CN101677823A - Tissue cavitation device and method - Google Patents

Abstract

The invention provides a medical device for forming or modifying cavities in tissue. Versions include a blade extendable laterally from a first shape to a second shape to cut tissue in a controlled manner. The first shape may be configured for insertion in accordance with minimally invasive procedures and the second shape may be configured for cutting or forming cavities.

Description

Tissue cavitation device and method

Technical field

The solution of the present invention relates to plastic surgery's medical procedures, particularly relates in osseous tissue forming or to change cavity so that use in plastic surgery's process.

Background technology

The surgeon uses minimally invasive surgical techniques to handle multiple medical condition more and more.These technology are usually directed to utilize pipe or sleeve pipe to insert surgery device by the body orifice of nature or by less relatively otch.On the contrary, common surgery operating technology is usually directed to obviously bigger otch, therefore is sometimes referred to as open surgical procedures.Therefore, compare with ordinary skill, minimally invasive surgical techniques provides following advantage: the damage to health tissues minimizes, blood loss minimizes, reduced the danger that complication for example infects and shortened rehabilitation duration.And some minimally invasive surgical techniques can carry out under the local anesthesia situation, anaesthetize in some cases even not, so the surgeon can treat the patient that can not bear the required anesthesia of common ordinary skill.

Surgical method need form cavity usually in soft or hard tissue (comprising bone).Tissue cavities is used for the collection tissue relevant with biopsy or autograft and is used for implantation piece fixing because multiple former thereby formation for example is used to remove pathological tissues.In order to obtain the advantage relevant with less invasive techniques, tissue cavities lessly relatively enters opening and forms by only only producing in destination organization usually.Then, instrument or device insert by this opening, and are used to form obviously greater than the cavity that enters opening.

Utilization forms cavity in tissue a kind of important surgical use is a surgical operation therapy and prevent the fracture relevant with osteoporosis, and this osteoporosis is a kind of disease of metabolism, and feature is that bone amount and intensity reduce.This disease causes fracturing during to medium damage light usually, and may cause fracturing under the normal physiological loading condition in its developmental stage.Osteoporosis is about 1500-2000 ten thousand people of u.s. influence according to estimates, and annual about 1,300,000 fresh fractures are relevant with osteoporosis, and prevailing fracture site is buttocks, wrist and vertebra.

Prophylactic treatment for osteoporosis, damage etc. relates to the next bone that dies down of changing with firmer synthetic bone substitute of use micro-wound surgical operation method.The bone that dies down is at first removed from affected position by surgical operation, thereby forms cavity.Then, this cavity is full of the synthetic bone substitute that can inject, and can solidify.The synthetic bone substitute provides structure to strengthen, and has therefore reduced the danger of affected osteogenesis fracture.But, under the situation that can not adopt the micro-wound surgical operation method, fixedly the bone of osteoporosis-die down is unactual in prevention by this way, because increased sickness rate, blood loss and the complication danger relevant with general surgery.And less invasive techniques will keep the integrity of more bone remaining structure, and this is because its damage to health tissues minimizes.

Enhanced other the more rare situation of structure that may wish bone comprises osteocarcinoma and ischemic necrosis.May relate to by producing tissue cavities for the surgical operation therapy of these situations and to remove pathological tissues, and be full of this cavity, so that provide structure to strengthen affected bone with firmer synthetic bone substitute.

The existing apparatus that is used for forming cavity in soft or sclerous tissues is the assembly of relative complex normally.The U.S. Patent No. 5445639 (" Kuslich ") of authorizing Kuslich etc. discloses reamer between a kind of vertebra that uses when connecting continuous vertebra.The device of Kuslich comprises columnar shaft, and this columnar shaft comprises mechanical mechanism, and this mechanical mechanism makes cutting blade stretch out vertically from this axle, cuts and organizes cavity during with the rotation of box lunch axle.The axle of Kuslich device has relatively large diameter, so that hold the blade extension mechanism, so it may need to produce the relatively large opening that enters, so that will install in the insertion health.Complicated apparatus may be associated with relative higher cost.Axially the cutting instrument that protrudes may limit user's available cutting selection in this processing procedure.

U.S. Patent No. 5928239 (" Mirza ") discloses a kind of percutaneous surgery cavitation device and method, is used at micro-wound surgical operation formative tissue cavity.The Mirza device comprises slender axles and independent cutting tip, and this cutting tip is connected with an end of axle by rotating freely hinge, as shown in fig. 1.The cutting tip of Mirza device around hinge to external rotation, thereby make device can cut the tissue cavities bigger than the diameter of axle.But, the device of Mirza may rely on the axle under 40000 to 80000rpm speed, rotating, this make cutting tip around hinge to external rotation.High rotating speed is like this produced by the high speed surgical drill usually, will be impossible for manual driven.Therefore, such device makes the surgeon accurately to control by artificial rotation when still effectively cutting and organizing.When operation in bone, has the problem that this less relatively hinge component produces structure failure or unclamps under high like this rotating speed.The rotation of the surgical operation drill bit of very high rotating speed (for example from the 40000-80000rpm scope) also may produce too much heat, and this heat may damage the health tissues around the cavity.

The U.S. Patent No. 6066154 (" Reiley ") of authorizing Reiley etc. discloses a kind of device of inflatable, balloon-like, is used for forming cavity at tissue.The Reiley device inserts in the tissue, and inflation then is so that form cavity by compression surrounding tissue (rather than passing through resection organization).But, the Reiley device will not cut and organize, and must cut or otherwise form than areola, so that at first insert the Reiley device in tissue at least usually.Inflatable apparatus also may limit user or the clinician control to cavity shape, and the compression of the osseous tissue of different densities may be very difficult.

Therefore, need a kind of apparatus and method that are used for tissue cavitation, it can be with Wicresoft's mode formative tissue cavity.Also need a kind of cavitation device, it has relatively simple structure, and makes cheaply, and it can manually-operated or operates by the power surgical drill, and makes the user increase the control to the size and dimension of the cavity that forms.

Description of drawings

By below in conjunction with the description of the drawings, will understand the present invention better.Following drawings and detailed description just illustrate, rather than limiting the scope of the invention.

Fig. 1 is the cutaway view of people's near end of thighbone, has represented to authorize the prior art cavitation device described in the U.S. Patent No. 5928239 of Mirza.

Fig. 2 A is the perspective view that expression is installed in a kind of scheme of the cavitation device on the surgical drill.

Fig. 2 B is the more detailed view of the far-end of the cavitation device shown in Fig. 2 A, has represented flexible cutting elements.

Fig. 3 A is the perspective view of a kind of scheme of flexible cutting elements, and expression is shown in an open position.

Fig. 3 B is the sectional side elevation of the foraminous insertion tube of tool, has represented that the flexible cutting elements of Fig. 3 A is inserted in wherein.

Fig. 3 C is the sectional side elevation of the insertion tube of Fig. 3 B, has represented that the flexible cutting elements of Fig. 3 B is opened by the hole.

Fig. 4 A is the perspective view of a kind of scheme of flexible cutting elements, and expression is in static or first shape.

Fig. 4 B is the sectional side elevation with insertion tube of sidewise hole and distal aperture, has represented that the flexible cutting elements of Fig. 4 A is inserted in wherein.

Fig. 4 C is the sectional side elevation of the insertion tube of Fig. 4 B, has represented that the flexible cutting elements of Fig. 4 B is opened by sidewise hole.

Fig. 4 D is the sectional side elevation of the insertion tube of Fig. 4 B, has represented that the flexible cutting elements of Fig. 4 B is opened by distal aperture.

Fig. 5 A is the sectional side elevation of insertion tube, has represented that flexible cutting elements has the distally and the sidewise hole of sawtooth, cut-in groove, irrigation channel and combination.

Fig. 5 B is the insertion tube of Fig. 5 A and the optional sectional side elevation of flexible cutting elements, more clearly shows the distally and the sidewise hole of combination.

Fig. 6 is the sectional side elevation of the foraminous insertion tube of tool, has represented that a kind of flexible cutting elements of scheme is opened by this hole.

Fig. 7 A is the sectional side elevation with the insertion tube in first hole and second hole, has represented that the flexible cutting elements with first cutting element and second cutting element is inserted in wherein.

Fig. 7 B is the insertion tube of Fig. 7 A and the sectional side elevation of flexible cutting elements, has represented that first and second cutting elements open by first hole and second hole respectively.

Fig. 8 A is the sectional side elevation of the foraminous insertion tube of tool, and a kind of flexible cutting elements of scheme is opened by this hole, has wherein represented the range of movement of flexible cutting elements.

Fig. 8 B is that the insertion tube of Fig. 8 A and the forward offlexible member 8B-8B along the line cut open figure, and wherein, the axle of flexible member is represented with section, so that show the element that is arranged at wherein.

Fig. 9 A is the fragmentary, perspective view that has the insertion tube in four holes and have the cavitation device of four flexible cutting elements, and wherein, cavitation device is expressed as and remains in the insertion tube.

Fig. 9 B is the fragmentary, perspective view of insertion tube and the cavitation device of Fig. 9 A, and wherein, four flexible cutting elements are expressed as by four holes to be opened.

Figure 10 A has the insertion tube in first hole and second hole and has first flexible cutting elements and the cutaway view of the cavitation device of second cutting element, has represented to be connected so that operate with T-handle.

Figure 10 B is the more detailed view of cavitation device when the actuator proximad pulling that is connected with it of Figure 10 A, and expression is shown in an open position.

Figure 11 A is the side view of a kind of scheme of the foraminous insertion tube of tool, and this insertion tube inserts in the area of bone tissue, and wherein, flexible member remains in the insertion tube.

Figure 11 B is the side view of the cavitation device of Figure 11 A, and wherein, flexible cutting elements is expressed as by the hole of insertion tube along lateral opening, and wherein, flexible cutting elements is expressed as rotation so that produce cavity.

Figure 11 C is the side view of the cavity of Figure 11 B, wherein, has represented that tube chamber makes cavity be full of structural compounds after the cleaning cavity.

Figure 12 A is the fragmentary, perspective view of insertion tube, maintains flexible cutting elements in this insertion tube, and wherein, flexible cutting elements is expressed as and is in static or first shape.

Figure 12 B is the fragmentary, perspective view of insertion tube and the flexible cutting elements of Figure 12 A, and wherein, flexible cutting elements is expressed as and is in the second position or shape.

Figure 12 C is the fragmentary, perspective view of insertion tube and the flexible cutting elements of Figure 12 A, and wherein, flexible cutting elements is expressed as and is in the 3rd position or shape.

Figure 13 is the fragmentary, perspective view of the foraminous insertion tube of tool, and wherein, the part of flexible cutting elements is expressed as above the end of insertion tube distad extends.

Figure 14 A is the fragmentary, perspective view of a kind of scheme of the foraminous insertion tube of tool, and a kind of winding of scheme or the flexible cutting part of reeling remain in this insertion tube.

Figure 14 B is the fragmentary, perspective view of a kind of scheme of the insertion tube of Figure 14 A and flexible cutting part, and wherein, flexible cutting part is expressed as by launching and open in the hole of insertion tube.

Figure 14 C is expressed as unfolded, the insertion tube of Figure 14 B and the vertical view of compliant member, and wherein, flexible cutting elements departs from longitudinal axis, and has represented to have convex and cut surperficial sword and spill cutting edge.

Figure 14 D is the insertion tube of Figure 14 B and the side view of compliant member.

Figure 15 A is a kind of fragmentary, perspective view of flexible cutting elements with the support unit that is connected with the tip of scheme, and expression is in static or first shape.

Figure 15 B is the fragmentary, perspective view of flexible cutting elements and the support unit of Figure 15 A, and expression is in second shape of opening by the sidewise hole of insertion tube.

Figure 15 C is the fragmentary, perspective view of flexible cutting elements and the support unit of Figure 15 A, and expression is in second shape of opening by the distal aperture of insertion tube.

Figure 16 is a kind of partial top view of flexible cutting elements of scheme.

Figure 17 is the partial top view of the flexible cutting elements of possibility.

Figure 18 is the partial top view of the flexible cutting elements of possibility.

Figure 19 is the partial top view of the flexible cutting elements of possibility.

Figure 20 is the partial top view of the flexible cutting elements of possibility.

Figure 21 is the cutaway view of a kind of flexible cutting elements of scheme along the line D-D among Figure 16.

Figure 22 is the cutaway view of the flexible cutting elements of possibility.

Figure 23 a is a kind of fragmentary, perspective view of flexible cutting elements of scheme.

Figure 23 B is the cutaway view of the flexible cutting elements 23a-23a along the line shown in Figure 23 a.

Figure 24 is the cutaway view of the flexible cutting elements of possibility.

Figure 25 is the cutaway view of the flexible cutting elements of possibility.

Figure 26 is the cutaway view of the flexible cutting elements of possibility.

Figure 27 is the cutaway view of the flexible cutting elements of possibility.

Figure 28 is the cutaway view of the flexible cutting elements of possibility.

Figure 29 is the cutaway view of the flexible cutting elements of possibility.

Figure 30 is the cutaway view of the flexible cutting elements of possibility.

Figure 31 is the cutaway view of the flexible cutting elements of possibility.

Figure 32 is the cutaway view of the flexible cutting elements of possibility.

Figure 33 is the cutaway view of the flexible cutting elements of possibility.

Figure 34 is the cutaway view of the flexible cutting elements of possibility.

Figure 35 is the cutaway view of the flexible cutting elements of possibility.

Figure 36 is the cutaway view of the flexible cutting elements of possibility.

Figure 37 is the cutaway view of the flexible cutting elements of possibility.

Figure 38 is the cutaway view of the flexible cutting elements of possibility.

Figure 39 is the cutaway view of the flexible cutting elements of possibility.

Figure 40 is the cutaway view of the flexible cutting elements of possibility.

Figure 41 is a kind of fragmentary, perspective view of flexible cutting elements of scheme, and wherein top surface has a plurality of cutting elements.

Figure 42 is a kind of fragmentary, perspective view of flexible cutting elements of scheme, and wherein top surface has a plurality of cutting elements.

Figure 43 is a kind of scheme, have the fragmentary, perspective view of flexible cutting elements of the top surface of texture.

Figure 44 is the cutaway view of a kind of tissue cavities of scheme along the axis of reference A-A shown in Figure 11 B.

Figure 45 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 46 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 47 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 48 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 49 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 50 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 51 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 52 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 53 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 54 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 55 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 56 is the cutaway view of the tissue cavities of possibility along the axis of reference A-A shown in Figure 11 B.

Figure 57 is a kind of perspective view of combination tissue's cavity of scheme, and this tissue cavities has the cavity part around axis A-A, axis B-B and axis C-C.

Figure 58 is the cutaway view of combination tissue's cavity of possibility along the line E-E among Figure 57.

Figure 59 is the cutaway view of combination tissue's cavity of possibility along the line E-E among Figure 57.

Figure 60 is the cutaway view of combination tissue's cavity of possibility along the line E-E among Figure 57.

Figure 61 is the cutaway view of combination tissue's cavity of possibility along the line E-E among Figure 57.

Figure 62 is the cutaway view of combination tissue's cavity of possibility along the line E-E among Figure 57.

Figure 63 is the sectional side elevation of a kind of tissue cavities of scheme along the axis of reference A-A among Figure 57.

Figure 64 is the sectional side elevation of the tissue cavities of possibility along the axis of reference A-A among Figure 57.

Figure 65 is the sectional side elevation of the tissue cavities of possibility along the axis of reference A-A among Figure 57.

Figure 66 is the sectional side elevation of the tissue cavities of possibility along the axis of reference A-A among Figure 57.

Figure 67 is the sectional side elevation of the tissue cavities of possibility along the axis of reference A-A among Figure 57.

Figure 68 is the sectional side elevation of the tissue cavities of possibility along the axis of reference A-A among Figure 57.

Figure 69 is the sectional side elevation of the tissue cavities of possibility along the axis of reference A-A among Figure 57.

Figure 70 is insertion tube, have the sectional side elevation with the part of the flexible cutting elements of its associated.

Figure 71 is sectional side elevation insertion tube, that have the part of the flexible cutting elements that links to each other with it of possibility.

Figure 72 is sectional side elevation insertion tube, that have the part of the flexible cutting elements that links to each other with it of possibility.

Figure 73 is sectional side elevation insertion tube, that have the part of the flexible cutting elements that links to each other with it of possibility.

Figure 74 is sectional side elevation insertion tube, that have the part of the flexible cutting elements that links to each other with it of possibility.

Figure 75 is sectional side elevation insertion tube, that have the part of the flexible cutting elements that links to each other with it of possibility.

Figure 76 is fragmentary, perspective view insertion tube, that have the part of the flexible cutting elements that links to each other with it of possibility.

Figure 77 is a kind of cutaway view of insertion tube of scheme.

Figure 78 is a kind of cutaway view of insertion tube of scheme.

Figure 79 is a kind of perspective view of cavitation device of scheme.

Figure 80 is the perspective view of the cavitation device of possibility.

Figure 81 is the perspective view of the cavitation device of possibility.

Figure 82 is the perspective view of the cavitation device of possibility.

Figure 83 is the perspective view of the cavitation device of possibility.

Figure 84 is the perspective view of the cavitation device of possibility.

Figure 85 is the perspective view of the cavitation device of possibility.

Figure 86 is the perspective view of the cavitation device of possibility.

Figure 87 is a kind of scheme, the perspective view of the hinged cavitation device of end effector is arranged.

Figure 88 is the more detailed view of the end effector of the hinged cavitation device shown in Figure 87.

The specific embodiment

The present invention includes tissue cavitation device and method, it utilizes the alteration of form performance to form or change cavity in hard or soft tissue.The alteration of form performance makes device to insert in the tissue by the less relatively opening that enters, and also makes device can form the diameter tissue cavities bigger than the diameter that enters opening.Therefore, the present invention is advantageous particularly in micro-wound surgical operation, and can be used in particular for following at least special-purpose: (1) treatment of fractures or prevention; (2) articulation; (3) implantation piece is fixed; (4) tissue collecting's (particularly bone); (5) remove pathological tissues (hard or soft tissue); (6) overall tissue is removed (hard or soft tissue); (7) vertebral plasty; And (8) kyphoplasty.

