Abstract: Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. A pair of fixation elements are adapted to be secured within a vertebra in an orientation that best assures a secure and durable attachment to cortical and/or cancellous bone. Artificial facet joint surfaces are mounted on the fixation elements, either directly or with the aid of a support. The artificial facet joint structure may be carried by an arm. The artificial facet joint structure is adapted for articulation with a complementary natural or artificial facet joint structure. Bilateral prostheses may by coupled by a brace to further secure and stabilize the prostheses.

Abstract: An extractable device is used to insert a medicinal filling into a spinal disc. The device comprises a filling member and a flowable medicine. The filling member is made of a flexible and permeable wall and is provided with a holding portion and an injection port via which the flowable medicine is injected into the holding portion after the filling member is inserted into the spinal disc. The holding portion is provided with an opening which is releasably lashed by one end of one or more threads so as to make the opening leakproof. Upon completion of solidification of the flowable medicine in the holding portion of the filling member, other end of the thread is pulled to unlash the opening of the holding portion, thereby enabling the filling member to be extracted from the spinal disc so as to leave only the medicine in the spinal disc.

Abstract: A filler instrument comprises a first chamber section having a first cross sectional area and a second chamber section having a second cross sectional area less than the first cross sectional area. The second chamber section communicates with the first chamber section. The first chamber section includes an inlet for receiving a material into the filler instrument, and the second chamber section includes an outlet for discharging the material from the filler instrument. A first plunger is sized to pass through the first chamber section and not the second chamber section. A second plunger is sized to pass through an interior bore of the first plunger and into the second chamber section. In use, the first plunger displaces material residing in the first chamber section through the second chamber section toward the outlet, and the second plunger displaces material residing in the second chamber section through the outlet.

Abstract: Apparatus for deploying an expandable structure in interior body regions provide an outer catheter tube, an inner catheter tube sized and configured to be received within the outer catheter tube, and an expandable structure having a distal end and a proximal end. The expandable structure also has a first end region adjacent the distal end and a second end region adjacent the proximal end. The distal end is bonded to the inner catheter tube to form a first bonded region and the proximal end is bonded to the outer catheter tube to form a second bonded region. The first end region is inverted to overlie the first bonded region and the second end region is inverted to overlie the second bonded region.

Abstract: Systems and methods provide for the fixation of osteoporotic and non-osteoporotic long bones, especially Colles' fractures. A cannula having a circumferential opening is inserted into cancellous bone and directed such that the circumferential opening faces the fracture. The cannula is further adapted to receive an expandable structure, the expandable structure being inserted through the cannula until it is in registration with the circumferential opening. The expandable structure is expanded through the circumferential opening into cancellous bone and toward the fracture. The expansion of the expandable structure through the circumferential opening toward the fracture causes compression of cancellous bone and moves fractured cortical bone, thus creating a cavity proximal to the fracture. The cavity is then filled with a flowable bone filling material and the material allowed to harden.

Abstract: Systems and methods for delivering material into bone deploy a cannula through soft tissue to establish a subcutaneous path into bone. A material is introduced into bone through the cannula. The systems and methods advance a tamping instrument through the cannula to urge material residing in the cannula into bone. The introducing step delivers material at a pressure no greater than about 360 psi.

Abstract: A composite instrument is provided comprising a first functional instrument and a second functional instrument when the first functional instrument is coupled with the second functional instrument. A composite handle for the composite instrument is provided comprising a first handle and a second handle when the first handle is coupled with the second handle. The handle makes possible the reliable transmission, with increased mechanical advantage, of both torsional and longitudinal loads by the physician to the composite instrument, while resisting relative rotation between the first and second instruments. The instrument is sterilization sensitive, changing physical appearance after sterilization.

Abstract: Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. The cephalad prostheses are adapted and configured to be attached to a lamina portion of a vertebra without blocking a pedicle portion of the cephalad vertebra. In some embodiments, the prosthesis is attached with a non-invasive support member, such as a clamp. In other embodiments, a translaminar screw may be used for additional fixation.

Abstract: A structure adapted to assume an expanded geometry having a desired configuration when used in bone includes material that limits the expanded geometry. The structure undergoes stress when expanded during its first use in bone. As a result, the structure can not be relied upon to reach its desired configuration during subsequent use in bone. Accordingly, the structure is packaged in a sterile kit, which verifies to the physician or user that the device packaged within it is sterile and has not be subjected to prior use. The physician or user is thereby assured that the expandable structure meets established performance and sterility specifications, and will have the desired configuration when expanded for use.

