Abstract: A tissue protector has a body structure having a longitudinal extending thin web. The body structure has an unconstrained first shape configured to form a nerve shield and is configured to shrink about a longitudinal axis to a smaller constrained second shape sized to fit into a lumen of a cannula. Preferably, the second constrained shape is oval or round having a maximum diameter equal or less than an inside diameter of the lumen. The body structure is configured to return to the first shape when the cannula is withdrawn or returned to this shape as the implant advances.

Abstract: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to a device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body. Guidewire exchange systems, devices and methods are also described. A guidewire may be exchanged between different surgical devices and may be releaseably or permanently coupled.

Abstract: Devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; one or more (e.g., two) flexible elongate length of cable that extend proximally to distally, a tissue modification region along a portion of the length of cable; and a guidewire coupler at the distal end of the device for attaching the distal end of the tissue modification device to the proximal end of a guidewire. Method of using these devices (including devices having two or more parallel length of cutting regions) to cut tissue (e.g., spinal lamina) are also described.

Abstract: An improved artificial disc has a superior and inferior member. The superior member has an upper body portion and a flange portion for positioning and attachment to an upper vertebral body. The inferior member has a lower body portion and a flange portion for positioning and attachment to a lower vertebral body. The upper body portion and the lower body portions, when positioned in a disc space between the upper and lower vertebral bodies and affixed to a respective vertebral body at the flange portion, are independently movable relative to the other along complimentary bearing surfaces on each of the superior and inferior members. The complimentary bearing surfaces are self-aligned by a magnetic attraction force generated by at least one first permanent magnet in either the inferior or superior member.

Abstract: A spinal fusion system for positioning between two vertebral bodies is presented. The system can have a substantially rigid body and a substantially rigid plate connected to a portion of the posterior face of the substantially rigid body that extends away from and substantially transverse to the posterior face of the substantially rigid body. The system also has a first implant body and a second implant body configured to matingly connect to one another with at least a portion of the substantially rigid plate positioned therebetween. The combination of the first and second implant bodies and the substantially rigid plate is configured for insertion between the two vertebral bodies.

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 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: 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 includes a profile having a width that is substantially greater than a height.

Abstract: A spinal alignment correction system (1) has a posted lumbar pedicle screw called a MAC Pin (10) which has an elongated shaft (11) and a rod coupler assembly (20) and a cannulated tower (40). The elongated shaft (11) has an inner pedicle screw portion (12) with pedicle threads (12A), an outer second thread portion (14) with second threads (14A) and a transition or intermediate portion (16) disposed between the pedicle screw portion (12) and the second thread portion (14). The cannulated tower (40) when mounted over said elongated shaft (11) abuts said coupler (20) along an outer cam surface and further tightening rotation of the cannulated tower (40) causes outward movement of the elongated shaft (11). The system (1) allows for a controlled alignment correction of malaligned vertebral bodies using a number of methods used to correct a variety of indications.

Abstract: An endoscopic portal protective shield assembly has an elongate portal shaft and an elongated protective shield. The elongate portal shaft has a viewing portal. The shaft has a slotted tubular body with interior surfaces. The shaft has a distal end and a proximal end and a slotted opening at the distal end extending partially along the slotted tubular body toward the proximal end. The elongated protective shield has a longitudinal shield body, a proximal end and a distal end. The protective shield is configured to be slid into the slotted opening of the tubular body with an interior portion of the longitudinal shield body being inserted inside the tubular body while maintaining the viewing portal open.

Abstract: An orthopedic fastener has a head and a shank. The shank has a leading end portion adjacent a distal tip and a trailing end portion adjacent a head. An intermediate portion is positioned between the leading and trailing end portions. At the intermediate portion, the shank increases in diameter. The leading end portion has a first thread which includes one or more self-tapping cutting grooves extending adjacent the distal tip and through a plurality of the first threads. The intermediate portion has second threads extending toward the head from the leading end portion. The second threads of the intermediate portion are larger in outer diameter than the first threads in the leading end portion. The intermediate portion has one or more cutting grooves traversing at each of a leading transition at the leading end portion and at a trailing transition.

