Abstract: A retraction system and method are provided for retracting tissues surrounding a surgical site. In one aspect, a method including engaging slide connections between a guide dilator and a plurality of tissue engaging members and sequentially enlarging an incision using the guide dilator and the plurality of tissue engaging members. In another aspect, a method of inserting a plurality of tissue engaging members into an incision including fixing tip portions of the plurality of tissue engaging members in an insertion configuration, advancing the tip portions into an incision, and restricting movement of the tip portions away from the insertion configuration. A guide dilator system comprising an elongate body, a plurality of tissue engaging members, and slide connections between the elongate body and the tissue engaging members is also provided.

Abstract: Disclosed are cement products, methods of forming cement using the cement product, and methods of using the cement product in orthopedic and dental applications. Generally, the disclosed cement product includes a first component comprising a polymerizable resin comprising ethylenic unsaturated double bond, a second component comprising a compound comprising more than one type of amine selected from the group consisting of primary amines, secondary amines, tertiary amines and quaternary amines, and, optionally, the cement product includes a bioactive component to promote bone formation.

Abstract: A fornix manipulator includes a collar and stabilizer. The collar has a first end and a second end, the second end having an opening and diameter greater than the first end and the first end having an opening to receive a cervix into the collar. The stabilizer has a base portion defining a guide hole and a plurality of prongs extending from the base portion to contact the first end of the collar.

Abstract: A spinal stabilization system includes a first engagement member and a support structure. The first engagement member is adapted to be disposed between a first vertebra and a second vertebra. The engagement member generally includes a seating surface for accommodating at least a portion of a laminar region of the first vertebra. The support structure engages a portion of the second vertebra. The structural cooperation of the first engagement member and the support structure is such that the engagement member restricts reduction of the intervertebral spacing between the first and second vertebrae.

Abstract: Bone plate systems are provided for surgical implants and bone repair. The bone plate is multi-tiered for receiving bone anchors screws for securing a plurality of bones or bone fragments in a desired relationship. The plate members include throughbores for receiving a pivot base therein, with head ends of the bone anchors being secured in the pivot bases. The throughbores may permit and define a translation path for the pivot base and the bone anchor secured therein relative to the plate. Pivot members extending between the pivot base and the plate member facilitate pivoting and optional translation of the pivot base relative to the plate. With the bone anchor seated within the pivot base, an apparatus for inhibiting screw back out is employed.

Abstract: An intervertebral disc implant with upper and lower bearing members with an articulation interface between the members for providing relative motion therebetween. In one form, a securing member with an elongate shaft and a bone-engaging member on the shaft is disposed on one of the bearing members. The bone-engaging member is deployable into a bone-engaging position via rotational displacement of the shaft. In another form, a bone-engaging member is deployable via an actuator inserted into the implant body. In another form, the securing member secures an intervertebral implant in intervertebral space via deformation of the securing member causing a bone-engaging member of the securing member to be deployed into contact with an adjacent vertebra.

Abstract: A multi-stage minimally invasive surgical procedure and associated instruments are disclosed. First, the surgical site is prepared. After preparation, the bone screws or anchors are attached to the bone. Subsequent to insertion of the screws, a rod or connecting member is positioned within the yoke portion of the bone screw. Caps are then placed in a pre-lock position within the yokes. The bone screws may be compressed together or distracted along the rod or connecting member, thereby setting the final spacing of the bones or bone segments. Finally the caps are moved to a final lock position to fix the screws to the rod or connecting member to maintain the bones in position relative to each other.

Abstract: A retraction system and method are provided for retracting tissues surrounding a surgical site. In one aspect, a method including engaging slide connections between a guide dilator and a plurality of tissue engaging members and sequentially enlarging an incision using the guide dilator and the plurality of tissue engaging members. In another aspect, a method of inserting a plurality of tissue engaging members into an incision including fixing tip portions of the plurality of tissue engaging members in an insertion configuration, advancing the tip portions into an incision, and restricting movement of the tip portions away from the insertion configuration. A guide dilator system comprising an elongate body, a plurality of tissue engaging members, and slide connections between the elongate body and the tissue engaging members is also provided.

Abstract: An implant device is provided that is configured for implantation at multiple locations between adjacent vertebrae. The implant device comprises an implant body, a first portion of the implant body, and a second portion of the implant body adjustably interconnected with the first portion. The implant body has a compact orientation and an extended orientation to allow the implant body to be shifted from one orientation to the other orientation for being positioned in any one of areas between the spinous processes of the adjacent vertebrae, between laminar regions of the adjacent vertebrae, spanning an opening in the annulus between the adjacent vertebrae, and in the intervertebral space between the adjacent vertebrae.

Abstract: The present invention is directed to a stabilized bioactive hydrogel matrix coating for substrates, such as medical devices. The invention provides a coated substrate comprising a substrate having a surface, and a bioactive hydrogel matrix layer overlying the surface of the medical device, the hydrogel matrix comprising a first high molecular weight component and a second high molecular weight component, the first and second high molecular weight components each being selected from the group consisting of polyglycans and polypeptides, wherein at least one of the first and second high molecular weight components is immobilized (e.g., by covalent cross-linking) to the surface of the substrate.

