Methods and apparatus for placing materials into bone

Abstract

A cannula establishes a subcutaneous path into bone. The cannula includes at least one radiopaque marker. A tamping instrument having a tamping terminus is 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.

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 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.  
     
     
         2 . Apparatus according to  claim 1  wherein the cannula has a length, and wherein the length of the tamping instrument exceeds the length of the cannula.  
     
     
         3 . Apparatus according to  claim 1  wherein a removable handle is carried by the proximal end of the cannula.  
     
     
         4 . Apparatus according to  claim 1  wherein a handle is carried by the proximal end of the tamping instrument.  
     
     
         5 . Apparatus according to  claim 4  wherein, when the tamping instrument is fully inserted into the cannula, the handle is adjacent the proximal end of the cannula.  
     
     
         6 . Apparatus according to  claim 1  wherein the cannula comprises a generally rigid material.  
     
     
         7 . Apparatus according to  claim 1  wherein the tamping instrument comprises a generally rigid material.  
     
     
         8 . Apparatus according to  claim 1  wherein the tamping instrument has a blunt distal end.  
     
     
         9 . Apparatus according to  claim 1  wherein the cannula has a blunt distal end.  
     
     
         10 . Apparatus according to  claim 1  wherein the tamping instrument and the cannula each have a blunt distal end.  
     
     
         11 . Apparatus according to  claim 1  further comprising a delivery device to convey material into the cannula.  
     
     
         12 . Apparatus according to  claim 1  wherein the tamping instrument includes at least one marking to visually gauge the advancement the terminus relative to the distal end of the cannula.  
     
     
         13 . 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.  
     
     
         14 . Apparatus according to  claim 12  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.  
     
     
         15 . Apparatus according to  claim 1  wherein the tamping instrument includes at least one radiopaque marker.  
     
     
         16 . Apparatus according to  claim 1  wherein the cannula is plastic.  
     
     
         17 . Apparatus according to  claim 16  wherein the tamping instrument is plastic.  
     
     
         18 . Apparatus according to  claim 1  wherein the tamping instrument has a substantially constant diameter along its length.  
     
     
         19 . Apparatus according to  claim 1  wherein the material comprises at least one of bone cement, autograft material, allograft material, calcium carbonate, demineralized bone matrix material, calcium phosphate.  
     
     
         20 . Apparatus for delivering material into bone comprising a cannula for establishing a subcutaneous path into bone, the cannula including at least one radiopaque marker and being sized and configured to accept insertion and withdrawal of a first instrument in the cannula, and a tamping instrument separate from the first instrument 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 and advancement of the tamping terminus in the cannula to urge material residing in the cannula into the bone.  
     
     
         21 . Apparatus for delivering material into bone comprising a cannula for establishing a subcutaneous path into bone, the cannula being sized and configured to accept insertion and withdrawal of a first instrument in the cannula, and a tamping instrument separate from the first instrument having a tamping terminus, the tamping instrument including at least one marking to visually gauge the advancement of the terminus relative to the distal end of the cannula and being sized and configured for manipulation independent of the cannula to enable insertion of the tamping instrument into the cannula and advancement of the tamping terminus in the cannula to urge material residing the cannula into bone.  
     
     
         22 . Apparatus according to  claim 21  wherein the tamping instrument includes a set point marking spaced from the terminus at a distance generally equal to the length of the cannula.  
     
     
         23 . Apparatus according to  claim 22  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.  
     
     
         24 . A method comprising 
 providing apparatus as defined in  claim 1 , and    manipulating the apparatus for delivering material into bone relying at least in part upon viewing the at least one radiopaque marker.    
     
     
         25 . A method comprising 
 deploying an expandable device through a percutaneous path into a vertebral body having a 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, and    gauging the advancement by observing at least one predetermined radiopaque marker to determine a position of a terminus of the tamping instrument relative to a distal end of the cannula.