Abstract: A coupling device for securing an elongate member to the spine is provided. The coupling device comprises a compressible inner member that secures an anchor member therein when the inner member is axially shifted within an outer member. Structures are provided to prevent disassembly of the anchor and coupling device prior to locking of the elongate member.

Abstract: The present invention relates to a biocompatible injectable filler composition comprising calcium phosphate particles having a porosity of about 10% to about 90%, a BET surface area of about 1 m2/g to about 100 m2/g, and a mean particle size of about 1 micron to about 30 microns, a thermoreversible hydrophilic gelling agent, a carrier comprising water and an optional persistence enhancer and/or volumizing agent, and methods of its use to restore tissue volume and/or to smooth out tissue defects as in soft tissue or deep tissue augmentation.

Abstract: A prosthetic spinal implant having a securing member for fixing the implant relative to an adjacent bone. In one form, the securing member is deployable into a portion of the vertebral space for affixing the implant between the vertebrae. The securing member may be disposed substantially within the body of a bearing member of the implant when the securing member is in an undeployed orientation. In other forms, the securing member is provided separately from the implant such that it may be inserted into the intervertebral space after the implant has been placed in an implanted orientation between the vertebrae. In such forms, the securing member is configured for ease of insertion between an outer bearing surface of the implant and an adjacent bone via linear or rotary motion.

Abstract: A system for replacing a natural nuclear disc in an intervertebral space has a spinal device configured for placement in the intervertebral space. An insertion tool is configured for holding the spinal device while the spinal device is inserted into the intervertebral space. A gripping member of the insertion tool has an end for adjustably holding the spinal device within the intervertebral space. A steering actuator of the insertion tool is operably connected to the spinal device and configured for pivoting the adjustably held spinal device within the intervertebral space while the steering actuator is controlled remotely from the intervertebral space. The steering actuator is rotatable about a longitudinal axis of the tool. A locking mechanism is provided to keep the spinal device from pivoting in an insertion position and to keep the disc device from being released unintentionally.

Abstract: Bone plate systems for surgical implants and bone repair are provided. The bone plate is multi-tiered for receiving bone anchors 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 within 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. The configuration of the pivot base and the throughbore 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 bone anchor back out is employed.

Abstract: A driver apparatus for implanting spinal rod fixation devices including an anchor member and a coupling member pivotable relative to the anchor member is disclosed. The driver apparatus generally immobilizes the anchor member and coupling member relative to each other and to the driver apparatus during insertion to minimize interference between the coupling member and tissues surrounding the implantation site, as well as to minimize the clearance required for implantation. The driver apparatus includes a driver portion engageable with the anchor member for effecting seating of the anchor member, such as by threadably driving the anchor member in the bone. The driver portion is closely fit between portions such as upstanding walls of the coupling member to prevent relative rotation therebetween. The driver apparatus further includes locking portions shiftable to secure the coupling member with the driver apparatus when the driver is engaged with the anchor member.

Abstract: An artificial disc device for replacing a damaged nucleus is disclosed. In one form, the device may be inserted in components such that the device may be assembled within and retained by the natural annulus therein. In another form, the device may be inserted into the natural annulus in a collapsed or compressed state or arrangement and then be expanded within and retained by the annulus therein. In a further form, the device may be provided with a releasable connection so that the device may be connected in an insertion configuration and may be released in an operable configuration. Insertion tools and methods are also disclosed.

Abstract: A medical instrument apparatus and method is provided for positioning and securing a spinal rod to a coupling device anchored to a vertebra. A reducer assembly shifts the spinal rod into place within the coupling device and a cap inserter assembly shifts a cap member into locking engagement with the coupling device to secure the spinal rod therein.

Abstract: A spinal stabilization system includes vertebral engagement members and an intermediate structure. The vertebral engagement members are configured to be disposed between a first vertebra and a second vertebra. The vertebral engagement members generally include seating surfaces for accommodating at least a portion of a laminar region of adjacent vertebra and are adjustable between an operable and inoperable configuration. The intermediate structure extends between the vertebral engagement members. The structural cooperation of the vertebral engagement members and the intermediate structure is such that the engagement members distract the adjacent vertebrae.

