Abstract: A filler instrument comprises a first chamber section having a first cross sectional area and a second chamber section having a second cross sectional area less than the first cross sectional area. The second chamber section communicates with the first chamber section. The first chamber section includes an inlet for receiving a material into the filler instrument, and the second chamber section includes an outlet for discharging the material from the filler instrument. A first plunger is sized to pass through the first chamber section and not the second chamber section. A second plunger is sized to pass through an interior bore of the first plunger and into the second chamber section. In use, the first plunger displaces material residing in the first chamber section through the second chamber section toward the outlet, and the second plunger displaces material residing in the second chamber section through the outlet.

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 first instrument having a distal end is sized and configured to penetrate tissue and a proximal end comprising a first handle assembly. A second instrument including an interior lumen is sized and configured to accept passage of the first instrument. The second instrument has a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly to form a composite instrument sized and configured to provide percutaneous access to a cancellous bone region. The second handle assembly is also sized and configured to permit controllably release by a user of the first handle assembly from the second handle assembly to allow removal of the first instrument from the interior lumen. At least one additional instrument is sized and configured for passage through the interior lumen of the second instrument upon removal of the first instrument.

Abstract: A device for treating vertebral bone including a releasably closed, removable filling member which can be placed within a plane separating superior and inferior portions of a vertebral body and oriented to promote its stabilization and realignment upon expansion of the filling member along the plane via injection of filler material, while minimally compacting bone or creating unsupported voids within the interior of the vertebral body.

Abstract: Systems and methods provide for the fixation of osteoporotic and non-osteoporotic long bones, especially Colles' fractures. A cannula having a circumferential opening is inserted into cancellous bone and directed such that the circumferential opening faces the fracture. The cannula is further adapted to receive an expandable structure, the expandable structure being inserted through the cannula until it is in registration with the circumferential opening. The expandable structure is expanded through the circumferential opening into cancellous bone and toward the fracture. The expansion of the expandable structure through the circumferential opening toward the fracture causes compression of cancellous bone and moves fractured cortical bone, thus creating a cavity proximal to the fracture. The cavity is then filled with a flowable bone filling material and the material allowed to harden.

Abstract: A cannula is positioned to establish a subcutaneous access path into a cancellous bone. A bone filling material is conveyed into the cancellous bone with a tamping instrument configured to be manipulated independent of the cannula. The bone filling material is compacted with the tamping instrument.

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.

Abstract: A cavity forming structure is introduced through a percutaneous access path into a selected bone having an interior volume occupied, at least in part, by cancellous bone, e.g., a vertebral body. A cavity is formed in the cancellous bone volume by manipulation of the cavity forming structure. Tissue is removed from within the cavity through the percutaneous access path.

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 balloon structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable balloon structure is expanded and the tool withdrawn, leaving the expandable balloon structure expanded inside the cancellous bone. Expansion of the expandable balloon 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: A flow path is established into cancellous bone within a vertebral body through a percutaneous path. A bone filling material is conveyed into the flow path in a volume and at a pressure that results in an enlargement of the flow path volume. The enlargement can create a cavity and/or move a fractured cortical plate of the vertebral body toward a desired anatomic position. The bone filling material can comprise, e.g., a bone cement.

Abstract: A percutaneous path is established into a selected bone, e.g., a vertebral body, having an interior volume occupied, at least in part, by cancellous bone. A first bone filling material is conveyed through the percutaneous path into a region of the cancellous bone. A second bone filling material is conveyed through the percutaneous path into the region. The second bone filling material is different than the first bone filling material.

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 mesh structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable mesh structure is expanded and the tool withdrawn, leaving the expandable mesh structure expanded inside the cancellous bone. Expansion of the expandable mesh 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: 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 stent structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable stent structure is expanded and the tool withdrawn, leaving the expandable stent structure expanded inside the cancellous bone. Expansion of the expandable stent 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: A percutaneous path is established into a vertebral body, having an interior volume occupied, at least in part, by cancellous bone. A first bone filling material is conveyed through the percutaneous path into a region of the cancellous bone. A second bone filling material is conveyed through the percutaneous path into the region. The first and second bone filling materials can, e.g., incrementally create then enlarge a compressed region of cancellous bone, or displace the fractured cortical bone in increments.

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 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: 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: 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: Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. The cephalad prostheses are adapted and configured to be attached to a lamina portion of a vertebra without blocking a pedicle portion of the cephalad vertebra. In some embodiments, the prosthesis is attached with a non-invasive support member, such as a clamp. In other embodiments, a translaminar screw may be used for additional fixation.

Abstract: A method provides a void creation device including an expandable structure adapted to undergo expansion in the cancellous bone volume of a bone selected for treatment. The expandable structure has at least one dimension so that the expandable structure will assume a predetermined shape and size when substantially expanded that compacts only a first volume of the cancellous bone volume to form a void, leaving a second volume of the cancellous bone volume substantially uncompacted by the expandable structure. A filling material is placed within the void through the percutaneous access path.