Abstract: The present invention discloses a system for securing at least one fastener to an implant. At least one adhesive capsule is inserted in a recess preferably located along a longitudinal axis of the implant. The at least one adhesive capsule may be inserted in the recess and held in place therein by a holder. A plurality of adhesive capsules and holders may be inserted in one or more recesses located substantially along the longitudinal axis of the implant. The at least one adhesive capsule preferably has a casing housing an adhesive material configured to be pierced by the at least one fastener to secure the at least one fastener to an aperture of the implant. The casing of the adhesive capsule may form an annular passageway to receive a guide wire for aiding the insertion of the capsule in an implant having a longitudinal bore along at least a portion thereof.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

Abstract: A universal rod holder including a drive member and an elongated shaft member. The drive member has a proximal portion and a distal portion, and may include a handle disposed on the proximal portion, external threads disposed on the proximal portion of the drive member, and a tip disposed on a distal end of the distal portion of the drive member. The elongated shaft member includes a through hole, the through hole configured to receive the drive member, internal threads disposed on an inner surface of the through hole and configured to engage the external threads, and a hook member disposed on a distal end of the shaft member. The through hole extends into an opening of the hook member. The distal portion of the drive member is configured to slide through the through hole and into the opening of the hook member to secure a rod positioned therein.

Abstract: A bone stent facilitates bone fixation via interior contact, as may be useful for flexible entry into a sidewall of an elongated bone. As consistent with one or more embodiments, a stent includes proximal and distal end caps connected by a plurality of elongated members extending longitudinally between the end caps, and a flexible cable extending through the proximal end cap and connected to one of the end caps. The flexible cable, end caps and elongated members are responsive to the end caps being moved toward one another by laterally bending the elongated members outwardly away from one another, with the cable fixing the elongated members in the compressed state (e.g., while applying pressure to the interior sidewalls of a bone). When the end caps are released from the compressed state, the longitudinal compressive force is released and the elongated members elastically return to the uncompressed state.

Abstract: A system for replacing at least a portion of a natural facet joint includes a fixation member implantable in a vertebra, an inferior facet articular surface and an inferior strut which may be formed separately from the inferior articular surface. The inferior strut has a first end securable to the fixation member and a second end which may comprise a sphere with a hemispherical surface. An attachment mechanism may include a capture feature shaped to receive the second end of the inferior strut, and the mechanism may provide an adjustable configuration, allowing polyaxial adjustment between the inferior articular surface and the second end. A locking member may be actuated to exert force on the second end to provide a locked configuration. The system may further include a superior facet joint implant with a superior articular surface shaped to articulate with the inferior articular surface.

Abstract: Interspinous process implants are disclosed. Also disclosed are systems and kits including such implants, methods of inserting such implants, and methods of alleviating pain or discomfort associated with the spinal column.

Abstract: A method of providing a minimally invasive hip arthroplasty in conjunction with a main incision formed through a patient's skin and soft tissue in the patient's hip, including providing an instrument having a main body and an arrangement for guiding the formation of a portal incision and a small path to the patient's acetabulum along an impaction axis. A trocar is placed through a guide ring on an arm of the instrument to form the portal incision and small path. Impaction of an acetubular shell is carried out along the impaction axis thus formed.

Abstract: A dilator retractor and the dilators that are used for minimally invasive spinal surgery or other surgery are configured to accommodate the anatomical structure of the patient as by configuring the cross sectional area in an elliptical shape, or by forming a funnel configuration with the wider end at the proximate end. In some embodiments the distal end is contoured to also accommodate the anatomical structure of the patient so that a cylindrically shaped, funnel shaped, ovoid shaped dilator retractor can be sloped or tunneled to accommodate the bone structure of the patient or provide access for implants. The dilator retractor is made with different lengths to accommodate the depth of the cavity formed by the dilators.

Abstract: An instrument for reducing a fixation rod within a screw extender that attaches to a spinal implant includes first, second, and third cannulated bodies and an inserter shaft. The first cannulated body includes a proximal end that couples with the screw extender. The second cannulated body rotates within the first cannulated body and includes a proximal end with a first driving feature and a distal end with an internal threaded portion. The third cannulated body includes a proximal end that engages the internal threaded portion and a distal end with a rod pusher for engaging the fixation rod. The inserter shaft rotates within the third cannulated body and includes a proximal end with a second driving feature and a distal end with a setscrew attachment feature.

