Abstract: An intervertebral implant having an endplate that can be slidably expanded following its placement in the intervertebral space.

Abstract: This invention relates to a musculoskeletogenic MSG graft composite made from whole bone marrow aspirate BMA having native levels of musculoskeletal progenitor cells MSPCs, comprising: a) a suspension of fractionated BMA comprising: i) MSPCs present at a level greater than their native level in whole BMA, and ii) red blood cells RBCs present at a level less than their native level in whole BMA, and b) a porous sterile matrix having an average pore size of at least 20 ?m.

Abstract: Methods and devices are provided for replacing a spinal disc. In an exemplary embodiment, artificial disc replacements and methods are provided wherein at least a portion of a disc replacement can be implanted using a posterolateral approach. With a posterolateral approach, the spine is accessed more from the side of the spinal canal through an incision formed in the patient's back. A pathway is created from the incision to the disc space between adjacent vertebrae. Portions of the posterolateral annulus, and posterior lip of the vertebral body may be removed to access the disc space, leaving the remaining annulus and the anterior and posterior longitudinal ligaments in tact. The disc implant can be at least partially introduced using a posterolateral approach, yet it has a size that is sufficient to restore height to the adjacent vertebrae, and that is sufficient to maximize contact with the endplates of the adjacent vertebrae.

Abstract: The invention includes a system and method for loosening of tissue. In one embodiment, an intervertebral tissue removal system includes at least one abrading member for abrading tissue in an area to be cleared and at least one expandable member operable to be expanded 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, the at least one expandable member operably connected to the at least one abrading member such that as the at least one expandable member expands from the first condition to the second condition, the at least one abrading member is moved from a first position to a second position.

Abstract: A implantable interference device configured for intra-facet placement within a facet joint is provided. The device includes a shank capable of engaging opposing faces of the facet joint. The shank can further include a head extending from a proximal end of the shank wherein the head is configured to engage and/or buttress opposing faces of the joint, and also configured for preventing over-insertion of the device. Optionally, at least a portion of the shank can include or be formed of a fusion-promoting bioactive material. Further, a method for providing fixation of a facet joint by intra-facet placement of an interference device within the facet joint is provided.

Abstract: Devices and methods are disclosed for expanding a spinal canal. An implantable device having a shaft with a first cross-sectional dimension distinct from a second cross-sectional dimension can be inserted into an opening in a lamina and rotated 90 degrees to hinge the lamina away from the spinal canal. The implant can have one or more radiused edges, a bulleted tip, one or more lateral extensions for fastening the implantable device to bone, one or more hinged lateral extensions, one or more arcuate protrusions for biting into adjacent bone, an enlarged proximal head to prevent over-insertion, and/or a sleeve disposed therearound to reduce friction. Various embodiments of an insertion apparatus that can be selectively coupled to the implantable device are also disclosed, along with methods of expanding a spinal canal in minimally-invasive procedures using an implantable device and/or an insertion apparatus.

Abstract: Bone anchor assemblies having a large diameter for fixing a spinal connection element to bone and methods of assembly are described. The assembly includes a receiver member for receiving the spinal connection element, a bone-engaging shank for engaging bone, a retaining member for retaining the head of the shank within the receiver member and a locking member for locking the retaining member within the receiver member.

Abstract: Methods and devices for treating spinal deformities are provided. In one exemplary embodiment, a low-profile spinal anchoring device is provided for receiving a spinal fixation element, such as a tether, therethrough. The device generally includes a staple body that is adapted to seat a spinal fixation element, a fastening element for fixing the staple body to bone, and a locking assembly for coupling a spinal fixation element to the staple body. In one embodiment, the locking assembly includes a washer that is adapted to couple to the staple body such that the spinal fixation is disposed therebetween, and a locking nut that is adapted to engage the staple body to mate the washer to the staple body.

Abstract: A method and apparatus assisting safe one-handed insertion of an implant. An implant implantation device has a frame which includes a trigger mechanism, an outer sleeve mechanically coupled to the frame, an inner shaft having a grabber for mechanically engaging an implant, the inner shaft slidably disposed within the outer sleeve, and a retaining element disposed over the inner shaft for directing the grabber toward a closed position. An implant clip has a first member, a second member pivotally coupled to the first member, a first implant holder pivotally coupled to the first member, the coupling causing the implant clip to have a closed position and an open position, and a second implant holder, the second implant holder pivotally coupled to the second member, a surface of the first implant holder and a surface of the second implant holder remaining substantially parallel to each other while the first member and the second member pivot between the closed position and the open position.

Abstract: A protective system for facilitating revision surgery includes a protective pad with a base portion and an overlying portion spaced apart from the base. A fluid pocket is formed between the base portion; and the overlying portion. The protective system prevents formation of adhesions or scar tissue in the area occupied by the protective pad. Thus a clean plane is obtained during revision surgery on the patient through an incision in the fluid pocket.

