Apparatuses for bone restoration

Background of the Invention

Various causes can be a source of bone compression, in particular osteoporosis, which causes (for example) natural compression of the vertebrae under the weight of the individual, but also injuries, for two reasons have occasionally been combined. Such bone compression can affect the vertebrae, but also others such as the radius and femur, for example.

Several vertebroplasty techniques are known to perform vertebral surgery, i.e. correction, to restore the vertebra to its original shape, or shape similar to the latter. For example, one technique involves introducing an inflatable vertebrate balloon, and then introducing fluid under pressure into the balloon to force the cortical vertebral shell, particularly in the lower and upper vertebral plateau, to improve the shape of the vertebra under pressure. This technique is known as kyphoplasty. After the ossicular shell has been dissolved, the balloon is emptied, and withdrawn from the circle to be able to introduce into the cement in the cortical shell, which is intended for broadcasting, sufficient mechanical strength for correction over a significant duration over time.

An important disadvantage of the Kyphoplasty method is found in numerous manipulations, in particular inflation, and there is a need to withdraw the balloon from the patient's body. In addition, balloon expansion is poorly controlled because the volume of the balloon is omnidirectional, which often causes a lot of pressure to place on the cortical shell in the wrong directions. Such high pressures risk of cracking the bark of the coating, in particular the side parts of the cortical coating connecting the lower and upper plateau from the vertebra.

Others v ertebral and mplants e xist in hichre and ntended fill avity ac inav ertebra.

Such implants, however, are generally accepted as the principle of radial extension obtained by ofap lurality of formation tand p oints HICH In sn ormally tot on ongitudinal 1 a XIS implant under the influence of contraction of the latter. Such implants apply too high pressure on individual points that can pierce the material on which the points support. In addition, similar to kyphoplasty, very high pressure can cause the tissue or walls of organs such as cortical to break, for example. The over-radiation expansion of some implants does not allow a specific expansion direction to be preferred.

SUMMARY OF THE INVENTION

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EP) 1) 778) 136) B1

Embodiments of the present invention, reducing the above-described disadvantages and providing additional advantages over known bone reconstruction devices. In particular, some embodiments of the present invention include methods for renovating human or animal bone anatomy, as well as one or more of the following steps: - introduction, nW and AB, one estoring for R, with a xpansible mplant worthy of Toa one specific plane expansion which preferably inherent in the implant,

- Positioning the foam expansion in the bone, so that the expansion corresponds to the plane of bone renovation,

- Opening to the outside of the implant foaming in the bone conservation planes and

- Injection of filling material in and around the implant.

The method, according to some embodiments of the invention, makes it possible to create a reinforced structure in a solid structure (e.g., an implant incorporated by the tempered filler material for the expansion of the implant). Moreover, the filler material can be injected at a relatively low pressure since the implant stays in place, which allows the dimensions of the corrected bone structure to be maintained through the implant's expansion.

Another feature of an embodiment of the present invention is that the implant can be expanded / open - in the plane for bone reconstruction of a specific value: from minimum thickness (e.g., thickness from implant before expansion unit), and Maximum thickness (e.g., thickness of implant after maximum expansion). This characteristic allows the extension of the implant voltage to be controlled, for example, for a given spine correction.

Another advantageous feature of an embodiment of the present invention includes a hole currently on the stretched implant, opening the first and / or second opposing plate, forming (respectively) and the first in the Drug bone bearing surface. The function enables pressure that the implant exerts on the tissues in contact with the implant to be reduced by increasing the contact or supporting surface in the tissues.

The length of the implant can also be selected is basically equal to at least one of the first and second bone support surfaces. This characteristic allows optimization of the ratio of support length (per tissue) to implant length.

This factor is closer to one, more implant will be profitable in places requiring short length. In addition, the function also allows the introduction of filler material under low injection pressure. The low injection pressure is preferably such as to avoid having to fill the material injected into the wrong tissues (e.g., such as the walls of blood vessels).

