Abstract: A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

Abstract: Methods, apparatus and systems for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments rely on placing a tether structure over at least three adjacent vertebral bodies or two adjacent vertebral bodies and the sacrum. The tether structures may be continuous, for example in the form of a continuous loop, or may be discontinuous, for example in the form of a loop or elongate element having at least two anchor structures for securing in bone.

Abstract: A device may be used to limit flexion of the spine without substantially limiting extension of the spine. Various accessories, instruments, and methods may be used to help deploy the flexion limiting device, manipulate, and adjust it.

Abstract: A method for improving shear loading capacity of a spinal segment having a superior vertebra, an inferior vertebra or sacrum, and a facet joint, includes providing a constraint device having an upper portion, a lower portion and a compliance member coupled therebetween. The constraint device is coupled with the spinal segment such that the upper portion of the constraint device is coupled with the superior vertebra and the lower portion of the constraint device is coupled with the inferior vertebra or a sacrum. The constraint device provides a force resistant to flexion of the spinal segment. Also, length or tension in the constraint device is adjusted so as to increase engagement between an upper portion of the facet joint and a lower portion of the facet joint, thereby increasing capacity of the spinal segment to resist shear loading.

Abstract: A device may be used to limit flexion of the spine without substantially limiting extension of the spine. Various accessories, instruments, and methods may be used to help deploy the flexion limiting device, manipulate, and adjust it.

Abstract: A method for improving shear loading capacity of a spinal segment having a superior vertebra, an inferior vertebra or sacrum, and a facet joint, includes providing a constraint device having an upper portion, a lower portion and a compliance member coupled therebetween. The constraint device is coupled with the spinal segment such that the upper portion of the constraint device is coupled with the superior vertebra and the lower portion of the constraint device is coupled with the inferior vertebra or a sacrum. The constraint device provides a force resistant to flexion of the spinal segment. Also, length or tension in the constraint device is adjusted so as to increase engagement between an upper portion of the facet joint and a lower portion of the facet joint, thereby increasing capacity of the spinal segment to resist shear loading.

Abstract: A constraining apparatus includes a constraining structure that captures a first and a second anatomical structure. A motion limiting member coupled with the constraining structure is adapted to provide a force resistant to relative movement of the first anatomical structure away from the second anatomical structure. A regulating member is detachably coupled with the motion limiting member or the constraining structure and is adapted to change the resistant force provided by the motion limiting member when the regulating member is in direct engagement with the motion limiting member or constraining structure.

Abstract: Methods and apparatus for controlling flexion in a spinal segment of a patient include performing a spinal fusion procedure on a pair of adjacent vertebrae in the spinal segment and implanting a constraint device into the patient. Adjusting length or tension in the constraint device allows the constraint device to provide a force a force resistant to flexion of the spinal segment undergoing fusion. The constraint device also modulates loads borne by the spinal segment undergoing fusion or tissue adjacent thereto.

Abstract: A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

Abstract: A system for restricting flexion of a spinal segment in a patient comprises a constraint device having a tether structure and a compliance member coupled with the tether structure. The tether structure is adapted to be coupled with a superior spinous process and a sacrum. The system also includes an anchor member that is anchored to the sacrum. The anchor member has an attachment feature that is adapted to couple with the constraint device.

Abstract: A system for fusing a spine comprises a flexion limiting tether having a superior portion, and an inferior portion. The superior portion of the device is coupled to a superior portion of the spine, and the inferior portion of the device is coupled to an inferior portion of the spine thereby constraining flexion of the spine. The system also includes bone graft for fusing the superior and inferior portions of the spine together. The bone graft is disposed between the superior and inferior portions of the spine, and the tether has a width suitable for holding the bone graft in a mass disposed between the superior and inferior portions of the spine. The tether also has a porosity suitable to allow body fluids to pass therethrough so that the graft material forms a solid mass.

Abstract: A device for restricting flexion of a spine comprises a pair of compliance members that are disposed around a spinal midline, an upper fastener, and a lower fastener. The upper fastener is configured to be coupled to a superior spinous process and the lower fastener is configured to be coupled to an inferior spinous process. The pair of compliance members are coupled to the upper and the lower fasteners such that the compliance members provide a force resistant to flexion between the upper and the lower spinous processes.

Abstract: A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

Abstract: A surgical fastening mechanism for releasably locking an implantable tether includes a housing having a central channel. The housing has an entry aperture, an exit aperture and a side channel extending therebetween. A roller element has a sidewall with an aperture therethrough and the roller is slidably disposed at least partially in the central channel such that the entry and exit apertures are at least partially aligned with the roller aperture. This permits passage of the tether therethrough. Rotation of the roller element in a first direction winds the tether around the roller thereby creating a friction interface between the roller element, the housing and the tether. A locking mechanism is operably connected with either the housing or the roller element and is adapted to prevent rotation of the roller in the central channel and also adapted to prevent release of the tether from the roller.

Abstract: A spinal implant for limiting flexion of the spine includes a tether structure for encircling adjacent spinal processes. Usually, a pair of compliance members will be provided as part of the tether structure for elastically limiting flexion while permitting an extension. A cross-member is provided between the compliance member or other portions of the tether structure to stabilize the tether structure and prevent misalignment after implantation.

Abstract: A system for restricting flexion of a spinal segment in a patient comprises a constraint device having a tether structure and a compliance member coupled with the tether structure. The tether structure is adapted to be coupled with a superior spinous process and a sacrum. The system also includes an anchor member that is anchored to the sacrum. The anchor member has an attachment feature that is adapted to couple with the constraint device.

Abstract: Methods and apparatus for controlling flexion in a spinal segment of a patient include performing a spinal fusion procedure on a pair of adjacent vertebrae in the spinal segment and implanting a constraint device into the patient. Adjusting length or tension in the constraint device allows the constraint device to provide a force a force resistant to flexion of the spinal segment undergoing fusion. The constraint device also modulates loads borne by the spinal segment undergoing fusion or tissue adjacent thereto.

Abstract: Spinal implants for limiting flexion of the spine are implanted between a superior spinous process and an inferior spinous process or sacrum. The implants include upper straps which are placed over the upper spinous process, while the lower portions of the implant are attached to the adjacent vertebra or sacrum. The attachments may be fixed, for example using screws or other anchors, or may be non-fixed, for example by placing a loop strap through a hole in the spinous process or sacrum.

Abstract: A spinal implant for limiting flexion of the spine includes a tether structure for encircling adjacent spinal processes. Usually, a pair of compliance members will be provided as part of the tether structure for elastically limiting flexion while permitting an extension. A cross-member is provided between the compliance member or other portions of the tether structure to stabilize the tether structure and prevent misalignment after implantation.

Abstract: A system for restricting spinal flexion includes superior and inferior tether structures joined by a pair of compliance members. Compliance members comprise tension members which apply a relatively low elastic tension on the tether structures. By placing the tether structures on or over adjacent spinous processes, flexion of a spinal segment can be controlled in order to reduce pain.