Abstract: A breath-powered, dry powder inhaler, a cartridge, and a pulmonary drug delivery system are provided. The dry powder inhaler can be provided with or without a unit dose cartridge for using with the inhaler. The inhaler and/or cartridge can be provided with a drug delivery formulation comprising, for example, a diketopiperazine and an active ingredient, including, peptides and proteins such as insulin and glucagon-like peptide 1 for the treatment of diabetes and/or obesity. The dry powder inhaler is compact; can be provided in various shapes and sizes, colors, and comprises a housing, a mouthpiece, a cartridge placement area, and a mechanism for opening and closing the medicament cartridge. The device is easy to manufacture, provides a pre-metered single unit dose, it is relatively easy to use, and can be reusable or disposable.

Abstract: Methods and techniques for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. An inline rod connector is utilized which includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure uses a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: Apparatus and devices for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.

Abstract: Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: Apparatus and instruments for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: Methods and techniques for attaching a cross connector to a pair of contraterally implanted spinal rods in a patient are disclosed. In one arrangement, the cross connector is subcutaneously placed to interconnect contralaterally to a pair of rod connectors that are percutaneously attached respectively to a pair of rods in existing spinal constructs implanted on opposite sides of spine.

Abstract: A method of attaching a curved rod to a plurality of pedicle screws in the thoracic region of the spine is disclosed. Preferably, the method is practiced in a procedure for percutaneously fixing the rod to the pedicle screws through slots formed through a plurality of screw extensions releasably attached respectively to the pedicle screws. The method includes the steps of releasably and pivotally attaching the curved rod to a rod introducer having a handle and holding the rod initially in a fixed position. The rod is introduced in the fixed position through the slots in the extensions with the rod curvature defining a lordotic angle relative to the spine. The rod is released from the fixed position without separating the rod from the introducer. While the rod is in the released position the handle is rotated 180° thereby rotating the rod to a kyphotic angle relative to the thoracic region of the spine.

Abstract: Gas permeation barriers can be deposited on plastic or glass substrates by atomic layer deposition (ALD). The use of the ALD coatings can reduce permeation by many orders of magnitude at thicknesses of tens of nanometers with low concentrations of coating defects. These thin coatings preserve the flexibility and transparency of the plastic substrate. Such articles are useful in container, electrical and electronic applications.

Abstract: A method and assembly is provided for linking an additional vertebral construct to an existing spinal construct having at least two bone screws engaged to corresponding vertebrae and connected by a connecting member. The assembly includes a fastener configured to engage a bone screw of the existing construct and to engage a connecting member connected to the bone screw. The assembly further includes a linking member having an elongated portion configured to connect to a bone screw of the additional construct and a mounting structure configured for mounting on the bone screw of the existing construct. A locking member fixes the orientation of the linking member relative to the bone screw and a clamping member locks the linking member and existing connecting member to the bone screw of the existing construct.

Abstract: A breath-powered, dry powder inhaler, a cartridge, and a pulmonary drug delivery system are provided. The dry powder inhaler can be provided with or without a unit dose cartridge for using with the inhaler. The inhaler and/or cartridge can be provided with a drug delivery formulation comprising, for example, a diketopiperazine and an active ingredient, including, peptides and proteins such as insulin and glucagon-like peptide 1 for the treatment of diabetes and/or obesity. The dry powder inhaler is compact; can be provided in various shapes and sizes, colors, and comprises a housing, a mouthpiece, a cartridge placement area, and a mechanism for opening and closing the medicament cartridge. The device is easy to manufacture, provides a pre-metered single unit dose, it is relatively easy to use, and can be reusable or disposable.

Abstract: An apparatus for processing data 2 is provided with a time-to-digital converter 18 which serves to measure signal processing delay through one or more signal paths through a processing stage. This measured delay generates a delay value representing a plurality of instances of the signal processing delay which have been measured. Analysis is performed under software control to estimate a worst case signal processing delay through the processing stage based upon the delay values which have been generated. An adjustment of the operating parameters, such as supply voltage and clock frequency, of the apparatus is made to provide a timing margin through the processing stage sufficient to satisfy the worst case signal processing delay which has been estimated without an excessive margin.

Abstract: A screwdriver for driving a multi-axial its distal end for engaging the head of the bone screw for joint rotational movement. The screw driver includes an outer retention sleeve within which the inner shaft rotates freely. The outer retention sleeve releasably attaches to the yoke of the bone screw. In another configuration, the screwdriver comprises a screw engagement member affixed to the shaft for joint rotational movement therewith, the screw engagement member comprising a stop sized to seat within a slot of the bone screw yoke, the stop being configured to rotate the yoke upon rotation shaft. A releasable retention member is provided on the screw engagement member for releasably attaching the screwdriver to the bone screw.

