US20090180349A1 - Apparatus for Mixing and Dispensing Components - Google Patents

Abstract

Apparatus and methods for mixing and dispensing components. The methods and apparatus of the invention are particularly advantageous to manually mix the components of radiopaque bone cement and inject the resulting radiopaque bone cement into skeletal structures. The manually actuated apparatus of the invention comprises: (1) a sealed mixing chamber for mixing components; (2) a dispensing chamber isolated from the sealed mixing chamber; (3) a controllable portal to open a flow path between the sealed mixing chamber and the dispensing chamber so that the dispensing chamber can receive the mixed components after they are mixed; and (4) a drive mechanism associated with the dispensing chamber to force the mixed contents from the dispensing chamber.

Description

1. CROSS REFERENCE TO RELATED APPLICATIONS
• This application is a continuation-in-part of U.S. patent application Ser. No. 10/438,471 filed by D. Barker et al. on May 15, 2003, and entitled “Apparatus For Mixing And Dispensing Components”. The parent Ser. No. 10/438,471 application is incorporated herein by reference.
• The parent application is also a continuation-in-part of application Ser. No. 10/266,053, filed on Oct. 7, 2002, entitled Multi-Component, Product Handling And Delivery System, by J. Seaton et al., which application is hereby incorporated herein by reference.
• This application is a continuation-in-part of application Ser. No. 10/417,553, filed on Apr. 17, 2002, entitled Multi-Component Handling And Delivery System, by J. Seaton et al., which application is hereby incorporated herein by reference.
• This application also claims the benefit of U.S. Provisional Application No. 60/424,398 filed on Nov. 6, 2002, entitled Multi-Component, Product Handling And Delivering System For Bone Void And Fracture Filling, by L. Trebing et al., which application is hereby incorporated herein by reference.
2. FIELD
• This invention relates to methods and apparatus for mixing and dispensing at least two components. The apparatus and methods of the invention are particularly useful to prepare bone cement and deliver the bone cement into the skeletal structure of patients, such as to injured spinal vertebrae.
3. BACKGROUND
• Numerous spinal vertebrae fractures occur each year, many in older women as a result of osteoporosis. The pain and loss of movement accompanying vertebral fractures severely limits activity and reduces the quality of life. In contrast to typical bone fractures, the use of surgery to treat vertebral fractures is extremely difficult and risky. A procedure called “vertebroplasty” is a less-invasive alternative to surgery, with fewer attendant risks, and has proved extremely effective in reducing or eliminating the pain caused by spinal fractures.
• Vertebroplasty involves injecting radiopaque bone cement into the damaged vertebral body by way of a needle or cannula using x-ray (fluoroscopy) to visualize and monitor delivery. Generally, vertebroplasty is performed by radiologists, neurosurgeons, and orthopedic surgeons.
• Directly prior to injection, bone cement is prepared by mixing bone-cement powder (e.g., polymethylmethacrylate “PMMA”), liquid monomer (e g., methyl methacrylate monomer), with an x-ray contrast agent (e.g., barium sulfate), to form a fluid mixture. The components of bone cement must be kept separate from each other until the user is ready to mix them to form the desired bone cement. Typically, bone-cement powder is stored in a flexible bag, pouch, bottle, or similar container, while the liquid monomer is stored for shipment and handling in a vial or tube, usually formed from glass. Bone cement sets and hardens rapidly, so the doctors must work quickly and efficiently. A typical bone-cement mixture may comprise 15 g polymethylmethacrylate powder, 5-10 g of methyl methacrylate monomer, and 5-8 grams of sterile barium sulfate for radiographic visualization of the cement. The radiopaque bone-cement mixture is placed in a cannula-type dispensation system, the needle portion is inserted into the patient, properly positioned, and the bone cement slowly injected into the subject vertebra using x-ray guidance allowing the doctors to see the mixture actively infuse. When enough of the cement is injected into the damaged bone, as seen by x-ray, the flow is stopped and the needle is removed. However, as discussed below, stopping the flow is easier said than done. There are serious control problems with current cannula-type bone-cement dispensation systems.
• While the procedure itself has proven very effective, problems are associated with handling and mixing the bone cement. Bone cement hardens very quickly, even more so upon exposure to air. Also, it is important that the cement delivered into the bone be virtually free of any entrapped air bubbles or air pockets. In spite of this, bone cement is typically hand mixed in an open environment directly before the procedure using a tongue depressor or spatula. The mixed cement is then manually transferred from the mixing vessel to a separate dispensing device, such as a syringe. Removal of the mixed cement from the mixing vessel into the caulking gun or syringe is cumbersome, time consuming, and has the potential for being mishandled, dropped or contaminated. In any case, the resulting bone cement, since it has been exposed to air, is less fluid and harder to force through the cannula into the vertebrae. Accordingly, more pressure must be exerted by the attending physician on the dispensing device. The increased pressure requirement makes control difficult and increases the likelihood that too much cement will be injected. For example, when the x-ray indicates that the vertebrae is filled, it is difficult to stop the cement flow out of the cannula and overflow of the cement into the surrounding tissues can result. This is unsafe for the patient since the excess cement may leak out of the vertebral body into surrounding tissue and vascular structures. In some cases, surgery may be required to remove the excess cement.
• Another disadvantage with current bone cement mixing protocols that require open-air transfers stems from the toxic nature of the liquid monomer component. Bone cement monomers, including methyl methacrylate, give off toxic vapor and are irritating to the eyes and respiratory system. Furthermore, acrylate monomer irritates skin and contact with minute concentrations can cause sensitization. Accordingly, handling requires the use of suitable gloves. So, not only must attending clinicians worry about the deleterious effects of incorporating air bubbles into the bone cement during the cumbersome hand mixing, but also be concerned with health and safety issues in connection with toxic methyl methacrylate vapors.
• Currently, many clinicians begin the bone-cement mixing process by first opening a glass vial containing the liquid monomer component. One common method for opening glass vials is to snap off the top of the vial at the smallest cross section. Unfortunately, this method risks injury to operating-room personnel from broken glass or sharp edges. Another disadvantage is that small glass shards often form during such breaking, which can fall into the cement mixture. In attempting to expedite the opening of the vial or tube holding the liquid monomer, as well as reduce any exposure to the foul odor possessed by the liquid monomer, various prior art systems have been developed for enabling the user to insert the sealed vial or tube into an area of the vessel and then break the vial or tube for releasing the liquid monomer directly into the dry powder.
• These prior art systems all require that the broken glass pieces or shards of the vial/tube must be separately retained and prevented from reaching the bone cement product. In attempting to satisfy this requirement, substantial construction and operational difficulties have occurred with these prior art systems. Furthermore, in other prior art systems, manual addition of the monomer is required, exposing the user to the foul odor of the monomer and the substantial difficulties typically encountered in handling such products.
