Systems and methods for treating bone using expandable bodies

Abstract

A vertebral body is selected for treatment. The vertebral body has a cortical wall enclosing a cancellous bone volume. The vertebral body also has at least one cortical plate that is depressed due to fracture. At least one maximum dimension for the cancellous bone volume is ascertained, and an expandable device is provided that has a predefined dimension when substantially expanded that is less than the maximum dimension. The expandable device is introduced into the vertebral body through a percutaneous access path while in an unexpanded condition. The expandable device is expanded while disposed within the cancellous bone volume from the unexpanded configuration toward the expanded configuration. An expansion barrier is provided in association with the expandable device that directs expansion of the expandable device in a desired direction to move the fractured cortical plate toward a desired anatomic position.

1 . A method comprising:
 selecting a vertebral body for treatment, the vertebral body having a cortical wall enclosing a cancellous bone volume, the vertebral body having at least one cortical plate that is depressed due to fracture,   ascertaining a maximum anterior-to-posterior dimension for the vertebral body measured between anterior and posterior cortical walls,   providing an expandable device including an expanded configuration and an unexpanded configuration, the expandable device having a predefined dimension when substantially expanded that is less than the maximum anterior-to-posterior dimension,   introducing the expandable device into the vertebral body through a percutaneous access path while in the unexpanded condition,   expanding the expandable device while disposed within the cancellous bone volume from the unexpanded configuration toward the expanded configuration, and   providing an expansion barrier in association with the expandable device that directs expansion of the expandable device in a desired direction to move the fractured cortical plate toward a desired anatomic position.   
     
     
         2 . A method according to  claim 1   further including placing a volume of filling material within the cancellous bone volume.   
     
     
         3 . A method according to  claim 2   wherein the filling material hardens within the vertebral body.   
     
     
         4 . A method according to  claim 2   wherein the filling material comprises bone cement.   
     
     
         5 . A method according to  claim 1   wherein the expandable device expands by inflation.   
     
     
         6 . A method according to  claim 1   wherein the expandable device comprises a balloon.   
     
     
         7 . A method according to  claim 1   further including removing the expandable device from the vertebral body.   
     
     
         8 . A method according to  claim 1   wherein the expansion barrier comprises a device sized and configured to be introduced into the vertebral body through a percutaneous access path and including a platform region sized and configured to be disposed relative to the expandable region of the first tool to define the expansion barrier.   
     
     
         9 . A method according to  claim 8   wherein the platform region comprises an expandable body.   
     
     
         10 . A method according to  claim 9   wherein the expandable body is inflatable.   
     
     
         11 . A method according to  claim 1   wherein the expandable device and the expansion barrier comprise parts of a single device.   
     
     
         12 . A method according to  claim 1   wherein the expandable device and the expansion barrier comprise separate structures.   
     
     
         13 . A method comprising
 selecting a vertebral body for treatment, the vertebral body having a cortical wall enclosing a cancellous bone volume, the vertebral body having at least one cortical plate that is depressed due to fracture,   ascertaining a maximum lateral dimension for the vertebral body measured between lateral cortical walls,   providing an expandable device including an expanded configuration and an unexpanded configuration, the expandable device having a predefined dimension when substantially expanded that is less than the maximum lateral dimension,   introducing the expandable device into the vertebral body through a percutaneous access path while in the unexpanded condition,   expanding the expandable device while disposed within the cancellous bone volume from the unexpanded configuration toward the expanded configuration, and   providing an expansion barrier in association with the expandable device that directs expansion of the expandable device in a desired direction to move the fractured cortical plate toward a desired anatomic position.   
     
     
         14 . A method according to  claim 13   further including placing a volume of filling material within the cancellous bone volume.   
     
     
         15 . A method according to  claim 14   wherein the filling material hardens within the vertebral body.   
     
     
         16 . A method according to  claim 14   wherein the filling material comprises bone cement.   
     
     
         17 . A method according to  claim 13   wherein the expandable device expands by inflation.   
     
     
         18 . A method according to  claim 13   wherein the expandable device comprises a balloon.   
     
     
         19 . A method according to  claim 13   further including removing the expandable device from the vertebral body.   
     
     
         20 . A method according to  claim 13   wherein the expansion barrier comprises a device sized and configured to be introduced into the vertebral body through a percutaneous access path and including a platform region sized and configured to be disposed relative to the expandable region of the first tool to define the expansion barrier.   
     
     
         21 . A method according to  claim 20   wherein the platform region comprises an expandable body.   
     
     
         22 . A method according to  claim 20   wherein the expandable body is inflatable.   
     
     
         23 . A method according to  claim 20   wherein the expandable device and the expansion barrier comprise parts of a single device.   
     
     
         24 . A method according to  claim 13   further including ascertaining a maximum anterior-to-posterior dimension for the vertebral body measured between anterior and posterior cortical walls, and   wherein the expandable device has a predefined dimension when substantially expanded that is less than the maximum anterior-to-posterior dimension and less than the maximum lateral dimension.   
     
     
         25 . A method comprising
 selecting a vertebral body for treatment, the vertebral body having a cortical wall enclosing a cancellous bone volume, the vertebral body having at least one cortical plate that is depressed due to fracture,   ascertaining at least one maximum dimension for the cancellous bone volume,   providing an expandable device including an expanded configuration and an unexpanded configuration, the expandable device having a predefined dimension when substantially expanded that is less than the maximum dimension,   introducing the expandable device into the vertebral body through a percutaneous access path while in the unexpanded condition, and   expanding the expandable device while disposed within the cancellous bone volume from the unexpanded configuration toward the expanded configuration,   providing an expansion barrier in association with the expandable device that directs expansion of the expandable device in a desired direction to move the fractured cortical plate toward a desired anatomic position.