Abstract: A method of inserting and positioning an intervertebral spacer is provided. The spacer includes a longitudinal axis, an on-axis interface coincident with or parallel to the longitudinal axis, and an off-axis interface angled to the longitudinal axis. The spacer's front end may be curved. The method may include inserting the spacer into the disc space utilizing a tool to engage an on-axis interface and then to engage one or more of the off-axis interfaces, which may be used for further modification of the spacer. The tool is moved substantially along a single insertion direction, which may be substantially parallel to a posterior-anterior axis of the disc space. The method may result in the longitudinal axis of the spacer being perpendicular to the insertion direction, or substantially parallel to a medial-lateral axis of the disc space. The spacer may also be positioned in an anterior aspect of the disc space.

Abstract: A device for use as a portal in percutaneous minimally invasive surgery performed within a patient's body cavity includes a first elongated hollow tube having a length adjusted with a self-contained mechanism. The first elongated tube includes an inner hollow tube and an outer hollow tube and the inner tube is adapted to slide within the outer tube thereby providing the self-contained length adjusting mechanism. This length-adjustment feature is advantageous for percutaneous access surgery in any body cavity. Two or more elongated tubes with adjustable lengths can be placed into two or more adjacent body cavities, respectively. Paths are opened within the tissue areas between the two or more body cavities, and are used to transfer devices and tools between the adjacent body cavities.

Abstract: In one embodiment, the present invention is a laminal implant including: a first body including a first flange adapted to engage a first lamina end, a tab and a receiving channel; and a second body including a second flange adapted to engage a second lamina end, and a plurality of teeth adapted to engage the tab, at least a portion of the second body adapted to be positioned within the receiving channel, the first and second bodies adapted to slideably engage one another.

Abstract: A method of inserting an expandable intervertebral implant is disclosed. The implant preferably includes first and second members capable of being expanded upon movement of first and second wedges. The first and second wedges, while being capable of moving with respect to each other and the first and second members are also preferably attached to the first and second members. In addition, the first and second wedges are preferably capable of moving only in a first direction, while movement in a second direction is inhibited. The first and second wedges are also preferably prevented from torsionally moving with respect to the first and second members.

Abstract: Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).

Abstract: Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).

Abstract: An intervertebral stabilization device and method is disclosed. The device preferably includes a planar spring enclosed within a housing. The housing is joined to an articulation component at either end, and the articulation components have couplings connectable to anchoring components which are securable to adjacent vertebrae. The planar spring can flex and retract providing relative motion between the adjacent vertebrae. The articulation components are ball and socket joints which allow the entire assembly to flexibly follow the curvature of the spine. A fusion rod with articulation components and couplings at either end may be substituted for the spring device. The couplings enable interchangeability between a fusion rod assembly and spring assembly, so that dynamic stabilization can occur at one vertebral level and fusion at the adjacent vertebral level. An overhung spring assembly with a sideways displaced housing which allows for a shorter pedicle to pedicle displacement is also disclosed.

Abstract: A method of inserting an expandable intervertebral implant is disclosed. The implant preferably includes first and second members capable of being expanded upon movement of first and second wedges. The first and second wedges, while being capable of moving with respect to each other and the first and second members are also preferably attached to the first and second members. In addition, the first and second wedges are preferably capable of moving only in a first direction, while movement in a second direction is inhibited. The first and second wedges are also preferably prevented from torsionally moving with respect to the first and second members.

Abstract: A prosthetic intervertebral spacer includes a body and an interface extending away from the body for use during implantation of the spacer. The interface can be a rail including a neck portion connected to the body and a lip portion connected to the neck portion. The lip portion can be wider than the neck portion in a direction extending between the top and bottom surfaces of the implant. Methods of implanting the spacer and tools used during such procedure are also provided.

Abstract: A spinal plating system for vertebral fixation includes a plate, a compression screw, multiple fixation members and polyaxially adjustable locking rings. The plate is shaped to conform to the curvature of the spine and the surfaces of the vertebral bodies. The compression screw fits through an insert, and together they are guided by the plate as the screw is driven into one of the vertebrae, producing compression between the adjacent vertebrae. A retaining lip on the plate prevents backout of the compression screw. The polyaxial locking rings can be polyaxially pivoted to attain a desired orientation, and are lockable to the plate to maintain the orientation. The fixation members fit through openings in the polyaxial locking rings and the plate to fix the plate to the vertebrae. Locking the polyaxial locking rings fixes the position of the fixation members relative to the plate, and prevents backout of the fixation members.

Abstract: A spinal plating system for vertebral fixation includes a plate, a compression screw, multiple fixation members and polyaxially adjustable locking rings. The plate is shaped to conform to the curvature of the spine and the surfaces of the vertebral bodies. The compression screw fits through an insert, and together they are guided by the plate as the screw is driven into one of the vertebrae, producing compression between the adjacent vertebrae. A retaining lip on the plate prevents backout of the compression screw. The polyaxial locking rings can be polyaxially pivoted to attain a desired orientation, and are lockable to the plate to maintain the orientation. The fixation members fit through openings in the polyaxial locking rings and the plate to fix the plate to the vertebrae. Locking the polyaxial locking rings fixes the position of the fixation members relative to the plate, and prevents backout of the fixation members.

