Abstract: A process for nucleotomy of an intervertebral disk to create a nuclear space and a method for replacing a nucleus pulposus of an intervertebral disk after a nucleotomy are provided. The methods position a nuclear implant between two overlying and underlying vertebrae of a spine segment in the form of one or more continuous wire arranged as a stack of helices inside the nuclear space.

Abstract: A clamping pin is provided for mounting in an opening of a medical device. The clamping pin comprises an axially extending screw, a first clamping element having a surface inclined to a longitudinal screw axis and provides a first part of a clamping section. A second clamping element has a surface inclined to the longitudinal axis and provides a second part of the clamping section which is complementary to the opening in the medical device. The inclined surfaces of the first and second clamping elements contact. A screw extends at least partly through both the first and second clamping elements. The screw engages one of the clamping elements such that the axial distance between the two clamping elements and the diameter of the clamping section that can come in contact with a surface of the opening in the medical device will be changed upon actuation of the screw.

Abstract: Methods and techniques for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.

Abstract: Described here are deformable, monolithic, stabilization devices, or implants, suitable for use within bone and between bones, for instance, to fuse vertebral bodies, to repair herniated discs, or to repair spinal compression fractures. The implants are introduced into a chosen site at a first, smaller height and then plastically deformed to achieve a second, but unique, pre-selected, larger height. Variations of the device provide one or more specific larger heights. The devices are particularly suitable as intervertebral spinal fusion implants for the immobilization of adjacent vertebral bodies. Methods of deploying the implants are also described as are instruments for such deployment. Also described are variations of the device particularly suitable as sizing instruments. These versions are elastic, i.e., not plastically deformable, and may be restored to their original size. Many of the described variations include deformable regions serving as hinges.

Abstract: Vertebral body replacement apparatuses, systems, and methods are provided. In various examples, an implantable device is configured to be inserted between a first vertebral body and a second vertebral body. The implantable device includes a first endplate configured to contact the first vertebral body. A second endplate is configured to contact the second vertebral body. An expansion bladder is disposed between and coupled to the first endplate and the second endplate. The expansion bladder includes a first chamber and a second chamber. The first chamber and the second chamber are sealed from fluid communication with one another. An injection port is disposed through one of the first endplate or second endplate. The injection port includes a first channel in fluid communication with the first chamber and a second channel in fluid communication with the second chamber.

Abstract: An adjustable surgical retractor clamping mechanism for attaching mechanism to an operating table. The mechanism includes an upper jaw, lower jaw, a drive member, an adjustable frame support post and a releasable clamp for adjusting the height of the surgical retracting frame. The upper portion of the lower jaw has a plurality of slots cut into the sidewalls of upper jaw to form at least one flexible finger. The clamp is in close sliding relationship to the upper portion of lower jaw member. The clamp includes a cam lever. Movement of the cam lever to its closed position compresses the clamp causing the flexible fingers to grip the adjustable post locking its longitudinal movement. Rotation of the cam lever to the open position releases the compressive force on the clamp, unlocking the adjustable post allowing the post to be longitudinally adjusted relative to the clamping mechanism.

Abstract: The present invention relates to an expandable implant for engagement between vertebrae generally comprising an inner member, outer member, and gear member positioned coaxial with respect to each other such that the inner and outer members are moveable relative to each other along an axis. The gear member is axially fixed to the outer member and freely rotatable with respect to the outer member and the gear member threadedly engages a threaded portion of the inner member to translate inner member along the axis. The implant is configured to engage the vertebrae in a predetermined alignment and the gear member includes gear teeth exposed to the exterior and configured to be accessible by a tool member at a plurality of angular positions around the perimeter of the implant device.

Abstract: The present invention relates to a clamp, and, more particularly, to a clamp for securing the position of a bone anchor with respect to a longitudinal rod, preferably for use in the spine. The clamp may include a housing, a rod clamping assembly, and a bone anchor clamping assembly. The clamp preferably enables the longitudinal axis of the rod to be offset or laterally displaced from the longitudinal axis of the bone anchor. The rod clamping assembly and the bone anchor clamping assembly are preferably moveably coupled to the housing in order to provide increased flexibility to better accommodate the location and geometry of the longitudinal rod and to better accommodate bone positioning.

Abstract: A growing rod for mounting between attachment mechanisms that are secured to anatomical structures of a patient having scoliosis. The growing rod includes a base rod having an attachment end, an extendable rod that is translatable relative to the base rod along a longitudinal axis and a housing enclosing at least a portion of the extendable rod therein. A magnet is rotatably mounted within the housing and is enclosed by a top magnet cover and a bottom magnet cover. The magnet includes a first pole and a second pole. A gear reduction mechanism is associated with the magnet and the extendable rod. The gear reduction mechanism reduces an output rotation to the extendable rod relative to an input rotation from the magnet.

Abstract: Methods and techniques for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. An inline rod connector is utilized which includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure uses a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: A minimally invasive system includes a bone screw and a tissue retractor having distal and proximal end portions and a partial pathway therebetween. The tissue retractor is removably couplable to the bone screw. An instrument has distal and proximal end portions and a hollow cavity and is removably couplable to the tissue retractor. A drive shaft has a diameter less than a diameter of the hollow cavity and is rotatable with respect to the instrument. A counter-torque handle has gripping and an interlock end portions with an instrument interface releasably positioned within the hollow cavity at the proximal end portion thereof and rotatably fixed thereto in an assembled configuration. The interlock end portion also includes an open-ended slot having a width greater than the drive shaft diameter such that the counter-torque handle is movable to and from the assembled configuration while the drive shaft is within the hollow cavity.

