Methods for creating a void within a bone. An elongate member is directed into a tube of an access cannula, and a handle is positioned adjacent the access cannula. A working tip and pre-bent elbow are disposed within the tube such that the pre-bent elbow is straightened. The device remains slidable relative to the access cannula. A control assembly is actuated to distally move the shaft relative to the handle. Bone adjacent the tube of the access cannula may resist the working tip from protruding from the access cannula so as to displace the handle of the device proximally, or the handle may be manually maintained adjacent the access cannula. The pre-bent elbow and the working tip are moved beyond the distal end of the tube to be freed from the constraint of the tube of the access cannula to assume a curve within the bone.

A system for restoring height of a vertebral body with a balloon and stabilizing the vertebral body with bone cement. A delivery tube extends from a handle and may be formed from a flexible polymer and a radiopaque filler. The flexible polymer maintains a patent lumen along a curve so as to receive sequential introduction of the balloon and the bone cement to within the vertebral body at a location offset from a longitudinal axis. The radiopaque filler provides for at least a portion of the delivery tube being radiopaque under fluoroscopic visualization. The radiopaque filler may be barium, and the delivery tube may be constructed from coextruding the flexible polymer with the barium. Visual indicia on the handle may indicate a position of the delivery tube relative to another component of the system such as an access cannula. The visual indicia may indicate a direction of the curve.

The present invention provides a circular bone tunneling device, comprising: a hollow elongate body comprising a hollow elongate body head, said hollow elongate body head defining a rigid circular arc, comprising a surgical needle; an extendable and retractable support element, reconfigurable from an extended configuration to a retracted configuration; said support element, in said extended configuration, adapted to be located along said path formed by said rigid circular arc; said support element and said hollow elongate body head are adapted to grasp said bone from at least two points along the circumference of said bone; a stabilizing element.

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Devices and methods for creating holes in the articular process of the vertebra are provided. One embodiment of the invention comprises a drill head comprising a frame, punch arm with punch tip and opposing plate. Methods of using the resulting holes to anchor or stabilize facet joint prosthesis, and also altering the spacing and motion at the facet joints of the vertebral column, are provided.

Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, the curved cannula comprising a curved distal end configured to be extended outward from the distal opening to generate a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured to allow a treatment device to be delivered through the central passageway to a location beyond the curved path.

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

A tool (1, 31) for cutting bone comprises an elongate blade (7, 37) connectable to a generator of longitudinal-mode ultrasonic vibrations. The blade (7, 37) has two lateral cutting edges (9, 10) linked by a rounded distal tip (8). A series of triangular teeth (13) extends along each cutting edge (9, 10) and the distal tip (8). The blade (37) may taper towards each cutting edge (9,10) and the distal tip (8). A variant of the tool (21) comprises an elongate part-cylindrical blade (27) connectable to a generator of torsional-mode ultrasonic vibrations. The blade (27) has a cutting edge at its distal tip (28) provided with a plurality of triangular teeth (23). All forms of the tool (1, 21, 31) are particularly suitable for cutting cancellous bone around an implant to be removed during revision of a joint arthroplasty.