U.S. patent application number 13/679312 was filed with the patent office on 2014-05-22 for multichannel cannula and methods for using same.
This patent application is currently assigned to Spinal Generations, LLC. The applicant listed for this patent is SPINAL GENERATIONS, LLC. Invention is credited to Patrick J. Sweeney.
Application Number | 20140142584 13/679312 |
Document ID | / |
Family ID | 49841792 |
Filed Date | 2014-05-22 |
United States Patent
Application |
20140142584 |
Kind Code |
A1 |
Sweeney; Patrick J. |
May 22, 2014 |
MULTICHANNEL CANNULA AND METHODS FOR USING SAME
Abstract
A method for delivering a substance to bone includes placing a
stabilizing wire in a bone, creating a hole in the bone around the
stabilizing wire, and providing a multichannel cannula, comprising.
The multichannel cannula includes a first channel having an open
proximal end and an open distal end, the first channel being
configured to receive the stabilizing wire, and a second channel
having an inlet portal and an exit portal that are in fluid
communication. The method further includes inserting the
multichannel cannula into the hole in the bone such that the first
channel receives the stabilizing wire, and delivering the substance
into the bone by introducing the substance into the inlet portal of
the second channel such that the substance exits the second channel
through the exit portal.
Inventors: |
Sweeney; Patrick J.;
(Flossmoor, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
SPINAL GENERATIONS, LLC |
Mokena |
IL |
US |
|
|
Assignee: |
Spinal Generations, LLC
Mokena
IL
|
Family ID: |
49841792 |
Appl. No.: |
13/679312 |
Filed: |
November 16, 2012 |
Current U.S.
Class: |
606/103 |
Current CPC
Class: |
A61B 17/8816 20130101;
A61B 2017/3447 20130101; A61B 17/3472 20130101 |
Class at
Publication: |
606/103 |
International
Class: |
A61B 17/88 20060101
A61B017/88 |
Claims
1. A method for delivering a substance to bone, comprising: placing
a stabilizing wire in a bone; creating a hole in the bone around
the stabilizing wire; providing a multichannel cannula, comprising:
a first channel having an open proximal end and an open distal end,
wherein the first channel is configured to receive the stabilizing
wire; and a second channel having an inlet portal and an exit
portal, wherein the inlet portal and the exit portal are in fluid
communication; inserting the multichannel cannula into the hole in
the bone such that the first channel receives the stabilizing wire;
and delivering the substance into the bone by introducing the
substance into the inlet portal of the second channel such that the
substance exits the second channel through the exit portal.
2. The method of claim 1, wherein the first channel is
substantially cylindrical, and a side wall of the cylindrical first
channel is continuous such that no open portals are formed in the
side wall.
3. The method of claim 1, wherein the exit portal of the second
channel is an open distal end of the second channel.
4. The method of claim 1, wherein the exit portal of the second
channel is a side exit portal on an outer wall of the second
channel, and wherein a distal end of the second channel is closed
such that the substance is prevented from exiting the distal end of
the second channel.
5. The method of claim 1, wherein the second channel includes a
plurality of exit portals.
6. The method of claim 1, wherein the multichannel cannula
comprises three, four, or five channels.
7. The method of claim 1, wherein the multichannel cannula further
comprises a delivery portal coupled to the inlet portal of the
second channel, wherein the delivery portal is configured to be
coupled to a delivery device.
8. The method of claim 1, further comprising the step of rotating
the multichannel cannula around the stabilizing wire to align the
exit portal with an intended delivery location within the bone.
9. The method of claim 1, wherein a user employs fluoroscopic
guidance during the step of inserting the multichannel cannula into
the hole in the bone.
10. The method of claim 1, further comprising the step of inserting
an insert having an exit portal into the second channel of the
multichannel cannula; wherein the step of delivering the substance
into the bone includes introducing the substance into the insert
such that the substance exits the exit portal of the second channel
via the exit portal of the insert; and wherein the insert is
adjustable within the second channel to alter the amount of
substance delivered to the bone through the exit portal of the
second channel.
