Abstract: Apparatus, systems and methods are used to repair, reconstruct and/or replace spinal features. A flexible longitudinal fixation component such a suture is passed around or through a portion of a spine, with the end sections of the component either being attached to one another or coupled to at least one bone implant. The bone implant may be a bone anchor or may form part of a pedicle screw assembly. The flexible longitudinal fixation component may pass through an anulus fibrosis (AF) and at least one intra-aperture component situated within a void or defect in an AF. The intra-aperture component may be composed of a porous mesh, allograft tissue or xenograft tissue. The intra-aperture component preferably includes one or more proximal-to-distal channels facilitating the intentional initial passage of nucleus pulposis (NP) tissue while preventing the extrusion of the NP long term.

Abstract: Artificial disc replacements (ADRs) and total disc replacements (TDRs) are based upon two, directly articulating components, resulting in a restricted-motion system that better approximates more normal spinal flexion, extension, and lateral bending. Both components are preferably made of a hard material and are highly polished to reduce friction.

Abstract: This invention improves upon prior art total disc replacements (TDRs) by more closely replicating the kinematics of a natural disc. The preferred embodiments feature two or more fixed centers of rotation (CORs) and an optional variable COR (VCOR) as the artificial disk replacement (ADR) translates from a fixed posterior COR that lies posterior to the COR of the TDR to facilitate normal disc motion. The use of two or more CORs allows more flexion and more extension than permitted by the facet joints and the artificial facet (AF). AF joint-like components may also be incorporated into the design to restrict excessive translation, rotation, and/or lateral bending.

Abstract: Instrumentation and methods facilitate reconstruction of the anulus fibrosus (AF) and the nucleus pulposus (NP). An intra-aperture component is dimensioned for positioning within a defect in the AF, with one or more components being used to maintain the intra-aperture component in position. The intra-aperture component may be porous and flexible while being intentionally non-expandable in cross section following its positioning within the defect. A component used to maintain the intra-aperture component within the defect includes a flexible longitudinal fixation component that passes through the intra-aperture component and a region of the AF apart from the defect. If available, this may be a region of the AF having overlapping layers with intact fibers in different directions. The flexible longitudinal fixation component may be anchored to one of the upper and lower vertebral bodies.

Abstract: Spacerless artificial disc replacements (ADR) are disclosed. One preferred embodiment includes two saddle-shaped components to facilitate more normal spinal flexion, extension, and lateral bending while limit axial rotation, thereby protecting the facet joints and the annulus fibrosus (AF). Either or both of the superior and inferior components are made of a hard material such as chrome cobalt, titanium, or a ceramic including alumina, zirconia, or calcium phosphate. The articulating surfaces of the ADR are also preferably highly polished to reduce friction between the components. Metals, alloys or other materials with shape-memory characteristics may also prove beneficial.

Abstract: A filament laterally spans a tear, fissure or other defect in an annulus. One portion of the filament is anchored to the annulus by passing at least one first anchor through the annulus and into the nucleus on one side of the fissure, and with a second portion of the filament being anchored to the annulus by passing at least one second anchor through the annulus and into the nucleus on a second side of the fissure, with the at least one first and second anchors being drawn back through the nucleus and against the inner surface of the posterior annulus by the application of a significant (e.g., about 15 N to 25 N) axial tension applied perpendicular to the posterior wall of the annulus, and with the fissure being drawn closed by the subsequent application of a significant axial tension applied perpendicular to the posterior wall of the annulus.

Abstract: Devices and methods for fixing defects in the anulus fibrosus (vertebral disc) of a patient are described. The devices include a mesh patch, and first and second suture assemblies, each of which include an anchor and a suture. The anchor has a first portion adapted to be inserted into a bone and a second portion having an opening therethrough. The suture is adapted to be disposed through the opening and has a first end is adapted to couple to the mesh patch. The method of treatment includes inserting the first portion of the first anchor into a cranial vertebra and inserting the second portion of the second anchor into a caudal vertebra. The first ends of the sutures are attached to the mesh patch. The mesh patch is positioned adjacent the defect by pulling on, or applying tension to, the second ends of the sutures.

