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: The present invention relates to spinal support devices and, more specifically, to a flexible member having variable flexibility for use with a dynamic stabilization system or implant to provide dynamic stability to a person's spine. The flexible member generally includes a first material having a first portion including a first material having a first elasticity and a second portion including a second material having a second elasticity greater than the first to provide the flexible member with a variable flexibility.

Abstract: A subcutaneously formed in place orthopedic fixation device is provided, such as for fixation of the spine or other bone or bones. The device comprises an inflatable member, such as a tubular balloon. The balloon is positioned at a treatment site in the body while in a flexible, low crossing profile configuration. The balloon is thereafter inflated with a hardenable epoxy media comprising one or more epoxy compounds and one or more amine curing compounds that cures rapidly in place with low to moderate exotherm. Methods and delivery structures are also disclosed.

Abstract: A combination of bone fixation device and bending tool. The bone fixation device comprising a plurality of screw receiving members. Each screw receiving member having an aperture extending there through for receiving a screw. The screw receiving members being connected together in a line by plastically deformable connecting arms extending therebetween. The bending tool comprising first and second bending arms. Each bending arm comprising a first face, a second face and a side wall extending therebetween. The side wall comprising a recess extending between the first and second faces. The intersection of the recess with the first and second faces defining first and second connecting arm receiving apertures respectively. The recess being adapted to receive a screw receiving member.

Abstract: A spinal connector includes a first seat having a first opening for coupling to a first spinal connecting member along a first longitudinal axis and a second seat having a second opening for coupling to a second spinal connecting member along a second longitudinal axis. The second longitudinal axis is substantially coaxial to the first longitudinal axis for connecting the first and second connecting members end to end. The spinal connector also includes a ball enclosure rotatably received in the second opening of the second seat. The ball enclosure defines a bore along the second longitudinal axis and articulates with the second opening for allowing change of orientation of the second connecting member relative to the first connecting member.

Abstract: Embodiments of the invention comprise a medical implant that delivers a therapeutic substance. In some embodiments, a component that carries a therapeutic substance is a tie secured to all or a portion of a surgical construct, surgical screw, pedicle screw, spinal rod cross-link, other element or device, or an anatomical structure.

Abstract: Some embodiments of the invention provide an apparatus that (1) delivers a fusion member between two vertebral bodies after at least a portion of the fibrocartilaginous disc between the vertebral bodies has been removed, and (2) affixes the fusion member to the vertebral bodies. In some embodiments, the apparatus includes (1) a fusion member that is delivered and positioned between the vertebral bodies, (2) a delivery mechanism that delivers and positions the fusion member between the vertebral bodies, and (3) an anchoring member that affixes the fusion member to the vertebral bodies.

Abstract: The immobilization device for a connecting rod (2) in an osseous anchoring element (3) of a rachidian implant (4) comprises an osseous anchoring implant (3) comprising retaining means (14, 15) adapted to deform elastically under a pressure force F and a blocking element (5) comprising on the one hand lugs (33, 34) which coact with the retaining means (14, 15) to permit the securement of the blocking element (5) on the osseous anchoring element (3), and on the other hand, a tightening screw (31) permitting immobilizing in rotation and in translation the connecting rod (2) between the osseous anchoring element (3) and the blocking element (5).

Abstract: Total disc replacement systems and related methods involving a lateral, trans-psoas surgical approach to the spine while performing at least one of continuous and intermittent intra-operative neural monitoring of the psoas muscle to avoid injury during introduction.

Abstract: A stand-alone interbody fixation system having a cage, anterior fixation blade and posterior fixation blade. The cage includes an annular side wall with an open interior and upper and lower surfaces, the cage being configured to fit between end plates of adjacent vertebrae. The anterior fixation blade includes an anterior alignment boss with two opposing outward extending anterior blades with end plate penetrating tips configured to fit within the open interior of the cage. The posterior fixation blade includes a posterior alignment boss with two opposing outward extending posterior blades with end plate penetrating tips configured to fit within the open interior of the cage. The anterior alignment boss and posterior alignment boss being rotatably coupled to each other and with a first opening and a second opening in the annular side wall opposite the first opening.

Abstract: A surgical access apparatus includes a liner base and an access housing for positioning outside the body. The liner base includes an inner member adapted for insertion through an opening within body tissue for positioning within the body; a sleeve member connected to the inner member and dimensioned to extend from the inner member through the opening within the body tissue, and a plurality of tensioning elements connected to the inner member and associated with the sleeve member to impart a tensioning effect on the sleeve member. The access housing includes a first element and a second element. The second element is operatively connected to the tensioning elements and adapted for rotational movement relative to the first member to cause the tensioning elements to displace the inner member toward the access housing and to cause the sleeve member to engage and retract tissue defining the opening within the body.