11. A method for removing material from a bone, comprising: placing
a stabilizing wire in a bone; creating a hole in the bone around
the stabilizing wire; providing a multichannel cannula comprising:
a first channel having an open proximal end and an open distal end,
wherein the first channel is configured to receive a stabilizing
wire; and a second channel having an inlet portal and an exit
portal, wherein the inlet portal and the exit portal are in fluid
communication; inserting the multichannel cannula into the hole in
the bone such that the first channel receives the stabilizing wire;
coupling a suction device to the multichannel cannula; and removing
a material from an interior of the bone by activating the suction
device such that the material is drawn into the second channel
through the exit portal of the second channel and the material
exits the second channel through the inlet portal of the second
channel.
12. A multichannel cannula for delivering a substance to bone,
comprising: a first channel having an open proximal end and an open
distal end, wherein the first channel is configured to receive a
stabilizing wire; and a second channel having an inlet portal and
an exit portal, wherein the inlet portal and the exit portal are in
fluid communication, wherein the multichannel cannula is
substantially rigid.
13. The multichannel cannula of claim 12, wherein the first channel
is substantially cylindrical, and a side wall of the cylindrical
first channel is continuous such that no open portals are formed in
the side wall.
14. The multichannel cannula of claim 12, wherein the exit portal
of the second channel is an open distal end of the second
channel.
15. The multichannel cannula of claim 12, wherein the exit portal
of the second channel is a side exit portal on an outer wall of the
second channel, and wherein a distal end of the second channel is
closed such that the substance is prevented from exiting the distal
end of the second channel.
16. The multichannel cannula of claim 12, wherein the second
channel includes a plurality of exit portals.
17. The multichannel cannula of claim 12, further comprising a
third channel.
18. The multichannel cannula of claim 17, further comprising a
fourth channel.
19. The multichannel cannula of claim 18, further comprising a
fifth channel.
20. The multichannel cannula of claim 12, further comprising a
delivery portal coupled to the inlet portal of the second channel,
wherein the delivery portal is configured to be coupled to a
delivery device.
Description
BACKGROUND
[0001] The present invention relates generally to the field of
devices and methods for delivering substances to bone. More
particularly, the present invention concerns devices and methods
for delivering substances to the interior of fractured or otherwise
injured bones, especially to the fracture interface. The present
invention further relates to devices and methods for removing
material from the interior of a bone.
[0002] As techniques for delivering substances to bone progress,
there remains an imprecision during substance delivery prior to
bone implant placement. A bone implant may be a bone screw, nail,
or other device implanted into a bone to stabilize portions of a
fractured bone. At least three techniques are currently available
to deliver substances to bone. One technique involves delivering
the substance into a drilled hole in a fractured bone without
fracture stabilization. The lack of fracture stabilization causes
difficulties in delivering substances to an intended location using
this technique. A second technique includes drilling a separate
hole in a bone for the substance to be delivered after implant
placement. Drilling a separate hole causes additional trauma to the
bone, and may also limit accessibility to the intended delivery
location. In a third technique, the substance is delivered through
the implant. This technique requires the use of a fenestrated or
slotted implant.
SUMMARY
[0003] The embodiments described herein allow delivery of a
substance (e.g., medication) to a fracture site after stabilization
of the bone. Furthermore, the embodiments described herein allow
delivery of a substance to bone through the same hole that will
receive the bone implant, without requiring a separate hole to be
drilled into the bone. The devices and methods described herein
also allow material to be removed from the interior of a bone.
[0004] One embodiment of the invention relates to a method for
delivering a substance to bone. The method includes placing a
stabilizing wire in a bone and creating a hole in the bone around
the stabilizing wire. A multichannel cannula is provided that
includes a first channel having an open proximal end and an open
distal end, the first channel being configured to receive the
stabilizing wire. The multichannel cannula further includes a
second channel having an inlet portal and an exit portal that are
in fluid communication. The method further includes inserting the
multichannel cannula into the hole in the bone such that the first
channel receives the stabilizing wire, and delivering the substance
into the bone by introducing the substance into the inlet portal of
the second channel such that the substance exits the second channel
through the exit portal.
