Abstract: A surgical inserter and a fusion cage system which may provide for simplified fusion cage attachment and positioning. The inserter may comprise a collapsible collet with a locking rod. The fusion cage with a rectangular cross-section head may be secured to the inserter through the reverse tapered aperture of the fusion cage. The collet may be inserted into the reverse tapered aperture and the locking rod may control collapse of the collet. The collet may lock the fusion cage to the inserter allowing simplified manipulation of the collet with the inserter. The inserter with the attached fusion cage is inserted into a surgical patient. The fusion cage may be positioned within an intervertebral space. The locking rod may be withdrawn from the collet allowing collapse and withdrawal of the collet from the fusion cage leaving the fusion cage positioned between two vertebrae and the inserter withdrawn from the surgical patient.

Abstract: A system for treating an aneurysm includes an expandable barrier positionable to bridge an aneurysm neck. The barrier may comprise a fiber mesh, a balloon or a molly anchor member, and may unroll, unfold, or inflate from a compact configuration to an expanded configuration. Expansion of the barrier may be greater radially than axially. A vaso-occlusive member comprising a coil or balloon may be deposited in the aneurysm. Another aneurysm treatment system comprises an outer fenestrated stent and/or an inner fenestrated sleeve, which may be implanted together adjacent an aneurysm neck to regulate blood flow to the aneurysm. The sleeve may be movable relative to the stent to open or occlude the fenestrations, which may vary in size, shape, and distribution. An intra-luminal vessel occlusion device comprises a stent and a sheath. A drawstring may be actuated to gradually close a sheath orifice to control blood flow through the vessel.

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: A soft tissue repair device can include a housing having a handle, a deployment system having an actuation member, and an insertion system having an inserter and a slider. The slider can be coupled to the actuation member and movable relative to the inserter between deployed and retracted positions. First and second anchors can be carried on an external surface of the slider such that the anchors are spaced apart and portions of the anchors are coaxial with the slider and each other. A flexible strand can couple the anchors. The insertion system can cooperate with the deployment system to move the slider to the deployed position to deploy the first anchor upon activating the actuation member a first time, and to move the slider to the deployed position from the retracted position to deploy the second anchor upon actuating the actuation member a second time after the first time.

Abstract: A system for providing dynamic stabilization and balance control at a vertebral motion segment has first and second bridge elements and at least one bias element. The bridge elements anchor to adjacent vertebrae with polyaxially adjustable anchoring members, and the bias elements attach to each bridge element to span between them. Each bias element has two fixation portions and a bias body extending between the fixation portions. Each bias element may comprise an elastically deformable material to provide dynamic stabilization with motion, or may comprise rigid material to provide rigid stabilization, and both bias element types may be included in one system. The bias elements are attachable to the bridge elements at discrete attachment locations, or at non-discrete attachment locations. Alternate embodiments may include three or more bridge elements on adjacent vertebrae, and multiple bias elements. A tensioning tool may provide adjustable tension to an elastically deformable bias element.

Abstract: A system for accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate the spine. The location may be at the L4-L5 vertebral level, and the curved path may lie in a plane oblique to the transverse, coronal and sagittal planes of the spine, and avoid the iliac crest. A targeting post may be inserted adjacent the spine to determine the location, and a guide member may be inserted to establish the curved path. A micrometer assembly may adjust a cephalad-caudal displacement between the post and the guide member. One or more intermediate cannulas may be inserted over the guide member to dilate tissues prior to insertion of the main cannula. An interbody device may be implanted into an intervertebral space through the cannula.

Abstract: A spinal stabilization system includes vertebral engagement members and an intermediate structure. The vertebral engagement members are configured to be disposed between a first vertebra and a second vertebra. The vertebral engagement members generally include seating surfaces for accommodating at least a portion of a laminar region of adjacent vertebra and are adjustable between an operable and inoperable configuration. The intermediate structure extends between the vertebral engagement members. The structural cooperation of the vertebral engagement members and the intermediate structure is such that the engagement members distract the adjacent vertebrae.

Abstract: Methods and instrumentation for implantation of an intervertebral disc prosthesis are provided. A guide tool with sagittal and coronal reference features guides placement of guide pins relative to a sagittal plane and a coronal plane of the vertebrae. A retainer lockable to the guide pins has a ratcheting mechanism providing distraction or compression. A rasp, planer or other tools may be aligned to the retainer and inserted into the intervertebral space to prepare the vertebral endplates. An interoperatively adjustable trial is alignable to the retainer and measures an angularity of the intervertebral space. A prosthesis with keying features may be mounted to a prosthesis inserter with complementary features, held by pivotable arms and compressed between prongs. The inserter may be aligned to the retainer and advanced to implant the prosthesis in the intervertebral space. A prosthesis remover may grip one prosthetic end plate and extract the entire prosthesis.

