Abstract: A dynamic stabilization device includes end caps that define a bore for receiving a corresponding bone screw therethrough. A spacer is engaged between each end cap and a cable passes through each of the components and is placed in tension to couple the spacer between the two end caps. The spacer is formed of a material that allows some flexible movement after implantation. An alternative stabilization device includes a spacer over-molded about two bushings defining the bores. According to a method of use, a stabilization device is passed along guide wires through a small incision. Once the device is in contact with the vertebrae, the bone screws are advanced along the guide wires and driven into the bone. One fastener bore may include a camming surface that causes distraction of the vertebrae as the bone screw is threaded into the vertebral bone.

Abstract: A spinal fixation system includes a rod and anchor devices that include a bone engaging fastener having a head defining a spherical socket. A ball insert is placed within the socket and rotated so that the ball insert is juxtaposed with the socket. The anchor device further includes a yoke defining a yoke channel for receiving the rod and a stem engaged to the ball insert captured within the socket. A sleeve disposed between the yoke channel and the fastener head supports the rod. A set screw is operable to clamp the rod against the sleeve and draw the insert into engagement within the socket. A releasable detent defined between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener. Portions of the releasable detent may also exert a frictional retention force against the fastener head.

Abstract: A screwdriver for driving a multi-axial its distal end for engaging the head of the bone screw for joint rotational movement. The screw driver includes an outer retention sleeve within which the inner shaft rotates freely. The outer retention sleeve releasably attaches to the yoke of the bone screw. In another configuration, the screwdriver comprises a screw engagement member affixed to the shaft for joint rotational movement therewith, the screw engagement member comprising a stop sized to seat within a slot of the bone screw yoke, the stop being configured to rotate the yoke upon rotation shaft. A releasable retention member is provided on the screw engagement member for releasably attaching the screwdriver to the bone screw.

Abstract: A cross connector for attachment between two spinal implants comprises a first element having one end and an opposite end configured for engaging one of the two spinal implants, a second element having one end and an opposite end configured for engaging the other of the two spinal implants, an engagement mechanism between the one end of each of the first and second elements, and a locking element for locking the two elements together at the respective one end. The engagement mechanism includes an interface configured to permit relative pivoting between the first element and the second element about at least two non-parallel axes.

Abstract: A kit for injecting a biomaterial into an intradiscal space accessed through an opening in the disc annulus comprises a plurality of needles, each sized for introduction through the annulus opening with a passageway for injecting the biomaterial therethrough, and each including a distal end to be disposed within the intradiscal space when the needle extends through the annulus opening. Each needle includes a stop affixed thereto at different pre-determined distances from the distal end to define the location of the distal end within the intradiscal space when the needle extends through the opening in the annulus. The kit further includes a plurality of seals defining a bore for sliding engagement with a needle, each of the plurality of seals including a sealing face for engaging the annulus around the needle. Each sealing face defines a differently configured area of contact, such as circular, elliptical, tapered and threaded.

Abstract: An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of interlocking expansion members or wafers. The like-configured wafers include features on their top and bottom surfaces that interlock the wafers in multiple degrees of freedom so that the wafer stack is not disrupted when the fusion device is fully expanded. One of the interlocking features includes a plurality of prongs projecting from an upper surface of the wafers and into a recess defined in the lower surface of an adjacent previously inserted like-configured wafer. The prongs and recesses are configured to prevent retrograde movement of each new wafer in a direction opposite the direction of insertion. Other interlocking features prevent movement in the direction of insertion, transverse to the insertion direction and vertically within the stack.

Abstract: An apparatus and method is provided for distracting, in a given direction, and supporting opposing vertebral bodies. A plurality of wafers are consecutively inserted between the vertebral bodies to create a column of wafers. The column of wafers is oriented between the vertebral bodies so as to expand in the given direction as the wafers are consecutively added to the column.

Abstract: An expandable interbody fusion device includes superior and inferior plates that are configured to receive a sequentially inserted stack of expansion members or wafers. The superior and inferior plates include features that at least initially interlock the two plates until the superior plate is dislodged by pressure from the growing wafer stack. The wafers include features on their top and bottom surfaces that interlock the wafers in multiple degrees of freedom so that the wafer stack is not disrupted when the fusion device is fully expanded. Each wafer also includes features that interlock with the inferior plate until the wafer id dislodged by sequential introduction of another wafer.

Abstract: Methods and techniques for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.

Abstract: An apparatus and method is provided for distracting, in a given direction, and supporting opposing vertebral bodies. A plurality of wafers are consecutively inserted between the vertebral bodies to create a column of wafers. The column of wafers is oriented between the vertebral bodies so as to expand in the given direction as the wafers are consecutively added to the column.

Abstract: A kit of parts is provided that comprises: a cannula, the distal end of the cannula adapted to be inserted through the disc annulus; an injection needle, the distal end adapted to be inserted into the proximal end of the cannula and configured for relatively close sliding fit therewithin; and a syringe for containing a quantity of curable biomaterial, the syringe adapted to be coupled to the proximal end of the needle and to inject the biomaterial into the needle under pressure. The kit may further comprise a quantity of curable biomaterial that is selected to have upon curing strong adhesive properties such as a protein polymer.

