Abstract: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to a device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body. Guidewire exchange systems, devices and methods are also described. A guidewire may be exchanged between different surgical devices and may be releaseably or permanently coupled.

Abstract: Surgical instruments and surgical methods associated therewith are described. The surgical instruments described herein can be used for scraping or for other purposes such as measuring distances between two points in hard to reach locales.

Abstract: An apparatus includes an elongate member configured to engage a spinal implant and a locking member. The locking member is disposed at a distal end portion of the elongate member. The locking member is configured to move relative to the elongate member between a first position and a second position in a direction substantially perpendicular to a center line of the elongate member. The locking member is configured to allow the distal end portion of the elongate member to move relative to the spinal implant when in the first position. The locking member is configured to couple the distal end portion of the elongate member to the spinal implant when in the second position.

Abstract: An auger is axially fixed to and positioned within a cutter. The auger and cutter advance at the same time relative to a contact structure placed against a vessel, penetrating the wall of the vessel and cutting a tissue plug. When the auger and the cutter are retracted from the vessel wall, the tissue plug is retained by the auger and cutter and removed from the vessel wall. The auger and the cutter thus create an opening in the vessel wall, without the need for a prior incision in that wall.

Abstract: Described herein are methods, devices and systems for performing an interspinous fusion, in particular for performing an interspinous fusion unilaterally. In general an interspinous fusion system may include a first fixation plate configured to couple to a first lateral side of a spinous process, a rod extending from the first fixation plate at a joint such that the rod is pivotable with respect to the first fixation plate, and a second fixation plate configured to couple to a second lateral side of a spinous process opposite from the first fixation plate.

Abstract: Described herein are devices, systems and methods for treating target tissue in a patient's spine. In general, the methods include the steps of advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location; connecting a tissue modification device to the wire; positioning the tissue modification device through the neural foramen using the wire; modifying target tissue in the spine by moving the tissue modification device against the target tissue; and delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue. In some embodiments, the step of modifying target tissue comprises removing target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.

Abstract: Described herein are pullwire handle devices for securing to a tissue-penetrating pullwire. In some embodiments, the device includes a handle body, a pullwire lock configured to removably lock the pullwire handle device onto a pullwire within the handle body, and a tip containment element configured to retain the distal tip of the pullwire. In some embodiments, the handle body further comprises a storage chamber configured to store a distal portion of the pullwire. Also described herein are methods for capturing a pullwire using a pullwire handle device. In some embodiments, the method includes the steps of inserting the distal end of a pullwire into the pullwire handle device, advancing the pullwire further into the pullwire handle device while the distal portion of the pullwire is contained within the pullwire handle device, and locking the distal portion of the pullwire within the pullwire handle device.

Abstract: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire through the body from a first location, around a curved pathway, and out of the body through a second location, so that the distal and proximal ends of the guidewire extend from the body, then pulling a device into position using the guidewire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to the device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body.

Abstract: Spinal tools and methods are described herein. In some embodiments, an apparatus includes an elongate member and a tissue disrupter. The elongate member has a distal end portion and defines a lumen. The tissue disruptor is coupled to the distal end portion of the elongate member. The tissue disruptor is configured to rotate relative to the elongate member to disrupt a body tissue.

Abstract: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire through the body from a first location, around a curved pathway, and out of the body through a second location, so that the distal and proximal ends of the guidewire extend from the body, then pulling a device into position using the guidewire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to the device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body.

Abstract: Surgical instruments and surgical methods associated therewith are described. The surgical instruments described herein can be used for scraping or for other purposes such as measuring distances between two points in hard to reach locales.

Abstract: Disclosed are devices and methods for emplacement of an expandable device in a body part of interest in human and animal subjects. In one embodiment, the expandable device comprises a cage that may be emplaced in the intervertebral disc for use in spine fusion techniques. The device is fashioned so that it may be delivered to the intervertebral disc by percutaneous means, such as via a cannula. Additionally disclosed are systems and kits employing the devices of the invention as well as methods of manufacturing the devices of the invention.

Abstract: Described herein are devices and systems for accessing a spine and particularly the epidural region of the spine and methods of using these systems and devices to access the spine or regions of the spine. In particular, cannulas that may be anchored to the ligamentum flavum or the periosteum are described. Ligamentum flavum access tools are also described. These tools may be used with (or without) an anchoring cannula to penetrate the ligamentum flavum and provide access to the epidural space without risk of injury to other structures within the epidural space. The devices, methods and systems described herein are particularly useful in minimally invasive surgical (MIS) uses. The devices, methods and systems described herein may be used for performing spinal decompressions and other spinal procedures.

Abstract: An anastomosis device includes a deployable section that may be connected to a discard section. The deployable section may be configured to expand in two substantially orthogonal directions during deployment. The deployable section may include a ring that includes one or more expandable elements.

Abstract: A method for performing anastomosis between a graft vessel and a target vessel with an integrated anastomosis tool may include actuating at least one control on the integrated anastomosis tool to create an opening in the target vessel and complete an anastomosis with the target vessel. Another method for performing anastomosis may include creating an opening in intact tissue of the target vessel with an integrated anastomosis tool; and deploying an anastomosis device with the integrated anastomosis tool. The anastomosis may be performed with an anastomosis device, such as an anastomosis device having a deployable section detachable from a discard section.

Abstract: A single integrated tool is used both to create an opening in a vessel wall and deploy an anastomosis device into that opening, thereby simplifying an anastomosis procedure such as a coronary artery bypass graft procedure. The creation of the opening and deployment of the anastomosis device may be actuated with a single control.