Abstract: An expandable implant is disclosed having an adjustable height for insertion between two adjacent bony structures or joint surfaces, for example between two adjacent spinal vertebrae. The implant includes at least one gear associated with at least one threaded shaft. Rotation of the gear engages the threaded shaft to expand the implant. The implant can be inserted in a collapsed configuration and expanded in situ. The invention also provides methods for using the implant to facilitate arthrodesis or fusion of adjacent joint surfaces or spinal vertebrae.

Abstract: Systems for interbody fusion of adjacent bone portions may include an expanding implant and related instruments. An expanding implant may be formed as a linkage which is movable between a compact configuration and an expanded configuration. A shaft of the implant may increase and decrease in length to move between the compact and expanded configurations, and an implant width perpendicular to the length may be increased in the expanded configuration. The implant width may increase more in a first direction than a second direction opposite the first direction. An inserter instrument may releasably grasp the spacer and transform the implant between the compact and expanded configurations.

Abstract: A surgical screw configured to expand and prevent or minimize bone growth inside of the surgical screw is provided. Accordingly, the surgical screw is configured to increase the purchase of the surgical screw with respect to the bone, but also to be withdrawn from the bone without damaging the bone as a result of bone ingrowth. The surgical screw includes a center post with an inner bore and an outer sleeve concentric to the center post. An outer surface of the outer sleeve includes a thread to engage bone. The outer sleeve includes a cut pattern defining an expandable region configurable between a first state with a first radius measured from a longitudinal axis of the surgical screw to the outer surface and a second state having a second radius measured from the longitudinal axis to the outer surface.

Abstract: The present invention includes a rod link reducer of a spinal fixation system that includes a first and a second spinal rod manipulator; a first spinal rod manipulator joint connected to the first spinal rod manipulator and a second spinal rod manipulator joint connected to the second spinal rod manipulator; a first and a second translatable transverse shaft connected to the first and second joints, respectively; and a universal reducer connected to both the first and second translatable transverse shafts, wherein the universal reducer, the shafts and the linkers provide movement and temporary fixation of a spine that has been manipulated into a final position during spinal surgery.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: A trial implant system including a trial implant configured to be temporarily inserted into an intervertebral space defined by a superior vertebral body and an inferior vertebral body is disclosed. The trial implant may include a superior plate and an inferior plate coupled to the superior plate. The superior plate may have a first mating portion that defines a first articulating interface and the inferior plate may have a second mating portion that defines a second articulating interface. The second articulating interface may be configured to interact with the first articulating interface of the superior plate such that at least one of the superior plate and the inferior plate is capable of movement relative to the other. The first and second articulating interfaces may be primary or auxiliary articulating interfaces. For example, the first and second articulating interfaces may be corresponding curved surfaces or they may be corresponding engagement features.

Abstract: A method of inserting a spinal stabilization system into a patient generally comprises inserting a first positioning tool through a first location on a patient's skin and along a path generally toward a first vertebral anchor, coupling an end of the first positioning tool to the first vertebral anchor, positioning at least a portion of a delivery device over a connecting element, and inserting the delivery device and the connecting element through the patient's skin at the first location and along at least a portion of the first positioning tool. The first positioning tool is configured to facilitate directing the delivery device and connecting element generally toward a second vertebral anchor within the patient's body.

Abstract: A modular interbody fusion device for fusing adjacent spinal vertebrae that is adapted to be implanted in a prepared interbody space including a first modular segment having a width including a first rail extending at least partially along one side of the width and beyond a periphery of a body portion of the first modular segment, a second modular segment having a width and slidably connected to the first rail on one side of the width and having a second rail extending at least partially along another side of the width and beyond a periphery of a body portion of the second modular segment, a third modular segment having a width and slidably connected to the second rail on one side of the width and wherein the device has an expanded position and an implanted position in which the modular segments are combined to mimic the shape of the vertebra.

Abstract: Retractor blade assemblies, retractors, kits, and methods of using the same. The retractor blade assembly may include a retractor blade, a pedicle screw, and a shim that connects the pedicle screw to the retractor blade. The retractor blade may have a proximal end configured to engage a retractor body and a distal end configured to retract soft tissue. The pedicle screw may have a head portion removably connected to the distal end of the retractor blade and a shaft portion configured to engage the pedicle of a vertebra. The shim couples the pedicle screw to the retractor blade. For example, the shim may include an extension portion configured to engage the retractor blade and a connection portion configured to receive and temporarily lock the pedicle screw to the retractor blade.

Abstract: A bone distractor to create separation between bone segments by means of a pair of mounts respectively secured to the bone segments and interconnected by means of a drive spring which is secured to one of the mounts and threadedly interconnected to the other mount such that rotation of the drive spring creates sufficient separation of the bone segments to allow for osteogenesis to occur.

