Abstract: Medical devices for treating an annulus fibrosis are described. The annulus fibrosis has an outer layer, at least one inner layer, and a defect extending through the outer and inner layers. The devices include first and second elongate fastening members, each having a first end, a second end, and an anchor on the first end that is substantially transverse when deployed.

Abstract: Methods and apparatus for treating disc herniation provide a conformable device which assumes a first shape associated with insertion and a second shape or expanded shape to occlude the defect which typically follows partial discectomy. The device may take different forms according to the invention, including patches size to cover the defect or plugs adapted to fill the defect. In a preferred embodiment, however, the device is a gel or other liquid or semi-liquid which solidifies to occlude the defect from within the body of the disc itself. In another preferred embodiment, a mesh screen is collapsed into an elongated form for the purposes of insertion, thereby minimizing the size of the requisite incision while avoiding delicate surrounding nerves.

Abstract: Methods and apparatus for treating defects in the annulus fibrosis are described. The methods include providing first and second elongate fastening members, each having a first end and an anchor on the first end that is substantially transverse when deployed. The first end of the first and second elongate fastening members are positioned distal of the outer layer and at least one inner layer of the annulus fibrosis. The defect is then closed by interlocking the first and second elongate fastening members. Alternatively, second ends of the elongate fastening members may be linked, resulting in reducing the size of the opening of the defect. Devices having first and second elongate fastening members, each having a first end, a second end, and an anchor on the first end that is substantially transverse when deployed; and a connector that links the first and second elongate fastening members are also described.

Abstract: Disclosed embodiments provide for treatment of the anulus fibrosus (AF) and intevertebral disc (IVD), including herniated discs, anular tears of the disc, or disc degeneration, while enabling surgeons to contain blood, fluid, proteins, or other materials that are placed into or migrate into or near defective regions of the spine. The invention also concentrates mesenchymal stem cells (MSCs) in the surgical area and increases the area of bone to be fused. Other aspects of the invention may be used to raise the temperature of tissues, including surgical tissues, to stimulate inflammation, thereby stimulating tissue healing. According to these embodiments, the invention places a heating element below the skin and adjacent to the tissue to stimulate the healing thereof.

Abstract: A method for retaining an intra-discal material within an annulus fibrosis is described. The annulus fibrosis has a posterior annulus, an inside surface, and an opening with a lateral and a vertical dimension. A single wire and a band is provided. The single wire is made of shape-memory material and has a first compressed configuration and a second expanded configuration. The band and the single wire, which is in the first compressed configuration, is inserted through the opening in the annulus fibrosis. After insertion through the opening, the single wire expands to the second expanded configuration. The single wire and the band are positioned near the posterior annulus to rest against annulus fibrosis tissues adjacent the opening on the inside surface of the annulus fibrosis, such that the band is positioned to rest against annulus fibrosis tissues adjacent the opening, thereby preventing escape of intra-discal material through the opening.

Abstract: The present invention relates to medical devices and methods generally aimed at spinal surgery. In particular, the disclosed system and associated methods relate to performing spinal fixation.

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: Apparatus and methods facilitates reconstruction of the anulus fibrosus (AF) and/or the nucleus pulposus (NP) to prevent recurrent herniation following microlumbar discectomy. The invention may also be used in the treatment of herniated discs, anular tears of the disc, or disc degeneration, while enabling surgeons to preserve the contained nucleus pulposus. A spinal repair system according to the invention comprises flexible longitudinal fixation components adapted for placement through portions of the AF with intact fibers, a porous mesh reinforcement component adapted for placement over a region of the AF with damaged fibers, and an anti-adhesion component for placement over flexible longitudinal fixation components and the porous mesh component. Preferred embodiments of the invention include an intra-aperture component dimensioned for positioning within a defect in the AF, with one or more components being used to maintain the intra-aperture component in position.

Abstract: The present invention involves a system and methods for nerve testing during anterior surgery, including but not limited to anterior disc replacement surgery, nucleus replacement, and interbody fusion.

Abstract: Neurophysiological instruments and techniques are improved through various enhancements. Stimulation of an instrument is possible while it is advancing into the spine or elsewhere, alerting the surgeon to the first sign the instrument or device (screw) may be too near a nerve. A directional probe helps surgeons determine the location of the hole in the pedicle. Electrically insulating sleeves prevent shunting into the soft tissues. According to a different improvement, the same probe to be used to stimulate different devices, such as screws and wires. Electrical impulses may be recorded from non-muscle regions of the body, including the spine and other portions of the central nervous system as opposed to just the extremities.

