Abstract: A trans-facet procedure for preparing a patient for oblique lateral lumbar interbody fusion (OLLIF). The preparation procedure includes providing a kit with instruments for accessing Kambin's triangle through bone at nominal approaches preferred for the OLLIF procedure, and providing instructions for the procedure on a non-transitory tangible medium.

Abstract: A spinal implant system includes an inserter that passes through a spinal implant for attachment to a distal end of the spinal implant. By this arrangement, stability of the implant system is enhanced for placement of the spinal implant while reducing local stresses imparted at the attachment. The disclosed spinal implant system may include an access tube that is coupled to a proximal end of the spinal implant. After placement of the spinal implant, the inserter may be removed from the spinal implant and access tube, providing access via the access tube to an interior of the spinal implant and the corresponding space between the vertebral endplates.

Abstract: An anchoring system for a spinal support rod. The anchoring system includes a self-tapping orthopedic fastener that is bored through the ilium via a lateral incision and a mounting receiver that is positioned to receive the orthopedic fastener via a posterior incision. The orthopedic fastener may be implanted from a lateral approach or a posterolateral approach. The mounting receiver may be implanted from a posterior or superior posterior approach.

Abstract: A “vascular-safe” pedicle screw and extension-ready spinal support system. The pedicle screw includes a self-tapping flute that recessed into a threaded shaft to define terminations of the threads at a face of said self-tapping flute. The terminations are curved to define a convex profile that extends from a root to a crest of the threads at said face of said self-tapping flute. The curved terminations tend to push soft tissue aside as opposed to slicing or tearing through the soft tissue, so that the self-tapping flute is less likely to slice into vascular vessels. The distal portion of the pedicle screw may also include depressions that reduce the circumferential contact area of the pedicle screw in the direction of rotation, which increases the applied pressure to the soft tissue for a given applied rotational force. The increased pressure augments penetration of the pedicle screw through tissue without resort to sharp cutting edges.

Abstract: A lateral disc cutter for morcellating and decorticating tissue of an intervertebral disc from between adjacent vertebrae. The device can be arranged in a retracted configuration for insertion via an access tube, and in an extended configuration for cutting of tissue in the target region. The blades may be extended to contact the concave endplate in an orientation that is substantially parallel to a mid-plane of the intervertebral disc. Blades of the device may be configured with a convex profile that substantially conforms to the concave shape of the endplate for enhanced contact length between the blade and the endplate. In some embodiments, the blades are configured for removal and replacement without need for tools, with the blades selectively determining a maximum displacement width of the morecellator assembly.

Abstract: An endplate plunger for implanting a growth-promoting tether between opposed adjacent vertebrae. The endplate plunger includes resilient arm assemblies that store potential energy when the endplate plunger is in a retracted configuration. In transitioning from the retracted configuration to a deployed configuration, the potential energy is released in a burst of kinetic energy, causing tip portions at the distal ends of the resilient arm assemblies to be thrust into the adjacent vertebrae. In some embodiments, each tip portion forms a cleft in the respective vertebral endplate and deposits the tether therein. The tether is thereby anchored directly in the clefts, without need for separately formed anchors. In some embodiments, devices and methods are disclosed to route the tether through an implanted spinal implant.

Abstract: An “extension ready” spinal support system that enables the extension to be accomplished with minimal disturbance to an existing spinal support structure to which the extension system is coupled. In some embodiments, the existing spinal support rod and pedicle screws can remain intact while extension subassemblies are mounted directly to the existing base rod receptacles. The extension subassemblies include a skirt portion that surrounds and engages the existing base receptacle to prevent splaying of the base receptacle. Additional resistance to splaying may be provided by a canted thread arrangement between the skirt and the base receptacle. In some embodiments, the extension receptacle is provided with a low profile (i.e., shortened axial length from the base rod receptacle) by providing a monoaxial rotation structure that rotates about but does not pitch relative to the extension axis and is shorter relative to polyaxial rotation structures.

Abstract: A system for performing a minimally invasive sacroiliac joint fusion. The system may be in the form of a disposable kit, with the components streamlined so that the procedure can be performed in a few minutes. The screw components are self-drilling and self-tapping. The system may deploy blades through the walls of the primary screw which cut away material as the primary screw is set, for denuding the sacroiliac joint. The primary screw is designed bore through and internalize bone tissue in an autografting process. The implant system may include components for packing bone grafting material into the screw to supplement autograft bone tissue internalized in the primary screw during placement. At least one side screw is passed through a head of the primary screw to anchor the head and prevent it from backing out after implantation.

Abstract: An interbody implant and inserter tool for spinal fusion. The interbody implant includes a cage portion and a nose portion. In some embodiments, an outer surface of the nose portion defines at least a first concave profile in a first direction, and may define a second concave profile in a second direction, the second direction being perpendicular to the first direction. The outer surface may also define an oblong cross-section normal to a nose axis. The oblong cross-section may be axisymmetric or continuously curved (or both) about the nose axis. The concave profile(s) enable easier initial insertion of for more precisely locating the interbody implant, so that the greater insertion forces required during implantation do not occur until the interbody implant is securely and accurately placed.

Abstract: A method of fabricating an “extension ready” spinal support system that enables the extension to be accomplished with minimal disturbance to an existing spinal support structure to which the extension system is coupled. In some embodiments, the existing spinal support rod and pedicle screws can remain intact while extension subassemblies are mounted directly to the existing base rod receptacles. The extension subassemblies include a skirt portion that surrounds and engages the existing base receptacle to prevent splaying of the base receptacle. Additional resistance to splaying may be provided by forming a canted thread arrangement between the skirt and the base receptacle. In some embodiments, the extension receptacle presents a low profile (i.e., shortened axial length from the base rod receptacle) is fabricated with a monoaxial rotation structure that rotates about but does not pitch relative to the extension axis and is shorter relative to polyaxial rotation structures.