Abstract: Methods and devices are described for occluding openings in an annulus fibrosis to prevent conditions such as disc herniation and recurrent disc herniation. An occluding device having an intradiscal component, an extradiscal component, and a barrier element disposed between the intradiscal and extradiscal components is provided. The intradiscal component has first and second arms having a collapsed state with a horizontal dimension less than the width of the opening and an expanded state having a horizontal dimension greater than the width of the opening. The barrier element and the intradiscal component in the collapsed state are inserted through the annulus fibrosis opening, the extradiscal component being positioned adjacent an outer surface of the annulus fibrosis. The intradiscal component assumes the expanded state in the intradiscal space, the first and second arms urging the barrier element against the inner wall of the annulus fibrosis adjacent the opening, thereby occluding the opening.

Abstract: A method for retaining an intra-discal material within an annulus fibrosis having a posterior annulus, an inside surface, and an opening is described. The opening has a lateral and a vertical dimension. A retention device that includes a shape memory alloy is inserted through the opening in the annulus fibrosis. The length dimension of the device is longer than the lateral dimension of the opening and the width dimension of the device is longer than the vertical dimension of the opening in the annulus fibrosis. The retention device is positioned against the posterior annulus to rest against annulus fibrosis tissues adjacent the opening on the inside surface of the annulus fibrosis such that both a portion of the length dimension and a portion of the width dimension rests against annulus fibrosis tissues adjacent the opening. The retention device prevents the escape of intra-discal material through the opening.

Abstract: Spacerless artificial disc replacements (ADR) are disclosed. One preferred embodiment includes two saddle-shaped components to facilitate more normal spinal flexion, extension, and lateral bending while limit axial rotation, thereby protecting the facet joints and the annulus fibrosus (AF). Either or both of the superior and inferior components are made of a hard material such as chrome cobalt, titanium, or a ceramic including alumina, zirconia, or calcium phosphate. The articulating surfaces of the ADR are also preferably highly polished to reduce friction between the components. Metals, alloys or other materials with shape-memory characteristics may also prove beneficial.

Abstract: Artificial disc replacements (ADRs) and total disc replacements (TDRs) are based upon two, directly articulating components, resulting in a restricted-motion system that better approximates more normal spinal flexion, extension, and lateral bending. Both components are preferably made of a hard material and are highly polished to reduce friction.

Abstract: One or more sutures can be used in spinal applications to hold an intradiscal device in place between two vertebrae or repair a defect in the soft tissue of the spine, such as the annulus fibrosis or the dura. Tension can also be applied to the sutures to stabilize a spinal segment having an intradiscal device to prevent or minimize excessive spinal extension, lateral bending, and axial rotation of the spinal segment. Anchors are placed in two adjacent vertebrae and sutures are passed through each anchor. The sutures can be passed through portions of the intradiscal device, Alternatively, the sutures can be passed through a mesh patch which is held against the vertebrae to hold the intradiscal device in place. Tension is applied to the first and second ends of the sutures and the sutures are welded together. The sutures can be welded in a cross-braced arrangement minimize or prevent extension, lateral bending, and rotation of the spinal segment.

Abstract: Apparatus for treating tissue, wherein the apparatus heats the tissue in a controlled manner so as to promote therapeutic inflammation in the tissue, whereby to augment healing of the tissue.

Abstract: Artificial disc replacements (ADRs) and total disc replacements (TDRs) are based upon two, directly articulating components, resulting in a restricted-motion system that better approximates more normal spinal flexion, extension, and lateral bending. One component may have a concave articulating surface, and the other a convex articulating surface. The radius of curvature of the articulating surface may be smaller in the anterior-to-posterior direction of the ADR than the radius of curvature of the articulating surface in the left-to-right direction of the ADR. Both components are preferably made of a hard material and are highly polished to reduce friction.