With reference to figure 2-20, but cavitation device scheme of the present invention can comprise translation, rotatable or movable axle, this has the flexible cutting elements that links to each other with it, and this flexible cutting elements is used for the processing procedure of formation internal cavities in tissue and moves between first shape and second shape.The process of formation cavity can comprise when axle and/or the insertion tube flexible cutting elements cutting when longitudinal axis rotates that links to each other, compress and otherwise influence tissue.The meaning that should be known in term " axis " is linearity, substantially linear, linear or curved line.Cavity forms can also work as axle local or rotation fully, axial translation or undertaken by impacting tissue or tissue being moved when otherwise driving.The internal cavities that is formed by this device can have than the obvious bigger diameter of the diameter that is used to make device insert in-house initial openings.The tissue cavities that produces according to the scheme here can be size, shape or the structure of any appropriate, comprises substantially spherical cavity, basic hemi-spherical cavities, substantially linear cavity, groove, conduit, has the cavity (for example linear cavity in top hemispherical chamber and bottom) of changes geometry or other suitable cavity arbitrarily.

In multiple scheme, the present invention includes bias voltage, translation or otherwise make flexible cutting elements move to second shape from first shape, perhaps opposite, like this, cutting element can insert by narrow relatively hole, opens then so that form relatively large cavity.The method of bias voltage flexible cutting elements including, but not limited to: provide by the elasticity of flexible cutting elements and/or plastic deformation and the spring bias voltage that causes; The bias voltage that is caused by hot marmem is provided; The bias voltage that is caused by the centrifugal force that produces when axle rotates is provided; The bias voltage that is caused by stretching cable (this stretching cable drives change of shape forcefully) is provided; And provide by coiling the bias voltage that cutting element (this coiling cutting element is upon deployment along extending laterally) causes.The meaning of term " side direction " is: the side that belongs to this element, move along the lateral direction of this element, motion in the direction substantially, generally along direction motion away from it, be positioned at this place, side, be positioned on this side, or be positioned at this side periphery, or be positioned at or extend the mid-plane of leaving main body or element.The meaning of term " laterally " is along crisscross layout, extension or protrusion, perhaps crosses the axis arranged of parts, element or body.The meaning of term " cutting " is to penetrate by for example sharp edges instrument, so that separate, cut, saw, truncate, shortening, separation, friction, excavate, hollow out, divide in bulk, excise or reduce.

The solution of the present invention can be bored by common surgical procedures and be operated, and it has common T-handle, straight handles, screw drives, knob, sliding part, rotary part, lever, actuator or passes through other appropriate device arbitrarily.In comprising the scheme of T-handle, T-handle can also be used for applying pulling force or being used to make the cable rotation to the stretching cable.Should be known in that the device that uses according to the scheme here can be used to exert pressure and/or pulling force.The term here " actuator " is meant control assembly, support unit, base component, actuation component, handle component, driver part and/or the hinge member of any appropriate.Should be known in that the hands that actuator or handle do not need to be arranged to by the people catches, and handle can comprise any suitable means or the mechanism that is used for by operation such as robot or supporting.

The scheme of flexible cutting elements can not need assembly that is complicated and expensive, that have a plurality of moving components to carry out the side direction cutting.The rotation of flexible cutting elements changes performance makes device to adopt to be fit to Wicresoft to be arranged in the shape in the tissue.The different shape, structure, cutting surface and/or the position that are provided for one or more cutting elements can provide multiple choices to the user when forming or change bone cavity.Other notion and example will be introduced according to other example described here.

Fig. 2 A has represented to be installed in a kind of scheme of thecavitation device 100 on the surgical drill 12.Shown in the scheme,surgical drill 12 is a battery powered, and has represented a kind of possible operational approach.Surgical drill 12 can be with for example about 5000 rpms or other suitable rotational speed rotation arbitrarily.In the scheme of use boring, can be favourable provide can be lower than thecavitation device 100 that work under the rotating speed that 40000-80000rpm bores, thereby reduced too much heat, vibrates and made parts or bone to be subjected to stress or disruptive probability.The more slow-speed of revolution (rpm) down efficiently produce whole effect and the safety that cavity can increase this process.Power or manually-operated for thecavitation device 100 that can use according to scheme described here also have multiple choices.For power operation, device can be used for multiple existing surgical drill (pneumatic or electronic).Also can select, axle can be connected with the mechanical actuator of any appropriate.

Shown in Fig. 2 B,cavitation device 100 comprisesaxle 110,flexible cutting elements 120 and cutting tip 130.Shown in the scheme,axle 110 haslongitudinal axis 111 and approximate circular cross-section.Should be known in and to consider any suitable cross-section, for example roughly square sectional, substantially elliptical cross section or polygonal cross-section.Shown in the scheme,cavitation device 100 comprisesinsertion tube 114, thisinsertion tube 114 is porose 124,flexible cutting elements 120 is arranged at least the part and is packed into or remain in theinsertion tube 114.

Also with reference to figure 2B, in a kind of scheme,flexible cutting elements 120 comprisesfree end 121, and relatively thin square-section is arranged.Therefore, in a kind of scheme,flexible cutting elements 120 is consistent with the mechanical organ that is called the sheet spring, and is also consistent with the structural detail that is called cantilever beam.Because this structure,flexible cutting elements 120 can be arranged in conversion betweenfirst shape 122 andsecond shape 123 in the shifting ground, in thisfirst shape 122, thelongitudinal axis 111 basic conllinear offlexible cutting elements 120 andaxle 110, in thissecond shape 123,flexible cutting elements 120 with the overall shape of curve arc fromlongitudinal axis 111 along extending laterally or protruding, as shown in Fig. 2 B.The meaning of term " distortion " is to change shape, transformation, changes shape or distorted shape by pressure or stress.

As shown in Fig. 2 B,flexible cutting elements 120 causesfree end 121 to protrude byhole 124 side direction from the motion of first shape, 122 to second shapes 123.Theaxle 110 and/or the rotation subsequently ofinsertion tube 114 can be so thatflexible cutting elements 120 clockwise or be rotated counterclockwise, so that form or change cavity, perhaps be used for other suitable purpose arbitrarily in tissue.Term described here " protrusion ", " can protrude " be meant from reference point outwards, release forward and/or away from reference point, stretch out, open, expand, launch, loosen and/or otherwise the motion.

Fig. 3 A-3C has represented the possibility of the alteration of form performance of cavitation device 100.Shown in the scheme among Fig. 3 A, whenflexible cutting elements 120 was in its original undeformed state,free end 121 extended or protrusion from thelongitudinal axis 111 of axle 110.But, as shown in Fig. 3 B,cavitation device 100 is sized to the inside by insertion tube 114.Thehole 124 ofinsertion tube 114 can be positioned at around the far-end ofinsertion tube 114, can be elliptical shape, and can be arranged so thatflexible cutting elements 120 can open or otherwise stretch out by this hole.Should be known in thathole 124 can be arranged to have any suitable size, shape, structure and/or position.According to special surgical use,insertion tube 114 can be for the trocar, sleeve pipe, syringe needle, tube chamber, be fixed on the pipe on the handle, the pipe that removably is connected with actuator or other suitable insertion device arbitrarily.

In a kind of scheme,flexible cutting elements 120 is subjected to strain when it placesinsertion tube 114 and takesfirst shape 122, wherein, andflexible cutting elements 120 basic andlongitudinal axis 111 conllinear.Shown in the scheme, cuttingtip 130 helps to makeflexible cutting elements 120 to remain oninsertion tube 114 in during by insertion tube at it to align.

Below with reference to Fig. 3 C, whenflexible cutting elements 120 extends through the leading edge in thehole 124 ofinsertion tubes 114, the spring bias voltage will makeflexible cutting elements 120 move tosecond shape 123 from first shape 122.Consistent with spring mechanism,flexible cutting elements 120 will manage to returnsecond shape 123, because this second shape is no load on spring structure.By putting upside down insertion process,flexible cutting elements 120 can be back tofirst shape 122 so that take out.

Flexible cutting elements 120 can be made of multiple material, comprises the surgical operation grade stainless steel, can flexible performance.Consistent with spring mechanism, the change of shape offlexible cutting elements 120 can be operated in the elasticity of material or plastic deformation scope.Another suitable material is metal alloy Nitinol (NiTi), and the biomaterial of super-elastic property mechanical performance can be arranged, and it can recover from comparing the obviously bigger distortion with a lot of other metal alloys.Also can select,flexible cutting elements 120 can be made of for example polymer, for example nylon or ultra-high molecular weight polyethylene.

With particular reference to Fig. 4 A-4D, Nitinol (perhaps arbitrarily other hot marmem) also can be used for bending device or method, moves to second shape so that flexible cutting elements is biased into from first shape.For example, the flexible cutting elements of being made by Nitinol can be deformed into when being lower than transition temperature and be fit to percutaneous and be arranged in the tissue.When heating by transition temperature, flexible cutting elements can observe reversal deformation.Heat that applies and/or cooling can be electricity, direct or indirect from surrounding tissue and/or relevant with the frictional heat that produces in operating process.

Fig. 4 A-4D has represented the possibility ofcavitation device 200, and thiscavitation device 200 comprisesaxle 210 andflexible cutting elements 220, and thisflexible cutting elements 220 hasfree end 221 and cutting tip 230.Flexible cutting elements 220 can by hot marmem for example Nitinol form, this hot marmem can cause change of shape by hot shape-memory properties.Shown in the scheme,axle 210 haslongitudinal axis 211.

Fig. 4 A has represented thatcavitation device 200 preparations are used for inserting, and whereinflexible cutting elements 220 is deformed intofirst shape 222 when being lower than transition temperature, in thisfirst shape 222, andflexible cutting elements 220 basic andlongitudinal axis 211 conllinear.When being infirst shape 222, theflexible cutting elements 220 that remains in theinsertion tube 214 can enter in the tissue by bullport etc.

Below with reference to Fig. 4 C, whenflexible cutting elements 220 extended through the leading edge in thehole 224 ofinsertion tubes 214, theheat 24 that applies was actuated the hot shape memory characteristic of flexible cutting elements 220.Heat that applies and/or cooling can be electricity, direct or indirect from surrounding tissue and/or relevant with the frictional heat that produces in operating process.Flexible cutting elements 220 can bias voltage to " memory "second shape 223, in thissecond shape 223,flexible cutting elements 220 is protruding or protrude from thelongitudinal axis 211 ofaxle 210 with the general curve circular shape, shown in Fig. 4 C.In case be insecond shape 223,rotating shaft 210 and/orinsertion tube 214 can be along rotating, so that form or change tissue cavities clockwise and/or counterclockwise.

With reference to figure 4D, the optional structure ofcavitation device 200 is disclosed among the figure.Shown in the scheme, whenflexible cutting elements 220 extended through the far-end 215 ofinsertion tubes 214, theheat 24 that applies was actuated the hot shape memory characteristic of flexible cutting elements 220.By actuating,flexible cutting elements 220 can be transformed into second shape 223.In the scheme shown in Fig. 4 D,axle 210 can rotate freely in immobilized substantiallyinsertion tube 214.

With reference to figure 4A-4D and all other suitable scheme disclosed herein, increase supplementary features that can be favourable improve performance and raising cavity production process, cavity change and/or the tissue of the cavitation device of scheme described here and remove.Help to organize a plurality of supplemental characteristics of cutting to be included in sawtooth sword, screw thread, cutting groove, projection, tip, barb, ridge, abrasive surfaces and the inclination sword of the one or both sides of cutting element.In not breaking away from spirit of the present invention, multiple variation and various combination can be arranged.

Geometry in spirit of the present invention changes can be used for strengthening or changing the dynamic shape characteristic.The example of such variation comprises the cross sectional shape and the length of flexible cutting elements.For example, as described in more detail here, the cross sectional shape of flexible cutting elements can form tetragon, and like this, the edge that is formed by tetragonal acute angle is used for helping cutting.And flexible cutting elements can be taked special shape at the sweep of extended position, and wherein, the shape of tissue cavities does not need to be restricted to the combination of cylindricality or hemispherical tissue cavities.Different tissue cavities shapes is applicable to the implantation piece handing-over or produces and is used for the zone of synthetic bone, bone mud, PMMA, bone matrix, bone cement and/or other structural detail, so that mate with complex anatomy.Cavity can be filled with balloon, healing potion, structural agent, stain in addition or keep empty.In addition, can use a plurality of flexible cutting elements to obtain suitable result, rather than only use the single flexible cutting element.

Below with reference to Fig. 5 A-5B, a kind of scheme ofcavitation device 300 comprisesaxle 310 andflexible cutting elements 320, and thisflexible cutting elements 320 has sawtooth 350, so that help the tissue cutting.Similarly, cuttingtip 330 can comprise cut-ingroove 360, so that help the tissuecutting.Cavitation device 300 can also compriseirrigation channel 340, and thisirrigation channel 340 can be used to remove osseous tissue as the conduit of tissue flushing, transmit and fill material for example bone matrix, transfer structure material and/or be used for other suitable purpose arbitrarily.Shown in the scheme,cavitation device 300 comprises wherein porose 324 rotatable insertion tube 314.Shown in the scheme,hole 324 is combinations of distal aperture and sidewise hole.The distally and the sidewise hole of combination provide motility to the user, so that make theflexible cutting elements 320 can side direction and/or axially stretch out.Thehole 324 of combination can provide more cutting to select to the user.The sidewise hole part that should be known inhole 324 can the longitudinal extension any convenient length, and can suitably be provided with in addition.

Fig. 6 has represented the possibility ofcavitation device 400, and thiscavitation device 400 comprises theaxle 410 with longitudinal axis 411.Cavitation device 400 also comprises: flexible cuttingelements 420, and thisflexible cutting elements 420 hasbat shape end 430; Androtatable insertion tube 414, thisinsertion tube 414 porose 424.In a kind of scheme,hole 424 is arranged for and makesflexible cutting elements 420 extend through.

With reference to figure 7A, the possibility ofcavitation device 500 is expressed as hasaxle 510 and a plurality of flexible cutting elements 520.Shown in the scheme, a plurality offlexible cutting elements 520 remain in theinsertion tube 514, thisinsertion tube 514 hasfirst hole 524 andsecond hole 525 that is formed at wherein, is used to hold a plurality of flexible cutting elements 520.Fig. 7 A has represented to have thecavitation device 500 offlexible cutting elements 520, thelongitudinal axis 511 basic conllinear of thisflexible cutting elements 520 andaxle 510, and consistent with first shape that is fit to be arranged in the tissue with Wicresoft.Below with reference to Fig. 7 B,flexible cutting elements 520 is expressed as and is in second shape, and wherein, a plurality of parts offlexible cutting elements 520 extend laterally or outwards protrude fromlongitudinal axis 511 byfirst hole 524 andsecond hole 525 respectively.

Should be known in that in scheme shown in Fig. 7 A-7Bflexible cutting elements 520 forms closed loop, it can be arranged to take suitable givenshape.Insertion tube 514 can provide thehole 524 of any suitable number, so that make one or moreflexible cutting elements 520 side direction protrude.Scheme shown in theflexible cutting elements 520 is just introduced as example, and wherein, a plurality of flexible cutting elements of any suitable architecture can be frominsertion tube 514 side direction or axially protruded.

The centrifugal force that another deflection method utilization that is used for flexible cutting elements is biased into from first shape towards second shape motion is caused by the rotating speed of axle.Centrifugal force is that a part with object or object is from the extrapolated power of center of rotation.Fig. 8 A has represented the possibility of cavitation device 600, and this cavitation device 600 comprises:axle 610, and thisaxle 610 haslongitudinal axis 611; Andflexible cutting elements 620, thisflexible cutting elements 620 has cuttingtip 630 and cut-ingroove 632, and wherein, cavitation device 600 is packed into or local at least remaining in wherein porose 624 theinsertion tube 614.

Shown in the scheme,flexible cutting elements 620 has approximate circular cross-section.Fig. 8 B has represented the section offlexible cutting elements 620 8B-8B along the line, has standard cable structure, have even screw arrangement,concentric stranding line 622 together.This cable structure can provide very high intensity and very high pliability.

Also with reference to figure 8B,flexible cutting elements 620 is expressed as and departs fromlongitudinal axis 611, so that further promote the outside motion offlexible cutting elements 620 under the influence of the centrifugal force that produces during with the rotation of enough speed whenaxle 610 and insertion tube 614.Cavitation device 600 can be driven by surgical drill (rotating speed of this surgical drill can greater than about 5000 rpms), is perhaps driven by other appropriate device arbitrarily.

With reference to figure 9A-9B, represented the optional embodiment ofcavitation device 700 among the figure.With reference to figure 9A, a plurality offlexible cutting elements 720 roughly withaxle 710 conllinear so that form first shape, be applicable to be arranged in device Wicresoft in the tissue or to be arranged in the bullport.In a kind of scheme, the near-end rigidity offlexible cutting elements 720 is installed on theaxle 710, and the far-end offlexible cutting elements 720 is installed on the axle 730.Shown in the scheme, be expressed asflexible cutting elements 720 to the small part that is in first shape and be loaded in theinsertion tube 714 with a plurality ofholes 724, theseholes 724 are corresponding with a plurality of flexible cutting elements 720.Provide a plurality of cutting elements can improve speed and efficient that cavity produces.Provide a plurality of cutting elements (particularly when cutting element is different structure) can also produce cavity part simultaneously with different geometries.

Below with reference to Fig. 9 B, whencoelosis device 700 andinsertion tube 714 during with enough rotating speed rotations,flexible cutting elements 720 has bandy trend under the influence of centrifugal force.In addition or independently, operator can be so thataxle 710 advances towardsaxle 730, so that helpflexible cutting elements 720 is moved towards second shape from first shape, in this second shape, flexible cutting elements is protruding from rotation axis.With reference to this and other scheme, although the far-end ofinsertion tube 714 is expressed as sealing, should be known in that this far-end can have Unclosing structure, like this,cavitation device 700 can pass it and extend.Can utilize centrifugal force, manual driven or the two to operate with reference to the scheme shown in the figure 9A-9B.

Figure 10 A-10B has represented the optional embodiment ofcavitation device 800, and thiscavitation device 800 comprises:axle 810, and thisaxle 810 haslongitudinal axis 811; Andflexible cutting elements 820, this flexible cutting elements part is at least packed into or is remained in therotatable insertion tube 814, in this rotatable insertion tube 814 a plurality ofholes 824 is arranged.Rotation insertion tube 814 can permanent or removably be connected with T-handle 880, and like this, in processing procedure, the rotation of T-handle 880 makesinsertion tube 814 corresponding rotations.In a kind of scheme, when finishing this process,insertion tube 814 can be turned on or otherwise separate with T-handle 880.

