Abstract: In a method of treating the spine of a patient, an access device is inserted into the patient with the access device in a first configuration having a first cross-sectional area at a distal portion thereof. The access device is actuated to a second configuration having an enlarged cross-sectional area at the distal portion thereof such that the distal portion extends across at least a portion of each of two adjacent vertebrae. A stabilization of the vertebrae is then achieved using either translaminar facet screw fixation or transfacet pedicle screw fixation.

Abstract: In one embodiment, an access device is inserted through an incision in skin of a patient. The access device is expanded from a first configuration to a second configuration, the second configuration having an enlarged cross-sectional area at a distal portion of said access device such that the distal portion extends across at least a portion of the interbody space. A prosthetic spinal disc implant is then delivered through the access device.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: A spacer device is provided for use with a primary spinal fixation device to treat, reduce, or delay adjacent level degenerative disc disease. The spacer device comprises a compressible spacer, a transverse member, and a connecting member. The compressible spacer is sized to fit between the spinous processes of two adjacent vertebrae and is configured to reduce the range of motion of at least one vertebra. The transverse member is configured to extend from one side of the midline of the spine, extending through the interspinous process space. The transverse member is coupled with the spacer. The connecting member is attachable to the transverse member and to a primary spinal fixation device.

Abstract: An artificial vertebral disc for replacing an intervertebral disc of a patient is provided. The artificial disc can comprise a first plate, a second plate, and an elongate member extending between the first plate and the second plate. The elongate member is preferably flexible to allow angulation between the plates. In one embodiment, a side support extends along the exterior of the disc to substantially enclose the disc. In another embodiment, the disc has an open configuration and a stopping member to limit the angulation of one plate relative to another plate. The disc can include an insert configured to be inserted in a space defined by the stopping member and one of the plates to prevent movement of the plates. Methods for replacing an intervertebral disc in an interbody space of a spine using the disclosed artificial discs are also provided.

Abstract: A structure for receiving surgical instruments for performing a surgical procedure on a body includes a passage through which the surgical instruments are inserted into the body. The passage has a proximal end and a distal end. An expandable portion enables an increase in the cross-sectional area of the distal end of the passage. The expandable portion has a contracted condition in which the cross-sectional area of the distal end of the passage has a first cross-sectional area. The expandable portion has an expanded condition in which the distal end of the passage has a second cross-sectional area greater than the first cross-sectional area. The second cross-sectional area is greater than a cross-sectional area of the proximal end of the passage when the expandable portion is in the expanded condition. A retaining mechanism resists movement of the expandable portion from the expanded condition toward the contracted condition during the surgical procedure.

Abstract: An apparatus includes a fastener engageable with a bone portion to connect a longitudinal member to the bone portion. A housing has a first passage configured to receive the longitudinal member and a second passage extending transverse to the first passage. The fastener extends through an opening in the housing into the second passage. The second passage includes a plurality of frustoconical surfaces for engagement with the fastener.

Abstract: An apparatus for shielding a body structure during surgical procedures which is configured for insertion into the internal passage of a support structure, and includes an elongated body portion comprising a distal tip portion configured to cover the body structure without substantially displacing the body structure. The apparatus also comprises a mounting portion at a proximal end portion thereof for mounting the apparatus within the internal passage of the support structure, and a member connected to the mounting portion to release the mounting portion with respect to the internal passage of the wall portion.

Abstract: A device that provides access to a surgical location within a patient has an elongate body that has a proximal end, a distal end, and an inner surface. The inner surface defines a passage that extends through the elongate body. The elongate body is capable of having a configuration when inserted within the patient wherein the cross-sectional area of the passage at a first location is greater than the cross-sectional area of said passage at a second location. The first location is distal to the second location. The passage is capable of having a generally oval shaped cross section between the second location and the proximal end.

Abstract: In one embodiment, a retractor is provided for retracting tissue at a surgical location within a patient for minimally invasive access to a region of the spine. The retractor comprises an elongate body having a proximal portion and a distal portion. The retractor comprises a first elongate member and a second elongate member. The first and second elongate members define an outer surface of the retractor. The retractor is actuatable between a low profile configuration and an expanded configuration.

