Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices are used in procedures to removal spinal tissue and in other embodiments, similar devices are used to remove thrombus from blood vessel.

Abstract: A surgical tool includes a drive assembly including a head assembly and a cutting assembly coupled to the drive assembly. The cutting assembly includes a first blade having a first cutting surface and a first contact surface. The cutting assembly also includes a second blade pivotally coupled to the first blade. The second blade has a second cutting surface and a second contact surface. The first and second contact surfaces define a constant travel ratio.

Abstract: Apparatus and methods for preparing the interior of a bone for therapy. The therapy may include therapy for a bone fracture. The apparatus and methods may involve orienting a surgical instrument for proper deployment in the interior of the bone. An instrument guide may be positioned and retained against translation along, and rotation about one or more of three substantially orthogonal axes. Apparatus placed exterior to the bone may register the guide to a region inside the bone that is designated for preparation or treatment. One or more broaching members may be used to prepare the region for treatment. A broaching member may be expandable inside the bone. A broaching member may be flexible such that it broaches bone having a relatively lower density and it leaves bone having a relatively higher density substantially intact.

Abstract: Devices, systems, and methods are provided for cutting bone and collecting bone debris. A disclosed device includes a receptacle having a proximal opening, a cutting tool having a connector on a proximal end, and a space between the cutting tool and receptacle. In use, bone debris produced by the cutting tool is received by the receptacle into the space. A distal opening of the receptacle may have dimensions corresponding to those of the cutting tool. The receptacle may be shaped so that it does not extend beyond the outer periphery of the cutting tool.

Abstract: An arthroscopic bone tunneling and suturing device including a bone-engaging needle driving assembly including a bone-engaging needle and being adapted for arthroscopic insertion into engagement with a patient's bone at a first bone location through an arthroscopic incision and for driving the needle forwardly along a generally arcuate tunneling path through the bone at least to a second bone location and a bone-engaging pin driving assembly arranged for operative engagement with the bone-engaging needle driving assembly and being adapted for arthroscopic insertion into engagement with a patient's bone at a third bone location through the arthroscopic incision.

Abstract: An orthopedic guidewire includes an elongate guidewire body having longitudinally spaced proximal and distal guidewire ends. An engaging feature is located at the distal guidewire end and is configured to selectively engage a bone surface. At least one of a variable diameter and a variable stiffness are along a portion of the guidewire body spaced apart from the engaging feature. A method of providing a relative location indication during a surgical procedure utilizing the orthopedic guidewire is also included.

Abstract: The present invention relates to a tool attachment for medical applications, comprising: a connecting section which is at rest relative to the part of the bone while the part of the bone is being machined; at least one machining section for machining a part of the bone; a fastening facility for fastening the tool attachment to a control device, wherein the connecting section is designed to connect the tool attachment, such that it is stationary, to a tool attachment guide.

Abstract: A surgical drilling instrument with a Curved Burr Attachment having an adapter removably coupled to a drill motor and a burr attachment coupled to said adapter. The burr attachment includes a tube with a wire shaft supported therein and a coil wire surrounding said wire shaft and having each of the coils touch the outer periphery surface of the wire shaft and the inner peripheral surface of said tube to enhance cooling of said outer periphery of said tube from the heat generated by said wire shaft and attenuate vibrations while allowing said burr attachment to be bent without kinking.

Abstract: A biological graft transferring instrument for transferring a biological graft includes a main body, a displacement member capable of being displaced relative to the main body, and a belt-shaped member which is wound around the forward end and base end of the displacement member and is joined to the main body. The biological graft is placed on the belt-shaped member at the forward end of the displacement member.

Abstract: A surgical blade for performing a wedge osteotomy, the blade including a body portion, having a cutting tip on a first end for initially cutting into the bone; a cutting slope comprising multiple rows of cutting teeth at multiple planes to resect bone as it enters, leaving a wedge osteotomy; a shaft of a predetermined length and width for supporting the cutting slope; and a saw attachment base on a second end of the blade for engaging a base of a saw to cause the blade to oscillate and perform the wedge osteotomy.

Abstract: A spinal disc preparation tool is provided that includes an elongate shaft having an inner lumen extending therethrough along a longitudinal axis between proximal and distal ends thereof. A lower jaw is located on a distal end of the elongate shaft for receiving tissue and delivering tissue to the inner lumen, and an upper jaw is pivotally movable relative to the lower jaw. The tool can include various features to facilitate removal and/or collection of tissue.