Abstract: Methods and instrumentation for implantation of an intervertebral disc prosthesis are provided. A guide tool with sagittal and coronal reference features guides placement of guide pins relative to a sagittal plane and a coronal plane of the vertebrae. A retainer lockable to the guide pins has a ratcheting mechanism providing distraction or compression. A rasp, planer or other tools may be aligned to the retainer and inserted into the intervertebral space to prepare the vertebral endplates. An interoperatively adjustable trial is alignable to the retainer and measures an angularity of the intervertebral space. A prosthesis with keying features may be mounted to a prosthesis inserter with complementary features, held by pivotable arms and compressed between prongs. The inserter may be aligned to the retainer and advanced to implant the prosthesis in the intervertebral space. A prosthesis remover may grip one prosthetic end plate and extract the entire prosthesis.

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: 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: 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: A system for accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate the spine. A guide member may be first inserted to establish the path between the tissues and fascia, and one or more intermediate cannulas may be temporarily inserted over the guide member to dilate the tissues prior to insertion of the main cannula. An interbody device may be implanted in an intervertebral space through the cannula. The system may include a guide bar removably coupled to a targeting post. The targeting post may be inserted adjacent the spine to provide a target, and the guide bar may be removably attached to the guide member, to guide it along the path to the target location. An external support arm may be secured to any other component of the system.

Abstract: An implantable bone anchor assembly for fixing an elongated member such as a spinal rod may include a bone anchor, a coupling head configured to receive the bone anchor and the elongated member, and a locking mechanism. The locking mechanism may provide compressive force to simultaneously fix the position of the elongated member and lock out polyaxial rotation of the bone anchor relative to the coupling head. The locking mechanism may include an engagement member with an oblique surface configured to slide along an oblique surface of the coupling head into engagement with the elongated member. The bone anchor may comprise a head portion and a threaded portion which may be coupled with the coupling head and joined together during manufacture. The assembly may further include a pin and/or a collar to retain the bone anchor. The bone anchor may be side-loaded into the coupling head.

Abstract: An implantable bone anchor assembly for fixing an elongated member such as a spinal rod may include a bone anchor, a coupling head configured to receive the bone anchor and the elongated member, and a locking mechanism. The locking mechanism may provide compressive force to simultaneously fix the position of the elongated member and lock out polyaxial rotation of the bone anchor relative to the coupling head. The locking mechanism may include an engagement member with an oblique surface configured to slide along an oblique surface of the coupling head into engagement with the elongated member. The bone anchor may comprise a head portion and a threaded portion which may be coupled with the coupling head and joined together during manufacture. The assembly may further include a pin and/or a collar to retain the bone anchor. The bone anchor may be side-loaded into the coupling head.

Abstract: An implantable bone anchor assembly for fixing an elongated member such as a spinal rod may include a bone anchor, a coupling head configured to receive the bone anchor and the elongated member, and a locking mechanism. The locking mechanism may provide compressive force to simultaneously fix the position of the elongated member and lock out polyaxial rotation of the bone anchor relative to the coupling head. The locking mechanism may include an engagement member with an oblique surface configured to slide along an oblique surface of the coupling head into engagement with the elongated member. The bone anchor may comprise a head portion and a threaded portion which may be coupled with the coupling head and joined together during manufacture. The assembly may further include a pin and/or a collar to retain the bone anchor. The bone anchor may be side-loaded into the coupling head.

Abstract: A system for accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate the spine. A guide member may be first inserted to establish the path between the tissues and fascia, and one or more intermediate cannulas may be temporarily inserted over the guide member to dilate the tissues prior to insertion of the main cannula. An interbody device may be implanted in an intervertebral space through the cannula. The system may include a guide bar removably coupled to a targeting post. The targeting post may be inserted adjacent the spine to provide a target, and the guide bar may be removably attached to the guide member, to guide it along the path to the target location. An external support arm may be secured to any other component of the system.

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. A hour glass shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. A distraction pliers having cylindrical tips is used to apply distraction to vertebrae. Once handles are pressed to impart appropriate amount of distraction to the vertebrae they are locked in this position. A compression pliers having cylindrical tips is used to apply compression to vertebrae. Once handles are pressed to impart appropriate amount of compression to the vertebrae they are locked in this position.

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.