Abstract: An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.

Abstract: A graft material injector device and method are disclosed. The injector device includes an elongated injector tube and a side loading aperture for receiving graft material. A graft material loader and a cover for the side loading aperture may optionally be included.

Abstract: Methods and apparatus for accessing and repairing a vertebral disc include a pad with a central cut-out mounted to the skin of a patient or, alternatively, a pedicle-mounted support. An incision is made and then a corridor is created using an elongated guide and a series of dilating tubes. An access to the disc space is created through the superior articular process and the facet joint using the corridor defined by the dilating tubes. Nucleus material is removed from the disc space and the vertebral endplates are prepared. The disc space may be sized to select a suitable implant, which is advanced through the corridor and into the disc space following discectomy and endplate preparation. Bone graft material may be inserted into the disc space following installation of the implant and then posterior rigid fixation may be achieved using percutaneous pedicle screws, followed by closure of the site.

Abstract: External fixation systems, and methods for immobilizing joints or fractured bones. An external fixation system may include one or more clamp assemblies connected to one or more rod assemblies at polyaxial joints. Each rod assembly may be length adjustable, and may include a one-way locking mechanism to provisionally lock the length of the rod assembly, and additional locking mechanisms to permanently lock the length of the rod assembly. The system may be deployed pre-assembled as a unit to immobilize a joint or fracture. Another external fixation system further includes a spanning member extending transverse to the rod assemblies. Two or more external fixation systems may be deployed in a stacked configuration on one set of bone pins to immobilize two joints and/or fractures. The systems may be provided in kits including guiding instrumentation, bone pins and pin clamping assemblies for connecting the bone pins to the external fixation systems.

Abstract: A graft material injector device and method are disclosed. The injector device includes an elongated injector tube and a side loading aperture for receiving graft material. A graft material loader and a cover for the side loading aperture may optionally be included.

Abstract: External fixation systems, and methods for immobilizing joints or fractured bones. An external fixation system may include one or more clamp assemblies connected to one or more rod assemblies at polyaxial joints. Each rod assembly may be length adjustable, and may include a one-way locking mechanism to provisionally lock the length of the rod assembly, and additional locking mechanisms to permanently lock the length of the rod assembly. The system may be deployed pre-assembled as a unit to immobilize a joint or fracture. Another external fixation system further includes a spanning member extending transverse to the rod assemblies. Two or more external fixation systems may be deployed in a stacked configuration on one set of bone pins to immobilize two joints and/or fractures. The systems may be provided in kits including guiding instrumentation, bone pins and pin clamping assemblies for connecting the bone pins to the external fixation systems.

Abstract: A minimally invasive dilation device includes a plurality of rigid arms radially arrayed about a center and a dilating member positioned between the arms. A stylus may occupy the center. An outer flexible sleeve may be circumferentially secured to the arms, lying within or without the plurality of arms. An inner mesh may surround the stylus and dilating member. The device may be introduced into tissue toward a targeted area, while in a closed configuration. The dilating member may be a balloon, wherein upon inflation of the balloon, the arms are pushed radially outward, expanding the device and dilating the surrounding tissue. The dilating member may be a tube, wherein upon insertion of the tube, the arms are pushed radially outward. A cannula may be inserted inside the plurality of arms to keep the arms in an open configuration, and the dilating member may be withdrawn, providing an open passageway through the device to the targeted area. The device may be used with a neural monitoring system.

Abstract: A coupled pair of retractors which are coupled at the distal end to allow the handles at the proximal end to be urged apart to increase the distance between handles to allow for direct line of sight to the surgical site while also allowing the use of curved tools and curved access to the surgical site. A cannula with a cross section taken perpendicular to a straight portion of the cannula that increases between the proximal end of the cannula and the distal end of the cannula allows for direct line of sight to the surgical site while also allowing the use of curved tools and curved access to the surgical site. These tools may be used in a postero-lateral approach from an incision in the back to a target position adjacent to the spine.

Abstract: A minimally invasive dilation device includes a plurality of rigid arms radially arrayed about a center and a dilating member positioned between the arms. A stylus may occupy the center. An outer flexible sleeve may be circumferentially secured to the arms, lying within or without the plurality of arms. An inner mesh may surround the stylus and dilating member. The device may be introduced into tissue toward a targeted area, while in a closed configuration. The dilating member may be a balloon, wherein upon inflation of the balloon, the arms are pushed radially outward, expanding the device and dilating the surrounding tissue. The dilating member may be a tube, wherein upon insertion of the tube, the arms are pushed radially outward. A cannula may be inserted inside the plurality of arms to keep the arms in an open configuration, and the dilating member may be withdrawn, providing an open passageway through the device to the targeted area. The device may be used with a neural monitoring system.

Abstract: A graft material injector device and method are disclosed. The injector device includes an elongated injector tube and a side loading aperture for receiving graft material. A graft material loader and a cover for the side loading aperture may optionally be included.