Abstract: A bone anchor locking device for receiving a bone anchor having a shank and an enlarged head, the device has a bone anchor, a dome and a conical split washer. The receiving portion has a base extending radially outward and inwardly to a wall. The dome has a center aperture sized to pass a bone anchor. The split washer has an inner conical surface sloped to slide and expand against at least a portion of the base on insertion of a bone anchor to allow a maximum diameter of a head of a bone anchor to pass and thereafter the split washer retracts overlying the maximum diameter of the head to prevent a bone anchor from backing out.

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 spinal alignment correction system (1) has a posted lumbar pedicle screw called a MAC Pin (10) which has an elongated shaft (11) and a rod coupler assembly (20) and a cannulated tower (40). The elongated shaft (11) has an inner pedicle screw portion (12) with pedicle threads (12A), an outer second thread portion (14) with second threads (14A) and a transition or intermediate portion (16) disposed between the pedicle screw portion (12) and the second thread portion (14). The cannulated tower (40) when mounted over said elongated shaft (11) abuts said coupler (20) along an outer cam surface and further tightening rotation of the cannulated tower (40) causes outward movement of the elongated shaft (11). The system (1) allows for a controlled alignment correction of malaligned vertebral bodies using a number of methods used to correct a variety of indications.

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: An improved spinal fusion system (10) for positioning between a first and second vertebral body, the system (10) has a body (100), a pair of polyaxial fasteners (220) and a locking bridge (102). The distal end has a slotted opening (120) extending through the body (100) and forming a gap extending between the two or more bore holes (110) to form a deflectable bridge (102) spanning the bore holes (110). The bridge (102) has a center opening (50) for receiving a set screw (20) passing through the bridge (102) into a threaded opening (52) in the body. When the set screw (20) is tightened, it deflects the bridge (102) closing the gap as the bridge (102) contacts an exterior surface of each head (210) of the polyaxial fasteners (200). The angulation of each polyaxial screw (200) is adjustable, controlled by the tightening of the set screw. Initial contact of the bridge (102) with the head (210) of the fastener (200) reduces angulation movement of the shank (220) requiring manual manipulation.

Abstract: A Pedicle Drill Guide is a radiolucent device which allows preliminary positioning of a needle/trochar near the pedicle in the AP view and adjusting the final position of the lateral view without changing the initial position of the AP position. This guide allows simultaneous alignment of both AP and Lateral views for ultimate ideal or perfect pathway for the pedicle cannulization.

Abstract: An orthopedic fastener has a head and a shank. The shank has a leading end portion adjacent a distal tip and a trailing end portion adjacent a head. An intermediate portion is positioned between the leading and trailing end portions. At the intermediate portion, the shank increases in diameter. The leading end portion has a first thread which includes one or more self-tapping cutting grooves extending adjacent the distal tip and through a plurality of the first threads. The intermediate portion has second threads extending toward the head from the leading end portion. The second threads of the intermediate portion are larger in outer diameter than the first threads in the leading end portion. The intermediate portion has one or more cutting grooves traversing at each of a leading transition at the leading end portion and at a trailing transition.

Abstract: Described herein are devices, systems and methods for treating target tissue in a patient's spine. In general, the methods include the steps of advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location; connecting a tissue modification device to the wire; positioning the tissue modification device through the neural foramen using the wire; modifying target tissue in the spine by moving the tissue modification device against the target tissue; and delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue. In some embodiments, the step of modifying target tissue comprises removing target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.

Abstract: A spinal alignment correction system (1) has a posted lumbar pedicle screw called a MAC Pin (10) which has an elongated shaft (11) and a rod coupler assembly (20) and a cannulated tower (40). The elongated shaft (11) has an inner pedicle screw portion (12) with pedicle threads (12A), an outer second thread portion (14) with second threads (14A) and a transition or intermediate portion (16) disposed between the pedicle screw portion (12) and the second thread portion (14). The cannulated tower (40) when mounted over said elongated shaft (11) abuts said coupler (20) along an outer cam surface and further tightening rotation of the cannulated tower (40) causes outward movement of the elongated shaft (11). The system (1) allows for a controlled alignment correction of malaligned vertebral bodies using a number of methods used to correct a variety of indications.