Abstract: This invention relates to devices, such as cannulas or needles, which are used for inserting expandable structures, such as medical balloons, into interior regions of a human or animal body, as well as methods for their use. In various embodiments, insertion devices described herein are capable of flaring at their tip to ease insertion and removal of expandable structures and reduce the risk of damaging such expandable structures during their insertion, inflation and removal. In other embodiments, insertion devices described herein are capable of directionally guiding and/or inhibiting expansion of an expandable structure within an interior region of an animal or human body to create optimally placed cavities for repair, augmentation and/or treatment of fractured and/or diseased bone.

Abstract: Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. A pair of fixation elements are adapted to be secured within a vertebra in an orientation that best assures a secure and durable attachment to cortical and/or cancellous bone. Artificial facet joint surfaces are mounted on the fixation elements, either directly or with the aid of a support. The artificial facet joint structure may be carried by an arm. The artificial facet joint structure is adapted for articulation with a complementary natural or artificial facet joint structure. Bilateral prostheses may by coupled by a brace to further secure and stabilize the prostheses. Artificial facet joints can be used in combination with artificial intervertebral discs to treat a spinal pathology.

Abstract: A medical implant device includes a shaft, an expandable member coupled to the distal end portion of the shaft, a sleeve and a detachment mechanism. The expandable member is configured to move between a collapsed configuration and an expanded configuration, and can be used to deliver a medicament, a therapeutic substance and/or a structural member into the body. The sleeve is coupled to the distal end portion of the shaft, and is configured to move relative to the shaft between a first position and a second position. The sleeve is configured to be disposed about the expandable member when in the first position and disposed apart from the expandable member when in the second position. The detachment mechanism is coupled to the distal end portion of the shaft, and is configured to detach the expandable member from the shaft when the sleeve is in the second position.

Abstract: An extractable device is used to insert a medicinal filling into a spinal disc. The device comprises a filling member and a flowable medicine. The filling member is made of a flexible and permeable wall and is provided with a holding portion and an injection port via which the flowable medicine is injected into the holding portion after the filling member is inserted into the spinal disc. The holding portion is provided with an opening which is releasably lashed by one end of one or more threads so as to make the opening leakproof. Upon completion of solidification of the flowable medicine in the holding portion of the filling member, other end of the thread is pulled to unlash the opening of the holding portion, thereby enabling the filling member to be extracted from the spinal disc so as to leave only the medicine in the spinal disc.

Abstract: A cavity creating device having a cavity creating axis is introduced through a percutaneous access path into a cancellous bone volume, e.g., within a vertebral body. The cavity creating device is manipulated to form a cavity in the cancellous bone volume. The manipulation includes deflecting the cavity creating device along the cavity creating axis relative to the axis of the access path. A material, such as bone cement, can be conveyed into the cavity.

Abstract: Systems and methods treat at least two vertebral bodies in a spinal column. The systems and methods make use of first and second tool assemblies operable to treat an interior region of, respectively, a first vertebral body and a second vertebral body in the spinal column. The systems and methods provide directions for operating the first and second tool assemblies to treat the first and second vertebral bodies, at least for a portion of time, concurrently.

Abstract: An extractable device is used to insert a medicinal filling into a spinal disc. The device comprises a filling member and a flowable medicine. The filling member is made of a flexible and permeable wall and is provided with a holding portion and an injection port via which the flowable medicine is injected into the holding portion after the filling member is inserted into the spinal disc. The holding portion is provided with an opening which is releasably lashed by one end of one or more threads so as to make the opening leakproof. Upon completion of solidification of the flowable medicine in the holding portion of the filling member, other end of the thread is pulled to unlash the opening of the holding portion, thereby enabling the filling member to be extracted from the spinal disc so as to leave only the medicine in the spinal disc.

Abstract: A cavity creation device is introduced into a cancellous bone volume of a vertebral body through a percutaneous access path. The cavity creating device is manipulated to form a cavity in the cancellous bone volume. A volume of filling material is placed in the cavity by introducing a tube through the percutaneous access path and by conveying the filling material through a side dispensing port of the tube.

Abstract: A percutaneous path is created into a bone having an interior volume occupied, at least in part, by a cancellous bone, e.g., a vertebral body. An expandable structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable structure is expanded and the tool withdrawn, leaving the expandable structure expanded inside the cancellous bone. Expansion of the expandable structure within cancellous bone can, e.g., compact cancellous bone, and/or create a cavity in cancellous bone, and/or move fractured cortical bone.