• What is needed is a mixing and dispensing device that can mix the components of bone cement in a sealed environment and provide increased control on dispensation so that the operator can readily stop the bone-cement flow when the desired amount has been dispensed.
4. SUMMARY
• The invention relates to apparatus, kits, and methods for mixing and dispensing components. The methods and apparatus of the invention can be adapted to mix and dispense any components but are particularly useful where the components require isolation from the surrounding atmosphere, for example, in cases where the components are adversely affected by air or because the components give off toxic vapors. The methods and apparatus of the invention are particularly appropriate where controlled and consistent mixing and dispensing are desired as well as limiting the exposure of those in proximity to any noxious fumes generated during the mixing process.
• In one embodiment, the invention is directed to a mixing and dispensing unit for mixing and dispensing biocompatible bone fillers. The mixing and dispensing unit of the invention is useful to mix and dispense the components of biocompatible bone fillers for delivery into human or animal patients. Examples of biocompatible fillers suitable for use in the invention include, but are not limited to, bone cements, calcium-based fillers, bioglass, bone substitutes, and grafts. In addition, the mixing and dispensing unit of the invention allows facile addition of other components before or during the mixing process, for example, antibiotics, colorants, bone-morphogenic proteins, and opacifying agents.
• The mixing and dispensing unit of the invention is useful in many medical procedures involving the preparation and delivery of biocompatible bone fillers into patients (both humans and animals), for example, vertebroplasty, tumor or bone-void filling, dental applications, in the treatment of avascular necrosis, and many others.
• The mixing and dispensing unit of the invention is particularly suited to mix the components of radiopaque PMMA-based bone cement and inject the resulting radiopaque bone cement to repair, reinforce, or replace injured, diseased, or insufficient bone or skeletal structures, such as to injured or diseased spinal vertebrae of human or animal patients. Preferably, delivery is accomplished by way of a tube, hose, cannula, or needle.
• The apparatus of the invention for mixing and dispensing components comprises: (1) a sealed mixing chamber for mixing components; (2) a dispensing chamber isolated from the sealed mixing chamber; (3) a controllable portal to open a flow path between the sealed mixing chamber and the dispensing chamber so that the dispensing chamber can receive the mixed components after they are mixed; and (4) a drive mechanism associated with the dispensing chamber to force the mixed contents from the dispensing chamber.
• The sealed mixing chamber comprises a mixing unit; an access portal for receiving the components; and a vacuum portal for attachment to a vacuum supply. The mixing and dispensing unit of the invention is preferably used in conjunction with a sealed container, which stores liquid monomer separately. In a preferred embodiment, the sealed mixing chamber is pre-packaged with bone-cement powder and the access portal is designed to sealably receive liquid monomer from the sealed container. In order to attain the desired transfer of the liquid monomer from the sealed vial or tube directly into the dry powder, without exposing the user to the liquid monomer, the mixing and dispensing unit of the invention comprises a transfer assembly, preferably, a fluid transfer assembly. The transfer assembly of the invention is constructed for cooperating with the sealed container containing the liquid monomer and the sealed mixing chamber for extracting the liquid monomer from the container in a closed loop operation and directly delivering the liquid monomer into the sealed mixing chamber containing the dry powder. This transfer operation is achieved upon demand by the user, while preventing those in the surrounding area from being exposed to the liquid monomer or noxious fumes.
• The sealed mixing chamber controllably communicates with the dispensing chamber by a controllable portal. In the mixing phase, the controllable portal is closed. After mixing is complete, the controllable portal is opened creating a flow path whereby the dispensing chamber receives the bone cement. The dispensing chamber comprises a dispensing portal, preferably, adapted to connect to a flexible tube, high-pressure hose, cannula, or a standard needle to deliver the mixed bone cement to a patient's vertebra. The dispensing chamber also communicates with a drive mechanism for forcing the bone cement through the dispensing portal and into the vertebroplasty delivery tube. In preferred embodiment, a single drive connection is used to mix the components and to dispense the components thereby reducing the number of manipulations required for mixing and dispensing bone cement.
• In an advantageous embodiment, the access portal of the sealed mixing chamber comprises a self-sealing elastic member to permit injection of the liquid component via a needle. In a preferred embodiment, The mixing unit comprises a helical mixing vane, and the drive mechanism for delivery is a reversible plunger. The apparatus can include a mechanical switch for changing the configuration of the apparatus from a component mixing state to a mixture dispensing state.
• A preferred exemplary embodiment is manually actuable to mix and dispense liquid and powder components for bone cement without power tools or power outlets.
5. BRIEF DESCRIPTION OF THE FIGS.
• These and other features, aspects, and advantages of the present invention will become better understood with regard to the following description, examples, appended claims, and accompanying drawings where:
• FIG. 1 is an exploded perspective view, partially broken away, depicting the multi-component product handling and delivering system of the present invention;
• FIG. 2 is a side elevation view, partially broken away and partially in cross-section depicting the multi-component product handling and delivering system ofFIG. 1 fully assembled;
• FIG. 3 is an exploded perspective view of the transfer assembly member of the multi-component product handling and delivering system of present invention;
• FIG. 4 is a top plan view of the transfer assembly ofFIG. 3;
• FIG. 5 is a cross-sectional side elevation view of the transfer assembly taken along the line A-A ofFIG. 4;
• FIG. 6 is a side elevation view of the fully assembled multi-component system of the present invention, partially broken away and partially in cross-section;
• FIG. 7 is an enlarged cross-sectional side elevation view detailing area7 ofFIG. 6;
• FIG. 8 is an exploded perspective view of an alternate embodiment of the transfer assembly of the present invention;
• FIG. 9 is a cross-sectional side elevation view of the transfer assembly ofFIG. 8;
• FIG. 10 is a cross-sectional side elevation view of the housing forming the transfer assembly ofFIG. 8; and
• FIG. 11 is a top plan view of the housing ofFIG. 10.
• FIG. 12 is a perspective view of a fully assembled mixing and dispensing unit of the invention;
• FIGS. 13 and 14 are exploded and cross-section side elevation views of a mixing and dispensing unit of the invention depicting the interrelation of component parts;
• FIG. 15 is a cross-sectional view of a mixing and dispensing unit of the invention in the mixing stage;
• FIG. 16 is a cross-sectional view of a mixing and dispensing unit of the invention depicting the mixed components transferring to the dispensing chamber;
• FIGS. 17 and 18 are cross-sectional views of a mixing and dispensing unit of the invention depicting the mixed components being dispensed from the dispensing chamber.