Abstract: A method for generating an improved tool path for cutting a bone so as to minimize soft tissue trauma, wherein the method comprises: accessing an image of the bone which is to be cut; accessing an image of a pre-determined cutting pattern; superimposing the image of the pre-determined cutting pattern against the image of the bone; calculating the intersection of the pre-determined cutting pattern and the bone using the superimposed images of the pre-determined cutting pattern and the bone; and generating a tool path based upon the intersection of the pre-determined cutting pattern and the bone so as to minimize soft tissue trauma by leaving a thin perimeter of bone at the boundary of the bone cut when the boundary of the bone cut is adjacent to a bone surface.

Abstract: An ultrasonic surgical tool comprises a substantially planar blade body having a pair of opposed lateral surfaces and a cutting edge. A shank integral on a distal side with the blade body is provided at a proximal side with a connector for operatively linking the blade to a source of ultrasonic mechanical vibrations. The blade body is provided in at least one of the lateral surfaces with a shallow recess which is nearly coextensive with that lateral surface. The blade body has a raised rim surrounding and defining the recess, the rim being narrow on the three sides between the recess and the cutting edge.

Abstract: A device for marking bone such as a patella is anchored to one surface of the bone, whereby the contact with the surface defines the desired resection plane, and then a cautery or other marking device is used to mark the bone relative to this plane. The marking device is removed and then the bone may be resected using techniques known in the art. A device for measuring the remaining bone allows a user to measure bone thickness and visually estimate superoinferior angle or mediolateral angle of the resected surface relative to the desired resection plane. The measuring device may optionally be used with a computer-assisted surgical system for numerical measurements.

Abstract: A bone rifling system for use in prosthesis, which allows improved prosthetic bone fixation. The system comprises orthopedic undercut reamer, which can cut controlled internal groove circles or spiral grooves on the internal surface of host bone. The system converts the commonly reamed smooth bone to grooved or rifled bony tube. Used together with bone cements, the bone rifling system ensures prosthetic bone fixation by significantly increasing the pull out strength, and decreasing the rate of clinical loosening and failure of replacement joints. Also disclosed is a method for preparing a bone for a prosthesis using such a bone rifling system to cut grooves in a host bone for increased prosthetic bone fixation.

Abstract: An apparatus for removal of a femoral implant may include a handle portion and a cutting blade opposite the handle portion. The cutting blade may include a cutting edge, wherein the cutting edge includes a non-linear shape to substantially match at least a portion of a profile of the femoral implant to be removed.

Abstract: A medical cutting device for producing thin cartilage disks has a device body with a first holding device with a first working section having a first recess disposed on a top side of the device body such that the first recess is entirely or partially enclosed by a first delimiting ridge and, a connecting section that is directly, rigidly adjoined by the first working section and a cover with a counterpart section to the connecting section that is directly, rigidly adjoined by a first pressure section, which comprises a central, first pressure plate that is resiliently held in the first pressure section and, in an operating state for producing thin cartilage disks, is disposed opposite the first recess, which is entirely or partially enclosed by the first delimiting ridge.

Abstract: A surgical instrument including a shaping instrument for shaping a bone as well as an impaction/extraction device for use with the shaping instrument is disclosed.

Abstract: The present disclosure relates to devices and methods for creating channels within bone. One method for treating bone generally includes traversing an elongated member through cancellous bone of a vertebral body along a first generally non-linear path and then retracting the elongated member, thereby leaving a generally non-linear channel. The elongated member then is traversed through the cancellous bone along a second generally non-linear path, which second path does not completely coincide with the first path and then retracted along the second generally nonlinear path, thereby leaving a second generally non-linear channel. Optionally, bone filler material is deployed into the channels.

Abstract: A device for percutaneously excising tissue. In an embodiment, the device comprises an outer tubular. In addition, the device comprises an inner tubular slidingly received within the outer tubular, wherein the inner tubular has a distal end including an upper member and a lower member. Further, the device includes an open position with the distal end fully extended from the outer tubular, and a closed position with the distal end disposed within the outer tubular, wherein the upper member is biased away from the lower member and is disposed at an open angle ?O relative to the lower member when the device is in the opened position.

