公开(公告)号：US07722620B2

公开(公告)日：2010-05-25

申请号：US11209035

申请日：2005-08-22

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B17/00

CPC分类号： A61B17/8805 ,  A61B17/70 ,  A61B17/8822 ,  A61B17/8827 ,  A61B17/8836 ,  A61B2017/00022 ,  A61B2017/00026 ,  A61B2017/00084 ,  A61B2017/564 ,  A61F2/44

摘要： The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.

摘要翻译： 本发明在某些实施例中涉及用于治疗脊椎压缩性骨折的医疗装置。 更具体地，本发明的实施例涉及通过控制骨水泥进入椎骨内部并且由水泥流引起的力的施加来可控地恢复椎体高度的仪器和方法。 示例性系统利用结合导电骨水泥的Rf能量来选择性聚合流入羽流以增加水泥的粘度。 在本发明的一个方面，该系统利用控制器来控制骨水泥流动参数以允许或不允许水泥交叉指向松质骨。 本发明的方法包括脉动骨粘固剂的流动，其中流动脉冲的高加速度可以施加穿过水泥羽流表面的膨胀力，以减少椎骨骨折。

公开(公告)号：US07682378B2

公开(公告)日：2010-03-23

申请号：US11271498

申请日：2005-11-10

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B17/88

CPC分类号： A61B17/32002 ,  A61B17/1615 ,  A61B17/1617 ,  A61B17/1631 ,  A61B17/1642 ,  A61B17/1668 ,  A61B17/1671 ,  A61B17/320725 ,  A61B2017/00261 ,  A61B2017/00557 ,  A61B2017/320004 ,  A61B2217/005 ,  A61B2217/007 ,  A61M1/0082

摘要： The invention provides instruments and methods for prophylactic treatment of an osteoporotic vertebral body or for treating a vertebral compression fracture (VCF). In one exemplary method, a probe system uses a high speed rotational elastomeric cutter having an optional expandable abrasive surface for abrading or cutting at least one path or region within vertebral cancellous bone. Irrigation and aspiration sources are included in the probe system for removing abraded bone debris. In one embodiment, the high speed rotational abrader uses a tissue-selective abrading surface that abrades or cuts bone but does not cut soft tissue. In another embodiment, an expandable abrading surface allows the treatment of bone with low pressures to create paths or spaces without explosive expansion forces known in prior art balloon procedures that are designed to crush and compact cancellous bone in a vertebra. After the creation of a path or space, an in-situ hardenable bone cement volume is introduced into each path or space to support the vertebra.

摘要翻译： 本发明提供了用于预防性治疗骨质疏松性椎体或用于治疗椎体压缩性骨折（VCF）的仪器和方法。 在一个示例性方法中，探针系统使用具有可选的可扩展研磨表面的高速旋转弹性体切割器，用于研磨或切割椎骨松质骨内的至少一个路径或区域。 用于清除磨损的骨碎片的探针系统中包含灌溉和吸入源。 在一个实施例中，高速旋转磨擦机使用磨损或切割骨骼而不切割软组织的组织选择性研磨表面。 在另一个实施方案中，可膨胀的研磨表面允许以低压处理骨骼以产生路径或空间，而不会在现有技术的球囊过程中已知的爆炸膨胀力被设计成压缩和压紧椎骨中的松质骨。 在创建路径或空间之后，将原位可硬化的骨水泥体积引入到每个路径或空间中以支撑椎骨。

公开(公告)号：US20090281535A1

公开(公告)日：2009-11-12

申请号：US12406914

申请日：2009-03-18

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/00404 ,  A61B2018/0063 ,  A61B2018/00702 ,  A61B2018/00809 ,  A61B2090/064

摘要： An electrosurgical instrument and method for treating varicose veins. In one embodiment, an elongate catheter has a distal working end that carries an electrosurgical energy delivery surface comprising at least one electrode with a positive temperature coefficient of resistance (PTCR) surface and/or an electrode with a pressure sensitive variable resistance to provide a smart surface for controlling Rf current flow at the interface of electrosurgical surface and the tissue. The electrode surface then can limit or modulate Rf energy delivery through the surface in response to the temperature of the surface or the engagement pressure of the surface against the engaged tissue. In operation, the smart electrosurgical surface prevents arcing at the electrode-tissue interface, and thus controls ohmic heating to prevent tissue desiccation, charring and emboli formation.

