Abstract: Methods for correcting a deformit in the spine by forming a trans-sacral axial instrumentation/fusion axial bore through vertebral bodies in general alignment with a visualized, anterior axial instrumentation/fusion line in a minimally invasive, low trauma, manner and providing a therapy to the spine employing the axial bore. Curved or relatively straight anterior axial bores are formed from the anterior starting positions. The therapies performed through the axial bores include discoscopy, full and partial discectomy, vertebroplasty, balloon-assisted vertebroplasty, drug delivery, electrical stimulation and various forms of spinal disc cavity augmentation, spinal disc replacement, fusion of spinal motion segments and implantation of radioactive seeds. Axial spinal implants and bone growth materials can be placed into single or multiple parallel or diverging TASIF axial bores to fuse two or more vertebrae, or distract or shock absorb two or more vertebrae.

Abstract: Disclosed are methods and apparatus for the provision of spinal therapy to three or more adjacent motion segments accessed through a trans-sacral approach. The spinal therapies include fusion and dynamic stabilization with and without a distraction of the most cephalad motion segment of the two or more adjacent motion segments provided therapy. The disclosure includes methods and apparatus to impart a distraction on a second more caudal motion segment after providing therapy to the more cephalad motion segment.

Abstract: Multi-membrane prosthetic nucleus and implants using same are disclosed having an outermost membrane that is semi-compliant and limits the innermost membrane and any intermediate membranes that are highly compliant from bulging out of any opening in the annulus fibrosus. The outermost membrane may help protect the innermost membrane from trauma including any trauma before the innermost membrane is expanded through the injection of prosthetic nucleus material and trauma during the expansion of the innermost membrane in response to the injection of prosthetic nucleus material. Also disclosed is a coated membrane which combines the mechanical properties of the foundation layer with the low permeability to the passage of the flowable prosthetic material of the coating. This coated membrane is semi-compliant and prevents the prosthetic nucleus from bulging out of any openings in the annulus fibrosus. Use is made of injected prosthetic nucleus material that changes to a non-flowable state.

Abstract: Disclosed are methods and apparatus for the provision of spinal therapy to two or more adjacent motion segments accessed through a trans-sacral approach. The spinal therapies include fusion and dynamic stabilization with and without a distraction of the most cephalad motion segment of the two or more adjacent motion segments provided therapy. The disclosure includes methods and apparatus to impart a push distraction to increase the distance between two adjacent vertebrae. Related concepts for the extraction of previously inserted devices and the delivery and removal of plugs for plugging the interior cavities of implantable devices are disclosed.

Abstract: Methods for correcting a deformity in the spine by forming a trans-sacral axial instrumentation/fusion axial bore through vertebral bodies in general alignment with a visualized, anterior axial instrumentation/fusion line in a minimally invasive, low trauma, manner and providing a therapy to the spine employing the axial bore. Curved or relatively straight anterior axial bores are formed from the anterior starting positions. The therapies performed through the axial bores include discoscopy, full and partial discectomy, vertebroplasty, balloon-assisted vertebroplasty, drug delivery, electrical stimulation and various forms of spinal disc cavity augmentation, spinal disc replacement, fusion of spinal motion segments and implantation of radioactive seeds. Axial spinal implants and bone growth materials can be placed into single or multiple parallel or diverging axial bores to fuse two or more vertebrae, or distract or shock absorb two or more vertebrae.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: The invention provides an implantable spinal distraction/fusion rod with varied thread pitch and diameters along different portions of its length that it is capable of distracting two or more vertebral bodies relative to each other and/or facilitating the procedure of fusing the vertebral bodies together from within the spine. The present invention also provides for methods of using the rod to distract and/or fuse two or more vertebral bodies from within the spine.

Abstract: Methods for correcting a deformity in the spine by forming a trans-sacral axial instrumentation/fusion axial bore through vertebral bodies in general alignment with a visualized, anterior axial instrumentation/fusion line in a minimally invasive, low trauma, manner and providing a therapy to the spine employing the axial bore. Curved or relatively straight anterior axial bores are formed from the anterior starting positions. The therapies performed through the axial bores include discoscopy, full and partial discectomy, vertebroplasty, balloon-assisted vertebroplasty, drug delivery, electrical stimulation and various forms of spinal disc cavity augmentation, spinal disc replacement, fusion of spinal motion segments and implantation of radioactive seeds. Axial spinal implants and bone growth materials can be placed into single or multiple parallel or diverging axial bores to fuse two or more vertebrae, or distract or shock absorb two or more vertebrae.

Abstract: Disclosed are methods and apparatus for the provision of spinal therapy to two or more adjacent motion segments accessed through a trans-sacral approach. The spinal therapies include fusion and dynamic stabilization with and without a distraction of the most cephalad motion segment of the two or more adjacent motion segments provided therapy. The disclosure includes methods and apparatus to impart a push distraction to increase the distance between two adjacent vertebrae. Related concepts for the extraction of previously inserted devices and the delivery and removal of plugs for plugging the interior cavities of implantable devices are disclosed.