In another embodiment of the invention, each of the first and second plates may form partially cylindrical support surfaces, a portion (or more) that may be parallel to the longitudinal axis of the stretched implant. Cylindrical (curved)

VP / 2280 / RW)

EP) 1) 778) 136) B1, the support surface can distribute forces that places on the tissue implant.

In another embodiment of the present invention, the opening of this first and second implant plates uses one or more carriers under the plates. This characteristic allows the ratio of length to bearing surfaces to implant length to be increased to be as close to one (1) as possible (see above). In addition, this feature allows longitudinal forces to be more evenly distributed over the plate to reduce the bracket.

Cement filler, which can be injected in and around the implant, so as to facilitate the compressive load of the implant in bone restoration, is an ionic cement, especially cement, phosphate acrylic cement or a compound about it.

Therefore, the combination of implant and cement is not unlike steel reinforced concrete structure in building construction.

In another embodiment of the present invention, the foaming implant for bone restoration comprises a single plane of internal expansion into the implant. Single plane expansion corresponding to the conservation plane of the bones. The implant may also include first and second opposing plates forming first and second bone support surfaces, respectively. The first and second boards are placed at a departure from each other depending on one plane of the terrain (e.g. during implant expansion). This implant may also include first and second supports for one or more of the first and second bearing surfaces, and are preferably in one or preferably both plates (respectively). This implant may also include means for controlling implant expansion. Such measures may include strips of material sandwiched between each support and a suitable plate of a certain thickness.

In other embodiments of the present invention, the expansion control device controls the expansion value ™ nimum of the implant thickness prior to the expansion assembly of the latter and the maximum implant thickness after maximum expansion.

This implant may also contain (preferably) means for placing the implant in the bone to foam to expand the plane of the implant correspond substantially to the plane of bone restoration. Such means may include coupling means (e.g., threaded connection) enabling the angular position of the longitudinal axis of the implant and may include one or more flat surfaces from one end of the implant (e.g.) to secure the implant carrier.

Yet another embodiment of the invention relates to a bone reconstruction system and may include at least one expansion implant having one expansion plane corresponding to the bone reconstruction plane (one or more implants may be used in one bone to produce more symmetrical bone reconstruction, see Fig. 37 ). .

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The system may also include a first tube adjacent the outer surface of the bone to reproduce and the first rod has a threaded end at which it is positioned with the distal end of the bone interior (the first rod may be received inside the first tube). The system may also include a second tube for receiving the first conduit there and a third tube for receiving the second conduit. The third tube may include one or more coupling users for attaching the third tube to the outer surface of the bone. The system may further include a drill bit for an enlarged hole in the bone portion that may rest on the first rod. Furthermore, the system may further comprise a medical insertion device to place the foamed implant into the patient's body.

In yet another embodiment of the invention, a medical insertion device has been disclosed for foaming the implant into the patient's body. The device may comprise a gripping portion having a central hole, a first tube placed in the central hole and a threaded rod placed in the first tube, which may include a distal end into which the implant enters for insertion into the patient's body. The device may also include a handle attached to the handle portion and / or an implant carrier, as well as an indicator for determining the expansion of the implant.

Still other features, advantages, forms and objects of the invention will become even more pronounced with reference to the accompanying drawings, the short description which is below, and the following detailed description.

BRIEF DESCRIPTION OF THE FIGURES

Lynx. . 1 is a perspective view of an exemplary embodiment of the Implant according to an embodiment of the invention in a rest position.

Lynx. . IB shows the example of FIG. 1, in the opened-out / expanded position.

Lynx. . 2A shows a side view of another embodiment of the expandable implant in accordance with another embodiment of the invention in a rest position.

Lynx. . 2B shows the example of FIG. 2A, in an opened-out / expanded position.

Lynx. . 3 shows a side view for example according to fig. 1A.

Lynx. . 4 is a cross-sectional view according to line II of FIG. 3.

Lynx. . 5 is a cross-sectional view according to the line U-II in FIG. 3.

Lynx. . 6 is an end view according to F for example according to fig. 1A.