• FIGS. 19A and 19B are perspective views of an exemplary manually actuable apparatus in condition for mixing and dispensing, respectively;
• FIG. 20 is an exploded view of the exemplary manually actuable apparatus.
6. DETAILED DESCRIPTION
• By referring toFIGS. 1-11, along with the following detailed discussion, the construction and operation of the preferred multi-component product handling and delivering systems of the present invention can best be understood. However, as will become evident from this disclosure, further alternate embodiments of the present invention can be implemented without departing from the scope of the present invention. Consequently, the embodiments detailed inFIGS. 1-11, and in the following detailed disclosure, are intended for exemplary purposes, and not as a limitation of the present invention.
• The present invention can be employed with any type of vessel used to intermix the two or more components. Thus, the present invention is not limited to combining or mixing bone cements.
• The components of the multi-component product handling and delivering systems of the present invention can be packaged and sold together as a kit.
• InFIGS. 1,2,6, and7, multi-component product handling and deliveringsystem20 of the present invention is fully depicted as comprisingcontainer21, integrated bone cement handling anddelivery system22, and transferassembly23, preferably, a fluid transfer assembly.Container21 is preferably a sealed container, more preferably, a sealed container designed for containing corrosive chemicals, such as liquid monomer. As used herein, “sealed” means that the container's contents are prevented from leaking during handling and transport and are protected from air. As shown, integrated bone cement handling anddelivery system22 comprisescover24 that is threadedly mounted tovessel25.
• In the preferred construction and implementation of the present invention, the second component of the bone cement, which comprisesdry powder26, is stored invessel25 of bone cement handling anddelivery system22, as clearly shown inFIG. 2. However, if desired,dry powder26 may be stored in any suitable container, bag, or pouch that is opened just prior to use with the powder being added tovessel25.
• In addition to preferably shippingdry powder26 invessel25 of bone cement handling anddelivery system22, the first component, which comprisesliquid monomer27, is contained in sealedcontainer21.Sealed container21 can be any suitable container adaptable to create a flow path to the vessel by way oftransfer assembly23. For example, sealedcontainer21 can be flexible or non-flexible plastic or polymer, preferably, glass or other chemically resistant material. In one preferred embodiment, sealedcontainer21 comprises glass vial ortube30 having a single opening or portal on which cap orclosure31 is mounted.
• As detailed above, cap orclosure31 of sealedcontainer21 comprises an integrally formed sealing membrane, preferably, a septum to provide access to the interior of glass vial/tube30. Sealingmembrane32 comprises a generally conventional construction, formed of elastomeric material, which typically comprises elastomeric plastics, rubbers, silicones, and the like. In this way,liquid monomer27 is sealed within glass tube/vial30, while providing access to the interior of tube/vial30 only upon creating a flow path, for example, by using a transfer conduit, such as a suitable syringe needle.
• In certain embodiments, vacuum is used to cause the sealed-container contents to transfer into the vessel (the means for transfer). In these embodiments, the vessel will comprisevacuum portal35 for attachment to a vacuum supply. In other embodiments, sealedcontainer21 can be constructed such that the system of the invention can operate without vacuum.Sealed container21 will comprise the means to transfer the container contents intovessel25. In these embodiments,vacuum portal35 is not required. In one such embodiment, sealedcontainer21 is a chemically resistant squeeze bottle or flexible bag so thatcontainer21's contents can be squeezed into thevessel25. In another such embodiment, sealedcontainer21 is preloaded with a pressurized gas that functions to push the monomer out ofcontainer21 upon creating a flow path by connection to transferassembly23. Preferably,container21's contents (e.g., monomer) is preloaded along with the pressurized gas.
• In addition, cover24 of bone cement handling anddelivery system22 comprises aaccess portal34 andvacuum portal35 that are mounted thereto and provide access to the interior ofvessel24.Vacuum portal35 comprises a generally conventional construction that enables a vacuum source to be connected thereto, using any suitable vacuum connection. In addition,access portal34 comprises a sealingmembrane36, preferably, a septa-like disk mounted inaccess portal34 for sealing the interior ofvessel25 from the ambient air, while also enabling access to the interior ofvessel25 to be achieved by creating a flow path, for example by employing a transfer conduit, such as a suitable needle or syringe.
• Finally,holder37 is employed for maintaining sealingmembrane36 in the precisely desired position withinaccess portal34. By formingholder37 with two separate and distinct diameters, one portion ofholder37 is inserted intoaccess portal34, while the second, larger diameter portion thereof engages the outer terminating edge ofaccess portal34. In this way, sealingmembrane36 is securely maintained in the desired position withinaccess portal34.
• The construction oftransfer assembly23 of the present invention is completed by providing for mating engagement thereof withcap31 of sealedcontainer21 andaccess portal34 ofcover24 of handling anddelivery system22. As fully depicted inFIGS. 1-7, in its preferred embodiment,transfer assembly23 comprisescollar portions40 and41, interconnected with each other alongsupport plate42. In addition,collar portions40 and41 preferably comprise generally cylindrical shapes and are coaxially aligned with each other.
• In addition,collar portion40 is constructed with an inside diameter dimensioned for co-operative, frictional engagement withcap31 of sealedcontainer21. In this way, whentransfer assembly23 is mounted to sealedcontainer21,transfer assembly23 is frictionally engaged securely with sealedcontainer21, preventing any unwanted, easy dislodgment of sealedcontainer21 fromassembly23.
• Similarly,collar41 comprises an inside dimension constructed for mating, co-operative, sliding engagement withaccess portal34 ofcover24. In addition, by designingcollar41 with an inside dimension that is slightly greater than the outside dimension ofaccess portal34, secure holding engagement oftransfer assembly23 withaccess portal34 is achieved wheneverassembly23 is telescopically mounted into overlying engagement withaccess portal34.
• In order to complete the construction oftransfer assembly23, a mechanism for providing a flow path between the vessel and the sealed container, is provided. The preferred flow path is created by a transfer conduit, such as dual ended piercing conduit44 (double-tipped syringe needle). As depicted,transfer conduit44 comprises asupport base45, a syringeneedle forming member46 mounted to one surface ofsupport base45 and a syringeneedle forming member47 mounted to the opposed surface ofsupport base45.
• In the preferred construction, syringeneedle forming members46 and47 comprise elongated, hollow tubes mounted to supportbase45 in coaxial alignment with each other, forming a continuous, elongated flow path therebetween. In addition, each syringeneedle forming member46 and47 comprises sharp, pointed, distal ends constructed for piercing the sealing membrane36 (any septa-like material) for gaining access to the interior associated with the sealing membrane.
• In addition,base45 of piercingelement44 is securely mounted intransfer assembly23, preferably affixed insupport plate42. When mounted in its secure position, syringeneedle forming member46 extends intocollar portion40, substantially centrally disposed therein. In this position, syringeneedle forming member46 is peripherally surrounded by the wall formingcollar portion40 with its sharp, distal end extending toward the opening ofcollar40.
