The present disclosure relates to the field of medical equipment, and more particularly, to a vertebral balloon dilation system for use in percutaneous kyphoplasty (PKP).
Osteoporotic vertebral compression fracture is a common disease harmful to the health of middle-aged and elderly people. For vertebral compression fractures, traditional treatment methods are conservative for the most part and include bed rest, drug analgesia, and external fixation with orthosis, etc. These traditional treatment methods often result in a further loss of bone mass and an exacerbation of osteoporosis, thus forming a vicious cycle, while an open surgery can easily result in failures of internal fixation due to the poor health condition of the patient or insufficient fixation strength of screws.
In 1987, French doctors, Deramond et al., reported that good curative effects had been achieved for treating aggressive hemangioma of C2 vertebral body by percutaneous vertebroplasty (PVP). Hereafter, such technology is also applied in treatment of the malignant vertebral tumor and osteoporosis. The drawbacks of such surgery include that it is only possible to fix the injured vertebral body with deformity and alleviate the pain, but impossible to restore the vertebral height or correct the kyphotic deformity. Moreover, since the low-viscosity bone cement is injected into the vertebral cancellous bone directly under a relatively higher pressure, it is difficult to control the flow, and the leakage rate of the bone cement is higher, which is within the range of 30%-67%, as reported in references. By 1994, American scholars, Reiley et al., designed a new technique for correcting kyphotic deformity by means of balloon dilation based on PVP, and such technique was developed as the percutaneous kyphoplasty (PKP) and was approved by the FDA in 1998 for clinical applications. The technique includes the following steps: inserting a dilatable balloon into a collapsed vertebral body by percutaneous puncture, lifting up the endplate by the dilation of the balloon, restoring the height of the vertebral body and correcting the kyphotic deformity, thereby forming a hollow cavity surrounded by the bone shell in the vertebral body and injecting it with the high-viscosity bone cement under a relatively lower pressure. In order to insert the balloon into the vertebral body smoothly, a working channel has to be established primarily with a puncture needle and a working sleeve tube, then a working cavity for the un-dilated balloon is drilled with a bone drill, and finally the balloon is inserted into the vertebral body. The surgical procedure is complex. Because of the structure of the vertebral body, the balloon dilation has to be operated at both sides of each vertebral body in order to maintain the biomechanical force balance of the vertebral body. Furthermore, the surgery has to be operated under X-ray monitoring, therefore, the more complicated the surgical procedures, the longer the time spent, the greater the damage to the health of the doctor, and the higher the level of physical strength of the doctor required. The balloon dilation operated at both sides of the vertebral body may thus result in a greater trauma to the patient a higher incidence of complications, and may increase the economical burden of the patient. The above defects will become more significant in the case of multi-segmental vertebral lesions.
The present disclosure aims to provide a vertebral balloon dilation system, which can be fed to the center or to the opposite side of the vertebral body simply by puncturing at only one side without drilling with a bone drill to form a cavity before feeding the dilatable balloon. According to the present disclosure, a dilatable balloon is fed to the center or the opposite side of the vertebral body with a liner core provided with a curved section at its distal end, and then a developer solution is injected into the balloon by means of a pushing tube, thereby simplifying surgical procedures, shortening the duration of surgery, reducing the incidence of complications, alleviating the pain of patients, and reducing the economical burden of patients.
An objective of the present invention is realized by the following technical scheme:
A vertebral balloon dilation system comprises a pushing tube and a balloon fixedly connected to a distal end of said pushing tube, wherein said vertebral balloon dilation system can withstand water pressure of no less than 10 atm; said pushing tube is a rigid tube, a lumen of said pushing tube is in communication with an interior of said balloon; and said balloon is made of a membrane material, a distal end of said balloon is fixedly connected with a sealing head that is closed at its distal end and has a blind hole at its proximal end, wherein said blind hole has an opening towards the interior of said balloon. Said vertebral balloon dilation system further comprises a sleeve tube and a liner core, wherein said liner core is slidably inserted into said pushing tube, a distal end part of said liner core is a curved section, which protrudes out of the distal end of said pushing tube, the distal end of said liner core is inserted into said blind hole of said sealing head through said pushing tube and the interior of said balloon, and said balloon is configured to wrap up the curved section of the liner core; a distal end part of said sleeve tube is a flexible section, whereas a proximal end part of said sleeve tube is a rigid section, wherein said flexible section is rigid in the radial direction and said sleeve tube is sleeved on said pushing tube and said balloon; and, when said vertebral balloon dilation system is operated, said sleeve tube slides towards a proximal end of said pushing tube in the axial direction, and said balloon is exposed.
Objectives of the present invention can be further realized by the following technical schemes:
In some embodiments, said sealing head is connected with said balloon in a connection manner selected from binding connection, threaded connection, compression connection, adhesive connection, or welding connection or combinations thereof.
In some embodiments, said membrane material is PTFE membrane.
In some embodiments, said sealing head is made of a rigid material, the distal end of which is in a sharp shape, whereas the distal end of said sleeve tube is sleeved on or connected with said sealing head.
In some embodiments, an end part of said curved section of said liner core is a straight section, which is inserted into said blind hole in said sealing head and reaches the bottom of said blind hole.
In some embodiments, said flexible section of said sleeve tube is cut from a metal tube, formed of a spring, made of a hard medical polymer material, or formed of any combinations of metal materials and polymer materials.