Shown in the scheme,axle 810 hascontrol channel 812 in addition, thiscontrol channel 812 substantiallylongitudinally axis 811 is extended.Shown in the scheme, stretchingcable 870 is connected withflexible cutting elements 820, and extends towards nearside by control channel 812.The near-end ofcavitation device 810 is installed on the T-handle 880 withhandle 890, and the near-end of stretchingcable 870 is installed on thehandle 890, and like this, handle 890 will apply tensile force to stretchingcable 870 around itslongitudinal axis 891 rotations.Like this, stretchingcable 870 is to be used for bias voltageflexible cutting elements 820 so that flexure mechanism or the device that moves from first shape towards second shape.When handle 890 during around itslongitudinal axis 891 rotation, tensile force is applied on the stretchingcable 870, thereby exerts pressure and bending force toflexible cutting elements 820, and makes them protruding towards second shape.T-handle 880 can also be aroundlongitudinal axis 811 rotations, so that the formative tissue cavity.Should be known in that other suitable actuator (for example straight handles, brill, knob, lever etc.) can be used for the scheme here arbitrarily.

With reference to figure 11A-11C, represented to be used to form a kind of scheme of the method forcavity 48 among the figure, wherein, theguide member 106 that the periphery of destination organization (for example bone) is arranged with percutaneous and approaching.Particularly, Figure 11 A-11C relates toformation cavity 48 in the osteoporosis spongy bone, fills this cavity to strengthen synthetic bone subsequently, and this enhancing synthetic bone can inject and sclerosis in vivo.This method roughly can be used for whole devices of the alteration of form performance of flexible cutting elements described here.

With reference to figure 11A, in a kind of scheme, standard surgical is bored and drill bit is used for utilizing definite technology to producebullport 46 byguide member 106 at bone.Should be known inbullport 46 can be by surgical drill, electric drill, manually bore, by artificial promotion or push part, by punching, produce by suction or by other appropriate method arbitrarily.Should be known in that bullport can be any desired configuration or structure, for example track (cavitation device can slide), cross, cylindrical hole (enough wide) etc. so that cavitation device can be pivoted around the edge in hole in this track.Bone structure shown in Figure 11 A comprisescortical bone 44 and spongy bone 42.Theflexible cutting elements 120 of cavitation device 110 (shown in Figure 11 A) is in first shape, is applicable to the far-end that leads to bullport 46.Shown in the scheme, cuttingtip 130 helps to make thatflexible cutting elements 120 keeps being centered in theinsertion parts 114 in by the process of guidingtube 106 and bullport 46.In case arrange,axle 110 and/orinsertion tube 114 can be used for transmitting moment of torsion toflexible cutting elements 120.

Below with reference to Figure 11 B, whenaxle 110 andinsertion tube 114 when axis A-A is rotated,flexible cutting elements 120 moves towards second shape in formation has the process of roughlyhemispherical tissue cavities 48 of cavity height 50.As shown in the figure, the diameter ofcavity 48 is twices ofcavity height 50 sizes.Should know, can produce cavity shape, size or the structure of any appropriate, as described in more detail here, wherein, for example cylindricality or local cylindrical cavity can be by producing around longitudinal axis A-A rotation 0 degree to 360 degree from longitudinal axis A-A any appropriate distance.

Figure 11 C has representedtissue cavities 48, but this tissue cavities 48 for example fillsinjection material 16 as synthetic bone, but should harden in vivo by injection material.Before filling synthetic bone etc.,tissue cavities 48 can clean by suction or flushing.The implant of any appropriate, bonding agent, structural agent or healing potion can be sent in the cavity.For example, the polymethyl methacrylate (PMMA) that is commonly referred to bone cement is the synthetic substitute of known bone, and it can inject or insert bone cavity.Other synthetic bone substitute comprises and can absorb and can not resorbent material again, for example the calcium phosphate that can inject and have the combeite glass-ceramic and strengthen the particulate ter-polymer resin that injects.Fill material and can comprise structural agent, healing potion, stain, inflatable element, bone mud, bone matrix, synthetic substrate, growth stimulator for example hydroxyapatite and/or other suitable material arbitrarily.Should be known in that inflatable apparatus can insert in the cavity, so that stablize or otherwise help the bone of heal fractures.Cavity can also not filled.

Osteoporosis may be the factor that causes fracture, particularly femur, scratch bone, humerus and vertebral body.There is multiple non-intruding method to determine the mineral density of bone, and can discerns patient with very high risk of fractures.The danger that had the fracture patients relevant to have very high fracture again or other bone structure to begin to fracture in the past with osteoporosis.Can be used to add bone strengthening with Wicresoft's apparatus and method (for example described here) of synthetic bone substitute combination, be used for the patient's of high risk of fractures prophylactic treatment.

Bone can be removed by known flushing and suction method.When harvesting of bone, a spot of bone is used for other surgical site, so that promote the healing that bone is damaged or promote articulation.Then, cavity can fill suitable bone substitute, and synthetic substrate for example, this bone substitute can inject and sclerosis in vivo.When removing and change osteoporotic bone, cavity can fill structure synthetic bone or bone cement.Because apparatus and method of the present invention are roughly Wicresoft, so they can be used to the fracture that makes the high-risk individual prophylaxis relevant with osteoporosis.The skeletal structure that the fracture relevant with osteoporosis takes place usually comprises scratches bone, femur and vertebral body.

According to possibility, the insertion tube that the periphery of destination organization (for example bone) can be arranged by percutaneous and approaching, and bullport can be formed in the bone by standard surgical brill and drill bit or by any other suitable insertion device or mechanism's (comprising that bullport is formed element to be pushed in the bone).Then, apparatus of the present invention can be inserted appropriate depth in the bullport.The flexible cutting elements of device can move to second shape from first shape, and like this, cutting element extends laterally by the hole in the insertion tube.The longitudinal axis that a plurality of parts of cutting element are left axle stretches out with osseous tissue and contact, like this, by rotating or other appropriate motion, will form or change tissue cavities.

Figure 12 A-12C has represented the possibility ofcavitation device 900, thiscavitation device 900 comprisesaxle 910, thisaxle 910 forms one withflexible cutting elements 920 or is connected, and thisflexible cutting elements 920 has stationary remote 921,first cutting edge 930 and second cutting edge 931.Shown in the scheme,cavitation device 900 holds or local remaining in wherein porose 924 the insertion tube 914.Shown in the scheme,flexible cutting elements 920 by flexible material for example rustlesssteel form.Axle 910 haslongitudinal axis 911.

Figure 12 A has representedcavitation device 900, and thiscavitation device 900 has theflexible cutting elements 920 of being arranged tofirst shape 922, in this first shape,flexible cutting elements 920 roughly withlongitudinal axis 911 aligned adjacent, like this, it remains in the insertion tube 914.Flexible cutting elements 920 can be made of the material of any appropriate, for example comprises rustless steel or Nitinol.Whenflexible cutting elements 920 was infirst shape 922,cavitation device 900 can be handled according to Wicresoft and insert in the bullport.Flexible cutting elements 920 can provide induction element, and the guide ridges of slight curvature portion is for example arranged, and as shown in the figure, like this, it leavesaxis 911 byhole 924 towards the opening bias voltage.Should be known in and also can consider any other appropriate method of impelling flexible cutting elements to open byhole 924.

Below with reference to Figure 12 B, in a kind of scheme, when axle 910 pressurizeds or when otherwise distad pushing, flexible cutting elements 920 is opened by the hole 924 of insertion tube 914, so that form second shape 925.Flexible cutting elements 920 can be by the hinge method (for example passing through T-handle) of any appropriate pressurized or otherwise move to one or more cutting profiles from first shape 922 (as shown in Figure 12 A).For example, in a kind of scheme, the near-end of axle 910 is installed on the T-handle with handle 890, for example the T-handle 880 of Figure 10 A.The near-end of axle 910 can be installed on the handle 890, and like this, handle 890 will be exerted pressure to axle 910 around its longitudinal axis rotation.Therefore, axle 910 is flexure mechanism or device, is used for bias voltage flexible cutting elements 920 so that move from first shape 922 towards 925 motions of second shape or towards the shape of any suitable number.When longitudinal axis when rotation of handle 890 around it, pressure is applied on the axle 910, therefore exerts pressure and bending force to flexible cutting elements 920, thereby makes it protruding towards second shape.When all schemes of being used for here, T-handle 880 can be manually around longitudinal axis 911 rotations, so that form or change tissue cavities.

In a kind of scheme,flexible cutting elements 920 when being arranged tofirst shape 922 roughly withlongitudinal axis 911 conllinear and/or adjacent, wherein, actuating compressing thatinsertion tube 914 applies by proximad makesflexible cutting elements 920 move tosecond shape 925 from first shape 922.In possibility,flexible cutting elements 920 bias voltages are tosecond shape 925 of " memory ", and in thissecond shape 925, thelongitudinal axis 911 thatflexible cutting elements 920 leavesaxle 910 with the shape of curve arc roughly stretches out or protrudes, shown in Figure 12 B.Actuator, T-handle etc. can be used for applying stretching action toaxle 910, and like this, flexible cutting elements initiatively pulls into first shape shown in Figure 12 A.The stretching action that discharges on theaxle 910 will makeflexible cutting elements 920 return the static of it orsecond shape 925.

With reference to figure 12C,flexible cutting elements 920 can move to the 3rd shape 926 according to scheme described here, for example by compressional axis 910.Flexible cutting elements 920 can push by the hinge method (for example by T-handle, manual actuator or electrical actuator) of any appropriate or otherwise move to one or more cutting profiles from first shape.The 3rd shape 926 for example can outwards be protruded farther (comparing withsecond shape 925, as shown in Figure 12B) fromlongitudinal axis 911 side direction.Make aflexible cutting elements 920 have a plurality of available cutting profiles and can increase the number that the doctor formed or changed the available selection scheme of tissue cavities.

When opening,flexible cutting elements 920 can become general curve arc shape or other suitable shape and leaveaxle 910longitudinal axis 911 and stretch out or protrude arbitrarily.The memory maintenance aspect of multiple material (for example Nitinol or rustless steel) makes can provide multiple possible structure.The response and the change pliability that can also change hardness by for example zones of different at flexible cutting elements, change material, change to temperature provide multiple shape.

First shape 922,second shape 925 and the 3rd shape 926 can or be selected in processing procedure before handling.For example, first cavity can produce by theflexible cutting elements 920 of being arranged to second shape 925.After finishing first cavity,flexible cutting elements 920 can be varied to the 3rd shape 926, so that increase the size of first cavity, thereby produces second cavity.Can consider that the user can replace, and does not need to take out from bone cavitation device between shape, structure and direction when producing cavity.Shape can set in advance, and like this, the user can select reservation shape, and by this selection, the user knows that accurately which shape is used to cut and organize.Should be known in thatfirst shape 922,second shape 925 and the 3rd shape 926 can be the structures that (discreetly) select that can disperse, perhaps in possibility, they can be along the point of continuum, and it can be selected in processing procedure or before handling.A plurality of selectable structures are provided and/or make the user regulate cutting element and can accurately produce or change cavity.

The scheme of flexible cutting elements can be provided with, hinged or be operable to any desired configuration, for example bowed shape, platform shape, curve shape, coiling shape, spiral type, extend laterally shape, convex shape, female shapes, linearity configuration and/or sine or wave.Shaft portion can be integral and adjacency with flexible cutting elements, perhaps can be the clearer actuation component of determining or dispersing, be connected with flexible cutting elements.The far-end of flexible cutting elements can be permanently secured on the insertion tube or on the cover, like this, when axle stretching, rotation, compression, hinged and/or otherwise move and make flexible cutting elements when first shape becomes second shape, it is static that far-end keeps.As described further herein, in possibility, the far-end of flexible cutting elements can freely-movable in insertion tube, and/or can removably be connected with insertion tube.

Figure 13 has represented the possibility of cavitation device 1000, and this cavitation device 1000 comprises axle 1010 and flexible cutting elements 1020, and this flexible cutting elements 1020 has fixed far-end 1021, first cutting edge 1030 and second cutting edge 1031.Shown in the scheme, cavitation device 1000 comprises wherein porose 1024 insertion tube 1014.Shown in the scheme, flexible cutting elements 1020 is by flexible material Nitinol and forming for example, this flexible material can have change of shape and shape-memory properties.Axle 1010 has longitudinal axis 1011, and flexible cutting elements 1020 can be around these longitudinal axis 1011 rotations so that form or change cavity.Particularly, Figure 13 has represented the optional shape of flexible cutting elements 1020, and wherein, the part of flexible cutting elements 1020 is distad protruded above the end of insertion tube 1014.The described scheme of cavitation device 1000 can be used for respect to the far-end of insertion tube 1014 and side direction and ground, location, distally form or change cavity.

With reference to figure 14A-14D, the possibility ofcavitation device 1100 is expressed as and comprisesaxle 1110 andflexible cutting elements 1120, and thisflexible cutting elements 1120 has stationary remote 1121,first cutting edge 1130 and second cutting edge 1131.Shown in the scheme,flexible cutting elements 1120 is packed into or local remaining in wherein porose 1124 the insertion tube 1114.Flexible cutting elements 1120 is by flexible material Nitinol and forming for example, and this flexible material can have change of shape and shape-memory properties.Axle 1110 haslongitudinal axis 1111.

Figure 14 A representscavitation device 1100, and it is coiled into spiral substantiallyfirst shape 1122, wherein,flexible cutting elements 1120 coiling or be wound in make it basic align withlongitudinal axis 1111 and theinsertion tube 1114 of packing in.Whenflexible cutting elements 1120 was infirst shape 1122,cavitation device 1100 can be handled according to Wicresoft and pass through bullport.First shape 1122 can realize by applying moment, perhaps also can select, and shape memory can be arranged, and it can be launched into and untie shape by applying moment.The meaning of term " spiral type " is to belong to or spiral and/or helical shaped arranged.

Below with reference to Figure 14 B, shown in the scheme, when axle 1110 launched or unties, flexible cutting elements 1120 extended laterally into second shape 1123 by the hole 1124 of insertion tube 1114.Flexible cutting elements 1120 can be by any appropriate method of attachment or device launches or otherwise move into one or more cutting profiles from first shape 1122.For example, in a kind of scheme, the near-end of axle 1110 is installed on the T-handle (for example T-handle 880 of Figure 10 A) with handle 890, and the near-end of axle 1110 is installed on the handle 890, like this, handle 890 will make axle 1110 rotate around the rotation of its longitudinal axis 891.Therefore, in a kind of scheme, axle 1110 is rotary apparatuss, is used to make flexible cutting elements 1120 to reverse, so that from first shape 1122 (shown in Figure 14 A) towards second shape 1123 or towards the shape motion of any suitable number (because the moment that applies from actuator).When handle 890 during around its longitudinal axis 891 rotation, flexible cutting elements 1120 can launch, thereby makes it protruding towards second shape, 1123 side direction.In case flexible cutting elements 1120 is taked second shape 1123, T-handle 880 grades just can be manually around longitudinal axis 1111 rotations, so that the formative tissue cavity.Should be known in that described operational approach can be used for all schemes of cavitation device described here.

With reference to figure 14A-14D,flexible cutting elements 1120 can by Nitinol or arbitrarily other suitable memory keep material to constitute, wherein,axle 1110 is launched after,flexible cutting elements 1120 is taked second shape 1123.As shown in the figure,second shape 1123 can become the bowed shape that departs fromlongitudinal axis 1111 and by outwards protruding in hole 1124.When it launched,flexible cutting elements 1120 side direction obliquely protruded, and like this,flexible cutting elements 1120 departs from hole 1124.The deviation structure of second shape 1123 (shown in the vertical view of Figure 14 C) can formfirst shape 1122 of coiling with effective and efficient manner, is used for Wicresoft in theinsertion tube 1114 and handles so thatcavitation device 1110 remained on.

With particular reference to Figure 14 C,second shape 1123 offlexible cutting elements 1120 comprisesfirst cutting edge 1130 of spill andsecond cutting edge 1131 of convex.When all schemes of being common to here, as shown in Figure 14 A,axle 1110 and/orinsertion tube 1114 can be along clockwise and/or rotation counterclockwise, so that form or change required cavity.First cutting edge 1130 has the concave surface andsecond cutting edge 1131 to have convex surface to cut geometry so that the user is useful on the suitable selection that forms cavity and changes.Provide non-linear cutting geometry that the effectively vertically cutting edge of progressive or taper can be provided.The direction of rotation that changesaxle 1110 can cut or promote to cut or spur by tissue by tissue and/or the Baltimore groove byfirst cutting edge 1130 so that the user puts by the convex of second cutting edge 1131.Should be known in that arbitrary dimension or convex degree or spill degree can be used for all or part of ofcutting edge 1130,1131 of flexible cutting elements 1120.It is also conceivable that the body offlexible cutting elements 1120 can provide a plurality of side direction spills and convex part (with reference to longitudinal axis 1111), wherein, convex part and concave portions can produce for example waveform outward appearance inflexible cutting elements 1120.

Figure 15 A-15C has represented the possibility ofcavitation device 1200, thiscavitation device 1200 comprises theaxle 1210 that links to each other withflexible cutting elements 1220, and thisflexible cutting elements 1220 has stationary remote 1221 andfirst cutting edge 1230 andsecond cutting edge 1231 that is installed on most advanced and sophisticated 1240.Shown in the scheme, most advanced and sophisticated 1240 are not permanently secured on the far-end 1215 of insertion tube 1214, like this, it can be aroundlongitudinal axis 1211 longitudinal translations.When theflexible cutting elements 1220 of location, provide pliability to select so that the user has multiple cavity toform.Support unit 1250 is arranged to andflexible cutting elements 1220 compounding practices, and thissupport unit 1250 has thestiff end 1251 that is installed on most advanced and sophisticated 1240.Shown in the scheme,flexible cutting elements 1220 andsupport unit 1250 can be packed into or local remaining in wherein porose 1224 the insertion tube 1214.Flexible cutting elements 1220 can be formed by flexible material, Nitinol for example, and this flexible material can have change of shape and shape-memoryproperties.Support unit 1250 can be made of rigidity or semi-rigid material.

Figure 15 A represents thatflexible cutting elements 1220 is infirst shape 1222, and wherein,flexible cutting elements 1220 is positioned to andlongitudinal axis 1211 conllinear roughly, and adjacent support parts 1250.Whenflexible cutting elements 1220 was infirst shape 1222,cavitation device 1200 can be handled to feed in the bullport or otherwise to insert and organize according to Wicresoft.Flexible cutting elements 1220 can be fixed withsupport unit 1250, removably is connected, freely-movable and/or be arranged to link to each other with insertion tube 1214 with other suitable method, shown in Figure 15 B-15C.Should be known in thatflexible cutting elements 1220 andsupport unit 1250 can be independent of insertion tube 1214 operations.