• Similarly, syringeneedle forming member47 is securely positioned to be centrally disposed withincollar portion40, peripherally surrounded by thewall forming collar41. In addition, the sharp distal end of syringeneedle forming portion47 extends towards the open end ofcollar41.
• By employing this construction, the telescopic axial advance oftransfer assembly23 into engagement with sealedcontainer21 andaccess portal34 ofcover24, causes syringeneedle forming portions46 and47 to pierce the sealingmembranes32 and36 and establish a direct fluid transfer flow path between sealedcontainer21 andvessel25. In the preferred construction, in order to eliminate any unwanted injuries,tip cover48 is preferably mounted to syringeneedle forming member46. Since the diameter ofcollar portion40 is large enough to enable a finger tip to enter its open end, the use ofcover48 prior to engagement ofcover40 ontocap31 provides the desired protection.
• In addition, in the preferred construction,collar40 comprises radially extendingflange49 formed on its terminating end. By employingflange49, ease of use and control ofcollar40 is provided.
• By referring toFIGS. 8-11, along with the following detailed discussion, the construction of an alternate, preferred embodiment oftransfer assembly23 of the present invention is provided. In this embodiment,transfer assembly23 comprises ahousing54 that incorporatescollar portions55 and56, interconnected to each other bysupport wall57. In the preferred embodiment,collar portions55 and56 preferably comprise generally cylindrical shapes and are vertically aligned with each other. In addition, the central axis of each collar portion is parallel to each other and offset from each other.
• As with the embodiment detailed above,collar portion56 comprises an inside diameter constructed for mating, co-operative, sliding engagement withaccess portal34 ofcover24. In addition, by designingcollar portion56 with an inside diameter that is slightly greater than the outside diameter ofaccess portal34, secure holding engagement oftransfer assembly23 withaccess portal34 is achieved wheneverassembly23 is telescopically mounted into overlying engagement withaccess portal34.
• In addition,collar portion55 comprises an inside diameter dimensioned for co-operative, frictional engagement withcap31 of sealedcontainer21. In addition, in this embodiment,collar portion55 comprises a plurality oftabs58 mounted to the inside wall ofcollar portion55 that extend radially inwardly therefrom. In addition,tabs58 are formed on the inside wall ofcollar portion55 in a vertical position that is slightly greater than the vertical height ofcap31 of sealedcontainer21. Finally, in the preferred construction,tabs58 are formed about the inside wall ofcollar portion55 substantially equidistant from each other, thereby being spaced apart a distance of about 120°.
• By employing this construction, whenever sealedcontainer21 is telescopically inserted intocollar portion55 oftransfer assembly23,cap31 of sealedcontainer21 is frictionally engaged withcollar portion55, securely locked in position bytabs58 engaging the edge ofcap31 and preventing telescopic removal of sealedcontainer21 fromcollar portion55. In this way, once sealedcontainer21 has been mounted in secure, locked engagement withtransfer assembly23, dislodgment or removal of sealedcontainer21 fromcollar55 is prevented.
• Furthermore, in this embodiment of the invention,transfer assembly23 comprises gas-flow aperture74 comprising gas-flow conduit61 mounted insupport wall57 and transferconduit60 also mounted insupport wall57. Preferably, transferconduit60 and gas-flow conduit61 are independent syringe needles. As shown inFIGS. 8 and 9, transferconduit60 comprises an elongated, continuous, tubular member that defines an elongated flow path and incorporates two separate and independent piercing ends63 and64 mounted to supportbase65. In another embodiment,conduit60 is molded directly intohousing54 and, thus,support base65 is not required.
• Withsupport base65 oftransfer conduit60 mounted in receivinghole69 ofsupport wall57 oftransfer assembly23, piercingend63 extends fromsupport wall57 into the interior ofcollar portion55, while piercingend64 extends fromsupport wall57 intocollar portion56. In this way, as detailed above, whenevertransfer assembly23 is mounted to accessportal34 ofcover24, and sealedcontainer21 is mounted to transferassembly23, the monomer contained in sealedcontainer21 is able to be transferred throughtransfer conduit60 intovessel25.
• In this embodiment of the present invention,transfer assembly23 also comprises a gas-flow conduit61 that incorporates an elongated, cylindrically shaped, hollow piercingelement66 mounted to supportbase67. In the preferred construction,support base67 is mounted in receivinghole68 formed insupport wall57 oftransfer assembly23, with hollow piercingelement66 extending therefrom into the interior ofcollar portion55. In addition,base67 of gas-flow conduit61 cooperates with gas-flow aperture74 formed insupport wall57, thereby providing an air flow path from the ambient surroundings through hollow gas-flow conduit61 into the interior of sealedcontainer21 whenever sealedcontainer21 is mounted incollar55.
• By employing this embodiment of the present invention,transfer assembly23 provides assurance that the monomer stored in sealedcontainer21 is capable of flowing freely throughtransfer conduit60 intovessel25 whenever the monomer is desired for being added intovessel25. By providing a separate gas flow pathway (preferably ambient air) through gas-flow aperture74 and gas-flow conduit61, gas, such as nitrogen, argon, or other inert gas or air is constantly replaced in sealedcontainer21 as the monomer is withdrawn therefrom. In this way, the creation of a partial vacuum is avoided and free flow of the monomer is provided.
• In the preferred construction, this embodiment of the present invention is completed by incorporatingcover70 that is constructed for being mounted incollar portion55 for preventing and blocking any unwanted entry intocollar portion55, prior to the insertion of sealedcontainer21. In this way, contact with the terminating ends of piercingelements63 and66 is prevented and any unwanted or accidental injury is avoided.
• In the preferred construction,cover70 comprises an outwardly extendingrim71 formed on the base thereof, which cooperates with inwardly extendingtabs58, in order to securecover70 in the desired position. In addition, whenever monomer bearing sealedcontainer21 is ready for insertion incollar portion55, cover70 is easily removed from its secured position, thereby enabling sealedcontainer21 to be telescopically inserted and locked in position incollar portion55.
6.1.1 Mixing and Dispensing Unit of the Invention
• FIGS. 12-18 and the corresponding text below provide a detailed disclosure of the construction and operation of further embodiments of an apparatus for mixing and dispensing components termed a mixing and dispensing unit.
• In operation, the mixing and dispensing unit of theinvention200 corresponds to bone cement handling anddelivery system22 ofFIGS. 1-11 and as discussed in detail above. Transfer of liquid monomer under vacuum to mixing and dispensing unit of theinvention200 is substantially similar to the transfer procedure described above forvessel25. Thus, the mixing and dispensing unit of the invention is preferably used in conjunction with sealedcontainer21 andfluid transfer assembly23, (both ofFIGS. 1,2,6, and7).
• FIG. 12 depicts one embodiment of a fully assembled mixing and dispensing unit of theinvention200.Apparatus200 comprises mixingchamber295, controllableportal assembly300, and dispensingchamber305, preferably, tube shaped, havingdispensing portal310. Preferably, dispensingportal310 is adapted to connect to the standard needle or cannula used in vertebroplasty procedures. Controllableportal assembly300 comprises a controllable portal discussed in more detail below, which provides controlled opening of a flow path between the sealedmixing chamber295 and dispensingchamber305. In a preferred embodiment, mixingchamber295 comprisescover assembly290. Preferably,cover assembly290 comprisestop cap315 attached to mixing-chamber cover320 by way of set screws. Mixingchamber295 comprisesaccess portal325,vacuum portal330, and preferably comprises engagement-pin-slot335 for receivingengagement pin355.
