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：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。

公开(公告)号：US08696679B2

公开(公告)日：2014-04-15

申请号：US11953800

申请日：2007-12-10

申请人： John H. Shadduck ,  Csaba Truckai

发明人： John H. Shadduck ,  Csaba Truckai

IPC分类号： A61F2/00

CPC分类号： A61B17/8836 ,  A61B17/7095 ,  A61B17/8822 ,  A61B2017/00039 ,  A61B2017/00544

摘要： The present invention relates in certain embodiments to methods, systems, and devices for treating vertebral compression fractures. In one embodiment, a bone cement injector is advanced into bone and injects a bone cement flow through the injector and a vapor flow from at least one vapor outlet in the injector. In another embodiment, the bone treatment system comprises an elongated member having a flow passageway, a bone fill material source, and a vapor source coupleable to the flow passageway. Still another embodiment describes a vapor injection device having an elongated member with a flow passageway, the elongated member configured for insertion into a bone and for delivering a bone fill material through the flow passageway, and having at least one vapor channel in communication with the flow passageway to deliver a vapor into the flow passageway to heat a bone fill material flow.

摘要翻译： 本发明在某些实施例中涉及用于治疗椎骨压缩性骨折的方法，系统和装置。 在一个实施例中，骨粘固剂注射器被推进到骨中并且注入穿过注射器的骨水泥流和来自注射器中的至少一个蒸气出口的蒸汽流。 在另一个实施例中，骨治疗系统包括具有流动通道，骨填充材料源和可耦合到流动通道的蒸气源的细长构件。 另一个实施例描述了具有带有流动通道的细长构件的蒸气喷射装置，细长构件构造成用于插入骨骼中并且用于通过流动通道输送骨填充材料，并且具有与流体连通的至少一个蒸汽通道 通道以将蒸气输送到流动通道中以加热骨填充物料流。

公开(公告)号：US08523871B2

公开(公告)日：2013-09-03

申请号：US12062337

申请日：2008-04-03

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

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

IPC分类号： A61B17/58 ,  A61B17/60 ,  A61F2/00

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：US08348955B2

公开(公告)日：2013-01-08

申请号：US12786362

申请日：2010-05-24

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61F2/44

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。 一个示例性系统利用Rf能量组合导电骨水泥，用于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：US08048083B2

公开(公告)日：2011-11-01

申请号：US11267950

申请日：2005-11-04

申请人： John H. Shadduck ,  Csaba Truckai

发明人： John H. Shadduck ,  Csaba Truckai

IPC分类号： A61B17/56 ,  A61F2/44

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。

公开(公告)号：US07981113B2

公开(公告)日：2011-07-19

申请号：US12098560

申请日：2008-04-07

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：US07955331B2

公开(公告)日：2011-06-07

申请号：US11080101

申请日：2005-03-14

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/14

CPC分类号： A61B18/1442

摘要： A particular embodiment of the invention provides an electrosurgical working end for performing high strength welding of tissue comprising a body having a tissue contacting energy delivery surface. The body includes pixel portions and non-pixel portions distributed within the tissue contacting surface. The pixel portions comprise a positive temperature coefficient of resistance (PTCR) material with at least one pixel portion configured to switch Rf current on and off in the at least one pixel portion responsive to tissue temperature adjacent the at least one pixel portion. The pixel portions can be configured to be coupled to an Rf current source such as an Rf generator. The pixelated energy delivery surfaces are capable of highly localized modulation of Rf energy application to the engaged tissue to create high strength tissue welds.

摘要翻译： 本发明的一个具体实施方案提供了一种电外科工作端，用于对组织进行高强度焊接，包括具有组织接触能量输送表面的主体。 主体包括分布在组织接触表面内的像素部分和非像素部分。 像素部分包括正温度系数电阻（PTCR）材料，其中至少一个像素部分被配置成响应于与至少一个像素部分相邻的组织温度在至少一个像素部分中开启和关闭Rf电流。 像素部分可以被配置为耦合到诸如Rf发生器的Rf电流源。 像素化的能量传递表面能够对接合的组织进行Rf能量的高度局部调节，以产生高强度组织焊接。

公开(公告)号：US20100280520A1

公开(公告)日：2010-11-04

申请号：US12786362

申请日：2010-05-24

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B17/56

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。 一个示例性系统利用Rf能量组合导电骨水泥，用于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：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。