[0005] Another embodiment of the invention relates to a method for
removing material from a bone. The method includes placing a
stabilizing wire in a bone and creating a hole in the bone around
the stabilizing wire. A multichannel cannula is provided that
includes a first channel having an open proximal end and an open
distal end, the first channel being configured to receive a
stabilizing wire. The multichannel cannula further includes a
second channel having an inlet portal and an exit portal that are
in fluid communication. The method further includes inserting the
multichannel cannula into the hole in the bone such that the first
channel receives the stabilizing wire. The method further includes
coupling a suction device to the multichannel cannula, and removing
a material from an interior of the bone by activating the suction
device such that the material is drawn into the second channel
through the exit portal of the second channel and the material
exits the second channel through the inlet portal of the second
channel.
[0006] Yet another embodiment of the invention relates to a
multichannel cannula for delivering a substance to bone. The
multichannel cannula includes a first channel having an open
proximal end and an open distal end. The first channel is
configured to receive a stabilizing wire. The multichannel cannula
further includes a second channel having an inlet portal and an
exit portal that are in fluid communication.
[0007] Alternative exemplary embodiments relate to other features
and combinations of features as may be generally recited in the
claims.
BRIEF DESCRIPTION OF THE FIGURES
[0008] The disclosure will become more fully understood from the
following detailed description, taken in conjunction with the
accompanying figures, wherein like reference numerals refer to like
elements, in which:
[0009] FIG. 1 illustrates a bone with a stabilizing wire and a hole
in the bone around the stabilizing wire, according to an exemplary
embodiment.
[0010] FIGS. 2-5 illustrate cross-sectional views of various
exemplary embodiments of a multichannel cannula.
[0011] FIG. 6 illustrates a multichannel cannula having a side port
and a delivery portal, according to an exemplary embodiment.
[0012] FIG. 7 illustrates a multichannel cannula with a plurality
of exit portals, including open distal ends of channels and
multiple side ports, according to an exemplary embodiment.
[0013] FIG. 8 illustrates the bone and stabilizing wire shown in
FIG. 1 with a multichannel cannula introduced over the stabilizing
wire, according to an exemplary embodiment.
[0014] FIG. 9 illustrates a multichannel cannula with a stabilizing
wire within a first channel and a delivery insert within a second
channel.
DETAILED DESCRIPTION
[0015] Before turning to the figures, which illustrate the
exemplary embodiments in detail, it should be understood that the
application is not limited to the details or methodology set forth
in the description or illustrated in the figures. It should also be
understood that the terminology is for the purpose of description
only and should not be regarded as limiting. For example, a femur
is illustrated in the drawings, but the devices and methods
described herein may be used in connection with any bone in the
body, including but not limited to bones in the spine, arms, hands,
legs, and feet.
[0016] Referring to FIG. 1, a bone 10 includes a fracture 2. The
fracture 2 separates the bone into portions 10A and 10B. In
surgical procedures to repair fractured bones, a stabilizing wire 4
may be used to hold bone portions together. The stabilizing wire 4
may be any type of wire used to temporarily or permanently secure
portions of bone together, such as Kirschner wires or Steinmann
pins. The stabilizing wire 4 is often placed in a fractured bone 10
prior to insertion of a more permanent bone implant, such as a bone
screw, nail, or other fixation structure. In addition to
stabilizing the bone portions 10A and 10B, the stabilizing wire 4
may serve as a guide for a drill or bone implant. For example, the
bone 10 of FIG. 1 includes a hole 6 created to eventually receive a
bone implant. To create the hole 6, a cannulated drill or reamer
can be used to create a hole around the stabilizing wire 4 while
the tip of the stabilizing wire 4 remains fixed in bone portion
10B. The hole 6 passes through the fracture 2. A bone implant to
further secure bone portions 10A and 10B together can then be
guided over stabilizing wire 4 and into the hole 6.
[0017] Referring to FIG. 8, according to an exemplary embodiment, a
multichannel cannula 800 having two or more channels may be
introduced over the stabilizing wire 4 to deliver substances to the
interior of bone 10. In one embodiment, the multichannel cannula is
introduced over the stabilizing wire 4 after creation of hole 6,
but prior to placement of a bone implant into the hole 6. A first
channel of the multichannel cannula receives the stabilizing wire
4. The other channels of the multichannel cannula may be used for
delivering substances to the interior of bone 10, as described in
more detail below. The substance delivered using the multichannel
cannulas described herein may be any type of substance a user
desires to deliver to the interior of a bone, including medication
such as calcium phosphate paste, an antibiotic, or a
chemotherapeutic agent.