Abstract: The present invention relates to a device for fixation of bone fragments at bone fractures. The device comprises at least two fixation means (5, 6) and a securing plate (4). With the object of preventing or counteracting re-dislocation, the respective fixation means (5, 6) each have a first fixing portion (19) for fixing the fixation means in an inner bone fragment (3), a second fixing portion (21) for locking the fixation means to the securing plate (4) which is disposed on the outside of an outer bone fragment (2) and allows movement of the outer bone fragment relative to it, so that the fixation means are prevented from changing their angular position relative to the securing plate and relative to one another, and a middle portion (22) which is situated between the fixing portions and runs through the outer bone fragment, along which middle portion the outer bone fragment can slide inwards towards the inner bone fragment in which the fixation means is fixed.

Abstract: An orthopedic intramedullary fixation apparatus and system for use in hip and femur fracture surgery comprises an intramedullary nail, a dynamic lag screw structure comprising a longitudinal sheath and a lag screw, and securing means to fix the intramedullary nail relative to a femur. A dynamic channel created by the lag screw structure allows the lag screw to adjust dynamically, and thereby may permit further compression of the fractured bone to an optimal level as a patient begins to bear weight on it following surgery. Surgical fixation may be expedited, as a favorable point of access for a lag screw may be determined readily, particularly with obese patients in whom access to the trochanter may be problematic. Complications during surgery, such as accidental fracturing of the femoral neck and head and over-penetration of the lag screw may be avoided.

Abstract: A coupling assembly is presented. The coupling assembly is used to selectively couple a bone screw having an elongate shaft and a head to an elongate rod. The coupling assembly has a coupling element configured to engage the head of a bone screw, as well as the elongate rod. When the elongate rod is engaged by the portion of the top of the coupling element, the coupling element does not extend above a top most portion of elongate rod.

Abstract: The surgical support system may include a primary telescoping support, secondary telescoping support supported from the primary telescoping support and configured for telescopically mounting a surgical tool thereto, such that telescoping of the primary support repositions the secondary telescoping support; and a positioning joint disposed between the primary and secondary telescoping supports for universally positioning and locking the secondary telescoping support with respecting to the primary telescoping support.

Abstract: A cannulated medical instrument handle apparatus comprises a handle housing component with a hollow handle insert channel and a tubular insert that fits within the handle insert channel. The airspace chamber created between the inner walls of said channel and the outer walls of said insert provides the handle with increased susceptibility to sterilization of the cannula lumen.

Abstract: An interbody spinal implant system includes an implant having separate, but joined top and bottom portions, a socket for receiving an expansion wedge, an expansion wedge, and an anchor pin. The anchor pin includes at least two prongs having a plurality of ridges or teeth. The top portion and the bottom portion each include a slot for receiving a prong of the anchor pin. A movable joint joins the top and bottom portions and allows the top and bottom portions to move vertically relative to each other.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

Abstract: Configurations are described for conducting minimally invasive medical interventions utilizing elongate instruments and assemblies thereof to stabilize and/or fixate a sacro-iliac joint. In one embodiment, a tool assembly may be advanced from a posterior approach into the SI junction and configured to create a defect defined at least in part by portions of both the sacrum and the ilium, the defect having a three dimensional shape defined in part by at least one noncircular cross sectional shape in a plane substantially perpendicular to the longitudinal axis of the tool assembly. After a defect is created, the tool assembly may be retracted and a prosthesis deployed into the defect.

Abstract: A surgical retractor includes a pair of small grips that are disposed at the ends of arms that can be moved toward or away from each other. The grips engage and separate the sides of an incision that has been made in a patient. A lifting mechanism that can be attached to one of the arms enables one side of the incision to be raised relative to the other side of the incision. The lifting mechanism includes a clamp that can be connected to the retractor and a foot that is connected to the clamp and which is movable relative thereto. The foot is engageable with the patient such that extension of the foot causes a selected grip to be raised. Retraction of the foot permits the selected grip to be lowered. In the preferred embodiment, the foot is disposed at one end of a notched rack; a rotatable pinion is in contact with the notches to extend and contract the rack; and a pivotally movable pawl permits movement of the rack in one direction and prevents movement of the rack in the other direction.

Abstract: The use of red or near infrared light upon neurons of the lumbar plexus that are in distress due to retraction-induced ischemia. The surgeon may protect nerves made ischemic in the surgery by: a) making an incision in a patient, b) inserting an access device into the patient through the incision to at least partially create a path to a spine of the patient, and c) irradiating nervous tissue adjacent the path with an amount of NIR or red light effective to provide neuroprotection.

Abstract: Disclosed is a surgical alignment and distraction frame and associated methods of use that facilitates correction of a sagittal imbalance. The alignment and distraction frame works in conjunction with pedicle screw installation guide assemblies to impart the desired correction. The alignment frame can be utilized to ensure the pedicle screw housings are aligned (to facilitate rod coupling) in concert with the completion of a correction maneuver.