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: 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 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 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: 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: 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 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: An exemplary method for constraining spinous processes to elastically limit flexion of a spinal segment comprises piercing an interspinous ligament to form a first penetration above an upper side of an upper spinous process and advancing a first end of a first tether through the first penetration. The interspinous ligament is pierced again to form a second penetration below a lower side of a lower spinous process and a second end of a second tether is advanced through the second penetration. Joining the first and second tethers together forms an extensible tether structure coupling the upper and lower spinous processes together while permitting extension therebetween. Adjusting the tether structure sets relative distance or angle between the upper and lower spinous processes to a target value.

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: Methods and kits for implanting constraints around spinous processes are described.