Below with reference to Figure 15 B, in a kind of scheme, whenaxle 1210 was promoted along the distally,flexible cutting elements 1220 was pushed against on most advanced and sophisticated 1240, and like this,flexible cutting elements 1220 extends laterally by the hole 1224 of insertion tube 1214, so that form second shape 1225.Whenflexible cutting elements 1220 for example when distad pushingaxle 1210 is transformed into second shape 1225, thesupport unit 1250 that is fixed on most advanced and sophisticated 1240 can stretch or pulling by proximad, so that relative power is provided, thereby makeflexible cutting elements 1220 to open.Should be known in and can consider other suitable operational approach arbitrarily, forexample axle 1210 keeps static, andtip 1240 and the pulling ofsupport unit 1250 proximads are so that be transformed into second shape 1225 from first shape 1222.In case open,axle 1210,support unit 1250 and/or insertion tube 1214 can rotate, so that cut and organize.

With reference to figure 15C, in a kind of scheme,support unit 1250 can be used for outwards distad promotingtip 1240 from the opening 1215 of insertion tube 1214, and like this,flexible cutting elements 1220 is away from end 1215.As shown in the figure, after stretching out,flexible cutting elements 1220 can be arranged to second shape 1225 by distad pushingaxle 1210 and stretching in opposite direction simultaneously or spur support unit 1250.Figure 15 C by example shown open the scheme of a kind of optional method offlexible cutting elements 1220.

Although can consider the shape or the structure of any appropriate, Figure 16-20 has represented basis multiple vertical cutting edge or surface effect scheme, that be used for flexible cutting elements here.One or more flexible cutting elements can be along rotating, so that form or change cavity clockwise and/or counterclockwise.Except can or moving along one or more direction rotations, flexible cutting elements can also provide one or more surface effects, so that produce different cutting effects.A plurality of cutting edges or surface effect can be combined in the single flexible cutting element, so that according to cut direction tissue is produced Different Effects.Term " surface effect " is meant the flexible cutting elements of cavitation device or random geometry, feature, projection, texture, processing, edging, sharpening, taper, material type, hardness, memory maintenance, heat treatment, the response to heat, roughness, smoothness, acuteness, shape and/or the structure on one or more surfaces, face, edge, point etc. of other parts arbitrarily.

With reference to Figure 16, a kind of scheme of flexible cutting elements 1320 is expressed as has first cutting edge 1330, second cutting edge 1331, far-end 1321 and shaft portion 1310.Shown in the scheme, flexible cutting elements 1320 is to be arranged to rotate the longitudinal extension parts that cut tissue.First cutting edge 1330 and second cutting edge 1331 can provide and be used for along surface effect clockwise and/or cutting counterclockwise or change tissue.Shown in the scheme, first cutting edge 1330 and second cutting edge 1331 are basic level and smooth and smooth, like this, will along clockwise with counterclockwise obtain identical cutting effect.With reference to figure 16-20, surface effect is meant the texture of operationally being arranged to cut or change one or more cuttings surface tissue, flexible cutting elements or cutting edge, structure, shape etc.The surface effect of any appropriate can consider, they are including, but not limited to sawtooth, ripple, convex, spill, edging, cusp, sharp edges, smooth edges, Roughen Edges, flat edge, sclerosis edge or their combination.Consider that also the first surface effect can be provided on the first cutting surface, the second surface effect can be provided in like this, to change direction of rotation and will change type of cut or tissue effect on the second cutting surface of flexible cutting elements.

For example, Figure 17 has represented to have a kind of scheme of theflexible cutting elements 1420 of first level andsmooth cutting edge 1430 and zigzag second cutting edge 1431.In use, the user can be replacing by level and smooth first cutting edge, 1430 cuttings with between by 1431 cuttings of zigzag second cutting edge, to produce required tissue effect.Figure 18 has represented to have a kind of scheme of theflexible cutting elements 1520 of level and smoothfirst cutting edge 1530 and waveform second cutting edge 1531.Figure 19 has represented to have a kind of scheme of level and smoothfirst cutting edge 1630 and theflexible cutting elements 1620 of optional waveform second cutting edge 1631.Figure 20 has represented to have a kind of scheme of theflexible cutting elements 1720 of waveformfirst cutting edge 1730 and zigzag second cutting edge 1731.Shown in surface effect just introduce as example, rather than be used for limiting.Surface effect described here (comprising their variation and combination) can be included in the flexible cutting elements of any appropriate.

Figure 21-40 has roughly represented the example of flexible cutting elements edge with the side sectional view of the corresponding axis of reference line D-D of Figure 16.The cross section of any appropriate can provide, and wherein, the shape, size and/or the structure that change flexible member can advantageously change cutting effect, hardness, acuteness and/or other characteristic of flexible cutting elements.Scheme shown in should be known in is just introduced as example, is not restriction, for example, shown in structure can be whole or part and structural grouping shown in other.

Figure 21 has represented the lateral cross of a kind of scheme offlexible cutting elements 1820, and this flexible cutting elements hasfirst cutting edge 1830,second cutting edge 1831,top surface 1840 and basal surface 1841.Cutaway view for example can be cut open along the line D-D shown in Figure 16.Shown in the scheme,first cutting edge 1830 is parallel flat surfaces withsecond cutting edge 1831,top surface 1840 is the parallel flat surfaces that form parallelogram with basal surface 1841.Cross section shown in Figure 21 (being used for all cross sections described here and their version) can be used for all or part of of flexible cutting elements, and/or in use changes shape.For example, the cross section of Figure 21 can be the cross section of a part whensecond shape 1123 offlexible cutting elements 1120, shown in Figure 14 B-14D.Infirst shape 1122, as shown in Figure 14 A, the cross section of theflexible cutting elements 1120 of winding can be obviously different.Shown in the cross section just introduce as example so that the expression user can be used to obtain the multiple choices of required tissue effect.

Figure 22 has represented the lateral cross of a kind of scheme offlexible cutting elements 1920, and thisflexible cutting elements 1920 has first cuttingedge 1930,second cutting edge 1931,top surface 1940 and basal surface 1941.Shown in the scheme,top surface 1940 is convexs, basal surface 1941 is spills.Provide one or more convex parts and concave portions can changeflexible cutting elements 1920 cutting angle and cutting effect organizationally.In addition, the concave portions of layout and/or convex part can improve the intensity or the rigidity of flexible cutting elements.The more progressive cutting that inclination or crooked cutting edge can be organized, this cutting only need power still less to finish.

Figure 23 A-23B has represented a kind of scheme of flexible cutting elements 2020, and this flexible cutting elements 2020 has first cutting edge 2030, second cutting edge 2031, top surface 2040 and basal surface 2041.With reference to figure 23A, represented the perspective view of the part of flexible cutting elements 2020 among the figure, wherein, the part of top surface 2040 comprises the concave portions 2042 that diminishes gradually.Make flexible cutting elements 2020 have concave portions 2042 can improve intensity, rigidity and/or the cutting effect of flexible cutting elements, for example more weak or the particular point of stress arranged.With reference to figure 23B, shown in the scheme, basal surface 2041 comprises convex part 2043, the size and dimension of this convex part 2043 is corresponding with the concave portions that diminishes gradually 2042, like this, the thickness of flexible cutting elements 2020 will be along its length and width substantially constant.Should be known in that convex part and/or concave portions can be for different mutually shape, thickness and structures and along with flexible cutting elements 2020 is different.Top surface 2040 can also comprise the top section 2044 of substantially flat, and basal surface 2041 can comprise the base section 2045 of substantially flat, and wherein, concave portions is as rib or bridgeware between the flat 2044,2045 of flexible cutting elements 2020.Should be known in concave portions and/or convex part that any suitable number can be provided, this concave portions and/or convex partly have the shape or the structure of any appropriate.

Shown in Figure 23 A-23B,flexible cutting elements 2020 can have in first lateral cross of first area and in second second area, the different lateral cross.For example, in the zone ofconcave portions 2042,flexible cutting elements 2020 can have the cross section shown in Figure 23 B.In flat site,flexible cutting elements 2020 can have and similar cross section, cross section shown in Figure 21.The cross section that changesflexible cutting elements 2020 along the length of flexible cutting elements can provide favourable tissue effect and/or structural advantages can be arranged.Should be known in that any appropriate that can consider the cross section changes or changes, scheme for example described here can be used in combination.

Figure 24 has represented the lateral cross of a kind of scheme offlexible cutting elements 2120, and thisflexible cutting elements 2120 has first cuttingedge 2130,second cutting edge 2131,top surface 2140 and basal surface2141.Top surface 2140 andbasal surface 2141 have one or more convex parts and/or concave portions, and these convex parts and/or concave portions are arranged so that lateral cross has wavy or sinusoidal structured.Shown in the scheme,flexible cutting elements 2120 comprisescenter summit 2142 and twooutside summits 2143, they can be structurally favourable, perhaps help tissue andform.Center summit 2142 can be used for structure support, as rib or the ridge along the central axis of flexible cutting elements 2120.Outside summit 2143 can provide supporting and/or inclinedcut surface.Summit 2142,2143 can for cut sth. askew, circular or other suitable shape.

Figure 25 has represented the lateral cross of a kind of scheme offlexible cutting elements 2220, and thisflexible cutting elements 2220 has first cuttingedge 2230,second cutting edge 2231,top surface 2240 and basal surface2241.Top surface 2240 andbasal surface 2241 can have one or more convex parts and/or concave portions, and this convex part and/or concave portions are arranged so that lateral cross is corrugated or sinusoidal structured.Shown in the scheme,flexible cutting elements 2220 comprisescenter summit 2242 and twooutside summits 2243, they can be structurally favourable or help tissue andform.Center summit 2242 can be used for structure support, as rib or the ridge along the central axis of flexible cutting elements 2220.Outside summit 2243 can provide supporting and/or inclinedcut surface.Summit 2242,2243 can for cut sth. askew, circular, angle, wedge angle, one-tenth ridge are arranged or form other suitable shape.

Figure 26 has represented the lateral cross of a kind of scheme offlexible cutting elements 2320, and thisflexible cutting elements 2320 has first cuttingedge 2330,second cutting edge 2331,top surface 2340 and basal surface 2341.Shown in the scheme, first cutting edge, 2330 substantially flats, and perpendicular totop surface 2340 and basal surface 2341.Second cutting edge 2331 diminishes towards most advanced and sophisticated 2342.Make win cuttingedge 2330 andsecond cutting edge 2331 have the different surfaces geometry to make the user when forming or change cavity the multiple choices scheme be arranged, wherein, for examplesuitable cutting edge 2330,2331 can be selected by direction of rotation.

Figure 27 has represented the lateral cross of a kind of scheme of flexible cutting elements 2420, and this flexible cutting elements 2420 has first cutting edge 2430, second cutting edge 2431, top surface 2440 and basal surface 2441.Shown in the scheme, first cutting edge 2430 is basically parallel to second cutting edge 2431, top surface 2440 is basically parallel to basal surface 2441, so that form parallelogram.First cutting edge 2430 comprises that first wedge shaped tip, 2442, the second cutting edges 2431 comprise second wedge shaped tip 2443 towards basic relative direction.Provide first cutting edge 2430 that differs from one another and second cutting edge 2431 can be so that the user has the multiple choices scheme when forming or change cavity, wherein, suitable cutting edge 2430,2431 can be selected by direction of rotation.

Figure 28 has represented the lateral cross of a kind of scheme of flexible cutting elements 2520, and this flexible cutting elements 2520 has first cutting edge 2530, second cutting edge 2531, top surface 2540 and basal surface 2541.Shown in the scheme, first cutting edge 2530 and second cutting edge 2531 are spill, so that producing cut point with top surface 2540 and basal surface 2541 intersections.Figure 29 has represented the lateral cross of a kind of scheme of flexible cutting elements 2620, and this flexible cutting elements 2620 has first cutting edge 2630, second cutting edge 2631, top surface 2640 and basal surface 2641.Shown in the scheme, second cutting edge 2631 is a zigzag.

Figure 30 has represented the lateral cross of a kind of scheme of flexible cutting elements 2720, and this flexible cutting elements 2720 has first surface 2740 and second surface 2741.The surface of flexible cutting elements 2720 can diminish gradually, and like this, they intersect at first cutting tip 2730 and second cutting tip, 2731 places.The surface 2740,2741 can be waveform, comprises convex part and/or concave portions, comprises tapering part and/or other appropriate geometry arbitrarily.Figure 31 has represented the lateral cross of a kind of scheme of flexible cutting elements 2820, and this flexible cutting elements 2820 has cutting surface 2830, and wherein, flexible cutting elements 2820 has been arranged to sharp point 2832 and round nose 2831.

The scheme that should be known in flexible cutting elements can have the lateral cross structure of any appropriate.For example, Figure 32-40 has represented other structures offlexible cutting elements 2920,3020,3120,3220,3320,3420,3520,3620 and 3720.Figure 32-40 has represented the lateral cross of edge with the corresponding reference line of line D-D shown in Figure 16.

Figure 41 has represented a kind of scheme of the part offlexible cutting elements 3820, and thisflexible cutting elements 3820 operationally is set to add that by axially-movable rotation forms or change tissue cavities.Flexible cutting elements 3820 comprisesfirst cutting edge 3830,second cutting edge 3831,top surface 3840 and basal surface 3841.Shown in the scheme,first cutting edge 3830 andsecond cutting edge 3831 can clockwise or be rotated counterclockwise, as previously mentioned so that form or change tissue cavities.In addition, thetop surface 3840 offlexible cutting elements 3820 can provide one ormore cutting elements 3850, and thiscutting element 3850 is arranged to cut and organize whenflexible cutting elements 3820 repeatedly opens and closes by axially-movable.

For example, thetop surface 3840 offlexible cutting elements 3820 can comprise into thecutting element 3850 of ridged formula, and thiscutting element 3850 can be used for axially-movable or sawing campaign, so that produce lateral cavity, for example shown in Figure 48.The lateral cavity of Figure 48 can and following of non-rotary situation by utilizing axially-movable to form.Be presented in first and second methods that form cavity under the situation about not rotatablely moving below.

In first method, cavitation device (forexample cavitation device 900 of Figure 12 A-12C) can provide top surface, and this top surface has one or more cutting elements 3850.For example, repeatedly replace (shown in Figure 12 A and 12B) by makingcavitation device 900 betweenfirst shape 922 andsecond shape 925, side cut is gone in the osseous tissue by the sawing campaign with thecutting element 3850 of this cavitation device combination, so that produce cavity.

In second method, thecavitation device 900 with one ormore cutting elements 3850 can lateral opening, up to cuttingelement 3850 adjacent bone tissues.Instrument can be vertically or the sawing motion translation then, andflexible cutting elements 3820 is in resting position, so that produce cavity.When wishing that cavity is bigger, cuttingelement 3850 can extend laterally, up to contacting with osseous tissue oncemore.Cavitation device 900 can be more in axial direction or the sawing motion translation like before.In this mode, cavitation device can use according to stepping method, so that produce suitable cavity.

In third party's method, thecavitation device 900 with one ormore cutting elements 3850 can lateral opening, up to cuttingelement 3850 adjacent bone tissues.Then, instrument or its cutting part can rotate so that produce cavity.When wishing that cavity is bigger, cuttingelement 3850 can extend laterally, up to contacting with osseous tissue oncemore.Cavitation device 900 can rotate again, so that produce bigger cavity.In this mode, cavitation device can use according to the rotation stepping method, so that produce suitable cavity.

The side direction cutting function offlexible cutting elements 3820 can be used in combination with the rotation cutting, so that form or change tissue cavities.For example, in case cavitation device (forexample cavitation device 900 of Figure 12 A-12C) inserts in the bullport, flexible cutting elements can at first be used to produce lateral cavity, for example tissue cavities shown in Figure 48.Then, the flexible cutting elements side direction stretches in the lateral cavity, and to rotate so that cut and organize clockwise or counterclockwise.Initial lateral cavity can provide favourable starting point, and the formation of rotation cavity can be from this starting point.

Figure 42 has represented the possibility of the part offlexible cutting elements 3920, and thisflexible cutting elements 3920 operationally is set to by rotatablely moving and/or axially-movable forms or change tissue cavities.Flexible cutting elements 3920 comprisesfirst cutting edge 3930,second cutting edge 3931,top surface 3940 and basal surface 3941.Shown in the scheme,first cutting edge 3930 andsecond cutting edge 3931 can clockwise or be rotated counterclockwise, as described here, so that form or change tissue cavities.In addition, thetop surface 3940 offlexible cutting elements 3920 can provide one ormore cutting elements 3950, and thiscutting element 3950 can cut and organize whenflexible cutting elements 3920 repeatedly opens and closes by axially-movable.Shown in the scheme, cuttingelement 3950 is convex pieces, it can have texture, so that be provided for forming the cutting surface of lateral cavity.

Figure 43 has represented the possibility of the part of veined flexible cutting elements 4020, and this flexible cutting elements 4020 operationally is set to by rotatablely moving and/or axially-movable forms or change tissue cavities.Flexible cutting elements 4020 comprises first cutting edge 4030, second cutting edge 4031, top surface 4040 and basal surface 4041.Shown in the scheme, first cutting edge 4030 and second cutting edge 4031 can clockwise or be rotated counterclockwise, as described here, so that form or change tissue cavities.In addition, the top surface 4040 of flexible cutting elements 4020 can provide a plurality of cutting elements 4050, this cutting element 4050 can be when flexible cutting elements 4020 repeatedly opens and closes by axially-movable cutting or grind ground and corrode tissue.Shown in the scheme, cutting element 4050 has the surface effect that produces texture on top surface 4040.This texture can be by additional special object (having less machining projection), by delineating top surface 4040 or producing by any other appropriate method.Should be known in that one or more cutting elements can have arbitrary surfaces effect, device, structure, acuteness and/or additament, and be arranged to help flexible cutting elements to form lateral cavity by axially-movable.The ridge that one or more cutting elements can also for example protrude by side direction when flexible cutting elements rotates changes tissue effect.

Figure 44-62 has represented the cutaway view of the example of thetissue cavities 48 that basis the scheme here forms.This cutaway view for example can betissue cavities 48 edges of different schemes and the view of the corresponding axle of the axis A-A shown in Figure 11 A-11C.As described in reference to figure 11A-11C,bullport 46 can for example be formed in thecancellous bone tissue 42, is used to insert cavitation device, for example thecavitation device 900 of Figure 12 A-12C.After the insertion, cavitation device can be to be arranged for second shape that forms or changetissue cavities 48 from first transfer of shapes that is arranged for insertion forexample.Tissue cavities 48 can be by the cutting that turns clockwise, be rotated counterclockwise the cutting of cutting, side direction and/or by other suitable cutting method or device form arbitrarily.The cross section of tissue cavities described here can be by here any appropriate cavitation device of scheme form or change.Should be known in thattissue cavities 48 will introduce as example, rather than be used for restriction.Should be known in that tissue cavities can be arranged in any appropriate tissue, and described scheme is introduced as example just.