[0018] The multichannel cannulas described herein are substantially
elongated structures with two or more channels, as can be seen in
FIGS. 6-8 (reference numbers 600, 700, and 800, respectively). The
multichannel cannulas described herein include a first channel
having an open proximal end (e.g., 824 shown in FIG. 8) and an open
distal end (e.g., 822 shown in FIG. 8). The open proximal end and
open distal end allow the first channel to be threaded over a
stabilizing wire 4. Thus, the first channel is configured to
receive a stabilizing wire 4. In one embodiment, the first channel
is substantially cylindrical and has a diameter slightly larger
than the diameter of the stabilizing wire. The side wall of the
cylindrical first channel (as distinguished from the open ends of
the first channel) may be continuous, meaning there are no open
portals or other openings along the side wall of the first channel.
In one embodiment, liquid cannot penetrate the side wall of the
first channel.
[0019] The multichannel cannulas described herein further include a
second channel (e.g., 802 shown in FIG. 8). The second channel
includes at least one inlet portal (e.g., 820 shown in FIG. 8) and
at least one exit portal (e.g., open distal end 810 shown in FIG.
8; side exit portals 708 shown in FIG. 7). In some methods
described herein, the inlet portal of the second channel serves as
an inlet for a substance to be delivered to the interior of a bone.
In these embodiments, the exit portal of the second channel serves
as an outlet for the substance. In other methods of using a
multichannel cannula, the exit portal of the second channel serves
as an inlet for material being drawn into the second channel and
removed from the interior of a bone. In these embodiments, the
inlet portal of the second channel serves out an outlet for this
removed material. The inlet portal and exit portal of the second
channel are thus in fluid communication to allow substances or
materials to be delivered to or removed from the interior of a
bone.
[0020] FIGS. 2-5 illustrate cross-sectional views of various
embodiments of multichannel cannulas. The multichannel cannulas
shown in FIGS. 2-5 each include at least two interior channels. The
channels of a multichannel cannula may be structured in a variety
of ways to enhance a user's ability to precisely deliver a
substance to an intended location within a bone.
[0021] The multichannel cannula 200 shown in FIG. 2 includes a
first channel 201 and a second channel 202. In this embodiment,
first channel 201 is smaller than second channel 202, and first
channel 201 is contained within the bounds of second channel 202.
The cross-section of multichannel cannula 200 is substantially
circular. In one embodiment, channel 201 receives a stabilizing
wire 4 during a surgical procedure.
[0022] The multichannel cannula 300 shown in FIG. 3 also includes
two channels--first channel 301 and second channel 302. In the
embodiment of FIG. 3, first channel 301 and second channel 302 have
substantially circular cross-sections and have approximately the
same diameter. Furthermore, first channel 301 and second channel
302 are arranged next to each other such that the multichannel
cannula 300 has a substantially ovular cross-section. During use of
the multichannel cannula 300 of FIG. 3, either first channel 301 or
second channel 302 may receive a stabilizing wire 4.
[0023] Referring to FIG. 4, multichannel cannula 400 includes a
first channel 401, a second channel 402, and a third channel 403.
The first channel 401 has a substantially circular cross-section,
while second channel 402 and third channel 403 have crescent-shaped
cross-sections. Second channel 402 and third channel 403 are
arranged on either side of first channel 401 such that multichannel
cannula 400 has a substantially ovular cross-section. In one
embodiment, first channel 401 receives a stabilizing wire 4 during
a surgical procedure.
[0024] Multichannel cannula 500, shown in FIG. 5, includes five
separate channels. The cross-section of first channel 501 is
substantially circular. Second channel 502, third channel 503,
fourth channel 504, and fifth channel 505 have crescent-shaped
cross-sections and are arranged around first channel 501. The
cross-sectional shape of multichannel cannula 500 is thus an
irregular shape, as illustrated in FIG. 5. In one embodiment, first
channel 501 receives a stabilizing wire 4 during a surgical
procedure.
