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:
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:
The present invention relates in certain embodiments to medical devices for treating osteoplasty procedures such as vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the geometry of fill material introduced into cancellous bone. A method of treating bone includes injecting a volume of fill material into a bone and selectively modifying a viscosity of the bone filler to control the direction of flow of the fill material within the bone. A system for treating bone using this method includes an introducer for delivering fill material into the bone and an energy source selectively coupleable to the fill material to alter the viscosity of the fill material via an energy emitter in the introducer.
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:
Systems and methods for delivering bone cement into a bone can include a handle body defining a flow path, a thermal emitter in the handle body to apply energy to bone cement passing through the flow path, a source of bone cement and an injection cannula. The cannula can be in communication with the flow path such that inserting the cannula into a bone can allow a flow of bone cement therethrough to an opening at a distal end of the cannula. Other systems and methods for delivering bone cement into a bone can include an injector body with a handle portion, and a cannula, a bone cement container, a low pressure drive mechanism configured to effect a flow of bone cement from said container to the injector body and a high pressure drive mechanism configured to effect a flow of bone cement through the injector body into the bone.
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:
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:
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:
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:
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.