• FIGS. 13 and 14 are exploded and cross-section side elevation views ofapparatus200 depicting the interrelation of component parts in a preferred embodiment of the mixing and dispensing unit of the invention. As illustrated inFIG. 13, mixingchamber295 defines mixingcavity360 for receiving the separate components to be mixed and dispensed. Preferably, mixingchamber295 comprises a smaller-diameter end365 to receive controllableportal assembly300.Dispensing chamber305 is connected to mixingchamber295. When the controllable portal housed in controllableportal assembly300 is closed, sealed mixingchamber295 is isolated from dispensingchamber305. On the other hand, opening the controllable portal creates a flow path so that dispensingchamber305 can receive mixed components from mixingchamber295 for dispensation. Preferably, dispensingchamber305 comprisessupport flange370.
• As discussed above, in a preferred construction, mixingchamber295 comprises cover assembly290 (seeFIG. 12), which, in turn, comprisesend cap315 and a mixing-chamber cover320. In this embodiment, as shown inFIG. 13,end cap315 comprises opening375 aligned withvacuum portal330, and mixing-chamber cover320 comprises opening380 aligned withaccess portal325.
• In a preferred embodiment ofcover assembly290, mixingchamber cover320 attaches to mixingchamber295 by threaded engagement. Mixingchamber295 houses mixing-unit385. Mixingunit385 can be any assembly well known in the art to mix components, for example, but not limited to, mixers comprising mixing vanes, such as paddles, blades, and propellers. Preferably, mixingunit385 comprises cylindrical,hollow mixing shaft390 and helical mixing vanes395. In a more preferred embodiment,hollow mixing shaft390 comprises a large-diameter end400 and mixinghead405.
• The mixing and dispensing unit of the invention further comprises a drive mechanism to drive the mixed components from dispensingchamber305 into the desired location. The drive mechanism can be any device well known in the art to drive contents from a chamber. Preferably, the drive mechanism comprises a plunger that can be driven by a rotational drive or simply by pushing the plunger down by hand.
• Thepreferred drive mechanism410 is shown inFIG. 13, which comprisesplunger shaft415 havingbore420, which houses axially-movable plungershaft advancing member425. Preferably,plunger advancing member425 terminates indrive head430 constructed for rotational engagement with drive-head engagement351. Preferably, advancing-member425 comprises male threads, and bore420 comprises complimentary female threads. Preferably,plunger shaft415 comprises plunger-sealing-end435. Preferably, plunger-sealing-end435 is constructed of a flexible, chemically resistant material and has a diameter slightly greater than the inner diameter of dispensingchamber305 to ensure that all of the material contained within dispensingchamber305 is axially advanced upon movement ofplunger shaft415. Preferably,drive mechanism410 is housed byhollow mixing shaft390.
• Rotational drive112 (shown inFIGS. 15-18 as an arrow indicating rotational movement) connects to rotating-means connection350 ofdrop shaft340. Rotating-means connection350 is firmly secured to endcap315 bylock washers352 and353.Rotational drive112 can be any motorized or manually driven rotating device inducing rotation, which are well known in the art, for example, but not limited to a drill, handle, or hand crank. In the mixing stage,rotational drive112 rotates mixingunit385 by way ofdrop shaft340. This is because, in the mixing stage, the lower portion347 (seeFIG. 14) of mixingunit connection345 is engaged with mixinghead405. Mixingunit connection345 comprises a lower portion347 (seeFIG. 14) having an interior configuration that is geometrically complementary to mixing head405 (e.g., hexagonal) so as to rotationally engage the mixing head405 (e.g., a hexagonal shape) and an upper portion349 (seeFIG. 14) having an interior configuration that will not engage mixing head405 (e.g., a smooth round shape). Mixingunit connection345 is designed in this manner so that when drop-shaft340 is in the up position (mixing phase), mixinghead405 and drop-shaft340 are rotationally engaged by way of complementary geometries between thelower portion347 of mixingunit connection345 and mixinghead405. On the other hand, after mixing is complete and the mixing chamber contents have been transferred to dispensingchamber305, drop-shaft340 is dropped, whereby the smooth round upper portion349 (FIG. 14) of mixingunit connection345 is adjacent to mixinghead405 and, in effect, drop-shaft340 is disengaged from mixinghead405. Thus, rotation of drop-shaft340 does not rotate mixingunit385. This dispensing phase is explained in more detail below.
• During the mixing stage, dropshaft340 is in the up position such that drive-head engagement351 is held above and is therefore not engaged withdrive head430. This is illustrated byFIGS. 15 and 16. At the point when dispensation is desired, however, by a simple mechanical adjustment (i.e., disengaging engagement pin355),drop shaft340 is forced down by the action ofspring440 andwasher445 with the result that the lower portion347 (FIG. 14) of mixingunit connection345 disengages from mixinghead405 and, at the same time, drive-head engagement351 ofdrop shaft340 engages withdrive mechanism410 by way ofdrive head430. Then activation ofrotational drive112 controllably advancesplunger415. This aspect of the embodiment is illustrated byFIGS. 17 and 18.
• As mentioned above, controllableportal assembly300 comprises a mechanism for opening a flow path between mixingchamber295 and dispensingchamber305 after mixing of the components contained in mixingchamber295 is complete. Such a mechanism is herein termed a controllable portal.FIG. 13 depicts a preferred controllableportal assembly300 comprisinglocking collar450, havingthreads455, andend cap460 having lockingslots465. Controllableportal assembly300 connects to the base of mixingchamber295. The controllable portal can be any valve, stopcock, or other device effective to isolate the contents of mixingchamber295 from dispensingchamber305 during the mixing phase and also to create a flow path between mixingchamber295 and dispensingchamber305 when transfer between mixingchamber295 and dispensingchamber305 is desired. A preferred embodiment of a controllable portal is depicted inFIG. 13 as467.
• Controllable portal467 comprises slidingtube470 securely fixed to dispensingchamber305. Preferably, slidingtube470 forms a tight seal with both the mixingchamber295 and dispensingchamber305, for example, by use of O-rings475. InFIG. 13, slidingtube470 comprises a pair ofwindows480 on each side and radially extending lockingrods485. Slidingtube470 further comprises plunger-locking-slot490. Slidingtube470 can be an integral part of dispensingchamber305 or can be a separate component for secure, fixed attachment to dispensingchamber305. In a preferred embodiment, radially extending lockingrods485 are positioned for cooperating, controlled, sliding engagement withthreads455 of lockingcollar450.Guide washer495 is designed to be geometrically complementary toplunger shaft415 so as allowplunger shaft415 to move up and down along its axis but not to rotate.Guide washer495 comprisestooth500 complementary in shape to plunger-locking-slot490.
6.1.1.1 The Mixing Phase of the Mixing and Dispensing Unit of the Invention
• The components to be mixed are contained within mixingchamber295. One or more of the components can be prepackaged in the mixing and dispensing unit and/or additional components can be added directly before mixing.
