Abstract: An expandable interbody fusion device configured for placement into the intradiscal space between vertebral bodies in a lumbar spine from a lateral approach. The device is expanded by the insertion of a plurality of wafers into the device in situ. The length of the device is configured to extend on the vertebral body endplate from pedicle to pedicle and to reside interiorly of the ring apophysis with at least a portion of the device resting on the area of increased bone density at the posterior portion of the endplate between the pedicles.

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: A composition suitable for use as replacement material for all or part of a disc nucleus during percutaneous injection, the composition comprising: an injectable, curable, cross-linkable, non-immunogenic non-toxic protein hydrogel that (i) the protein component of the protein hydrogel contains at least one crosslinkable amino acid (ii) has a static compressive modulus of at least about 10 kPa, and (iii) has a dynamic compressive modulus of at least about 10 kPa; an iodinated contrast solution comprising an amount of an iodine compound sufficient to increase radiopacity to a discernable level, wherein the solution causes a decrease in the static and/or dynamic compressive modulus; and an amount of a crosslinker sufficient to restore at least about 100% of the decrease in static and/or dynamic compressive modulus caused by addition of the iodinated contrast solution.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

Abstract: An apparatus and method is provided for interbody fusion including 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 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 friction element in the form of a wave spring is disposed between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener.

Abstract: An elongate inserter has a distal end releasably connected to an expandable interbody fusion device and a proximal end including a trigger actuator. The interbody fusion device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other in the intradiscal space. The inserter includes a lifting platform and an elevator that define cooperatively engaging ramps and ramps surfaces that upon operation of the trigger actuator cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert into the expanded device between the superior and inferior endplates.

Abstract: An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.

Abstract: An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.

Abstract: An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.

Abstract: An apparatus and method for locating the position of a spinal implant in an intradiscal space patient during surgery, comprising a spinal implant formed of radiolucent material and a releasably attached inserter comprising a positioning element including thereon a marker of material more radiopaque than the material of the spinal implant. The positioning element extends into the implant such that the marker is positioned at a predetermined location within the implant, the positioning element with the radiopaque maker being removable from the spinal implant after insertion. In a particular method of locating the position of the spinal implant, the spinal implant is inserted from the lateral approach.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

Abstract: An expandable interbody fusion device includes a superior endplate and an inferior endplate. The superior endplate is designed and structured to be angled; the angled surface of the superior endplate becomes prominent upon expansion. The inferior endplate has a bounded cavity in which the superior endplate is fully nested in an unexpanded condition. In a fully expanded condition, the entire outer surface of the superior endplate moves out of the cavity and above an upper surface of the inferior endplate.

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 in interlocking engagement. The superior and inferior plates have openings therethrough in communication with aligned holes through the wafers for receipt and containment of bone graft to promote fusion between opposing vertebral bodies. One of said superior and inferior endplates has a multi-contoured opening extending therethrough.

Abstract: An expandable device for expanding and supporting body tissue comprises an inferior endplate having an outer surface configured to contact one body tissue surface and a superior endplate having an outer surface configured to contact an opposing body tissue surface. The inferior endplate and the superior endplate are movable relative to each other in a direction of expansion. The device includes an elevator captively supported between the inferior endplate and the superior endplate for independent movement along the direction of expansion. In the first direction the elevator is moved toward said superior endplate to lift the superior endplate and expand the device. In the second direction the elevator moves away from said superior endplate toward said inferior endplate to create a space for insertion of an insert into the expanded device.

Abstract: A minimally invasive spinal fixation system comprises first and second bone screws each including a threaded shaft for respective engagement with a vertebra and a yoke articulatingly attached to the shaft, each yoke including a pair of upstanding opposed arms defining a slot therebetween. A connecting element has opposite ends and a longitudinal axis extending therebetween, the connecting element including a tab adjacent each end projecting from the connecting element transversely to the longitudinal axis. Bone screw extensions are provided for guiding the placement of the connecting element into the yoke slots, each extension having a pair of opposing slots that are sized to pass the tabs through the extensions when oriented in a first position and to prevent passage when the tabs are oriented in a second different position.

Abstract: An elongate inserter has a distal end releasably connected to an expandable device for expanding body tissue and a proximal end including a trigger actuator. The expandable device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other between opposing tissue surfaces of a body. The inserter includes a lifting platform comprising ramp surfaces that upon operation of the trigger actuator cooperatively engage complementary surfaces of expansion structure within the device to cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert between the superior and inferior endplates after expansion of the device.

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 rotatable relative to each other. A screw engaging member projects radially from the distal end of the inner sleeve and is configured to engage an extension coupling surface on the outer sleeve upon relative rotation of the inner and outer sleeves. A securement member including cooperative surfaces is defined adjacent the distal end of the inner and outer sleeves that is operable upon relative rotation of the inner sleeve and outer sleeve to radially secure the sleeves together to thereby maintain the engagement of the screw engaging member and the bone screw.

Abstract: Described here are deformable monolithic, stabilization devices, or implants, suitable for use within bone and between bones, for instance, to fuse vertebral bodies, to repair herniated discs, or to repair spinal compression fractures. The implants are introduced into a chosen site at a first, smaller height and then plastically deformed to achieve a second, but unique, pre-selected, larger height. Variations of the device provide one or more specific larger heights. The devices are particularly suitable as intervertebral spinal fusion implants for the immobilization of adjacent vertebral bodies. Methods of deploying the implants are also described as are instruments for such deployment.

Abstract: An expandable anterior lumbar interbody fusion device comprises a deformable monolithic body having posterior and anterior ends, an upper bone contact structure and a lower bone contact structure. The body is expandable along a height axis between a first smaller height to a second larger height. The body comprises a pair of opposed side structures, each including a translatable center section being movable in a direction transverse to the height axis, a first locator arm adjacent the posterior end, a second locator arm adjacent the anterior end and a pair of formable load-bearing columns supported by the upper bone contact structure, the lower bone contact structure and the center section. The columns are not formed at the first height but are operative upon expansion of the body to the second height to form load-bearing columns along the height axis between the upper and lower bone contact structures.