Abstract: A lateral disc cutter for morcellating and decorticating tissue of an intervertebral disc from between adjacent vertebrae. The device can be arranged in a retracted configuration for insertion via an access tube, and in an extended configuration for cutting of tissue in the target region. The blades may be extended to contact the concave endplate in an orientation that is substantially parallel to a mid-plane of the intervertebral disc. Blades of the device may be configured with a convex profile that substantially conforms to the concave shape of the endplate for enhanced contact length between the blade and the endplate.

Abstract: A cannula tool in combination with other tools is used to provide multiple instruments necessary for surgical procedures. The cannula tool is used in combination with a piercing tool to form a dilator instrument to access a treatment site and in combination with a plunger tool to deliver biological or grafting material to a treatment site. Each of the plunger and piercing tools includes a guide lumen to track the tools over a K-wire or other guide device for placement at the treatment site. The application discloses asymmetrical piercing and plunger tools for placement proximate to a facet joint for treatment.

Abstract: A cannulated plunger assembly for setting a tether with anchors on both ends to extend between adjacent vertebrae. The cannulated form enables minimally invasive access to an evacuated space between the vertebral endplates. Each of the anchors are coupled to a respective one of a pair of plunger arms, the plunger arms being configured to deploy the anchors beyond an outer radius of a tubular housing. In some embodiments, in a retracted configuration, the pair of plunger arms are surrounded by the housing, and in a deployed configuration, the pair of plunger arms extend through an open distal end of and beyond an outer radius of the housing to drive the anchors into the vertebral end plates.

Abstract: An interbody implant and inserter tool for spinal fusion. The interbody implant includes a cage portion and a nose portion. In some embodiments, an outer surface of the nose portion defines at least a first concave profile in a first direction, and may define a second concave profile in a second direction, the second direction being perpendicular to the first direction. The outer surface may also define an oblong cross-section normal to a nose axis. The oblong cross-section may be axisymmetric or continuously curved (or both) about the nose axis. The concave profile(s) enable easier initial insertion of for more precisely locating the interbody implant, so that the greater insertion forces required during implantation do not occur until the interbody implant is securely and accurately placed.

Abstract: A reinforcement cap for use with pedicle screws and rod receptacles (“tulips”) in spinal support systems. The unitary reinforcement cap engages both the internal and the external surfaces of the wall segments of the rod receptacle. In some embodiments, both the internal and the external surfaces are threadably engaged. By doubling the number of threads that are engaged, additional strength and structural integrity are realized over conventional set screw arrangements. Also, because of the unitary construction, wherein an internal set screw portion and an external skirt portion are integral to the reinforcement cap, lateral movement between the set screw portion and the skirt portion is limited. In some embodiments, the threads are of a canted cantilever construction, wherein the interfaces of threadably engaged components are tailored to generate reaction force vectors that mitigate slippage at the threaded interfaces.

Abstract: A cannula tool in combination with other tools is used to provide multiple instruments necessary for surgical procedures. The cannula tool is used in combination with a piercing tool to form a dilator instrument to access a treatment site and in combination with a plunger tool to deliver biological or grafting material to a treatment site. Each of the plunger and piercing tools includes a guide lumen to track the tools over a K-wire or other guide device for placement at the treatment site. The application discloses asymmetrical piercing and plunger tools for placement proximate to a facet joint for treatment.

Abstract: A method of fabricating an “extension ready” spinal support system that enables the extension to be accomplished with minimal disturbance to an existing spinal support structure to which the extension system is coupled. In some embodiments, the existing spinal support rod and pedicle screws can remain intact while extension subassemblies are mounted directly to the existing base rod receptacles. The extension subassemblies include a skirt portion that surrounds and engages the existing base receptacle to prevent splaying of the base receptacle. Additional resistance to splaying may be provided by forming a canted thread arrangement between the skirt and the base receptacle. In some embodiments, the extension receptacle presents a low profile (i.e., shortened axial length from the base rod receptacle) is fabricated with a monoaxial rotation structure that rotates about but does not pitch relative to the extension axis and is shorter relative to polyaxial rotation structures.

Abstract: Systems for performing a minimally invasive sacroiliac joint fusion. The system may be in the form of a disposable kit, with the components streamlined so that the procedure can be performed in a few minutes. The screw components are self-drilling and self-tapping. The system may deploy blades through the walls of the primary screw which cut away material as the primary screw is set, for denuding the sacroiliac joint. The primary screws are designed to bore through and internalize bone tissue in an autografting process. The implant system may include components for packing bone grafting material into the screw to supplement autograft bone tissue internalized in the primary screw during placement. At least one side screw is passed through a head of the primary screw to anchor the head and inhibit rotation (backing out) after implantation. The primary screw may include features that facilitate rotational alignment.

Abstract: An “extension ready” spinal support system that enables the extension to be accomplished with minimal disturbance to an existing spinal support structure to which the extension system is coupled. In some embodiments, the existing spinal support rod and pedicle screws can remain intact while extension subassemblies are mounted directly to the existing base rod receptacles. The extension subassemblies include a skirt portion that surrounds and engages the existing base receptacle to prevent splaying of the base receptacle. Additional resistance to splaying may be provided by a canted thread arrangement between the skirt and the base receptacle. In some embodiments, the extension receptacle is provided with a low profile (i.e., shortened axial length from the base rod receptacle) by providing a monoaxial rotation structure that rotates about but does not pitch relative to the extension axis and is shorter relative to polyaxial rotation structures.