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: Artificial disc devices are disclosed that restore correct anatomical intervertebral spacing for damaged discs while maintaining a substantially normal range of biomechanical movement for the vertebrae between which they are implanted. The disc devices include center bearing and outer or annular bearing portions with the center bearing portion including generally axially extending locating surfaces which cooperate with the facing vertebral surfaces to resist migration. The outer bearing portion is for load bearing or load sharing with the center bearing portion and includes surfaces that extend radially toward the periphery of the vertebrae so that subsidence about the center bearing portion is minimized. Alternate forms of the disc devices include one with an axially enlarged center ball bearing having an annular ring bearing extending thereabout and another having upper and lower plate members with a central bumper member and a surrounding resilient annular member therebetween.

Abstract: A retraction apparatus and method are provided including slider assemblies for being slidably connected to a retractor body with end portions of the slider assemblies disposed within a central retractor opening. A retractor blade is slidably connected to one of the slider assembly end portions such that the depth of the retractor blade can be readily adjusted. Once the retractor blade is at the desired depth within the incision, a handle is pivoted to a locked position to fix the blade relative to the slider assembly. A cantilever lock between the blade and the slider assembly pivots the blade relative to the slider assembly to fix the blade thereto. In one form, the retractor body has a substantially flat surface configured to be placed adjacent a bone and slide connections which position slider assemblies such that the connected blades avoid contact with the bone during retraction.

Abstract: A cable tensioning apparatus and method are provided for positioning and tensioning a surgical cable to skeletal tissue or to implants. The invention is most applicable for securing surgical cable and/or orthopedic implants to bone in orthopedic surgery. A linearly translated drive rod attached to cable is driven by a friction drive to create tension on the surgical cable.

Abstract: Implant apparatuses are provided for being inserted between adjacent vertebral bone portions and maintaining mechanical engagement with the vertebral bone portions. The implant apparatuses are generally constructed to be inserted in an insertion orientation and pivoted between the vertebral bone portions to an implanted orientation. The implant apparatuses are further secured in the implanted orientation to maintain engagement with the adjacent vertebral bone portions.

Abstract: A spinal fixation system is provided that, in one form, comprises a pedicle screw assembly having a coupling device with an elongate member for guiding a fixation element, such as a spinal rod, into the coupling device and a lock device for fixing the spinal rod to the coupling device. The pedicle screw assembly may be passed through a small incision and connected to a vertebral bone. By connecting a second pedicle screw assembly to a second vertebral bone, the elongate members of the pedicle screw assemblies provide guideposts for directing the spinal rod subcutaneously between the pedicle screw assemblies and into the coupling devices thereof.

Abstract: An artificial disc device for replacing a damaged nucleus is disclosed. In one form, the device may be inserted in components such that the device may be assembled within and retained by the natural annulus therein. In another form, the device may be inserted into the natural annulus in a collapsed or compressed state or arrangement and then be expanded within and retained by the annulus therein. In a further form, the device may be provided with a releasable connection so that the device may be connected in an insertion configuration and may be released in an operable configuration. Insertion tools and methods are also disclosed.

Abstract: Instruments and methods are provided for securing a spinal rod in one or more coupling devices secured to the spine by one or more anchor members. The instruments include members for grasping the coupling device and members for shifting one or more elements along a linear path to fix the position of an anchor member and/or fix the position of the rod with respect to the vertebra.

Abstract: A motion preserving implant having first and second bearing members and a biasing member disposed therebetween operable to provide resistance to the translation of the bodies with respect to one another. An intervertebral implant having first and second bearing members, a translatable member, a resilient connection between the translatable member and one of the bearing members to allow for relative motion therebetween and bearing surfaces of the translatable member and the other bearing member to allow complex, natural motion between the bearing members. A spinal implant having upper and lower bodies and an articulation surface that allows for polyaxial articulation and translation through a concave articulation surface having a first radius of curvature and a second radius of curvature in at least one plane, and a convex articulation surface having the first radius of curvature in the same plane.

Abstract: A minimally invasive surgical system for implanting pedicle screw assemblies to be connected by a spinal rod is disclosed. In one form, the system includes a plurality of holding mechanisms for the pedicle screw assemblies, each holding mechanism for being inserted through an incision and configured to receive tools along an axis thereof for driving a screw anchor of the pedicle screw assembly into a vertebra and securing the spinal rod thereto and a rod inserter that is configured to adjustably hold the rod and insert the rod through a common incision with one of the holding mechanism for being fed into position in an initial direction that is transverse to the axes of the holding mechanisms.