Lynx. . 7 is a top view of the example of Fig. 1 A.

Lynx. . 8 is a perspective view of a second embodiment of an expandable implant in accordance with another embodiment of the invention in a rest position.

Lynx. . 9 illustrates the example of FIG. 8, in the open -out position.

Lynx. . 10 shows a side view for example according to Fig. 8th

Lynx. . 11 is a cross-sectional view according to the line n and n in Fig. 10th

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Lynx. . 12 is a cross-sectional view according to the line JN-1N of FIG. 10th

Lynx. . 13 shows a cross-sectional view according to the LV line of the drawing. 10th

Lynx. . 14 is a cross-sectional view according to the line NI -ni of Fig. 10th

Lynx. . 15 is an end view according to G for example accordmg to FIG. 8th

Lynx. . 16 is a top view of the example of Fig. 8th

Figs 17-29 schematically show individual steps of an embodiment of the bone restoration method according to the invention.

Figs 30-32 schematically illustrate the steps of another embodiment of the bone restoration method according to the invention.

Lynx. . 33 is a perspective view of an implant carrier device for inserting an implant into a patient's bone, in accordance with another embodiment of the present invention.

Lynx. . 34 is a top view of the implant carrier device of FIG. 33.

Lynx. . 35 illustrates the expansion indicator for the implant carrier shown in Fig. 33 and 34.

Lynx. . 36 is a table with values ​​for implant expansion according to the illustrated embodiments using the implant carrier shown in FIG. 33 and 34.

Lynx. . 37 illustrates the use of a pair of implants according to another embodiment of the present invention.

DETAILED DESCRIPTION OF EXECUTION EXAMPLES

The expandable implant 1 shown in Figures 1A to 7 (and other embodiments) may include one or more of the following:

- One specific expansion aircraft 2 that may be key to the implant,

- Means 3 for positioning the foaming implant in the bone allowing the aircraft expansion to correspond with the bone restoration plane - means 4 for opening the foaming implant in one extension plane 2,

- Means 5 to control the specified expansion value between the minimum thickness A of the implant before the expansion assembly of the latter and the maximum thickness b of the implant after its maximum expansion, and

The first 6 and the second 7 opposite the plate, which are capable of forming respectively the first 8 and the second 9 supporting surface in the bone is to be spaced apart from each other along one expansion plane 2 during the expansion of the implant 1.

As shown in FIG. 1A and IB, implant 1 may contain a cylindrical shape with an external circular cross-section, and may be made of biocompatible material (titanium) in the tubular body 24 by means of machines, laser, and / or electro-erosive production echniques (cast m anufacturing m ay LSO sed beu). T he mplant I 1 m aj also the first end 20 and the second end 21, each respectfully taking shape

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EP) 1) 778) 136) B1 cross section of the tubular body 24. The ends are preferably intended to be directed toward each other to allow opening-out / expansion of the implant as shown in FIG. IB and 2B.

Accordingly, the two ends 20, 21 are connected to each other for the first 22 seconds and 23 rectilinear arms that are parallel when the implant is not open to lower. The arms can be formed in the longitudinal direction of the tubular body 24 ~, i.e. which can be folded on the base, at the ends 20 and 21 rolling towards each other, which also causes the first and 6 y Drug 7 OP pposite base to move away from 1 ongitudinal axis 10 of pipe body 24.

Figs 2A-2B show an embodiment of the implant that is similar to the embodiment disclosed in Fig. 1i IB, but with an additional set of supports (e.g. four bar lift). More specifically, in the implant figure. 2A - 2B includes supports 13a, 13b, 14a, 14b, 15a, 15b, 16a and 16b for two pairs for each of the upper and lower plates. Additional carriers may provide further implant rigidity and / or may ensure that plates 6 and 7 open in a substantially parallel and / or even manner.

