阅读说明：本技术 使用勺形插管来执行球囊椎体后凸成形术程序的方法 (The method for being intubated to execute sacculus balloon kyphoplasty program using spoon shape ) 是由 H·陈 A·L·阿瑟尔 T·T·赛克 于 2019-05-16 设计创作，主要内容包括：一种治疗患者骨骼的方法包括识别所述患者中待受保护的一部分。提供插管,其包括在相对的第一端部表面与第二端部表面之间延伸的轴件。轴件包括界定内腔的内表面。插管包括从第二端部表面延伸的勺形。勺形包括与轴件的内表面连续的内表面和相对的外表面。将插管插入到骨骼中,以使得勺形的外表面被定位成与患者中待受保护的部分相邻。将球囊插入到插管中,以使得球囊被定位于勺形内。使球囊膨胀,以使得在使球囊膨胀时,所述球囊远离勺形扩张,并且在骨骼中产生空隙。公开系统。(A kind of method that treating subjects bones includes identifying a part to be protected in the patient.There is provided intubation comprising the shaft member extended between opposite first end surface and the second end surface.Shaft member includes defining the inner surface of inner cavity.Intubation includes the spoon shape extended from the second end surface.Spoon shape include and the continuous inner surface of the inner surface of shaft member and opposite outer surface.Intubation is inserted into bone so that the outer surface of spoon shape be oriented it is adjacent with part to be protected in patient.Sacculus is inserted into intubation, so that sacculus is located in spoon shape.Make balloon inflation, so that the sacculus is expanded far from spoon shape, and generates gap in bone when making balloon inflation.Open system.)

1. a kind of method for treating subjects bones, the method includes:

Identify a part to be protected in the patient；

Intubation is provided, the intubation includes the shaft member extended between opposite first end surface and the second end surface, institute Stating shaft member includes to define the inner surface of inner cavity, and the intubation includes the spoon shape extended from the second end surface, the spoon shape Comprising with the continuous inner surface of the inner surface of the shaft member, opposite outer surface；

Be inserted into described in the bone so that the outer surface of the spoon shape be oriented in the patient The part to be protected is adjacent；

Sacculus is inserted into the intubation, so that the sacculus is at least partly located in the spoon shape；And

Make the balloon inflation, so that the sacculus is expanded far from the spoon shape, and in institute when making the balloon inflation It states and generates gap in bone.

2. according to the method described in claim 1, wherein the outer surface of the spoon shape is towards to be protected in the patient The part.

3. according to the method described in claim 1, wherein the outer surface of the spoon shape directly engage in the patient to by The part of protection.

4. according to the method described in claim 1, wherein the part to be protected in the patient is nerve.

5. according to the method described in claim 1, wherein the part to be protected in the patient is the bone of the bone Folding.

6. according to the method described in claim 5, wherein the outer surface of the spoon shape extends across the fracture.

7. according to the method described in claim 1, wherein the bone is vertebra, and it is to be protected described in the patient Part is the first end plate of the vertebra.

8. according to the method described in claim 7, wherein the sacculus is expanded far from the first end plate to prevent the sacculus Break through the first end plate.

9. according to the method described in claim 7, wherein the sacculus is expanded far from the first end plate, so that the sacculus It is expanded towards the second end plate of the vertebra.

10. according to the method described in claim 7, wherein the outer surface of the spoon shape towards the first end plate, and Second end plate of the inner surface of the spoon shape towards the vertebra.

11. according to the method described in claim 7, wherein the spoon shape is oriented than the second end plate apart from the vertebra more Close to the first end plate.

12. according to the method described in claim 7, wherein the intubation is inserted in the of the first end plate and the vertebra Between two end plates.

13. according to the method described in claim 1, wherein the bone is vertebra, and the method be further contained in by Described to be inserted into the operation pathway for generating before in the bone and leading to the bone, the operation pathway is oriented to compare The first end plate of the second end plate apart from the vertebra closer to the vertebra.

14. according to the method described in claim 1, wherein the bone is vertebra, and the method be further contained in by Described to be inserted into the operation pathway for generating before in the bone and leading to the bone, the operation pathway is oriented to compare The first side wall of second sidewall apart from the vertebra closer to the vertebra.

15. according to the method described in claim 1, it is further included:

Shrink the sacculus；

The sacculus is removed from the intubation；

Bone filler is delivered by the intubation, and is delivered in the gap；And

Make the bone filler in the interspace.

16. according to the method for claim 15, wherein the bone filler is based on polymethyl methacrylate Bone cement.

17. according to the method described in claim 1, it is further included:

Shrink the sacculus；

The intubation is removed from the bone；

Second is inserted into the bone, so that the end of second intubation is located in the gap；With And

By bone filler by the second intubation delivering, and it is delivered in the gap；And

Make the bone filler in the interspace.

18. according to the method for claim 17, wherein the bone filler is based on polymethyl methacrylate Bone cement.

