Abstract: A segmented intervertebral body fusion support includes a plurality of segments, the segments including an initial segment, a final segment and at least one intermediate segment. The intermediate segment has a generally trapezoidal configuration and the initial and final segments include tapered side walls providing triangular gaps between adjacent segments. A draw wire is fixed to the first segment and passes through the remaining segments. By pulling the draw wire relative to the segments, the segments are drawn together in a generally arcuate configuration. The draw wire includes an enlargement that passes through the final segment and engages a plurality of fingers on the final segment, which prevents the draw wire from retracting, maintaining the arcuate configuration. The segmented device can be inserted through a laparoscopic device into the intervertebral space and can be subsequently drawn into the arcuate configuration to establish the desired intervertebral spacing.

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. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members 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.

Abstract: Embodiments of the present invention provide a spinal implant system and method. One embodiment of the present invention includes a spinal implant comprising, a first implant plate, a second implant plate, a spacer member coupled between the first implant plate and the second implant plate and an end plate coupled to the spacer member, the end plate configured to couple to adjacent vertebrae. The implant plates can include spacer channels that receive the spacer member and insertion tool channels that receive an insertion tool. Preferably, on each implant plate, the spacer channel is near the center of the plate and the insertion tool channels are on either side of the spacer channel. The spacer channels and insertion tool channels can be dovetailed or otherwise shaped to capture a portion of the spacer member and insertion tool. Mating connectors can prevent removal of the spacer member from the spacer channels.

Abstract: A composite interbody vertebral implant for facilitating fusion of adjacent vertebrae. The implant includes a first endplate of a porous metal material and a second endplate of a porous metal material which are configured to allow bone in-growth. The implant also includes a polymeric body positioned between and bonded to the first and second endplates such that polymeric material of the polymeric body is impregnated into pores of the first and second endplates to bond the components together. The implant may include a cavity extending through the composite implant configured to receive bone growth material to facilitate fusion between a first vertebra and a second vertebra.

Abstract: A system for installing a vertebral stabilization system. The system includes an installation tool including a handle portion and a shaft extending distally from the handle portion. The shaft includes a conduit and a staple mechanism. The system also includes a flexible implant member extending along the conduit configured to be advanced out from a distal end of the shaft, and a staple housed in the staple mechanism. The staple is configured to secure the flexible implant member to a vertebra. The handle portion is configured to selectively advance the flexible implant member from the shaft and to selectively actuate the staple mechanism.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which the head portion is passable through the lower opening of the retainer.

Abstract: Spinal fixation systems may be installed utilizing instruments and techniques alone or in combination with selectively attached extension members mounted on vertebral anchors to extend percutaneously from the spine. The surgical procedures associated with this invention involve making small, discrete incisions for the placement of select vertebral anchors. The extension members retract soft tissue, muscle and the like to thereby provide visibility and access to the head of the anchor. Instrumentation is utilized to deliver and install components such as a spine rod, set screw and other required hardware to the anchors. Once a spine rod or other components are secured to the pedicle screws, the instrumentation and extension members are removed from the patient.

Abstract: An interbody vertebral implant for facilitating fusion of adjacent vertebrae. The implant includes a first end plate, a second end plate, and an intermediate member disposed therebetween. The end plates are configured to allow bone in-growth. The intermediate member may include features to engage the end plates and to prevent over insertion of the intermediate member within the end plates. The implant may include a cavity extending through the composite implant configured to receive bone growth material to facilitate fusion between a first vertebra and a second vertebra.

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: A composite interbody vertebral implant for facilitating fusion of adjacent vertebrae. The implant includes a first endplate of a porous metal material and a second endplate of a porous metal material which are configured to allow bone in-growth. The implant also includes a polymeric body positioned between and bonded to the first and second endplates such that polymeric material of the polymeric body is impregnated into pores of the first and second endplates to bond the components together. The implant may include a cavity extending through the composite implant configured to receive bone growth material to facilitate fusion between a first vertebra and a second vertebra.