Abstract: Methods and techniques for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.

Abstract: A bone screw extension assembly for use in placing a connecting rod percutaneously into tissue of a patient comprises a multi-axial bone screw and a screw extension releasably coupled to yoke of the bone screw. The screw extension includes coaxially disposed outer sleeve and inner sleeves that are movable axially relative to each other. A screw engaging member projects radially from the distal end of the inner sleeve and is configured to releasably engage an extension coupling surface on the inner surface of opposed upstanding arms of the yoke. A securement member including cooperative surfaces is defined adjacent the distal end of the inner and outer sleeves that is operable upon relative axial movement of the inner and outer sleeves to radially secure the sleeves together for minimization of splaying and to thereby maintain the engagement of the screw engaging member and the bone screw.

Abstract: A surgical instrument for the distraction or compression of bones or bone portions comprises a pair of elongate cross members pivotally coupled for relative movement having at one end a respective pair of handles and at the other end a respective pair of jaws. The jaws are generally parallel to each other and define a first plane within which the jaws are relatively movable, the space on both sides of the plane defining a work space between the jaws. The instrument further comprises a fulcrum supported by at least one of the cross members projecting into the work space and having an axis spaced from the jaws.

Abstract: An apparatus for detecting the presence of a connecting rod during percutaneous spinal surgery comprises a tubular member and an elongate strip extending therethrough. The strip has a flag at the proximal end and an elastically flexible rod detection tip projecting outwardly from the distal end for contacting a connecting rod. The strip is supported in the tubular member for pivoting movement relative to the longitudinal axis of the member. A biasing member biases the strip to a first position in which the flag is adjacent a first side of the tubular member and the detection tip at the distal end is adjacent an opposite second side. Upon application of a force to elastically flex the detection tip, in which the force is sufficient to overcome the bias, the flag is shifted to a second position adjacent the second side of the tubular member.

Abstract: An introducer is provided for inserting a connecting rod into tissue of a spine that comprises an outer sleeve with an actuatable rod attachment portion at a distal end thereof to releasably pivotally attach to a connecting rod, and an elongate inner shaft movable translationally within the outer sleeve. The proximal end of the shaft is coupled to an actuation mechanism for selectively translating the inner shaft. The distal end of the shaft includes a rod engagement surface that is movable y the actuation mechanism to a first position to engage a cooperative engagement surface on the rod to hold the rod in a selected locked orientation, to a second position to space the rod engagement surface from the cooperative engagement surface of the rod to allow pivoting of the rod, and to a third position to release the rod from the outer sleeve.

Abstract: A system for percutaneously fixing a connecting rod to vertebrae comprises first and second bone screws, each with a corresponding hollow bone screw extension mounted thereto, and a connecting rod of length sized for subcutaneous receipt in the yokes of the bone screws. A rod introducer is provided for inserting the connecting rod into slots of the screw extensions and into the yokes of the bone screws. A rod persuader may also be provided that is attachable to at least one of the screw extensions, the rod persuader being operable to engage the connecting rod and urge the rod into the slot of the yoke of the corresponding bone screws. A rod detector may also be provided for insertion one of the screw extensions, the rod detector having an indicator sensing the presence of a rod in the slot of the yoke of at least one of the bone screws.

Abstract: A system for percutaneously fixing a connecting rod to vertebrae comprises first and second bone screws, each with a corresponding hollow bone screw extension mounted thereto, and a connecting rod of length sized for simultaneous receipt in the yokes of the bone screws. A rod introducer is provided for inserting the connecting rod into slots of the screw extensions and into the yokes of the bone screws. A rod persuader may also be provided that is attachable to at least one of the screw extensions, the rod persuader being operable to engage the connecting rod and urge the rod into the slot of the yoke of the corresponding bone screws. A rod detector may also be provided for insertion one of the screw extensions, the rod detector having an indicator sensing the presence of a rod in the slot of the yoke of at least one of the bone screws.

Abstract: A method of attaching an extension to a bone anchor for use in percutaneous spinal surgery is provided that comprises the steps of: providing a bone anchor including a first portion for attachment to a vertebra and a second portion for attachment to a connecting element, the bone anchor including an extension coupling surface; providing an elongate hollow extension having a distal end and a proximal end, the extension having a rotationally movable anchor engaging member projecting radially from the distal end thereof; placing the distal end of the extension adjacent the bone anchor; and rotating the anchor engaging member to engage the extension coupling surface on the anchor and couple the extension and the bone anchor.