19. a kind of method for treating vertebra, the method includes:

Intubation is provided, the intubation includes the shaft member extended between opposite first end surface and the second end surface, institute Stating shaft member includes to define the inner surface of inner cavity, and the intubation includes the spoon shape extended from the second end surface, the spoon shape Comprising with the continuous inner surface of the inner surface of the shaft member, opposite outer surface；

The operation pathway for leading to the vertebra is generated, the operation pathway is oriented than the second end plate apart from the vertebra more Close to the first end plate of the vertebra；

The intubation is inserted by the operation pathway and is inserted into the vertebra, so that the spoon shape is described outer Surface is oriented adjacent with the first end plate；

Sacculus is inserted into the intubation, so that the sacculus is located in the spoon shape；And

Make the balloon inflation, so that the sacculus is far from the spoon shape and the first end when making the balloon inflation It plate and is expanded towards second end plate, to generate gap in the vertebra, while preventing the sacculus from breaking through described the End plate and.

20. a kind of method for treating vertebra, the method includes:

Intubation is provided, the intubation includes the shaft member extended between opposite first end surface and the second end surface, institute Stating shaft member includes to define the inner surface of inner cavity, and the intubation includes the spoon shape extended from the second end surface, the spoon shape Comprising with the continuous inner surface of the inner surface of the shaft member and opposite outer surface；

The operation pathway for leading to the vertebra is generated, the operation pathway is oriented than the second end plate apart from the vertebra more Close to the first end plate of the vertebra；

The intubation is inserted by the operation pathway and is inserted into the vertebra, so that the spoon shape is described outer Surface is oriented adjacent with the first end plate；

Sacculus is inserted into the intubation, so that the sacculus is located in the spoon shape；

Make the balloon inflation, so that the sacculus is far from the spoon shape and the first end when making the balloon inflation It plate and is expanded towards second end plate, to generate gap in the vertebra, while preventing the sacculus from breaking through described the End plate；

Shrink the sacculus；

Bone filler is delivered in the gap；And

Make the bone filler in the interspace.

Technical field

The disclosure relates generally to operation method, and more precisely, is related to making in balloon kyphoplasty program The method for being intubated to treat bone with spoon shape.Open system.

Background technique

Height loss is usually associated with spinal fracture (such as vertebral compression fractures).Spinal fracture influences significant portion Sufferers of osteoporosis face.For example, annual estimation about 700,000 spinal fracture is occurred by osteoporosis.It has developed The program for treating spinal fracture.This class method of one kind is balloon kyphoplasty.Balloon kyphoplasty is a kind of for treating The minimally invasive procedure of spinal fracture (such as vertebral compression fractures), the treatment on the inside of the zygantrum of fracture by being inserted into one Or multiple sacculus (such as sacculus with biddability) Lai Jinhang.Make one or more balloon inflations in the zygantrum of fracture, So that the cancellous bone of zygantrum is pushed to the cortical wall of zygantrum to form cavity in zygantrum.Then with material (such as Bone cement) at least partly fill cavity.

For example, intubation can be used sacculus is inserted into zygantrum.Some intubations include spoon in cannula end Shape.Sacculus engages spoon shape to guide the expansion of sacculus, so that sacculus is expanded far from spoon shape.However, into the access of zygantrum May be too low or too high, this generates a possibility that vertebral body endplate and/or side wall are broken through during expansion process, this will prevent to cure It is raw to realize desired procedure result.The disclosure describes the improvement for these prior arts.

Summary of the invention

In one embodiment, the method for treating subjects bones includes identifying a part to be protected in the patient. There is provided intubation comprising the shaft member extended between opposite first end surface and the second end surface.Shaft member includes defining The inner surface of inner cavity.Intubation includes the spoon shape extended from the second end surface.Spoon shape includes continuously interior with the inner surface of shaft member Surface and opposite outer surface.Intubation is inserted into bone so that the outer surface of spoon shape be oriented in patient to by The part of protection is adjacent.Sacculus is inserted into intubation, so that sacculus is located in spoon shape.Make balloon inflation, so that When making balloon inflation, the sacculus is expanded far from spoon shape, and gap is generated in bone.In some embodiments, open System.

In one embodiment, the method for treating vertebra includes providing intubation, and the intubation includes in opposite first end The shaft member extended between portion surface and the second end surface.Shaft member includes defining the inner surface of inner cavity.Intubation includes from second end The spoon shape that portion surface extends.Spoon shape include and the continuous inner surface of the inner surface of shaft member, opposite outer surface.Vertebra is led in generation Operation pathway.Operation pathway is oriented the first end plate than the second end plate apart from vertebra closer to vertebra.Intubation is logical Cross operation pathway be inserted into and be inserted into vertebra so that the outer surface of spoon shape be oriented it is adjacent with first end plate.By ball Capsule is inserted into intubation, so that sacculus is located in spoon shape.Make balloon inflation, so that when making balloon inflation, it is described Sacculus is expanded far from spoon shape and first end plate and towards the second end plate, to generate gap in vertebra, while preventing sacculus from rushing Broken first end plate.In some embodiments, sacculus is shunk, and bone filler is delivered in gap.Fill out bone Material is filled in interspace.