As shown in FIG. 4-5, in order on the arms 22 and 23 to open in one plane (2 passing through the longitudinal axis 10 of the tubular body 24), the arms 22 and y 23 are preferably diametrically opposed. In this regard, the arms 22, 23 can be formed with a transverse recess 40 of the tubular body 24, passing through the tubular body, and the extension Ver OT 1 year ength often on T ubular BB Ody etween T on T WO 20 ends and 21 ofthe 1 implant. As shown in fig. 5 , the arms, 22, 23 connecting the two ends 20 and 21, respectively, adopt a cross-section of the circular 26 bounded to the outer surface of the tubular body 24. Chord 27 defines circular arc 26 and can be included in wall 25 to form recess 40. The recess 40 may be symmetrical about the longitudinal axis 10.

Each of the arms 22, 23 can be divided into three successive rigid elements which can be articulated with each other in connection with the terminals 20 and 21 in the following manner (for example).

In relation to the arm 22: the first rigid part 28 is connected at one end to the end 20 by means of a joint 29. The second end of the rigid portion 28 is connected to the first end of the second adjacent rigid portion 30 by means of a hinge 31. The second rigid part 30 can be connected at the other end to the third rigid part 32 by means of a hinge 33. The other end of the third rigid portion 32 may be connected to the end 21 by means of a hinge 34. Preferably, the joints 29, 31, 33 and 34 may comprise one degree of freedom of rotation, constituting, respectively, around axes that are perpendicular to the plane of expansion 2. Preferably, joints 29, 31, 33 are

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EP) 1) 778) 136) B1 formed by the tm'nning walls forming the arm in the respective articulation zone as shown in FIG. 1-3 (see, for example, identification numbers 5 and 81).

Each of the arms 22, 23 may open so that the central rigid portion 30 moves away from the longitudinal axis 10 of the implant inserted into two adjacent rigid portions 28 and 32 when the ends 20 and 21 show the implant depicts one side Other. As shown in more detail in Fig. 3, in order to start the arm movement in the right direction when the ends 20 and 21 are inserted into the other, it is preferable to establish a suitable pair of turns of the individual parts of the arm.

Accordingly, the rigid portions of the end 28, 32 of the upper arm 22 may be articulated at the ends 20 and 21, respectively, in the low portion of the web of material forming these rigid elements.

The rigid portions of the end 28, 32 may also be formed in a central rigid portion 30 in the upper portion of the strip of material that constitutes the rigid portions 28, 32. The displacement of the joints are determined by several rotations on the rigid portion of the ends 28 and 32 when force is applied to bring the ends 20 and 21 together along the longitudinal axis 10 of the implant. This displacement tends to rigid spigot portion 32 outward from the implant as a result of displacement of the rigid central portion 30 from the longitudinal axis 10.

The lower arm 23 can be constructed in a similar manner to the arm and is preferably symmetrical to the upper part of the arm 22 with respect to the plane which is perpendicular to the plane passing through the 2 extensions of the longitudinal axis 10.

Thus, according to some embodiments of the present invention, the upper joints 22 and lower arms 23 are preferably formed by weakened lines formed by 81 grooves. Grooves define a thin web of material (i.e., material thickness at 31, 33) forming a tubular body 24, the thickness of which can be determined by the depth of the grooves 81 (as shown in the drawings) to allow plastic deformation of the material without breaking. In particular, according to one embodiment, the rigid end portions 28 and 32 in the upper arm 22, and those that have them symmetrical on the lower arm 23, can assume a position, referred to as the extreme extension, in which the provided rigid elements are perpendicular to longitudinal axis 10 of implant 1 at the ends 20 and 21 rolling towards each other (the latter is open up to its maximum expansion capacity), as a result of plastic deformation of the relevant material. The width of the grooves 81 are preferably predetermined to allow loosening of the upper and lower arms parts, as well as to provide a suitable radius of curvature to the webs to provide plastic deformation without material cracking.

