Abstract: Intervertebral spacers, such as interbody vertebral cages, that facilitate minimally-invasive corrective restoration surgeries, and related methods. In some implementations, an introducer may be used introduce an intervertebral spacer in a first, straightened shape into an intervertebral disc space. The introducer may engage a plurality of adjacent recesses of the intervertebral spacer to maintain the intervertebral spacer in the first, straightened shape during introduction. An introducer, in some cases the same introducer, may be used to articulate the intervertebral spacer by actuating at least one hinge of the intervertebral spacer such that the intervertebral spacer assumes a second, curved shape once within the intervertebral disc space.

Abstract: A specialized spinous process retractor surgical instrument comprises a pair of opposing proximal handles coupled to a pair of opposing distal jaws through a joint such that when the handles are compressed the jaws spread apart, the handles defining a plane when viewed from the side. The jaws curve downwardly from the plane distally from the joint, then curve back upwardly before terminating in end portions configured for spreading. The instrument defining a centerline when viewed from above, with the jaws distally from the joint diverging outwardly from the centerline, then curving back toward the centerline before terminating in the end portions. The end portions may include opposing, outwardly facing textured or roughened bone-contacting surfaces. The end portions of the jaws when viewed from the sides may define a plane that is substantially parallel to the plane defined by the handles.

Abstract: An interbody vertebral cage facilitates minimally invasive approaches to the intervertebral disc for corrective restoration of disc height, stabilization between vertebra, and fusion. The preferred embodiment provides a streamlined, slender straight contour with a central hinge or other articulating apparatus that allows the introduction of the cage into the operative field and disc space in a minimally invasive, bone-sparing manner. After partial insertion, the hinge component is activated, allowing the operator to steer the cage anterior-medially within the disc space to an anterior-central position within the intervertebral space. In this state the cage is shaped like a crescent, chevron or boomerang.

Abstract: Intervertebral spacers, such as interbody vertebral cages, that facilitate minimally-invasive corrective restoration surgeries, and related methods. In some implementations, an introducer may be used introduce an intervertebral spacer in a first, straightened shape into an intervertebral disc space. The introducer may engage a plurality of adjacent recesses of the intervertebral spacer to maintain the intervertebral spacer in the first, straightened shape during introduction. An introducer, in some cases the same introducer, may be used to articulate the intervertebral spacer by actuating at least one hinge of the intervertebral spacer such that the intervertebral spacer assumes a second, curved shape once within the intervertebral disc space.

Abstract: A system may be fixed in place to stabilize a spinal fusion, or released for dynamic motion, thereby providing stability with flexibility in conjunction with artificial mechanical or plasma discs, or normal physiologic discs. In terms of apparatus, the invention involves pedicle fixation utilizing a superior facet complex (SFC) with soft tissue attachment points. The SFC receives one or more inferior facet gliding arms (IFGAs) and associated joints which permit flexion, extension, lateral bending and/or other movements.

Abstract: A minimally invasive bone stabilization and locking system and method are applicable to joint fusion and fracture repair, including human facet joint stabilization. A bone-boring bit on an elongated shaft is used to drill a hole through the bone or joint such that the bit penetrates through the distal surface. An implant is provided having hollow body terminating in a spreadable distal end. The implant is placed over the elongated shaft and into the drilled hole such that the spreadable end protrudes through the distal surface. The elongated shaft is then pulled, such that the bit interacts with the distal end of the implant, thereby causing the spreadable end of the implant sleeve to spread so as to prevent backout of the implant body through the hole. A proximal cap may be tightened against the proximal surface, thereby fixing the bone or joint in compression.

Abstract: Percutaneous facet fixation implants. In some embodiments, the implant may comprise fasteners and/or fastener portions configured to be coupled on opposite sides of a facet joint such that a portion of one fastener is configured to be positioned adjacent to one of a superior articular process and an inferior articular process of a facet joint and a portion of another fastener is configured to be positioned adjacent to one of the other of an inferior articular process and a superior articular process of the facet joint so as to engage a surface of the respective articular process. In some embodiments, one or both of the fasteners may be configured to couple with an arm of a facet gun instrument.

Abstract: A percutaneous facet fixation system minimally invasive, reproducible, efficient, and effective. Capable of immediate stabilization of a facet joint complex, the instrumentation and methods may be used with C-arm and/or endoscopic visualization.

Abstract: In a spinal stabilization system a facet fixation device is interconnected to an anchor or fixation device driven into a portion of the spine. The facet fixation device has a proximal head and a distal fastener providing compression across a facet joint. A rigid or elastic member interconnects the proximal head of the facet fixation device to the anchor or fixation device, facilitating static or dynamic stabilization. The facet fixation device may extend directly across the facet joint, or a translaminar or laminar transverse process facet (LTPF) fixation device may be used. In the preferred embodiment the facet fixation device includes a distal tip which is self-cutting and tapping. The anchor may be a pedicle screw. The fixation device itself be a facet fixation device, and the facet fixation device may be connected to the anchor or fixation through two members joined with a coupling unit.

Abstract: A percutaneous facet fixation system minimally invasive, reproducible, efficient, and effective. Capable of immediate stabilization of a facet joint complex, the instrumentation and methods may be used with C-arm and/or endoscopic visualization.