Detailed description of the invention

The disclosure will become more apparent from according to the specific descriptions of the following drawings, in the accompanying drawings:

Fig. 1 is the perspective view according to one embodiment of the surgery systems component of the principle of the invention in the disclosure；

Fig. 2 is the end view of component shown in Fig. 1；

Fig. 3 is the side cross-sectional view according to the surgery systems component of the principle of the invention in the disclosure；

Fig. 4 is the side cross-sectional view of component shown in Fig. 3；

Fig. 5 is the plan view of component shown in Fig. 1 and 3；

Fig. 6 is the plan view of component shown in Fig. 1 and 3；And

Fig. 7 is the plan view of component shown in Fig. 1 and 3.

In entire schema, similar reference numerals indicate like.

Specific embodiment

The example of operation method and related system is discussed in terms of the method and system for executing balloon kyphoplasty Property embodiment.In some embodiments, the system comprises sizing spoon shape intubation, such as size 2 are carried out for vertebra It is intubated with No. 3 spoon shapes.Spoon shape intubation is equivalent to standard cannula seen in existing bone inserter system (OIS) tool, but remote End has notch.Notch provides platform targeted when the expansion of expandable bone packer (IBT), therefore allows the list of IBT To expansion.Spoon shape intubation can be used for " remedying " situation, with when the access entered for the first time using standard OIS is not ideal enough to doctor Life is assisted.If too low or too high using the access that standard OIS enters, IBT will have breaks through vertebra during expansion process A possibility that end plate, and doctor will can not achieve desired procedure result.Spoon shape intubation will be inserted into along the identical channel that enters, Platform is directed away from closer end plate simultaneously.It is orientated since spoon shape is intubated, therefore the expansion of sacculus will be directed to farther away end Plate, to protect closer end plate that possible rupture does not occur.Spoon shape intubation can be also used for the passage side wherein entered for the first time To too big situation is deviated, to help protective side wall not rupture during IBT expansion.

In some embodiments, one of surgery systems or all components can be disposable, removing packaging (peel- Pack), pre-packaged sterile device.In some embodiments, the component of surgery systems is configured for a purposes, and It is abandoned after it is used once.It is contemplated, however, that one of surgery systems or all components may be reused.Surgery systems can To be configured to have multiple kits by sizing and configuration component, the component includes for example various spoon shape spoons Shape, sacculus etc..In some embodiments, the one or more components of surgery systems are configured to by sterilizing.

In some embodiments, disclosed surgery systems and method can alternatively be used for wherein patient and be in prostrate In the operative treatment of position or supine position, and/or in any body region use various operative approaches, including anteposition, rear position, Posterior median line, positive side, rear side, front side approach etc..Disclosed method and system can be used for animal, skeleton model and other nothings On life substrate, such as training, testing and show.

It is described in detail below by reference to the disclosure carried out in conjunction with the drawing figures for forming a part of this disclosure, it can The disclosure is more easily to understand.It should be understood that the present disclosure is not limited to specific devices that is described herein and/or showing, method, item Part or parameter, and the term as used herein is only used for by way of example for the purpose of describing particular embodiments, and be not intended to limit Required disclosure.In addition, as used in the description and including the appended claims, unless context is in addition bright Really regulation, otherwise singular " one (a/an) " and " (the) " include plural form, and refer to that special value includes extremely Few particular value.Range can be expressed as herein from one particular value of "about" or "approximately" and/or to " about " or " greatly About " another particular value.When stating such range, another embodiment include from a particular value and/or to another spy Definite value.Similarly, when value is expressed as approximation by using preposition " about ", it should be appreciated that particular value forms another reality Apply example.It should also be understood that all georeferencing labels (such as horizontal, vertical, top, top, lower part, bottom, left and right) are all only For explanatory purposes, and can change within the scope of this disclosure.For example, reference marker " top " and " lower part " are It is opposite and in the case where being only used for relative to each other, and it is not necessarily " too high " and " too low ".

In addition, referring to execution as used in the description and including the appended claims, " treatment " disease or symptom Certain procedures are to alleviate the symptom or symptom of disease or symptom.Alleviating may be before the appearance of the symptom or symptom of disease or symptom Occur, and occurs after the occurrence of which.Therefore, the symptom for the treatment of including prevention disease or undesirably is (for example, prevention disease The disease may be susceptible to suffer from but be not yet diagnosed as occurring in the patient with the disease).In addition, treatment does not require completely Alleviate symptom or symptom, not seek medical advice more, and particularly including only there is the program of edge effect to patient.Treatment may include Inhibit disease, such as disease is prevented to develop；Or mitigate disease, such as cause disease regression.For example, treatment may include subtracting Light acute or chronic inflammation；Relieve pain and alleviate and induce the regrowth of new ligament, bone and other tissues；As operation Auxiliary；And/or any repair procedure.In addition, as used in the description and including the appended claims, unless in addition It specifically refers to, otherwise term " tissue " includes soft tissue, ligament, tendon, cartilage and/or bone.