Figure 44 has represented to have the preformedbullport 46 of axis A-A and to make cavitation device revolve a kind of scheme of thetissue cavities 48 that three-sixth turn forms around axis A-A then by for example cavitation device (forexample cavitation device 900 of Figure 12 A-12C) being inserted.Shown in the scheme, bullport 46 just is expressed as dotted line, because cavitation device will makebullport 46 extend in thetissue cavities 48 around the rotation of axis A-A.When all schemes of being used for here,tissue cavities 48 can thereby produce owing to the former of any suitable number, and these reasons for example comprise that treatment of fractures or prevention, articulation, implantation piece are fixed, tissue collecting, remove pathological tissues (hard or soft tissue), overall tissue and remove protruding shaping after (hard or soft tissue), vertebral plasty and thecone.Tissue cavities 48 can be full of healing potion, structural material, device, inflatable part, fluid, gas and/or other suitable material arbitrarily when forming or change, comprise their combination.Should be known in thattissue cavities 48 can also remain sky.

Figure 45-46 has represented by cavitation device being inserted the scheme that bullport 46 neutralization makes thetissue cavities 48 that cavitation device forms around the axis A-A Rotate 180 then.Can be arranged to cut cavity less than 360 degree according to the cavitation device (forexample cavitation device 900 of Figure 12 A-12C) of the scheme here.Become thetissue cavities 48 of hemispherical shape that structure or treatment advantage can for example be arranged.Cavitation device according to scheme described here can be used for producingtissue cavities 48 in any appropriate range of movement of axis A-A.Making cavitation device be arranged to provide can be so that the user has motility when how to determine optimization process particular tissues zone less than the cavitys of 360 degree.Finishingtissue cavities 48 can have treatment and structural advantages (because on can implementation structure accurate).

With reference to Figure 47, a kind oftissue cavities 48 of scheme is expressed as has the firsttissue cavities zone 4150, and this first tissue cavities zone 4150 can form in for example identical with thetissue cavities 48 of Figure 45 mode.The tissue cavities 48 of Figure 47 comprises the second tissue cavities zone 4151 that size and first tissue cavities zone 4150 is different.In a kind of scheme,tissue cavities 48 shown in Figure 47 can form by the cavitation device (forexample cavitation device 900 of Figure 12 A-12C) with single flexible cutting element 920.For example, after producing the firsttissue cavities zone 4150, cavitation device can the Rotate 180 degree, and like this, cavitation device is at this moment towards relative direction.Then, the flexible cutting elements of cavitation device can be used to produce the second tissue cavities zone 4151.In this mode, can produce have different size, a plurality oftissue cavities zone 4150,4151 of structure, shape and/or size.Although disclose the 4150 and secondtissue cavities zone 4151, first tissue cavities zone, should be known in the tissue cavities zone that can form any suitable architecture and any suitable number.

Figure 48 has represented a kind of scheme oftissue cavities 48, and this tissue cavities 48 comprises the part of bullport 46.Shown in the scheme,tissue cavities 48 is side direction tissue cavities, it for example can form according to theflexible cutting elements 3820 that uses Figure 41.For example,bullport 46 can at first form by piercing in the osseous tissue.Cavitation device (forexample cavitation device 900 of Figure 12 A-12C) with flexible cutting elements (for exampleflexible cutting elements 3820 of Figure 41) can insert in the bullport 46.In case insert, theflexible cutting elements 3820 with thecutting element 3850 that is attached thereto can the translation with the sawing campaign, so that produce thetissue cavities 48 that side direction is protruded.Provide the cavitation device that is set to form side direction tissue cavities (for example tissue cavities shown in Figure 48 48) when the formative tissue cavity, to provide additional selection scheme to the user.

With reference to Figure 49, a kind of scheme oftissue cavities 48 can compriselateral cavity part 4152, and thislateral cavity part 4152 can be for example to form with reference to mode shown in Figure 48.Side directiontissue cavities part 4152 can make up with the secondtissue cavities part 4153 that forms according to the described utilization rotation of Figure 45-46 cutting.Figure 49 has represented a kind of scheme, and wherein, side direction cutting and rotation cutting can be made up, so that form suitable cavity 48.Should be known in that the single flexible cutting element can be arranged for two cutting functions by using for exampleflexible cutting elements 3820 of Figure 41.

Figure 50-56 has represented the view of the additional example oftissue cavities 48 along axis A-A.Figure 50-56 has represented that thebullport 46 with first radius can utilize rotary cutting apparatus and be widened to second radius (reference center axis A-A).Can also produce the second tissue cavities part less than 360 degree, this second tissue cavities partly has three radius bigger than second radius of the bullport of widening 46.Like this, can obtain a plurality of modification of tissue cavities, it has the cavity part (axis of reference A-A) of different radii.Tissue cavities described here can consider just as the example introduction, can provide multiple tissue cavities modification according to the scheme here.

Figure 57 has represented a kind of scheme of tissue cavities 4248, and this tissue cavities 4248 is provided with by making up the first cavity part 4250, the second cavity part 4252 and the 3rd cavity part 4254.The first cavity part 4250 for example can form according to the description of the cylindrical cavity 48 that forms among reference Figure 44.The first cavity part 4250 can form by cavitation device being inserted first bullport 4246, and this first bullport 4246 for example can pierce in the tissue in advance.Then, cavitation device can be according to for example described and rotate around axis A-A with reference to figure 12A-12C, so that form the first cavity part 4250.The second cavity part 4252 can form by cavitation device being inserted second bullport 4247.Then, this cavitation device can be around axis B-B rotation, so that form the second cavity part 4252.Axis A-A and B-B can be oriented like this, make cavitation device will produce the cavity part that overlaps around their rotations.The 3rd cavity part 4254 can form by cavitation device being inserted the 3rd bullport 4249.Then, cavitation device can be around axis C-C rotation, so that form the 3rd cavity part 4254.Axis B-B and C-C can be oriented like this, make cavitation device will produce the cavity part that overlaps around their rotations.By operating cavitation device in this way, can form three cavity parts 4250,4252,4254, make them overlap so that produce single tissue cavities 4248.Should be known in the position changeableization of axis, and just introduce that wherein, axis for example can be parallel, convergence, overlapping, many planes, linearity, non-linear etc. as example.

Provide the tissue cavities part of a plurality of connections when the design organization cavity, to provide a plurality of selection schemes to the user.Thetissue cavities 4248 of Figure 57 is introduced as example, wherein, should be known in that any suitable number cavity part of the structure with any suitable number can make up, so that form suitable cavity.The tissue cavities of Chan Shenging can be particularly well suited to receive for example PMMA of structural material in this way, perhaps is used to hold the inflatable apparatus of handling according to protruding shaping after the cone.

Figure 58 has represented the view of the possibility of tissue cavities 4348 along reference line E-E, and this tissue cavities 4348 is provided with by making up the first cavity part 4350, the second cavity part 4352 and the 3rd cavity part 4354.The first cavity part 4350 can be for example according to cylindrical cavity 48 described formation the with reference to formation in Figure 45-46.The first cavity part 4350 can form by cavitation device being inserted first bullport 4346, and this first bullport 4346 for example can be holed in advance.Then, cavitation device can be according to for example described and rotate around axis A-A with reference to figure 12A-12C, so that form the first hemi-spherical cavities part 4350.The second cavity part 4352 can form by cavitation device being inserted second bullport 4347.Then, this cavitation device can be around axis B-B rotation, so that form the second cylindrical cavity part 4352.Axis A-A and B-B can be oriented like this, and cavitation device will produce the cavity part that overlaps around their rotations.The 3rd cavity part 4354 can form by cavitation device being inserted the 3rd bullport 4349.Then, cavitation device can be around axis C-C rotation, so that form the 3rd hemi-spherical cavities part 4354.Axis B-B and C-C can be oriented like this, and cavitation device will produce the cavity part that overlaps around their rotations.By operating cavitation device in this way, can form three cavity parts 4350,4352,4354 around a plurality of adjacent shaft lines, make them overlap so that produce single tissue cavities 4348.As shown in the figure, various cavity part-structures can make up, so that produce single suitable tissue cavities 4348.

Figure 59-62 has represented the possibility oftissue cavities 4448,4548,4648,4748 of combination along the cutaway view of axis A-A, and thesetissue cavities 4448,4548,4648,4748 produce around the first axle A-A and the second axis B-B by making cavitation device.Should be known in that axis A-A and B-B and respective cavities just introduce as example, wherein, axis can be linear, non-linear, parallel, convergence etc.As shown in the figure, any suitable number cavity of any desired configuration can connect, so that produce the tissue cavities of combination.Such combination tissue's cavity can they be definitely required so that the user can be adjusted into tissue cavities, so that high-quality patient is provided.

Figure 63-69 has represented the side view of the scheme of the tissue cavities that can produce according to cavitation device described here (forexample cavitation device 900 of Figure 12 A-C).Figure 63-69 has represented tissue cavities, and this tissue cavities is along a plurality of tissue cavities parts of single axis (for example axis A-A) combination, so that form the tissue cavities of combination.Produce combination cavity (making up cavity for example) and make the user can adjust tissue cavities, so that obtain maximum treatment advantage.The tissue cavities of Chan Shenging can be particularly well suited to receive for example PMMA of structural material in this way, perhaps is used to hold the inflatable apparatus of handling according to protruding shaping after the cone.

Figure 63 has represented to have the side view of combination tissue's cavity 4848 of the first cavity part 4850 and the second cavity part 4852.The first cavity part 4850 and the second cavity part 4852 for example can be the cavitys along the coaxial and substantially spherical of single axis A-A formation.The tissue cavities 4848 of combination can form by single instrument (for example by at the cavitation device described in Figure 12 A-12C).The tissue cavities 4848 of combination for example can form by the far-end that cavitation device is inserted bullport 4846 with the closed position or first shape.Cavitation device can extend laterally and rotate again, so that form the first cavity part 4850.After producing the first cavity part 4850, cavitation device can and be pulled to the second position along the withdrawal of bullport 4846 proximads.In case in place, cavitation device can extend laterally and rotate again, so that produce the second cavity part 4852.Like this, single cavitation device can be used to produce along a plurality of cavity parts single axis, one or more geometries.A plurality of cavity parts for example can be by bullport 4846 or by other suitable conduit, hole or connector connect arbitrarily.

Figure 64 has represented a kind of scheme of combination tissue'scavity 4948, and a plurality of cavity parts of these combination tissue'scavity 4948 combinations are so that produce the single cavity with basic homogeneous diameter.Thetissue cavities 4948 of combination can also by when coelosis device rotation so that proximad or distad drive cavitation device and produce during the generation hole.Figure 65 has represented a kind of scheme of thetissue cavities 5048 of combination, and wherein, the barycenter of thefirst cavity part 5050 and thesecond cavity part 5052 will depart from or be otherwise not coaxial with the central axis A-A of bullport 5046.Figure 65 has represented an example of thetissue cavities 5048 of combination, wherein, can adjust at in-house cavity, and like this, according to cavitation device described here, special area carries out the cutting different with other parts.

Figure 66 has represented to have a kind of side view of scheme of combination tissue'scavity 5148 of the firstlateral cavity part 5150 and the second lateral cavity part 5152.Thetissue cavities 5148 of combination for example can produce by the cavitation device 900 (shown in Figure 12 A-12C) with flexible cutting elements 3820 (shown in Figure 41).As a reference, Figure 66 for example can be similar to the cutaway view of Figure 48 along the cutaway view of A-A central axis.Bullport 5146 can pierce in the tissue in advance.

The firstlateral cavity part 5150 can produce according to described first method of reference Figure 41, and wherein, the far-end that cavitation device can be close to bullport 5146 inserts in the bullport 5146.Then,flexible cutting elements 3820 can repeatedly be urged to the closed position from open position with the sawing campaign, so that produce the first lateral cavity part 5150.In this scheme, it is static substantially that the handle of cavitation device can keep.

Then, cavitation device can be closed, and proximad is retracted into the second position, operates according to described second method of reference Figure 41 then.For example, cavitation device can be opened, like this, and flexible cutting elements adjacent bone surface.Cavitation device is axial translation again, and flexible cutting elements is in basic resting position, so that produce the second lateral cavity part 5152.When wishing that cavity is bigger, flexible cutting elements can further axially stretch out, and restarts the axial cutting movement of cavitation device once more.As shown in the figure, a plurality of different cavitys parts or section can be combined into single cavity.

Figure 67 has represented a kind of scheme ofcombination cavity 5248, and thiscombination cavity 5248 has a plurality of basic dishtype cavity part 5250,5252,5254,5256 that is connected with bullport 5246.Make up so that form the cavity part of combination tissue's cavity and (for example make up so that thecavity part 5250,5252,5254,5256 offormation combination cavity 5248 can be number, geometry, size, shape and/or the structure that changes.Should be known in any appropriate first cavity can with second cavity combinations of any appropriate so that form the combination cavity.

Figure 68 has represented to have a kind of scheme of combination tissue'scavity 5348 of thefirst cavity part 5350 and the second cavity part 5352.Shown in the scheme, thefirst cavity part 5350 is in the part of fractured bones, thesecond cavity part 5352 is in the second portion of fractured bones.By operating cavitation device (for example cavitation device shown in Figure 12 A-12C 900) according to the scheme here, thefirst cavity part 5350 and thesecond cavity part 5352 can form by the single cavitation device that passes single bullport 5346 insertions.Thefirst cavity part 5350 and thesecond cavity part 5352 can produce, and are used for being used in combination with inflatable apparatus.This process that is used to handle fracture for example can be included in the process described in the U.S. Patent application 60/822440 (applying date is on August 15th, 2006) of common pending trial of Rossenwasser etc., and the document is incorporated herein by reference, but is not limited to this.Also can for example use in the stepping tissue cavities 5448 shown in Figure 69 according to this process.

Figure 70 has represented the partial view of a kind of scheme of the relation betweeninsertion tube 5514 and flexible cutting elements 5520.Shown in the scheme,insertion tube 5514 comprises that shut-off block 5550 for example covers, the far-end 5521 offlexible cutting elements 5520 is fixed on this shut-off block.Flexible cutting elements 5520 can press shut-off block 5550 and by opening inhole 5524, like this, power makes at least a portion offlexible cutting elements 5520 extend laterally withflexible cutting elements 5520 to far-end by distad oppressing.Should be known in that lid described here, cover or shut-off block can be the retainer of any appropriate, movable part, shutoff device, closing assembly, distal cap, side direction lid etc.

Figure 71 has represented the partial view of a kind of scheme of the relation betweeninsertion tube 5614 and flexible cutting elements 5620.Shown in the scheme,spherical member 5650 is fixedlyed connected with the far-end 5621 of flexible cutting elements 5620.Spherical member 5650 can be by makingspherical member 5650 engage withaccepter 5652 and being connected releasedly with insertion tube 5614.Spherical member 5650 and/oraccepter 5652 can have enough flexibilities, so that can connect and throw off.Should be known in that insertion tube version described here can be fabricated to fixed part.

In a kind of scheme,insertion tube 5614 inserts in the bullport under the situation that does not have flexible cutting elements 5620.Incase insertion tube 5614 location,flexible cutting elements 5620 just can insert, and engages withaccepter 5652 up to ball-joint parts 5650.Then, can be byflexible cutting elements 5620 be being pressed ball-joint parts 5650 (like this, this compresses and makes at least a portion offlexible cutting elements 5620 extend laterally) and is makingflexible cutting elements 5620 extend laterally byhole 5624 to far-end.Connection between ball-joint parts 5650 andaccepter 5652 can be like this, and promptlyflexible cutting elements 5620 can connect required less than disengagement by the boundary that pressure extends laterally.In a kind of scheme, so that throw off connection,flexible cutting elements 5620 can take out frominsertion tube 5614 by applying enough proximal force, andinsertion tube 5614 remains in the bullport simultaneously.In this mode, a plurality of flexible cutting elements (for example flexible cutting elements 5620) can insert, and will not take out from bullport by insertion tube 5614.The motility of this device can because the polytype blade can insert, and need not taken out this instrument fully so that accurately form cavity after having used each flexible cutting elements.

Figure 72 has represented the partial view of a kind of scheme of the relation betweeninsertion tube 5714 and flexible cutting elements 5720.Shown in the scheme, thelink 5750 of basic dish type is fixedlyed connected with the far-end 5721 of flexible cutting elements 5720.Dish type link 5750 can and be connected withinsertion tube 5714 releasedly by thisdish type link 5750 andaccepter 5752 joints.Disc-shapedpart 5750 can have enough flexibilities, so that can connect and throw off.Should be known in the structure according toinsertion tube 5714,dish type link 5750 can be any desired configuration, for example polygonal shape.

Figure 73 has represented the partial view of a kind of scheme of the relation betweeninsertion tube 5814 and flexible cutting elements 5820.Shown in the scheme,buckle link 5850 is fixedlyed connected with the far-end 5821 of flexible cutting elements 5820.Buckle link 5850 can and be connected withinsertion tube 5814 releasedly by thisbuckle link 5850 and ratchet 5852joints.Cup 5850 and/or ratchet 5852 can have enough flexibilities, so that can connect and throw off.

Figure 74 has represented the partial view of a kind of scheme of the relation betweeninsertion tube 5914 and flexible cutting elements 5920.Shown in the scheme,t shape link 5950 is fixedlyed connected with the far-end 5921 of flexible cutting elements 5920.T shape link 5950 can and be connected withinsertion tube 5914 releasedly by thist shape link 5950 andaccepter 5952 joints.T shape link 5950 can have enough flexibilities, so that can connect and throw off.

Figure 75 has represented the partial view of a kind of scheme of the relation betweeninsertion tube 6014 and flexible cutting elements 6020.Shown in the scheme, tongue piece or s shape link 6050 are fixedlyed connected with the far-end 6021 of flexible cutting elements 6020.Tongue piece or s shape link 6050 can be by this tongue piece or s shape link 6050 with groove 6052 joints and be connected withinsertion tube 6014 releasedly.Tongue piece or s shape link 6050 can have enough flexibilities, so that can be connected and throw off with groove 6052.Should be known in that described here, the relation between insertion tube and flexible cutting elements is an example, rather than limit.

