Methods and apparatus for placing materials into bone

Abstract

A cannula establishes a subcutaneous path into bone. The cannula includes at least one predetermined marking. A tamping instrument is advanced through the cannula to deliver material into the bone by grasping an enlarged handle portion formed on the tamping instrument. The advancement is visually gauged by observing at least one predetermined marking on the tamping instrument to determine a position of a terminus of the tamping instrument relative to a distal end of the cannula.

1 . Apparatus for delivering material into bone comprising a cannula for establishing a subcutaneous path into bone and including at least one radiopaque marker; and a tamping instrument for advancement through the cannula comprising a body portion and a handle portion, the handle portion having a cross-sectional area greater than the cross-sectional area of the body portion.  
     
     
         2 . Apparatus according to  claim 1 , wherein the body portion is sized and configured to substantially fill the cannula when the tamping instrument is fully inserted into the cannula.  
     
     
         3 . Apparatus according to  claim 1  wherein the tamping instrument includes a set point marking spaced from the terminus at a distance generally equal to the length of the cannula.  
     
     
         4 . Apparatus according to  claim 3  wherein the tamping instrument includes at least one additional marking to visually gauge advancement of the terminus relative to the distal end of the cannula.  
     
     
         5 . Apparatus according to  claim 1 , wherein the body portion has a substantially constant diameter along its length.  
     
     
         6 . Apparatus for delivering material into bone comprising a cannula for establishing a subcutaneous path into bone; and a tamping instrument for advancement through the cannula including at least one marking to visually gauge the advancement of the terminus relative to the distal end of the cannula and comprising a body portion and a handle portion, the handle portion having a cross-sectional area greater than the cross-sectional area of the body portion.  
     
     
         7 . Apparatus according to  claim 6  wherein the tamping instrument includes a set point marking spaced from the terminus at a distance generally equal to the length of the cannula.  
     
     
         8 . Apparatus according to  claim 7  wherein the tamping instrument includes at least one additional marking to visually gauge advancement of the terminus relative to the distal end of the cannula.  
     
     
         9 . Apparatus according to  claim 6 , wherein the body portion has a substantially constant diameter along its length.  
     
     
         10 . Apparatus for delivering material into bone comprising a cannula for establishing a subcutaneous path into bone, the cannula comprising a generally rigid material and including at least one radiopaque marker, a tamping instrument comprising a generally rigid material and having a tamping terminus, the tamping instrument being sized and configured for manipulation independent of the cannula to enable insertion of the tamping instrument into the cannula, advancement of the tamping terminus in the cannula to urge material residing in the cannula into bone, and withdrawal of the tamping terminus from the cannula, and a handle carried by the proximal end of the tamping instrument.  
     
     
         11 . Apparatus according to  claim 10  wherein the tamping instrument has a blunt distal end.  
     
     
         12 . Apparatus according to  claim 10  wherein the cannula is sized and configured to accept insertion and withdrawal of a first instrument in the cannula, and wherein the tamping instrument is separate from the first instrument.  
     
     
         13 . Apparatus according to  claim 12  wherein the handle carried by the tamping instrument has a cross-sectional area greater than the cross-sectional area of the tamping terminus of the tamping instrument.  
     
     
         14 . Apparatus according to  claim 13  wherein the tamping instrument is sized an configured to substantially fill the cannula.  
     
     
         15 . Apparatus according to  claim 14  wherein the tamping instrument has a substantially constant diameter along its length.  
     
     
         16 . Apparatus according to  claim 10  wherein the cannula has a length, and wherein the length of the tamping instrument exceeds the length of the cannula.  
     
     
         17 . Apparatus according to  claim 10  wherein a removable handle is carried by the proximal end of the cannula.  
     
     
         18 . A method comprising 
 providing apparatus as defined in  claim 1 , and    manipulating the apparatus to delivery material into bone relying at least in part upon viewing the radiopaque marker.    
     
     
         19 . A method comprising 
 providing apparatus as defined in  claim 6 , and    manipulating the apparatus to delivery material into bone relying at least in part upon the at least one marking to visually gauge the advancement of the terminus relative to the distal end of the cannula.    
     
     
         20 . A method comprising 
 deploying an expandable device through a percutaneous path into a vertebral body having cancellous bone volume to create a cavity in the cancellous bone volume,    advancing a tamping instrument through a percutaneous cannula to deliver material into the cavity by manipulating an enlarged handle portion formed on the tamping instrument, and    gauging the advancement by observing at least one predetermined marking on the tamping instrument or the cannula to determine a position of a terminus of the tamping instrument relative to a distal end of the cannula.