Abstract: A system for reduction of vertebral bodies (or vertebrae) in various embodiments includes a reducer, and extender, and a hollow tube. The reducer couples to the extender, which in turn couples to an elongated member, such as a rod, and to a bone fastener assembly. The reducer allows reduction of the vertebral body incrementally, and by a desired amount. The reducer may include or may be used in conjunction with a holding device or holder in order to hold or keep the amount of reduction constant or steady once the desired amount of reduction has been obtained. The reducer may use one of several embodiments, including embodiments that use threaded assemblies or members, inclining members or wedges, offset cams, scissor jacks, and/or levers.

Abstract: An occipital plate may include a central section, a pair of angled sections, and attachment assemblies comprising slide members configured to move along slots in the angled sections, and posts coupled to the slide members. Each post has a first and second cross dimensions. The first cross dimension of each post is less than a first cross dimension of a slide member. The second cross dimension of each post is approximately equal to a second cross dimension of a slide member. Rods may be coupled to the occipital plate at a variety of angles with respect to a midline of the plate. The angular adjustability may accommodate any misalignments in the rods. Further, the position of the attachment assemblies relative to the midline is adjustable to thereby provide for medial-lateral adjustability when attaching the rods to the occipital plate as part of an occipito-cervico-thoracic construct.

Abstract: A spinal stabilization system including an insert positionable in the channel of the housing of a poly-axial pedicle screw which allows for locking the housing of the poly-axial pedicle screw from pivotal movement through a clamping force generated by rotational engagement of a fastener with the housing while clamping a cord of a support construct in the housing of the poly-axial pedicle screw through direct contact of the fastener against the cord.

Abstract: A vertebral fixing system having a flexible elongated member, a connecting part, and an anchor, where the anchor may engage a bone structure (e.g., a vertebra) through an opening of the connecting part and the flexible elongated member may connect to the connecting part. In some cases, the vertebral fixing system may include a tightening part configured to apply a tension to the elongated member and/or secure the elongated member with respect to the connecting part. The vertebral fixing system may be configured to receive a rod and may be capable of connecting thereto. The connecting part may have a plurality of connecting members, where at least one of the connecting members includes an opening for receiving the anchor and at least one of the connecting members connects to the elongated member.

Abstract: A transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system. The transverse connector includes a first coupling assembly proximate a first end, a second coupling assembly proximate a second end, a first fastener having external threading configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor, and a second fastener having external threading configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper surface, such as a spherically concave upper surface. A spherical surface of each of the first and second coupling assemblies mates with the spherical upper surface of the respective fastener to provide multi-axial rotation of the transverse connector relative to the housings to permit a desired orientation of the transverse connector.

Abstract: A polyaxial bone anchor including a housing and a bone screw. A bottom surface of the housing includes an aperture that defines an angulation limit of the bone screw for each azimuthal angle around a longitudinal axis of the housing. The aperture is V-shaped, with the V-shape having converging side walls that define a low-angulation direction near their intersection and a high-angulation direction opposite the low-angulation direction. In some cases, the angulation limit of the bone screw is generally constant over a range of azimuthal angles centered around the high-angulation direction. The housing may be modular, including tabs on one component that are plastically deformed to engage a lip on another component. During assembly, a mandrel advances longitudinally along a bore in the housing, and forces the tabs radially outward toward the lip to a radially outward plastically deformed state.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

Abstract: A spinal stabilization system may include a pair of structural members coupled to at least a portion of a human vertebra with connectors. Connectors may couple structural members to spinous processes. Some embodiments of a spinal stabilization system may include fasteners that couple structural members to vertebrae. In some embodiments, a spinal stabilization system, provides three points of fixation for a single vertebral level. A fastener may fixate a facet joint between adjacent vertebrae and couple a stabilization structural member to a vertebra. Connectors may couple the structural members to the spinous processes of the vertebrae. Use of a spinal stabilization system may improve the stability of a weakened or damaged portion of a spine. When used in conjunction with an implant or other device, the spinal stabilization system may immobilize vertebrae and allow for fusion of the implant or other device with vertebrae.

Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60).

Abstract: A polyaxial bone anchor including a housing and a bone screw. A bottom surface of the housing includes an aperture that defines an angulation limit of the bone screw for each azimuthal angle around a longitudinal axis of the housing. The aperture is V-shaped, with the V-shape having converging side walls that define a low-angulation direction near their intersection and a high-angulation direction opposite the low-angulation direction. In some cases, the angulation limit of the bone screw is generally constant over a range of azimuthal angles centered around the high-angulation direction. The housing may be modular, including tabs on one component that are plastically deformed to engage a lip on another component. During assembly, a mandrel advances longitudinally along a bore in the housing, and forces the tabs radially outward toward the lip to a radially outward plastically deformed state.