Following discussion includes the description to the surgery systems according to disclosure principle and the correlation technique using the system. Alternate embodiment is also disclosed.Now with detailed reference to the exemplary embodiment of the disclosure, the embodiment carries out in the accompanying drawings Explanation.Fig. 1-7 is turned now to, illustrates the component of the surgery systems 20 according to disclosure principle.

Depending on specific application and/or the preference of healthcare givers, the component of surgery systems 20 can be answered by being suitable for medical treatment Biology acceptable material construction, including metal, synthetic polymer, ceramics and bone material and/or its compound.Citing comes It says, the component of surgery systems 20 can either individually or collectively be constructed by following material: such as stainless steel alloy, commercially pure titanium, titanium Alloy, 5 grades of titaniums, super-elastic titanium alloys, cobalt-chromium alloy, stainless steel alloy, superelastic metal alloy are (for example, Nitinol (Nitinol), superlastic plastic metal is (such as by material limited liability company, Toyota (the Toyota Material of Japan Incorporated) the GUM manufactured)), ceramics and its compound (such as calcium phosphate is (for example, by baroque company (Biologix Inc.) manufacture SKELITETM)), thermoplastic (such as polyaryletherketone (PAEK), including polyether-ether-ketone (PEEK), polyether ketone ketone (PEKK) and polyether-ketone (PEK), carbon-PEEK compound, PEEK-BaSO4 polyrubber, poly- to benzene two Formic acid second diester (PET)), fabric, silicone, polyurethanes, silicone-polyurethane co-polymer, polyrubber, polyene Hydrocarbon rubbers, hydrogel, semi-rigid and rigid material, elastomer, rubber, thermoplastic elastomer (TPE), thermo-setting elastomer, elastomer are multiple Close object, rigid polymer (including polyphenylene, polyamide, polyimides, polyetherimide, polyethylene, epoxy resin), aggregate Material (including autograft, allograft, xenograft or transgenosis cortex bone and/or skin cancellous bone and group Knit growth or differentiation factor), the material that can partially absorb is (for example, the compound of metal and calcium base ceramics, PEEK and calcium base are ceramic Compound, PEEK and absorbable polymer compound), the material that can fully absorb (for example, calcium base ceramics, as calcium phosphate, Tricalcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate or other absorbable polymers, as polyactide, polyglycolide, Polytyrosinecarbonates, polycaprolactone) with and combinations thereof.The various assemblies of surgery systems 20 can have material composite (packet Include material above), to realize a variety of desired characteristics, such as intensity, rigidity, elasticity, biddability, biomechanical property, durable Property and radioparency or imaging priority.The component of surgery systems 20 either individually or collectively can also be by dissimilar materials system At such as the combination of two or more materials described above.As described herein, the component of surgery systems 20 can whole shape At being integrally connected, or including tightening member and/or instrument.

Surgery systems 20 are intubated including spoon shape, such as balloon kyphoplasty intubation 22.Intubation 22 includes along longitudinal axis The shaft member 24 that line L extends between first end surface 26 and opposite the second end surface 28.Shaft member 24 includes to define inner cavity 32 inner surface 30.Inner cavity 32 and axis L are coaxial, and extend the whole length of shaft member 24.Inner cavity 32 is whole along inner cavity 32 A length has circular cross section configuration and uniform diameter.In some embodiments, inner cavity 32 can have various cross sections Configuration, such as ellipse, rectangle, triangle, rectangle, square, polygon, irregular shape, uniform shapes, uneven shape Shape, shape-variable, tubulose and/or taper.In some embodiments, inner cavity 32 can be alternately oriented placement relative to axis L, Such as lateral and/or other angle orientations coaxially and/or can deviate or interlock such as acute angle or obtuse angle.Shaft member 24 includes to extend Across end surface 26 first opening 34 and extend through end surface 28 second opening 36.Opening 34,36 respectively with it is interior Chamber 32 is connected to.

Intubation 22 includes the semicircle platform extended along axis L from end surface 28, such as spoon shape 38, so that spoon shape 38 back to end surface 26.Spoon shape 38 include and the continuous outer surface 38a of the outer surface 24a of shaft member 24.That is, in appearance Gap or groove are not present between face 24a and outer surface 38a, so that outer surface 24a smoothly transitions from into outer surface 38a.In In some embodiments, outer surface 38a is extended parallel to along the whole length of spoon shape 38 with outer surface 24a and/or axis L.In In some embodiments, outer surface 38a be can be relative to outer surface 24a and/or axis L to be alternately oriented placement, such as laterally, Vertical and/or other angle orientations coaxially and/or can deviate or interlock such as acute angle or obtuse angle.

