Abstract: A detachable vertical cutter for insertion into a cylinder or tube is formed as a single unitary structure. The single blade has a pair of tool attachment end portions and a cutting blade extending in a loop between the attachment ends. The cutting blade is inclined vertically relative to a longitudinal axis of a cylinder or tube into which the attachment ends can slide into. The cutting blade has a cutting edge, a portion of which when extended free of the cylinder or tube will extend a distance greater than the tube outside diameter. The cutting edge when pushed inwardly and pulled outwardly between adjacent vertebrae scrapes and cuts disc material. When retracted the cutting blade deflects into the cylinder or tube for insertion or extraction into or from the disc space.

Abstract: A modular head pedicle screw assembly has a bone screw, a tulip, a locking split ring and a saddle. The locking split ring is internal of the tulip positioned in a recess of an inner surface of the tulip. The saddle has a proximal end for engaging a rod and a distal end for receiving the bone screw. The saddle has an exterior surface positioned between the ends. The outer surface is sized to move axially inside the tulip. The saddle expands the locking split ring in an initial pre-loaded position and upon insertion of the tulip over the bone screw, the saddle moves proximally disengaging the locking split ring simultaneously causing the locking split ring to relax to an unexpanded condition while providing tactile and audible feedback to the surgeon and locking the bone screw into the tulip.

Abstract: An expandable implant device (100, 300, 600) for insertion between two vertebrae (400) is disclosed. The device (100, 300, 600) has a center body (10) one or more lift bodies (20, 40) and an external retaining band (60). The external retaining band (60) holds the sides (22, 42) of the one or more lift bodies (20, 40). The center body (10) has ramp surfaces (11) having a plurality or sets of ramps (11) sloped for allowing upward movement of the one or more lift bodies (20, 40). The sides (22, 42) have complimentary ramp surfaces that fit onto the ramps (11) of the center body (10). The height of the device (100, 300, 600) is increased by upward movement or downward movement or both of the one or more lift bodies (20, 40) driven by the lengthwise movement of the center body (10).

Abstract: The present invention describes a system, devices and methods for percutaneous pedicle screw revision procedures. The present invention utilizes a tulip rod stub/connector adapted to be used to extend pedicle screw/rod constructs with minimal disruption to surrounding soft tissue and without having to remove existing hardware.

Abstract: A modular head bone screw assembly has a bone screw, a tulip and a saddle. The saddle is positioned in a recess inside of the tulip. The saddle has a proximal end for engaging a rod and a distal end for receiving a hemispherical or at least partial hemispherical head of the bone screw. The saddle is sized to move axially inside the tulip. The saddle has a plurality of fingers separated by slots extending from near the proximal end through the distal end in an initial un-loaded position and upon insertion of the tulip over the head of the bone screw, the saddle moves proximally over the head simultaneously causing the fingers to move past a maximum diameter of the hemispherical head and upon tightening the rod by a set screw, the fingers locking the bone screw into the tulip.

Abstract: An angled offset tulip has an angled offset tulip with a rod receiving portion and a bone screw receiving portion. The bone screw receiving portion has a distal opening on a distal end. The rod receiving portion is positioned offset a distance from a center of the distal opening and elevated above the distal opening to form an angle ?. The angle ? is defined as a line passing through the center of the distal opening and a slotted end center. The rod receiving portion has a slotted opening defined by a pair of sides, each side having a proximal end with threads for engaging a set screw to secure a rod. The angled offset tulip can be an angled offset tulip assembly having a collet for receiving, holding and fixing the head of a bone screw.

Abstract: A dual tulip assembly has a bone screw and a dual tulip. The dual tulip has a first tulip and a second tulip. Each first and second tulip has a slotted opening for receiving a rod. Each tulip is defined by a pair of sides, one side being common to both first and second tulips. On each side of each slotted opening, the sides have a proximal end with threads for engaging a set screw to secure a rod. The first tulip has an annular tapered distal end with an opening for receiving and securing the bone screw. The second tulip has a base forming a closed distal end. The bone screw has at least a partially hemispherical head. The bone screw has one of the following head shapes; at least partially a hemispherical or spherical head, or any other bulbous head. The dual tulip is a single piece structure.

Abstract: A tulip bone screw assembly has a bone screw, a tulip and a saddle. The bone screw has a threaded shank and a polyaxial head. The tulip has a slotted opening for receiving a rod and an open distal end for passing the shank of the bone screw and holding the head and a locking ring positioned between the slotted opening and the distal end. The saddle has an axis defined by a center opening, a proximal concave end for engaging and holding the rod and a distal end with a plurality of friction fingers bent inwardly toward an axis of the saddle for applying a friction force to the head of the bone screw.