Abstract: Instruments and methods for creating an operative corridor to the spine are described. The instruments include, for example, a retractor assembly with at least one retractor blade that may be releasably coupled to a bone anchors via a hoop shim. The hoop shim includes a shim portion that may slidably engage the retractor blade and a hoop portion extending from the shim portion that includes an aperture that receives the bone anchor. The hoop portion may have an unlocked configuration that allows passage of the bone anchor and a locked position which prevents passage of the bone anchor to releasably couple the hoop shim to the bone anchor. The hoop shim may be configured to couple to the bone anchor such that the hoop shim may angulate relative to the bone anchor.

Abstract: A laryngoscope assembly with enhanced viewing capability including a laryngoscope handle having a permanently mounted laryngoscope optical system. The laryngoscope optical system has a view tube with a leading aperture lens for affording a field of view along a deflected line of sight viewing in an operative intubation position. The laryngoscope handle includes a laryngoscope optical system securing arrangement for mechanically securing the laryngoscope optical system in the operative intubation position. The laryngoscope assembly also includes an interchangeable laryngoscope blade including a trailing view tube sleeve for slidably mounting on the view tube and a leading spatula wherein the view tube sleeve has a leading transparent window for covering the aperture lens. The laryngoscope assembly further includes a blade securing arrangement for mechanically securing the laryngoscope blade on the laryngoscope handle in the operative intubation position.

Abstract: The present application provides an apparatus for forming and method of creating a wedge-like opening in a bone for an open wedge osteotomy by identifying a cutting plane through the bone; and inserting an apex pin along the cutting plane to limit cutting and minimize stress risers in the bone.

Abstract: Treating fractures using one or both of an implant, such as an intramedullary nail, and a fastening assembly, such as a lag screw and compression screw assembly. The implant in some embodiments has a proximal section with a transverse aperture having a non-circular cross-section that may be shaped to selectively constrain the fastening assembly within the transverse aperture. Two or more components of the fastening assembly may be received to slide, in a controlled way, in the transverse aperture of the implant, and to cooperate to resist a force moment applied thereto. Without the presence of one of the components, such as the lag screw, another component, such as the compression screw may not resist a force moment applied thereto.

Abstract: A vertebra implant is provided that includes an elongate body with a first end configured to mate the first end to a first location on a vertebra, and a second end having at least one fastener configured to mate the second end to a second location on a vertebra. The elongate body also includes a deformable portion extending between the first and second ends that has an unexpanded configuration in which the deformable portion is configured to allow a tool to cut bone extending between the first and second ends when the first and second ends are mated to first and second locations on a vertebra, and an expanded configuration in which the deformable portion is deformed to increase a distance between the first and second ends such that a gap is created in the cut bone. The deformable portion is configured to maintain the first and second ends at a fixed distance apart when the deformable portion is in the expanded configuration.

Abstract: Instruments and methods for creating an operative corridor to the spine and performing a spinal fusion. The instruments including, for example, a retractor assembly with a plurality of retractor blades, at least two pedicle screws, and a connecting rod. The retractor blades are coupled to the pedicle screws such that the operative corridor is registered to known anatomical landmarks aiding the surgeon with intraoperative orientation and anatomy identification. The retractor blades may be coupled to the pedicle screws via a polyaxial connection such that the angle of the operative corridor may be adjusted while maintaining the registration to the landmarks. Rod receivers may be attached to the pedicle screws after the disc space is operated on to minimize encumbrances on the working space within the operative corridor. A connecting rod is subsequently locked to the receivers to fix the spinal segment.

Abstract: A metal bone supporter for medical bone substitute including a supporter and a connector component which are functionally and structurally designed according to anatomical data and biomechanical data. The titanium alloy powders in the device are able to be scanned, melted and molded through electron beams, to form a cylinder with the strength and elastic modulus similar to cancellous bones of the human body. The supporter component is a porotic spongy body structure with threads on an end, and porous structure forms a rough surface. The connector component is made with a smooth surface and a dense solid mass inside, a thread on an end, and is connected to the supporter component as a removable body. The porous structure enables bone growth, and the device has a high surface friction coefficient, and has a stable structure and mechanical properties are similar to bones.

Abstract: A system for fixing a fracture near a joint of a bone comprises (a) an intramedullary device including a longitudinal body and a head, the longitudinal body extending from a proximal end to a distal end, the head being attached to the proximal end of the longitudinal body; and (b) a plate implantable into a head portion of the bone to provide support to a joint zone, the plate engageable with the intramedullary device. The plate is substantially U-shaped and includes a midsection and a pair of arms extending from the midsection, the pair of arms forming a space therebetween, the space sized and shaped to accommodate the head of the intramedullary device.

Abstract: A surgical instrument, generally in the form of an expandable elongate conduit, for use as a distractor and/or retractor. The conduit generally includes a first elongate trough and a second elongate trough movable between an expanded state and a collapsed state wherein the second trough is nestable with the first trough. The first and second troughs may be fastened to vertebrae to facilitate distraction and/or compression of the vertebrae relative to one another.