Abstract: A device is disclosed for reducing a vertebral compression fracture, comprising a superior end plate and an inferior end plate disposed along a vertical axis. The superior end plate and the inferior end plate are slidably separable in a vertical direction along the vertical axis. An interior chamber is provided in fluid communication with a port extending from an exterior to the interior chamber. The device is deployable within a vertebral body and expandable within the vertebral body by injecting a flowable material into the interior chamber thereby displacing the superior and inferior end plates along the vertical axis.

Abstract: A device for trimming an osteochondral plug graft to an implantable configuration, includes a blade assembly terminating in a configured leading cutting blade and a plug graft housing comprising a substantially longitudinal holding sleeve having a bore and oriented complementarily to the longitudinal structure of the blade assembly to receive the longitudinal structure within the sleeve bore with the assembly cutting blade in close tolerance along an inner bore surface of the longitudinal housing structure.

Abstract: In one preferred aspect, a method is provided for forming an opening in bone for the sequential dilation of tissue.

Abstract: The present disclosure relates to the field of spine disc implants. Exemplary embodiments of the disclosed spinal disc implants advantageously and ultimately provide fusion with the body of the vertebra and stabilization of the spine in an anatomically correct position, e.g., in cervical, thoracic and/or lumbar regions. More particularly, the present disclosure is directed to a disc implant that addresses and overcomes the shortcomings of the prior implants by providing first and second inter-vertebral elements that are movably coupled relative to each other and are adapted to permit bone in-growth over time.

Abstract: A device for percutaneously excising tissue. In an embodiment, the device comprises an outer tubular. In addition, the device comprises an inner tubular slidingly received within the outer tubular, wherein the inner tubular has a distal end including an upper member and a lower member. Further, the device includes an open position with the distal end fully extended from the outer tubular, and a closed position with the distal end disposed within the outer tubular, wherein the upper member is biased away from the lower member and is disposed at an open angle ?O relative to the lower member when the device is in the opened position.

Abstract: An orthopedic guidewire includes an elongate guidewire body having longitudinally spaced proximal and distal guidewire ends. An engaging feature is located at the distal guidewire end and is configured to selectively engage a bone surface. At least one of a variable diameter and a variable stiffness are along a portion of the guidewire body spaced apart from the engaging feature. A method of providing a relative location indication during a surgical procedure utilizing the orthopedic guidewire is also included.

Abstract: A method for manipulating intervertebral tissue in one embodiment includes inserting at least one abrading member for abrading tissue into an area to be cleared, expanding at least one expandable member from a first condition to a second condition, wherein the volume defined by the at least one expandable member in the second condition is greater than the volume defined by the at least one expandable member in the first condition, moving the inserted at least one abrading member from a first position to a second position by the expansion of the at least one expandable member, manipulating the inserted at least one abrading member to loosen tissue, and removing the loosened tissue from the area to be cleared.

Abstract: A single use bone cutter comprised of two concentric cylinders and a series of insert blades or cutter disc is described. The cutter blades or cutter disc is preferably positioned at the distal end of the cutter. The bone cutter also comprises a guide rod that aids in the line of sight when using the cutter device.

Abstract: Methods and devices are provided for cutting and removing tissue from a body. In one exemplary embodiment, a surgical device is provided having a suction shaft and a cutting assembly. The suction shaft can have an inner passageway configured to receive tissue. The cutting assembly can include an outer shaft having at least one opening formed in a sidewall thereof configured to receive tissue. The cutting assembly can be configured to mate with the suction shaft, and it can include a cutting element configured to move relative to the opening to cut tissue disposed through the opening. Suction can be applied to cause the cut tissue to flow proximally through the suction shaft and away from the cutting assembly.

Abstract: An apparatus for penetrating a bone marrow of a bone is provided. The apparatus includes a housing comprising a handle and a trigger mechanism, a spring-loaded assembly comprising a rod and a shaft; and a connector comprising a first end operable to connect to the drive shaft and a second end operable to attach to a penetrator hub. The penetrator hub includes a penetrator operable to access the bone marrow.

