公开(公告)号：US07559932B2

公开(公告)日：2009-07-14

申请号：US11165652

申请日：2005-06-24

申请人： Csaba Truckai ,  John H. Shadduck ,  Robert Luzzi ,  Grace A. Carlson ,  C. Travis Rappleye

发明人： Csaba Truckai ,  John H. Shadduck ,  Robert Luzzi ,  Grace A. Carlson ,  C. Travis Rappleye

IPC分类号： A61B17/00

CPC分类号： A61B17/8836 ,  A61B17/864 ,  A61B2017/00022 ,  A61B2017/00026 ,  A61B2017/00084 ,  A61F2/44

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. An exemplary system utilizes Rf energy in combination a conductive bone fill material for polymerizing the surface of the inflow plume to control the geometry of the fill material and the application of force caused by inflows of fill material. In another embodiment, method of treating bone includes injecting a volume of fill material into a bone and selectively modifying a viscosity of a selected portion 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 as it flows out of the introducer.

摘要翻译： 本发明在某些实施例中涉及用于治疗诸如椎体压缩性骨折的骨整形术程序的医疗装置。 更具体地，本发明的实施例涉及通过控制引入松质骨的填充材料的几何形状来可控地恢复椎体高度的仪器和方法。 示例性系统利用Rf能量组合导电骨填充材料，用于聚合流入羽流的表面以控制填充材料的几何形状以及由填充材料的流入引起的力的施加。 在另一个实施方案中，治疗骨的方法包括将一定体积的填充材料注入骨中，并选择性地改变骨填充物的选定部分的粘度以控制填充材料在骨内的流动方向。 使用这种方法治疗骨骼的系统包括用于将填充材料输送到骨骼中的导引器，以及选择性地与填充材料耦合的能量源，以改变填充材料流出导引器时的粘度。

公开(公告)号：US20080255571A1

公开(公告)日：2008-10-16

申请号：US12062384

申请日：2008-04-03

申请人： Csaba Truckai ,  Robert Luzzi ,  John H. Shadduck

发明人： Csaba Truckai ,  Robert Luzzi ,  John H. Shadduck

IPC分类号： A61B17/58 ,  A61B18/04

CPC分类号： A61B17/8836 ,  A61B17/8822 ,  A61B2017/00022

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.

公开(公告)号：US20080188858A1

公开(公告)日：2008-08-07

申请号：US12024969

申请日：2008-02-01

申请人： Robert Luzzi ,  John H. Shadduck ,  Csaba Truckai

发明人： Robert Luzzi ,  John H. Shadduck ,  Csaba Truckai

IPC分类号： A61B17/58

CPC分类号： A61L24/0084 ,  A61B17/8822 ,  A61B17/8836 ,  A61B2017/00026 ,  A61B2017/00088 ,  A61B2017/00101 ,  A61L24/02 ,  A61L24/06 ,  A61L27/16 ,  A61L27/46 ,  A61L27/50 ,  A61L2430/02 ,  C08L33/12

摘要： Bone cement formulations are provided that have an extended working time for use in vertebroplasty procedures and other osteoplasty procedures. In one embodiment, a settable bone cement includes a polymerizable composition with a powder component comprising an X-Ray contrast medium and a liquid component, wherein the setting time of the cement is at least about 25 minutes, at least about 30 minutes, at least about 35 minutes, and at least about 40 minutes.

摘要翻译： 提供骨水泥配方，其具有用于椎体成形术和其它成骨术程序的延长的工作时间。 在一个实施方案中，可固化骨粘固剂包括具有包含X射线造影剂和液体组分的粉末组分的可聚合组合物，其中所述胶泥的凝固时间至少为约25分钟，至少约30分钟，至少 约35分钟，至少约40分钟。

公开(公告)号：US20070191858A1

公开(公告)日：2007-08-16

申请号：US11469752

申请日：2006-09-01

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61F2/00

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 system for delivering a bone fill material to a bone includes an elongated introducer configured for insertion into a bone and having a channel sized to allow a flow of bone fill material therethrough. The introducer has at least one outlet opening in communication with the channel for delivering the bone fill material into the bone. A thermal energy emitter is coupled to the introducer and configured to apply thermal energy to the bone fill material flowing through the introducer. A hydraulic pressure source is operatively coupled to the introducer and configured to apply a force on the bone fill material to provide a pressurized flow of bone fill material through the introducer.