Abstract: Methods and apparatus for forming one or more trans-sacral axial instrumentation/fusion (TASIF) axial bore through vertebral bodies in general alignment with a visualized, anterior or posterior axial instrumentation/fusion line (AAIFL or PAIFL) in a minimally invasive, low trauma, manner and providing a therapy to the spine employing the axial bore. Anterior or posterior starting positions aligned with the AAIFL or PAIFL are accessed through respective anterior and posterior tracts. Curved or relatively straight anterior and curved posterior TASIF axial bores are formed from the anterior and posterior starting positions. The therapies performed through the TASIF axial bores include discoscopy, full and partial discectomy, vertebroplasty, balloon-assisted vertebroplasty, drug delivery, electrical stimulation and various forms of spinal disc cavity augmentation, spinal disc replacement, fusion of spinal motion segments and implantation of radioactive seeds.

Abstract: Multi-membrane prosthetic nucleus and implants using same are disclosed having an outermost membrane that is semi-compliant and limits the innermost membrane and any intermediate membranes that are highly compliant from bulging out of any opening in the annulus fibrosus. The outermost membrane may help protect the innermost membrane from trauma including any trauma before the innermost membrane is expanded through the injection of prosthetic nucleus material and trauma during the expansion of the innermost membrane in response to the injection of prosthetic nucleus material. Also disclosed is a coated membrane which combines the mechanical properties of the foundation layer with the low permeability to the passage of the flowable prosthetic material of the coating. This coated membrane is semi-compliant and prevents the prosthetic nucleus from bulging out of any openings in the annulus fibrosus. Use is made of injected prosthetic nucleus material that changes to a non-flowable state.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: A spinal implant with associated surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: A driver for delivering an insert to a bone anchor, the bone anchor having an internal cavity with a set of internal threads, the driver adapted to rotate with respect to a bone anchor that is anchored in a vertebral body in order to engage external threads on the insert with the set of internal threads in the bone anchor and axially advance the threadedly engaged insert within the bone anchor while simultaneously preventing the bone anchor from rotating with respect to the vertebral body the driver having: 1) a threaded retention rod for engaging a bore in the insert; 2) a driver head to engage with the insert to apply torque to the insert and rotate the insert; and 3) an anchor stabilizer to engage with a proximal face of the bone anchor to prevent the bone anchor from rotating with respect to the vertebral body.

Abstract: Methods and apparatus for providing percutaneous access to the presacral space in a minimally invasive, low trauma, manner. A number of related methods and surgical tool sets form a percutaneous pathway from an incision through the patient's skin adjacent to the coccyx and inserting an elongated guide assembly through the incision to locate the guide assembly against the anterior surface of the sacrum to access a presacral target point. The provision of the percutaneous pathway described herein allows for the introduction of therapeutic devices or media, diagnostic instruments, and/or drug delivery to the presacral space.

Abstract: Tools and methods for preparing an intervertebral disc space with an emphasis on abrading the vertebral endplates to promote controlled bleeding of the vertebral endplate without compromising the structural integrity of the vertebral endplate. The abrading process may be used to remove cartilage from the vertebral endplate if this remains to be done. Various mechanisms are discussed to either statically or dynamically alter blade angle of the cutter blade. Cutter blades may come in a variety of configurations including cutter blades with abrading heads for preparing endplates. Abrading heads may be used on upcutters or down cutters. Also disclosed is a cutter assembly adapted to resist unwanted changes in blade angle.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be avertebral motion segments in the lumbar and sacral regions of the spine. The tool set may a retraction device for retracting bowel from a sacrum. The device can induce a collapsible enclosure that defines a chamber. The collapsible enclosure can have a collapsed configuration and an expanded configuration. In some arrangements, the chamber is filled with an inflation media. The expanded configuration defines a working channel positioned between the sacrum and the bowel and extending over or through at least a portion of the device.

Abstract: Tools for use in the deployment of spinal implant assemblies such as spinal motion preservation assemblies adapted for use in a spinal motion segment are disclosed including the process for delivering and assembling the spinal motion preservation assemblies in the spinal motion segment via an axial channel created with a trans-sacral approach. The tools allow the deployment of a pair of spinal implant components that are not rigidly connected to one another to be driven into adjacent vertebral bodies. The tools further allow for distraction via either dissimilar thread pitch or by axially advancing a distraction tool based on a threaded engagement with a proximal component in a proximal vertebral body to impose an distraction between that vertebral body and an adjacent distal vertebral body. The tools also allow for the provision of flowable biomaterials such as prosthetic nucleus material. Delivery of flowable biomaterials can be performed while the vertebrae are being held apart by a distraction tool.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: A spinal mobility preservation apparatus and methods are disclosed. The spinal mobility preservation apparatus may include a proximal body, an intermediate body, a distal body, and an expandable membrane. The proximal body and the distal body secure the mobility preservation apparatus to adjacent vertebral bodies. At least one of an intermediate body and an expandable membrane secure the proximal body to the distal body and provide a degree of support to a spinal motion segment defined by the adjacent vertebral bodies. A single proximal body and an expandable membrane may also compose a spinal mobility preservation apparatus. The proximal body secured to one of a superior or an inferior vertebral body and the expandable membrane extending into the intervertebral disc space to support the spinal motion segment.