Figure 76 has represented the partial view of a kind of scheme of the relation between insertion tube 6114 and flexible cutting elements 6120.Shown in the scheme, the far-end 6121 of flexible cutting elements 6120 for example permanently is connected with insertion tube 6114 by pad 6150.Scheme shown in the insertion tube 6114 makes flexible cutting elements 6120 to extend laterally and withdraw by hole 6124, allows the open distal end of material (for example flush fluid) by insertion tube 6114 simultaneously.

With reference to Figure 77 and 78, Figure 77 and 78 has introduced the optional structure ofinsertion tube 6170 and 6190respectively.Insertion tube 6170,6190 can have the axle, flexible cutting elements of relative set or other suitable componentsarbitrarily.Insertion tube 6170 and 6190 will be introduced so that represent the cavitation device element of admissible any suitable architecture as example.

With reference to Figure 79, a kind of scheme ofcavitation device 6200 is disclosed among the figure, thiscavitation device 6200 can be arranged so thatflexible cutting elements 6220 can extend laterally from the hole the insertion tube 6,214 6224 and withdraw.Shown in the scheme,flexible cutting elements 6220 is fixed on theaxle 6210, this 6210 length proximad alongcavitation device 6200 extends, and in axial direction is fixed on theknob 6204 ofhandle 6202 at its near-end 6223 places.Near-end 6223 can be connected withknob 6204, thereby it is rotated freely with respect toknob 6204, like this, the axially-movable ofknob 6204 will make theaxle 6210 translations, but independent rotatablely moving will can not make theaxle 6210translations.Knob 6204 can withbase element 6206 threads engage, like this, with proximad pushingaxle 6210,knob 6204 will distad pushaxle 6210 along the rotation of other direction to knob along the manual rotation of a direction.Shown in the scheme, the driving ofaxle 6210 makesflexible cutting elements 6220 extend laterally byhole 6224 and withdraws.Should be known in that in optional embodiment flexible cutting elements can connect into axle and make it can be with respect to this rotation, wherein, the near-end of axle can rotate and be axially fixed on the knob.

Cavitation device 6200 can be operated byinsertion tube 6214 being inserted in the bullport that gets out in advance (wherein,flexible cutting elements 6220 pack into substantiallyinsertion tube 6214 in).In case the location,knob 6204 can be screwed in thebase element 6206, and thereforeaxle 6210 is distad pushed.Whenaxle 6210 was distad pushed,flexible cutting elements 6220 can be by transversal thrust when it is pressing the far-end of insertion tube 6214.After makingflexible cutting elements 6220 part extends laterally at least, acavitation device 6200 or its part can be rotated, so that form or change tissue cavities.After finishing tissue cavities, knob can rotate in opposite direction, like this, and with theaxle 6210 proximads pulling that is installed on this knob.Shown in the scheme, proximad pullingaxle 6210 will makeflexible cutting elements 6220 be retracted in thehole 6224, so that take out from bullport.All schemes that should be known in cavitation device described here can be operated in this way or be operated with any other suitable method.

In possibility, cavity can be formed bycavitation device 6200 byinsertion tube 6214 being inserted in the bullport that gets out in advance (wherein,flexible cutting elements 6220 pack into substantiallyinsertion tube 6214 in).In case the location,knob 6204 can be screwed in thebase element 6206, therefore distad pushing of axle 6210.Whenaxle 6210 distad pushed,flexible cutting elements 6220 can side direction pushing when it is pressing the far-end of insertion tube 6214.Makingflexible cutting elements 6220 extend laterally up to after tissue contact,cavitation device 6200 can be with sawing campaign axial translation, so that the generation cavity.In order to produce bigger tissue cavities, knob can rotate along equidirectional, and like this, the flexible cutting elements adjacent bone is organized once more and extended laterally.Then,cavitation device 6200 and previous the same axial translation.The scheme that should be known in cavitation device described here can be used according to any suitable method that cavity forms.

In possibility, cavity can be formed bycavitation device 6200 byinsertion tube 6214 being inserted in the bullport that gets out in advance (wherein,flexible cutting elements 6220 pack into substantiallyinsertion tube 6214 in).In case the location,knob 6204 can be screwed in thebase element 6206, therefore distad pushing of axle 6210.Whenaxle 6210 distad pushed,flexible cutting elements 6220 can side direction pushing when it is pressing the far-end of insertion tube 6214.Makeflexible cutting elements 6220 extend laterally up to the tissue contact after,cavitation device 6200 or its cutting part can rotate so that form cavity.In order to produce bigger tissue cavities, knob can rotate along equidirectional, and like this, the flexible cutting elements adjacent bone is organized once more and extended laterally.Then,cavitation device 6200 and the same rotation before.The scheme that should be known in cavitation device described here can be used according to any suitable method that cavity forms.

With reference to Figure 80, the possibility ofcavitation device 6300 is disclosed among the figure, thiscavitation device 6300 can be arranged so that thehole 6324 offlexible cutting elements 6320 frominsertion tube 6314 extends laterally and withdraw.Shown in the scheme,flexible cutting elements 6320 is fixed on thethread spindle 6310, thisthread spindle 6310 extends along the length proximad of cavitation device 6300.Shown in the scheme,thread spindle 6310 engages with screw threadrotation driver part 6304, this screw threadrotation driver part 6304 can rotate in handle 6302.Relation betweenthread spindle 6310 androtary driving part 6304 can be like this,rotary driving part 6304 pushesthread spindle 6310 along the manual rotation of a direction with proximad, androtary driving part 6304 will distad pushthread spindle 6310 along the rotation of other direction.Shown in the scheme, the driving ofaxle 6310 will makeflexible cutting elements 6320 extend laterally byhole 6324 and withdraw, and self-locking.

With reference to Figure 81, the possibility ofcavitation device 6400 is disclosed among the figure, thiscavitation device 6400 can be arranged so that thehole 6424 offlexible cutting elements 6420 frominsertion tube 6414 extends laterally and withdraw.Shown in the scheme,flexible cutting elements 6420 is connected withthread spindle 6410, thisthread spindle 6410 extends along the length proximad of cavitation device 6400.Shown in the scheme,thread spindle 6410 by be loaded in thehandle 6402gear assembly 6406 and withrotary driving part 6404 associated.Relation betweenthread spindle 6410 androtary driving part 6404 can be like this,rotary driving part 6404 pushesthread spindle 6410 along the manual rotation of a direction with proximad, androtary driving part 6404 will distad pushthread spindle 6410 along the other direction rotation.Shown in the scheme, the driving ofaxle 6410 will makeflexible cutting elements 6420 extend laterally byhole 6424 and withdraw, and self-locking.

With reference to Figure 82, the possibility ofcavitation device 6500 is disclosed among the figure, thiscavitation device 6500 can be arranged so that thehole 6524 offlexible cutting elements 6520 frominsertion tube 6514 extends laterally and withdraw.Shown in the scheme,flexible cutting elements 6520 is connected withaxle 6510, this 6510 length proximad alongcavitation device 6500 extends, and is fixed on the slidingpart 6504 at its near-end 6523 places, and this slidingpart 6504 operationally is arranged in thetrack 6506 interior translations in the handle 6502.Slidingpart 6504 can be along axis D-D translation intrack 6506, like this, slidingpart 6504 will distad pushaxle 6510 along the manual actuation of distal direction, and thereforeflexible cutting elements 6520 is extended laterally, and drive slidingpart 6504 with proximad pushingaxle 6510 along proximal direction, thereby makeflexible cutting elements 6520withdrawals.Cavitation device 6500 has for example ratchet (not looking out) of element, and by this ratchet, sliding part and/or flexible cutting elements can move to a certain degree.

With reference to Figure 83, the possibility of cavitation device 6600 is disclosed among the figure, this cavitation device 6600 can be arranged so that the hole 6624 of flexible cutting elements 6620 from insertion tube 6614 extends laterally and withdraw.Shown in the scheme, flexible cutting elements 6620 is connected with axle 6610, this 6610 length proximad along cavitation device 6600 extends, and be fixed on first cylinder 6604 at its near-end 6623 places, the long rails 6606 that this first cylinder 6604 operationally is arranged in the handle 6602 is interior along axis E-E translation, wherein, first cylinder 6604 is by remaining on spring 6618 in the long rails 6606 and the proximad bias voltage.Handle 6602 also comprises second cylinder 6608, and this second cylinder 6608 operationally is arranged in the axial trajectory 6612 along axis F-F translation.Second cylinder 6608 comprises abutment surface 6615, and this abutment surface 6615 operationally is arranged to engage with the inclination abutment surface 6616 of first cylinder 6604.When manually pushing second cylinder 6608, first cylinder 6604 can distad translation in track 6606, wherein, pushes second cylinder 6608 and will make abutment surface 6615 and inclination abutment surface 6616 engage, thereby distad push first cylinder 6604.Should be known in that institute's presentation surface can have any suitable architecture.When second cylinder 6608 discharged, first cylinder 6604 can proximad be back to resting position by spring 6618.Drive first cylinder 6604 along distal direction and will distad push axle 6610, thereby make flexible cutting elements 6620 extend laterally, and drive first cylinder 6604 with proximad pushing axle 6610, thereby make flexible cutting elements 6620 withdrawals along proximal direction.Cavitation device 6600 can also provide locking mechanism (not looking out), so that the fixing flexible cutting element, and/or represents the shape or the position of flexible cutting elements to the user.

Figure 84 has represented the possibility of cavitation device 6700, and this cavitation device 6700 comprises axle 6710, has first flexible cutting elements 6720 and second flexible cutting elements 6722 of free end 6721.Flexible cutting elements 6720 and 6722 can be formed by for example rustless steel.Shown in the scheme, axle 6710 has longitudinal axis 6711.When second flexible cutting elements 6722 aligns with the sidewise hole 6724 of insertion tube 6714, second flexible cutting elements 6722 can from longitudinal axis outwards or side direction protrude.Before being opened into the side direction projective structure or second shape, second flexible cutting elements 6722 can remain on the withdrawal or first shape, simultaneously in insertion tube 6714, as shown in the figure.Second flexible cutting elements can outwards be opened into shape memory by introducing hole 6724, and can protrude when being heated, and can launch, perhaps lateral extension otherwise.Second flexible cutting elements 6722 can have towards the bias voltage of second shape of " memory ", and wherein, flexible cutting elements 6722 extends or protrusion with the longitudinal axis 6711 of the arciform shape of general curve from axle 6710, as shown in the figure.In case be in second shape, second flexible cutting elements 6722 can be used to form or change tissue cavities along clockwise and/or anticlockwise rotation.

Also with reference to Figure 84, when the far-end 6715 of first flexible cutting elements, 6720 process insertion tubes 6714 stretched out, first flexible cutting elements 6720 can side direction or outside the protrusion.When protruding, first flexible cutting elements 6720 can be transformed into the protrusion or second shape, and wherein, first flexible cutting elements 6720 and second flexible cutting elements 6722 all side direction protrude.When being in second shape, as shown in the figure, two tissue cavities parts can produce simultaneously, are used to arrange for example vertebral plasty or kyphoplasty balloon.Should be known in and to consider the arbitrary patterns of flexible cutting elements from first transfer of shapes.It is also conceivable that have a plurality of flexible cutting elements to be positioned near any suitable location of cavitation device 6700.It is also conceivable that, first flexible cutting elements and second flexible cutting elements can response change protrusion stimulate, for example first flexible cutting elements can outwards protrude when introducing first temperature, and second flexible cutting elements can outwards protrude when introducing second temperature.Like this, for example first flexible cutting elements and second flexible cutting elements can be opened independently of each other.

Figure 85 has represented the possibility of cavitation device 6800, and this cavitation device 6800 comprises axle 6810, second flexible cutting elements 6822 that has first flexible cutting elements 6820 of free end 6821 and have free end 6823.Flexible cutting elements 6820,6822 can be formed by for example rustless steel.Shown in the scheme, axle 6810 has longitudinal axis 6811.When first flexible cutting elements 6820 alignd with first sidewise hole 6824 of insertion tube 6814, first flexible cutting elements 6820 can be from longitudinal axis 6811 outside or side direction protrusions.Before being opened into the side direction projective structure or second shape, first flexible cutting elements 6820 can remain on the withdrawal or first shape, is loaded on simultaneously in the insertion tube 6814, as shown in the figure.First flexible cutting elements 6820 can outwards be opened into shape memory when guiding first sidewise hole 6824 into, can protrude when being heated, and can launch, perhaps lateral extension otherwise.First flexible cutting elements 6820 can have towards the bias voltage of " memory " second shape, and wherein, first flexible cutting elements 6820 is protruding or protrude from the longitudinal axis 6811 of axle 6810 with the shape of general curve projection, as shown in the figure.In case be in second shape, first flexible cutting elements 6820 can be used to form or change tissue cavities along clockwise and/or anticlockwise rotation.

When secondflexible cutting elements 6822 alignd with secondsidewise hole 6825 ofinsertion tube 6814, secondflexible cutting elements 6822 can be fromlongitudinal axis 6811 outside or side direction protrusions.Before being opened into the side direction projective structure or second shape, secondflexible cutting elements 6822 can remain on the withdrawal or first shape, is loaded on simultaneously in theinsertion tube 6814, as shown in the figure.Secondflexible cutting elements 6822 can be when being guided second sidewisehole 6825 into and outwards is opened into shape memory, can protrude when being heated, and can launch, perhaps lateral extension otherwise.Secondflexible cutting elements 6822 can have towards the bias voltage of " memory " second shape, and wherein, secondflexible cutting elements 6822 is with thelongitudinal axis 6811 protruding or protrusions of the arciform shape of general curve fromaxle 6810, as shown in the figure.In case be in second shape, secondflexible cutting elements 6822 can be used to form or change tissue cavities along clockwise and/or anticlockwise rotation.

Figure 86 has represented the possibility ofcavitation device 6900, thiscavitation device 6900 comprise theaxle 6910, thisaxle 6910 have the firstaxle part divide 6912 and the second axle part divide 6913.Shown in the scheme, the first axle part divides 6912 to be connected with firstflexible cutting elements 6920 withfree end 6921, and the second axle part divides 6913 to be connected with secondflexible cutting elements 6922 with free end 6923.Shaft portion 6912,6913 can be contiguous hemisphere, is arranged so thataxle 6910 is basiccylindricality.Shaft portion 6912,6913 can move relative to each other, and like this,flexible cutting elements 6920,6922 can drive.Flexible cutting elements 6920,6922 can be formed by for examplerustless steel.Axle 6910 haslongitudinal axis 6911.

Also with reference to Figure 86, when firstflexible cutting elements 6920 alignd with firstsidewise hole 6924 ofinsertion tube 6914, first flexible cutting elements can be fromlongitudinal axis 6911 outside or side direction protrusions.Before being opened into the side direction projective structure or second shape, firstflexible cutting elements 6920 can remain on the withdrawal or first shape, is loaded on simultaneously in theinsertion tube 6914, as shown in the figure.Firstflexible cutting elements 6920 can divide 6912 to guide first sidewisehole 6924 into by the first axle part, and can outwards be opened into shape memory, can side direction protrude when being heated, and perhaps otherwise side direction is protruded.Firstflexible cutting elements 6920 can have the bias voltage that becomes the general curve convex shape towards " memory " second shape, as shown in the figure.In case be in second shape, firstflexible cutting elements 6920 can be used to form or change tissue cavities along clockwise and/or anticlockwise rotation.

When secondflexible cutting elements 6922 alignd with secondsidewise hole 6925 ofinsertion tube 6914, secondflexible cutting elements 6922 can be fromlongitudinal axis 6911 outside or side direction protrusions.Before being opened into the side direction projective structure or second shape, secondflexible cutting elements 6922 can remain on the withdrawal or first shape, is loaded on simultaneously in theinsertion tube 6914, as shown in the figure.Secondflexible cutting elements 6922 can divide 6913 to guide second sidewisehole 6925 into by the second axle part, and can outwards be opened into shape memory, can side direction protrude when being heated, and perhaps otherwise side direction is protruded.Secondflexible cutting elements 6922 can have the bias voltage that becomes the general curve convex shape towards " memory " second shape, as shown in the figure.In case be in second shape, secondflexible cutting elements 6922 can be used to form or change tissue cavities along clockwise and/or anticlockwise rotation.

With reference to figure 87-88, the possibility ofcavitation device 7000 is disclosed among the figure, thiscavitation device 7000 can be arranged so that thehole 7024 offlexible cutting elements 7020 frominsertion tube 7014 extends laterally and withdraw.Shown in the scheme,flexible cutting elements 7020 is fixed on thethread spindle 7010, thisthread spindle 7010 extends along the length proximad of cavitation device 7000.Shown in the scheme,thread spindle 7010 engages with screw threadrotation driver part 7004, this screw threadrotation driver part 7004 can rotate in actuator or handle 7002.Relation betweenthread spindle 7010 and therotary driving part 7004 can be like this,rotary driving part 7004 pushesthread spindle 7010 along the manual rotation of a direction with proximad, androtary driving part 7004 will distad pushthread spindle 7010 along the rotation of other direction.Shown in the scheme, the driving ofaxle 7010 will makeflexible cutting elements 7020 extend laterally byhole 7024 and withdraw, and self-locking.

Also with reference to figure 87-88,cavitation device 7000 comprises theend effector 7012 that is arranged for connection.Thisend effector 7012 can be arranged to be used for rotatably, laterally, pivotally or so that other suitable direction, pattern or mode connect arbitrarily.For example, the joint 7028 thatend effector 7012 can be wound with angle pivots, and wherein, pivoting action is for example controlled by therotary driving part 7006 that is connected with angled joint 7028, like this, rotatablely moving ofrotary driving part 7006 is transformed into the pivoting action of end effector 7012.End effector 7012 also comprises swivel joint 7016, and this swivel joint 7016 is arranged so thatend effector 7012 is around M-M axis or the rotation of its central axis.Can provide byrotary driving part 7008 around rotatablely moving of swivel joint 7016, wherein, the rotation ofrotary driving part 7008 can correspondingly be transformed into rotatablely moving of end effector 7012.Insertion tube 7014 can comprise swivel joint 7018, and this swivel joint 7018 can be connected with the actuator (not shown), like this, provides additional degrees of freedom.Should be known in connection, rotation or the motion of any appropriate that can consider cavitation device, wherein, can provide the connection of any suitable number or structure.

The flexible cutting elements that should be known in any suitable number with any suitable architecture can be arranged in cavitation device any suitable location place on every side.For example, a plurality of flexible cutting elements are can the compartment of terrain axial arranged and around the longitudinal axis radial arrangement.Also considered the distad combination in any of the flexible cutting elements of location and axial location.Should also be appreciated that, can consider to open or be transformed into any appropriate pattern of second shape.

