Abstract: The risk of bone cement extravasation can be reduced by delivering a calcium-dependent polymerizing sealant into a bone structure prior to delivery of bone cement into that structure. The polymerization of the sealant in response to the calcium within the bone structure can fill cracks and any other potential cement leakage paths, thereby minimizing the potential for subsequent extravasation. The benefits of the use of a calcium-dependent polymerizing sealant can be provided in any procedure involving the use of bone cement, such as spinal fixation, vertebroplasty, and kyphoplasty, among others.

Abstract: A bone filling device includes a catheter that defines a longitudinal axis and extends between a proximal end and a distal end. A first lumen extends along the longitudinal axis of the catheter and defines a first passageway. A second lumen extends along the longitudinal axis of the catheter and defines a second passageway. An inflatable body includes a wall that defines a fillable cavity. The fillable cavity is in fluid communication with the first passageway. A bone filler delivery port continuous with the second passageway and configured to dispense bone filling material.

Abstract: An instrument for performing a medical procedure includes a drive shaft, a holding clutch, a drive clutch, and an actuator. The holding clutch only allows advancement of the drive shaft, while the drive clutch transfers an advancement force from the actuator to the drive shaft. The dual clutch system allows a lever to be used as the actuator so that a user can generate large actuation forces manually (and optionally remotely) without significant physical effort. This capability can beneficially improve the usability and effectiveness of percutaneous surgical systems, such as those for vertebroplasty or kyphoplasty.

Abstract: A surgical instrument includes a first member comprising an end surface. A second member includes a flange and a first groove having a holding member movably disposed therein. A third member includes a lip and a second groove having the holding member movably disposed therein. The lip extends at an acute angle relative to an axis defined by the third member. The holding member is movable between a first configuration in which the holding member is disposed in the second groove and first and second portions of the holding member are positioned in the first groove and a second configuration in which the holding member is spaced apart from the second groove and the first and second portions of the holding member are spaced apart from the first groove. Systems and methods are disclosed.

Abstract: An inflatable bone tamp for performing a minimally invasive surgical procedure includes a shaft having a primary region and a reduced diameter region, and an inflatable structure surrounding at least a portion of the reduced diameter region. The reduced diameter region of the shaft allows the deflated size of the inflatable structure to be minimized, while at the same time eliminating the need for the conventional dual lumen balloon catheter construction.

Abstract: The risk of bone cement extravaation can be reduced by delivering a calcium-dependent polymerizing sealant into a bone structure prior to delivery of bone cement into that structure. The polymerization of the sealant in response to the calcium within the bone structure can fill cracks and any other potential cement leakage paths, thereby minimizing the potential for subsequent extravaation. The benefits of the use of a calcium-dependent polymerizing sealant can be provided in any procedure involving the use of bone cement, such as spinal fixation, vertebroplasty, and kyphoplasty, among others.

Abstract: A system for performing a minimally invasive surgical procedure comprises a cannula, a bone filler material delivery nozzle for performing the procedure through the cannula, and a retainer for securing the delivery nozzle relative to the cannula. The retainer eliminates the need to manually stabilize and position the delivery nozzle during the procedure, thereby allowing the physician to perform the procedure outside of the fluoroscopic radiation field used to visualize the procedure location. The retainer can be attached to the cannula, and can provide either selective or constant clamping force onto the delivery nozzle.

Abstract: In one form, a system for use in percutaneous surgical procedures includes a cannula having an elongate body extending along a longitudinal axis between a proximal end and a distal end and including a working channel dynamically expandable from a first, unexpanded configuration. The system also includes a device that is positionable in and engageable with the working channel to expand the working channel from the first configuration as the device is moved through the working channel. In response to disengagement of the device with the working channel, the working channel returns to the first, unexpanded configuration. In one aspect of this form, the device includes an interbody spinal implant that is deliverable to a surgical site through the working channel of the cannula. In another form, a method for performing a percutaneous surgical procedure is provided. However, different forms and applications are envisioned.

Abstract: A valve controller includes a housing, and a lever extending from the housing. The lever includes a protrusion rigidly attached to the lever, and the lever is biased to an initial position. A switch has an open and a closed position. A linkage is pivotally connected to the switch, and the linkage includes a centrally disposed slot configured to receive the protrusion such that movement of the switch controls movement of the linkage and the lever such that moving the switch to the closed position closes a valve controlled by the lever regardless of a position of the lever.

Abstract: A system for bone cement includes a vial holder configured for receiving a vial and including a holding structure for maintaining the vial in the vial holder. The vial includes a monomer component for bone cement. A holder chamber is configured to receive and secure the vial holder. The vial holder is advanced toward a vial-breaking device for breaking the vial and releasing its contents into the holder chamber past the elastomeric seal. Once the vial holder is advanced further the elastomeric seal is deformed to form a seal and prevent fumes produced from escaping from the device.