Spoon shape 38 includes the central part 40 being located between the lateral section 42,44 of spoon shape 38.As discussed herein, Central part 40 is configured to support the bottom surface of the sacculus when making balloon inflation, so that the sacculus is far from spoon shape 38 Expansion, and lateral section 42,44 respectively is configured to support the side surface of the sacculus when making balloon inflation, to make ball Capsule prevents the sacculus from climbing over spoon shape 38 when expanding.In some embodiments, lateral section 42,44 is respectively since the end of spoon shape 38 Surface 28 is gradually thinning to distal surface 52.That is, each comfortable height with 28 adjacent of end surface of lateral section 42,44 Degree is greater than lateral section 42,44 in the height with 52 adjacent of distal surface.In some embodiments, lateral section 42,44 is each Since the end surface 28 of spoon shape 38 is continuously gradually thinning to distal surface 52.

Lateral section 42 includes top surface 46, and lateral section 44 includes top surface 48.Spoon shape 38 includes and axis The continuous inner arcuate surfaces 50 of inner surface 30 of part 24.That is, being not present between inner surface 30 and inner arcuate surfaces 50 Gap or groove, so that inner surface 30 smoothly transitions from archwise inner surface 50.As discussed herein, 50 quilt of inner arcuate surfaces It is configured to support the bottom surface of the sacculus when making balloon inflation, targeted back gear when providing balloon inflation (backstop).In some embodiments, inner arcuate surfaces 50 are from top surface 46 to 48 convex curve of top surface.Some In embodiment, inner arcuate surfaces 50 are continuously bent from top surface 46 to top surface 48.That is, inner arcuate surfaces 50 It is smooth or smooth from top surface 46 to top surface 48 along the whole length of inner arcuate surfaces 50 and be free of any gap Or protrusion.In some embodiments, inner arcuate surfaces 50 have continuous curvature from top surface 46 to top surface 48 Radius.In some embodiments, inner arcuate surfaces 50 are equal to shaft member 24 from top surface 46 to the radius of curvature of top surface 48 Inner surface 30 radius of curvature.In some embodiments, inner arcuate surfaces 50 are from top surface 46 to the song of top surface 48 Rate radius is greater than the radius of curvature of the inner surface 30 of shaft member 24.In some embodiments, inner arcuate surfaces 50 are from top surface 46 To top surface 48 radius of curvature be less than shaft member 24 inner surface 30 radius of curvature.

In some embodiments, the outer surface 38a of spoon shape 38 is from top surface 46 to 48 convex curvature of top surface.One In a little embodiments, outer surface 38a is continuously bent from top surface 46 to top surface 48.That is, outer surface 38a along The whole length of outer surface 38a is smooth or smooth from top surface 46 to top surface 48 and is free of any gap or protruding portion Point.In some embodiments, outer surface 38a has continuous radius of curvature from top surface 46 to top surface 48.Some In embodiment, outer surface 38a is equal to the song of the outer surface 24a of shaft member 24 from top surface 46 to the radius of curvature of top surface 48 Rate radius.In some embodiments, outer surface 38a is greater than shaft member 24 from top surface 46 to the radius of curvature of top surface 48 The radius of curvature of outer surface 24a.In some embodiments, outer surface 38a is from top surface 46 to the curvature of top surface 48 half Diameter is less than the radius of curvature of the outer surface 24a of shaft member 24.

In some embodiments, shaft member 24 and/or spoon shape 38 are made of shape-memory material.In some embodiments, axis Part 24 and/or spoon shape 38 are made of elastic material.In some embodiments, shaft member 24 and/or spoon shape 38 are by super-elasticity NiTi Promise is made.In some embodiments, shaft member 24 and/or spoon shape 38 by will be resiliently deformed and be then returned to its original-shape with The material for minimizing the influence of deformation is made.For example shaft member 24 and/or spoon shape 38 are made of superelastic Nitinol, with So that lateral section 42,44 will be deflected when making balloon inflation relative to central part 40, and then sacculus is made to shrink it After return to its original-shape.In some embodiments, shaft member 24 and/or spoon shape 38 are by cannot be curved in cases where no fracturing is occurring Bent and/or deformation rigid material is made.In some embodiments, shaft member 24 by that cannot be bent in cases where no fracturing is occurring And/or the rigid material of deformation is made, and spoon shape 38 is made of shape-memory material or elastic material.In some embodiments In, spoon shape 38 is made of the rigid material that cannot be bent and/or deform in cases where no fracturing is occurring, and shaft member 24 is by shape Memory material or elastic material are made.

