Transverse Cavity Device and Method

Abstract

A surgical instrument and method is provided for creating and preparing a cavity in a bony intervertebral body. Asymmetical cutting structures selectively open a cavity which has a relatively large surface area in the vertical direction. One method pertains to the treatment of a vertebral compression fracture.

1 - 8 . (canceled)  
   
   
       9 . A tool for creating a cavity in a bone comprising: 
 an elongated body having a distal end and having a proximal end, said body having an exterior diameter defining a tool body area for the tool;    a shearing element anchored to said distal end of said body by an anchor element;    said anchor element and said distal end of said body together forming a hinge to permit and to restrict said shearing element to move substantially only in a transverse plane relative to said body;    whereby the motion of said shearing element in said transverse plane sweeps out a cutting arc, said cutting arc defining an area larger than said delivery area;    an actuator located within said body and connected to said shearing element; and    a handle attached to said actuator and having a portion extending exteriorly of the proximal end of said body for manual manipulation of said actuator;    whereby motion imparted to said actuator rod moves said shearing element through said cutting arc.    
   
   
       10 . The tool of  claim 9  wherein said shearing element is a blade.  
   
   
       11 . The tool of  claim 9  wherein said blade is blunt.  
   
   
       12 . The tool of  claim 9  wherein said blade includes a cutting surface.  
   
   
       13 . The tool of  claim 9  wherein said actuator includes a push-pull element coupled between said proximal end and said distal shearing element.  
   
   
       14 . The tool of  claim 9  wherein said actuator includes a cable pull element coupled between said proximal end and said distal shearing element.  
   
   
       15 . The tool of  claim 9  wherein said handle is indexed relative to said shearing element so as to position said shearing element within said bone to a desired orientation by the position of the handle.  
   
   
       16 . The tool of  claim 15  wherein said handle includes a finger loop.  
   
   
       17 . The tool of  claim 9  further including: an electrical solenoid to provide power to said actuator.  
   
   
       18 . The tool of  claim 17  further including: a high frequency forcing function superimposed on the solenoid drive signal generating an impacting force to said actuator.  
   
   
       19 . The tool of  claim 9  further including: a pneumatic cylinder to provide power to said actuator.  
   
   
       20 . The tool of  claim 19  further including: a high frequency forcing function superimposed on the pneumatic cylinder drive signal generating an impacting force to said actuator.  
   
   
       21 . The tool of  claim 9  further including: an electro mechanical actuator to provide power to said actuator.  
   
   
       22 . The tool of  claim 21  further including: a high frequency forcing function superimposed on the electro mechanical actuator drive signal generating an impacting force to said actuator.  
   
   
       23 . (canceled)  
   
   
       24 . The tool of  claim 9  wherein said shearing element is a flexible bow element.  
   
   
       25 . The tool of  claim 24  wherein said flexible bow element has a cross section that varies along its length.  
   
   
       26 . The tool of  claim 24  wherein said bow has a sharp exterior edge for shearing bone.  
   
   
       27 . The tool of  claim 24  wherein said bow has a set of sharp teeth members on said exterior edge for shearing bone.  
   
   
       28 . The tool of  claim 24  wherein said bow element is blunt.  
   
   
       29 . The tool of  claim 24  wherein said bow element is connected to said body at the distal end of said body and said bow element is anchored to said actuator at the distal end of said actuator; whereby relative motion of said actuator toward said distal end of said body forces said bow outwardly in said transverse cutting plane.  
   
   
       30 . The tool of  claim 24  wherein said flexible element is located within a cover, which moves to accommodate the motion through an arc.  
   
   
       31 . The tool of  claim 24  wherein said flexible bow element has a proximal end and a distal end wherein said flexible element has a constant mechanical strength from its distal end to its proximal end.  
   
   
       32 . The tool of  claim 24  wherein said flexible element has a proximal end and a distal end and wherein said flexible element varies in mechanical strength from its distal end to its proximal end.  
   
   
       33 . The tool of  claim 24  wherein said flexible element has a proximal end and a distal end and wherein said flexible element is constant in cross sectional area from its distal end to its proximal end.  
   
   
       34 . (canceled)  
   
   
       35 . (canceled)  
   
   
       36 . (canceled)  
   
   
       37 . (canceled)  
   
   
       38 . (canceled)  
   
   
       39 . The tool of  claim 9  wherein the shearing element is constructed of a superelastic material.  
   
   
       40 . The tool of  claim 9  further including a pair of said shearing elements including a first shearing element and a second shearing element each being anchored to said distal end of said body by an anchor element.  
   
   
       41 . The device of  claim 40  wherein said shearing elements are flexible bow elements.  
   
   
       42 . The device of  claim 41  wherein said bow elements have a sharp exterior edge for shearing bone.  
   
   
       43 . The device of  claim 41  wherein said bow elements have a set of sharp teeth members on said exterior edge for shearing bone.  
   
   
       44 . The device of  claim 41  wherein said bow elements are blunt.  
   
   
       45 . A tool for use in treating a vertebral compression fracture in a spine, comprising: 
 an elongated body having a distal end and a proximal end;    a movable element configured to be placed into a fractured vertebra, said element supported by and movable relative to said body at said distal end thereof substantially only in a plane transverse to said body;    an actuator supported by said body and operably coupled to said element to impart relative movement between said element and said body; and    a handle attached to said actuator and having a portion extending exteriorly of the proximal end of said body for manual manipulation of said actuator.    
   
   
       46 . The tool of  claim 45 , wherein said handle is indexed relative to said movable element so as to position said movable element within said vertebra to a desired orientation by the position of the handle.  
   
   
       47 . The tool of  claim 45 , wherein said handle comprises a finger loop.  
   
   
       48 . A tool for use in treating a vertebral compression fracture in a spine, comprising: 
 an elongated body having a distal end and a proximal end;    a movable element supported by and movable relative to said body at said distal end thereof and configured to be placed into a fractured vertebra and move substantially only in a plane transverse to said body; and    a container substantially surrounding said element and attached to said body and configured to accommodate the movement of said element.    
   
   
       49 . The tool of  claim 48 , wherein said element comprises a flexible element configured to swing outwardly in said transverse plane.  
   
   
       50 . The tool of  claim 49 , wherein said flexible element comprises two flexible arms configured to swing outwardly in opposite directions.  
   
   
       51 . The tool of  claim 48 , wherein said container is releasably attached to said body.  
   
   
       52 . The tool of  claim 48 , wherein said container is inflatable.  
   
   
       53 . The tool of  claim 52 , wherein said container comprises a balloon.  
   
   
       54 . The tool of  claim 52 , further including a bone filler material for introduction into said container.