[0025] The multichannel cannulas described herein can be made of
any material suitable for placement into a bone without harmful
effects on the patient. In one embodiment, the multichannel cannula
is made of stainless steel or other type of metal. In another
embodiment, the multichannel cannula is made of a rigid plastic,
such as polyethylketone, that cannot be easily bent or manipulated
into alternative configurations. A rigid cannula may be
advantageous to provide stability when introducing the cannula into
a hole 4 in a bone 10. Furthermore, a rigid cannula provides
stability for various procedures that a more flexible multichannel
cannula may not provide. For example, if a surgeon desires to use a
plunger or other device to push a substance from the multichannel
cannula and into the bone, a rigid cannula may be more desirable.
As another example, a rigid cannula is able to withstand more
significant forces than a flexible cannula (e.g., forces applied to
the cannula by a delivery device 628 or a suction device 826, and
the forces resulting from movement of substances through the
channels and through any open portals in the cannula).
[0026] FIG. 6 provides a perspective view of another embodiment of
a multichannel cannula. Multichannel cannula 600 includes a first
channel 601, a second channel 602, a delivery portal 604, and a
side exit portal 608. The multichannel cannula 600 is threaded over
a stabilizing wire 4, such as stabilizing wire 4 in bone 10 (as
shown in FIG. 8). The stabilizing wire therefore lies within the
first channel 601. The delivery portal 604 is coupled to an inlet
portal 620 of the second channel 602 such that a substance can flow
from the delivery portal 604, through the inlet portal 620, and
into the second channel 602. The delivery portal 604 may be angled
relative to the multichannel cannula 600, as shown in FIG. 6. In an
alternative embodiment, the longitudinal axis of the delivery
portal 604 is aligned parallel to the longitudinal axis of the
multichannel cannula 600.
[0027] Various delivery devices can be coupled to the delivery
portal 604 to assist in delivering substances to the second channel
602 of multichannel cannula 600. The delivery portal 604 may
include a removable plug 606. In one embodiment, a user removes
plug 606 to couple a delivery device 628 (illustrated schematically
in FIG. 6) to delivery portal 604. The delivery device 628 may
include a syringe, a pump, or a reservoir. Tubing 629 may be used
to connect the delivery device 628 to the delivery portal 604. The
type of delivery device selected by a user may depend on the type
of substance to be delivered to the bone.
[0028] Once a substance has been delivered to second channel 602 of
the multichannel cannula 600 through the inlet portal 620, the
substance exits second channel 602 via a side exit portal 608
located on an outer wall of the second channel 602. In this
embodiment, the distal end 610 of second channel 602 is closed,
preventing the substance from exiting the distal end 610 of the
second channel 602. However, in an alternative embodiment, the
distal end 610 of the second channel 602 may be open to create an
exit portal such that the substance can exit the second channel 602
through both the side exit portal 608 and the open distal end 610.
During use of multichannel cannula 600, a user can align the side
exit portal 608 with the area of the bone to be treated with the
substance.
[0029] Referring to FIG. 7, multichannel cannula 700 includes five
channels (701-705), each with an open distal end that can serve as
an exit portal for substance delivery. In this embodiment, the
fourth channel 704 includes a plurality of side exit portals 708,
although any of the other channels 702-705 may include one or more
side exit portals. The first channel 701 is configured to receive
stabilizing wire 4 during a surgical procedure. A substance can be
delivered to the inlet portals of any of channels 702-705 via a
delivery portal, such as the delivery portal 604 described in
connection with FIG. 6. In one embodiment, the substance is
delivered to fourth channel 704. The substance then travels through
fourth channel 704, exiting through side exit portals 708 and the
exit portal created by the open distal end 710 of the fourth
channel 704. In an alternative embodiment, the distal end 710 of
fourth channel 704 is closed to prevent substance from exiting the
distal end 710. The multiple exit portals 708, 710 in the
embodiment of FIG. 7 allow the substance to be delivered to
multiple areas within the interior of a bone. For example, the open
distal end 710 may deliver the substance to a distal end of a hole
6 in a bone (e.g., in bone 10 shown in FIG. 8) while the exit
portals 708 deliver the substance to one or more fracture sites
2.