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的一种系统包括细长导引器，其构造成用于插入骨骼并且具有通道，其尺寸允许骨填充材料流过其中。 引导器具有与通道连通的至少一个出口开口，用于将骨填充材料输送到骨中。 热能发射器耦合到导引器并且构造成将热能施加到流过导引器的骨填充材料。 液压源可操作地联接到导引器并且构造成在骨填充材料上施加力以通过导引器提供加压的骨填充材料流。

公开(公告)号：US07189233B2

公开(公告)日：2007-03-13

申请号：US10934755

申请日：2004-09-03

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

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：US07112201B2

公开(公告)日：2006-09-26

申请号：US10351449

申请日：2003-01-22

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

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

IPC分类号： A61B18/12

CPC分类号： A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00125 ,  A61B2018/00148 ,  A61B2018/0063

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 carrying a conductive-resistive matrix of a conductively-doped non-conductive elastomer. The engagement surface portions thus can be described as a positive temperature coefficient material that has a unique selected decreased electrical conductance at each selected increased temperature thereof over a targeted treatment range. The conductive-resistive matrix can be engineered to bracket a targeted thermal treatment range, for example about 60° C. to 80° C., at which tissue welding can be accomplished. In one mode of operation, the engagement plane will automatically modulate and spatially localize ohmic heating within the engaged tissue from Rf energy application—across micron-scale portions of the engagement surface. In another mode of operation, a conductive-resistive matrix can induce a “wave” of Rf energy density to sweep across the tissue to thereby weld tissue.

公开(公告)号：US06913579B2

公开(公告)日：2005-07-05

申请号：US10136874

申请日：2002-04-30

申请人： Csaba Truckai ,  Rodney Perkins ,  John H. Shadduck

发明人： Csaba Truckai ,  Rodney Perkins ,  John H. Shadduck

IPC分类号： A61B17/00 ,  A61B18/14 ,  A61B10/00 ,  A61B18/18

CPC分类号： A61B18/1442 ,  A61B18/1815 ,  A61B2017/00084 ,  A61B2017/2933 ,  A61B2017/2934 ,  A61B2017/2945 ,  A61B2018/00619 ,  A61B2018/00702 ,  A61B2018/00791 ,  A61B2018/1432

摘要： An electrosurgical working end and method for obtaining a tissue sample for biopsy purposes, for example, from a patient's lung or a liver. The working end provides curved jaw members that are positioned on opposing sides of the targeted anatomic structure. The working end carries a slidable extension member that is laterally flexible with inner surfaced that slide over the jaw members to clamp tissue therebetween. As the extension member advances, the jaws compress the tissue just ahead of the advancing extension member to allow the laterally-outward portion of the extension member to ramp over the tissue while a cutting element contemporaneously cuts the tissue. By this means, the transected tissue margin is captured under high compression. The working end carries a bi-polar electrode arrangement that engages the just-transected medial tissue layers as well as surface layers to provides Rf current flow for tissue welding purposes that is described as a medial-to-surface bi-polar approach.

摘要翻译： 一种电外科手术工作端和用于获得例如来自患者的肺或肝的活组织检查目的的组织样本的方法。 工作端提供弯曲的夹爪构件，其定位在目标解剖结构的相对侧上。 工作端承载可滑动的延伸构件，其具有内表面的侧向柔性，其在钳口构件上滑动以在其间夹紧组织。 当延伸构件前进时，钳口在前进的延伸构件正前方压缩组织，以允许延伸构件的横向向外部分在组织上斜坡，同时切割元件同时切割组织。 通过这种方式，在高压缩下捕获横切的组织边缘。 工作端携带双极电极装置，其接合刚刚横切的内侧组织层以及表面层，以提供用于组织焊接目的的Rf电流，其被描述为内向 - 双向极性方法。

公开(公告)号：US06890332B2

公开(公告)日：2005-05-10

申请号：US10282555

申请日：2002-10-28

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/00 ,  A61B18/18

CPC分类号： A61B17/22004 ,  A61B18/042 ,  A61B2017/22008 ,  A61B2018/1213

摘要： A medical instrument coupled to first and second energy means and a computer controller for the controlled volumetric removal of thin tissue layers. The system provides a source for introducing a gas to controllably form and capture transient gas volumes in a microchannel structure at the working surface of the instrument that interfaces with a targeted tissue site. Each of the microchannel features of the working surface carries an electrode element coupled to the electrical source. The energy may be applied to the targeted site in either of two modes of operation, depending in part on voltage and repetition rate of energy delivery. In one mode of energy application, electrical potential is selected to cause an intense electrical arc across the transient ionized gas volumes to cause an energy-tissue interaction characterized by tissue vaporization. In another preferred mode of energy delivery, the system applies selected levels of energy to the targeted site by means of an energetic plasma at the instrument working surface to cause molecular volatilization of surface macromolecules thus resulting in material removal. Both modes of operation limit collateral thermal damage to tissue volumes adjacent to the targeted site. Another preferred embodiment provides and an ultrasound source or other vibrational source coupled to the working end to cause cavitation in fluid about the working end.

