 그로부터 제조된 물품
US20070093840A1 (en) 2005-10-06 2007-04-26 Pacelli Nicolas J Flexible shaft
KR100778142B1 (ko) 2005-11-09 2007-11-29 황창모 신체조직의 선택적 제거를 위한 방사주파수 전극체
US7713273B2 (en) 2005-11-18 2010-05-11 Carefusion 2200, Inc. Device, system and method for delivering a curable material into bone
US7799035B2 (en) 2005-11-18 2010-09-21 Carefusion 2200, Inc. Device, system and method for delivering a curable material into bone
US7823753B2 (en) 2005-11-18 2010-11-02 Kovac Karen S Double barrel caulking gun caddy
US20070173939A1 (en) 2005-12-23 2007-07-26 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for fixation of bone with an expandable device
US7993334B2 (en) 2005-12-29 2011-08-09 Boston Scientific Scimed, Inc. Low-profile, expanding single needle ablation probe
US20070185231A1 (en) 2006-01-23 2007-08-09 Liu Y K Bone cement composite containing particles in a non-uniform spatial distribution and devices for implementation
WO2007089739A2 (en) 2006-01-27 2007-08-09 Stryker Corporation Low pressure delivery system and method for delivering a solid and liquid mixture into a target site for medical treatment
US20070203500A1 (en) 2006-02-28 2007-08-30 Vermillion Technologies, Llc Apparatus and method of shaping an intervertebral space
US7976542B1 (en) 2006-03-02 2011-07-12 Cosman Eric R Adjustable high frequency electrode
US20070270876A1 (en) 2006-04-07 2007-11-22 Yi-Chen Kuo Vertebra bone cement introduction system
FR2899967B1 (fr) 2006-04-12 2008-06-20 Valeo Vision Sa Procede de determination de la position angulaire d'un projecteur au moyen de plusieurs moyens de mesure d'un champ magnetique
US7905884B2 (en) 2006-04-27 2011-03-15 Warsaw Orthopedic, Inc. Method for use of dilating stylet and cannula
US7615044B2 (en) 2006-05-03 2009-11-10 Greatbatch Ltd. Deflectable sheath handle assembly and method therefor
US8075556B2 (en) 2006-05-23 2011-12-13 Andres Betts High frequency epidural neuromodulation catheter for effectuating RF treatment in spinal canal and method of using same
US20080033422A1 (en) 2006-08-04 2008-02-07 Turner Paul F Microwave applicator with margin temperature sensing element
US20080058840A1 (en) 2006-09-01 2008-03-06 Albrecht Thomas E Implantable coil for insertion into a hollow body organ
WO2008045212A2 (en) 2006-10-06 2008-04-17 Kyphon Sarl Products and methods for percutaneous material delivery
US9237916B2 (en) 2006-12-15 2016-01-19 Gmedeleware 2 Llc Devices and methods for vertebrostenting
WO2008084479A2 (en) 2007-01-09 2008-07-17 Nonlinear Technologies Ltd. Devices for forming curved or closed-loop structures
US20080183265A1 (en) 2007-01-30 2008-07-31 Cardiac Pacemakers, Inc. Transvascular lead with proximal force relief
US8211099B2 (en) 2007-01-31 2012-07-03 Tyco Healthcare Group Lp Thermal feedback systems and methods of using the same
US8157804B2 (en) 2007-03-07 2012-04-17 Vertech, Inc. Expandable blade device for stabilizing long bone fractures
US8556910B2 (en) 2007-04-03 2013-10-15 Dfine, Inc. Bone treatment systems and methods
US20080269766A1 (en) 2007-04-30 2008-10-30 Warsaw Orthopedic, Inc. Intravertebral reduction device with retention balls
US8465420B2 (en) 2007-05-18 2013-06-18 Boston Scientific Scimed, Inc. Articulating torqueable hollow device
CA2692002A1 (en) 2007-05-21 2008-11-27 Aoi Medical Inc. Articulating cavitation device
EP2211981A1 (en) 2007-10-09 2010-08-04 Boston Scientific Limited Electrophysiology electrodes and apparatus including the same
US20090105775A1 (en) 2007-10-19 2009-04-23 David Mitchell Cannula with lateral access and directional exit port
WO2011066465A1 (en) 2009-11-25 2011-06-03 Osseon Therapeutics, Inc. Steerable and curvable vertebroplasty system with clog-resistant exit ports
US20090131950A1 (en) 2007-11-16 2009-05-21 Liu Y King Vertebroplasty method with enhanced control
US20090131867A1 (en) 2007-11-16 2009-05-21 Liu Y King Steerable vertebroplasty system with cavity creation element
US9510885B2 (en) 2007-11-16 2016-12-06 Osseon Llc Steerable and curvable cavity creation system
US20090299282A1 (en) 2007-11-16 2009-12-03 Osseon Therapeutics, Inc. Steerable vertebroplasty system with a plurality of cavity creation elements
US20090131886A1 (en) 2007-11-16 2009-05-21 Liu Y King Steerable vertebroplasty system
US8961571B2 (en) 2007-11-19 2015-02-24 David Lee Method and apparatus for spinal facet joint fusion using irregularly shaped cortical bone implants
WO2009073209A1 (en) 2007-12-06 2009-06-11 Osseon Therapeutics, Inc. Vertebroplasty implant with enhanced interfacial shear strength
US8353902B2 (en) 2008-01-31 2013-01-15 Vivant Medical, Inc. Articulating ablation device and method
US20090198243A1 (en) 2008-02-06 2009-08-06 Melsheimer Jeffry S Device and method for stabilizing a damaged bone with a bone cement mixture
US8262672B2 (en) 2008-04-16 2012-09-11 Medtronic, Inc. Medical delivery device construction
US7762164B2 (en) 2008-06-02 2010-07-27 Eca Medical Instruments Torque-limiting device
AU2009270307B2 (en) 2008-07-15 2013-03-21 Lorne Beckman Bone cement injection device
US8246627B2 (en) 2008-08-07 2012-08-21 Stryker Corporation Cement delivery device for introducing cement into tissue, the device having a cavity creator
US9101734B2 (en) 2008-09-09 2015-08-11 Biosense Webster, Inc. Force-sensing catheter with bonded center strut
US8758349B2 (en) 2008-10-13 2014-06-24 Dfine, Inc. Systems for treating a vertebral body
WO2010039894A1 (en) 2008-09-30 2010-04-08 Dfine, Inc. System for use in treatment of vertebral fractures
US20100114184A1 (en) 2008-10-07 2010-05-06 Brainsgate Ltd. Flexible tools for preparing bony canals
US8355799B2 (en) 2008-12-12 2013-01-15 Arthrocare Corporation Systems and methods for limiting joint temperature
JP2012515024A (ja) 2009-01-15 2012-07-05 キャスリックス リミテッド 操向可能なスタイレット
WO2010129075A1 (en) 2009-04-28 2010-11-11 Avinger, Inc. Guidewire support catheter
US20100298832A1 (en) 2009-05-20 2010-11-25 Osseon Therapeutics, Inc. Steerable curvable vertebroplasty drill
WO2010135602A1 (en) 2009-05-20 2010-11-25 Osseon Therapeutics, Inc. Steerable curvable ablation catheter for vertebroplasty
US8057403B2 (en) 2009-05-29 2011-11-15 Promex Technologies, Inc. Flexible biopsy needle
US9616246B2 (en) 2010-01-04 2017-04-11 Covidien Lp Apparatus and methods for treating hollow anatomical structures
US8465488B2 (en) 2010-03-16 2013-06-18 Olympus Medical Systems Corporation Endoscopic surgical instrument
US10058336B2 (en) 2010-04-08 2018-08-28 Dfine, Inc. System for use in treatment of vertebral fractures
WO2011137377A1 (en) 2010-04-29 2011-11-03 Dfine, Inc. System for use in treatment of vertebral fractures
US9526507B2 (en) 2010-04-29 2016-12-27 Dfine, Inc. System for use in treatment of vertebral fractures
WO2011137357A1 (en) 2010-04-29 2011-11-03 Dfine, Inc. System for use in treatment of vertebral fractures
US9241762B2 (en) 2010-06-03 2016-01-26 Covidien Lp Specific absorption rate measurement and energy-delivery device characterization using image analysis
CA2818876C (en) 2010-11-22 2018-10-02 Dfine, Inc. System for use in treatment of vertebral fractures
JP6527329B2 (ja) 2011-05-03 2019-06-05 シファメド・ホールディングス・エルエルシー 操縦可能な送達シース
US9119639B2 (en) 2011-08-09 2015-09-01 DePuy Synthes Products, Inc. Articulated cavity creator
US20130072941A1 (en) 2011-09-16 2013-03-21 Francisca Tan-Malecki Cement Injector and Cement Injector Connectors, and Bone Cement Injector Assembly
US20130237795A1 (en) 2012-03-09 2013-09-12 Carefusion 2200, Inc. Performance concentric electromyography needle
US8591507B2 (en) 2012-03-27 2013-11-26 Dfine, Inc. Methods and systems for use in controlling tissue ablation volume by temperature monitoring
EP2914186B1 (en) 2012-11-05 2019-03-13 Relievant Medsystems, Inc. Systems for creating curved paths through bone and modulating nerves within the bone
US9918766B2 (en) 2012-12-12 2018-03-20 Dfine, Inc. Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement
CA2927436C (en) 2013-10-15 2022-04-26 Stryker Corporation Device for creating a void space in living tissue, the device including a handle with a control knob that can be set regardless of the orientation of the handle
EP3397334A4 (en) 2015-10-06 2019-08-07 Halcyon Medical, Inc. GANGLION-AORTICORENALE DETECTION

