Abstract: Facet fixation implants include a cap member with a circular base portion and an eccentric raised portion. The raised portion includes first and second lobes and is smoothly contoured to provide an unobtrusive profile when implanted. Beveled teeth project from the implant to provide fixation and compression across the facet joint. The cap member includes an offset aperture which receives a fastener. Tools, guiding instruments and methods for implantation of the implants are disclosed.

Abstract: Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).

Abstract: Methods are disclosed for replaceable attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device or an attachment cuff, within a patient's digestive tract for treatment of obesity.

Abstract: A total hip femoral prosthesis provides a shortened neck and more proximal coating level. Additionally, a means for strengthening the neck may be incorporated to increase stress transfer to the native bone. A method for reducing potential impingement that results from a high neck resection level includes instrumentation for cutting chamfered surfaces into the bone surrounding the proximal end of the implant. Instrumentation and methods of creating chamfered cuts are disclosed.

Abstract: A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distractor apparatus and method and an anchor remover and method are also provided.

Abstract: In an artificial hip joint stem of the present invention, a distance between an inner wall portion and an outer wall portion is decreased as separating from an opening part in a sectional view that is parallel to a stem central axis and includes the inner wall portion and the outer wall portion, and both a front wall portion and a rear wall portion have a planar region in a sectional view that is parallel to the stem central axis and includes the front wall portion and the rear wall portion. A stem inserter of the present invention includes a disk-shaped front end part. The present invention also provides an artificial hip joint system including the artificial hip joint stem and the stem inserter, and an artificial hip joint including the artificial hip joint stem.

Abstract: A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distractor apparatus and method and an anchor remover and method are also provided.

Abstract: An implantable fixation system for fusing a joint between a first bone and a second bone. The system may include an anchor, standoff, bolt, and cortical washer. The system may be implanted across the joint along a single trajectory, the length of the system adjustable to provide compressive force between the anchor and the cortical washer. The system may be implanted across a tibiotalar joint with the anchor positioned in the sinus tarsi. A spacing member may be inserted between the two bones and the fixation system implanted to extend through an opening in the spacing member. The spacing member may be anatomically shaped and/or provide deformity correction. An ankle arthroplasty system may include a tibial plate, a talar plate, and a bearing insert. The plates may be anchored to the tibia and talus along a single trajectory. The ankle arthroplasty system may be revisable to a fusion system.

Abstract: Pedicle screws are designed to provide polyaxial coupling to pedicles of a vertebra. Intermediate pieces are attached to the pedicles screws and receive extender shafts. Extenders are inserted in the intermediate piece. The extenders project the anatomic points located in the cage outside the patient's body to facilitate proper contouring of a rod. An alignment linkage is used to ensure that the extenders are parallel to each other. The alignment linkage includes a linkage frame, an articulating linkage and a locking member. The articulating linkage has all rotational degrees of freedom and thereby adapts to any varying trajectories of the extenders and distance between the extenders. The alignment linkage includes a locking member with a pop-up indicator. The pop-up indicator notifies the users when the locking member is tightened with two of the extenders in non-parallel configuration.

Abstract: A knee prosthesis including a femoral implant, a tibial implant, a tibial insert and a cam post. The femoral implant is secured to a femur and has a gap for receiving a natural PCL. The tibial implant is secured to a tibia. The tibial insert comprises a medial cavity with a rotational axis. The tibial insert has articulating surfaces that match the contours of the condyles of the femoral implant and a notch for retaining the natural PCL. The tibial insert has a medial boss that aligns with the medial cavity allowing it to rotate about the rotational axis. A post is secured to the tibial implant and enters a hole of the tibial insert providing anterior and posterior stops for the rotation of the tibial insert about the rotational axis.

Abstract: A total hip femoral prosthesis provides a shortened neck and more proximal coating level. Additionally, a means for strengthening the neck may be incorporated to increase stress transfer to the native bone. A method for reducing potential impingement that results from a high neck resection level includes instrumentation for cutting chamfered surfaces into the bone surrounding the proximal end of the implant. Instrumentation and methods of creating chamfered cuts are disclosed.

Abstract: A system and method for treating a defect. The system may comprise a first expandable barrier insertable into a defect interior space in a compact state and then expanded once positioned inside the defect. The first expandable barrier is expanded to be positioned against the inner surface of the defect. The system may also comprise a second barrier which may be expandable, positioned against the outer surface of the defect. Each of the first and second barriers may expand laterally to a greater extent than axially. The first and second barriers may be in communication through a connection member which couples the two barriers together. The barriers each obliterate the defect and can prevent subsequent CSF or other fluid leaks. Fibrin glue may be introduced into the defect to seal and secure the barriers to the defect. Each barrier may comprise a mesh, a basket, an umbrella or a balloon.

Abstract: Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).

Abstract: An apparatus and method for advancement of a spinal rod in a spinal implant, wherein the apparatus includes a body and a handle attached to the body. A shaft is slidably attached to the body, the shaft is coupled to the handle and has a first end adapted to engage the spinal rod. At least one retractor blade is attached to the body and the spinal implant. The operation of the handle results in the shaft persuading the spinal rod in the spinal implant. The force exerted by the shaft on the spinal rod is limited to a pre-selected force. The apparatus can also be operated in a non-limiting mode when a reduction retractor blade is used.

Abstract: The present invention provides a compression and distraction shaft assembly used to apply compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. An hourglass-shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. Distraction pliers having cylindrical tips are used to apply distraction to vertebrae. Once handles are pressed to impart an appropriate amount of distraction to the vertebrae, they are locked in this position. Compression pliers having cylindrical tips are used to apply compression to vertebrae. Once handles are pressed to impart an appropriate amount of compression to the vertebrae, they are locked in this position.

Abstract: Methods are disclosed for replaceable attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device or an attachment cuff, within a patient's digestive tract for treatment of obesity.

Abstract: The present invention provides artificial disc prostheses, methods and instrumentation for implantation and revision thereof. Each prosthesis may comprise superior and inferior end plates and a nucleus positioned between articular surfaces of the end plates. The end plates may have planar bone engagement surfaces with a plurality of self-cutting teeth. The articular surfaces of the end plates may be planar or include a flattened portion. The nucleus includes superior and inferior articular surfaces which may comprise flattened portions such that when the articular surfaces of the nucleus and the end plates are placed in cooperation in a preferred orientation, the flattened and/or planar portions are aligned. Each prosthesis may provide flexion/extension, anterior/posterior translation, lateral bending, and/or axial rotation degrees of freedom.

Abstract: Instrumentation for preparation of a bone includes a first guide having a first collet and a second collet. The first and second collets are formed around divergent first and second axes, and share a common opening. A bone preparation instrument may be inserted into each of the collets toward a bone. A second guide may be carried in the first guide, and a bone preparation instrument inserted through the second guide toward the bone, along a third axis.

Abstract: Disclosed herein are systems and methods for filling bone voids which may be present at the time of surgery. The systems disclosed herein generally include a baseplate component, a spacer component, and void filler component. The spacer component is generally assembled to the baseplate component with a taper or press-fit, for example, in one of a plurality of selected axial positions. The void filler component is then generally assembled to the spacer component in one of a plurality of selected axial positions. The void filler component preferably has an outer surface with portions having varying diameters such that the outer surface thereof can be received within a canal of a bone and contact the bone forming the canal at different locations in order to aid in stabilizing the assembled components in the canal.

Abstract: A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.