Abstract: A system for the treatment of a spine generally comprises an implant and an attachment device for securing the implant to a portion of a patient's bone. A first portion of the attachment device is sized for insertion into a hole in the bone, and a second portion of the attachment device is configured to be received in an opening of the implant. The first portion comprises a biocompatible material defined by a network of interconnected pores configured promote bone growth into the first portion.

Abstract: An interbody vertebral implant for facilitating fusion of adjacent vertebrae. The implant includes a first end plate, a second end plate, and an intermediate member disposed therebetween. The end plates are configured to allow bone in-growth. The intermediate member may include features to engage the end plates and to prevent over insertion of the intermediate member within the end plates. The implant may include a cavity extending through the composite implant configured to receive bone growth material to facilitate fusion between a first vertebra and a second vertebra.

Abstract: A surgical access system for accessing a surgical target site within a spine includes a retractor and an elongated element. The refractor has a closed configuration defining a lumen with an internal circumference, and an open configuration in which the internal circumference, at least at the distal end of the retractor, is enlarged relative to said closed configuration. The open configuration creates and maintains an operative corridor to said target site. The elongated element is releasably coupled to an interior wall of the retractor and has an extension extending distal of the distal end of the retractor into the surgical target site. When coupled to the retractor, the elongated element covers a body structure at the target site without blocking access to the operative corridor.

Abstract: A cannula (10) receives surgical instruments (120) for performing a surgical procedure on a body (130). The cannula (10) comprises a tube structure (12) defining a passage (16) through which the surgical instruments (120) are inserted into the body (130). The tube structure (12) has a proximal end (20) and a distal end (62). The tube structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16) at the distal end (62). The expandable portion (40) of the tube structure (12), when expanded, has a conical configuration.

Abstract: Systems and methods for implanting a spinal implant in a spinal column are disclosed. In one example, an illustrative system may include a delivery device including a proximal end region and a distal end region, a spinal implant releasably coupled to the distal end region of the delivery device, and a sleeve disposed about the spinal implant and at least a portion of the delivery device. In some cases, a distal portion of the sleeve may include a predetermined weakened region that may be configured to separate when a force is applied to the weakened region, which in some cases, may be applied with a pull string. In another example, a distal portion of the sleeve may be reverse folded upon itself such that the retractable sleeve rolls off of the spinal implant when the retractable sleeve is retracted.

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 method of interconnecting first and second longitudinal members extending along a spinal column of a patient includes inserting an access port into the body of the patient. A transverse connector is moved through the access port. A first end of the transverse connector is connected to the first longitudinal member. A second end of the transverse connector is connected to the second longitudinal member.

Abstract: A device for provides access to a surgical location within a patient. The device has an elongate body that has a proximal portion, a distal portion, a first slot segment, and a second slot segment that is angled relative to said first slot segment. The elongate body defines a passage for accessing the surgical location with surgical instruments. The elongate body has a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location. The cross-sectional area of the passage at a first location of the elongate body is greater than the cross-sectional area of said passage at a second location of the elongate body. A movable tab is configured to extend into the second slot segment when the elongate body is in the expanded configuration to retain the elongate body in the expanded configuration.

Abstract: The insertion points for guide pins used in percutaneous vertebral fixation by pedicle screw are determined by establishing an approach path on a CT image, measuring on the CT image the distance from the intersection of the approach path and the skin of the patient's back to the patient's midline, and marking off the corresponding distance while visualizing the patient by anteroposterior fluoroscopy. An longitudinally expansible pedicle screw comprises a shaft with bone-engaging threads on a distal portion, machine screw threads on a proximal portion, and a tubular extension having wrench-engageable holes on a proximal face, and internal threads engaging the machine screw threads on the proximal portion of the shaft. An oval cannula accommodates an arthroscope and forceps simultaneously for intervertebral disc surgery.