Abstract: A spinal implant system for restricting flexion of a spine includes an elongate band proportioned to engage at least two spinous processes. During use, the band is positioned engaging the spinous processes at a spinal segment of interest, where it restricts flexion at the segment. The length and tension of the band may be adjustable following to implantation using percutaneous or transcutaneous means.

Abstract: Methods, apparatus and systems for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments rely on placing a tether structure over at least three adjacent vertebral bodies or two adjacent vertebral bodies and the sacrum. The tether structures may be continuous, for example in the form of a continuous loop, or may be discontinuous, for example in the form of a loop or elongate element having at least two anchor structures for securing in bone.

Abstract: A system for restricting flexion of a spinal segment in a patient comprises a constraint device having a tether structure and a compliance member coupled with the tether structure. The tether structure is adapted to be coupled with a superior spinous process and a sacrum. The system also includes an anchor member that is anchored to the sacrum. The anchor member has an attachment feature that is adapted to couple with the constraint device.

Abstract: Spinous process constraint structures include a first attachment element for placement over a first spinous process and a second attachment element for placement over a second spinous process. The attachment elements are joined by a single connector which may optionally include a compliance member for providing controlled elasticity between the spinous processes.

Abstract: A spinal implant system for restricting flexion of a spine includes an elongate band proportioned to engage at least two spinous processes. During use, the band is positioned engaging the spinous processes at a spinal segment of interest, where it restricts flexion at the segment. The length and tension of the band may be adjustable following to implantation using percutaneous or transcutaneous means.

Abstract: Methods and devices for restricting movement of a spinal segment by providing an adjustable constraining device that includes a tether and a compliance member coupled together. The tether is coupled to a superior spinous process and an inferior spinous process or a sacrum so that the construct of the compliance member and tethers provides a force resistant to flexion and a force resistant to extension of a spinal segment. In some embodiments, the construct of the compliance member and tethers may provide only a force resistant to extension.

Abstract: A constraining apparatus includes a constraining structure that captures a first and a second anatomical structure. A motion limiting member coupled with the constraining structure is adapted to provide a force resistant to relative movement of the first anatomical structure away from the second anatomical structure. A regulating member is detachably coupled with the motion limiting member or the constraining structure and is adapted to change the resistant force provided by the motion limiting member when the regulating member is in direct engagement with the motion limiting member or constraining structure.

Abstract: Methods, apparatus and systems for constraining spinous processes to elastically limit flexion of two or more adjacent spinal segments rely on placing a tether structure over at least three adjacent vertebral bodies or two adjacent vertebral bodies and the sacrum. The tether structures may be continuous, for example in the form of a continuous loop, or may be discontinuous, for example in the form of a loop or elongate element having at least two anchor structures for securing in bone.

Abstract: A method for coupling a prosthesis to a spinal segment in a patient includes the steps of selecting first and second reference points disposed along the spinal segment and pre-operatively measuring a target distance. The target distance extends between the first and second reference points while the patient is in a preferred posture such as the standing position. A prosthesis is coupled to the spinal segment and the prosthesis is then intra-operatively adjusted in order to set the distance between the first and second reference points based on the target distance.

Abstract: A spinal implant system for restricting flexion of a spine includes an elongate band proportioned to engage at least two spinous processes. During use, the band is positioned engaging the spinous processes at a spinal segment of interest, where it restricts flexion at the segment. The length and tension of the band may be adjustable following to implantation using percutaneous or transcutaneous means.

Abstract: A spinal implant for limiting flexion of the spine includes a tether structure for encircling adjacent spinal processes. Usually, a pair of compliance members will be provided as part of the tether structure for elastically limiting flexion while permitting an extension. A cross-member is provided between the compliance member or other portions of the tether structure to stabilize the tether structure and prevent misalignment after implantation.

Abstract: A system for restricting spinal flexion includes superior and inferior tether structures joined by a pair of compliance members. Compliance members comprise tension members which apply a relatively low elastic tension on the tether structures. By placing the tether structures on or over adjacent spinous processes, flexion of a spinal segment can be controlled in order to reduce pain.

Abstract: Fastening mechanisms for releasably locking a tether are provided. The mechanisms find application with orthopedic internal-fixation implants and make the implants more reliable and their implantation less invasive. A method for releasably locking a tether comprises advancing the tether through a tether aperture in a clamp body. The tether enters the tether aperture in a first plane and exits in a second plane generally transverse to the first plane. Positioning a fastener element in a fastener aperture in the clamp body captures the tether between the clamp body and the fastener element thereby releasably locking the tether in position relative to the clamp body.

Abstract: A spinal implant for limiting flexion of the spine includes a tether structure for encircling adjacent spinal processes. Usually, a pair of compliance members will be provided as part of the tether structure for elastically limiting flexion while permitting an extension. A cross-member is provided between the compliance member or other portions of the tether structure to stabilize the tether structure and prevent misalignment after implantation.

Abstract: A system for restricting spinal flexion includes a compliance member having a body and an elongation limit. The body typically comprises a spring or other tension element which provides elastic constraint to the spinal segment when the compliance member is attached to the spinous processes. The elongation limit prevents overextension of the compliance member, thus reducing the likelihood that the patient will experience over flexion of the spinal segment and reducing the risk of placing excessive mechanical load on the compliance member.

Abstract: A method for improving shear loading capacity of a spinal segment having a superior vertebra, an inferior vertebra or sacrum, and a facet joint, includes providing a constraint device having an upper portion, a lower portion and a compliance member coupled therebetween. The constraint device is coupled with the spinal segment such that the upper portion of the constraint device is coupled with the superior vertebra and the lower portion of the constraint device is coupled with the inferior vertebra or a sacrum. The constraint device provides a force resistant to flexion of the spinal segment. Also, length or tension in the constraint device is adjusted so as to increase engagement between an upper portion of the facet joint and a lower portion of the facet joint, thereby increasing capacity of the spinal segment to resist shear loading.

Abstract: A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

Abstract: Methods and apparatus for controlling flexion in a spinal segment of a patient include performing a spinal fusion procedure on a pair of adjacent vertebrae in the spinal segment and implanting a constraint device into the patient. Adjusting length or tension in the constraint device allows the constraint device to provide a force a force resistant to flexion of the spinal segment undergoing fusion. The constraint device also modulates loads borne by the spinal segment undergoing fusion or tissue adjacent thereto.

Abstract: A system for restricting spinal flexion includes superior and inferior tether structures joined by a pair of compliance members. Compliance members comprise tension members which apply a relatively low elastic tension on the tether structures. By placing the tether structures on or over adjacent spinous processes, flexion of a spinal segment can be controlled in order to reduce pain.

Abstract: A surgical fastening mechanism for releasably locking an implantable tether includes a housing having a central channel. The housing has an entry aperture, an exit aperture and a side channel extending therebetween. A roller element has a sidewall with an aperture therethrough and the roller is slidably disposed at least partially in the central channel such that the entry and exit apertures are at least partially aligned with the roller aperture. This permits passage of the tether therethrough. Rotation of the roller element in a first direction winds the tether around the roller thereby creating a friction interface between the roller element, the housing and the tether. A locking mechanism is operably connected with either the housing or the roller element and is adapted to prevent rotation of the roller in the central channel and also adapted to prevent release of the tether from the roller.