Described in this manual scheme is an example.Those skilled in the art can also be developed multiple variation and change, and these variations and change do not break away from the spirit and scope of described cavitation device and method.For example, have some examples not need insertion tube, the bullport in osseous tissue is fit to lead to re-entrant portion.Be used for the bias voltage flexible cutting elements so that the described deflection method or the device that move to second shape from first shape comprise strain, hot shape memory, centrifugal force and the power that applies by the stretching cable.Although these consider separately that in example cavitation device of the present invention can comprise the combination of additional movement method and two or more these methods.It will be appreciated by those skilled in the art that the labelling on the axle of cavitation device of the present invention can be used to indicate insertion depth, the additional accessory on axle can be used to limit insertion depth.Therefore, scope of the present invention will be determined by accessory claim and their legal equivalents, rather than given example.

Claims (216)

1. one kind is used for the medical treatment device that cavity forms, and it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and link to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) in first shape of the very first time, be used for being arranged in anatomical structure; And

(ii) in second shape of second time, wherein, second shape of flexible cutting elements operationally is arranged to outwards distortion so that form cavity;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

2. medical treatment device according to claim 1, wherein: second shape is a shape memory.

3. medical treatment device according to claim 1, wherein: second shape obtains by centrifugal force.

4. medical treatment device according to claim 1, wherein: second shape obtains by variations in temperature.

5. medical treatment device according to claim 1, wherein: flexible cutting elements is the sheet spring.

6. medical treatment device according to claim 1, wherein: flexible cutting elements comprises cutting tip.

7. medical treatment device according to claim 1, wherein: spindle unit comprises the fluid conduit.

8. medical treatment device according to claim 1, wherein: flexible cutting elements departs from longitudinal axis when first shape.

9. medical treatment device according to claim 1, wherein: cavity forms by manually carrying out.

10. medical treatment device according to claim 1, wherein: cavity forms and points to ridge.

11. medical treatment device according to claim 1, wherein: medical treatment device is arranged for the processing of selecting from following group, and this group comprises that prevention, articulation, the implantation piece of treatment of fractures, fracture are fixed, the soft tissue of pathological changes is collected, removed in tissue collecting, osseous tissue, the sclerous tissues of removing pathological changes, overall soft tissue remove, the removal of overall sclerous tissues, vertebral plasty, kyphoplasty and their combination.

12. medical treatment device according to claim 1, wherein: insertion tube is set as has the cross section of selecting from following group, this group comprises polygon, circle, hexagon, pentagon, hemispherical, curvilinear cross and their combination.

13. the method that tissue cavities forms, it comprises:

Medical treatment device is provided, and this medical treatment device comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and link to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) in first shape of the very first time, be used for being arranged in anatomical structure; And

(ii) in second shape of second time, wherein, second shape of flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage;

The flexible cutting elements of first shape is inserted in the tissue;

Make flexible cutting elements be deformed into second shape; And

The formative tissue cavity.

14. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and link to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) in first shape of the very first time, be used for being arranged in anatomical structure; And

(ii) in second shape of second time, wherein, second shape of flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged in the very first time and allows second shape of flexible cutting elements therefrom to pass through;

(d) distal aperture, wherein, this distal aperture is arranged in the insertion tube, and second time that operationally was arranged in allows second shape of flexible cutting elements therefrom to pass through; And

(e) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

15. medical treatment device according to claim 14, wherein: second shape is a shape memory.

16. medical treatment device according to claim 14, wherein: second shape obtains by centrifugal force.

17. medical treatment device according to claim 14, wherein: second shape obtains by variations in temperature.

18. medical treatment device according to claim 14, wherein: flexible cutting elements is the sheet spring.

19. medical treatment device according to claim 14, wherein: flexible cutting elements comprises cutting tip.

20. medical treatment device according to claim 14, wherein: spindle unit comprises the fluid conduit.

21. medical treatment device according to claim 14, wherein: flexible cutting elements departs from longitudinal axis when first shape.

22. medical treatment device according to claim 14, wherein: cavity forms by manually carrying out.

23. medical treatment device according to claim 14, wherein: cavity forms and points to ridge.

24. medical treatment device according to claim 14, wherein, medical treatment device is arranged for the processing of selecting from following group, and this group comprises: treatment of fractures; The prevention of fracture; Articulation; Implantation piece is fixed; Tissue collecting; Osseous tissue is collected; Remove the soft tissue of pathological changes; Remove the sclerous tissues of pathological changes; Overall soft tissue is removed; Overall sclerous tissues removes; Vertebral plasty; Kyphoplasty; And their combination.

25. medical treatment device according to claim 14, wherein: insertion tube is set as has the cross section of selecting from following group, this group comprises: polygon; Circular; Hexagon; Pentagon; Hemispherical; Curvilinear cross; And their combination.

26. the method that tissue cavities forms, it comprises:

Medical treatment device is provided, and this medical treatment device comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) first shape is used for being arranged in anatomical structure; And

(ii) second shape, wherein, second shape of flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged in the very first time and allows second shape of flexible cutting elements therefrom to pass through; And

(d) distal aperture, wherein, this distal aperture is arranged in the insertion tube, and second time that operationally was arranged in allows second shape of flexible cutting elements therefrom to pass through; And

(e) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage;

The flexible cutting elements of first shape is inserted in the tissue;

Make flexible cutting elements be deformed into second shape, like this, its hole by from the group that comprises distal aperture, sidewise hole and their combination, selecting; And

The formative tissue cavity.

27. method according to claim 26, wherein: it is at user option making the step of flexible cutting elements distortion.

28. method according to claim 26, wherein: sidewise hole comprises a plurality of sidewise holes, and flexible cutting elements can protrude by these transverse holes.

29. method according to claim 26, wherein: flexible cutting elements comprises a plurality of flexible cutting elements.

30. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) in first shape of the very first time, be used for being arranged in anatomical structure; And

(ii) in second shape of second time, wherein, second shape of flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through, and the hole of combination comprises sidewise hole part and distal aperture part; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

31. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) the first side direction projecting member;

The (ii) second side direction projecting member;

(iii) first shape is used for being arranged in anatomical structure, and wherein, this first shape comprises the first side direction projecting member and the second side direction projecting member of withdrawal; And

(iv) second shape, wherein, this second shape comprises the first side direction projecting member and the second side direction projecting member that extends laterally;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) first sidewise hole, wherein, this first sidewise hole is arranged in the insertion tube, and operationally is arranged to allow the first side direction projecting member therefrom to pass through;

(d) second sidewise hole, wherein, this second sidewise hole is arranged in the insertion tube, and operationally is arranged to allow the second side direction projecting member therefrom to pass through; And

(e) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

32. medical treatment device according to claim 31, wherein: the first side direction projecting member and the second side direction projecting member extend laterally by pressure.

33. medical treatment device according to claim 31, wherein: the first side direction projecting member and the second side direction projecting member have remember condition.

34. medical treatment device according to claim 31, wherein: the first side direction projecting member and the second side direction projecting member are positioned to toward each other.

35. medical treatment device according to claim 31, wherein: the first side direction projecting member is arranged to different with the second side direction projecting member.

36. medical treatment device according to claim 31, wherein: the first side direction projecting member and the second side direction projecting member are formed by the overall structure with spindle unit.

37. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) but a plurality of projecting member;

(ii) first shape is used for being arranged in anatomical structure, wherein, but these a plurality of projecting member withdrawals; And

(iii) second shape wherein, outwards is out of shape so that form cavity but second shape of this flexible cutting elements comprises a plurality of projecting member;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) a plurality of holes, wherein, these a plurality of holes are arranged in the insertion tube, and wherein, but one of them of a plurality of projecting member of each Kong Douyu in these a plurality of holes is corresponding; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

38. according to the described medical treatment device of claim 37, wherein: but these a plurality of projecting member outwards are deformed into second shape by pressure.

39. according to the described medical treatment device of claim 37, wherein: but these a plurality of projecting member have remember condition.

40. according to the described medical treatment device of claim 37, wherein: but these a plurality of projecting member are around the longitudinal axis radial arrangement.

41. according to the described medical treatment device of claim 37, wherein: but these a plurality of projecting member are arranged to difference.

42. according to the described medical treatment device of claim 37, wherein: but these a plurality of projecting member are formed by the overall structure with spindle unit.

43. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end is connected with spindle unit;

(ii), be used for being arranged in anatomical structure in first shape of the very first time; And

(iii) in second shape of second time, wherein, second shape of this flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

44. according to the described medical treatment device of claim 43, wherein: flexible cutting elements is rotated, so that form cavity.

45. according to the described medical treatment device of claim 44, wherein: flexible cutting elements was rotated in a clockwise direction in the very first time, rotated in the counterclockwise direction in second time, so that form cavity.

46. according to the described medical treatment device of claim 43, wherein: flexible cutting elements comprises first cutting edge with first surface effect.

47. according to the described medical treatment device of claim 46, wherein: flexible cutting elements comprises second cutting edge with second surface effect.

48. according to the described medical treatment device of claim 47, wherein: the first surface effect is arranged to different with the second surface effect.

49. according to the described medical treatment device of claim 43, wherein: will carry out mechanically to the transformation of second shape from first shape.

50. according to the described medical treatment device of claim 43, wherein: will be undertaken by centrifugation to the transformation of second shape from first shape.

51. according to the described medical treatment device of claim 43, also comprise: the 3rd shape, the 3rd shape are arranged for cavity and form.

52. according to the described medical treatment device of claim 43, wherein: second shape is arranged so that the far-end that the part of flexible cutting elements surpasses insertion tube distad extends.

53. according to the described medical treatment device of claim 43, wherein: first shape and second shape can be selected from a plurality of structures.

54. according to the described medical treatment device of claim 43, wherein: but first shape and second shape are the chosen positions that disperses.

55. according to the described medical treatment device of claim 43, wherein: flexible cutting elements operationally is arranged for after insertion and becomes second shape from first transfer of shapes.

56. according to the described medical treatment device of claim 53, wherein, these a plurality of structures are arranged to select from following group, this group comprises: a plurality of structures along continuum, a plurality of discrete structures and their combination.

57. according to the described medical treatment device of claim 43, wherein: flexible cutting elements when first shape longitudinally axis be smooth substantially.

58. according to the described medical treatment device of claim 57, wherein: first shape comprises induction element, this induction element is arranged to mechanically impel flexible cutting elements to open by sidewise hole.

59. according to the described medical treatment device of claim 57, wherein: flexible cutting elements is protruding from longitudinal axis when being deformed into second shape.

60. according to the described medical treatment device of claim 43, wherein: insertion tube is arranged to have the cross section of selecting from following group: polygon, circle, hexagon, pentagon, hemispherical, curvilinear cross and their combination.

61. according to the described medical treatment device of claim 43, wherein: spindle unit is fixed on the flexible cutting elements.

62. according to the described medical treatment device of claim 61, wherein: flexible cutting elements is fixed on the insertion tube.

63. according to the described medical treatment device of claim 62, wherein: spindle unit is connected with insertion tube.

64. according to the described medical treatment device of claim 43, wherein: spindle unit removably is connected with flexible cutting elements.

65. according to the described medical treatment device of claim 64, wherein: flexible cutting elements removably is connected with insertion tube.

66. according to the described medical treatment device of claim 65, wherein: flexible cutting elements is fixed on the insertion tube.

67. according to the described medical treatment device of claim 43, wherein: spindle unit removably is connected with flexible cutting elements, and flexible cutting elements is fixed on the insertion tube.

68. according to the described medical treatment device of claim 43, wherein: between spindle unit and flexible cutting elements, be connected to overall structure.

69. according to the described medical treatment device of claim 43, wherein: being connected to whole connection the between spindle unit and flexible cutting elements.

70. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end is connected with spindle unit;

(ii) in first shape of the very first time, be used for being arranged in anatomical structure, wherein, this first is shaped as basic spiral type; And

(iii) in second shape of second time, wherein, second shape of this flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) sidewise hole, this sidewise hole are arranged in the insertion tube and axis of pitch are arranged, and this sidewise hole operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

71. according to the described medical treatment device of claim 70, wherein: this spiral substantially first shape provides by spindle unit is reversed, and like this, flexible cutting elements remains basic helical structure under twisting action.

72. according to the described medical treatment device of claim 71, wherein: second shape provides by launching this spiral substantially first shape.

73. according to the described medical treatment device of claim 72, wherein: second shape is protruded by the hole side direction, and the flexible cutting elements of second shape departs from the longitudinal axis of insertion tube and the axis of pitch of sidewise hole.

74. according to the described medical treatment device of claim 72, wherein: second shape is the remember condition that loosens.

75. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end is connected with spindle unit;

(ii), be used for being arranged in anatomical structure in first shape of the very first time; And

(iii) in second shape of second time, wherein, outwards distortion is so that form cavity for second shape of this flexible cutting elements, and this second shape comprises first concave portions and first convex part and second concave portions and the second convex part;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) sidewise hole, this sidewise hole has axis of pitch, and this sidewise hole operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

76. according to the described medical treatment device of claim 75, wherein: when the flexible cutting elements side direction outwards is deformed into second shape, first concave portions and arc provide of first convex part by forming.

77. according to the described medical treatment device of claim 76, wherein: second concave portions and second convex part will be provided with reference to longitudinal axis.

78. according to the described medical treatment device of claim 77, wherein: second convex part can be used for cutting and organizing along first direction, and second concave portions can be used for cutting and organizing along second direction.

79. according to the described medical treatment device of claim 78, wherein: first direction is that counterclockwise second direction is a clockwise direction.

80. one kind is used for the method that tissue cavities forms, it comprises:

Provide tissue to form device, this tissue forms device and comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) first cutting element;

(ii) second cutting element;

(iii), be used for being arranged in anatomical structure in first shape of the very first time; And

(iv) in second shape of second time, wherein, second shape of this flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage;

By first cutting element along first direction formative tissue cavity; And

By second cutting element along second direction formative tissue cavity.

81. 0 described method according to Claim 8, wherein: flexible cutting elements comprises free distal end.

82. 0 described method according to Claim 8, wherein: flexible cutting elements comprises the far-end of connection.

83. 2 described methods according to Claim 8, wherein: flexible cutting elements comprises stationary remote.

84. 3 described methods according to Claim 8, wherein: flexible cutting elements is band shape substantially.

85. 4 described methods according to Claim 8, wherein: first cutting element is first cutting edge, and second cutting element is second cutting edge.

86. 5 described methods according to Claim 8, wherein: first cutting edge comprises the first surface effect, and second cutting edge comprises the second surface effect.

87. 6 described methods according to Claim 8, wherein: the first surface effect is provided with different with the second surface effect, like this, first tissue effect provides by flexible cutting elements is rotated along first direction, and second tissue effect provides by flexible cutting elements is rotated along second direction.

88. 0 described method according to Claim 8, wherein: first cutting element is the convex part, and second cutting element is a concave portions, and is arranged so that: along first direction, concave portions is used to cut and organize, and along second direction, convex partly is used to cut and organize.

89. 8 described methods according to Claim 8, wherein: first cutting element comprises the first surface effect, and second cutting element comprises the second surface effect.

90. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend;

(b) flexible cutting elements, this flexible cutting elements is connected with spindle unit at near-end, and this flexible cutting elements comprises:

(i) deformable slender body;

(i) in first shape of the very first time, this first shape is arranged for and is arranged in the anatomical structure; And

(ii) in second shape of second time, wherein, second shape of this flexible cutting elements outwards is out of shape so that form cavity;

(c) cover, wherein, the far-end of flexible cutting elements is connected with this cover;

(d) insertion tube, this insertion tube has longitudinal axis, and this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, this cover longitudinally axis moves with respect to insertion tube;

(e) support unit, this support unit is connected with cover at far-end, and wherein, this support unit is a rigidity substantially, makes that flexible cutting elements can be with respect to this support unit translation, so that make this flexible cutting elements distortion;

(f) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

91. according to the described medical treatment device of claim 90, also comprise: distal aperture, wherein, this distal aperture is arranged in the insertion tube, and operationally is arranged to allow second shape of cover and cutting element therefrom to pass through.

92. according to the described medical treatment device of claim 90, wherein: second shape of flexible cutting elements is by keeping tensile force and providing pressure to form to flexible cutting elements on support unit.

93. according to the described medical treatment device of claim 90, wherein: second shape of flexible cutting elements is by keeping tensile force and providing pressure to form to support unit on flexible cutting elements.

94. according to the described medical treatment device of claim 90, wherein: flexible cutting elements can selectively be deformed into second shape by the hole of selecting from following group, this group comprises sidewise hole, distal aperture and their combination.

95. according to the described medical treatment device of claim 90, wherein: but this cover freely-movable.

96. according to the described medical treatment device of claim 90, wherein: this cover can be regulated between a plurality of predeterminated positions along insertion tube.

97. according to the described medical treatment device of claim 90, wherein: the position of indicating cover and flexible cutting elements to the user.

98. a tissue forms device, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) first cutting element, this first cutting element has the first surface effect;

(ii) second cutting element, this second cutting element has the second surface effect;

(iii), be used for being arranged in anatomical structure in first shape of the very first time; And

(iv) in second shape of second time, wherein, second shape of this flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

99. according to the described medical treatment device of claim 98, wherein: first surface effect and second surface effect are the structures of selecting from following group, and this group comprises the different settings of identical, similar, basic class Sihe.

100. according to the described medical treatment device of claim 98, wherein: first surface effect and second surface effect are selected from following group, and this group comprises serrated-surface effect, waved surface effect, sinusoidal surface effect, shaped form surface effect, marginate surface effect, sharp-pointed surface effect, veined surface effect, the surface effect that rib is arranged, taper tissue effect and their combination.

101. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this deformable slender body has first end and second end, and it comprises:

(A) first cutting edge

(B) second cutting edge;

(C) top surface; And

(D) basal surface;

(ii), be used for being arranged in anatomical structure in first shape of the very first time; And

(iii) in second shape of second time, wherein, second shape of this flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, insertion tube are arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

102. according to the described medical treatment device of claim 101, wherein: top surface is a convex.

103. according to the described medical treatment device of claim 101, wherein: basal surface is a spill.

104. according to the described medical treatment device of claim 101, wherein: top surface is a spill.

105. according to the described medical treatment device of claim 101, wherein: basal surface is a convex.

106. according to the described medical treatment device of claim 101, wherein: the first of flexible cutting elements is smooth, and second portion is a non-flat forms.

107. according to the described medical treatment device of claim 106, wherein: the part of this non-flat forms is the convex part.

108. according to the described medical treatment device of claim 106, wherein: the part of this non-flat forms is a concave portions.

109. according to the described medical treatment device of claim 101, wherein: the vicissitudinous thickness of this flexible cutting elements.