Abstract: A spinal stabilization system including a cord extendable between first, second and third vertebral anchors. A first length of the cord includes a first set of intermingled filaments, and a second length of the cord includes a second set of intermingled filaments. The first set of intermingled filaments includes a first subset of filaments and a second subset of filaments, and the second set of intermingled filaments includes the first subset of filaments of the first set of intermingled filaments and a third subset of filaments different from the second subset of filaments of the first set of intermingled filaments. When secured to the first, second and third vertebral anchors, a first portion of the cord may be tensioned a first amount and a second portion of the cord may be tensioned a second amount different from the first amount.

Abstract: A spinal intervertebral support implant, for fusion or for dynamic stabilization purposes. A rod, preferably in the form of a screw, is inserted obliquely from the pedicle of an inferior vertebra into the body of a neighboring superior vertebra, through the disc space. The rod can be anchored into the body of the superior vertebra by means of a force fit or a screw thread. A pile of elements is disposed on the rod in the disc space like a pile of washers, so that the compression load between vertebrae is carried partly by these elements. These elements can be inserted through the bore through which the rod was inserted in a tightly folded configuration, and deployed into their washer-like form only when in position in the intervertebral space, such that there is no need for any additional incisions.

Abstract: Apparatus (20, 120, 300) and methods for use in the performance of minimally invasive orthopedic procedures, including apparatus and methods for use in the performance of such procedures under the visualization of an endoscope (22), are herein disclosed. Such procedures include a minimally invasive intramedullary nailing procedure, a minimally invasive bone graft harvesting procedure, a minimally invasive pelvic osteotomy procedure, an orthopedic implant revision procedure, and a minimally invasive percutaneous bone plating procedure.

Abstract: A method of removing bone material including the steps of drivingly connecting a bone removal tool to an output shaft; and rotating a plurality of drive shafts in an open frame, one of the plurality of drive shafts being connected to the output shaft.

Abstract: An intramedullary fixation assembly for bone fusion includes a first member positioned at a proximal end of the intramedullary fixation assembly, and a second member positioned at a distal end of the intramedullary fixation assembly. The first member is slideably coupled to the second member and provides for an interference fit with the second member. The intramedullary fixation assembly includes an optional cannulated threaded screw member having a plurality of threads on an external surface of the threaded screw member.

Abstract: A device is disclosed for insertion in the human or animal body in order to increase the spacing between adjacent spinous processes of the spinal column. The device comprises a plurality of shaped members which are pivotally joined to each other and arranged around a central screwed rod which is supported by a collar at one end and a threaded collar at the opposite end said collar and collar being located within the pivoting axis of the adjacent members forming each end of the device. Following insertion in the body and positioning between adjacent spinous processes the device may be deployed by rotation of the central screwed rod in order to achieve the desired separation of adjacent spinous processes while at the same time providing a secure location of the device in the deployed condition.

Abstract: An accessory device for an external orthopedic fixator where the fixator has an external frame made up of frame components which surround the lower leg and ankle of a patient with one or more transfixation wires fixed thereto. The accessory device includes a walking plate which connects to one of the fixator frame components for supporting the sole of a patient's foot. The accessory device also includes a companion shroud which is wrapped about the fixator with the fixator being received within the interior of the shroud. The shroud has a width and height which are sufficient to conceal the fixator within the shroud interior. The shroud has fasteners which allow it to be easily installed and removed from about the fixator.

Abstract: The present invention relates to an instrument for tensioning a flexible tie (14) used for fastening an implant on a bony element of a patient by forming a first loop around the bony element. Said instrument comprises: a rod (42) having a first end provided with bearing means (44) for bearing against said implant; a moving part (46) that is movable in translation and that surrounds said rod (42) over a fraction of its length, said moving part including holder means (50) for holding the end of said tie; and control means (52) mounted on said moving part (46) to cause the moving part to move relative to said rod, thereby tending to move the first end (42a) of the rod away from said moving part, thereby exerting tension on said tie relative to said implant.

Abstract: An intervertebral implant for separating an upper vertebra and a lower vertebra. The implant includes an upper mount having a first surface sized and shaped for mounting on the upper vertebra and a second surface opposite the first surface. The implant includes a lower mount having a first surface sized and shaped for mounting on the lower vertebra and a second surface opposite the first surface. The implant includes an element positioned between the upper mount and the lower mount spacing the first surface of the upper mount from the first surface of the lower mount by a predetermined distance. The element is configured to permit the upper mount to pivot relative to the lower mount. The element allows the upper vertebra to pivot relative to the lower vertebra while maintaining spacing between the upper vertebra and the lower vertebra.