• As shown inFIG. 15, during the mixing phase, slidingtube470 is positioned bythreads455 of lockingcollar450 so that: (1)windows480 are within large-diameter end400 ofhollow mixing shaft390; and (2) the flow path (i.e., windows480) between mixingchamber295 and dispensingchamber305 is blocked. In other words, the interior of dispensingchamber305 is isolated from the interior of mixingchamber295, preventing the contents from entering dispensingchamber305 during mixing.
• Further, in this mixing phase,drop shaft340 is engaged byengagement pin355 and therefore locked in the up position such thatdrive head430 is not engaged with rotating-drive-head engagement351. And in the up position, as discussed above,drop shaft340 is rotationally engaged with mixinghead405. Also, advancingmember425 is fully inserted intobore420.Tooth500 ofguide washer495 is engaged with locking-slot490 so thatplunger shaft415 is prevented from rotating.
• In the above configuration, upon connection and operation of arotational drive112 to rotating-means connection350, mixingunit385 is rotated along its axis thereby mixing the components within mixingchamber295.
6.1.1.2 Transfer of Mixed Components from Mixing Chamber to Dispensing Chamber of the Mixing and Dispensing Unit of the Invention
• When the mixing phase is complete, the contents of mixingchamber295 are ready for transfer to dispensingchamber305. This is accomplished by openingcontrollable portal467 to create a flow path. In a preferred embodiment, rotation of helical shaped mixingvanes395 is used force the contents of mixingchamber295 into dispensingchamber305 by action of mixingunit385.
• FIGS. 15 and 16 illustrate operation ofcontrollable portal467 to open a flow path between mixingchamber295 and dispensingchamber305 and using the action of mixingunit385 to transfer the contents. First lockingcollar450 is rotated whereupon lockingrods485 are guided withinthreads455 of lockingcollar450 thereby pushing slidingtube470 and dispensingchamber305 downward such thatwindows480 are below plunger-sealing-end435 and a flow path between mixingchamber295 and dispensingchamber305 is created. Thus, the axial rotational movement of lockingcollar450 causeswindows480 of slidingtube470 to move out of engagement with the larger diameter end400 ofhollow mixing shaft390, wherebywindows480 are positioned below plunger-sealing-end435 to complete the flow path.
• Rotating of lockingcollar450 is complete when lockingrods485 are locked withincomplementary locking slots465 ofend cap460. The construction of lockingrods485 and lockingcollar450 effectively provide a turnbuckle construction that causes dispensingchamber305 to move downward.
• Once dispensingchamber305 is in the position depicted inFIG. 16,rotational drive112 is activated to force the contents of mixingchamber295 into dispensingchamber305 by the helical action of mixingunit385.
6.1.1.3 The Dispensing Phase of the Mixing and Dispensing Unit of the Invention
• Once the contents are loaded into dispensingchamber305,drop shaft340 can be dropped by releasingengagement pin355. This causes drive-head engagement351 ofdrop shaft340 to rotationally engage withdrive head430 ofplunger advancing member425. At the same time the upper portion349 (FIG. 14) of mixingunit connection345, having a smooth interior (not shown), drops over mixinghead405 and the geometrically complementary lower portion347 (FIG.14)ofconnection345 disengages from mixinghead405. Accordingly, in this position, the rotation of drop-shaft340 does not rotate mixingunit385. Dispensing the contents of dispensingchamber305 is illustrated inFIGS. 17 and 18.
• Upon activatingrotational drive112, rotatingmeans connection350 is controllably rotated. The rotational movement causesplunger advancing member425 to rotate. Sinceplunger advancing member425 is axially fixed (cannot move up and down but can only rotate),plunger shaft415 and plunger-sealing-end435 are controllably axially advanced longitudinally through dispensingchamber305. The longitudinal movement of plunger-sealing-end435 in dispensingchamber305 forces the mixed components contained therein to be delivered throughoutlet portal310 of dispensingchamber305. Preferably, dispensingportal310 is adapted to connect to the standard needle or cannula (not shown) used in vertebroplasty procedures.
• In addition, by controlling the rotational movement or speed of rotating-means connection350, the precisely desired pressure for advancing the mixed components through dispensingchamber305 is achieved. Furthermore, by stopping the rotational movement of rotating-means connection350 or reversing the direction rotating-means connection350, complete control over the delivery of the mixed components to the precisely desired site is achieved. In fact, by reversing the rotation of rotating-means connection350, the plunger direction is reversed and the contents can actually be pulled back into dispensingchamber305. This provides much greater control than previously available. In addition, in the preferred embodiment, reference indicia are marked or etched on the outer surface of dispensingchamber305, thereby enabling the operator to precisely measure the quantity of material being delivered.
• In another convenient embodiment, the mixing and dispensing unit of the invention can be calibrated such that the number of revolutions ofdrop shaft340 and/or therotational drive112 corresponds to an amount (e.g., a weight or volume) of bone cement dispensed. In this embodiment, a clinician dispensing a biocompatible filler using the mixing and dispensing unit of the invention can dispense a predetermined amount by completing a predetermined number of rotations ofdrop shaft340 and/orrotational drive112.
• In view of the above disclosure, it is clear that in one embodiment, the invention is directed to an apparatus for mixing and dispensing components comprising:
• (a) a sealed mixing chamber having an access portal and a vacuum portal;
• (b) a dispensing chamber connected to the sealed mixing chamber, wherein the dispensing chamber is isolated from the mixing chamber;
• (c) a controllable portal for opening a flow path between the sealed mixing chamber and the dispensing chamber after the components are mixed;
• (d) a drive mechanism associated with the dispensing chamber for driving the mixture from the dispensing chamber.
• Preferably, the apparatus further comprises:
• a. a sealed container for containing a first component; and
• b. a transfer assembly for providing a flow path between the sealed container and the sealed mixing chamber,
• wherein, in operation, when the sealed container comprises the first component, connection of vacuum to the vacuum portal induces the first component to transfer into the sealed mixing chamber by way of the flow path.
• In another embodiment, the invention is directed to a method for mixing and dispensing components comprising:
• (a) adding the components to an apparatus comprising:
• • (i) a sealed mixing chamber comprising an access portal and a vacuum portal,
  • (ii) a dispensing chamber connected to the sealed mixing chamber, wherein the dispensing chamber is isolated from the mixing chamber,
  • (iii) a controllable portal,
  • (iv) a drive mechanism associated with the dispensing chamber;
• (b) mixing the components in the mixing chamber to form a mixture;
• (c) opening the controllable portal to create a flow path between the sealed mixing chamber and the dispensing chamber;
• (d) transferring the mixture to the dispensing chamber by way of the flow path; and
• (e) activating the drive mechanism to dispense the mixture from the dispensing chamber.
6.1.1.4 Illustrative Embodiment—Manually Actuable Mixer and Dispenser
• Aspects of the invention may now be more clearly understood by consideration of the following specific embodiment in the form of a manually actuable mixing and dispensing apparatus. By manually actuable is meant that both mixing of the components and dispensing of the mixed components can be manually effected and controlled without the use of power tools. One advantage of manual actuation is that operation is not dependent on the presence of power tools or electrical outlets in a sterile environment. Another is the finer level of control provided by direct hand control.
