Abstract: An instrument may be used to move a rod attached to vertebrae to an opening of a fixation device. Positioning the rod in the opening may properly align the vertebrae with respect to the vertebra attached to the fixation element. A fixation holder may be coupled to the fixation element. The holder may include a protrusion. The protrusion may engage a guide of the instrument during use. The protrusion and the guide may ensure that the rod is properly positioned within the opening in the connector. The instrument and holder may automatically align the rod to the opening without requiring manual manipulation of the rod or the fixation element. The fixation element may include a connector. The connector may be positioned within the fixation element so that removal of the connector from the fixation element is inhibited.

Abstract: An endoscopic stone extraction device includes a handle that supports a sheath, and a filament such as a wire slidably disposed in the sheath. One end of the wire is mounted to the handle for rotation with respect to the handle and the other end of the handle supports a stone extraction basket. A manipulator is provided on the wire to allow a user to rotate the filament and therefore the basket with respect to the handle. The basket can have a side-facing opening or a rear-facing opening. In either case, a stone retention region is provided with relatively small openings sized to retain stones smaller than two millimeters in diameter. A collapsible rake is disclosed which facilitates the collection and extraction of stone fragments.

Abstract: An embolic coil deployment system for placing a coil at a preselected site within a vessel of the human body. The deployment system includes a heating element at the distal end of a delivery member and a heat responsive coupling for holding the coil during positioning of the coil and activation means for releasing the coil at a desired position within the vessel.

Abstract: A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. The system locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired. A special suction cup is used which accommodates multiplanar movement of the heart and the myocardium while also preventing heart tissue from interrupting the suction being applied to the heart. One form of the system can be used in minimally invasive surgery.

Abstract: An implantable container is used to stabilize or restore height in a vertebral body. After insertion the container is filled with a bone filler material such as bone cement.

Abstract: The invention facilitates the fixation of bone fractures. In a particular embodiment, the head component includes a tip, cutting threads and mating threads which are inserted into the far cortex of the bone. A wire extends from the head component and exits from the near cortex. A cap device having a sawtooth inner surface is threaded over the wire having an inverse sawtooth outer surface such that the cap is restricted from backwards movement. Tension is then applied to the wire while the cap is tightened against or within the bone surface to thereby apply an appropriate amount of pressure between the surfaces of the fracture. The excess wire beyond the cap can then be removed.

Abstract: An apparatus for attaching soft tissue to bone.

Abstract: A distraction device for moving apart a bone, present in one or more parts and possibly separated, so as to extend or bridge a bone fissure, comprising an intramedullary nail which can possibly be introduced into a medullary space of a bone and has at least two elements which can be axially displaced in relation to each other. To effect said displacement at least one working device is joined to the element and a movable retaining element which is supported on the element.

Abstract: A fixation device is provided which includes a proximal nail portion and a distal plate portion. The nail portion includes a flexible tapered section, and a rigid distal section larger in diameter and is adapted to be inserted into a medullary canal of a fractured bone. The plate portion has a low, narrow profile and includes three longitudinally displaced peg holes, each of which is adapted to orient a peg in a different orientation from the others. The plate portion is adapted to be positioned on the outside of a fractured bone when the nail portion is within the medullary canal. The device provides the benefits of both an intramedullary nail and a bone plate in a single device. The fixation device permits a minimally invasive treatment of the metaphyseal fractures that may otherwise be undertreated.

Abstract: A spinal column fixation device includes a support member, a top seat fastened at the top end with the support member, and a bottom seat fastened at the bottom end with the support member. The top seat and the support member are fastened by an angle adjusting mechanism such that the angle between the top seat and the support member is adjustable. The bottom seat and the support member are fastened by an angle adjusting mechanism such that the angle between the bottom seat and the support member is adjustable.

Abstract: A heart retractor links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the heart retractor of the present invention. The retractor includes a plurality of flexible arms and a plurality of rigid arms as well as a surgery target immobilizing element. One form of the retractor can be used in minimally invasive surgery, while other forms of the retractor can accommodate variations in heart size and paracardial spacing.

Abstract: A surgical manipulator (10) can manipulate a medical tool (12) with one or more degrees of freedom. In preferred embodiments, the manipulator (10) is a parallel mechanism including a plurality of arms (21, 22) pivotally supporting a medical tool (12), with the orientation of the medical tool (12) being adjusted by varying the position of joints (23, 24) mounted on the arms (21, 22). The motions of the joints (23, 24) can be controlled such that the tool (12) is pivoted about a virtual pivot point located within the body wall of a patient (30). The manipulator (10) can enhance the dexterity of an operator and enable the operator to perform medical procedures more easily than by hand.