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The first 6 and 7 seconds of opposing tiles can be formed in the upper 22 and lower 23 weapons. In relation to the arm 22, for example, the rigid plate 6 may be formed by a rigid central portion 30 and by extension of the relevant end portions (28 and 32) which extends on both sides thereof. To form the rigid plate 6, the end of parts 28 and 32 are separated from the upper arm 22 by means of a pair of transverse slots 35 and 36 that extend longitudinally over the entire length of each respective end portion (see FIGS. 3-4). Joints 31 and 33 and final parts 28 and 32 form, respectively, first 12 and second 13 support for the first 6 plate. The same applies to the second tile 7 by symmetry.

Hence, according to the illustrated embodiment, the first 6 and second plates 7 may comprise, respectively, first 16, 18 and 17 seconds, 19 cantilever wings, respective connecting zones are located at the level of the first 12, 14 and 13 seconds, 15 supports. As shown in FIG. 1A - 3, first 16, second 18 and 17,19 cantilever wings may include a length substantially corresponding to the maximum displacement value of one of the first or second plate in one expansion plane 2.

The first 6 and 7 seconds of the plates form the first 8 and second 9 support surfaces, respectively, each of which has a length that can be substantially equal to the length of the implant, which can be displaced in a direction perpendicular to the longitudinal axis 10 during expansion. According to one embodiment of the invention, the implant is made in a tubular body 24, first 6 and second 7 plate form, suitably curved bearing surfaces, which are preferably parallel to the longitudinal axis 10.

Means3 for positioning the foam expansion in the bone to allow extension of plane 2 to correspond to the bone reconstruction plane, it may include coupling means that allows the angular position of the implant with a longitudinal axis of 10. For example, such means may include flat surfaces 37, 38, which are formed on a cylindrical surface with a circular cross-section with an end 20 that can allow the rotary engagement of the implant 1. That is, 4 to open for foaming, the implant in one plane of extension 2, may contain end portions 28 and 32 of upper arm 22 and corresponding symmetrical end portions on lower arm 23, thereby opening from the upper and lower 6 7 plates.

Implant carrier 71 (see Fig. 23). They can be used to allow the ends 20 and 21 of the implant to be attached when placed in the bone. The implant carrier 71, supporting the end 20 of the implant, for example, allows the end to 21 to be pulled toward end 20, or vice versa (e.g., end 21 is supported and end 20 is pushed toward end 21). To this end, the distal end 21, for example, comprises a threaded hole 39 along the longitudinal axis 10 to allow engagement with

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EP) 1) 778) 136) B1 with the implant carrier 71, which includes a corresponding threaded portion. The proximal end 20 may include an opening 80 along the longitudinal axis 10 to pass the implant carrier core 71 to the distal end 21.

The control means 5 may be provided by an implantation carrier which may include rniilirnetric control means for bringing the ends 20 and 21 together, preferably by means of a thread of engagement, allowing expansion to break at any time depending on requirements. On the other hand, the controls are also by joints of the arms 22 and 23, more precisely, the thickness of the material web (e.g., 31, 33) determining which each arm, deformations in the area of ​​plastic, allow expansion on the principle of firmly opening the position of the arms, in addition to elastic contraction, which is irrelevant in practice.

Expansion of implant plates 6 and 7 and their stabilization once open can be achieved by adapting plates 6 and 7 to bone geometry through the plates. While in some embodiments of the invention, plates 6 and 7 are open in parallel, other embodiments of the invention allow plates 6 and 7 of the implant to be open, in non-parallel capacity, as needed (e.g., depending on the anatomical structure bones ) . For example, the extension of the plates 6 and 7 may be non-parallel if the lengths of the individual arms are different. For example, when the supports 12 and 14 are longer than the supports 13 and 15 (see FIGS. 1A-2B), the opening implant will force the plates 6 and 7 to be gradually deflected from each other. In FIG. 1A-2B, this will cause the plates 6 and 7 at the end 21 to be further apart from each other, and then to the end 20. As a person skilled in the art, he will know that, depending on the configuration, only the appropriate support must be elongated / shortened in order to achieve a certain angle.