System 20 includes foley's tube, such as expandable bone packer 58.An implementation shown in figure 3 and 4 In example, expandable bone packer 58 includes exterior tube, such as pipe 60, and is connected to the sacculus 62 of 60 end of pipe.It can incite somebody to action Expanding material (such as air, salt water or contrast solution) is delivered and is delivered in sacculus 62 by pipe 60, by sacculus 62 from Unexpanded orientation, which is moved to, shown in Fig. 3 expands orientation shown in Fig. 4.In some embodiments, as shown in Figures 3 and 4, Sacculus 62 is configured to around 1 radial dilatation of longitudinal axis L defined by pipe 60.In some embodiments, sacculus 62 can be by It is configured to only expand in one direction.For example, sacculus 62 can be manufactured so that the top section of sacculus 62 is thicker Or comprising the material different from 62 bottom of sacculus, so that the expansion of the bottom part of sacculus 62 will when expanding sacculus 62 Top section than sacculus 62 is more.

As shown in Figures 5 and 6, bone packer 58 is configured for being inserted into intubation 22, so that pipe 60 is determined In the inner cavity of shaft member 24 32, and sacculus 62 is located in spoon shape 38.In some embodiments, when by inflatable bone When packer 58 is inserted into intubation 22, axis L and axis L1 are coaxial.When sacculus 62 is located in spoon shape 38, sacculus 62 Bottom surface 62a directly engage inner arcuate surfaces 50, the direct joint side part 42 first side surface 62b of sacculus 62, and And the opposite direct joint side part 44 second side surface 62c of sacculus 62.It is moved in sacculus 62 from unexpanded orientation When expansion orientation, the bottom surface 62a of the supporting balloon 62 when expanding sacculus 62 of inner arcuate surfaces 50, to provide the expansion of sacculus 62 When targeted back gear so that sacculus 62 is expanded far from inner arcuate surfaces 50.As shown in Figure 6, because sacculus 62 is expanded far From spoon shape 38, so the center line C of sacculus 62 is deviated from axis L when expanding sacculus 62.In some embodiments, such as Fig. 5 Shown in, when sacculus 62 is unexpanded, the center line C of sacculus 62 can be coaxial with axis L.It is moved in sacculus 62 from unexpanded orientation When moving expansion orientation, the side edge surface 62b of 42 supporting balloon 62 of lateral section of spoon shape 38, and the lateral section of spoon shape 38 The side edge surface 62c of 44 supporting balloons, to prevent sacculus 62 from climbing over spoon shape 38 when expanding sacculus 62.

In operation and in use, healthcare givers is in any appropriate manner in order to treat bone disorders (such as spinal fracture) (as by the cutting of tissue and lead contracting (retraction)) obtain and enter including at least one bone structure (such as vertebra of fracture Bone) target position access.It is contemplated that surgery systems 20 can be used for any existing operation method or technology, including opening Operation, mini open surgery, Minimally Invasive Surgery, including percutaneous surgery implantation, wherein it is logical to provide protection by micro- cutting or for region The casing in road enters the vertebra of patient.Once being entered the access of (one or more) operative site, execute for treating bone The specific surgical procedure of bone illness.

A part 64 of patient is identified as protected during sacculus 62 expands.In some embodiments, part 64 makes It is studied with computer tomographic scan (CT), magnetic resonance image (MRI), the fluoroscopy for being able to carry out CT or similar two-dimensional imaging To be identified.In some embodiments, part 64 uses radiography, is known via quantitatively or semi-quantitatively evaluating Not.In some embodiments, radiopaque radiography material is injected into bone visual to be used under radiographic image Change display (fluoroscopy).In some embodiments, part 64 is identified using x-ray scan.In some embodiments, Using radiophotography or x-ray scan, the image of bone (such as vertebra) can be compared for other images, to be based on In the shape of the bone and other images the shape of bone come determine the bone whether include fracture and/or other defects. In some embodiments, using radiophotography or x-ray scan, the image of bone (such as vertebra) can be directed to normal bone Mathematical model be compared, determine that the bone is to use adjacent vertebrae as the predictive factor for vertebra shape of not fracturing No includes fracture and/or other defects.In some embodiments, part 64 is identified using vertebra morphology techniques.One In a little embodiments, part 64 is identified using digital density measurement device, and it is special that described device generates broad-based bone Value indicative, such as bone mineral content or bone mineral density.That is, part 64 can be identified as bone mine in bone Content of material and/or bone mineral density are lower than a part of selected threshold value.

