Abstract: Apparatus and methods are disclosed for determining and placing a first bony segment in relation with a second bony segment, both segments belonging to the same bone, including cutting said bone partially, to separate it into the first and second bony segment. The two bony segments are linked together by a bony hinge and placing the two boney segments in relation to each other may include distracting both bony segments around said hinge. The hinge may be configured to allow distraction of both bony segments around a single degree of freedom of the hinge and accommodate corrections in two substantially orthogonal planes.

Abstract: Disclosed herein is a kit for augmenting a primary repair construct in an articulating joint. The kit includes a flexible member, a first implant that fixes a first end of the flexible member in a first bone adjacent to the primary repair construct and a second implant that may selectively couple to the flexible member, and thereby fix a second end of the flexible member in a second bone adjacent to the primary repair construct. The kit also includes a tension adjusting construct that may operatively couple to the flexible member and controllable adjust a tension on the flexible member disposed between the first and second implant, the tension adjustable so as to define an angle of joint articulation at which the flexible member changes from being passive to augment the primary repair construct.

Abstract: An anchor includes an anchor body configured to be retained within base tissue. The anchor body includes a unidirectional mechanism to selectively restrict passage of a flexible member through the anchor. The flexible member includes a loop to enable attachment of candidate tissue to base tissue without the use of knots.

Abstract: An apparatus and method for securing boney structures is disclosed which includes a compression mechanism and a force transfer mechanism. The compression mechanism may have bone engagement members that have one portion slideably coupled to a housing positioned within the implant and another portion rotatably coupled to the implant so that a movement of the housing causes the slideable portion to move within the housing and a penetrating member to rotate about the rotatably coupled portion. The force transfer mechanism may be coupled to the compression mechanism to move the housing.

Abstract: There is disclosed a system and method for dynamic stabilization which provides for distraction of the inter-vertebral space while still allowing a patient a substantial range of motion. In one embodiment, an inter-vertebral dynamic brace is used to maintain proper distraction. The dynamic brace is designed to allow the vertebrae to which it is attached to move through their natural arc, maintaining the correct instantaneous center of rotation. An adjustable tensioning device is used to maintain the proper distraction and compression forces to restore and maintain proper kinematics, while allowing the dynamic brace to move through an arc centered with respect to the center of rotation of the portion of the spine between the vertebrae. In one embodiment, a method is provided for adjusting the dynamic brace both with respect to the center of rotation of the vertebrae in both the flexion/extension axis and in the superior/inferior axis.

Abstract: Provided is a system for dynamically stabilizing a spine. In one example, the system includes a first bone anchor coupled to a first polyaxial head and a second bone anchor coupled to a second polyaxial head. An axis passing through a center of each polyaxial head is aligned with a center of rotation. A first member has a first end movably coupled to the first polyaxial head and a second end. A second member has a third end coupled to the second polyaxial head and a fourth end moveably coupled to the second end. The first and second members are configured to maintain the alignment of the axes with the center of rotation during three dimensional movement of the first member relative to the second member.

Abstract: A method and system are described for immobilizing three or more vertebrae. The system includes a first bone anchor assembly, a second bone anchor assembly including a connector having a predefined arc, and at least a third bone anchor assembly. The first and second bone anchor assemblies are inserted into the pedicles of vertebrae spanning at least a third vertebra. The third bone anchor assembly is positioned into the third vertebra between the first and second bone anchor assemblies using an arc defining instrument which is used to locate the proper position for the third bone anchor assembly based on the predefined arc of the connector. Once the third bone anchor assembly is in place the connector is rotated into position and captured by the first and third bone anchor assemblies.

Abstract: A method, apparatus, and system are provided to place an insert in a space between boney structures. The insert may be rotatably coupled to the delivery instrument. The delivery instrument may comprise a body and an articulating member. The articulating member may slidably interact with the insert to rotate the insert about a pivot point. A first actuator is operatively coupled to the articulating member such that actuating the first actuator translates the articulating member relative to the body. An engagement member may be coupled to the body and adapted to releasably and rotatably secure the insert to the delivery instrument. The articulating member and the engagement member may be offset from each other in such a manner that when the articulating member engages the insert, the insert rotates relative to the delivery instrument. Alternatively, the insert may be coupled to the delivery instrument via rotatable attachment members.

Abstract: A tool is described for use in a stabilization system for bony structures such as vertebrae, where the system involves connected a connector from one bone anchor in a vertebra to a second bone anchor in another vertebra. The tool includes a handle attached to an arm. The arm is connected by a pivot to a connector engagement mechanism, the pivot allowing the connector engagement mechanism to move from an orientation inline with the arm to an orientation at an angle relative to the arm by rotating at the pivot. The connector engagement mechanism is engaged to an end of the connector when the tool is in its inline orientation and by causing the movement, which can be by the movement of a lever on the handle, of the connector engagement mechanism to the angled orientation, the end of the connector is moved into a position for engagement with the second bone anchor.