Abstract: A percutaneous cross connector system for use with implantation rods comprising a rod attachment device comprising a first jaw portion and a second jaw portion. The first jaw portion comprises a first concave surface to engage with a surface of a rod, a first biasing member, and a first pivoting mechanism. The second jaw portion comprises a second concave surface to engage with an opposite surface of the rod from the first jaw portion, a second pivoting mechanism, a second biasing surface, and a second locking surface. The first and second jaw portions can be mated so that the first and second concave surfaces are positioned on opposite sides of the rod, the first and second pivoting mechanisms are aligned to pivot on a common axis, and the first biasing member is engaged against the second biasing surface to drive the second jaw portion against the rod.

Abstract: Embodiments of devices and methods of correcting vertebral misalignment, including, e.g., spondylolisthesis, are disclosed. In one embodiment, a vertebral implant may include an assembly configured to be secured to a first vertebral body, wherein the assembly includes a frame made of a first material and at least one end plate made of a second material different than the first material; a reducing plate configured to be slidably received over the central portion, wherein the reducing plate is configured to be secured to a second vertebral body; and an actuator configured to move the reducing plate relative to the frame.

Abstract: An intervertebral implant includes a three-dimensional body and a securing plate. The three-dimensional body includes a front surface and a rear surface. The three-dimensional body further includes a plurality of boreholes for accommodating fixation elements. The intervertebral implant also includes a front plate disposed at the front surface of the three-dimensional body and has a plurality of boreholes. A securing plate can be fastened to the front plate.

Abstract: Apparatuses for attaching tissue to bone are provided. In one exemplary embodiment, the apparatus includes an expandable body defining a bore, an expander pin having a shaft sized to be received in the bore of the expandable body, and an insertion shaft slidingly disposed in the bore of the expandable body and in a bore of the expander pin. The body is configured to expand laterally into and attach to bone when the expander pin is driven into the expandable body. The body includes a proximal main member having a distally extending threaded projection and a harder, distal tip member having a threaded recess in a proximal surface thereof such that the projection is threadedly interengageable with the recess. The expansion of the body by way of the pin can occur when the proximal main member and distal tip member are threadedly engaged. The insertion shaft is releasably secured to the expandable body and extends distally beyond the expandable body.

Abstract: A fixation clamp for use in an external fixation system for holding bone fragments adjacent to each other with the help of fixation elements has at least one clamping assembly having a pair of jaws with at least two different size grooves to accommodate a bone fixation element such as a pin or rod. An alternate clamping assembly has at least three grooves wherein at least two of the grooves have a different size adapted to accommodate a correspondingly sized bone fixation element such as a bone pin. The longitudinal axes of the grooves define a polygon. The jaw pairs can be rotated about a central longitudinal axis to present different size reception cavities towards the pins or rocks depending on their diameter.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

Abstract: The subject invention provides a suction retractor comprising a flexible continuous dam which forms a closed loop of any shape and which defines one or more inlet opening into an interior of the closed loop, so that suction can be applied into an interior of the continuous dam. The suction retractor may further comprise a suction tube defining a suction channel, the suction tube attached to or attachable to the continuous dam and when attached the suction channel continuous with the one or more inlet. The one or more inlet may open to a continuous channel extending throughout an interior of the closed loop. Preferably, the continuous dam is planar or substantially planar and comprises a first compacted configuration for insertion and a second open configuration for retraction. The suction retractor of the invention finds application in single incision and convention laparoscopic surgery.

Abstract: An implant retention device is provided to assist in restraining movement of a nuclear implant and to assist in preventing expulsion of the nuclear implant through an incision portal or defect in the annular wall. In one form, the implant retention device may include an elongated tensioning member having a portion configured to connect to the implant and at least one anchoring device disposed on the tensioning member, the anchoring device configured to at least partially penetrate spinal tissue such as the annulus, vertebral body, or other secure tissue.

Abstract: A method and apparatus for an osteotomy fixation or arthrodesis cage allows the adjustment of the relative position of two bone segments while supporting the joining of those bone segments into one structure through the implant and methods described herein. The implant's embodiments fixate to the adjacent bones while inter-positioning its body between the bone segments. This inter-positioning allows anatomical adjustments in the distance between and angle of the bone segments. The adjustment is further enhanced by the use of shape memory materials that when activated through the application of heat energy, transition from a second shape to a first shape while changing the distance between the bones or their relative angle. This method and apparatus can be used on any adjacent bone or bone segments including but not limited to the vertebrae of the spine or long bone such as the tibia or metatarsal.

Abstract: A spinal spacer for engagement between vertebrae includes a body having a substantially contoured first end surface at a distal end and a second end surface opposite thereto at a proximal end. The body extends between the first and second end surfaces to define top and bottom vertebral engaging surfaces that are opposed to one another. The body extends between the top and bottom vertebral engaging surfaces to define opposed side surfaces. The top and bottom vertebral engaging surfaces intersect with the side surfaces to provide a substantially quadrilateral cross-section with rounded corners. The top and bottom vertebral engaging surfaces have a substantially streamlined convex profile. The surfaces converge at the distal end to define a substantially atraumatic blunt nose having a tip configured with planar and/or convex surfaces.