Abstract: The present invention is directed to a stabilized cross-linked hydrogel matrix comprising a first high molecular weight component and a second high molecular weight component that are covalently linked, and at least one stabilizing or enhancing agent, wherein the first high molecular weight component and the second high molecular weight component are each selected from the group consisting of polyglycans and polypeptides. This stabilized hydrogel matrix may be prepared as bioactive gels, pastes, slurries, cell attachment scaffolds for implantable medical devices, and casting or binding materials suitable for the construction of medical devices. The intrinsic bioactivity of the hydrogel matrix makes it useful as a gel or paste in multiple applications, including as a cell attachment scaffold that promotes wound healing around an implanted device, as gels and pastes for induction of localized vasculogenesis, wound healing, tissue repair, and regeneration, as a wound adhesive, and for tissue bulking.

Abstract: Methods for the synthesis of tricalcium phosphates are presented, as well as a series of specific reaction parameters that can be adjusted to tailor, in specific ways, properties in the tricalcium phosphate precursor precipitate. Particulate tricalcium phosphate compositions having an average crystal size of about 250 nm or less are provided. Compositions of the invention can be used as prosthetic implants and coatings for prosthetic implants.

Abstract: Spinal rods are provided that transition from one diameter to another without an extended transition region to which coupling devices may not be attached, allowing coupling devices for mounting the spinal rod to the spine to be secured almost anywhere along the rod's length without having a weakened transition point.

Abstract: A multi-stage minimally invasive surgical procedure and associated instruments are disclosed. First, the surgical site is prepared. After preparation, the bone screws or anchors are attached to the bone. Subsequent to insertion of the screws, a rod or connecting member is positioned within the yoke portion of the bone screw. Caps are then placed in a pre-lock position within the yokes. The bone screws may be compressed together or distracted along the rod or connecting member, thereby setting the final spacing of the bones or bone segments. Finally the caps are moved to a final lock position to fix the screws to the rod or connecting member to maintain the bones in position relative to each other.

Abstract: A coupling assembly is provided with a yoke device that allows an anchor member secured thereto to rotate in a turret-like manner with respect to an elongate member secured by the yoke in addition to allowing the anchor member to pivot away from the central axis of the yoke. A first yoke member holds the elongate member and is rotatably coupled to a second yoke member that holds a bone anchor. A combination of rotation of the second yoke member and pivoting of the anchor member allows the anchor to be positioned in a wide variety of orientations with respect to the yoke device and elongate member.

Abstract: Bone plate systems are provided for surgical implants and bone repair. The bone plate is multi-tiered for receiving bone anchors screws for securing a plurality of bones or bone fragments in a desired relationship. The plate members include throughbores for receiving a pivot base therein, with head ends of the bone anchors being secured in the pivot bases. The throughbores may permit and define a translation path for the pivot base and the bone anchor secured therein relative to the plate. Pivot members extending between the pivot base and the plate member facilitate pivoting and optional translation of the pivot base relative to the plate. With the bone anchor seated within the pivot base, an apparatus for inhibiting screw back out is employed.

Abstract: A small cannulated bone screw is provided having an optimized combination of strength, cannula size and thread depth. A set of such strong and small size screws is also provided where the smallest sizes can have one performance ratio emphasized over another, and the larger sizes can have the emphasis reversed. In particular, the smallest screws optimize the combination of their strength and cannula size with the larger screws optimizing the combination of their strength and thread depth. In any event, each of the screws in the set has an optimized combination of strength, cannula size and thread depth throughout the full range of screw sizes in the set, e.g. 3.0 mm to 7.5 mm major diameters.

Abstract: A coupling device for securing an elongate member to the spine is provided. The coupling device comprises a compressible inner member that secures an anchor member therein when the inner member is axially shifted within an outer member. Structures are provided to prevent disassembly of the anchor and coupling device prior to locking of the elongate member.

Abstract: The present invention is directed to a stabilized bioactive hydrogel matrix coating for substrates, such as medical devices. The invention provides a coated substrate comprising a substrate having a surface, and a bioactive hydrogel matrix layer overlying the surface of the medical device, the hydrogel matrix comprising a first high molecular weight component and a second high molecular weight component, the first and second high molecular weight components each being selected from the group consisting of polyglycans and polypeptides, wherein at least one of the first and second high molecular weight components is immobilized (e.g., by covalent cross-linking) to the surface of the substrate.

Abstract: An implant device includes a pair of hook devices and an elongate guide device. The hook devices are configured to be disposed between and engage adjacent vertebral bodies. The elongate guide device is connected to the hook devices and allows for relative movement of at least one of the hook devices to adjust for the geometries of the vertebral surfaces to be engaged by the hook devices.