Abstract: A device for providing access to a surgical location within a patient comprises an elongate body having a proximal portion and a distal portion. The elongate body defines a first passage for accessing the surgical location with surgical instruments. The elongate body has a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location. The cross-sectional area of the first passage at a first location of the expanded configuration is greater than the cross-sectional area of the first passage at a second location of the expanded configuration. A second passage is formed integrally with the elongate body. The second passage extends from the proximal portion toward the distal portion and is sized and configured to receive a surgical instrument, such as a viewing element for visualizing the surgical location. The second passage is partially enclosed by a wall of the proximal portion.

Abstract: A method for treating the spine. A guidewire is advanced through the skin of a patient along a percutaneous path to a target location of a vertebra. An implant is advanced over the guidewire to the target location of the vertebra. The implant is coupled with the vertebra at the target location. An elongate body having a proximal end and a distal end is advanced until the distal end is adjacent the target location, the elongate body having an inner surface defining a passage extending therethrough. A procedure is performed at the target location.

Abstract: A retractor has an elongate body and an expandable shroud. The elongate body has an outer surface and an inner surface partially defining a passage. The elongate body also has a first longitudinal edge and a second longitudinal edge. The elongate body is capable of having an enlarged configuration when inserted within the patient. In the enlarged configuration the first longitudinal edge is spaced apart from the second longitudinal edge. The expandable shroud is configured to extend from the first longitudinal edge to the second longitudinal edge when the first and second edges are spaced apart. The shroud partially defines the passage. The cross-sectional area of said passage at a first location is greater than the cross-sectional area of the passage at a second location, wherein the first location is distal to the second location.

Abstract: A device for provides access to a surgical location within a patient. The device has an elongate body that has a proximal portion, a distal portion, a first slot segment, and a second slot segment that is angled relative to said first slot segment. The elongate body defines a passage for accessing the surgical location with surgical instruments. The elongate body has a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location. The cross-sectional area of the passage at a first location of the elongate body is greater than the cross-sectional area of said passage at a second location of the elongate body. A movable tab is configured to extend into the second slot segment when the elongate body is in the expanded configuration to retain the elongate body in the expanded configuration.

Abstract: A device for providing access to a surgical location within a patient comprises an elongate body having a proximal portion and a distal portion. The elongate body defines a first passage for accessing the surgical location with surgical instruments. The elongate body has a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location. The cross-sectional area of the first passage at a first location of the expanded configuration is greater than the cross-sectional area of the first passage at a second location of the expanded configuration. A second passage is separate from the first passage and is formed integrally with the elongate body. The second passage extends from the proximal portion toward the distal portion and is sized and configured to receive a viewing element for visualizing the surgical location.

Abstract: A device for providing access to a surgical location within a patient is provided. The device includes an elongate body and a sleeve. The elongate body has an outer surface, an inner surface, and a distal portion. The inner surface defines a passage that extends through the elongate body along a longitudinal axis through which surgical instruments can be inserted to the surgical location. The distal portion is capable of having an expanded configuration when inserted within the patient. In the expanded configuration, the cross-sectional area of the passage at a first location is greater than the cross-sectional area of the passage at a second location, wherein the first location is distal to the second location. The sleeve is configured to be moved relative to the elongate body along the longitudinal axis to increase or to decrease the length of the passage along the longitudinal axis.

Abstract: A cannula (10) for receiving surgical instruments for performing a surgical procedure on a body includes a tubular structure (12) defining a passage (16) through which the surgical instruments are inserted into the body. The tubular structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16). The expandable portion (40) of the tubular structure (12) has a slot (100) and a guide member (114) disposed in the slot. The guide member (114) is movable from a first end (102) of the slot (100) toward a second end (104) of the slot to enable the cross-sectional area of the passage (16) to increase. The expandable portion (40) has a stop (106) between the first and second ends (102 and 104) of the slot (100) engageable with the guide member (114) to retain the guide member in a position relative to the slot and resist movement of the guide member from the position relative to the slot.

Abstract: In a method of treating the spine of a patient, an access device is inserted into the patient with the access device in a first configuration. The first configuration has a first cross-sectional area at a distal portion thereof. The access device is actuated to a second configuration that has an enlarged cross-sectional area at the distal portion thereof such that the distal portion extends across at least a portion of two adjacent vertebrae. A motion preserving stabilization device is delivered through the access device and coupled with both vertebrae, stabilizing the vertebrae while permitting a range of motion therebetween.