[0030] FIG. 8 illustrates a multichannel cannula 800 placed within
bone 10 for substance delivery. The multichannel cannula 800
illustrated in FIG. 8 includes at least a first channel 801 and a
second channel 802. First channel 801 is shown threaded over
stabilizing wire 4. Second channel 802 is therefore used for
substance delivery or to remove material from the interior of a
bone. Any of the embodiments of multichannel cannulas described
herein (e.g., 200, 300, 400, 500, 600, 700, and 900), and any
combination of the features of these embodiments, may be utilized
in the manner shown in FIG. 8 to either deliver a substance to bone
or remove material from the interior of a bone. Thus, references
and disclosures related to methods for using multichannel cannula
800 are to be understood to be references and disclosures related
to methods for using any of the other structural embodiments of
multichannel cannulas described herein.
[0031] One method of delivering a substance to bone according to an
exemplary embodiment includes placing stabilizing wire 4 into bone
10 and creating a hole 6 in the bone 10 around the stabilizing wire
4, as described above. The method further includes providing a
multichannel cannula 800 having a first channel 801 with an open
proximal end 824 and an open distal end 822. As also described
above, the proximal end 824 and distal end 822 of the first channel
801 are open so that the first channel 801 can receive the
stabilizing wire 4. The multichannel cannula 800 further includes a
second channel 802 having an inlet portal 820 and an exit portal
818 that are in fluid communication.
[0032] The multichannel cannula 800 may be inserted into the hole 6
in the bone 10 such that the first channel 801 receives the
stabilizing wire 4. During the step of inserting the multichannel
cannula 800 into the hole 6, the multichannel cannula 800 can be
inserted into the proximal end 6A of hole 6 to any desired depth. A
substance is then delivered to the interior of bone 10 by
introducing the substance into the inlet portal 820 of the second
channel 802 such that the substance exits the second channel 802
through the exit portal 818 (i.e., the open distal end 810 of
second channel 802). In one embodiment, the multichannel cannula
800 is inserted into hole 6 such that the distal end 809 of the
multichannel cannula 800 is near fracture 2. The substance can
therefore be delivered to the fracture site through the open distal
end 810 of the second channel 802. In another embodiment, the
multichannel cannula 800 is inserted farther into hole 6 such that
substance is delivered through the open distal end 810 of the
second channel 802 closer to the distal end 6B of hole 6.
[0033] A user may select a multichannel cannula having a particular
configuration and number of exit portals depending on a patient's
bone fracture. For example, some types of fractures may be most
easily treated by delivering a substance to a location that can be
aligned with a distal end of a multichannel cannula. In this
scenario, a user may select a multichannel cannula 800 in which the
distal end 810 of a second channel 802 is open such that the
substance can be delivered to bone 10 through this open distal end
810. In connection with other types of fractures, the user may
desire to treat the bone 10 by delivering medication to one or more
locations along the periphery of a hole 6 in the bone 10. Thus, a
user may select a multichannel cannula 800 in which distal end 810
of second channel 802 is closed, and a substance is delivered to
the bone through side exit portals such as those described in
connection with FIGS. 6 and 7. In yet another embodiment, a
substance may be delivered to bone 10 through a channel in
multichannel cannula 800 having both an open distal end 810 and one
or more side exit portals.
[0034] The multichannel cannula 800 may also be used during
treatment of a patient with a weakened, but unfractured bone. A
patient's bone can be weakened due to osteoporosis, metastasis of a
cancer, or other disease that causes bone deterioration. A surgeon
may be able to analyze the state of the patient's bone and
determine areas that are likely to sustain a fracture in the
future. To treat the weakened bone, a stabilizing pin 4 is inserted
and a hole is drilled into the bone. The multichannel cannula 800
is then threaded over the stabilizing pin 4. A cement (e.g.,
calcium phosphate paste, methylmethacrylate) is injected through a
channel of the multichannel cannula 800. The cement penetrates the
surrounding bone and strengthens the area. After removal of the
multichannel cannula 800, the hole in the bone may be filled with
cement or a bone implant.