• The exemplary apparatus is similar in structure and function to the apparatus previously illustrated and described except that it provides adaptions to facilitate manual mixing and manual dispensing of the mixed components.FIG. 19A is a perspective view of the assembledexemplary apparatus500 with aradially extending handle543 in a first position to facilitate manual mixing of liquid monomer and bone cement powder. Thehandle543 is pivotally mounted on ahandle cap547.FIG. 19B shows thesame apparatus500 with thehandle543 pivoted to a second position to facilitate dispensing the mixture. The assembledapparatus500 comprises a mixingchamber502, controllableportal assembly507, and dispensingchamber535, preferably tube shaped, having a dispensing portal (not visible). Preferably the dispensing portal is adapted to connect to the standard needle or cannula used in vertebroplasty procedures. The controllableportal assembly507 provides controlled opening of a flowpath between the sealedmixing chamber502 and dispensingchamber535. Preferably mixingchamber502 comprises atop cap501.
• FIG. 20 is an exploded view of the exemplary manually actuable mixing and dispensingapparatus500. The apparatus is similar in operation and structure to those already described herein. The discussion here will emphasize the modifications found advantageous for manual actuation.
• It is contemplated that theapparatus500 will be delivered with the crank handle543 in the open radially extended position (FIG. 19A) and theneedle transfer housing531,532 in place. The user will remove thecover532 of theneedle transfer housing531 and attach a vacuum source (not shown) to thevacuum port501A as previously described. With vacuum applied, needles of the transfer housing pierce the cap of a monomer vial and liquid monomer from the vial is drawn into thetransfer housing531.
• The monomer is further drawn into the mixinghousing502 which can contain the powder polymer. The vial and thetransfer housing531 are then removed together, the simultaneous removal assured by locking fingers of the transfer housing locking onto the cap of the vial.
• The user then mixes the monomer and powder to form bone cement by rotating the radiallyextended handle543 or by rotating the handle cap547 (which acts as a knob). With thehandle543 in open position, acam surface543A pushes downward on a crankhandle gear548 causing the gear configuration to interface with acorresponding gear configuration503A on the end of mixingpaddle503. The manual rotational movement of the handle or knob is thus transmitted to actuate the mixingpaddle503.
• When the cement is mixed, the user rotates the controllableportal assembly507 to open the controllable port between the mixingchamber502 and the dispensingsyringe tube535. Thehandle543 is then turned to move the mixed material through the now open port into thesyringe tube535.
• After thesyringe tube535 is filled, the user flips the hingedhandle543 across the center of thecap547 to lock the handle in the second position (FIG. 19B) into a receivingslot547A of the cap. This change of handle position releases the pressure of thecrank handle cam543 on thecrank handle gear548, permitting the spring biased gear to move upward, disengaging the gear from thepaddle503. In the second position, ahex cap546 in thehandle543 engages thedrive configuration511A of a threadedplunger shaft511. The paddle is thus disengaged so that it does not move or mix during the discharge of material from the apparatus, and the handle is engaged with threadedshaft511 for driving the mixed material out throughsyringe tube535.
• The user then rotates handle543 or the knobbed crankhandle cap547 to actuate the plunger mechanism (511,518,533) pushing the mixed material out the end of thesyringe tube535 and typically into a needle or cannula (not shown).
Component Structure
• Theneedle housing531 andneedle housing cap532 are preferably of the design shown and described in connection withFIG. 9. Advantageously theneedle housing531 has adetent bump531A in the lower tube portion to hold the housing in place during shipment and preparation. The needle housing in place also aligns thevacuum port501A with anopening547B in thecrank handle cap547 to facilitate the attachment of a vacuum line (not shown). Alternatively, thevacuum port501A can be disposed on the exterior of the mixing chamber or the end cap to facilitate attachment. Crankhandle cap547 houses the crank handle543 and assembled knob components.
• The crank handle is held in place by a crank handle cup comprising apivot half541 and aclamp half542, each secured to the crankhandle cap547. The cup (541,542) also houses thecrank handle gear548, permitting it to slide longitudinally. The longitudinal position of thegear548 is controlled by thecam surface543A of the handle. The gear is loaded byspring549 in the disengaged condition with respect to the mixingpaddle503. Thus when the handle is in the first position (FIG. 19A), the gear is engaged with the paddle. Pivoting the handle to the second position (FIG. 19B) releases the gear to its spring biased disengaged position.
• The crank handle cup assembly (541,542) also locks onto the top end of thepaddle503 to provide alignment between the paddle and thegear548. The twohalves541,542 are secured together as byscrews539 or snap-fit connections (not shown). The cup could also be molded as a one piece part.
• Theend cap501 is advantageously similar totop cap315 ofFIG. 12. It attaches the upper cap assembly to the mixingchamber502.
• The mixingpaddle503 is advantageously similar to paddle390 ofFIG. 13, except that thedrive end503A has a gear configuration for interfacing with thecrank handle gear548. It is preferred that the top of thedrive end503A have lead-in edges to assist in engagement with the crank handle gear.
• In other regards, the drive mechanisms for mixing and dispensing and the mechanisms for operating the controllable port between the mixing chamber and the dispensing chamber are the same as those described for other embodiments herein.
• It can now be seen that the exemplary apparatus for manually mixing and dispensing components comprises a sealed mixing chamber having an access portal and a vacuum portal, a mixing unit in the mixing chamber to mix the components, and a first manually actuable drive mechanism associated with the mixing unit to actuate mixing.
• The apparatus further includes a dispensing chamber connected to the sealed mixing chamber but which is isolated from the mixing chamber. A controllable portal is provided for opening a flow path between the sealed mixing chamber and the dispensing chamber after the components are mixed. A second manually actuable drive mechanism associated with the dispensing chamber is provided to drive the mixture from the dispensing chamber.
• In advantageous forms, the mixing chamber is preloaded with bone cement powder. The first and second drive mechanisms comprise rotationally movable handles or knobs and preferably a common handle or knob. A mechanical switching arrangement can be provided to disengage the common handle or knob from the first drive mechanism. The preferred mixing unit comprises a mixing paddle, and the preferred second drive mechanism comprises a plunger shaft.
• Although the present invention has been described in considerable detail with reference to certain preferred embodiments and versions, other versions and embodiments are readily implemented by those of skill in the art. Therefore, the scope of the appended claims should not be limited to the description of the versions and embodiments expressly disclosed herein.
• It is understood that the above-described embodiments are illustrative of only a few of the many possible specific embodiments, which can represent applications of the invention. Numerous and varied other arrangements can be made by those skilled in the art without departing from the spirit and scope of the invention.