Similarly, as shown in FIG. 2A -2C, when the four folding bar lifter supports 12A, 12B, 13A, 13B, 14A, 14B, 15A, 15B, as you can see, they are equal in length (i.e. length 12A = length 13A, length 12B = length 13B, etc.), parallelogram these results are due to the implant's expansion (parallelism is insured between the AD and BC segments; see Figure 2c). By modifying the lengths of LI and L2, the four bar lifter will not cause a parallelogram after expansion, but the alcoves between plate 6 and 7 occur. The angle formed may also depend on how close the ends 20 and 21 are prepared near each other. As the implant is open, with, the angle increases gradually.

Figs 8-16 relate to the second embodiment of the expanding implant 101, components that are functionally similar to the corresponding components in the form of an implant, shown in Fig. 1-7. In addition, relevant functions in the figures. 8-16 with respect to the embodiment shown in FIG. 1-7 contain the same reference numbers, respectively, with the addition of the number 100 and will therefore not be described further.

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The implant 101 represented differs from the implant 1 in that there is no wing portion on plates 106 and 107, as shown in more detail in the drawing. 9th Implant 101 includes a parallelogram system 141 on one of the end portions 128 and 132 of each of the arms 122 and 123. In the example shown, the parallelogram system is represented on the end portion 128 with the arm 122 connected to the end 120 and the corresponding system on the lower arm 123. Parallelogram systems can be used to provide displacement of the plates from each of the arms 122 and 123, parallel to the longitudinal axis 110 of the implant. As shown, the end portion 128 of the arm 122 (similar to the corresponding arm 123) is divided, as are the joints 131 and 129 (respectively) relative to the central portion 130 and 120 relative to the end of the implant to form a parallelogram, which is deformable when moving the corresponding board.

The joints of the deformable parallelogram 141 can be manufactured in the same manner as other joints 131, 133, 134 with the arm 122, as shown in FIG. 8-16. Geometry disclosed as described above and shown in Fig. 11-14, sets the life pairs of the various parts of the arm 129, 130, 132. This allows desirable when displacement connecting the ends 120 and 121 101 of the implant.

To obtain the deformable parallelogram 141, 128, the end portion of the arm is preferably divided into three longitudinal levers: two side levers 142 and central levers 143 that form the two sides 141 of the deformable parallelogram. The other two sides of the parallelogram can be formed by extending 144 in the central part of the arm 122, centered extension of the central lever 143, and by double extension 145 with the end 120, parallel to extendmg the longitudinal axis 110 of the implant and placed in the extension axis of the two transverse levers 142 ( see figure 8).

It is noteworthy that the arms 122 and 123 may be symmetrical with respect to a plane that is perpendicular to the expansion plane 102 passing through the longitudinal axis 110 of the implant 101 to obtain, during expansion of the FHE implant, displacement of the two plates 106 and 107 in a parallel manner to the longitudinal axis 110.

Examples of Bone Restoration

A first example of a method for human bone restoration according to one embodiment of the present invention by means of foaming implant will now be described with reference to the figures. 17-29. This applies, in particular, to the way of vertebral bone maintenance through the posterior route, with reduced fractures. Accordingly, the method may comprise one or more (preferably all) of the following steps. One skilled in the art will appreciate that the implant according to such embodiments of the present invention pushes / divides the tissue into the bone, so that the bearing surfaces of the implant preferably contact the bone tissue for restoration.

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Foaming implant, foaming (preferably) in one plane determined 2 (internal tot on and mplant) is ntroduced and nto av ertebra 60, t he s hape which istobe restored. In order to perform this operation, the rod / pin 61 (e.g. Kirschner pin type) is placed transdermally through the posterior route so that the threaded end 62 can be placed (e.g. screwed) in the cortical bone 63 opposite the cortical 64 bone that passes through stem (fig. 17). A pin 61 is placed in the first tube 65 expansion, up to the end of the first tube (65 contacts for example, can be operated) of the outer surface of the cortex bone 64 (Fig. 18).