Abstract: An instrument for spinal rotation that aligns and holds direct vertebral rotation (DVR) lever arms relative to each other to achieve an initial axial alignment of a segment of vertebrae and allows the final DVR rotation by rotating the instrument and lever arms together. A method of direct vertebral rotation that allows rotating the vertebrae to be aligned relative to each other, and collectively rotating the vertebrae to be aligned relative to adjacent spinal segments by rotating the direct vertebral rotation instrument. A system for direct vertebral rotation having at least two pedicle screws. The system also includes at least two levers attachable to the pedicle screws and a clamping instrument configured to clamp the levers.

Abstract: An intervertebral stabilization device and method is disclosed. The device preferably includes a planar spring enclosed within a housing. The housing is joined to an articulation component at either end, and the articulation components have couplings connectable to anchoring components which are securable to adjacent vertebrae. The planar spring can flex and retract providing relative motion between the adjacent vertebrae. The articulation components are ball and socket joints which allow the entire assembly to flexibly follow the curvature of the spine. A fusion rod with articulation components and couplings at either end may be substituted for the spring device. The couplings enable interchangeability between a fusion rod assembly and spring assembly, so that dynamic stabilization can occur at one vertebral level and fusion at the adjacent vertebral level. An overhung spring assembly with a sideways displaced housing which allows for a shorter pedicle to pedicle displacement is also disclosed.

Abstract: A method of dilating an incision to provide access to a surgical site. Such method may include the steps of making an incision in the skin of a patient near a predetermined surgical site, inserting into the incision a dilator, inserting at least one shoe horn in juxtaposition or in direct apposition with the dilator, removing the dilator from the incision, inserting a blunt dissector adjacent the at least one shoe horn, removing the at least one shoe horn, inserting a retractor or a tube over the blunt dissector and into the incision such that the retractor or tube is at or adjacent the predetermined surgical site, removing the blunt dissector from the incision, and performing a surgical procedure at the predetermined surgical site through the retractor or tube.

Abstract: An expandable implant (210, 410) includes top and bottom plates (220, 250, 420, 450) having angled inner surfaces (222, 252, 422, 452) that interact with expansion members (300, 302, 500, 502). The expansion members (300, 302, 500, 502) may be situated on an actuator (280, 480), and may include at least one vertical projection (312, 314, 512, 514) for interacting with a recess (230, 430) in the plates (220, 250, 420, 450). In some instances, rotation of the actuator (280, 480) in opposing directions about a longitudinal axis may cause the expansion members (300, 302, 500, 502) to move toward or away from one another, thereby resulting in separation or collapse of the top and bottom plates (220, 250, 420, 450). Pins (316, 516) may also be associated with the expansion members (300, 302, 500, 502) and received in respective slots (318, 518) in the plates (220, 250, 420, 450).

Abstract: A method of stabilizing bone, such as a spine, includes providing a coupling element having first and second sections that are angled relative to one another, the coupling element having rod receiving openings for securing an elongated member such as an orthopedic rod, and assembling the coupling element with an anchoring element. The method includes securing the anchoring element in bone, moving the coupling element relative to the anchoring element to align the rod receiving openings with the orthopedic rod, securing the orthopedic rod in the rod receiving openings, and after the securing step, locking the coupling element from further movement relative to the anchoring element.

Abstract: A compression and distraction shaft assembly applies compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. An hourglass-shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. Distraction pliers having cylindrical tips are used to apply distraction to vertebrae. Once handles are pressed to impart an appropriate amount of distraction to the vertebrae, they are locked in this position. Compression pliers having cylindrical tips are used to apply compression to vertebrae. Once handles are pressed to impart an appropriate amount of compression to the vertebrae, they are locked in this position.

Abstract: In one embodiment, the present invention is a system for use in a laminoplasty procedure, the system including an implant comprising a first body and a second body, the first and second bodies adapted to slide relative to one another; and an implantation instrument including: a shaft having a longitudinal length, a proximal end, a distal end and a hollow throughbore along at least a portion of its length; a handle positioned on the proximal end of the shaft; an actuator rod having a proximal portion and a distal portion, the actuator rod being positioned within the hollow throughbore of the shaft; a knob adapted to engage the proximal portion of the actuator rod; a first connector adapted to engage the distal portion of the actuator rod; and a second connector fixedly secured to the distal end of the shaft.

Abstract: An orthopedic bone plate system having a bone plate for placement adjacent one or more vertebral bodies. The system further includes a locking element including a compression member and a fixation member wherein the compression member includes an aperture and at least one deformable portion. A bone fastener is also included in the present system which includes a bone engaging portion and a stem portion. The stem is capable of being slidably received within the aperture of the compression member while the locking member is capable of being received within an aperture of the bone plate. As the compression member is brought into proximity of a vertebral body along the longitudinal axis of the bone fastener, an increasing force is exerted against the fixation member and translated to the bone plate. The resultant force translated back to the fixation member to the compression member which causes the deformable portion of the compression member to clamp the bone fastener relative to the bone plate.

Abstract: An instrument for spinal rotation that aligns and holds direct vertebral rotation (DVR) lever arms relative to each other to achieve an initial axial alignment of a segment of vertebrae and allows the final DVR rotation by rotating the instrument and lever arms together. A method of direct vertebral rotation that allows rotating the vertebrae to be aligned relative to each other, and collectively rotating the vertebrae to be aligned relative to adjacent spinal segments by rotating the direct vertebral rotation instrument. A system for direct vertebral rotation having at least two pedicle screws. The system also includes at least two levers attachable to the pedicle screws and a clamping instrument configured to clamp the levers.