Abstract: Surgical techniques and instruments are provided for performing surgical procedures in a disc space. The instrument includes a sleeve having a distal end and an opposite proximal end and a working channel extending therebetween. The working channel includes a first portion and an adjacent second portion configured to receive surgical instruments therethrough. A cap member is secured to the sleeve at the proximal end. The cap member has a sealable access port substantially aligned with a corresponding one of the first or second portions. The cap member is movable with respect to the sleeve to substantially align the access port with the other of the first and second portions while the working channel remains sealed. Various techniques using various surgical instruments in laparoscopic procedures are also disclosed.

Abstract: Techniques and systems for distracting a spinal disc space and supporting adjacent vertebrae are provided. Trial instruments are insertable into the disc space to determine a desired disc space height and to select a corresponding implant. Implants can be also be self-distracting and the implant providing the desired disc space height can be implanted in the spinal disc space.

Abstract: This invention relates to orthopedic implants and to methods of treating bone defects. More specifically, but not exclusively, the present invention is directed to non-metallic implants and to methods for intra-operative assembly and fixation of orthopedic implants to facilitate medical treatment. The non-metallic implant assembly can be secured to underlying tissue by a fastener, such as a bone screw, that is capable of swelling on contact with fluid in the underlying tissue. Alternatively, the non-metallic implant assembly can be assembled intra-operatively using a fastener that is adhesively bonded to a bone plate or the bone plate can be deformed using heat, force, or solvents to inhibit withdrawal of the fastener. In preferred embodiments, both the fastener and the bone plate are formed of biodegradable material.

Abstract: Described are osteogenic paste compositions with enhanced osteoinductive properties for use in bone repair. Compositions comprising a quickly resorbable paste carrier, a more slowly resorbed mineral matrix, and Bone Morphogenetic Protein (BMP) or other osteogenic factor are described which enable increased osteoinductive activity while retaining a reliable scaffold for the formation of new bone at the implant site. Methods for making and methods for therapeutic use of the compositions are also disclosed.

Abstract: This invention relates to methods and instruments for performing a surgical procedure in a disc space between adjacent vertebrae. The instruments include a distractor and a cutting instrument. In one embodiment the distractor includes a body portion and a pair of flanges extending along opposite sides of the body portion such that a slot is formed between the flanges and the body portion. The cutting instrument is positionable over the body portion and into the slots of the distractor so that the flanges are positioned between the cutting instrument and the adjacent tissue.

Abstract: A device for supporting and/or assisting in bone fusion, particularly in the spine, is described. A plate member is provided, along with two or more attachment members that are anchorable to bones. In one embodiment, the plate member has a slot near one end and an aperture at another end. The attachment members include threaded posts for connection to the plate member via the latter's slot(s) and aperture(s). Alternatively, attachment members need not have a threaded post, and attachment members may be connected to the plate member via a bone bolt or similar fixation member. The slot(s) allow a single plate member to be used for a variety of operative situations and anatomies. A device for repositioning bones and a method for using the disclosed devices is also described.

Abstract: A guide and a blade for contouring vertebral bodies. The guide is sized to be mounted between two vertebral members and includes a pair of edges for receiving the blade. The pair of edges are spaced a distance apart for the first edge to align with a first vertebral member, and the second edge to align with a second vertebral member. The blade includes a pair of arms with at least one cutting edge. The arms are sized to fit within the pair of edges respectively. Using the blade and guide comprises inserting the guide adjacent to two vertebral members, and inserting the arms through the pair of edges to contour the ends of the members. In an embodiment with cutting edges at the distal ends of each of the arms, the two vertebral members can be contoured simultaneously.

Abstract: A small profile, cylindrically shaped prosthetic disc device is provided. The device housing is comprised of two longitudinally split hollow halves, between which are contained multiple discoid shaped resilient bodies which may be of a polymeric type, or they may contain hydrogel. These bodies may lie in concave surfaces located on the interior of each side of the split cylindrical housing. The housing halves even under maximum physiological loads, do not contact one another directly. Threads on the exterior surface of the cylindrical housing facilitates insertion and retention in the prepared bone opening.