Claims (9)

1. An apparatus for manually mixing and dispensing components comprising:

(a) a sealed mixing chamber having an access portal and a vacuum portal;

(b) a mixing unit in the mixing chamber to mix the components;

(c) a first manually actuable drive mechanism associated with the mixing unit to actuate mixing;

(d) a dispensing chamber connected to the sealed mixing chamber, wherein the dispensing chamber is isolated from the mixing chamber;

(e) a controllable portal for opening a flow path between the sealed mixing chamber and the dispensing chamber after the components are mixed; and

(f) a second manually actuable drive mechanism associated with the dispensing chamber to drive the mixture from the dispensing chamber.

2. The apparatus ofclaim 1 wherein the mixing chamber contains bone cement powder.

3. The apparatus ofclaim 1 wherein the first drive mechanism comprises a rotationally movable handle or knob.

4. The apparatus ofclaim 1 wherein the second drive mechanism comprises a rotationally movable handle or knob.

5. The apparatus ofclaim 1 wherein the first and second drive mechanisms both comprise a common rotationally movable handle or knob.

6. The apparatus ofclaim 5 further comprising a mechanical switch whereby the handle or knob actuating the first drive mechanism can be disengaged from the first drive after mixing and engaged to the second drive mechanism.

7. The apparatus ofclaim 1 wherein the mixing unit comprises a mixing paddle.

8. The apparatus ofclaim 1 wherein the second drive mechanism comprises a plunger shaft.

9. The apparatus ofclaim 1 wherein the mixing chamber comprises a powder component to be mixed with a liquid component and further comprising a transfer housing to facilitate transfer of the liquid component into the mixing chamber.

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