SYSTEMS AND DEVICES FOR TREATING GRACTURED OR DESEASED BONES USING EXPANDABLE BODIES, (ALTERNATIVES), STERILE KIT OF TOOLS FOR INSERTION INTO BONE (ALTERNATIVES)

摘要

1. A tool for insertion into bone having cortical bone surrounding an interior volume occupied, at least in part, by cancellous bone, the tool comprising a guide tube, an expandable body carried by the guide tube in a normally collapsed geometry for insertion into the interior volume, a nozzle carried by the guide tube near the expandable body for insertion into the interior volume with the expandable body, a first lumen in the guide tube communicating with the expandable body to convey medium causing expansion of the expandable body in the interior volume to compact cancellous bone and form a cavity in the interior volume, and a second lumen in the guide tube communicating with the nozzle to convey a material for discharge from the nozzle into the cavity. 2. A tool according to claim 1 wherein the nozzle is a bone cement injection nozzle. 3. A system for insertion into bone having cortical bone surrounding an interior volume occupied, at least in part, by cancellous bone, the system comprising an expandable body adapted to selectively assume a collapsed geometry for insertion into the interior volume, a nozzle for insertion into the interior volume to occupy the interior volume with the expandable body, a first element communicating with the expandable body to convey medium causing expansion of the expandable body in the interior volume to compact cancellous bone and form a cavity in the region, and a second element communicating with the nozzle to convey a material for discharge from the nozzle into the cavity at least partially while the expandable body occupies the interior volume. 4. A system according to claim 3 wherein the nozzle is a bone cement injection nozzle. 5. A system for treating bone having cortical bone surrounding an interior volume occupied, at least in part, by cancellous bone, the system comprising a first expandable body having a collapsed geometry for insertion into the interior volume through a first access path in cortical bone, a second expandable body having a collapsed geometry for insertion into the interior volume through a second access path in cortical bone different than the first access path, and the first and second expandable bodies each being adapted to individually assume an expanded geometry for compacting cancellous bone to form a cavity in the interior volume. 6. A system for treating a vertebral body having cortical bone surrounding an interior volume occupied, at least in part, by cancellous bone, the system comprising a first expandable body having a collapsed geometry for insertion into the interior volume through a first access path in cortical bone comprising either transpedicular access or postereolateral access, a second expandable body having a collapsed geometry for insertion into the interior volume through a second access path in cortical bone different than the first access path, and the first and second expandable bodies each being adapted to individually assume an expanded geometry for compacting cancellous bone to form a cavity in the interior volume. 7. A system according to claim 6 wherein the first and second access paths comprise different posterolateral accesses. 8. A system according to claim 6 wherein the first and second access paths comprise different transpedicular accesses. 9. A system according to claim 6 wherein the first a second access paths comprise a transpedicular access and a postereolateral access. 10. A system for treating bone having cortical bone surrounding an interior volume occupied, at least in part, by cancellous bone, the system comprising an expandable body comprising a first expandable zone having a collapsed geometry for insertion into the interior volume, the first expandable zone being adapted to assume an elongated expanded geometry having a first dimension extending substantially across the interior volume, to form a barrier within the interior volume, and a second dimension less than the first dimension, to leave a region of substantially uncompacted cancellous bone extending from the barrier within the interior volume, a second expandable zone having a collapsed geometry for insertion into the region, the second expandable zone being adapted to assume an expanded geometry for compacting cancellous bone to form a cavity in the region while the barrier serves to direct expansion of the second expandable zone in the region away from the first expandable zone. 11. A system according to claim 10 wherein the first and second expandable zones comprise separate expandable assemblies. 12. A system according to claim l0 wherein the first and second expandable zone comprise parts of a single expandable assembly. 13. A device for deployment into an interior body region comprising a catheter tube extending along a first axis, and a structure carried by the catheter tube comprising a body adapted to assume a collapsed geometry for deployment into the interior body region and an expanded geometry for use within the interior body region, the expanded geometry being oriented about a second axis not aligned with the first axis. 14. A device for insertion into bone having cortical bone surrounding an interior volume occupied, at least in part, by cancellous bone, the device comprising a catheter tube extending along a first axis, and a structure carried by the catheter tube comprising a body adapted to assume a collapsed geometry for deployment into the interior body region and an expanded geometry for compacting cancelious bone to form a cavity in the interior volume, the expanded geometry being oriented about a second axis not aligned with the first axis. 15. A device according to claim 13 or 14 wherein the second axis is offset from the first axis by an angle. 16. A device according to claim 15 wherein the angle is an acute angle. 17. A device according to claim 13 or 14 wherein the second axis is offset from the first axis by a distance. 18. A device according to claim 17 wherein the second axis is generally parallel to the first axis. 19. A device according to claim 13 or 14 wherein the body includes conical end portions. 20. A device according to claim 19 wherein each conical end portion includes a cone top secured about the catheter tube. 21. A device according to claim 20 wherein at least one of the conical end portions includes a cone base that is oriented generally parallel to the respective cone top. 22. A device according to claim 20 wherein at least one of the conical end portions includes a cone base that is oriented generally nonparallel to the respective cone top. 23. A device according to claim 13 or 14 wherein the body comprises a relatively elastic material. 24. A device according to claim 13 or 14 wherein the body comprises a relatively inelastic material. 25. A device for deployment into an interior body region comprising a catheter tube having a first diameter, a structure carried by the catheter tube comprising a body adapted to assume a collapsed geometry for deployment into the interior body region and an expanded geometry for use within the interior body region, the expanded geometry having a second diameter greater than the first diameter, the body including spaced apart end regions, and at least one of the end regions providing a non-conical diameter transition between the first and second diameters. 26. A device according to claim 25 wherein at least one of the end regions is inverted. 27. A device according to claim 25 wherein at least one of the end regions define a compound curve. 28. A device according to claim 25 wherein the end regions are bonded to the catheter tube. 29. A device according to claim 25 wherein the end regions each includes an attachment region in which the end region is secured to the catheter tube, and wherein at least one of the end regions is inverted about the respective attachment region. 30. A device according to claim 25 wherein the catheter tube includes a distal end, and wherein one of the end regions is inverted about the distal end of the catheter tube. 31. A device for deployment into an interior body region comprising a first catheter tube having a distal end, a second catheter tube extending beyond the distal end, the second catheter tube being slidable within the first catheter tube, and a structure carried by the first and second catheter tubes and comprising a body adapted to assume a collapsed geometry for deployment into the interior body region and an expanded geometry for use within the interior body region, the body included a first end region secured to the first catheter tube and a second end region secured to the second catheter tube, whereby sliding the second catheter tube to move the second end region toward the first end region inverts the first and second end regions about the respective first and second catheter tubes. 32. A device according to claim 31 and further including a region securing the first and second catheter tubes to hold the first and second end regions in inverted conditions. 33. A device for deployment into an interior body region comprising a first catheter tube having a distal end, the first catheter tube being formed from a first material, a second catheter tube extending beyond the distal end, the second catheter tube being formed from a second material which is more compliant than the first material, and a structure carried by the first and second catheter tubes comprising a body adapted to assume a collapsed geometry for deployment into the interior body region and an expanded geometry for use within the interior body region, the body included a first end region secured to the first catheter tube and a second end region secured to the second catheter tube, the body being formed from a material more compliant than the first material. 34. A device according to claim 33 wherein the first catheter tube has an interior diameter, wherein the second catheter tube includes a portion which extends within the first catheter tube, and where