Abstract: An intervertebral implant for being implanted between adjacent vertebrae is provided. The implant includes a generally elongate implant body having a length extending between opposite longitudinal ends thereof, a superior face and an inferior face. The superior face and inferior face include cortical teeth adjacent to the implant body longitudinal ends. Additionally, the superior and inferior faces include longitudinally central teeth intermediate the cortical teeth and have bone engaging ends. The central teeth have a sharper configuration than that of the cortical teeth bone engaging ends for biting into the softer central bone material of the vertebrae. The cortical teeth are arranged in a first density per unit area and the central teeth are arranged in a second density per unit area that is less than the first density.

Abstract: Disclosed are cement products, methods of forming cement using the cement product, and methods of using the cement product in orthopedic and dental applications. Generally, the disclosed cement product includes a first component and a second component. The first component comprises a polymerizable resin comprising ethylenic unsaturated double bond, a suitable glycidyl group and/or a suitable isocyanate group. The second component includes a compound comprising more than one type of amine selected from the group consisting of primary amine, secondary amines, tertiary amines and quaternary amines. Alternatively, the second component includes a compound comprising a suitable mercapto (SH—) group, a hindered amine or a dimethylthiotoluenediamine (DMTDA). Optionally, the cement product includes a filler and/or a bioactive component to promote bone formation.

Abstract: An expandable interbody device for implantation within an intervertebral space is provided, together with methods and tools for use therewith. The interbody devices of the present invention include upper and lower bearing members configured to expand via an expansion mechanism configured to allow the insertion of osteoconductive materials and other structures into the interior of the interbody device before and after implantation, and before and after expansion of the interbody device. The insertion tool is configured expand the interbody device and to allow insertion of materials into the interbody device through a protected pathway.

Abstract: An articulated fixation device is provided having a high degree of adjustability for securing a plate member thereof to a skull and at least one spinal rod thereof to a vertebral bone. In one form, an adjustable bridge member is provided that is adjustably connected to both the plate member and the spinal rod. The adjustable connections can include an upper and rearward pivot connection between the plate member and the bridge member and a lower and forward pivot connection between the spinal rod and the bridge member.

Abstract: Instruments are provided for shifting elongate members, such as spinal rods, with respect to coupling members of spinal fixation systems. The instruments include a low friction drive mechanism having one or more rolling elements that ride along a helical groove or track in order to transform rotational movement of a drive member into linear shifting of a reducer member that shifts the elongate member. A one-way locking mechanism may be provided to selectively prevent unwanted counter-rotation of the low friction drive mechanism. The one-way locking mechanism may include annular ratchet teeth arranged on the exterior of the drive member and a ratchet pawl located adjacent to the teeth and selectively engageable therewith.

Abstract: An expandable interbody device for implantation within an intervertebral space is provided, together with methods and tools for use therewith. The interbody devices include a leading first and trailing second bearing member configured to expand laterally via connecting portions disposed at the trailing end of the first being member and at least the leading end of the second bearing member. In some forms, the connecting portions have an arcuate configuration. The insertion tool is configured expand the interbody device by holding the first bearing member while shifting the second bearing member.

Abstract: Disclosed are cement products, methods of forming cement using the cement product, and methods of using the cement product in orthopedic and dental applications. Generally, the disclosed cement product includes a first component and a second component. The first component comprises a polymerizable resin comprising ethylenic unsaturated double bond, a suitable glycidyl group and/or a suitable isocyanate group. The second component includes a compound comprising more than one type of amine selected from the group consisting of primary amine, secondary amines, tertiary amines and quaternary amines. Alternatively, the second component includes a compound comprising a suitable mercapto (SH—) group, a hindered amine or a dimethylthiotoluenediamine (DMTDA). Optionally, the cement product includes a filler and/or a bioactive component to promote bone formation.

Abstract: The present invention is directed to a stabilized cross-linked hydrogel matrix comprising a first high molecular weight component and a second high molecular weight component that are covalently linked, and at least one stabilizing or enhancing agent, wherein the first high molecular weight component and the second high molecular weight component are each selected from the group consisting of polyglycans and polypeptides. This stabilized hydrogel matrix may be prepared as bioactive gels, pastes, slurries, cell attachment scaffolds for implantable medical devices, and casting or binding materials suitable for the construction of medical devices. The intrinsic bioactivity of the hydrogel matrix makes it useful as a gel or paste in multiple applications, including as a cell attachment scaffold that promotes wound healing around an implanted device, as gels and pastes for induction of localized vasculogenesis, wound healing, tissue repair, and regeneration, as a wound adhesive, and for tissue bulking.

Abstract: A retraction system and method are provided for retracting tissues surrounding a surgical site. In one aspect, a method including engaging slide connections between a guide dilator and a plurality of tissue engaging members and sequentially enlarging an incision using the guide dilator and the plurality of tissue engaging members. In another aspect, a method of inserting a plurality of tissue engaging members into an incision including fixing tip portions of the plurality of tissue engaging members in an insertion configuration, advancing the tip portions into an incision, and restricting movement of the tip portions away from the insertion configuration. A guide dilator system comprising an elongate body, a plurality of tissue engaging members, and slide connections between the elongate body and the tissue engaging members is also provided.

Abstract: The present invention is direct to a body-absorbable, mechanically hemostatic composition comprising a solid poloxamer having an average molecular weight of about 7,000 g/mol to about 15,000 g/mol, a high molecular weight dextran, optionally a fatty acid salt, and water, and a method for mechanically controlling the bleeding of bone comprising applying an effective amount of the composition to the affected area.