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: Bone morphogenetic proteins (BMPs) are introduced into an affected intervertebral disc without the inclusion of disc cells. The inventions applies to all known and yet-to-be developed or discovered BMPs, including BMP-1, -2, -3, -4, -5, -6, -7, -8, -9, -10, . . . BMPn. The BMP(s) may be obtained from natural and/or recombinant sources. The BMP(s) may be introduced using any surgical technique, including percutaneous or laparoscopic approaches. As one delivery mechanism, a passageway may be formed through the annulus, with the substances then being introduced through the passageway. Alternatively, a carrier may be sewn or otherwise adhered to the inside or outside of the existing annulus using standard surgical procedures. Additional therapeutic substances such as culture medium, growth factors, differentiation factors, hydrogels, polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications could be introduced in conjunction with the BMP(s).

Abstract: Methods for stabilizing upper and lower spinal vertebrae having a disc situated between the upper and lower vertebrae are described. First and second fasteners are inserted into the upper vertebra. Third and fourth fasteners are inserted into the lower vertebra. At least two of the first, second, third, and fourth fasteners are connected with an elongate element. In an alternative embodiment, at least three of the first, second, third, and fourth fasteners are connected with the elongate element. The elongate element may be an elastic connector or a cable. The elongate element may also have first and second ends that are connected by a crimp.

Abstract: Bone morphogenetic proteins (BMPs) are introduced into an affected intervertebral disc without the inclusion of disc cells. The inventions applies to all known and yet-to-be developed or discovered BMPs, including BMP-1, -2, -3, -4, -5, -6, -7, -8, -9, -10, . . . BMPn. The BMP(s) may be obtained from natural and/or recombinant sources. The BMP(s) may be introduced using any surgical technique, including percutaneous or laparoscopic approaches. As one delivery mechanism, a passageway may be formed through the annulus, with the substances then being introduced through the passageway. Alternatively, a carrier may be sewn or otherwise adhered to the inside or outside of the existing annulus using standard surgical procedures. Additional therapeutic substances such as culture medium, growth factors, differentiation factors, hydrogels, polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications could be introduced in conjunction with the BMP(s).

Abstract: A method for retaining an intra-discal material within an annulus fibrosis is described. The annulus fibrosis has a posterior annulus, an inside surface, and an opening with a lateral and a vertical dimension. A single wire and a band is provided. The single wire is made of shape-memory material and has a first compressed configuration and a second expanded configuration. The band and the single wire, which is in the first compressed configuration, is inserted through the opening in the annulus fibrosis. After insertion through the opening, the single wire expands to the second expanded configuration. The single wire and the band are positioned near the posterior annulus to rest against annulus fibrosis tissues adjacent the opening on the inside surface of the annulus fibrosis, such that the band is positioned to rest against annulus fibrosis tissues adjacent the opening, thereby preventing escape of intra-discal material through the opening.

Abstract: A bone plate system comprising a thin plate and fasteners for securing the plate to at least two segments of bone. The plate may be hinged along the central axis, with a pair of collinear holes on each portion of the plate. Each of the holes accommodates a bolt which is screwed into the bone and secured to the plate using a nut.

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: 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. A suture banding tool may be used to place the sutures around the anchors in a looped configuration, apply tension to the suture ends to tighten the suture loop around the anchors and weld the ends of the suture to form a suture band connecting the anchors.

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.

Abstract: Artificial disc replacements (ADRs) use mobile spacers between vertebral endplates. In the preferred embodiment, spherical spacers are used between metal or ceramic plates placed over or in the endplates of the vertebrae. The spherical spacers may be made of metal, ceramics or polymers such as polyethylene. One or more of the bearings may be used in each disc replacement, and one or more disc replacements may be inserted into the disc space. The small bearings allow the preservation of the vertebral endplates. Although the preferred embodiment use mobile units preferably in the form of small spheres and two ADRs per level, alternatives are disclosed, wherein the mobile unit is non-spherical, including oblong shapes. Further alternative configurations include an elongated mobile bearing contained by interdigitating projections from superior and/or inferior endplates.