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.

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: 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 surgical tool for deploying an implant includes an elongate outer shaft having a proximal end, a distal end and a central channel therebetween. An elongate inner shaft is at least partially slidably received in the central channel and an actuator mechanism is operatively coupled with either the outer or inner shaft. The tool also includes a piercing element that is coupled with the outer shaft and releasably coupled with the implant.

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: Spinous process constraint structures include a first attachment element for placement over a first spinous process and a second attachment element for placement over a second spinous process. The attachment elements are joined by a single connector which may optionally include a compliance member for providing controlled elasticity between the spinous processes.

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: 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 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: Spinous process constraint structures include a first attachment element for placement over a first spinous process and a second attachment element for placement over a second spinous process. The attachment elements are joined by a single connector which may optionally include a compliance member for providing controlled elasticity between the spinous processes.

Abstract: A surgical tool for deploying an implant includes an elongate outer shaft having a proximal end, a distal end and a central channel therebetween. An elongate inner shaft is at least partially slidably received in the central channel and an actuator mechanism is operatively coupled with either the outer or inner shaft. The tool also includes a piercing element that is coupled with the outer shaft and releasably coupled with the implant.

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 devices for restricting movement of a spinal segment by providing an adjustable constraining device that includes a tether and a compliance member coupled together. The tether is coupled to a superior spinous process and an inferior spinous process or a sacrum so that the construct of the compliance member and tethers provides a force resistant to flexion and a force resistant to extension of a spinal segment. In some embodiments, the construct of the compliance member and tethers may provide only a force resistant to extension.

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 method for coupling a prosthesis to a spinal segment in a patient includes the steps of selecting first and second reference points disposed along the spinal segment and pre-operatively measuring a target distance. The target distance extends between the first and second reference points while the patient is in a preferred posture such as the standing position. A prosthesis is coupled to the spinal segment and the prosthesis is then intra-operatively adjusted in order to set the distance between the first and second reference points based on the target distance.

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.

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: Fastening mechanisms for releasably locking a tether are provided. The mechanisms find application with orthopedic internal-fixation implants and make the implants more reliable and their implantation less invasive. A method for releasably locking a tether comprises advancing the tether through a tether aperture in a clamp body. The tether enters the tether aperture in a first plane and exits in a second plane generally transverse to the first plane. Positioning a fastener element in a fastener aperture in the clamp body captures the tether between the clamp body and the fastener element thereby releasably locking the tether in position relative to the clamp body.

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 a compliance member having a body and an elongation limit. The body typically comprises a spring or other tension element which provides elastic constraint to the spinal segment when the compliance member is attached to the spinous processes. The elongation limit prevents overextension of the compliance member, thus reducing the likelihood that the patient will experience over flexion of the spinal segment and reducing the risk of placing excessive mechanical load on the compliance member.