Abstract: An apparatus and method for advancement of a spinal rod in a spinal implant, wherein the apparatus includes a body and a handle attached to the body. A shaft is slidably attached to the body, the shaft is coupled to the handle and has a first end adapted to engage the spinal rod. At least one retractor blade is attached to the body and the spinal implant. The operation of the handle results in the shaft persuading the spinal rod in the spinal implant. The force exerted by the shaft on the spinal rod is limited to a pre-selected force. The apparatus can also be operated in a non-limiting mode when a reduction retractor blade is used.

Abstract: A line lock system may include a line routed through a plate. The plate may have an elongated body with a plurality of passageways. The line is routed to form at least one one-way slide so no knots are required. The system may include filaments routed through the passageways of the plate or around a dogbone feature of the plate. The filaments may be used to toggle the plate after passage through a hole to prevent withdrawal of the plate back through the hole. The system may include a line lock stabilizer or counter-tension tool to stabilize the line lock as the line is adjusted. The system may include a compression limiter to selectively reduce compression in the one-way slide to facilitate adjustment of the line. The line lock stabilizer, counter-tension tool, or compression limiter may be a filament.

Abstract: A fixation screw, graft ligament anchor assembly, and method for fastening a graft ligament in a bone tunnel. The screw comprises an elongated shank having a distal end and a proximal end, and a central axis extending from the distal end to the proximal end. Screw threads are disposed on the shank and extend from the distal end to the proximal end. The proximal end defines an end plane disposed transversely to the axis and at an angle thereto other than a normal angle.

Abstract: A fixation screw, graft ligament anchor assembly, and method for fastening a graft ligament in a bone tunnel. The screw comprises an elongated shank having a distal end and a proximal end, and a central axis extending from the distal end to the proximal end. Screw threads are disposed on the shank and extend from the distal end to the proximal end. The proximal end defines an end plane disposed transversely to the axis and at an angle thereto other than a normal angle.

Abstract: A spinal stabilization system includes vertebral engagement members and an intermediate structure. The vertebral engagement members are configured to be disposed between a first vertebra and a second vertebra. The vertebral engagement members generally include seating surfaces for accommodating at least a portion of a laminar region of adjacent vertebra and are adjustable between an operable and inoperable configuration. The intermediate structure extends between the vertebral engagement members. The structural cooperation of the vertebral engagement members and the intermediate structure is such that the engagement members distract the adjacent vertebrae.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: A line lock system may include a line routed through a plate. The plate may have an elongated body with a plurality of passageways. The line is routed to form at least one one-way slide so no knots are required. The system may include filaments routed through the passageways of the plate or around a dogbone feature of the plate. The filaments may be used to toggle the plate after passage through a hole to prevent withdrawal of the plate back through the hole. The system may include a line lock stabilizer or counter-tension tool to stabilize the line lock as the line is adjusted. The system may include a compression limiter to selectively reduce compression in the one-way slide to facilitate adjustment of the line. The line lock stabilizer, counter-tension tool, or compression limiter may be a filament.

Abstract: A spinal stabilization system includes vertebral engagement members and an intermediate structure. The vertebral engagement members are configured to be disposed between a first vertebra and a second vertebra. The vertebral engagement members generally include seating surfaces for accommodating at least a portion of a laminar region of adjacent vertebra and are adjustable between an operable and inoperable configuration. The intermediate structure extends between the vertebral engagement members. The structural cooperation of the vertebral engagement members and the intermediate structure is such that the engagement members distract the adjacent vertebrae.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: An apparatus and method for advancement of a spinal rod in a spinal implant, wherein the apparatus includes a body and a handle attached to the body. A shaft is slidably attached to the body, the shaft is coupled to the handle and has a first end adapted to engage the spinal rod. At least one retractor blade is attached to the body and the spinal implant. The operation of the handle results in the shaft persuading the spinal rod in the spinal implant. The force exerted by the shaft on the spinal rod is limited to a pre-selected force. The apparatus can also be operated in a non-limiting mode when a reduction retractor blade is used.