Abstract: A method of performing a minimally invasive procedure on a hip joint of a patient to relieve a femoral acetabular impingement. An access device is placed through skin of the patient to provide minimally invasive access to a target volume of material that creates the femoral acetabular impingement. A cutting accessory is placed into the access device to remove material and relieve the femoral acetabular impingement. A tracking and control system establishes a virtual boundary that defines the target volume of material that creates the femoral acetabular impingement, tracks a position of the cutting accessory relative to the virtual boundary, and controls movement of the cutting accessory so that cutting is substantially maintained within the virtual boundary.

Abstract: Method and set of surgical instruments for fitting a shoulder prosthesis, and the shoulder prosthesis. The proposed method seeks to interpose a bone graft between the previously prepared glenoid surface (G) of a scapula (S) of a patient's shoulder and the face of a glenoid prosthetic component opposite the articular surface. The set of instruments permit the bone graft to be taken from the upper epiphysis of the humerus (H), either in situ or ex vivo.

Abstract: Methods and apparatus for performing knee arthroplasty, including, but not limited to, bicruciate retaining knee arthroplasty, are described herein. Methods and apparatus for preparing a distal femur for a femoral implant as well as methods and apparatus for preparing a proximal tibia for a tibial implant are described. These methods and apparatus, in at least some embodiments and uses, facilitate decreasing the complexity of knee arthroplasty procedures such as bicruciate retaining procedures, while maintaining, if not improving on, the safety, accuracy and/or effectiveness of such procedures.

Abstract: A method of preparing a femur and tibia in surgery on a knee joint using a navigation system and a robotic system. The navigation system tracks movement of the femur and tibia during the surgery. The navigation system may include a plurality of locating devices. The robotic system includes a base, a plurality of arms, and a cutting tool.

Abstract: A cleaning module for cleaning bone stock used in surgical procedures. The cleaning module includes a shell. The shell defines a void space to receive the bone stock. A cutter is located within the void space. A shaving tube is coaxially disposed about the cutter to move at different speeds and/or directions relative to the cutter. When actuated, the cutter rotates to clean the bone stock by cutting soft tissue from the bone stock. A tumble plate reorients the bone stock, while an arm moves across the tumble plate from a disengaged position to an engaged position to press the bone stock into the cutter through a window in the shaving tube. A drive assembly actuates the cutter, shaving tube, arm and tumble plate.

Abstract: A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.

Abstract: A surgical cutting instrument including two coaxially arranged tubular members. The first tubular member has a cutting tip and is co-axially disposed within the second tubular member, which in turn has a cutting window to expose the cutting tip to tissue and bone through the cutting window. Movement of the tubular members with respect to each other debrides soft tissue and thin bone presented to the cutting window. The second (outer) tubular member has one or more features which contribute to reduced clogging of the cutting tip as a whole.

Abstract: An instrument for selectively decorticating a bony surface is described. The instrument may have a decorticating implement having a truncated scoop on its medial face and an inclined blade disposed on its opposing lateral face. The blade edge may be coincident with the linear distal edge of the truncated scoop. Also described is a method for using such an instrument to selectively decorticate a bony surface in order to prepare it for service as a bone graft bed.

Abstract: An exemplary nucleus removal device may be used to remove a portion of nucleus pulposus from an intervertebral disc. A nucleus removal device may include a cannula, an access tool, a maceration tool, and an evacuation tool. The access cannula is inserted into an intervertebral body laterally, creating a fissure in the annular fibrosis. The access tool 304 is slid through the access cannula and the fissure in annular fibrosis, such that a portion of access tool extends into the nucleus pulposus. The maceration tool is extended from the access tool into the nucleus pulposus, in a direction orthogonal to the axial extension of access tool, and macerates the nucleus pulposus. To assist in maceration, a stream of liquid may also be introduced into the vertebral body through the access tool before, during, or after maceration. Macerated material and liquid is removed from the intervertebral disc by the evacuation tool.

Abstract: Devices and methods for removing a spinal disc are provided herein. Discectomy instruments are disclosed that can remove a spinal disc in a single-pass, i.e., without repeatedly inserting and removing the instrument from a patient. In an exemplary embodiment, the discectomy instrument includes a distal housing, at least one cutting blade, and a handle. When the distal housing is positioned adjacent to a spinal disc, a handle can be actuated to advance the cutting blade along a substantially arc-shaped path through the disc. In certain aspects, the path of the blade can correspond to the anatomy of the disc and to the approach used to access the spine. A second cutting blade can be advanced through the disc and can intersect with the arc-shaped path, forming a complete cut. The cut disc can be received in the distal housing and removed from the patient.