Abstract: Methods and devices for providing a stabilized implant at a site of implantation include providing locking members on faces of the implant and applying bone cement to the implant faces. The locking members secure the bone cement so that the bone cement will not be substantially displaced when the implant is inserted at an implantation site.

Abstract: Embodiments of the invention include devices and methods for determining information regarding the distance and/or tensile force between bodies based on the travel of a device rotated between the bodies and the torque applied to rotate the device. In some embodiments, the device and method are useful to determine parameters related to spinal vertebral bodies.

Abstract: An intervertebral disc nucleus replacement is provided that is configurable into a first configuration to be assumed while the replacement is implanted in the nuclear cavity and a second configuration to be assumed during the procedure of inserting the replacement into the nuclear cavity. The first configuration may have an accordion-like structure formed by a plurality of sections folded in an alternating, zigzag-like manner, and may be sized and shaped to conform to the nuclear cavity. The second configuration may be formed by straightening the plurality of folded sections into an unfolded, elongated, linear member, thereby affording a smaller effective cross-section. The nucleus replacement may be made of an elastic material having shape memory and may be formed so that the first configuration is an unmanipulated or relaxed configuration and the second configuration is a manipulated or unrelaxed configuration.

Abstract: A spinal stabilization apparatus and method according to which a fastener is engaged with a vertebra of a spinal system. The fastener is connected to a rod and the direction of extension of at least a portion of the rod in a coronal plane may be selectively adjusted.

Abstract: A vertebral implant for interposition between two vertebral endplates comprises a first endplate component having a first exterior surface for engaging a first vertebral endplate and having a first interior surface. The implant further comprises a second endplate component having a second exterior surface for engaging a second vertebral endplate and having a second interior surface. The implant also comprises a plurality of movable bearing members attached to the second interior surface and movably engaged with the first interior surface.

Abstract: A vertebral implant for interposition between first and second vertebral bodies comprises a first component for engaging a vertebral endplate of the first vertebral body and a second component for engaging a vertebral endplate of the second vertebral body. The second component is adapted to articulate with respect to the first component. The implant further includes a first sensor for detecting a first physical parameter and a transmitter coupled to the first sensor. The transmitter is adapted for interposition between the first and second vertebral bodies.

Abstract: Embodiments of the invention include devices and methods for manipulating bone. Instruments of some of the embodiments are insertable into a vertebral body or between vertebral bodies to apply forces to the vertebral bodies to strengthen bone or prepare bone to be strengthened.

Abstract: Apparatus and method for compressing a shape memory material implant to be implanted in a patient. The apparatus in some embodiments includes opposing dies, an actuator, and a uniformity controller. The opposing dies are configured to grasp the shape memory material implant, when placed therebetween. The actuator actuates the opposing dies toward each other to compress the shape memory material implant. The uniformity controller of some embodiments provides uniform compression of a given type of shape memory material implant.

Abstract: An intervertebral prosthetic device and method for spinal stabilization, according to which an outer member of a relatively flexible and soft material is formed over an inner member of a relatively stiff and hard material. When the device is inserted between two vertebrae, the outer member engages the vertebrae.

Abstract: A method of decompressing a facet joint comprises forming an opening in a facet capsule of the facet joint and inserting a spacer device through the opening into the facet capsule.

Abstract: An artificial joint is configured for surgical insertion between two bones. The joint includes first and second parts supported for relative movement, and structure that can be selectively used to facilitate relative fixation of the first and second parts in a manner preventing the relative movement thereof. A method involves surgically inserting such a joint between two bones, and completing the surgical procedure with the first and second parts movable relative to each other. A different method relates to a situation where such a joint was previously surgically installed, and involves modifying the joint in situ to fix the first and second parts against relative movement.

Abstract: Techniques and systems for distracting a spinal disc space and supporting adjacent vertebrae are provided. Trial instruments are insertable into the disc space to determine a desired disc space height and to select a corresponding implant. Implants can be also be self-distracting and the implant providing the desired disc space height can be implanted in the spinal disc space.