Abstract: A system and method is provided for distracting opposite surfaces from the interior of a bone, such as a vertebral body. A working channel cannula provides a working channel through which an inserter and an injection cannula can simultaneously pass. The inserter transports a plurality of wafers into the interior of the bone to form a load-bearing stack bearing against the opposite surfaces. The injection cannula is used to inject a fluent material into and/or around the stack. In certain embodiments, the fluent material is a load-bearing or hardenable material, such as bone cement. In other embodiments, the fluent material can be a BMP, HAP, or other osteo-inductive, osteo-conductive, or pharmaceutical compositions. A syringe containing the fluent material is engaged to the injection cannula and is operable to inject the fluent material into the vertebral body under controlled pressure.

Abstract: A system and method is provided for distracting opposite surfaces from the interior of a bone, such as a vertebral body. A working channel cannula provides a working channel through which an inserter and an injection cannula can simultaneously pass. The inserter transports a plurality of wafers into the interior of the bone to form a load-bearing stack bearing against the opposite surfaces. The injection cannula is used to inject a fluent material into and/or around the stack. In certain embodiments, the fluent material is a load-bearing or hardenable material, such as bone cement. In other embodiments, the fluent material can be a BMP, HAP, or other osteo-inductive, osteo-conductive, or pharmaceutical compositions. A syringe containing the fluent material is engaged to the injection cannula and is operable to inject the fluent material into the vertebral body under controlled pressure.

Abstract: In one embodiment, the invention relates to a composition suitable for preparing a hydrogel useful as replacement material for all or part of a disc nucleus. The composition comprises: a curable, cross-linkable, non-immunogenic, non-toxic protein comprising a minimum of about 10% and a maximum of about 25% of the hydrogel by weight; a metal contrast agent comprising a minimum of about 2% and a maximum of about 70% of the hydrogel by weight; and a crosslinker comprising a minimum of about 0.1% and a maximum of about 10% of the hydrogel by weight; wherein the composition has a discernable radiopacity level.

Abstract: A bone screw extension assembly for use in placing a connecting rod percutaneously into tissue of a patient comprises a multi-axial bone screw and a screw extension releasably coupled to yoke of the bone screw. The screw extension includes coaxially disposed outer sleeve and inner sleeves that are movable axially relative to each other. A screw engaging member projects radially from the distal end of the inner sleeve and is configured to releasably engage an extension coupling surface on the inner surface of opposed upstanding arms of the yoke. A securement member including cooperative surfaces is defined adjacent the distal end of the inner and outer sleeves that is operable upon relative axial movement of the inner and outer sleeves to radially secure the sleeves together for minimization of splaying and to thereby maintain the engagement of the screw engaging member and the bone screw.

Abstract: A spinal fixation system includes a rod and anchor devices that include a bone engaging fastener having a head defining a spherical socket. A ball insert is placed within the socket and rotated so that the ball insert is juxtaposed with the socket. The anchor device further includes a yoke defining a yoke channel for receiving the rod and a stem engaged to the ball insert captured within the socket. A sleeve disposed between the yoke channel and the fastener head supports the rod. A set screw is operable to clamp the rod against the sleeve and draw the insert into engagement within the socket. A releasable detent defined between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener. Portions of the releasable detent may also exert a frictional retention force against the fastener head.

Abstract: A system and method is provided for distracting opposite surfaces from the interior of a bone, such as a vertebral body. A working channel cannula provides a working channel through which an inserter and an injection cannula can simultaneously pass. The inserter transports a plurality of wafers into the interior of the bone to form a load-bearing stack bearing against the opposite surfaces. The injection cannula is used to inject a fluent material into and/or around the stack. In certain embodiments, the fluent material is a load-bearing or hardenable material, such as bone cement. In other embodiments, the fluent material can be a BMP, HAP, or other osteo-inductive, osteo-conductive, or pharmaceutical compositions. A syringe containing the fluent material is engaged to the injection cannula and is operable to inject the fluent material into the vertebral body under controlled pressure.

Abstract: A surgical instrument for the distraction or compression of bones or bone portions comprises a pair of elongate cross members pivotally coupled for relative movement having at one end a respective pair of handles and at the other end a respective pair of jaws. The jaws are generally parallel to each other and define a first plane within which the jaws are relatively movable, the space on both sides of the plane defining a work space between the jaws. The instrument further comprises a fulcrum supported by at least one of the cross members projecting into the work space and having an axis spaced from the jaws.

Abstract: An apparatus and method for distracting, in a given direction, and supporting two tissue surfaces. An expandable implant includes a plurality of elements are consecutively inserted between the two tissue surfaces to create a column of elements. The column of elements is oriented between the tissue surfaces so as to expand in the given direction as the elements are consecutively added to the column. The expandable implant includes a constraint including a cooperative engagement structure between adjacent elements.

Abstract: An apparatus and method is provided for distracting, in a given direction, and supporting opposing vertebral bodies. A plurality of wafers are consecutively inserted between the vertebral bodies to create a column of wafers. The column of wafers is oriented between the vertebral bodies so as to expand in the given direction as the wafers are consecutively added to the column.