Also Published As

Publication number Publication date
US9743938B2 (en) 2017-08-29
BR112012027708B1 (pt) 2021-03-09
US20150335336A1 (en) 2015-11-26
US20110295262A1 (en) 2011-12-01
US10624652B2 (en) 2020-04-21
EP2563233B1 (en) 2020-04-01
CN106618669A (zh) 2017-05-10
US9125671B2 (en) 2015-09-08
BR112012027708A8 (pt) 2019-12-10
CN102958456A (zh) 2013-03-06
US20180028199A1 (en) 2018-02-01
EP2563233A1 (en) 2013-03-06
WO2011137377A1 (en) 2011-11-03
CN106618669B (zh) 2019-11-12
BR112012027708A2 (pt) 2019-09-10
EP2563233A4 (en) 2014-11-19

Similar Documents

Publication Publication Date Title
CN102958456B (zh) 用于治疗椎骨骨折的系统
CN102985015B (zh) 用于治疗椎骨骨折的系统
US10123809B2 (en) System for use in treatment of vertebral fractures
US10299805B2 (en) Systems for treating a vertebral body
JP5865387B2 (ja) 脊椎骨折の治療において使用するためのシステム
EP3294110B1 (en) System for use in treatment of vertebral fractures
CN104470453A (zh) 用于通过温度监视来控制组织切除体积的方法和系统
CN106535982A (zh) 用于流体连通的医疗设备

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
C14 Grant of patent or utility model
GR01 Patent grant