In some embodiments, said balloon is in a banana shape or a dumbbell shape.
In some embodiments, said balloon is foldable in its axial direction, and is configured to wrap up said curved section of the liner core along its circumferential direction.
In some embodiments, said vertebral balloon dilation system further comprises a liner core handle fixedly connected to the proximal end of said liner core, a pushing handle fixedly connected to the proximal end of said pushing tube, and a sleeve tube handle connected to the proximal end of said sleeve tube, wherein said pushing handle includes one or more guide grooves, a distal end of said pushing handle is provided with a stop block for limiting the position of said sleeve tube handle, and said sleeve tube handle is provided with one or more guide blocks engaged with said guide grooves such that while said sleeve tube handle is moved, said sleeve tube will move in the axial direction together with said sleeve tube handle.
In some embodiments, the distal end of said pushing tube and said balloon are fixedly connected by means of hot melt welding, or sintering the proximal end of said balloon entirely to an outside of said pushing tube.
As compared with the prior art, the present disclosure has the following characteristics and advantages:
1. In a surgical procedure with a prior art balloon, each vertebral body needs to be punctured and dilated at both sides. The vertebral balloon dilation system of the present disclosure is provided with a curved section at its distal end so as to feed the balloon to the center or the opposite side of the vertebral body, such that the dilation at both sides can be achieved by puncturing at only one side, thereby effectively reducing the trauma to the patient, shortening the duration of surgery, reducing the incidence of complications and meanwhile reducing the economical burden of the patient, and such advantages are more apparent in the surgery for multi-segmental vertebral lesions.
2. In the prior art, before using a balloon, a channel for feeding the balloon has to be drilled with a bone drill. In view of the defect of complicated procedures, the balloon of the present disclosure is provided with a hard sealing head at the distal end thereof, and furthermore, a rigid sleeve tube is sleeved on the balloon, such that when feeding the balloon to the vertebral body, it is unnecessary to drill a working cavity for the balloon in advance like that in the traditional PKP surgery. Due to the protection effect of the sleeve tube on the balloon, the balloon can be fed into the vertebral body directly such that the surgical procedures are simplified and the risk of surgery is lowered, and due to the reinforcing effect of the liner core, the procedure of inserting the vertebral balloon dilation system into the vertebral body can be implemented more reliably and conveniently.
3. The flexible section of the sleeve tube of the present disclosure is rigid in the radial direction, such that it can withstand a certain pressure and the bone tissue can be pushed away by the curved section by rotating the handle so as to feed the balloon to the vertebral body more smoothly.
4. According to the anatomical knowledge, the vertebral body is approximately in an oval shape, and vertebral compression fractures basically occur at the front edge of the vertebral body; in some embodiments, the balloon of the present disclosure is in a banana shape or a dumbbell shape so as to be better conform to the shape of the leading edge of the vertebral body, and better maintain the original biomechanical balance of the vertebral body after the bone cement is solidified.
In order to make the objectives, technical schemes and advantages of the present disclosure more apparent and better understood, the present disclosure will be described in more detail with reference to the accompanying figures and embodiments.
The proximal end, as described in the present disclosure, refers to the end near to the surgical operator, and the distal end refers to the end far away from the surgical operator.
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According to above-mentioned embodiments, the sealing head 11, the inner core 112′ and the fixing ring 112″ are made of a metal material (preferably, pure titanium) or a hard medical polymer material (preferably, PEEK). The balloon 1 is made of a medical polymer material (preferably, expanded PTFE). The pushing tube 2 is formed of a metal tube (preferably, 304 stainless steel), the flexible section 31 of the sleeve tube 3 is cut from a metal tube, formed of a spring or shaped from a medical polymer material (preferably, PEEK), and the rigid section 32 of the sleeve tube 3 is formed of a metal tube or made of a medical polymer material (preferably, PEEK). The liner core 4 is made of shape memory alloy (preferably, nitinol). The sleeve tube handle 7, the pushing handle 6 and the liner core handle 5 are made of a medical polymer material (preferably, POM).
In surgical procedures, after a working channel is established, the vertebral balloon dilation system is inserted into the vertebral body through the working channel up to a predetermined position under the observation with a C-arm, and during the procedure, the liner core 4 has the following functions:
1. The distal end of the liner core 4 abuts against the blind hole 111 of the sealing head 11, such that the balloon 1 can be prevented from moving or turning over in the sleeve tube 3 during the feeding procedure, and the sealing head 11 can be driven to push away the bone tissue by pushing the liner core 4.
2. The balloon 1 is configured to wrap up the curved section 41 of the liner core 4 such that the balloon can be fed to the center or the opposite side of the vertebral body under the protection of the sleeve tube 3.
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Finally, it should be noted that the above mentioned are only preferred embodiments of the present invention, but not to limit the scope of the invention, and any amendments, equivalent replacements, improvements and so on made within the spirits and principles of the present invention all should be included in the protection scope of the present invention.
Number | Date | Country | Kind |
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201310671713.6 | Dec 2013 | CN | national |
This application is a continuation application of PCT Patent Application No. PCT/CN2014/089873, entitled “Vertebral Balloon Dilation System”, filed on Oct. 30, 2014, which claims priority to Chinese Patent Application No. 201310671713.6, entitled “Vertebral Balloon Dilation System”, filed on Dec. 12, 2013, the entire contents of which are incorporated herein by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/CN2014/089873 | 10/30/2014 | WO | 00 |