Abstract: A percutaneous cross connector system for use with implantation rods comprising a rod attachment device comprising a first jaw portion and a second jaw portion. The first jaw portion comprises a first concave surface to engage with a surface of a rod, a first biasing member, and a first pivoting mechanism. The second jaw portion comprises a second concave surface to engage with an opposite surface of the rod from the first jaw portion, a second pivoting mechanism, a second biasing surface, and a second locking surface. The first and second jaw portions can be mated so that the first and second concave surfaces are positioned on opposite sides of the rod, the first and second pivoting mechanisms are aligned to pivot on a common axis, and the first biasing member is engaged against the second biasing surface to drive the second jaw portion against the rod.

Abstract: A method and system for percutaneous fusion to correct disc compression is presented. The method has several steps, for instance, inserting a percutaneous lumbar interbody implant; positioning guide wires for each facet screw to be implanted; performing facet arthrodesis in preparation for the facet screws; fixating the plurality of facet screws; and optionally performing foramen nerve root or central decompression. The system includes an implant, an elongate cannulated insertion tool, and an elongate lockshaft positioned within the insertion tool.

Abstract: A pedicle screw assembly has a bone screw, a tulip, a multi-segmented locking member and a saddle. The multi-segmented locking member is internal of the tulip positioned in a recess or undercut groove of an inner surface of the tulip. The saddle has a proximal end for engaging a rod and a distal end for receiving a head of the bone screw. The saddle has an exterior surface positioned between the ends. The outer surface is sized to move axially inside the tulip.

Abstract: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on (or formed from) rungs that are flexibly connected. The rungs are typically rigid, somewhat flat and wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used. The blades (on the rungs) may be arranged in a staggered arrangement. A tissue-collection or tissue capture element may be used to collect the cut or modified tissue.

Abstract: A modular head pedicle screw assembly has a bone screw, a tulip and a saddle. The saddle is positioned in a recess inside of the tulip. The saddle has a proximal end for engaging a rod and a distal end for receiving a hemispherical or at least partial hemispherical head of the bone screw. The saddle is sized to move axially inside the tulip. The saddle has a plurality of fingers separated by slots extending from near the proximal end through the distal end in an initial un-loaded position and upon insertion of the tulip over the head of the bone screw, the saddle moves proximally over the head simultaneously causing the fingers to move past a maximum diameter of the hemispherical head and upon tightening the rod by a set screw, the fingers locking the bone screw into the tulip.

Abstract: A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In some embodiments, a surgical tissue removal device includes a flexible elongate body that is adapted to conform with the target anatomy and a guidewire connector at the distal end region of the flexible elongate body configured to removably connect to the end of a guidewire so that the guidewire and flexible elongate body can be pulled distally. The body may have at least one blade edge, and the flexible elongate body may be a thin, flat, ribbon shaped flexible body that comprises a profile having a width that is substantially greater than a height.

Abstract: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on (or formed from) rungs that are flexibly connected. The rungs are typically rigid, somewhat flat and wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used. The blades (on the rungs) may be arranged in a staggered arrangement. A tissue-collection or tissue capture element may be used to collect the cut or modified tissue.

Abstract: An orthopedic fastener (10) has a head (50) and a shank (20). The shank (20) extends from the head (50) to a distal tip (11). The shank (20) has a leading end (1) adjacent the distal tip (11) and a trailing end (3) adjacent the head (50). An intermediate transition (2) is positioned between the leading (1) and trailing ends (3). The leading end (1) has first threads (40) with one or more self-tapping cutting grooves (41) extending adjacent the distal tip (11) and through a plurality of the first threads (40). The trailing end (3) has a second thread (60) extending toward the head (50) from the intermediate transition (2). The intermediate transition (2) has one or more second cutting grooves (61) extending from at least a first thread (40) in the intermediate transition (2) through at least one of said second threads (60) to initiate tapping of the second threads (60) into cortical bone.

Abstract: A device for modifying tissue in a spine may include: a shaft having a proximal portion and a distal portion, the distal portion having dimensions which allow it to be passed into an epidural space of the spine and between target and non-target tissues; at least one distal force application member extending from the distal portion of the shaft and configured to facilitate application of at least one of anchoring force and tensioning force to the shaft; at least one movable tissue modifying member coupled with the shaft at or near its distal portion; at least one drive member coupled with the at least one tissue modifying member to activate the at least one tissue modifying member; and at least one power transmission member coupled with the at least one drive member to deliver power to the at least one drive member.

Abstract: A device for creating endoscopic operating space includes an external cannula, an internal cannula disposed in the external cannula, and an expandable retractor disposed at a distal end of the device and cooperable with the external cannula and the internal cannula. The expandable retractor is displaceable between an unexpanded position and an expanded position. An actuator is cooperable with the expandable retractor to displace the expandable retractor between the unexpanded position and the expanded position.

Abstract: A spinal implant revision device has a revision connector and a tulip member. The revision connector is configured for attachment to a pre-existing rod in a patient. The revision connector has a slotted opening configured to receive a first or a pre-existing rod. The tulip member is pivotally connected to the revision connector and movable in angularity within predetermined ranges in a first plane. This first plane is parallel to a rod to which the revision connector is attached. A second plane which is non-parallel to that first plane allows a second or new rod to be received in the tulip and allows the second rod to pivot relative to the first rod.