The first extension tube 65 is received by the second expansion tube 66 until the end of the second tube 66 contacts (e.g., supported) the outer surface of the cortex bone 64 (Fig. 19). The second tube is to expand the fur to obtain a third tube extension 67 that comes into contact (e.g., is handled) on the outer surface 64 of the cortex bone (Fig. 20). Teeth 68 at the end of the third expansion of the tube 67. Cortical anchor 64 bones.

First 65 and second 66 expansion joints as shown. 21, and then are removed, leaving only the pin 61 surrounded by the pipe 67, which are separated from each other by a spacer pipe 68. The proximal bark 64 and the spongy bone 70 is pierced with a drill 69 (e.g.) directed through the pin 61 as shown. 22th In one embodiment, the spongy bone is pierced as far as the third (about), and then the drill bit 69 can be retracted (pin 61 can be retracted, a).

The proximal end of the implant 1 is detachably attached to the distal end of the hollow core (preferably) of the implant carrier 71, which is then inserted into the core of the tube 67 as shown. 23 This implant can be removed placed on the implant carrier through a threaded connection (for example). Inside the implant carrier core 71, a rod 3316 having a distal end that includes coupling means for attachment to the distal end of the implant (and which may also include a flared proximal end larger than the diameter of the rod) can be inserted. Like placing the implant into the implant carrier, the interlocking rods to the implant cannot be through a threaded connection.

Implant Carrier 71 as shown in FIG. 33, includes handling means 3310 for controlled movement of the rod relative to the implant carrier (e.g.). The means may comprise handing over to block 3312 having a central opening through which the implant carrier 71 is positioned and held in place at least rotationally, but preferably rotationally and linearly. In this regard, the proximal end of the gripping member and the proximal end of the implant carrier are preferably flush. The handle 3314, according to one embodiment of the invention, may be attached to the proximal end of one or

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EP) 1) 778) 136) B1 of both the gripping member and the implant carrier, but it is preferably free to rotate relative to it in one or both clockwise and counterclockwise directions. In yet another embodiment of the invention, the handle may be attached to one or both gripping block and implant carrier. The holder may include a central hole that preferably contains an internal thread with a specified thread pitch.

Rod 3316, which he received in the implant carrier, preferably includes external threads corresponding to the pitch of the thread with the handle 3314. The locking device 3311 slides relative to the block holder and may include a pin that thorns 3321 distort the rod 3316 to lock the rod in place (i.e., there is no rotational movement).

The rod thread is preferably at least along most of the length of the rod. According to one embodiment of the invention, the rod, implant carrier of the gripping block and handle can be assembled. One could insert a threaded distal end of the rod into the hole in the center of the proximal end of the implant, in which it could be made in a suitably threaded part in the center of the distal end of the implant. The far end (i.e. , implant position) of the implant assembly with the carrier / handling agents implant may be inserted into the expansion tube 67.

Lynx. . 34 is a different view of the implant carrier, and includes a 3320 device that can be used to indicate the amount of implant expansion (e.g., determining the number of revolutions of the 3316 rod). The indicator may contain a window for the 3316 bar. As shown in the picture. 35, according to one embodiment of the invention, the part of the mandrel that is visible cannot threads. On the contrary, this part of the rod may contain 3322 markings that indicate the percentage of expansion. Additional 3324 markings adjacent to the window allow the user to measure the percentage of expansion from the relative movement between two markings.

Depending on the specific thread pitch and thread direction of the 3316 mandrel, rotation of the handle moves the 3316 rod relative to the implant carrier in a linear direction. Preferably, the threads are on the rod clockwise so that the rotation of the handle moves the rod outward, away from the area where the implant is enlarged (implantation area). For example, on an M5 thread, with a pitch of 0.8 mm, can be used. However, those skilled in the art will appreciate that a thread pitch of between about 0.5 mm and about 1.0 mm (for example) may be used. Lynx. . 36 is a graph illustrating the expansion load ofani mplant dignity up to one e mbodiments ofthe and t be he number of revolutions of the rod for three specific implant sizes.

