Abstract: A cannula (10) for receiving surgical instruments for performing a surgical procedure on a body includes a tubular structure (12) defining a passage (16) through which the surgical instruments are inserted into the body. The tubular structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16). The expandable portion (40) of the tubular structure (12) has a slot (100) and a guide member (114) disposed in the slot. The guide member (114) is movable from a first end (102) of the slot (100) toward a second end (104) of the slot to enable the cross-sectional area of the passage (16) to increase. The expandable portion (40) has a stop (106) between the first and second ends (102 and 104) of the slot (100) engageable with the guide member (114) to retain the guide member in a position relative to the slot and resist movement of the guide member from the position relative to the slot.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: A device for retracting tissue provides access to a spinal location within a patient. The device includes an elongate body and a passage. The elongate body has a proximal portion and a distal portion. The elongate body defines a length between the proximal and distal portions along a longitudinal axis such that the distal portion can be positioned inside the patient adjacent the spinal location while the proximal portion is accessible. A transverse cross-section of the elongate body in the proximal portion has a first dimension that is longer than a second dimension. The first dimension is perpendicular to the second dimension. The passage extends through the elongate body between the proximal and distal portions. The elongate body is configured such that the proximal portion may be tilted with respect to the distal portion in a first direction generally aligned with the first dimension and in a second direction generally aligned with the second dimension.

Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60).

Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60).

Abstract: An apparatus for stabilizing vertebrae while permitting a range of motion therebetween may include first and second fasteners for engaging adjacent vertebrae and a motion preserving device that can be coupled to the first and second fasteners. The motion preserving device may include a longitudinal member that includes an array of load-bearing elements. The longitudinal member may be configured to permit the load-bearing elements to move relative to each other and/or relative to other portions of the member. In some embodiments, the longitudinal member is relatively inflexible along a longitudinal axis and relatively flexible in a direction transverse to the longitudinal axis.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: A cannula (10) for receiving surgical instruments for performing a surgical procedure on a body includes a tubular structure (12) defining a passage (16) through which the surgical instruments are inserted into the body. The tubular structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16). The expandable portion (40) of the tubular structure (12) has a slot (100) and a guide member (114) disposed in the slot. The guide member (114) is movable from a first end (102) of the slot (100) toward a second end (104) of the slot to enable the cross-sectional area of the passage (16) to increase. The expandable portion (40) has a stop (106) between the first and second ends (102 and 104) of the slot (100) engageable with the guide member (114) to retain the guide member in a position relative to the slot and resist movement of the guide member from the position relative to the slot.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: A device for provides access to a surgical location within a patient. The device has an elongate body that has a proximal portion, a distal portion, a first slot segment, and a second slot segment that is angled relative to said first slot segment. The elongate body defines a passage for accessing the surgical location with surgical instruments. The elongate body has a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location. The cross-sectional area of the passage at a first location of the elongate body is greater than the cross-sectional area of said passage at a second location of the elongate body. A movable tab is configured to extend into the second slot segment when the elongate body is in the expanded configuration to retain the elongate body in the expanded configuration.

Abstract: A spacer device is provided for use with a primary spinal fixation device to treat, reduce, or delay adjacent level degenerative disc disease. The spacer device comprises a compressible spacer, a transverse member, and a connecting member. The compressible spacer is sized to fit between the spinous processes of two adjacent vertebrae and is configured to reduce the range of motion of at least one vertebra. The transverse member is configured to extend from one side of the midline of the spine, extending through the interspinous process space. The transverse member is coupled with the spacer. The connecting member is attachable to the transverse member and to a primary spinal fixation device.

Abstract: An apparatus for stabilizing vertebrae while permitting a range of motion therebetween may include first and second fasteners for engaging adjacent vertebrae and a motion preserving device that can be coupled to the first and second fasteners. The motion preserving device may include a longitudinal member that includes an array of load-bearing elements. The longitudinal member may be configured to permit the load-bearing elements to move relative to each other and/or relative to other portions of the member. In some embodiments, the longitudinal member is relatively inflexible along a longitudinal axis and relatively flexible in a direction transverse to the longitudinal axis.

Abstract: In one embodiment, an access device is inserted through an incision in skin of a patient. The access device is expanded from a first configuration to a second configuration, the second configuration having an enlarged cross-sectional area at a distal portion of said access device such that the distal portion extends across at least a portion of the interbody space. A prosthetic spinal disc implant is then delivered through the access device.

Abstract: An apparatus is provided for connecting a longitudinal member to a bone portion. The apparatus includes a fastener engageable with a bone portion, a housing having a first passage configured to receive a longitudinal member and a second passage configured to receive the fastener. The fastener extends through an opening in the housing into the second passage and is movable relative to the housing. The longitudinal axis of the fastener is positionable in any one of a plurality of angular positions relative to a longitudinal axis of the second passage. The apparatus also includes a clamping member configured to be received in threaded engagement within the housing. The clamping member has a first end configured such that when a longitudinal member is positioned in the first passage in the housing, the first end of the clamping member engages the longitudinal member at an angle not orthogonal to an axis along which the clamping member is advanced.

Abstract: A retractor has a proximal portion comprising a first side portion having a first longitudinal edge and a second side portion having a second longitudinal edge. The first and second portions being movable relative to each other such that the first and second longitudinal edges can be positioned in close proximity to each other or spaced apart by a selected distance. A distal portion is coupled with the proximal portion. The distal portion has an outer surface and an inner surface partially defining a passage. The distal portion is capable of having a configuration when inserted within the patient wherein the cross-sectional area of the passage at a first location is greater than the cross-sectional area of the passage at a second location, wherein the first location is distal to the second location.

Abstract: A surgical instrument includes a first device adapted to be connected to a fastener fixed to a first bone portion. A second device includes a first portion associated with the first device and a second portion for supporting a member which engages the fastener fixed to the first bone portion and secures a rod connected to the second bone portion to the fastener. The second portion is adapted for pressing the member against the rod. The first device has a part that prevents the second device from moving toward the fastener that is connected to the first device so that the member is rotated relative to the fastener but is not moved axially relative to the fastener in response to rotation of the second device.

Abstract: An apparatus includes a fastener engageable with a bone portion to connect a longitudinal member to the bone portion. A housing has a first passage configured to receive the longitudinal member and a second passage extending transverse to the first passage. The fastener extends through an opening in the housing into the second passage. A longitudinal axis of the fastener is positionable in any one of a plurality of angular positions relative to a longitudinal axis of the second passage. A spacer received in the second passage of the housing is engageable with the fastener and the longitudinal member. A positioning member applies a force to prevent relative movement between the fastener and the housing and permit manual movement of the fastener relative to the housing against the force when the longitudinal member is disengaged from the spacer. A clamping mechanism clamps the longitudinal member, the spacer, and the housing to the fastener to prevent movement of the fastener relative to the housing.

Abstract: A retractor has a proximal portion comprising a first side portion having a first longitudinal edge and a second side portion having a second longitudinal edge. The first and second portions being movable relative to each other such that the first and second longitudinal edges can be positioned in close proximity to each or spaced apart by a selected distance. A distal portion has an outer surface and an inner surface partially defining a passage. The distal portion is capable of having a configuration when inserted within the patient wherein the cross-sectional area of the passage at a first location is greater than the cross-sectional area of the passage at a second location, wherein the first location is distal to the second location.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.