Abstract: A graft ligament strand tensioner includes a frame member for slidingly retaining loops of sutures extending from graft ligament strands. The tensioner further includes a collar portion, and is provided with a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion. The tensioner still further includes a spherical member connected to the handle and having rounded surfaces facing the collar portion. The collar portion is tiltingly movable on the spherical member rounded surfaces when manipulation of the handle, to pull sutures on the frame member taut, causes the collar portion to engage the spherical member rounded surfaces. The sliding retention of the sutures and the tilting movement of the collar portion provide substantial equalization of tension in the sutures and thereby the graft ligament strands.

Abstract: A fixation screw, graft ligament anchor assembly, and method for fastening a graft ligament in a bone tunnel. The screw comprises an elongated shank having a distal end and a proximal end, and a central axis extending from the distal end to the proximal end. Screw threads are disposed on the shank and extend from the distal end to the proximal end. The proximal end defines an end plane disposed transversely to the axis and at an angle thereto other than a normal angle.

Abstract: A cannulated threaded bone tunnel dilator that accurately advances through bone and dilates a bone tunnel in a gentle, controlled manner, including a distal tapered, threaded tip and a body mounted on the distal end of a shaft. The proximal end of the shaft includes a drive attachment for rotating the dilator so as to threadingly advance the dilator. In use, a guidewire is driven into bone, and then the surgeon advances the dilator along the guidewire until the tip of the dilator engages the bone. The surgeon then rotates the dilator clockwise so as to threadingly advance the dilator through the bone until the dilator reaches a desired depth. After reaching the desired depth, the surgeon removes the dilator by rotating the dilator counterclockwise and retracting the dilator from the then-compacted bone tunnel. The peaks and troughs of the dilator's thread compact the bone so as to create the dilated bone tunnel.

Abstract: A graft ligament strand tensioner includes a frame member for slidingly retaining loops of sutures extending from graft ligament strands. The tensioner further includes a collar portion, and is provided with a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion. The tensioner still further includes a spherical member connected to the handle and having rounded surfaces facing the collar portion. The collar portion is tiltingly movable on the spherical member rounded surfaces when manipulation of the handle, to pull sutures on the frame member taut, causes the collar portion to engage the spherical member rounded surfaces. The sliding retention of the sutures and the tilting movement of the collar portion provide substantial equalization of tension in the sutures and thereby the graft ligament strands.

Abstract: A graft ligament strand tensioner includes a frame member for slidingly retaining loops of sutures extending from graft ligament strands. The tensioner further includes a collar portion, and is provided with a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion. The tensioner still further includes a spherical member connected to the handle and having rounded surfaces facing the collar portion. The collar portion is tiltingly movable on the spherical member rounded surfaces when manipulation of the handle, to pull sutures on the frame member taut, causes the collar portion to engage the spherical member rounded surfaces. The sliding retention of the sutures and the tilting movement of the collar portion provide substantial equalization of tension in the sutures and thereby the graft ligament strands.

Abstract: A cannulated threaded bone tunnel dilator that accurately advances through bone and dilates a bone tunnel in a gentle, controlled manner, including a distal tapered, threaded tip and a body mounted on the distal end of a shaft. The proximal end of the shaft includes a drive attachment for rotating the dilator so as to threadingly advance the dilator. In use, a guidewire is driven into bone, and then the surgeon advances the dilator along the guidewire until the tip of the dilator engages the bone. The surgeon then rotates the dilator clockwise so as to threadingly advance the dilator through the bone until the dilator reaches a desired depth. After reaching the desired depth, the surgeon removes the dilator by rotating the dilator counterclockwise and retracting the dilator from the then-compacted bone tunnel. The peaks and troughs of the dilator's thread compact the bone so as to create the dilated bone tunnel.

Abstract: A threaded suture anchor useful in orthopedic rotator cuff repair surgical procedures.