Abstract: A system for reduction of vertebral bodies (or vertebrae) in various embodiments includes a reducer, and extender, and a hollow tube. The reducer couples to the extender, which in turn couples to an elongated member, such as a rod, and to a bone fastener assembly. The reducer allows reduction of the vertebral body incrementally, and by a desired amount. The reducer may include or may be used in conjunction with a holding device or holder in order to hold or keep the amount of reduction constant or steady once the desired amount of reduction has been obtained. The reducer may use one of several embodiments, including embodiments that use threaded assemblies or members, inclining members or wedges, offset cams, scissor jacks, and/or levers.

Abstract: A transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system. The transverse connector includes a first coupling assembly proximate a first end, a second coupling assembly proximate a second end, a first fastener having external threading configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor, and a second fastener having external threading configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper surface, such as a spherically concave upper surface. A spherical surface of each of the first and second coupling assemblies mates with the spherical upper surface of the respective fastener to provide multi-axial rotation of the transverse connector relative to the housings to permit a desired orientation of the transverse connector.

Abstract: Spinal stabilization devices for addressing back pain originating in the facet joints and the spinous processes of the vertebrae. One embodiment of the present invention includes a substantially T-shaped facet implant for insertion between the facets of two successive vertebrae after a desired amount of the articulating surfaces have been resected. The long and flat portion of the T-shaped facet implant is inserted in between the facets and then the wings of the T-shape, also called fixation tabs, are secured to the spine to secure the facet implant into place. The T-shape implant may also be a part of a spinal stabilization system that includes a facet implant, a spinous process spacer, and a flexible connecting member securing the same.

Abstract: A bone anchoring device including a clamping device and a flexible band configured to be secured a vertebra. The clamping device includes a base member and an upper member configured to be secured together with a fastener. The flexible band is configured to be passed around a bone portion and through a passage of the base member to position the flexible band between a clamping surface of the base member and a clamping surface of the upper member. The flexible band is tensioned to urge the clamping device against the bone portion and then clamped between the clamping surfaces of the base member and the upper member. A stabilization member of a vertebral stabilization construct may be secured to the vertebra with the bone anchoring device without invasively altering or impairing the structural integrity of the vertebra.

Abstract: A system and associated method are provided for mechanically fixating a region of a skull to a portion of a spine. A plate is provided to contact a region of a skull and be secured thereto. A spinal rod is configured to extend from a location adjacent the plate to a location adjacent at least one vertebra. An adjustable housing is provided to secure the rod to the plate, and has a first position wherein the relative position of the rod to the plate can be adjusted and a second position wherein the relative position of the rod to the plate is secured.

Abstract: A method of thermally treating tissue during a surgical procedure where a surgical access device, including a body member having walls with at least one conduit therein, is inserted into the patient. A chilled fluid is circulated through the at least one conduit such that the tissue that is located proximate the body member is cooled. Alternatively, the body member may be constructed from a highly thermally conductive material such that heat energy is transmitted through the body from the tissue located proximate the body member and into a heat sink. The surgical device may include a first or second blade portions constructed from an inner and an outer shell having walls. Ribs located on the inner shell sealingly coupled to the inner wall of the outer shell to create the at least one conduit within the walls of the blade portion.

Abstract: A spinal implant for stabilizing first and second vertebrae. The spinal implant includes an intervertebral spacer and a bone stabilization member configured to be coupled to the intervertebral spacer. The bone stabilization member includes a plurality of bone screw openings and a plurality of bone screws extendable through the bone screw openings to secure the bone stabilization member to the vertebrae. A retention member, which is slidably coupled to the bone stabilization member, is linearly slidable between a first position and a second position while coupled to the bone stabilization member. In the first position, each of the bone screws is permitted to be inserted into the bone screw openings, and in the second position the retention member at least partially covers each of the bone screw openings to prevent a bone screw from backing out of the respective bone screw opening.

Abstract: One embodiment provides a bone fastener including a collar, a fastener member, and a pin. The collar can have an upper portion with slot to receive an elongated member and a lower portion with a socket and an opening. The fastener member can have head and shank portions. The socket can receive the head portion and prevent movement of the head portion through the opening when the head portion is out of registration with the opening. The head portion and the socket can be configured to allow angulation of the fastener member within a defined range of motion within a selected plane. The head portion and the socket can define apertures which can be aligned with each other when the head portion is in the socket and which can receive the pin. One embodiment provides a generally spherical head portion with a flat.

Abstract: A bone anchoring device including a clamping device and a flexible band configured to be secured a vertebra. The clamping device includes a base member and an upper member configured to be secured together with a fastener. The flexible band is configured to be passed around a bone portion and through a passage of the base member to position the flexible band between a clamping surface of the base member and a clamping surface of the upper member. The flexible band is tensioned to urge the clamping device against the bone portion and then clamped between the clamping surfaces of the base member and the upper member. A stabilization member of a vertebral stabilization construct may be secured to the vertebra with the bone anchoring device without invasively altering or impairing the structural integrity of the vertebra.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.