Abstract: A low-profile bone anchoring system particularly suited to pelvis fixation in conjunction with spinal correction. The preferred embodiment utilizes screw fixation, followed by deployment of penetrating anchoring arms, expansion of outer sleeve, or both. The proximal ends of the screw anchors are preferably flush or deep to the bone surface. An internal screw mechanism is utilized to deploy side anchoring arms, or expansion of outer sleeve, or both. Serrated top edge interfaces with low profile variable axis/angled elbow (VAE), which has varying lengths/dimensions to accommodate anatomy and differing rod sizes. The VAEs preferably feature a serrated bottom edge to interface with anchor screw. Locking screw at elbow secures into inner threads of pelvis anchor screw. Each VAE captures a rod, end to end, or by passing rod through the side of elbow.

Abstract: A facet fixation system facilitates dynamic or static stabilization with few exposed components. A first anchor component is adapted for implantation through a facet joint and into intra-pedicle bone, and a second anchor component is adapted for fixation to the outer surface of the facet joint. A connector component connects the first and second anchor components. The connector component may be at least partially elastic, facilitating a dynamic stabilization of a facet joint, or rigid, facilitating a static stabilization of a facet joint.

Abstract: Implants, tools and techniques facilitate a percutaneous posterior lateral approach to the placement of an in-situ cage, and an inventive cage design to meet this objective. In terms of apparatus, the invention includes a laterally expandable cage, including a locking gate, enabling the system to be introduced into an intradiscal space through a minimally invasive percutaneous posteo-lateral approach. In addition to the cage designs, adapted to hold bone graft and/or other biologic materials, the invention includes other novel instruments, including an introducer associated with cage placement, deployment and closure.

Abstract: A skin closure instrument and method of use are disclosed. Broadly a tool grasps skin edges and applies glue evenly in rapid and reproducible fashion, thereby enabling a single healthcare provider to perform the procedure. In the preferred embodiment, the instrument is packaged in a sterile container for a single use. The glue may be packaged along with the instrument, or may be added to a reservoir. The system is applicable to both small and large wounds, and is easy to manipulate by a single operator, resulting in a rapid consistent closure of wound edges.

Abstract: An inserter and associated method improve the placement of a fastener into a bone. Although ideally suited to the placement of a pedicle screw into a vertebral body (VB), the apparatus and method are applicable to other bones and fasteners, pins, and the like. The apparatus includes cannulated body having a proximal end, a distal end, and a threaded section therebetween. The proximal end is shaped for rotational tightening by a wrench or other tool, and the distal end including a perforated nozzle so that cement and/or biologics may be injected into the bone through the cannulated body. The proximal end includes a Lur-loc or other appropriate fitting to receive a cement-filled syringe. The device is also preferably disposable using, for example, clear plastic construction. The inserter may further including a member for sealing the nozzle relative to a bone. Such a member may be composed of a silatstic or other compressible material, or may be inflatable.

Abstract: A specialized spinous process retractor surgical instrument comprises a pair of opposing proximal handles coupled to a pair of opposing distal jaws through a joint such that when the handles are compressed the jaws spread apart, the handles defining a plane when viewed from the side. The jaws curve downwardly from the plane distally from the joint, then curve back upwardly before terminating in end portions configured for spreading. The instrument defining a centerline when viewed from above, with the jaws distally from the joint diverging outwardly from the centerline, then curving back toward the centerline before terminating in the end portions. The end portions may include opposing, outwardly facing textured or roughened bone-contacting surfaces. The end portions of the jaws when viewed from the sides may define a plane that is substantially parallel to the plane defined by the handles.

Abstract: A minimally invasive bone stabilization and locking system and method are applicable to joint fusion and fracture repair, including human facet joint stabilization. A bone-boring bit on an elongated shaft is used to drill a hole through the bone or joint such that the bit penetrates through the distal surface. An implant is provided having hollow body terminating in a spreadable distal end. The implant is placed over the elongated shaft and into the drilled hole such that the spreadable end protrudes through the distal surface. The elongated shaft is then pulled, such that the bit interacts with the distal end of the implant, thereby causing the spreadable end of the implant sleeve to spread so as to prevent backout of the implant body through the hole. A proximal cap may be tightened against the proximal surface, thereby fixing the bone or joint in compression.

Abstract: A spinal fusion system includes a cage with a fillable volume and removable locking gate, thereby enabling the fillable volume to be packed with graft, biologic or other materials prior to the gate being closed and locked. In the preferred embodiment, the locking gate is positioned anteriorally, though lateral, posterior, and combinations thereof are also possible. The cage is preferably radiolucent, being composed of a carbon fiber, but with one or more radiopaque markers to provide a certain degree of visualization. Some or all of the walls of the cage may include superior and/or inferior surface features to enhance positioning and/or minimize back-out, and the posterior wall may be indented to prevent neurocompression. The sidewalls of the cage may further include a recessed face with nipple indents and locking fasteners. According to a system aspect of the invention, multiple cages are provided, each being shaped differently for use at different spinal levels.

Abstract: A system may be fixed in place to stabilize a spinal fusion, or released for dynamic motion, thereby providing stability with flexibility in conjunction with artificial mechanical or plasma discs, or normal physiologic discs. In terms of apparatus, the invention involves pedicle fixation utilizing a superior facet complex (SFC) with soft tissue attachment points. The SFC receives one or more inferior facet gliding arms (IFGAs) and associated joints which permit flexion, extension, lateral bending and/or other movements.