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: A spinal alignment system is disclosed and includes vertebral connectors, elongated elements that link the vertebral connectors, and fasteners that lock the elongated elements in position. An elongated element has at least one shaped end that is received by a coupling member of the connector. The shaped end permits the elongated element to be angularly moveable with respect to the coupling member until locked in place with a fastener received in the coupling member. The elongated element also preferably includes a length adjustment mechanism, such as a telescoping or threaded section to provide a desired length in conjunction with a desired degree of alignment. Various coupling mechanisms are disclosed to provide multiple degrees of freedom prior to fixation.

Abstract: A spinal alignment system is disclosed and includes vertebral connectors, elongated elements that link the vertebral connectors, and fasteners that lock the elongated elements in position. An elongated element has at least one shaped end that is received by a coupling member of the connector. The shaped end permits the elongated element to be angularly moveable with respect to the coupling member until locked in place with a fastener received in the coupling member. The elongated element also preferably includes a length adjustment mechanism, such as a telescoping or threaded section to provide a desired length in conjunction with a desired degree of alignment. Various coupling mechanisms are disclosed to provide multiple degrees of freedom prior to fixation.

Abstract: Spacerless artificial disc replacements (ADRs) 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 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: Instrumentation for determining the integrity of a natural or synthetic implant includes a component that is at least temporarily attached to or constrained by a bone or tissue, and a handle coupled to the component including a force-measurement gauge. Operation of the device permits a user to push or pull on the handle and determine the integrity of the component by referring to the force-measurement gauge. The handle may be modularly attachable to a plurality of different components or the same component at different sizes for different uses. One preferred embodiment resides in a disc pressure gauge that helps in determining the risk of extrusion of intradiscal devices. Although described in terms of spinal applications, the invention is not limited in this regard, and may be used in any medical, dental, surgical/orthopaedic, or veterinarian application through appropriate extension.

Abstract: A biomedical material for transplant to a subject is provided according to embodiments of the present invention which includes an isolated donor tissue enzyme-treated to reduce the amount of proteoglycans in the donor tissue compared to untreated tissue. Isolated cells are optionally added to the enzyme-treated donor tissue, including leukocytes, particularly monocytes; macrophages; platelets; cells derived from an intervertebral disc such as chondrocyte-like nucleus pulposus cells; fibrocytes; fibroblasts; mesenchymal stem cells; mesenchymal precursor cells; chondrocytes; or a combination of any of these. The isolated donor tissue is articular cartilage or an intervertebral disc tissue such as nucleus pulposus tissue and/or annulus fibrosis tissue enzyme-treated to remove proteoglycans normally present in these tissues. A biomedical material of the present invention is administered to a subject to treat a disorder or injury, such as a disorder or injury to connective tissue.

Abstract: A method for stabilizing upper and lower spinal vertebrae having a disc space situated therebetween is described. First and second fasteners are inserted into the upper vertebra. Third and fourth fasteners are inserted into the lower vertebra, such that the first and third fasteners are substantially vertically aligned and the second and fourth fasteners are substantially vertically aligned. The first and third fasteners are connected with a first elongate element. The second and fourth fasteners are connected with a second elongate element. The first and fourth fasteners are connected with a third elongate element. The second and third fasteners are connected with a fourth elongate element.

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: 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: Check reins in the form of elongated members are used to limit the extreme range of motion which would otherwise be permitted by some ADR designs. The check reins serve two main purposes. First, they retain disc spacers, if present. Additionally, the wedge shape of ADRs and the removal of the Anterior Longitudinal Ligament (ALL) and a portion of the Annulus Fibrosus (AF) to insert the ADR from an anterior approach, favor anterior extrusion of disc spacers. In preferred embodiments the check reins are therefore limited to the anterior portion of the periphery of the ADR. Second, check reins serve to prevent excessive spinal motion. Again, although they may be helpful in other locations, anterior check reins help restore the motion limiting functions of the ALL and AF that were removed in anterior approaches to the spine.

Abstract: This invention relates generally to spine surgery and, in particular, to methods and apparatus for treating spinal stenosis.

Abstract: Methods and devices for fixing a defect in the anulus fibrosus of a patient. The devices include first and second vertical components extending from the middle region of the horizontal component, each of the first and second vertical components having a width and an end. The middle region of the horizontal component of the device blocks the defect in the anulus fibrosus. The first vertical component is attached to the upper vertebra and the second vertical component is attached to the lower vertebra. The horizontal component can be positioned beneath a layer of the posterior longitudinal ligament.

Abstract: Methods and devices for fixing a defect in the annulus fibrosis of a patient. The devices include first and second vertical components extending from the middle region of the horizontal component, each of the first and second vertical components having a width and an end. The middle region of the horizontal component of the device to block the defect in the annulus fibrosis. The first vertical component is attached to the upper vertebra and the second vertical component is attached to the lower vertebra. The horizontal component can be positioned beyond at least an outer layer of the annulus fibrosis, alternatively positioned beyond the innermost layer of annulus fibrosis, alternatively positioned between adjacent layers of annulus fibrosis, or alternatively positioned on the exterior of the annulus fibrosis.

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 for treating an annulus fibrosis having a defect include inserting a flexible device into the defect. The flexible device is advanced distally beyond an outer layer of the annulus fibrosus. The flexible device is then expanded such that a width of the flexible device is larger than the defect, where the flexible device prevents escape of nucleus pulposus through the defect. The flexible device may have at least two appendages made from a shape-memory metal. Alternatively, the flexible device may have a U-shaped structure that includes a central portion and two legs. The flexible device may also be anchored to the annulus fibrosis and/or the vertebrae.

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: Apparatus and methods are used to expand and/or connect disc replacement devices in situ, allowing such devices to be inserted through smaller openings including posterior as well as an anterior approaches to the spine. Other embodiments reside in nucleus replacements that do not expand within the disc space, providing improved longevity compared to existing NRs. Embodiments of the invention may be used in the cervical, thoracic, or lumbar spine. The invention may also be used in other joints such as, the knee, prosthetic knees, prosthetic hips, or other joints in the body.

Abstract: An artificial joint or disc replacement (ADR) broadly includes a pair of opposing endplate components, each attached to one of the upper and lower vertebrae, a cushioning component disposed between the endplate components, and a mechanism for coupling the cushioning component to one or both of the endplates. In the preferred embodiment, the cushioning component takes the form of a tire-like outer structure attached to an inner hub. A filler material is also preferably contained within the cushioning component. The filler material may be a gas, liquid, foam, or gel, including a hydrogel. One or both of the endplate components may include a modified surface to increase adherence to respective opposing bone surfaces.

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.