Abstract: External fixation systems, and methods for immobilizing joints or fractured bones. An external fixation system may include one or more clamp assemblies connected to one or more rod assemblies at polyaxial joints. Each rod assembly may be length adjustable, and may include a one-way locking mechanism to provisionally lock the length of the rod assembly, and additional locking mechanisms to permanently lock the length of the rod assembly. The system may be deployed pre-assembled as a unit to immobilize a joint or fracture. Another external fixation system further includes a spanning member extending transverse to the rod assemblies. Two or more external fixation systems may be deployed in a stacked configuration on one set of bone pins to immobilize two joints and/or fractures. The systems may be provided in kits including guiding instrumentation, bone pins and pin clamping assemblies for connecting the bone pins to the external fixation systems.

Abstract: An electrosurgical instrument for ablating cartilage while limiting collateral damage includes a non-conducting head with a small electrically conductive surface. The head of the instrument is coupled to a shaft by a flexible portion. The flexible portion biases the electrically conductive surface towards a tissue surface. The head is pivotably coupled to the shaft such that the electrically conductive surface is oriented substantially parallel to the tissue surface as the head slides across the tissue surface. A method of performing electrosurgery includes positioning the electrically conductive surface adjacent to the tissue surface, and sliding the shaft across the tissue surface with the head pivoting such that the electrically conductive surface is oriented substantially parallel to the tissue surface.

Abstract: A suture passing instrument including an operation handle, a needle member, and a suture holder assembly. The operation handle has at least one actuator movable between a first position and a second position. The needle member extends from the operation handle. The needle member has a curved end portion and defines an eyelet extending therethrough. The suture holder assembly extends from the operation handle and has a movable suture carrier at a distal end configured to hold a suture. The movable suture carrier has a suture pusher telescopically and movably received in the movable suture carrier. The suture carrier is movable between a retracted position and an extended position. The suture pusher is movable beyond the suture carrier to carry the suture through the eyelet.

Abstract: External fixation techniques for immobilizing joints or fractured bones are described herein. An external fixation system may include one or more clamp assemblies connected to one or more rod assemblies at polyaxial joints. Each rod assembly may be length adjustable, and may include a one-way locking mechanism to provisionally lock the length of the rod assembly, and additional locking mechanisms to permanently lock the length of the rod assembly. The system may be deployed pre-assembled as a unit to immobilize a joint or fracture. Another external fixation system further includes a spanning member extending transverse to the rod assemblies. Two or more external fixation systems may be deployed in a stacked configuration on one set of bone pins to immobilize two joints and/or fractures. The systems may be provided in kits including guiding instrumentation, bone pins and pin clamping assemblies for connecting the bone pins to the external fixation systems.

Abstract: An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.

Abstract: A surgical rasping and/or shaving system functions in multiple orthopedic applications, including but not limited to shoulder, knee, hip, wrist, ankle, spinal, or other joint procedures. The system may comprise a tissue removal member with a rasping and/or shaving head which may be low profile and offer a flat cutting/rasping/shaving surface, or with a cutting head with at least one cutting edge. The tissue removal member is configured to be driven by an attached hub that translates a rotational movement into a reciprocating motion. Suction for removal of bone fragments or other tissues is provided through an opening spaced apart from or adjacent to the rasping surface. A radiofrequency ablation (RF) electrode may be carried on the system to provide ablation or coagulation of soft tissues.

Abstract: Systems for single tunnel, double bundle anterior cruciate ligament reconstruction include implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. The instruments are also used to exercise and insert the ligament graft constructs. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on a single femoral tunnel, single or double tibial tunnels, and one or more ligament grafts.

Abstract: A minimally invasive dilation device includes a plurality of rigid arms radially arrayed about a center and a dilating member positioned between the arms. A stylus may occupy the center. An outer flexible sleeve may be circumferentially secured to the arms, lying within or without the plurality of arms. An inner mesh may surround the stylus and dilating member. The device may be introduced into tissue toward a targeted area, while in a closed configuration. The dilating member may be a balloon, wherein upon inflation of the balloon, the arms are pushed radially outward, expanding the device and dilating the surrounding tissue. The dilating member may be a tube, wherein upon insertion of the tube, the arms are pushed radially outward. A cannula may be inserted inside the plurality of arms to keep the arms in an open configuration, and the dilating member may be withdrawn, providing an open passageway through the device to the targeted area. The device may be used with a neural monitoring system.

Abstract: Systems for single tunnel, double bundle anterior cruciate ligament reconstruction include implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. The instruments are also used to exercise and insert the ligament graft constructs. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on a single femoral tunnel, single or double tibial tunnels, and one or more ligament grafts.

Abstract: A method and apparatus include determining a value of a parameter associated with operation of an electrosurgical probe having a particular probe design, and determining whether the value of the parameter is within a range of values that has been predetermined for the particular probe design to indicate that the probe is treating tissue in a desired manner. Power is delivered to the probe according to an algorithm based upon a determination that the value of the parameter is outside the range of values The algorithm delivers power in a pulsed profile including portions of low power and portions of high power. In one embodiment, the tissue treatment is ablation, the parameter is impedance, and the method limits tissue necrosis to less than 200 microns. In another embodiment, the tissue treatment is shrinkage, the parameter is temperature, and the method limits power delivery when the probe is not shrinking tissue.