Abstract: A bone filling device includes a catheter that defines a longitudinal axis and extends between a proximal end and a distal end. A first lumen extends along the longitudinal axis of the catheter and defines a first passageway. A second lumen extends along the longitudinal axis of the catheter and defines a second passageway. An inflatable body includes a wall that defines a fillable cavity. The fillable cavity is in fluid communication with the first passageway. A bone filler delivery port continuous with the second passageway and configured to dispense bone filling material.

Abstract: A steerable catheter system is provided including an elongated shaft having a proximal end, a distal end and an outer surface. The outer surface includes at least one cavity configured to facilitate movement of the distal end relative to the proximal end so as to steer the elongated shaft. A catheter tip is attached to the distal end of the shaft. The catheter tip comprises a curved body having at least one RF cutting edge and at least one non-cutting area recessed from the at least one cutting edge.

Abstract: A method of treating a fracture includes creating an access path to a fracture site in a bone and inserting a guidewire through the access path into the fracture site is provided. The method includes the steps of positioning a cannulated drill bit having a distal end including helical flutes configured for drilling through bone over the guidewire into the fracture site, and advancing the drill bit to create a passageway in the bone configured to receive a screw. Positioning a cannulated inflatable bone tamp over the guidewire and inflating the inflatable bone tamp to compress at least a portion of the bone in or near the fracture site so as to create a void. Delivering a bone void filler into the void through the access path to fill the void. Systems and kits are disclosed.

Abstract: A device including a first member extending along an axis. The first member includes an inner surface defining a cavity extending through a first surface and an opposite second surface and a side surface extending between the first and second surfaces. The inner surface defines an opening extending that is in communication with the cavity. A pivoting member is disposed in the cavity and includes an inner surface defining a passageway having a second member disposed therein. An engaging member is disposed in the opening. The pivoting member is movable between a first orientation such that the engaging member is spaced apart from the pivoting member and the pivoting member is rotatable to a selected trajectory relative to the longitudinal axis and a second orientation such that the engaging member engages the pivoting member and the second member is fixed in the selected trajectory. Methods of use are disclosed.

Abstract: Effective devices and methods using a chemonucleolysis agent are provided for treating an intervertebral disc or treating spinal arachnoiditis. The devices and methods comprise a chemonucleolysis agent to degrade or to shrink at least a portion of the intervertebral disc. In some embodiments, the methods and devices are configured to immediately release an effective amount of the chemonucleolysis agent within 24 hours when the device comes in contact directly or indirectly with an activator and provide sustained release of the chemonucleolysis agent over a period of up to one year to treat the intervertebral disc. In some embodiments, the chemonucleolysis agent in the device is administered in or near the intrathecal space and/or thecal sac to treat spinal arachnoiditis.

Abstract: A cutting device includes an elongated shaft extending between a proximal end and a distal end. A lower portion extends from the distal end of the elongated shaft and includes an outer surface and an inner surface spaced apart from the outer surface which together form a blunt end configured as a stop so as to protect adjacent tissue. An upper portion extends from the distal end of the elongated shaft and including an inner surface. The upper portion is configured so as to be disposed opposite the lower portion. A cutting element is disposed between the lower portion and the upper portion and is configured for retractable extension beyond the distal end of the elongated shaft so as to contact tissue.

Abstract: A valve controller includes a housing, and a lever extending from the housing. The lever includes a protrusion rigidly attached to the lever, and the lever is biased to an initial position. A switch has an open and a closed position. A linkage is pivotally connected to the switch, and the linkage includes a centrally disposed slot configured to receive the protrusion such that movement of the switch controls movement of the linkage and the lever such that moving the switch to the closed position closes a valve controlled by the lever regardless of a position of the lever.

Abstract: A cutting device for performing a surgical procedure includes an elongated shaft extending between a proximal end and a distal end, a first cutting element, and a second cutting element. The elongated shaft of the cutting device includes an inner surface defining a passageway. The first cutting element extends from the distal end of the elongated shaft so as to contact tissue. The second cutting element is disposed at least partially within the passageway and extends from the distal end of the elongated shaft. The second cutting element is configured for retractable extension beyond the distal end of the elongated shaft so as to contact tissue. The cutting device also includes a deployment mechanism disposed with the proximal end of the elongated shaft for engaging and actuating the second element.

Abstract: A bone filling device includes a catheter that defines a longitudinal axis and extends between a proximal end and a distal end. A first lumen extends along the longitudinal axis of the catheter and defines a first passageway. A second lumen extends along the longitudinal axis of the catheter and defines a second passageway. An inflatable body includes a wall that defines a fillable cavity. The fillable cavity is in fluid communication with the first passageway. A bone filler delivery port is continuous with the second passageway and is configured to dispense bone filling material.

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.