摘要翻译： 一种用于治疗静脉曲张的电外科器械和方法。 在一个实施例中，细长导管具有远端工作端，其承载电外科能量输送表面，其包括具有正温度系数电阻（PTCR）表面的至少一个电极和/或具有压敏可变电阻的电极，以提供智能 用于控制电外科表面和组织界面处的Rf电流的表面。 电极表面然后可以响应于表面的温度或表面对接合的组织的接合压力而限制或调节通过表面的Rf能量传递。 在操作中，智能电外科表面防止电极 - 组织界面处的电弧，从而控制欧姆加热以防止组织干燥，炭化和栓塞形成。

公开(公告)号：US20090012525A1

公开(公告)日：2009-01-08

申请号：US11469783

申请日：2006-09-01

申请人： Eric Buehlmann ,  Csaba Truckai ,  John H. Shadduck

发明人： Eric Buehlmann ,  Csaba Truckai ,  John H. Shadduck

IPC分类号： A61F2/00 ,  A61M31/00

CPC分类号： A61B17/8836 ,  A61B17/8811 ,  A61B17/8822 ,  A61B2017/00022 ,  A61B2017/00084 ,  A61B2090/064 ,  A61F2/44 ,  A61F2/4601

摘要： The present invention relates in certain embodiments to medical devices, systems and methods for use in osteoplasty procedures, such as vertebral compression fractures. One device for delivering a bone fill material to a bone, such as a vertebra, includes an elongated introducer having a working end at a distal end of the introducer, the working end positionable within the bone and having at least one outlet opening configured to allow a bone fill material flow therethrough. An insulative coating is disposed on an external surface of the introducer, the coating being lubricious and configured to inhibit scratching of said external surface. One system for delivering a bone fill material to a bone includes such a device, a thermal energy emitter operably coupled to the introducer to apply energy to the bone fill material flowing through a channel of the introducer, and a controller in communication with the thermal energy emitter to control the operation of the thermal energy emitter.

摘要翻译： 本发明在某些实施例中涉及用于骨成形术程序的医疗装置，系统和方法，例如椎体压缩性骨折。 用于将骨填充材料递送到骨骼（例如椎骨）的一种装置包括细长导引器，其具有在导引器的远端处的工作端，所述工作端可定位在骨内，并且具有至少一个出口开口，其配置为允许 骨填充物流过其中。 绝缘涂层设置在导引器的外表面上，涂层是光滑的并且被配置成抑制所述外表面的划伤。 用于将骨填充材料递送到骨头的一个系统包括这样的装置，热能发射器，其可操作地联接到导引器以将能量施加到流过导引器的通道的骨填充材料，以及与热能连通的控制器 发射器来控制热能发射器的运行。

公开(公告)号：US20080208260A1

公开(公告)日：2008-08-28

申请号：US12036179

申请日：2008-02-22

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B17/58 ,  A61F2/44

CPC分类号： A61B17/7059 ,  A61B17/1642 ,  A61B17/7098 ,  A61B17/8085 ,  A61B2017/00557 ,  A61B2017/00867

摘要： A modular implant system and method is provided for the dynamic stabilization of a spine segment and that can be implanted in a posterior approach. The implant system can include first and second support bodies configured for fixation to outward or lateral surfaces of first and second vertebrae, respectively. The implant system can also comprise a resilient portion. The method can comprise fixating first and second support bodies to first and second vertebrae respectively.

摘要翻译： 提供了模块化植入系统和方法，用于脊柱段的动态稳定并且可以在后路进行植入。 植入系统可以包括被配置用于分别固定到第一和第二椎骨的外表面或第二椎骨的第一和第二支撑体。 植入系统还可以包括弹性部分。 该方法可以包括分别将第一和第二支撑体固定到第一和第二椎骨。

公开(公告)号：US07381209B2

公开(公告)日：2008-06-03

申请号：US11673889

申请日：2007-02-12

申请人： Csaba Truckai ,  John H. Shadduck ,  Bruno Strul

发明人： Csaba Truckai ,  John H. Shadduck ,  Bruno Strul

IPC分类号： A61B18/12 ,  A61B18/18

CPC分类号： A61B18/1445 ,  A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00125 ,  A61B2018/00148 ,  A61B2018/0016 ,  A61B2018/00404 ,  A61B2018/00601 ,  A61B2018/0063 ,  A61B2018/1412 ,  A61B2018/1455

摘要： An embodiment of the invention includes an electrosurgical jaw structure that carries cooperating PTC bodies in both series and parallel circuit components for controlled RF energy application to engaged tissue to effectively weld tissue.

摘要翻译： 本发明的实施例包括电外科钳口结构，其在串联和并联电路部件中携带协作的PTC体，用于受控RF能量施加到接合组织以有效地焊接组织。

公开(公告)号：US07220951B2

公开(公告)日：2007-05-22

申请号：US11110363

申请日：2005-04-19

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A05B6/62 ,  A61F2/00

CPC分类号： A61B18/14 ,  A61B18/1442 ,  A61B2018/0063

摘要： Various embodiments provide compositions that exhibit positive temperature coefficient of resistance (PTCR) properties for use in thermal interactions with tissue—including thermal sensing and I2R current-limiting interactions. Embodiments also provide tissue-engaging surfaces having PTCR materials that provide very fast switching times between low resistance and high, current-limiting resistance. One embodiment provides a matrix for an electrosurgical energy delivery surface comprising a PTCR material and a heat exchange material disposed within an interior of the matrix. The PTCR material has a substantially conductive state and a substantially non-conductive state. The heat exchange material has a structure configured to have an omni-directional thermal diffusivity for exchanging heat with the PTCR material to cause rapid switching of the PTCR material between the conductive state and non-conductive state. Preferably, the structure comprises a graphite foam having an open cell configuration. The matrix can be carried by tissue contacting surfaces of various electrosurgical devices.

