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: A method for repairing a fractured bone includes providing a bone fracture fixation assembly including a plate, an elongated shaft, and a rod. At least a portion of the shaft is threaded, and the shaft has a hole extending therethrough. The hole has an axis transverse to a longitudinal axis of the shaft. The method further includes positioning the plate adjacent the surface of the fractured bone, extending the shaft into the bone, cooperatively engaging the threaded portion of the shaft with a screw receiving aperture of the plate, extending the rod into the bone, and inserting the rod into the hole of the shaft.

Abstract: A surgical access assembly is provided for retaining tissue, membrane, and organs in a retracted position after insertion into an incision on a patient. The assembly includes a hollow surgical access channel of oblong cross-section optionally expandable and contractible in diameter, thereby providing means for distraction of structure affixed to the retractor. The assembly optionally further comprises: gripping means for grasping by a surgeon or device and an introducer of generally oblong cross-section. The introducer, adapted to fit within the access channel, is generally rectangular in cross-section, rounded at the edges, with parallel sides. The distal end of the introducer protrudes from the retractor when inserted therein, and works to delicately push tissue apart. The introducer is placed within the hollow access channel and provides an hollow access channel for access by a surgeon and surgical instruments.

Abstract: A bone anchoring device is provided that includes an anchoring element with a shank to be anchored in a bone or a vertebra, a connection element for connecting at least two anchoring elements, the connection element being made of an elastic material, a receiving part being connected to the shank for receiving the connection element and connecting the connection element to the shank, a seat for the connection element the seat being provided in the receiving part, and a locking element being engageable with the receiving part for fixation of the connection element in the seat. At least the portion of the connection element which is received in the recess has a substantially smooth-surface. The locking element has an engagement structure which contacts the surface of the connection element in such a way that a form-fit connection is provided.

Abstract: A method of performing a procedure on an intervertebral disc includes inserting a cannulated delivery tube through an opening in an annulus fibrosus of the intervertebral disc, positioning an expandable portion of the tube within the opening in the annulus fibrosus, expanding the expandable portion into contact with the annulus fibrosus about the opening to create a seal between the expandable portion and the annulus fibrosus, performing a procedure through the cannulated delivery tube within the annulus fibrosis, removing the tube, and closing the opening in the annulus fibrosus.

Abstract: A stabilization device for use with a system for the percutaneous stabilization of adjacent vertebrae includes an elongated body having a radius of curvature, a leading end and a trailing end, wherein the trailing end is shaped and dimensioned to protrude from a pedicle surface once it is properly introduced within a vertebral body. It also an object of the present invention to a method for the percutaneous stabilization of adjacent vertebral bodies. The method includes inserting first and second elongated stabilization devices within the vertebrae such that they extend between adjacent vertebral bodies to securely stabilize the adjacent vertebral bodies, wherein the trailing ends of the first and second stabilization devices protrude from a pedicle surface once inserted within the vertebrae.

Abstract: A system for the percutaneous stabilization of adjacent vertebrae includes a plurality of elongated stabilization devices. Each stabilization device includes a radius of curvature. Each stabilization device further includes a leading end and a trailing end wherein the leading end is pointed for penetration through a vertebral body.

Abstract: Systems, devices, and associated methods for correcting spinal column deformities that help minimize a number of attachment anchors utilized for correction, facilitate use of straight or contoured rods, and/or help promote a more natural, physiologic motion of the spinal column.

Abstract: A prosthetic device and a method of implanting same between two vertebrae of a vertebral column to stabilize the column, according to which each vertebrae is engaged by a spacer, and the spacers are connected to permit relative movement between the spacers so that the distance between the spacers can vary to conform with the distance between the vertebrae and accommodate bending movements of the vertebral column.

Abstract: Some embodiments relate to systems, devices, and associated methods for correcting spinal column deformities that help minimize a number of attachment anchors utilized for correction, facilitate use of straight or contoured rods, and/or help promote a more natural, physiologic motion of the spinal column.

Abstract: The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either, allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.

Abstract: A spinal fixation device including two plates and a coupling element for coupling the plates in a fixed manner about adjacent spinous processes of the spine. Each plate is preferably equipped with integral spikes on the inwardly facing surfaces for pressing into the spinal processes and thereby augmenting the purchase between the plates and the spinous processes. Each plate contains a central aperture through which the coupling element passes in order to couple the plates together.

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 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 system and method is provided for distracting opposite surfaces from the interior of a bone, such as a vertebral body. A working channel cannula provides a working channel through which an inserter and an injection cannula can simultaneously pass. The inserter transports a plurality of wafers into the interior of the bone to form a load-bearing stack bearing against the opposite surfaces. The injection cannula is used to inject a fluent material into and/or around the stack. In certain embodiments, the fluent material is a load-bearing or hardenable material, such as bone cement. In other embodiments, the fluent material can be a BMP, HAP, or other osteo-inductive, osteo-conductive, or pharmaceutical compositions. A syringe containing the fluent material is engaged to the injection cannula and is operable to inject the fluent material into the vertebral body under controlled pressure.

Abstract: A fracture fixation device is described for fixing a bone having a near cortex and a far cortex, comprising a shaft portion configured to span a distance between the near cortex and the far cortex of the bone; a head portion adjoining the shaft portion and providing for engagement of the device with a bone plate, wherein the head portion is integral with the shaft portion; and a threaded front section for engagement of the device with the far cortex of the bone, wherein the device permits motion of the shaft portion relative to the near cortex.

Abstract: A repair system including a closure prosthesis and deployment device, and associated methods for repairing any imperfection including a flaw, hole, tear, bulge, or, in some cases, a deliberate cut or incision in any tissue including an intervertebral disc. The prosthesis has first and second side portions with a connecting central portion, and is designed to span an imperfection with opposite ends positioned on opposite sides of the imperfection. The prosthesis may include anchoring features including barbs and/or members that extend transversely. The deployment device can include a cannula for positioning the prosthesis near the imperfection, and, in some cases, a mechanism that may cause the two sides of the prosthesis to be deployed in a specific order.

Abstract: A percutaneous path is established into a selected bone having an interior volume occupied, at least in part, by a cancellous bone, e.g., a vertebral body. An expandable mesh structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable mesh structure is expanded within cancellous bone by conveying a material into the mesh structure. Expansion of the mesh structure can, e.g., compact cancellous bone, and/or form a cavity in cancellous bone, and/or move fractured cortical bone.

Abstract: An implant has a bone plate with a bone contacting surface and an opposite outwardly facing surface. The plate includes a split-ring receiving recess open to the outwardly facing surface located intermediate first and second bone screw receiving openings in the plate. The first and second bone screw receiving openings each having a slot spaced from the outwardly facing surface towards the bone contacting surface. The slot is formed in a wall of the first and second bone screw receiving openings. The slot is open to the split ring receiving recess. A resilient split-ring has a thickness less than a height of the slots in the first and second bone screw openings when measured along the bone screw receiving opening axis.

Abstract: A cannulated fastener system is provided for orthopedic applications that include attaching bone plates to bone. The bone fastener has a cannulation with an inner shape. One or more screwdrivers is provided with a shaft having a shape that matches the cannulation of the fastener to rotationally fix the fastener to the screwdriver. In addition, the screwdrivers have a cutting blade that begins the drilling of a hole for the bone fastener. The screwdrivers may either be for use with a single fastener or have multiple fasteners loaded within a retaining sleeve for automatic or controlled dispensing.