Abstract: Methods and apparatus for immobilizing a synovial joint, such as a sacroiliac (SI) joint are disclosed. In one form, a multipiece fixation device, such as a dowel, includes multiple expandable fasteners that are configured to fix adjacent bones of a synovial joint with respect to one another. The expandable fasteners include expansion portions that are expanded radially via insertion of another expandable fastener or an expansion device to fix the expandable fasteners to the bone. The fixation device may be configured to provide for compression or distraction of the bones of the synovial joint while at the same time stabilizing the joint.

Abstract: The present invention is directed to a stabilized bioactive hydrogel matrix coating for substrates, such as medical devices. The invention provides a coated substrate comprising a substrate having a surface, and a bioactive hydrogel matrix layer overlying the surface of the medical device, the hydrogel matrix comprising a first high molecular weight component and a second high molecular weight component, the first and second high molecular weight components each being selected from the group consisting of polyglycans and polypeptides, wherein at least one of the first and second high molecular weight components is immobilized (e.g., by covalent cross-linking) to the surface of the substrate.

Abstract: Bone plate systems are provided for surgical implants and bone repair. The bone plate is multi-tiered for receiving bone anchors screws for securing a plurality of bones or bone fragments in a desired relationship. The plate members include throughbores for receiving a pivot base therein, with head ends of the bone anchors being secured in the pivot bases. The throughbores may permit and define a translation path for the pivot base and the bone anchor secured therein relative to the plate. Pivot members extending between the pivot base and the plate member facilitate pivoting and optional translation of the pivot base relative to the plate. With the bone anchor seated within the pivot base, an apparatus for inhibiting screw back out is employed.

Abstract: A bone plate system is provided that includes bone plates and bone anchor assemblies for being inserted into bone plate bores to secure the bone plates to one or more bones. In one aspect, the bone plate system includes a bone anchor assembly having a locking cap and a locking fastener connected to a head portion of a bone anchor. The bone anchor assembly is driven into a bone plate bore before the locking fastener is shifted to expand the locking cap and fix the bone anchor assembly within the bore. In another aspect, the bone plate system includes a bone anchor assembly having a locking cap that deflects radially inward due to contact with the bone plate at large bone anchor assembly insertion angles. In addition, a bone anchor assembly having a preassembled condition with a locking cap resisting back out of a locking fastener.

Abstract: A multi-stage minimally invasive surgical procedure and associated instruments are disclosed. First, the surgical site is prepared. After preparation, the bone screws or anchors are attached to the bone. Subsequent to insertion of the screws, a rod or connecting member is positioned within the yoke portion of the bone screw. Caps are then placed in a pre-lock position within the yokes. The bone screws may be compressed together or distracted along the rod or connecting member, thereby setting the final spacing of the bones or bone segments. Finally the caps are moved to a final lock position to fix the screws to the rod or connecting member to maintain the bones in position relative to each other.

Abstract: An intervertebral implant for being implanted between adjacent vertebrae is provided. The implant includes a generally elongate implant body having a length extending between opposite longitudinal ends thereof, a superior face and an inferior face. The superior face and inferior face include cortical teeth adjacent to the implant body longitudinal ends. Additionally, the superior and inferior faces include longitudinally central teeth intermediate the cortical teeth and have bone engaging ends. The central teeth have a sharper configuration than that of the cortical teeth bone engaging ends for biting into the softer central bone material of the vertebrae. The cortical teeth are arranged in a first density per unit area and the central teeth are arranged in a second density per unit area that is less than the first density.

Abstract: An implant device is provided that is configured for implantation at multiple locations between adjacent vertebrae. The implant device comprises an implant body, a first portion of the implant body, and a second portion of the implant body adjustably interconnected with the first portion. The implant body has a compact orientation and an extended orientation to allow the implant body to be shifted from one orientation to the other orientation for being positioned in any one of areas between the spinous processes of the adjacent vertebrae, between laminar regions of the adjacent vertebrae, spanning an opening in the annulus between the adjacent vertebrae, and in the intervertebral space between the adjacent vertebrae.

Abstract: A bone plate system having a retainer for resisting back-out of a bone anchor from a throughbore of a bone plate is provided. In one aspect, a bone plate system having a resilient retainer disposed in a bone plate throughbore with a pair of elongate arm portions of the resilient retainer extending along opposite sides of the throughbore. In another aspect, a bone plate system having a resilient retainer with a pair of elongate interference portions completely exposed in the throughbore and spaced from each other across the throughbore to retain a head of a bone anchor received in the throughbore. In addition, a bone plate system having a resilient retainer with a pair of opposite end portions disposed within a groove of a throughbore wall such that a bone anchor may be inserted into the throughbore without contacting either of the opposite end portions of the retainer.

Abstract: In one aspect, a bone anchor assembly is provided having a bone anchor with a head, a resilient locking cap extending about a portion of the bone anchor head, and a cap drive member having a depending annular wall. The annular wall and locking cap have engagement surfaces configured to engage and expand the locking cap as the cap drive member is shifted from an unlocked to a locked position. In another form, a bone plate system is provided including a bone plate having an elongated throughbore and a resilient support member received therein. The support member has an opening sized to receive a bone anchor head and an actuator device carried thereon. The bone plate and support member have interfering portions configured to be shifted to a locked orientation to lock the support member and the bone anchor head at an axial position in the throughbore.

Abstract: In one form, a bone compression device is provided having a shape-retentive bone plate with an initial, unflexed configuration and a flexed configuration. The bone plate may be shifted to the flexed configuration and secured to bones using bone screws of the bone compression device. Once the bone plate has been secured to the bones, the bone plate returns toward its unflexed configuration which compresses the bones.