[0035] Prior to or during substance delivery, a user may rotate the
multichannel cannula 800 around the stabilizing wire 4. Rotating
the multichannel cannula 800 may help a user align an exit portal
with an intended delivery location within the bone in order to
direct substance delivery to the intended delivery location.
Furthermore, the ability to rotate the multichannel cannula 800
around a stabilizing wire 4 may help during guidance of the
multichannel cannula 800 proximally and distally within hole 6.
[0036] Fluoroscopic guidance may increase a user's ability to
precisely deliver a substance to a desired location within bone 10.
The ability to view the multichannel cannula 800 during insertion
allows a user to adjust the position of multichannel cannula 800 to
precisely align any exit portals of the multichannel cannula 800
with the intended delivery sites within bone 10. Once the
multichannel cannula 800 is positioned and substance delivery has
begun, the user can use fluoroscopic guidance to determine whether
any adjustments to the position of the multichannel cannula 800
should be made to more precisely deliver the substance. For
example, based on fluoroscopic guidance, the user may determine
that the multichannel cannula 800 should be inserted farther into
hole 6. As another example, the image guidance may indicate that
multichannel cannula 800 should be rotated about stabilizing wire 4
to increase delivery accuracy.
[0037] The multichannel cannulas described herein may include
radiopaque markers to facilitate image guidance. The radiopaque
markers may be located on or near the distal tip of the
multichannel cannula. In one embodiment, separate radiopaque
markers are provided near the distal opening of multiple channels
of the multichannel cannula. Radiopaque markers may also be
provided near side portal openings in the cannula. The radiopaque
markers assist a user in accurately positioning the multichannel
cannula during a surgical procedure to deliver or remove a
substance from a bone. Furthermore, the markers allow a user to see
where a substance is exiting or entering the multichannel
cannula.
[0038] Referring to FIG. 9, a multichannel cannula 900 in
accordance with another exemplary embodiment includes a first
channel 901 and a second channel 902. The second channel 902
includes a side exit portal 908 for the substance to exit the
second channel 902. In the embodiment of FIG. 9, an insert 912
having an exit portal 914 is used in combination with multichannel
cannula 900 to deliver a substance to bone. In an alternative
embodiment, the insert 912 includes multiple side exit portals (not
shown). The insert 912 may be one of the embodiments of inserts
described in U.S. patent application Ser. No. 13/270,072, titled
"Method and Device for Delivering Medicine to Bone," filed Oct. 10,
2011, and hereby incorporated by reference herein in its entirety.
In use, the insert 912 is inserted into the second channel 902. A
substance is then introduced into the proximal end 916 of the
insert 912. The substance then exits the exit portal 914 of the
insert and the exit portal 908 of the second channel 902 of the
multichannel cannula 900. The insert 912 can be adjusted within
second channel 902 to alter the amount of substance ultimately
delivered through side exit portal 908 of the multichannel cannula
900. For example, the insert 912 may be pulled in a proximal
direction (i.e., away from the multichannel cannula 900) such that
only a portion of side exit portal 914 is aligned with side exit
portal 908. Alternatively, the insert 912 can be pushed in a distal
direction to fully align side exit portal 914 with side exit portal
908, as shown in FIG. 9, which maximizes the amount of the
substance delivered through side exit portal 908. The insert 912
may also be rotated around its longitudinal axis to alter the
alignment of side exit portal 914 of the insert 912 and side exit
portal 908 of the multichannel cannula 900, thus adjusting the
amount of the substance delivered. A delivery device 628 (shown
schematically in FIG. 6), such as a syringe, a pump, or a
reservoir, may be attached to the proximal end 916 of the insert
912.