Abstract: An expandable structure made from an elastomer material is preformed to a desired geometry by exposure to heat and pressure. The structure undergoes controlled expansion and further distention in cancellous bone, with controlled deformation and without stress failure.

Abstract: Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. The prostheses provide an artificial facet joint structure including an artificial articular configuration unlike the preexisting articular configuration. The radii and material stress values of the prostheses are configured to sustain contact stress. The cephalad prosthesis provides for posterior-anterior adjustment. Both prostheses permit lateral adjustment and adjustment to accomodate interpedicle distance. Further, the prostheses may be customized to provide a pre-defined lordotic angle and a pre-defined pedicle entry angle.

Abstract: Systems and methods treat fractured or diseased bone by deploying more than a single therapeutic tool into the bone. In one arrangement, the systems and methods deploy an expandable body in association with a bone cement nozzle into the bone, such that both occupy the bone interior at the same time. In another arrangement, the systems and methods deploy multiple expandable bodies, which occupy the bone interior volume simultaneously. Expansion of the bodies form cavity or cavities in cancellous bone in the interior bone volume.

Abstract: An expandable structure made from an elastomer material is preformed to a desired geometry by exposure to heat and pressure. The structure undergoes controlled expansion and further distention in cancellous bone, with controlled deformation and without stress failure.

Abstract: A tube body includes an interior bore to carry a material flow into bone. The tube body includes a dispensing end having an opening communicating with the bore to dispense the material flow. One embodiment provides a cutting element, which extends in the opening to permit passage of the material flow and to sever the material flow in response to rotation of the tube body. Another embodiment deflects the dispensing end from the main axis of the tube body, to facilitate targeted introduction of flowable material, even when the access path does not align the tube body along the natural geometric axes of the treatment site. Another embodiment provides a connector having a rotating fitting, which releasably connects the tube body to a cement injecting tool. The rotating fitting allows the physician to rotate the injection nozzle assembly to control orientation and position in the treatment site, without rotating the associated injection tool itself.

Abstract: Systems and methods treat at least two vertebral bodies in a spinal column. The systems and methods make use of first and second tool assemblies operable to treat an interior region of, respectively, a first vertebral body and a second vertebral body in the spinal column. The systems and methods provide directions for operating the first and second tool assemblies to treat the first and second vertebral bodies, at least for a portion of time, concurrently.

Abstract: An expandable structure carried at the end of a catheter tube assembly can be contracted and/or wrapped to present a reduced profile during deployment and/or removal from a targeted tissue site.

Abstract: An expandable structure carried at the end of a catheter tube assembly can be contracted and/or wrapped to present a reduced profile during deployment and/or removal from a targeted tissue site.

Abstract: A tube body includes an interior bore to carry a material flow into bone. The tube body includes a dispensing end having an opening communicating with the bore to dispense the material flow. One embodiment provides a cutting element, which extends in the opening to permit passage of the material flow and to sever the material flow in response to rotation of the tube body. Another embodiment deflects the dispensing end from the main axis of the tube body, to facilitate targeted introduction of flowable material, even when the access path does not align the tube body along the natural geometric axes of the treatment site. Another embodiment provides a connector having a rotating fitting, which releasably connects the tube body to a cement injecting tool. The rotating fitting allows the physician to rotate the injection nozzle assembly to control orientation and position in the treatment site, without rotating the associated injection tool itself.

Abstract: Systems and methods treat at least two vertebral bodies in a spinal column. The systems and methods make use of first and second tool assemblies operable to treat an interior region of, respectively, a first vertebral body and a second vertebral body in the spinal column. The systems and methods provide directions for operating the first and second tool assemblies to treat the first and second vertebral bodies, at least for a portion of time, concurrently.

Abstract: A filler instrument comprises a first chamber section having a first cross sectional area and a second chamber section having a second cross sectional area less than the first cross sectional area. The second chamber section communicates with the first chamber section. The first chamber section includes an inlet for receiving a material into the filler instrument, and the second chamber section includes an outlet for discharging the material from the filler instrument. A first plunger is sized to pass through the first chamber section and not the second chamber section. A second plunger is sized to pass through an interior bore of the first plunger and into the second chamber section. In use, the first plunger displaces material residing in the first chamber section through the second chamber section toward the outlet, and the second plunger displaces material residing in the second chamber section through the outlet.