In some embodiments, part 64 is the nerve in vertebra or around vertebra.In some embodiments, part 64 is Fracture in vertebra or around vertebra.In some embodiments, part 64 is the end plate of vertebra, wherein the end plate includes defect And/or it is injured in other ways.In some embodiments, part 64 is the side wall of vertebra.Bone (such as vertebra) is led in generation Operation pathway.In some embodiments, operation pathway is oriented closer to vertebra than the second end plate apart from vertebra End plate.In some embodiments, operation pathway is oriented the first side than the second sidewall apart from vertebra closer to vertebra Wall.Expandable bone packer 58 is inserted into intubation 22, so that pipe 60 is located in the inner cavity 32 of shaft member 24, and And sacculus 62 is located in spoon shape 38.As shown in Figure 7, spoon shape 38 and sacculus 62 are inserted into and are inserted by operation pathway Into the zygantrum of vertebra so that spoon shape 38 be oriented it is adjacent with part 64.In some embodiments, it inserts 22 will be intubated Before entering into zygantrum, expandable bone packer 58 is inserted into intubation 22.In some embodiments, it will be intubated After 22 are inserted into zygantrum, expandable bone packer 58 is inserted into intubation 22.

In some embodiments, expandable bone packer 58 is inserted into intubation 22, so that sacculus 62 is complete It is positioned in spoon shape 38 entirely, so that sacculus 62 will be far from the expansion of spoon shape 38 when expanding sacculus 62.In some embodiments In, the distal end of sacculus 62 is inwardly concaved relative to the distal end of spoon shape 38.In some embodiments, the distal end of sacculus 62 and spoon shape 38 Distal end flush.In some embodiments, expandable bone packer 58 is inserted into intubation 22, so that sacculus 62 Distal end is more farther than the distal end of spoon shape 38.In some embodiments, the distal end of sacculus 62 is Chong Die with the distal end of spoon shape 38.In such reality It applies in example, sacculus 62 is unidirectional sacculus, so that 62 part of sacculus more farther than the distal end of spoon shape 38 will be far from the expansion of part 64. It is contemplated that sacculus 62 can have the different wall of thickness, for example to provide the sacculus 62 with unidirectional expanding ability.

In one embodiment that wherein part 64 is nerve, intubation 22 can be relative to nerve positioning, so that spoon shape 38 outer surface 38a is towards nerve, and the inner surface 50 of spoon shape 38 is back to nerve.In the reality that wherein part 64 is nerve It applies in example, intubation 22 can be relative to nerve positioning, so that the outer surface 38a of spoon shape 38 directly engages nerve.Then by ball Capsule 62 is moved to expansion from unexpanded orientation and is orientated.When sacculus 62 is moved to expansion from unexpanded orientation and is orientated, spoon shape 38 The bottom surface 62a of the supporting balloon 62 when expanding sacculus 62 of inner arcuate surfaces 50, it is targeted when sacculus 62 expands to provide Back gear, so that sacculus 62 is far from nerve expansion.This allows healthcare givers to guide sacculus 62 far from nerve.For example, such as Fig. 7 Shown in, spoon shape 38 can be used for guiding sacculus 62 far from part 64 and towards the wall of the end plate of vertebra 66.As begged for herein By spoon shape 38 helps to be allocated the load generated by sacculus 62 for vertebra, to increase the lifting force of sacculus 62.In ball Capsule 62 from it is unexpanded orientation be moved to expansion be orientated when, sacculus 62 generates void space in vertebra.

In one embodiment that wherein part 64 is fracture, intubation 22 can be positioned relative to fracture, so that spoon shape 38 outer surface 38a is towards fracture, and the inner surface 50 of spoon shape 38 is back to fracture.In the reality that wherein part 64 is fracture It applies in example, intubation 22 can be positioned relative to fracture, so that the outer surface 38a of spoon shape 38 directly engages fracture.In some realities It applies in example, spoon shape 38 may be oriented such that spoon shape 38 extends across fracture.In some embodiments, spoon shape 38 can be and be determined Position is at extending in parallel axis L with fracture.In some embodiments, spoon shape 38 is positioned such that axis L and fracture are crosscutting Extend.Then sacculus 62 expansion is moved to from unexpanded orientation to be orientated.Expansion is moved to from unexpanded orientation in sacculus 62 to take Xiang Shi, the bottom surface 62a of the supporting balloon 62 when expanding sacculus 62 of inner arcuate surfaces 50 of spoon shape 38, it is swollen to provide sacculus 62 Targeted back gear when swollen, so that sacculus 62 is far from fracture expansion.This allows healthcare givers to guide sacculus 62 far from fracture.It lifts For example, as shown in Figure 7, spoon shape 38 can be used for guiding sacculus 62 far from fracture and towards the end plate of vertebra 66.Such as this Text is discussed that spoon shape 38 helps to be allocated the load generated by sacculus 62 for vertebra, to increase the promotion of sacculus 62 Power.When sacculus 62 is moved to expansion from unexpanded orientation and is orientated, sacculus 62 generates void space in vertebra.