Abstract: An anchor includes an anchor body configured to be retained within base tissue. The anchor body includes a unidirectional mechanism to selectively restrict passage of a flexible member through the anchor. The flexible member includes a loop to enable attachment of candidate tissue to base tissue without the use of knots.

Abstract: A method and system are described for immobilizing three or more vertebrae. The system includes a first bone anchor assembly, a second bone anchor assembly including a connector having a predefined arc, and at least a third bone anchor assembly. The first and second bone anchor assembly are inserted into the pedicles of vertebrae spanning at least a third vertebra. The third bone anchor assembly is positioned into the third vertebra between the first and second bone anchor assemblies using an arc defining instrument which is used to locate the proper position for the third bone anchor assembly based on the predefined arc of the connector. Once the third bone anchor assembly is in place the connector is rotated into position and captured by the first and third bone anchor assemblies.

Abstract: An anchor includes an anchor body configured to be retained within base tissue. The anchor body includes a unidirectional mechanism to selectively restrict passage of a flexible member through the anchor. The flexible member includes a loop to enable attachment of candidate tissue to base tissue without the use of knots.

Abstract: There is disclosed a system and method for dynamic stabilization which provides for distraction of the inter-vertebral space while still allowing a patient a substantial range of motion. In one embodiment, an inter-vertebral dynamic brace is used to maintain proper distraction. The dynamic brace is designed to allow the vertebrae to which it is attached to move through their natural arc, maintaining the correct instantaneous center of rotation. An adjustable tensioning device is used to maintain the proper distraction and compression forces to restore and maintain proper kinematics, while allowing the dynamic brace to move through an arc centered with respect to the center of rotation of the portion of the spine between the vertebrae. In one embodiment, a method is provided for adjusting the dynamic brace both with respect to the center of rotation of the vertebrae in both the flexion/extension axis and in the superior/inferior axis.

Abstract: Systems and methods for displacing bony structures relative to each other using a single device is disclosed. Displacement includes distraction and compression. Bony structures are engaged with displacement arms. The user selects one of a plurality of manners in which to manipulate a user interface, where a first manner results in compression and a second manner results in distraction. The user interface is manipulated in the selected manner until a desired amount of displacement has been reached. This displacement is performed in a manner that is minimally invasive to the patient.

Abstract: An assembly for use in spinal stabilization procedures having first and second bone anchor assemblies. Embodiments of the first bone anchor assembly may include an anchor, a poly-axial head, including a cavity, mated with the anchor such that the anchor is movable relative to the poly-axial head. Embodiments of the second bone anchor assembly may include an anchor, a poly-axial head mated with the second anchor such that the anchor is movable relative to the poly-axial head, a slide ring rotatably mated in the second poly-axial head, and a connector slideably mated in the slide ring along a distal end, and having a proximal end having an enlarged portion. The connector may be movable from a first position axially inline with the second bone anchor to a second position wherein the enlarged portion of the connector rests in the cavity of the first poly-axial head.

Abstract: An apparatus and method for securing boney structures is disclosed which includes a compression mechanism and a force transfer mechanism. The compression mechanism may have bone engagement members that have one portion slideably coupled to a housing positioned within the implant and another portion rotatably coupled to the implant so that a movement of the housing causes the slideable portion to move within the housing and a penetrating member to rotate about the rotatably coupled portion. The force transfer mechanism may be coupled to the compression mechanism to move the housing.

Abstract: An extension for use in a procedure to implant a stabilization system for bony structures such as vertebrae is described. The extension is formed by a tubular body with an engagement mechanism at one end to removably engage with a poly-axial head of a bone anchor assembly. A locking ring working with a slide are used to temporarily lock the poly-axial head and extension in the desired relationship for performing the procedure. The locking ring includes a slot in which resides a pin on the slider. Twisting the locking ring causes the pin to move in the slot and thereby move the slider either up or down. In one position a locking body on the slider engages with the poly-axial assembly locking the extension in place. In the other position, the locking body is disengaged from the poly-axial head allowing the extension to be decoupled from the bone anchor assembly.

Abstract: Disclosed is a guided bone anchoring device comprising a head, a shank and a passage for receiving a guide wire, the passage having a longitudinal center axis which is not concentric to the longitudinal center axis of the shank. Also disclosed is a system for guiding bone anchors, the system comprising: a guide wire, an anchor comprised of a shank wherein the shank has an offset bore at the distal end which is adapted to allow the guide wire to slide through the bore, a dilator having a longitudinal slot wherein the longitudinal slot allows the guide wire to extend through the longitudinal slot when the anchor is positioned within the dilator, and a driving device which is adapted to engage the proximal end of the anchor.

Abstract: A medical device, method and system are provided for stabilizing and/or for fusing bone material, such as vertebra of the spine. The medical device (fusion device) has a pair of clamp members and an optional anchor member that cooperate to securely attach the fusion device to a facet joint of the spine. The fusion device may slide down a guide wire and driven into facet bone material of a facet joint. The clamp members may be pivoted together to grip adjacent bone facets and promote their fusion. Further features include injecting flowable bone fusion material between adjacent bone facets gripped by the device.