Accordingly, in connection with the above embodiment, when the ISP implant ositioned inside the tube and dilatation slid there, so that it is located in the inner part of the 60 vertebra. The implant is preferably positioned so that in one extension plane 2 it corresponds to the desired bone renovation plane (Fig. 24). The position of the implants can be

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EP) 1) 778) 136) B1 verified by any known imaging techniques, including, for example, x-rays and ultrasound.

The handle 3314 is then rotated to "pull" the rod away from the implantation site. Because the proximal end of the implant is shaded relative to the implant carrier, and pulls on the rod causing the distal end of the implant to move toward the proximal end (or vice visa). This results in the ends of the implant drawing relative to each other that opens the implant. More precisely, the opposing plates 6 and 7 are open to the outside, preferably forming, respectively, the first 8 and second 9 bearing surfaces in the circle 60, which can be continuous surfaces along their length, which can be substantially equal to the length of the implant 1 (Fig. 25) . During development, fracture reduction control

Therefore, the development of the implant in the vertebra is obtained support under the plates enabling the pressure force to be distributed along the entire length of the plate under it. In this way, sufficient length of tiles can be provided while limiting excessive thickness dimensioning of the latter to resist bends. It will be understood by those skilled in the art that the implant according to some embodiments of the invention is assumed to have a ratio of the spatial length requirement (UN extended) over the length of the elevator plate that is highly optimized, enabling the beneficial use of limited intra-bone spaces with a view of fracture reduction, for example .

The rod 3316 may also include, in accordance with one embodiment of the invention, a disengagement, which may include an internal hexagon at the proximal end 3318 of the rod. This may allow the rod to be released from the implant when the implant has been opened outwards. Alternatively, when the handle is not attached to the block holder and / or implant carrier, the handle may be contraindicated to rotate (i.e. rotate so that the rod does not move in the opposite direction to the implant) so that it moves away from the flushing part of the gripping block and the implant carrier, so that it contacts the proximal end of the rod. Further counter-rotation of the handle (after opening from the implant) causes the rod to rotate in the same opposite rotation as the handle, which causes the rod to detach from the implant. Depending on the set thread pitch, this shutdown can occur in any number of turns (for example, less or more than one turn). See also fig. 26

Preferably, the bolt has been removed, filler material 74 is injected around the implant. The filler material may contain, for example, ionic cement, in particular, an acrylic phosphate cement cement or a compound of the latter, for filling in and around the implant. To this end, the injector needle 73 is moved down the tube 67, reaching the distal end of the needle reaches the distal opening 39 of the implant 1 (Fig. 27). The filling material is injected through the needle. Reverse injection can

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14)

EP) 1) 778) 136) B1 be made to the proximal opening 64 to the circle 60 (Fig. 28). Injector needles can then be pull back from tube 67 (Fig. 29).

A second embodiment of the method according to an embodiment of the invention for the renovation of bone anatomy, will now be described with reference to FIG. 30-32. This example generally relates to a method of renovating vertebral bones by transpedicular, with fracture reduction.

The second example is similar to the first one and differs from it by penetration r oute oft he instill i. Nto t on v ertebra 60, in a non-complex way of transpedicular (Fig. 30), instead of used in the route, backwards first way. Sar esult, O oLko s OME s Teps of the group S econd M ethod h ave b een r epresented in the drawings. 3032, to show another route used to insert implant 1 into the vertebra. In fig. thirty to 32, the same elements as in the first method example have the same reference numbers, and these data correspond to the steps of FIG. 24, 25 and 28 of the first method example. As for the stage shown in Fig. 32, the latter is slightly different from the drawing. 28 from the position of the injector needle 73, closer to the distal end of the implant in FIG. 32

That in this way it can be said that the invention achieves the objects made, it follows from the above description. Since some changes can be made without departing from the scope of the present invention, it should be understood that all content contained in the above description and presented in the accompanying drawings should be interpreted as an illustration and not in a literal sense (and thus without limitation). Practitioners in this field will realize that the method, device and system configurations illustrated and described are examples of various possible system configurations that fall within the scope of the present invention.

VP / 2280 / RW)

EP) 1) 778) 136) B1