Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: Disclosed are embodiments of a removable tip device, which include a bone penetration feature at a distal end and a securing feature that allows the removable tip device to be removably secured to a distal end of various embodiments of a bone coring device. Some embodiments of the removable tip device include features that assist in transmitting torsional loads from the bone coring device to the bone removal feature. In addition, some embodiments of the removable tip device include a protective element that is configured to provide a protective surface for a distal feature of the bone coring device.

Abstract: An anchor device for attaching materials within bone including a body having a distal end region, a proximal end region, and a plurality of struts extending between the distal end region to the proximal end region and at least partially surrounding an interior volume of the body. The anchor device includes an attachment feature positioned within the interior volume of the body and coupled near the distal end region. The attachment feature is configured to secure material to the body. Upon removal of a constraint and after delivery of the anchor device into bone, the body passively transitions from a constrained, delivery configuration that is radially contracted and axially elongated to a relaxed, deployment configuration that is radially expanded and axially shortened.

Abstract: Provided are devices, systems and methods related to articulating interbody cages. The device includes a caudal plate configured to be positioned adjacent a first vertebral endplate within an intervertebral disc space, a cephalad plate configured to be positioned adjacent a second vertebral endplate within the intervertebral disc space; and a first and second sidewall each rotatably coupled to both the caudal and cephalad plates. At least one of the first and second sidewalls includes a hinge element restricted from achieving an on-center or over-center rotational position around the hinge element upon dimensional expansion of the device in at least a first dimension.

Abstract: Disclosed are embodiments of a removable tip device, which include a bone penetration feature at a distal end and a securing feature that allows the removable tip device to be removably secured to a distal end of various embodiments of a bone coring device. Some embodiments of the removable tip device include features that assist in transmitting torsional loads from the bone coring device to the bone removal feature. In addition, some embodiments of the removable tip device include a protective element that is configured to provide a protective surface for a distal feature of the bone coring device.

Abstract: Disclosed herein are devices (100), systems and methods of use relating to articulating interbody cages. In one aspect, disclosed is an intervertebral device (100) for use in a human spine including an anterior end (104); a posterior end (102); and at least four peripheral walls (22,24,26). The peripheral walls (26) define an interior volume surrounding a midline of the device and include a superior wall (22), an inferior wall (24) and a pair of opposing, generally trapezoidal-shaped sidewalls. Each of the trapezoidal-shaped sidewalls (26) includes an internal hinge element (60) that is rotatable from a first configuration to at least a second configuration such that the device is expandable in first dimension. Each of the internal hinge elements includes an axis that is coplanar with the midline of the device.

Abstract: Disclosed is a bone coring device having a handle including a first handle component and a second handle component. The first handle component is rotatably coupled to the second handle component. The device also includes a coring assembly mechanically coupled to the handle. The coring assembly includes an elongated outer cutting member having an internal bore and distal edge adapted to cut through cancellous bone. The coring assembly also includes an elongated inner member slidably positioned within the internal bore of the outer cutting member. Rotatable movement of the first handle component relative to the second handle component causes relative, linear movement between the elongated outer cutting member and the inner member to facilitate coring of a sample of bone when the coring assembly is positioned within the bone.

Abstract: Apparatus and methods for accessing an inferior vertebra, a superior vertebra, and a disc space therebetween via a transpedicular approach in the inferior vertebra that may include creating a channel normal to the pedicle and using an offset guide to create a second transpedicular channel at an angle to the first, normal pedicle channel where the second transpedicular channel passes into the inferior vertebra, superior vertebra, or the disc space therebetween.

Abstract: This disclosure is directed to minimally-invasive devices, methods and systems used through small access portals to minimize trauma to structures adjacent the treatment site. The access device includes a guide frame and a cannula support washer movebly coupled to the guide frame. The washer has a cannula port aperture extending therethrough and a surface geometry complementary to the surface geometry of the guide frame. The complementary surface geometries limit movement of the cannula port aperture to arcuate movement along a surface segment of a sphere.

Abstract: Disclosed herein are devices (100), systems and methods of use relating to articulating interbody cages. In one aspect, disclosed is an intervertebral device (100) for use in a human spine including an anterior end (104); a posterior end (102); and at least four peripheral walls (22,24,26). The peripheral walls (26) define an interior volume surrounding a midline of the device and include a superior wall (22), an inferior wall (24) and a pair of opposing, generally trapezoidal-shaped sidewalls. Each of the trapezoidal-shaped sidewalls (26) includes an internal hinge element (60) that is rotatable from a first configuration to at least a second configuration such that the device is expandable in first dimension. Each of the internal hinge elements includes an axis that is coplanar with the midline of the device.