110. according to the described medical treatment device of claim 101, wherein: this flexible cutting elements has basic section thickness uniformly.

111. according to the described medical treatment device of claim 101, wherein: the basal surface of flexible cutting elements comprises the convex part, this convex part is corresponding with the concave portions of top surface.

112. according to the described medical treatment device of claim 101, wherein: flexible cutting elements comprises a plurality of concave portions.

113. according to the described medical treatment device of claim 108, wherein: flexible cutting elements comprises a plurality of convex parts.

114. according to the described medical treatment device of claim 101, wherein: flexible cutting elements comprises at least one axially extended rib.

115. according to the described medical treatment device of claim 101, wherein: flexible cutting elements comprises at least one lateral ribs.

116. according to the described medical treatment device of claim 101, wherein: flexible cutting elements comprises at least one support unit.

117. according to the described medical treatment device of claim 116, wherein: support unit is a rib.

118. according to the described medical treatment device of claim 117, wherein: this rib is an axial rib.

119. according to the described medical treatment device of claim 117, wherein: this rib is a lateral ribs.

120. according to the described medical treatment device of claim 116, wherein: support unit is selected from following group, this group comprises pillar, bar, rib, material result, reinforcement, beam, axial members, cross member and their combination.

121. according to the described medical treatment device of claim 101, wherein: flexible cutting elements comprises at least one non-flat forms part.

122. according to the described medical treatment device of claim 101, wherein: the top surface of flexible cutting elements is the structure of selecting from following group, and this group comprises axial convex, axially spill, laterally convex, laterally spill, planar-shaped and their combination.

123. according to the described medical treatment device of claim 101, wherein: the basal surface of flexible cutting elements is the structure of selecting from following group, and this group comprises axial convex, axially spill, laterally convex, laterally spill, planar-shaped and their combination.

124. according to the described medical treatment device of claim 101, wherein: spindle unit comprises the fluid conduit.

125. according to the described medical treatment device of claim 101, wherein: medical treatment device is arranged for the processing of selecting from following group, and this group comprises that prevention, articulation, the implantation piece of treatment of fractures, fracture are fixed, the soft tissue of pathological changes is collected, removed in tissue collecting, osseous tissue, the sclerous tissues of removing pathological changes, overall soft tissue remove, the removal of overall sclerous tissues, vertebral plasty, kyphoplasty and their combination.

126. according to the described medical treatment device of claim 101, wherein: insertion tube is arranged to have the cross section of selecting from following group, and this group comprises polygon, circle, hexagon, pentagon, hemispherical, curvilinear cross and their combination.

127. according to the described medical treatment device of claim 101, wherein: the flexible cutting elements rotation is so that form cavity.

128. according to the described medical treatment device of claim 127, wherein: flexible cutting elements was rotated in a clockwise direction in the very first time, rotated in the counterclockwise direction in second time, so that form cavity.

129. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, comprise first cutting element and second cutting element, and wherein, first cutting element is connected with second junction point at first abutment with second cutting element;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

130. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and comprise single successive cutting surface;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

131. according to the described device of claim 130, wherein: first end is a fundamental curve shape, and second end is basic pointed shape.

132. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and comprise flexible cutting elements, and this flexible cutting elements has:

(i) deformable slender body, this deformable slender body has first end and second end, and it comprises:

(A) first edge;

(B) second edge;

(C) top surface, this top surface has the top surface effect, and it operationally is set to form lateral cavity; And

(D) basal surface;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) hole, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

133. according to the described medical treatment device of claim 132, wherein: top surface operationally is arranged to cut and organize.

134. according to the described medical treatment device of claim 133, wherein: the top surface effect comprises at least one projection.

135. according to the described medical treatment device of claim 133, wherein: the top surface effect comprises texture.

136. according to the described medical treatment device of claim 132, wherein: first edge and second edge are arranged to form cavity by rotatablely moving, and top surface is arranged to cut and organize by axially-movable.

137. according to the described medical treatment device of claim 132, wherein: first edge and second edge are arranged to form cavity by rotatablely moving, and top surface is arranged to cut and organize by lateral movement.

138. according to the described medical treatment device of claim 132, wherein: spindle unit comprises the fluid conduit.

139. according to the described medical treatment device of claim 132, wherein: medical treatment device is arranged for the processing of selecting from following group, and this group comprises that prevention, articulation, the implantation piece of treatment of fractures, fracture are fixed, tissue collecting, osseous tissue collect, remove the pathological changes soft tissue, remove pathological changes sclerous tissues, overall soft tissue is removed, the removal of overall sclerous tissues, vertebral plasty, kyphoplasty and their combination.

140. according to the described medical treatment device of claim 132, wherein: insertion tube is arranged to have the cross section of selecting from following group, and this group comprises polygon, circle, hexagon, pentagon, hemispherical, curvilinear cross and their combination.

141. one kind is used for the method that lateral cavity forms, it may further comprise the steps:

Be provided for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this deformable slender body has first end and second end, and it comprises:

(A) first edge;

(B) second edge;

(C) top surface, this top surface has the top surface effect, and it operationally is set to form lateral cavity; And

(D) basal surface;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of flexible cutting elements is connected with insertion tube;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage; And

Cut by top surface, thus the formative tissue cavity.

142. according to the described method of claim 141, wherein: cutting step comprises makes insertion tube remain on basic resting position, makes flexible cutting elements repeatedly become second shape from first warpage simultaneously, so that side direction cuts and organizes.

143. according to the described method of claim 141, wherein, cutting step comprises:

Make flexible cutting elements extend into second shape at the first lateral distance place;

Flexible cutting elements is fixed on second shape; And

Make instrument along roughly longitudinal direction translation, so that form the first cavity part.

144., further comprising the steps of according to the described method of claim 143:

Make flexible cutting elements extend laterally to second lateral distance, wherein, this second lateral distance is greater than first lateral distance; And

Make instrument along roughly longitudinal direction translation, so that form the second cavity part.

145. according to the described method of claim 141, wherein: flexible cutting elements is arranged for rotation and the cutting of side direction tissue.

146. the method for a formative tissue cavity, it comprises:

Be provided for the medical treatment device that cavity forms, this medical treatment device comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) in first shape of the very first time, be used for being arranged in anatomical structure; And

(ii) in second shape of second time, wherein, second shape of flexible cutting elements outwards is out of shape so that form cavity;

(b) insertion tube, wherein, insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage; And

Cut the first tissue cavities part by making the flexible cutting elements that is in second shape rotate less than 360 degree around central axis.

147. according to the described method of claim 146, wherein: first tissue cavities partly is a hemispherical.

148., also comprise: the step of cutting second tissue cavities part according to the described method of claim 146.

149. according to the described method of claim 148, wherein: first tissue cavities part partly is different settings with second tissue cavities.

150. according to the described method of claim 148, wherein: first tissue cavities part and second tissue cavities part produce simultaneously.

151. according to the described method of claim 148, wherein: first tissue cavities part and second tissue cavities part produced in the very first time and second time.

152. according to the described method of claim 148, wherein: first tissue cavities partly produces by the rotation cutting, and second tissue cavities part produces by the side direction cutting.

153. the method that cavity forms, it may further comprise the steps:

Tissue cutting instrument is provided, and this tissue cutting instrument comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) first cutting element, this first cutting element has the first surface effect;

(ii) second cutting element, this second cutting element has the second surface effect;

(iii) first shape is used for being arranged in anatomical structure; And

(iv) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage;

Form the first tissue cavities part around first axle; And

Form the second tissue cavities part around second axis.

154. according to the described method of claim 153, wherein: the first axle and the second axis disalignment.

155. according to the described method of claim 153, wherein: described axis is substantially parallel.

156. according to the described method of claim 153, wherein: described axes intersect.

157. according to the described method of claim 153, wherein: described axial alignment.

158. according to the described method of claim 153, wherein: the geometry of each cavity part is selected from following group, and this group comprises hemispherical dome structure, circular configuration, column construction, oval structures, polygonized structure, impalpable structure, axially symmetric structure and their combination.

159., also comprise: partly be connected the step of the tissue cavities that produces combination by making first tissue cavities part and second tissue cavities according to the described method of claim 153.

160. according to the described method of claim 153, wherein: first tissue cavities part and second tissue cavities part are similar substantially.

161. according to the described method of claim 153, wherein: first tissue cavities part partly is different settings with second tissue cavities.

162. according to the described method of claim 153, wherein: first tissue cavities part and second tissue cavities part form simultaneously.

163. according to the described method of claim 153, wherein: first tissue cavities part and second tissue cavities part formed in the very first time and second time.

164. according to the described method of claim 153, also comprise: the step that forms the 3rd tissue cavities part around the 3rd axis, wherein: the 3rd tissue cavities part partly is connected with second tissue cavities with first tissue cavities part, thereby forms the tissue cavities of combination.

165. according to the described method of claim 164, wherein: described axis is substantially parallel.

166. according to the described method of claim 164, wherein: described axes intersect.

167. according to the described method of claim 164, wherein: described axial alignment.

168. according to the described method of claim 164, wherein: the geometry of each cavity part is selected from following group, and this group comprises hemispherical dome structure, circular configuration, column construction, oval structures, polygonized structure, impalpable structure, axially symmetric structure and their combination.

169. according to the described method of claim 164, further comprising the steps of: form a plurality of tissue cavities step partly around a plurality of axis, wherein, a plurality of tissue cavities partly connect, thereby form the tissue cavities of combination.

170. according to the described method of claim 164, wherein: described axis distortion.

171. according to the described method of claim 153, wherein: described axis distortion.

172. the method that cavity forms, it may further comprise the steps:

Tissue cutting instrument is provided, and this tissue cutting instrument comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements has:

(i) first cutting element, this first cutting element has the first surface effect;

(ii) second cutting element, this second cutting element has the second surface effect;

(iii) first shape is used for being arranged in anatomical structure; And

(iv) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage;

Form the first tissue cavities part around first axle; And

Form the second tissue cavities part around first axle.

173. according to the described method of claim 172, wherein: first tissue cavities part partly is connected with second cavity.

174. according to the described method of claim 173, wherein: first tissue cavities partly partly is connected with second cavity by bullport.

175. according to the described method of claim 172, wherein: first tissue cavities part is local at least different with the second cavity part.

176. according to the described method of claim 172, wherein: first tissue cavities part and second tissue cavities partly make up so that form the basic tissue cavities of combination uniformly.

177. according to the described method of claim 172, wherein: first axle departs from the barycenter of tissue cavities part.

178. according to the described method of claim 172, wherein: first tissue cavities partly is arranged to different with the second cavity part.

179. according to the described method of claim 172, wherein: first tissue cavities partly is the side direction tissue cavities.

180. according to the described method of claim 172, wherein: first tissue cavities partly is the rotation tissue cavities.

181. according to the described method of claim 180, wherein: second tissue cavities partly is the side direction tissue cavities.

182. according to the described method of claim 172, wherein: first tissue cavities partly is in first fracture portions, second tissue cavities is in second fracture portions, and first and second tissue cavities partly are arranged for ease of the healing between first and second fracture portions.

183. according to the described method of claim 182, wherein: first tissue cavities part and second tissue cavities partly are stairstepping.

184. according to the described method of claim 172, wherein: first tissue cavities partly is axial tissue cavities.

185. according to the described method of claim 172, wherein: first tissue cavities part and second tissue cavities partly are the cavity parts of selecting from following group, and this group comprises side direction tissue cavities, axially tissue cavities, rotation tissue cavities and their combination.

186. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it comprises flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end is connected with spindle unit;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements removably is connected with insertion tube;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

187. according to the described medical treatment device of claim 186, wherein: flexible cutting elements can exchange with a kind of a plurality of flexible cutting elements that have in the multiple structure.

188. according to the described medical treatment device of claim 186, wherein: removably the flexible cutting elements of Lian Jieing can take out in processing procedure.

189. according to the described medical treatment device of claim 186, wherein: removably the flexible cutting elements of Lian Jieing selectively permanently is connected with insertion tube.

190. according to the described medical treatment device of claim 186, wherein: flexible cutting elements comprises first link, insertion tube comprises second link, and wherein, first link is arranged to removably be connected with second link.

191. according to the described medical treatment device of claim 186, wherein: removably the flexible cutting elements of Lian Jieing comprises the link of selecting from following group, and this group comprises hook, button, buckle, interference fit, cup-shaped adapter, ratchet, a plurality of ratchet, accepter, dish type adapter, t shape adapter, s shape adapter, tongue piece, groove and their combination.

192. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end is connected with spindle unit;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is fixed on the insertion tube by at least one pad;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through;

(d) distal aperture, wherein, this distal aperture is arranged in the insertion tube, and operationally is arranged for fluid and passes through; And

(e) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

193. according to the described medical treatment device of claim 192, wherein: second end of flexible cutting elements is welding around distal aperture.

194. according to the described medical treatment device of claim 192, wherein: second end of flexible cutting elements is welding around sidewise hole.

195. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) first shape is used for being arranged in anatomical structure; And

(ii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator comprises:

(i) base element, this base element is connected with insertion tube, makes spindle unit be arranged between them and passes through; And

(ii) knob, this knob and base element threads engage, this knob is connected with spindle unit, makes the axially-movable of knob with spindle unit translation vertically, and wherein, the translation of spindle unit makes the flexible cutting elements distortion.

196. according to the described medical treatment device of claim 195, wherein: spindle unit is connected with knob, makes the near-end of spindle unit to rotate with respect to knob, and is arranged to respect to the axially-movable of knob and carries out axially-movable.

197. according to the described medical treatment device of claim 196, wherein: the rotation of knob and base element threads engage make the spindle unit that links to each other with knob along roughly axial direction translation.

198. according to the described medical treatment device of claim 195, wherein: the near-end of spindle unit is fixed on the knob, the far-end of spindle unit is connected with flexible cutting elements, make the far-end of spindle unit to rotate, and be arranged to respect to the axially-movable of knob and carry out axially-movable with respect to flexible cutting elements.

199. according to the described medical treatment device of claim 198, wherein: the rotation of knob and base element threads engage make the spindle unit that links to each other with knob along roughly axial direction translation.

200. according to the described medical treatment device of claim 195, wherein: flexible cutting elements is arranged to be out of shape along continuum.

201. according to the described medical treatment device of claim 195, wherein: knob comprises the indicator of the shape of flexible cutting elements.

202. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit has threaded portion, and this spindle unit longitudinally axis extends, and comprises flexible cutting elements, and this flexible cutting elements comprises:

(i) first shape is used for being arranged in anatomical structure; And

(ii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, sidewise hole is arranged in the insertion tube and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator comprises:

(i) body; And

(ii) actuator, wherein, the threaded portion threads engage of this actuator and spindle unit, the driving of actuator makes the spindle unit axial translation, thereby makes the flexible cutting elements distortion.

203. according to the described medical treatment device of claim 202, wherein: actuator is arranged to drive along basic direction transverse to longitudinal axis.

204. according to the described medical treatment device of claim 203, wherein: actuator is arranged for rotation and drives.

205. according to the described medical treatment device of claim 202, wherein: actuator is arranged to drive along basic axial direction.

206. according to the described medical treatment device of claim 205, wherein: actuator by intermediary gear assembly with the threaded portion threads engage of spindle unit.

207. according to the described medical treatment device of claim 205, wherein: actuator is arranged for rotation and drives.

208. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit has near-end and far-end, and this spindle unit longitudinally axis extends, and comprises flexible cutting elements, and this flexible cutting elements comprises:

(i) first shape is used for being arranged in anatomical structure; And

(ii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator comprises:

(i) body;

(ii) track, this orbital arrangement is in body; And

(iii) sliding part, this sliding part is arranged in the track movingly, and is connected with spindle unit, wherein, sliding part makes the spindle unit that links to each other along roughly correspondingly translation of axial direction along track with the driving of axial direction roughly, thereby makes the flexible cutting elements distortion.

209. according to the described medical treatment device of claim 208, wherein: sliding part is contained in the track fully.

210. according to the described medical treatment device of claim 208, wherein: actuator comprises ratch mechanism, this ratch mechanism operationally is arranged to fix this sliding part.

211. according to the described medical treatment device of claim 208, wherein: actuator comprises a plurality of along predeterminated position track, that be used for sliding part.

212. according to the described medical treatment device of claim 209, wherein: sliding part distad drives and makes flexible cutting elements be deformed into second shape.

213. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit have first end and second end, and this spindle unit longitudinally axis extends, and comprises the flexible cutting elements that links to each other with second end, and this flexible cutting elements comprises:

(i) first shape is used for being arranged in anatomical structure; And

(ii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, wherein, this insertion tube operationally is arranged at least a portion of retainer shaft parts;

(c) hole, wherein, sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator comprises:

(i) body;

(ii) first driver part, this first driver part has first end and second end, and first driver part is arranged in first conduit that longitudinally axis extends, and second end of first driver part is connected with spindle unit; And

(iii) second driver part, this second driver part has first end and second end, first driver part is arranged in along in second conduit of axis of pitch extension, wherein, second end of first driver part operationally is arranged to close with first termination of first driver part, first driver part and second driver part are arranged so that driving second driver part along axis of pitch will engage with second driver part, make the axis translation longitudinally of second driver part.

214. according to the described medical treatment device of claim 213, wherein: first conduit also comprises spring disposed therein, this spring is biased into and makes flexible cutting elements return first shape.

215. a cavity formation method, it may further comprise the steps:

Provide cavity to form instrument, this cavity forms instrument and comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and it links to each other with flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end is connected with spindle unit;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is connected with insertion tube;

(c) sidewise hole, wherein, this sidewise hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, this actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage; And

Make the flexible cutting elements rotation that is in the second position, so that form cavity.

216. one kind is used for the medical treatment device that cavity forms, it comprises:

(a) spindle unit, this spindle unit longitudinally axis extend, and comprise flexible cutting elements, and this flexible cutting elements comprises:

(i) deformable slender body, this slender body have first end and second end, and wherein, this first end removably is connected with spindle unit;

(ii) first shape is used for being arranged in anatomical structure; And

(iii) second shape, wherein, second shape of this flexible cutting elements outwards distortion so that form cavity;

(b) insertion tube, this insertion tube is arranged at least a portion of retainer shaft parts, and wherein, second end of this flexible cutting elements is fixed on the insertion tube;

(c) hole, wherein, this hole is arranged in the insertion tube, and operationally is arranged to allow second shape of flexible cutting elements therefrom to pass through; And

(d) actuator, this actuator is connected with insertion tube, and wherein, actuator is arranged so that operationally flexible cutting elements becomes second shape from first warpage.

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