Abstract: Prostheses, systems, and methods are provided for replacement of natural facet joints between adjacent vertebrae using polyaxial attachment mechanisms for securing the prostheses to the vertebrae. A cephalad prosthesis attached to a superior adjacent vertebra replaces the inferior half of a natural facet joint. A caudal prosthesis attached to an inferior adjacent vertebra replaces the superior half of a natural facet joint. Both the cephalad and caudal prostheses are configured with artificial facet joint structures that include articulating surfaces that cooperate and form an artificial articular configuration. The polyaxial attachment mechanism permits adjustment of the position of the artificial facet joint structure along more than one axis at or after the time the cephalad or caudal prosthesis is attached to a vertebra.

Abstract: At least one bone fixation device comprising a stem having a maximum outer diameter is inserted into the sacroiliac joint through a minimally invasive incision path sized approximately at or about the maximum outer diameter of the stem in soft tissue, into the iliac bone, across the sacroiliac joint and into the sacrum. The stem is inserted through the incision path to a position within the sacroiliac joint between the iliac bone and the sacrum, to fuse the sacroiliac joint, without invasive joint preparation, removal of cartilage, or scraping at or near the sacroiliac joint. Desirably, at least a portion of the stem includes a surface permitting bony in-growth.

Abstract: A prosthesis replaces all or a portion of a natural facet joint on a vertebral body. The prosthesis has a prosthesis body accommodating fixation to the vertebral body at or near a pedicle and without support by a lamina. The prosthesis body has a fastening element installed within the vertebral body at or near a pedicle. The prosthesis further has an artificial facet joint structure carried by the prosthesis body at a location spaced from the fastening element. The artificial facet joint structure is adapted and configured to replace all or a portion of a natural facet joint.

Abstract: Bone fracture reduction devices, systems, and methods couple to a patient platform a mechanical bone fracture reduction fixture, which is sized and configured to be conveyed separate from the patient platform. The bone fracture reduction fixture carries an array of mechanical force reduction assemblies that are sized and configured to independently mechanically manipulate a fractured bone region. Each mechanical force reduction assembly functions independently of the other mechanical force reduction assemblies, to independently apply and maintain one of the prescribed mechanical reduction forces to the fracture and also mechanically reduce the fracture in the desired reduction planes.

Abstract: A prosthesis replaces all or a portion of a natural facet joint on a vertebral body. The prosthesis has a prosthesis body accommodating fixation to the vertebral body at or near a pedicle and without support by a lamina. The prosthesis body has a fastening element installed within the vertebral body at or near a pedicle. The prosthesis further has an artificial facet joint structure carried by the prosthesis body at a location spaced from the fastening element. The artificial facet joint structure is adapted and configured to replace all or a portion of a natural facet joint.

Abstract: A frame is sized and configured to support a reduced bone fracture of an individual. A guide assembly on the frame carries a bone fixing device guide that defines a guide path along which a bone fixing device can be advanced into a region of the reduced bone fracture. A linkage system couples the bone fixing device guide to the frame for articulation of the guide path among a plurality of desired orientations with respect to the reduced bone fracture. A guide bushing is included. Which includes packaging that maintains the guide bushing in a sterile condition prior to insertion into the bone fixing device guide.

Abstract: Surgically installed prostheses replace either the caudal portion of a natural facet joint, the cephalad portion of a natural facet joint, or both. The prostheses are readily attached to the pedicles of a vertebral body and support at least one element that defines an artificial facet joint structure. The caudal facet joint structure is sized and located to articulate with the cephalad facet joint structure. Together, the prostheses form a total facet replacement system. The system is suitable for use in virtually all levels of the spine.

Abstract: Systems, devices, and methods for diagnosing and treating conditions of the spine employ a garment for selectively positioning vertebrae of a spine of a supine individual, e.g., during diagnostic imaging of the spine. The garment affects movement of vertebrae that can be diagnostically correlated with incidents of back pain.

Abstract: Devices and surgical methods treat various types of adult spinal pathologies, such as degenerative spondylolisthesis, spinal stenosis, degenerative lumbar scoliosis, and kypho-scoliosis. Various types of spinal joint replacement prostheses, surgical procedures for performing spinal joint replacements, and surgical instruments are used to perform the surgical procedures.

Abstract: A prosthesis assembly replaces a cephalad portion of a left natural facet joint on a vertebral body and a cephalad portion of a right natural facet joint on a vertebral body. The prosthesis assembly has a left prosthesis body accommodating fixation to the vertebral body at or near a left pedicle and without support by a lamina. An artificial left facet joint structure carried by the left prosthesis body and is adapted and configured to replace a cephalad portion of the left natural facet joint. The prosthesis assembly further has a right prosthesis body accommodating fixation to the vertebral body at or near a left pedicle and without support by a lamina. An artificial right facet joint structure is carried by the right prosthesis body and is adapted and configured to replace a cephalad portion of the right natural facet joint.

