Abstract: Apparatus and methods for spinal surgery include a retractor with an elongated body extending along a longitudinal axis between a distal end and an opposite proximal end. The retractor defines a passage between the distal and proximal ends and a window opening into the passage adjacent to the distal end. The apparatus also includes a guide member extending laterally from the proximal end of the retractor and the guide member includes a body extending along an arc. The body defines a number of trajectories each intersecting the window of the retractor. The apparatus further includes an instrument removably mounted to the guide member and the instrument is movable along the guide member and securable to the guide member in any one of the number of trajectories so that the instrument can be moved along the selected trajectory through the window.

Abstract: A spinal construct comprises a first member engageable with a receiver of a first fastener having a shaft fixed with tissue. A second member is engageable with a receiver of a second fastener having a shaft fixed with the tissue. A longitudinal element connects the members. At least one of the members includes a mating element that is releasably engageable with a surgical instrument to manipulate the tissue such that movement of the receivers relative to the shafts is resisted and/or prevented. Surgical instruments, implants, systems and methods are disclosed.

Abstract: The present disclosure pertains to a mechanical ventilator system configured to deliver a pressurized flow of breathable gas to the airway of a subject. The system is configured to generate the pressurized flow of breathable gas according to a volume control mode therapy regime that delivers a target tidal volume to the subject during inhalation. During an individual inhalation, the system is configured to determine and/or adjust an inspiratory pressure level of the pressurized flow of breathable gas of the volume control mode therapy regime. The inspiratory pressure level is adjusted such that during the inhalation the inspiratory pressure level is not reduced to impede respiratory effort by the subject responsive to the target tidal volume being exceeded during the inhalation. The system comprises one or more of a pressure generator, a subject interface, one or more sensors, one or more processors, a user interface, electronic storage, and/or other components.

Abstract: Apparatus and methods are disclosed for controlling pressure delivery to a user such as a patient. A flow generator generates an outlet flow at an outlet port for delivery to a patient. At least one sensor measures properties of the flow of gas at the outlet port or being delivered to the patient. A controller is operatively connected to the flow generator and the at least one sensor, and is adapted to operate according to a pressure control mode in which the controller controls the flow generator to output a substantially steady pressure or a flow control mode in which the controller controls the flow generator to output a substantially steady flow. The controller operates in the flow control mode when a patient may be awake and in the pressure control mode when the patient may be asleep.

Abstract: A self-administered oxygenation apparatus for increasing pressure within a non-intubated patient's lungs and thereby increasing an amount of oxygen in the non-intubated patient's blood when operated by the patient includes a mouthpiece, a vent member, and a resistance member. The mouthpiece includes an external portion defining a center orifice through which the patient selectively inhales and exhales air. The vent member includes a continuous side wall fixedly coupled to the external portion of the mouthpiece and defining an interior area in fluid communication with the center orifice. The resistance member is positioned between the interior area of the vent member and the mouthpiece, the resistance member having a flexible construction configured to fold inwardly upon inhalation so as to allow ambient air inhaled by the patient to pass thereby without resistance and having a perforated construction configured to decrease the flow of air exhaled by the patient.

Abstract: Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a ball having a spherical exterior surface and a central lumen sized to receive the head portion of the shank, and a clip configured to be engaged between the head portion and the ball such that the clip is effective to lock the ball in engagement with the shank.

Abstract: A spinal fixation device is provided, comprising a body member having a first side and an opposite second side, and an elongate flexible strap having a first section and a second section. The first section of the strap is attached or attachable to attachment means of the body member arranged at a first location thereof. The second section of the strap is sized and shaped to pass through a passageway arranged at a second location of the body member. The strap has a series of teeth and the passageway of the body member has a latch configured for engaging one of the teeth. The teeth and the latch are configured to allow a movement of the second section of the strap through the passageway in a tightening direction from the first side to the second side of the body member, and to prevent a movement of the second section in the opposite direction.

Abstract: A spinal screw assembly is provided. The assembly may be provided with a screw and a movable head in which angulation of the screw relative to the movable head is constrained so that angulation within limits is allowed in one plane but lesser or no angulation is allowed in another plane. Methods to assemble the disclosed apparatus are also disclosed.

Abstract: Open implant closure structures include a helically wound guide and advancement flange form having pivot-splay accommodating and splay control surfaces with opposing load flanks in initial non-parallel relation.

Abstract: A retractor system for use in spinal surgical procedures includes at least two retractor blades, each of the at least two retractor blades, a shim and a shim inserter. The shim has an expansion band and the shim inserter is configured to slide the shim between and along the at least two retractor blades and dispose the shim at a distal end of the at least two retractor blades. The shim spreads the at least two retractor blades away from each other when the shim insert slides the shim between and along the at least two retractor blades and the shim prevents the distal end of each of the at least two retractor blades from closing in on each other due to musculature load when the shim is disposed at the distal end of the at least two retractor blades.