In one that wherein part 64 is the first end plate of vertebra (such as first end plate injured and/or thinning in vertebra) In embodiment, intubation 22 can be positioned relative to first end plate, so that the outer surface 38a of spoon shape 38 is towards first end plate, and And the inner surface 50 of spoon shape 38 is back to first end plate.It is first end plate injured and/or thinning in vertebra in wherein part 64 In one embodiment, intubation 22 can be positioned relative to first end plate, so that the outer surface 38a of spoon shape 38 directly engages first End plate.For example, intubation 22 may be oriented such that the outer surface 38a of spoon shape 38 directly engages the osteoplaque of first end plate. In some embodiments, when the outer surface 38a of spoon shape 38 directly engages the osteoplaque of first end plate, spoon shape 38 directly engages vertebra Cyclic annular apophysis.In some embodiments, intubation 22 can be located in the osteoplaque of first end plate and the hyaline cartilage layer of vertebra Between.In some embodiments, spoon shape 38 may be oriented such that across the first end plate extension of spoon shape 38.Then by sacculus 62 from Unexpanded orientation is moved to expansion orientation.When sacculus 62 is moved to expansion from unexpanded orientation and is orientated, in the arch of spoon shape 38 The bottom surface 62a of the supporting balloon 62 when expanding sacculus 62 of surface 50, to provide back gear targeted when sacculus 62 expands, with So that sacculus 62 is expanded far from first end plate.This allows healthcare givers to guide sacculus 62 far from first end plate.For example, as schemed Shown in 7, spoon shape 38 can be used for guiding sacculus 62 far from first end plate and towards the end plate of vertebra 66.As begged for herein By spoon shape 38 helps to be allocated the load generated by sacculus 62 for vertebra, to increase the lifting force of sacculus 62.In ball When capsule 62 is moved to expansion from unexpanded orientation and be orientated, sacculus 62 is generating sky in vertebra between end plate 64 and end plate 66 Gap space.

Wherein part 64 be the first side wall of vertebra (such as be positioned in vertebra vertebra first end plate and the second end plate Between injured and/or thinning the first side wall) one embodiment in, intubation 22 can relative to the first side wall position so that Spoon shape 38 outer surface 38a towards the first side wall, and the inner surface 50 of spoon shape 38 is back to the first side wall.Part 64 wherein It is an implementation of the injured and/or thinning the first side wall being positioned in vertebra between the first end plate of vertebra and the second end plate In example, intubation 22 can be positioned relative to the first side wall, so that the outer surface 38a of spoon shape 38 directly engages the first side wall.In In some embodiments, spoon shape 38 may be oriented such that across the first side wall extension of spoon shape 38.Then by sacculus 62 from unexpanded Orientation is moved to expansion orientation.When sacculus 62 is moved to expansion from unexpanded orientation and is orientated, the inner arcuate surfaces 50 of spoon shape 38 The bottom surface 62a of supporting balloon 62 when expanding sacculus 62, to provide back gear targeted when sacculus 62 expands, so that ball Capsule 62 is expanded far from the first side wall.This allows healthcare givers to guide sacculus 62 far from the first side wall.For example, such as institute in Fig. 7 Show, spoon shape 38 can be used for guiding sacculus 62 far from the first side wall and towards the second sidewall of vertebra 66.As discussed herein, Spoon shape 38 helps to be allocated the load generated by sacculus 62 for vertebra, to increase the lifting force of sacculus 62.In sacculus 62 are moved to expansion from unexpanded orientation when be orientated, and sacculus 62 is generating gap being in vertebra between side wall 64 and side wall 66 Space.

In one embodiment, after generating void space in vertebra in sacculus 62, make sacculus 62 shrink, and from insert Inflatable bone packer 58 is removed in pipe 22.By bone filler by 22 insertion of intubation, and it is inserted into vertebra In void space.In one embodiment, after generating void space in vertebra in sacculus 62, shrink sacculus 62, and Removal intubation 22 and inflatable bone packer 58 from vertebra.Second intubation (not shown) is inserted into vertebra, so that The end for obtaining the second intubation is positioned in void space.By bone filler by the second intubation delivering, and it is delivered to sky In gap space with fill void space all or part of.In some embodiments, bone filler is curable bone Bone packing material, such as the bone cement based on polymethyl methacrylate.Bone cement then solidifies in vertebra to treat vertebra, The treatment is by reducing pain, keeping vertebra stable and/or its normal level being returned in vertebra reparation.

In some embodiments, a kind of external member is provided, the one or more components containing surgery systems 20.The external member It may include the component from any embodiment discussed in this article.In some embodiments, the external member includes to be begged for herein One or more expanding materials of opinion.In some embodiments, the external member includes one or more bone fillers, such as The bone cement made of polymethyl methacrylate.In some embodiments, the external member includes multiple intubations, such as with quilt It is disposed for the intubation 22 of the different length of different building shape patient.In some embodiments, the external member includes multiple intubations, Such as spoon shape 38 therein has the intubation 22 of the different in width and/or length that are configured for different size sacculus.

It should be understood that can various modification can be adapted to presently disclosed embodiment.Therefore, description above should not be construed To be restrictive, and it is merely possible to the illustration of various embodiments.Those skilled in the art will imagine appended by this paper Claims scope and spirit in other modifications.