Abstract: Methods and devices for fixing a defect in a vertebral disc of a patient. One method includes providing first, second, third, and fourth sutures. The first and second sutures are fastened to a vertebra cranial to the vertebral disc at first and second locations, respectively. The third and fourth sutures are fastened to a vertebra caudal to the vertebral disc at third and fourth locations, respectively. A device, such as a mesh device, is positioned adjacent the defect. The first, second, third, and fourth sutures are then positioned against the device, on the side of the device opposite of the defect. Tension is then applied to the first, second, third, and fourth sutures. Each of the first, second, third, and fourth sutures are then attached to at least one of the first, second, third, and fourth sutures, thereby holding the device adjacent the defect.

Abstract: Methods for providing a flexible spinal stabilization system operative to prevent lateral bending, extension, and rotation across two or more adjacent vertebrae are described. Broadly, the invention utilizes a pair of connectors on each vertebrae, and flexible elongated elements, such as sutures or cables, in an axial and crisscrossed pattern to provide an arrangement that resists extension, lateral bending, and torsional/rotational motion. In some embodiments, the flexible stabilization system includes a pair of locking anchors and a pair of hook-like anchors. The locking anchors are pre-threaded with a suture in a loose looped configuration before insertion into the vertebra. Once the locking anchors have been inserted, the suture loops can be looped over hook-like anchors inserted into an adjacent vertebrae to join the vertebrae and apply tension across the disc space. In some embodiments, the hook-like anchors can have multiple hooks for use in joining multiple vertebral levels.

Abstract: This invention improves upon prior aft total disc replacements (TDRs) by more closely replicating the kinematics of a natural disc. The preferred embodiments feature two or more fixed centers of rotation (CORs) and an optional variable COR (VCOR) as the artificial disk replacement (ADR) translates from a fixed posterior COR that lies posterior to the COR of the TDR to facilitate normal disc motion. The use of two or more CORs allows more flexion and more extension than permitted by the facet joints and the artificial facet (AF). AF joint-like components may also be incorporated into the design to restrict excessive translation, rotation, and/or lateral bending.

Abstract: A method for closing a fissure in a region of tissue having an inner surface and an outer surface, the method comprising: providing at least a pair of transverse anchor components, each transverse anchor component being coupled to at least one flexible longitudinal fixation component having a longitudinal axis; placing the transverse anchor components relative to the inner surface of the tissue on both sides of the fissure such that an exposed end of a flexible longitudinal fixation component extends through the tissue and past the outer surface of the tissue on both sides of the fissure; applying axial tension to the exposed ends; and anchoring the exposed ends.

Abstract: One or more sutures can be used in spinal applications to hold an intradiscal device in place between two vertebrae or repair a defect in the soft tissue of the spine, such as the annulus fibrosis or the dura. Tension can also be applied to the sutures to stabilize a spinal segment having an intradiscal device to prevent or minimize excessive spinal extension, lateral bending, and axial rotation of the spinal segment. Anchors are placed in two adjacent vertebrae and sutures are passed through each anchor. The sutures can be passed through portions of the intradiscal device. Alternatively, the sutures can be passed through a mesh patch which is held against the vertebrae to hold the intradiscal device in place. Tension is applied to the first and second ends of the sutures and the sutures are welded together. The sutures can be welded in a cross-braced arrangement minimize or prevent extension, lateral bending, and rotation of the spinal segment.

Abstract: Spinal stabilization mechanisms act to prevent lateral bending, extension, and rotation across adjacent vertebrae. Methods for spinal stabilization includes placing one or more anchors at each vertebral level, positioning one or more sutures around each anchor at each level such that the each suture forms a loop or band around two adjacent anchors, applying tension to the ends of each suture to tighten the suture loop around the anchors and welding overlapping ends of each suture together to form suture bands connecting the anchors and thereby preventing lateral bending, extension, and rotation of the spinal segment. An in-growth component is placed over the anterior portions of the three adjacent vertebrae and the disk space therebetween. An anti-adhesion patch is placed over the in-growth component, anchors and elongate members. The anti-adhesion patch has one or more notches that provide access to at least two of the anchors and a flap extending from between the notches.