Abstract: The rod coupler according to the present invention comprises two clamping jaws and locking means for locking said clamping jaws against one another. Each clamping jaw comprises an outside surface and a clamping surface, the latter providing at least a first and a second groove. Each groove runs laterally from a different part of the outside surface extending into the rod coupler, wherein longitudinal axis of the first groove and the second groove include an angle that is equal to or less than 160 degrees. Opposing grooves form an aperture. The apertures are adapted for receiving a rod if the locking means is released. Clamping jaws that are locked by the locking means clamp the rods received in said apertures.

Abstract: Disclosed are various instruments and implants used in minimally invasive spine surgery. Disclosed is a cannulated probe, a guide wire handle; a guide wire handle having a locking mechanism, an all-in-one guide wire tool; a retractor flex rod passage; or a tab break tool.

Abstract: An expandable interbody fusion device includes superior and inferior plates that are configured to receive a sequentially inserted stack of expansion members or wafers. The superior and inferior plates include features that at least initially interlock the two plates until the superior plate is dislodged by pressure from the growing wafer stack. The wafers include features on their top and bottom surfaces that interlock the wafers in multiple degrees of freedom so that the wafer stack is not disrupted when the fusion device is fully expanded. Each wafer also includes features that interlock with the inferior plate until the wafer id dislodged by sequential introduction of another wafer.

Abstract: A tracheal/endotracheal device that has an integrated system for removing mucins and similar infectious secretions. The tracheal/endotracheal device has several channels. One channel delivers air to a patient's lungs. At least two other channels cooperate to deliver a mist of antiseptic ingredients to an area in the trachea and to suction away the mist and any mucins and secretions. The mist and bodily fluids captured by the suctioning channel are delivered to a collection vessel outside of the trachea.

Abstract: A vertebral fixing system having a flexible elongated member, a connecting part, and an anchor, where the anchor may engage a bone structure (e.g., a vertebra) through an opening of the connecting part and the flexible elongated member may connect to the connecting part. In some cases, the vertebral fixing system may include a tightening part configured to apply a tension to the elongated member and/or secure the elongated member with respect to the connecting part. The vertebral fixing system may be configured to receive a rod and may be capable of connecting thereto. The connecting part may have a plurality of connecting members, where at least one of the connecting members includes an opening for receiving the anchor and at least one of the connecting members connects to the elongated member.

Abstract: In various embodiments, an intervertebral disc prosthesis is provided. The prosthesis may be provided with an insertion adapter, such as a head, holder, or other carrier of the prosthesis. The insertion adapter may be configured to retain the prosthesis and to engage an insertion tool body. In various embodiments, the prosthesis and the insertion holder are provided in a sterile pack, with the prosthesis components and the insertion holder sterilized and packaged in one or more types or layers of sterile packaging. In various other embodiments, the prosthesis and an insertion tool are provided in a sterile pack, with the prosthesis components and the insertion tool sterilized and packaged in one or more types or layers of sterile packaging.

Abstract: A spinal implant comprises an implant body extending between an anterior surface and a posterior surface, and including a first vertebral engaging surface and a second vertebral engaging surface. The implant body further including an inner surface that defines at least a first cavity and a second cavity spaced from the first cavity. The first cavity is oriented to implant a fastener oblique relative to a bilateral axis of a subject body. The second cavity is oriented to implant a fastener in substantial alignment with the bilateral axis. Systems and methods of use are disclosed.

Abstract: A receiver subassembly adapted to couple with a universal shank to form a bone anchor assembly. The universal shank having an integral upper capture structure with opposed spaced apart flat side surfaces. The receiver subassembly including a receiver including a distal opening for bottom loading of the capture structure of the universal shank there-through. The receiver supporting a retainer and a positioner within the receiver. The positioner supporting a position of the retainer within the receiver. The retainer configured to couple with the capture structure when the capture structure extends at least partially through the distal opening.

Abstract: An inhaler comprising a housing defining a chamber to receive a strip having a plurality of blisters each containing a dose of medicament for inhalation by a user is disclosed.

Abstract: A polyaxial vertebral assembly that includes a polyaxial vertebral anchor and an articulating connector. The anchor is configured to penetrate and secure to a vertebra, and includes a spherical head end. The connector includes a base, an extension, and a common trajectory split lock. The split lock includes a first lock and a second lock. The first lock is configured to engage rigidly the base in a selected pivotal configuration to the head end along the second axis of the extension, wherein the head end is disposed in the base in the selected pivotal configuration with respect to the first axis of the base. The second lock is configured to engage rigidly a stabilizing rod at selected configurable height and rotational configuration with respect to the polyaxial vertebral anchor along the second axis, wherein the pivotal configuration and the height and rotational configuration are independently adjustable along the second axis.