[0039] In another exemplary method, any of the multichannel
cannulas described herein may be used to remove material, such as
bone marrow or blood, from the interior of a bone 10. Referring to
FIG. 8, a suction device 826 may be coupled to the proximal end of
multichannel cannula 800 to aid in the removal of material. In one
embodiment, the suction device 826 is coupled to the proximal end
of second channel 802 by tubing 829 or via a delivery portal (e.g.,
the delivery portal 604 shown in FIG. 6). Upon activating the
suction device 826, material being removed from the bone 10 travels
through the multichannel cannula 800 in an opposite manner from the
embodiments in which a substance is being delivered to the bone
through multichannel cannula 800. For example, in the embodiment
shown in FIG. 8, activation of suction device 826 causes material
to enter the multichannel cannula 800 through the exit portal
created by open distal end 810 or through any side exit portals in
the multichannel cannula 800. The material then travels through
second channel 802 and exits the multichannel cannula 800 through
the inlet portal 820 at the proximal end of the second channel 802.
The exit portals of the multichannel cannula 800 may be aligned
within bone 10 to remove material from intended locations near the
exit portals.
[0040] A user may use the multichannel cannula 800 to both deliver
substances to bone 10 and remove materials from the interior of a
bone 10 during the same surgical procedure. In one embodiment, a
user first uses the multichannel cannula 800 to remove material
from the interior of the bone 10. Next, the multichannel cannula
800 is used to deliver substances to areas within the bone 10.
Alternatively, a user may first deliver a substance to the interior
of bone 10 using the multichannel cannula 800. After substance
delivery, the user may remove excess substance (e.g., medication)
or other materials (e.g., blood) by utilizing a suction device 826
coupled to the proximal end of the multichannel cannula 800. The
combination of a multichannel cannula and an insert, such as the
multichannel cannula 900 and insert 912 shown in FIG. 9, may
similarly be used in connection with a suction device 826 to remove
material from the interior of a bone 10. In this embodiment, the
suction device 826 can be coupled via tubing or via a delivery
portal (e.g., the delivery portal 604 shown in FIG. 6) to the
proximal end 916 of the insert 912.
[0041] The multichannel cannulas described herein can be used to
irrigate the interior of a bone by simultaneously delivering a
substance to the bone 10 using one channel and applying a suction
force to a separate channel. Irrigation may be useful for reducing
the risk of infection or contamination within a bone. In one
embodiment, a solution containing antibiotics or other medication
is introduced into a first channel of a multichannel cannula. The
solution travels through the first channel and enters the interior
of a bone through one or more exit portals of the first channel.
Simultaneously or shortly thereafter, a suction force is applied to
a second channel of the multichannel cannula using a suction
device, such as suction device 826 shown in FIG. 8. The suction
draws the solution from the interior of the bone and back into the
multichannel cannula through an open portal of the second channel.
In this manner, the interior of the bone can be irrigated using a
multichannel cannula. The channel used to deliver the substance to
the bone may or may not contain a stabilizing wire 4. Similarly,
the channel used to draw the substance back out of the bone may or
may not contain a stabilizing wire 4. In other words, the presence
of a stabilizing wire 4 within a channel does not prevent
substances from flowing through the channel.
[0042] The various multichannel cannula embodiments can be used in
surgical procedures other than in connection with delivering or
removing substances from bone. For example, the multichannel
cannulas can be used in procedures requiring insertion of a cannula
into a vessel. In this embodiment, a guidewire is inserted into the
patient's vessel, and a first channel of the multichannel cannula
is then threaded over the guidewire. The cannula can then be used
as described in connection with the various methods disclosed
herein to deliver or remove a substance from the vessel through a
channel of the cannula. In another embodiment, the multichannel
cannula is used in ear, nose, and throat procedures, with or
without the use of a guidewire.
[0043] The construction and arrangement of the devices and methods
as shown in the various exemplary embodiments are illustrative
only. Although only a few embodiments have been described in detail
in this disclosure, many modifications are possible (e.g.,
variations in sizes, dimensions, structures, shapes and proportions
of the various elements, use of materials, orientations, etc.). For
example, the position of elements may be reversed or otherwise
varied and the nature or number of discrete elements or positions
may be altered or varied. Accordingly, all such modifications are
intended to be included within the scope of the present disclosure.
The order or sequence of any process or method steps may be varied
or re-sequenced according to alternative embodiments. Other
substitutions, modifications, changes, and omissions may be made in
the design, operating conditions and arrangement of the exemplary
embodiments without departing from the scope of the present
disclosure.
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