Abstract: A tube body includes an interior bore to carry a material flow into bone. The tube body includes a dispensing end having an opening communicating with the bore to dispense the material flow. One embodiment provides a cutting element, which extends in the opening to permit passage of the material flow and to sever the material flow in response to rotation of the tube body. Another embodiment deflects the dispensing end from the main axis of the tube body, to facilitate targeted introduction of flowable material, even when the access path does not align the tube body along the natural geometric axes of the treatment site. Another embodiment provides a connector having a rotating fitting, which releasably connects the tube body to a cement injecting tool. The rotating fitting allows the physician to rotate the injection nozzle assembly to control orientation and position in the treatment site, without rotating the associated injection tool itself.

Abstract: A constrained prosthetic knee having a modular hinge post and a rotating bearing. A cannulated hinge post is rotatably connected to the femoral component of the knee prosthesis so that a hinge post extension may be anteriorly positioned through the hinge post and into the tibial component of the knee prosthesis, after positioning of the femoral component in the femur and the tibial component in the tibia. The hinge post is preassembled to the femoral component so that such assembly is not required during the implantation procedure. A meniscal component forming the rotating bearing of the knee prosthesis is packaged together with the hinge post extension so that the appropriate hinge post extension is readily available. The meniscal component includes a mechanism for preventing lift off of the meniscal component from the tibial component, while allowing rotation of the meniscal component relative to the tibial component.

Abstract: A bone plate includes an upper surface, a bone contacting surface, and at least one hole extending through the upper and bone contacting surfaces. The bone plate defines a longitudinal axis. The at least one hole defines a central axis and is elongated in a direction substantially aligned with the longitudinal axis. The hole may include a threaded portion and a non-threaded portion, and the threaded portion may extend through an angle of between about 190° and about 280° with respect to the central axis.

Abstract: A dorsal fracture is treated from the volar side by using a T-shaped plate opposite the fracture. The plate is positioned against the volar side of the radial bone, a plurality of bone screws secure the plate along a non-fractured portion of the radial bone, and a plurality of bone pegs extend from the plate and into the bone fragments of the fracture. A support portion of the plate is provided distal of the bone pegs and supports comminuted bone fragments. One or more channels are optionally provided in the plate to receive wires which are adapted to anchor distal bone fragments to the plate. The plate is adapted in strength and materials to withstand the large bending forces thereon.

Abstract: This invention comprises an apparatus and a method of spreading an intervertebral space to help guide tools that will prepare the vertebrae for accepting an implant. The spreader is a thin blade with cam surfaces forming a paddle on the proximal end, which spreads the vertebra when rotated 90 degrees about its axis. A stem between the paddle and a handle is notched to clear the vertebral protrusions so the vertebra will be distracted on the vertebral end plates. Since the spreader is in the center of the end plates, the centerline of the spreader shaft will coincide with the vertebral end plate centerline. The surgeon can monitor the spreading, stop and remove the spreader to make adjustments or to change the size of spreader as required at the time of the surgery. Once the vertebrae are distracted a tube may be placed over the handle and aligned with the vertebral end plates.

Abstract: A fixation system includes a device having a nail portion and a plate portion, preferably horizontally and vertically offset relative to the nail portion by a neck portion. The nail portion includes threaded screw holes, and the plate portion includes longitudinally displaced peg holes, each of which is adapted to orient a peg in a different orientation from the others. The system also includes unicortical screws having a reasonably large head adapted to seat against the outer surface of the bone and a threaded shaft adapted to engage in the screw holes, and pegs adapted to engage in the peg holes. Bone is clamped between the nail portion and the head of the unicortical screws. The pegs provide stabilization and support for subchondral fragments. Moreover, as the pegs preferably enter the subchondral fragments from a plurality of directions, additional fixation of the device into the bone is provided.

Abstract: A bone anchoring assembly includes at least one fixation plate and at least one bone anchoring element. Each bone anchoring element includes a circular-cylindrical hollow body with an upper end and a lower end, a connecting element that is pivotably mounted to a fixation plate or longitudinal support, an external thread that extends partially along the outer surface of the circular-cylindrical body for anchoring the bone anchoring element into the cortical portion of the bone, and a series of teeth located on the lower end of the circular-cylindrical body for cutting into bone.

Abstract: A system for manipulating and supporting a beating heart during cardiac surgery, including a gross support element for engaging and supporting the heart (the gross support element preferably including a head which is sized and shaped to cradle the myocardium of the left ventricle”), a suspension head configured to exert lifting force on the heart when positioned near the apical region of the heart at a position at least partially overlying the right ventricle, and a releasable attachment element for releasably attaching at least one of the gross support element and the suspension head to the heart. The releasable attachment element can be a mechanical element (such as one or more staples or sutures') or an adhesive such as glue. Alternatively, the system includes a suspension head and a releasable attachment element for releasably attaching it to the heart, but does not include a gross support element.