Abstract: A prosthesis replaces all or a portion of a natural facet joint on a vertebral body. The prosthesis has a prosthesis body accommodating fixation to the vertebral body at or near a pedicle and without support by a lamina. The prosthesis body has a fastening element installed within the vertebral body at or near a pedicle. The prosthesis further has an artificial facet joint structure carried by the prosthesis body at a location spaced from the fastening element. The artificial facet joint structure is adapted and configured to replace all or a portion of a natural facet joint.

Abstract: A spinal prosthesis system having a caudal prosthesis provided with a pair of pedicle anchors for coupling to an inferior vertebral body, the caudal prosthesis including an artificial caudal facet joint structure comprising a pair of caudal bearing surfaces. A cephalad prosthesis is provided with a second pair of pedicle anchors for coupling to a superior vertebral body. The cephalad prosthesis includes an artificial cephalad facet joint structure having a pair of cephalad bearing surfaces. An artificial facet joint is formed between the adjoining vertebral bodies by articulation of the artificial caudal facet joint structure with the artificial cephalad facet joint structure.

Abstract: A total ankle replacement system, novel surgical method for total ankle replacement, and novel surgical tools for performing the surgical method are described. The total ankle replacement system includes the calcaneus in fixation of a lower prosthesis body, thereby significantly increasing the amount of bone available for fixation of the lower prosthesis body and allowing the lower prosthesis body to be anchored with screws. The total ankle replacement system further includes a long tibial stem which can also be anchored into the tibia with, for example, screws, nails, anchors, or some other means of attachment. The novel surgical arthroscopic method allows introduction of ankle prostheses into the ankle joint through an exposure in the tibial tubercle. Various novel surgical instruments, such as a telescoping articulating reamer and a talo-calcaneal jig, which facilitate the novel surgical method, are also described.

Abstract: An ankle implant for use in ankle arthroplasty in total ankle replacement is provided. The implant includes an upper prosthesis anchored to the tibia and a lower prosthesis anchored to the talus. The lower prosthesis is operable associated with the upper prosthesis. The implant also includes a stem which is rigidly removably connected to the second member. The stem includes a portion for attachment to the calcaneous. The stem is be adapted to be in a first position in the calcaneous when the stem is in a first relative position with respect to the lower prosthesis, and to provide for a second position in the calcaneous when the stem is in a second relative position with respect to the lower prosthesis.

Abstract: A percutaneous path is created into a bone having an interior volume occupied, at least in part, by a cancellous bone, e.g., a vertebral body. An expandable structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable structure is expanded and the tool withdrawn, leaving the expandable structure expanded inside the cancellous bone. Expansion of the expandable structure within cancellous bone can, e.g., compact cancellous bone, and/or create a cavity in cancellous bone, and/or move fractured cortical bone.

Abstract: A system for treating a vertebral body comprises a cannula leading into a vertebral body and a cavity creating device. The cavity creating device comprises a shaft having a distal end portion sized to extend through the cannula, an expandable body that undergoes expansion between a collapsed condition and an expanded condition to form a cavity in the vertebral body, and a tubular fluid transport member to convey fluid through the distal region of the expandable body and into the cavity. The system further comprises a device coupled to the shaft to change the expandable body between the collapsed condition to the expanded condition. The system further comprises a source of fluid coupled to the tubular fluid transport member to convey fluid through the distal region of the expandable body and into the cavity. The system further includes a device to convey a filling material into the cavity.

Abstract: A tubular member is sized and configured to establish an access path to bone having an interior volume occupied, at least in part, by cancellous bone. The tubular member includes a distal end portion having at least one opening. A structure is sized and configured to be carried by the tubular member and controllably advanced through the at least one opening to define a cutting surface that projects outside the distal end portion. The cutting surface has a dimension capable of cutting cancellous bone in response to rotation of the tubular member within the cancellous bone.

Abstract: A device is introduced into the vertebral body through a percutaneous access path. The device is manipulated to modify the cancellous bone volume for introduction of bone filling material. Bone filling material is introduced into the cancellous bone volume modified by the device along the percutaneous path. Discharge of the bone filling material is directed into the cancellous bone volume through an opening that is oriented at an angle relative to the axis of the access path.

Abstract: Systems and method create a cavity in cancellous bone by use of a system or kit that includes a cannula having an axis that establishes a percutaneous path leading into bone and a shaft having a distal end portion carrying an elongated loop structure or bristles capable of extension from the shaft to create a cavity forming structure. The shaft is movable relative to the axis of the cannula to move the cavity forming structure when extended within cancellous bone to form a cavity in the cancellous bone. A tool is sized for passage through the cannula. The tool is capable of dispensing a filling material into the cavity.

Abstract: A method for delivering material into bone deploys a cannula through soft tissue to establish a subcutaneous path into bone. The method deploys a cavity forming instrument through the cannula to form a cavity in cancellous bone. The method introduces a material into the cavity through the cannula, which includes the advancement of a tamping instrument through the cannula to urge material into the cavity.