Integrated cement delivery system for bone augmentation procedures and methods
A bone cement delivery system for vertebroplasty with a cannula having a rigid metal tubular inner wall surrounding a central conduit with a distal outlet port, a rigid metal tubular outer wall extending around the inner wall to define a peripheral conduit with a distal inlet port in the form of fenestrations defined in the tubular outer wall, unobstructed and directly exposed to an environment of the delivery system, a proximal inlet port in communication with the central conduit and a proximal outlet port in communication with the peripheral conduit. A vacuum pump communicating with the proximal outlet port of the peripheral conduit applies a pressure in the range of 10 to 100 KPa to create a pressure gradient between the central conduit and the peripheral conduit to produce a difference in flow rate between the conduits guiding the displacement of bone fluid and the flow of cement.
1. A delivery system for percutaneous injection comprising:
a cannula having:
a rigid tubular inner wall defining a central conduit to percutaneously deliver viscous fluid into a bone under pressure, the inner wall defining a distal outlet port of the central conduit at a distal end of the cannula;
a rigid tubular outer wall concentric with the inner wall and spaced apart therefrom to define a peripheral conduit separate from the central conduit for aspirating bone fluids, the outer wall sized and configured for percutaneous injection, the outer wall defining a distal inlet port in the form of fenestrations defined in the outer wall in communication with the peripheral conduit at the distal end of the cannula, the outlet port of the central conduit and the inlet port of the peripheral conduit being spaced apart linearly, the fenestrations being unobstructed and directly exposed to an environment of the delivery system; and
a proximal end of the cannula including a proximal inlet port in communication with the central conduit and a proximal outlet port in communication with the peripheral conduit.
2. The delivery system according to claim 1 , further comprising a rigid tubular middle wall extending concentrically between the inner and outer walls and spaced apart therefrom to define a middle conduit between the middle and inner walls, the peripheral conduit being defined around the middle conduit.
3. The delivery system according to claim 2 , further including a pressure sensor connected to the proximal end of the cannula such as to sense an internal pressure at the distal end of the cannula through the middle conduit.
4. The delivery system according to claim 1 , further including a pressure sensor connected to the proximal outlet port such as to sense an internal pressure at the distal inlet through the peripheral conduit.
5. The delivery system according to claim 1 , further including a rotatable screw delivery mechanism extending within the central conduit along a length thereof.
6. The delivery system according to claim 5 , wherein the rotatable screw delivery mechanism includes an inner conduit defined therewithin and along a length thereof, the inner conduit being concentric with the central conduit.
7. The delivery system according to claim 1 , further including a pressure sensor connected to a proximal outlet of the central conduit such as to sense an internal pressure at the distal end of the cannula through the central conduit.
8. The delivery system according to claim 1 , wherein the tubular inner wall is shaped as a rotatable screw delivery mechanism extending within the peripheral conduit along a length thereof, such that the central conduit is defined inside the screw delivery mechanism.
9. The delivery system according to claim 1 , further including an elastic and permeable membrane covering the distal outlet of the central conduit for delivery of injected fluid therethrough.
10. The delivery system according to claim 9 , wherein the cannula is used to deliver bone cement, and the membrane has a permeability corresponding to approximately 10% of a permeability of osteoporotic cancellous bone.
11. The delivery system according to claim 9 , wherein the size and elasticity of the membrane is such as to define an expanded diameter of at most 5 mm.
12. The delivery system according to claim 1 , further comprising a vacuum pump communicating with the proximal outlet port of the peripheral conduit and applying a pressure not exceeding 100 KPa to create a pressure gradient between the central conduit and the peripheral conduit to produce a difference in flow rate between the conduits guiding the displacement of bone fluid through the peripheral conduit and out of the proximal outlet port of the peripheral conduit.
13. The delivery system of claim 1 , wherein the outer wall has a diameter not exceeding acceptable parameters for vertebroplasty.
14. The delivery system of claim 1 , wherein the inner and outer walls are made of metal.