Abstract: Disclosed is a spinal stabilization device having a plurality of elongate arms having a distal end portion and a proximal end portion, wherein the elongate arms define an interior volume between the distal end portion and the proximal end portion; at least one limit band coupled circumferentially to one or more of the plurality of elongate arms; and a tensioning element positioned within the interior volume. The plurality of elongate arms can transition from a constrained, delivery configuration that is radially contracted and axially elongated to a relaxed, deployment configuration that is radially expanded and axially shortened.

Abstract: Disclosed is a spinal transconnector device for coupling longitudinal spinal rods on either side of the mid-sagittal plane. The device includes two interconnected rod engagement elements, a first rod engagement elements having a vaulted surface adapted to secure to a first longitudinal spinal rod via an interference fit comprising compression of the first longitudinal spinal rod against the generally vaulted surface; and an interference pin that advances into a bore of the first rod engagement element forming an interference fit between the interference pin and the rod engagement element. The interference fit can be associated with elastic deformation of the first rod engagement element occurring as a consequence of the interference pin being advanced through the bore in the engagement element and contacting a surface of the first longitudinal spinal rod.

Abstract: Disclosed are devices, methods and systems for manipulating a pedicle screw assembly and for inserting and reducing a rod relative to the pedicle screw assembly. The system can include a cannula assembly having a reduction cannula with an internal bore extending between a proximal region and a distal region and an insertion cannula co-axially positioned within the internal bore of the reduction cannula. The insertion cannula includes a pair of opposed prongs extending distally from a distal region of the insertion cannula, wherein each prong is interposed between a pair of flexible projecting elements. The pair of opposed prongs of the insertion cannula and the distal region of the reduction cannula are aligned to collectively define an opening that is sized and shaped for receiving a spinal rod. The device also can include an annular collar mounted on the proximal region of the reduction cannula and rotatably coupled to a proximal region of the insertion cannula.

Abstract: This disclosure is directed to minimally-invasive devices, methods and systems for treating vertebral diseases and injuries using multiple therapeutic procedures through small access portals of sufficient dimension that minimize trauma to the patient. More particularly, disclosed herein are devices, methods and systems for an intraosseous transiliac-transsacral surgical approach through the iliac ala and sacral ala that can be used for a variety of surgical procedures within the lumbar spine.

Abstract: Disclosed is a spinal transconnector device for coupling longitudinal spinal rods on either side of the mid-sagittal plane. The device includes two interconnected rod engagement elements, a first rod engagement elements having a vaulted surface adapted to secure to a first longitudinal spinal rod via an interference fit comprising compression of the first longitudinal spinal rod against the generally vaulted surface; and an interference pin that advances into a bore of the first rod engagement element forming an interference fit between the interference pin and the rod engagement element. The interference fit can be associated with elastic deformation of the first rod engagement element occurring as a consequence of the interference pin being advanced through the bore in the engagement element and contacting a surface of the first longitudinal spinal rod.

Abstract: An apparatus and a method for guiding the placement of an object to a desired location based on an image generated by an image intensifier where the apparatus includes a first coupling mechanism that is configured to be releasably attachable to one of the transmitter and receiver of the image intensifier and a second coupling mechanism that is coupled to the first coupling mechanism and includes an object holding mechanism, the object holding mechanism is configured to releasably hold the object and where at least a portion of the second coupling mechanism is visible in the image generated by the image intensifier when the apparatus is attached to the image intensifier.

Abstract: Apparatus and methods for accessing an inferior vertebra, a superior vertebra, and a disc space therebetween via a transpedicular approach in the inferior vertebra that may include creating a channel normal to the pedicle and using an offset guide to create a second transpedicular channel at an angle to the first, normal pedicle channel where the second transpedicular channel passes into the inferior vertebra, superior vertebra, or the disc space therebetween.

Abstract: Apparatus and methods for distracting or compressing distance between a first and second boney structure and for engaging a connecting element.

Abstract: A pedicle screw assembly (10) that includes a cannulated pedicle screw (20) having a scalloped shank (24), a swivel top head 30 having inclined female threads (44) in a left and right arm (34, 36) to prevent splaying, a set screw (50) having mating male threads 52, a rod conforming washer (60) that is rotatably coupled to the set screw (50), the conforming washer including reduced ends to induce a coupled rod (80) to bend. A rod reduction system including an inner and an outer cannula (90, 100), the inner cannula (90) including a left and right arm (92, 94) that engage the swivel top head's (30) left and right arm (34, 36) and the outer cannula (100) dimensioned to securely slide over the inner cannula (90) to reduce the rod (80) into the swivel top head's (30) rod receiving area (38).