摘要翻译： 各种实施方案提供了组合物，其表现出与包含组织的热感测和I 2 R限流相互作用的热相互作用中的正温度系数（PTCR）性质。 实施例还提供具有PTCR材料的组织接合表面，其在低电阻和高电流限制电阻之间提供非常快的开关时间。 一个实施例提供了一种用于电外科能量输送表面的基质，其包含PTCR材料和设置在基质内部的热交换材料。 PTCR材料具有基本上导电的状态和基本上不导电的状态。 热交换材料具有被配置为具有用于与PTCR材料进行热交换的全向热扩散性以使PTCR材料在导电状态和非导电状态之间快速切换的结构。 优选地，该结构包括具有开孔构造的石墨泡沫。 基质可以由各种电外科装置的组织接触表面携带。

公开(公告)号：US07169146B2

公开(公告)日：2007-01-30

申请号：US10781925

申请日：2004-02-17

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/18

CPC分类号： A61B18/1442 ,  A61B2018/00005 ,  A61B2018/00017 ,  A61B2018/00619 ,  A61B2018/0063 ,  A61B2018/00797

摘要： An electrosurgical instrument that allows precise modulation of active Rf density in an engaged tissue volume. The working end of the instrument has a tissue-contacting surface of a conductive-resistive matrix that is variably resistive depending on its temperature. The matrix comprises a positive temperature coefficient (PTC) polymeric material hat exhibits very large increases in resistivity as any local portion increases beyond a selected temperature. In a method of use, the polymeric PTC material senses the temperature of engaged tissue in a manner akin to pixel-by-pixel sensing and thereby changes its resistance in a corresponding pixel-by-pixel manner. The instrument further carries cooling means to cause accelerated thermal relaxation of the PTC matrix during use to make the engagement surface highly responsive to temperature changes that in turn alter the matrix between being electrically conductive and electrically resistive.

摘要翻译： 一种电外科手术器械，允许精确调节接合组织体积中的活性Rf密度。 仪器的工作端具有导电电阻矩阵的组织接触表面，其可根据其温度而具有可变阻性。 该基质包括正温度系数（PTC）聚合物材料，当任何局部部分增加超出所选择的温度时，电极表现出非常大的增加。 在使用的方法中，聚合物PTC材料以类似于逐像素感测的方式感测接合组织的温度，从而以对应的逐像素方式改变其电阻。 仪器还带有冷却装置，以在使用期间引起PTC矩阵的加速热松弛，以使接合表面对温度变化高度响应，从而改变矩阵在导电和电阻之间。

公开(公告)号：US07087054B2

公开(公告)日：2006-08-08

申请号：US10676841

申请日：2003-09-30

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/12

CPC分类号： A61B18/1445 ,  A61B2018/00345 ,  A61B2018/00404 ,  A61B2018/00619

摘要： An electrosurgical medical device and method for creating thermal welds in engaged tissue. In one embodiment, at least one jaw of the instrument defines a tissue engagement plane that carries a recessed central portion. In another embodiment, the controller coupled to the Rf source is adapted to switch from a power control operational mode to a voltage controlled operational mode at a selected transition impedance level.

摘要翻译： 一种用于在接合组织中产生热焊缝的电外科医疗装置和方法。 在一个实施例中，器械的至少一个钳口限定了携带凹入的中心部分的组织接合平面。 在另一个实施例中，耦合到Rf源的控制器适于在选定的转变阻抗级别上从功率控制操作模式切换到电压控制的操作模式。

公开(公告)号：US07011657B2

公开(公告)日：2006-03-14

申请号：US10340144

申请日：2003-01-10

申请人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

发明人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

IPC分类号： A61B18/12

CPC分类号： A61B18/1445 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/0063 ,  A61B2018/1455

摘要： An electrosurgical medical device and technique for creating thermal welds in engaged tissue that provides very high compressive forces. In one exemplary embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying first and second surface portions that comprise (i) an electrically conductive material and (ii) a positive temperature coefficient (PTC) material having a selected increased resistance that differs at each selected increased temperature over a targeted treatment range. One type of PTC material is a doped ceramic that can be engineered to exhibit a selected positively sloped temperature-resistance curve over about 37° C. to 100° C. The 70° C. to 100° C. range can bracket a targeted “thermal treatment range” at which tissue welded can be accomplished. The engineered resistance of the PTC matrix at the upper end of the temperature range will terminate current flow through the matrix. In one mode of operation, the engagement plane cause ohmic heating within tissue from Rf energy delivery tissue PTC matrix is heated to exceed the treatment range. Thereafter, energy density in the engaged tissue will be modulated as the conductivity of the second portion hovers within the targeted treatment range to thereby provide optical tissue heating for purposes of tissue welding.