Abstract: Disclosed herein are devices and methods for removing tissue. In one aspect, a device for removing tissue includes a hollow elongate member having an outer wall and a lumen, a selectively deployable tissue-cutting element extending from the hollow elongate member, and an actuation member extending through the lumen and coupled to the hollow elongate member at a location that is distal to the tissue-cutting element. Movement of the actuation member can cause the tissue-cutting element to move from the insertion configuration where the tissue-cutting element is not deployed to a tissue-cutting configuration where the tissue-cutting element is deployed such that it is radially extended relative to the insertion configuration.

Abstract: Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In general, the method involves advancing a spinal fixation element in a first, lengthwise orientation along a pathway extending from a minimally invasive percutaneous incision to a spinal anchor site. As the spinal fixation element approaches the spinal anchor site, the fixation element can be manipulated to extend in a second orientation, which is preferably substantially transverse to the first orientation, to position the fixation element in relation to one or more spinal anchors.

Abstract: Methods and devices that utilize segmental fixation between several adjacent vertebrae, thus allowing each vertebrae to be adjusted independently, are provided. In general, the device includes a spinal anchoring element that is adapted to seat at least one spinal fixation element, and a closure mechanism that is adapted to mate to the spinal anchoring element to lock the at least one spinal fixation element in a fixed position relative to the spinal anchoring element.

Abstract: An instrument for inserting, adjusting and engaging an implant, such as a polyaxial screw of a spinal fixation system, includes at least one retractable tab for engaging a corresponding recess on the implant and a shaft that moves relative to the retractable tab. The movable shaft selectively moves the tab between an expanded position for engaging the recess and a retracted position out of engagement with the recess. The shaft selectively engages a portion of the implant to rigidify the implant after the retractable tab engages the recess. The axially extending shaft may be disposed within an axially extending passageway of a body assembly. A rotatable collar surrounding the body assembly is coupled to the shaft for moving the shaft relative to the retractable tab.

Abstract: Method and devices are provided for correction of spinal deformities. The methods and devices are particularly useful for correcting an abnormal curvature of the spine. In one exemplary embodiment, the methods and devices provide a spinal implant that can include a wedged-shape configuration. The wedged implant can be interposed between adjacent vertebrae that form part of an abnormal spinal curvature, thereby realigning the vertebrae and restoring the normal curvature to the spine.

Abstract: Spinal implants and methods for spinal stabilization and/or fusion are provided. Exemplary implants described herein can be configured for delivery to a facet joint to stabilize and/or fuse the facet joint, and can optionally be anchored within the pedicle for added fixation. The implant can optionally include a fusion-promoting bioactive material thereby providing a single device capable of spinal stabilization and/or fusion. Furthermore, a method of placing such an implant within a facet joint is provided.

Abstract: Spinal implants and methods for spinal stabilization and/or fusion are provided. Exemplary implants described herein can be configured for delivery to a facet joint to stabilize and/or fuse the facet joint, and can optionally be anchored within the pedicle for added fixation. The implant can optionally include a fusion-promoting bioactive material thereby providing a single device capable of spinal stabilization and/or fusion. Furthermore, a method of placing such an implant within a facet joint is provided.

Abstract: Various methods and devices for replacing damaged, injured, diseased, or otherwise unhealthy posterior elements, such as the facet joints, the lamina, the posterior ligaments, and/or other features of a patient's spinal column, are provided. In certain exemplary embodiments, a four bar linkage mechanism can be used to construct spinal stabilization devices and methods for restoring function to adjacent vertebrae. In particular, spinal stabilization devices can be provided that kinematically form a four-bar linkage mechanism with adjacent vertebrae and a disc or other element disposed between the adjacent vertebrae.

Abstract: An intervertebral connection system wherein the bone anchor has a helical configuration, and includes: a) a conformable synthetic ligament having a first end portion and an intermediate portion, b) an anchor having a central axis which is axially implantable into a bone in a patient's body, the anchor comprising: i) a distal head portion having a body portion that extends transverse to the central axis of the anchor, a proximal surface, a distal surface, and an axially extending throughhole; ii) a first helix extending axially from the body portion of the distal head portion and transversely engagable with the bone, the first helix having a proximal end, a distal end, and an intermediate portion having an opening, wherein the first end portion of the ligament extends through the throughhole of the distal head portion of the anchor, and wherein the intermediate portion of the ligament extends through the opening within the intermediate portion of the helix.

Abstract: This invention includes surgical retractors that comprise an expandable frame that includes at least two base components, a connector, and at least two retractor blades attached to the expandable frame. Also included are surgical retractors that comprise a housing component that includes a cylindrical portion and a contiguous blade portion, assemblies comprising a surgical retractor assembled to at least one obtruator, illuminated surgical cannulas, and methods of using the same during a surgical procedure.