Abstract: An exchange system is disclosed, for providing a protected path to a subcutaneous procedure site. An exchange cannula is provided with a central lumen, and a drill wire lumen that serves as a portal for a drill wire for coupling the assembly to bone. The wall thickness of the exchange cannula may be eccentric, to accommodate the drill wire lumen within the exchange cannula wall. A tensioning handle may be carried over the exchange cannula, for engaging adjacent tissue. The exchange cannula may have a proximal “T” handle. An exchange rod is movably positionable within the central lumen of the exchange cannula.

Abstract: A sealing clip for sealing or holding punctures or openings in tissue closed is applied from the inner surface of the tissue. In one embodiment, the clip has piercing members for penetrating the tissue from an inner surface thereof adjacent the opening. A delivery apparatus is used to releasably hold the clip in one configuration for introduction of the clip through the puncture or opening and expand the clip to a more open configuration for pulling the clip through the tissue as the delivery apparatus is retracted. Further retraction of the delivery apparatus causes the edges of the tissue surrounding the opening to move along the clip and come together after which the clip is released and closed to hold the tissue edges of the opening together. In the case where the clip has a memory set closed shape, the clip returns toward that shape after being released to hold the tissue edges of the opening together, thereby holding the opening closed.

Abstract: A self-closing fastener is described that comprises a clip passable through a tissue opening. The fastener is adapted for holding by a mechanism in an open configuration for passing through the tissue, followed by releasing the fastener from the holding mechanism, allowing the clip to remain in the tissue in a shape that can clip two or more locations on the tissue. The fastener and delivery devices are particularly useful for tissue approximation, such as anastomosis. When used for anastomosis, the inventive clips provide intima-to-intima contact with a minimal amount of intraluminal exposure.

Abstract: Tools for use in the deployment of spinal implant assemblies such as spinal motion preservation assemblies adapted for use in a spinal motion segment are disclosed including the process for delivering and assembling the spinal motion preservation assemblies in the spinal motion segment via an axial channel created with a trans-sacral approach. The tools allow the deployment of a pair of spinal implant components that are not rigidly connected to one another to be driven into adjacent vertebral bodies. The tools further allow for distraction via either dissimilar thread pitch or by axially advancing a distraction tool based on a threaded engagement with a proximal component in a proximal vertebral body to impose an distraction between that vertebral body and an adjacent distal vertebral body. The tools also allow for the provision of flowable biomaterials such as prosthetic nucleus material. Delivery of flowable biomaterials can be performed while the vertebrae are being held apart by a distraction tool.

Abstract: Spinal motion preservation assemblies adapted for use in a spinal motion segment are disclosed including the process for delivering and assembling the spinal motion preservation assemblies in the spinal motion segment via an axial channel created with a trans-sacral approach. The spinal motion preservation assemblies make use of a dual pivot. A number of different embodiments of spinal motion preservation assemblies are disclosed which include at least one component adapted for elastic deformation under compressive loads. The disclosed mobility preservation assemblies provide for dynamic stabilization (DS) of the spinal motion segment.

Abstract: Disclosed are methods and apparatus for the provision of spinal therapy to two or more adjacent motion segments accessed through a trans-sacral approach. The spinal therapies include fusion and dynamic stabilization with and without a distraction of the most cephalad motion segment of the two or more adjacent motion segments provided therapy. The disclosure includes methods and apparatus to impart a distraction on a second more caudal motion segment after providing therapy to the more cephalad motion segment. Related concepts for the extraction of previously inserted devices and the delivery and removal of plugs for plugging the interior cavities of implantable devices are disclosed.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: A self-closing fastener is described that comprises a clip passable through a tissue opening. The fastener is adapted for holding by a mechanism in an open configuration for passing through the tissue, followed by releasing the fastener from the holding mechanism, allowing the clip to remain in the tissue in a shape that can clip two or more locations on the tissue. The fastener and delivery devices are particularly useful for tissue approximation, such as anastomosis. When used for anastomosis, the inventive clips provide intima-to-intima contact with a minimal amount of intraluminal exposure.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: A sealing clip for sealing or holding punctures or openings in tissue closed is applied from the inner surface of the tissue. In one embodiment, the clip has piercing members for penetrating the tissue from an inner surface thereof adjacent the opening. A delivery apparatus is used to releasably hold the clip in one configuration for introduction of the clip through the puncture or opening and expand the clip to a more open configuration for pulling the clip through the tissue as the delivery apparatus is retracted. Further retraction of the delivery apparatus causes the edges of the tissue surrounding the opening to move along the clip and come together after which the clip is released and closed to hold the tissue edges of the opening together. In the case where the clip has a memory set closed shape, the clip returns toward that shape after being released to hold the tissue edges of the opening together, thereby holding the opening closed.

Abstract: A system for anastomosing a first tubular structure to a second tubular structure having an opening formed therein comprises a support device having a plurality of arms forming spaces therebetween and a plurality of piercing members slidably coupled to the arms. The support device piercing members have a retracted state and an extended state to support the first tubular structure thereon for placement within an opening in the second tubular structure to facilitate anastomosing the tubular structures together. The arms can be configured to urge the first tubular structure against the portion of the second tubular structure surrounding the opening to form a seal therebetween. According to one embodiment, a plurality of discrete fasteners are provided to pass through the support device spaces and the first and second tubular structures. In another embodiment, fasteners are integrated into the support device and releasably coupled thereto for delivery to the anastomosis site.

Abstract: A self-closing fastener is described that comprises a clip passable through a tissue opening. The fastener is adapted for holding by a mechanism in an open configuration for passing through the tissue, followed by releasing the fastener from the holding mechanism, allowing the clip to remain in the tissue in a shape that can clip two or more locations on the tissue. The fastener and delivery devices are particularly useful for tissue approximation, such as anastomosis. When used for anastomosis, the inventive clips provide intima-to-intima contact with a minimal amount of intraluminal exposure.

Abstract: A self-closing fastener is described that comprises a clip passable through a tissue opening. The fastener is adapted for holding by a mechanism in an open configuration for passing through the tissue, followed by releasing the fastener from the holding mechanism, allowing the clip to remain in the tissue in a shape that can clip two or more locations on the tissue. The fastener and delivery devices are particularly useful for tissue approximation, such as anastomosis. When used for anastomosis, the inventive clips provide intima-to-intima contact with a minimal amount of intraluminal exposure.