Abstract: An elongated shaft is sized and configured to establish an access path to bone having an interior volume occupied, at least in part, by cancellous bone. The elongated shaft includes a generally closed distal end portion and a side opening spaced from the closed distal end. A first tool is sized and configured to be selectively inserted into the shaft and selectively removed from the shaft. The tool includes a region that, when the first tool is inserted into the shaft, is capable of being aligned with and advanced through the side opening to project outside the side opening and contact cancellous bone. A second tool is sized and configured, upon removal of the first tool from the shaft, to introduce into the shaft a bone filling material for discharge through the side opening into the cancellous bone contacted by the first tool.

Abstract: A system for treating a vertebral body comprises a cannula leading into a vertebral body and a cavity creating device. The cavity creating device comprises a shaft having a distal end portion sized to extend through the cannula, an expandable body that undergoes expansion between a collapsed condition and an expanded condition to form a cavity in the vertebral body, and a tubular fluid transport member to convey fluid through the distal region of the expandable body and into the cavity. The system further comprises a device coupled to the shaft to change the expandable body between the collapsed condition to the expanded condition. The system further comprises a source of fluid coupled to the tubular fluid transport member to convey fluid through the distal region of the expandable body and into the cavity. The system further includes a device to convey a filling material into the cavity.

Abstract: An elongated shaft is sized and configured to establish an access path to bone having an interior volume occupied, at least in part, by cancellous bone. The elongated shaft includes a generally closed distal end portion and a side opening spaced from the closed distal end. A first tool is sized and configured to be selectively inserted into the shaft and selectively removed from the shaft. The tool includes a region that, when the first tool is inserted into the shaft, is capable of being aligned with and advanced through the side opening to project outside the side opening and contact cancellous bone. A second tool is sized and configured, upon removal of the first tool from the shaft, to introduce into the shaft a bone filling material for discharge through the side opening into the cancellous bone contacted by the first tool.

Abstract: A device is introduced into the vertebral body through a percutaneous access path. The device is manipulated to modify the cancellous bone volume for introduction of bone filling material. Bone filling material is introduced into the cancellous bone volume modified by the device along the percutaneous path. Discharge of the bone filling material is directed into the cancellous bone volume through an opening that is oriented at an angle relative to the axis of the access path.

Abstract: A method for delivering material into bone deploys a cannula through soft tissue to establish a subcutaneous path into bone. The method deploys a cavity forming instrument through the cannula to form a cavity in cancellous bone. The method introduces a material into the cavity through the cannula, which includes the advancement of a tamping instrument through the cannula to urge material into the cavity.

Abstract: An expandable structure carried at the end of a catheter tube assembly can be contracted and/or wrapped to present a reduced profile during deployment and/or removal from a targeted tissue site.

Abstract: An extractable device is used to insert a medicinal filling into a spinal disc. The device comprises a filling member and a flowable medicine. The filling member is made of a flexible and permeable wall and is provided with a holding portion and an injection port via which the flowable medicine is injected into the holding portion after the filling member is inserted into the spinal disc. The holding portion is provided with an opening which is releasably lashed by one end of one or more threads so as to make the opening leakproof. Upon completion of solidification of the flowable medicine in the holding portion of the filling member, other end of the thread is pulled to unlash the opening of the holding portion, thereby enabling the filling member to be extracted from the spinal disc so as to leave only the medicine in the spinal disc.

Abstract: A cavity creating device having a cavity creating axis is introduced through a percutaneous access path into a cancellous bone volume, e.g., within a vertebral body. The cavity creating device is manipulated to form a cavity in the cancellous bone volume. The manipulation includes deflecting the cavity creating device along the cavity creating axis relative to the axis of the access path. A material, such as bone cement, can be conveyed into the cavity.

Abstract: This invention relates to devices for inserting expandable structures, such as medical balloons, into interior regions of a human or animal body, as well as methods for their use. The insertion devices described herein are capable of directionally guiding and/or inhibiting expansion of an expandable structure within an interior region of an animal or human body to create optimally placed cavities for repair, augmentation and/or treatment of fractured and/or diseased bone.

Abstract: A method for delivering material into bone deploys a cannula through soft tissue to establish a subcutaneous path into bone. The method deploys a cavity forming instrument through the cannula to form a cavity in cancellous bone. The method introduces a material into the cavity through the cannula, which includes the advancement of a tamping instrument through the cannula to urge material into the cavity.

Abstract: Cancellous bone is accessed through a subcutaneous access path in soft tissue. A cavity is formed in cancellous bone by a cavity forming tool that is advanced through the subcutaneous access path into cancellous bone and manipulated to form the cavity. A measured volume of bone filling material is delivered into the cavity through the subcutaneous access path by a nozzle having an interior bore defining an interior volume sized for containing bone filling material, which is advanced through the subcutaneous access path. A nested instrument is formed while clearing residual bone filling material from the interior bore by an auxiliary tool that can be manipulated independently of the nozzle, which is advanced through the interior bore of the nozzle.