摘要翻译： 耦合到第一和第二能量装置的医疗器械和用于受控体积移除薄组织层的计算机控制器。 该系统提供用于引入气体的源，以可控地形成并捕获与目标组织部位相接触的仪器工作表面处的微通道结构中的瞬态气体体积。 工作表面的每个微通道特征带有耦合到电源的电极元件。 能量可以以两种操作模式中的任一种施加到目标位置，部分取决于能量传递的电压和重复率。 在一种能量应用模式中，选择电势以在瞬态电离气体体积上引起强烈的电弧以引起以组织蒸发为特征的能量 - 组织相互作用。 在另一种优选的能量输送模式中，系统通过仪器工作表面上的能量等离子体将选择的能量施加到目标部位，从而导致表面大分子的分子挥发，从而导致材料去除。 两种操作模式都限制了与目标部位相邻的组织体积的附带热损伤。 另一个优选实施例提供了耦合到工作端的超声源或其他振动源，以在工作端周围引起流体中的空化。

公开(公告)号：US09247983B2

公开(公告)日：2016-02-02

申请号：US13676249

申请日：2012-11-14

申请人： Csaba Truckai ,  Aaron Germain ,  John H. Shadduck

发明人： Csaba Truckai ,  Aaron Germain ,  John H. Shadduck

IPC分类号： A61B18/18 ,  A61B18/08 ,  A61B18/14 ,  A61B18/00

CPC分类号： A61B18/1445 ,  A61B18/08 ,  A61B18/085 ,  A61B2018/00172 ,  A61B2018/00589 ,  A61B2018/00601 ,  A61B2018/146

摘要： A medical for removing tissue from a patient includes an elongated probe with a working end. A pair of jaws is provided at the working end. The jaws may be closed for cutting and treatment of the tissue. Cutting may be effective through a sharpened cutting blade, and RF cutting blade, and similar cutting edges. The tissue may be remodeled using heat generated from passive heating elements on the jaws, active heating elements on the jaws, a PTCR heating element carried by the jaws, or resistive heaters on the jaws.

摘要翻译： 用于从患者去除组织的医学包括具有工作端的细长探针。 工作端设有一对钳口。 钳口可以关闭以切割和处理组织。 切割可以通过锋利的切割刀片和RF切割刀片以及类似的切削刃而有效。 可以使用由钳口上的被动加热元件，钳口上的主动加热元件，由钳口承载的PTCR加热元件或钳口上的电阻加热器产生的热量来重组组织。

公开(公告)号：US08932300B2

公开(公告)日：2015-01-13

申请号：US13282653

申请日：2011-10-27

申请人： John H. Shadduck ,  Csaba Truckai

发明人： John H. Shadduck ,  Csaba Truckai

IPC分类号： A61B17/58 ,  A61B17/70

CPC分类号： A61B17/7098

摘要： Methods and instruments for treating an osteoporotic vertebral body or for treating a vertebral compression fracture. An exemplary method includes introducing an open knit structure together with a bone cement into a bone wherein the knit structure extends substantially throughout the interior of the cement volume. In one aspect of the invention, the bone cement volumes cures with the filament structure reinforcing the cement. In another aspect of the invention, the open knit structure is configured to direct flows of bone cement to apply forces for reducing a vertebral compression fracture. In another aspect of the invention, the system provides bone cement flows that extend through the knit structure thus allowing the cement to fully interdigitate with the cancellous bone.

摘要翻译： 用于治疗骨质疏松性椎体或用于治疗椎体压缩性骨折的方法和手段。 一种示例性的方法包括将开放的针织结构与骨水泥一起引入到骨中，其中针织结构基本上在水泥体积的整个内部延伸。 在本发明的一个方面，骨水泥体积固化，细丝结构增强了水泥。 在本发明的另一方面，开放针织结构被配置为引导骨粘固剂的流动以施加用于减少椎骨压缩性骨折的力。 在本发明的另一方面，该系统提供延伸穿过针织结构的骨水泥流，从而允许水泥与松质骨完全交叉指向。