Abstract: An endoscopic surgical instrument for removing tissue or bone, the instrument comprising (1) a generally tubular component (2) a cutting device which is housed in the distal end member and part of which protrudes beyond the window in the distal member, and (3) a means for operating the cutting device. The tubular component comprises a distal end member containing a cutting device, a proximal member, and between the distal member and the proximal member a hollow, generally tubular intermediate member which deforms elastically when the angle between the distal member family proximal member is changed.

Abstract: A soft tissue displacer tool can include a shaft that is elongate along a central axis, the shaft including a shaft body that defining a proximal end, a distal end that is spaced from the proximal end in a distal direction, and a central location that is disposed equidistantly between the proximal and distal ends. The shaft defines at least one inclined groove that 1) is inclined with respect to a plane that is normal to the central axis, and 2) revolves about the central axis, the groove terminating at a first end and a second end that is spaced from the first end along the distal direction, and the second end is spaced from the distal end. Soft tissue displacer tools are also described in which the shaft is cannulated. The soft tissue displacer tool can further include a guidance member, such as a K-wire, a trocar, or a bone punch.

Abstract: A device includes an outer member extending along a longitudinal axis between a first end and a second end. The first end includes an opening. The outer member includes an inner surface defining a first passageway that is in communication with the opening. An inner member is movably disposed in the first passageway. The inner member includes an inner surface defining a second passageway. The inner member further includes a first end including a cutting tip. The inner member is movable between a first orientation in which the cutting tip is disposed within the first passageway and the inner member has a linear configuration and a second orientation in which the cutting tip extends through the opening and the inner member has an arcuate configuration. Methods of use are provided.

Abstract: A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. An access cannula may be introduced over the first dilator tube. A drill may be inserted through the access cannula and used to perform a foraminoplasty. Surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Abstract: A cutting device includes a lower jaw extending between a proximal end and a distal end. The distal end terminates with a cavity and a blunt tip. An upper jaw extends between and proximal end a distal end. The upper jaw is configured for translation along the lower jaw. The upper jaw includes a cutting tip configured to cut bone.

Abstract: Disclosed herein are systems and methods for bone preparation with designed areas having accurate tolerance profiles to enable improved initial fixation and stability for cementless implants and to improve long-term bone ingrowth/ongrowth to an implant. A method of preparing a bone surface to receive a prosthetic implant thereon having an articular surface and a bone contacting surface includes resecting the bone surface at a first location to create a first resected region having a first tolerance profile with a first cross-section, resecting the bone surface at a second location to create a second resected region having a second tolerance profile with a second cross-section less dense than the first cross-section, and contacting the bone contacting surface of the prosthetic implant with the first resected region.

Abstract: A harvesting apparatus is disclosed for harvesting anatomical structures such as tendons, fine muscles, nerves and blood vessels, where the apparatus includes an elongate member having two longitudinally extending tubes or tubular apertures extending from the member's proximal end to its distal end. The distal end includes opposing heads and an arcuate base. The anatomical structure is placed on the arcuate base and a flexible cutting member is threaded through one tube over the anatomical structure and into and through the other tube. The elongate member is then directed into an animal or human body along the structure to a position where the anatomical structure is to be cut. Then the cutting member is pulled back and forth at the distal end causing into to cut the anatomical structure at the distal head.

Abstract: Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

Abstract: A method of milling a calcar region of the femur. The method includes using a miller assembly including a cutter and a frame. The frame has a longitudinal axis and a cutter mount for mounting the cutter at a first angle with respect to the longitudinal axis of the frame. The cutter mount extends at the first angle from the longitudinal axis of the frame and receives a portion of the cutter and maintain the received cutter oriented at the first angle during rotation. The frame includes a handle that forms a portion of a drive joint for coupling the frame to a drill. The handle is coupled to the drill and the miller assembly is inserted into the femur such that the cutter is located in the calcar region. The drill is then operated, causing the cutter to rotate and mill bone in the calcar region.

Abstract: Disclosed are devices and methods for creating a bore in bone. The devices and methods described involve driving a rotating bit in an axial direction such that both rotation and linear movement are controlled and measurable. The instrument is useful for a surgeon to control and simultaneously measure the travel of the tool into the bone and prevent injury to surrounding structures.