Abstract: Methods for the prevention, or delayed onset or progression of, bone marrow edema or bone marrow lesion, and subchondral treatment to prevent the progression of osteoarthritis of a joint are disclosed. The methods involve treating the subchondral bone, while preserving, as much as possible, the joint's articular and cartilage surface. The methods could be performed before, during, or after an initial arthroscopic surgery to repair the joint. Associated devices and instruments for treatment of the subchondral bone are also disclosed.

Abstract: An apparatus for performing a microwave ablation procedure is provided. The apparatus includes a catheter including an open proximal end and a closed distal end configured to percutaneously access tissue. A directional microwave antenna probe adapted to connect to a source of microwave energy selectively couples to the catheter. The directional microwave antenna is rotatable within the catheter for directing the emission of microwave energy therefrom to tissue.

Abstract: An ablation device includes an antenna assembly having a radiating portion configured to deliver energy from a power source to tissue of a patient. The radiating portion has an outer conductor and an inner conductor extending therethrough. The inner conductor is disposed within the outer conductor and defines a longitudinal axis. One of the inner conductor and the outer conductor is movable relative to the other to cause at least a portion of the outer conductor to expand radially relative to the longitudinal axis.

Abstract: The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

Abstract: A microwave ablation device including a cable assembly configured to connect a microwave ablation device to an energy source and a feedline in electrical communication with the cable assembly. The microwave ablation device further includes a balun on an outer conductor of the feedline, and a temperature sensor on the balun sensing the temperature of the balun.

Abstract: A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.

Abstract: A medical robotic system has a joint coupled to medical device or a slave manipulator or robotic arm adapted to hold and/or move the medical device for performing a medical procedure, and a control system for controlling movement of the joint according to user manipulation of a master manipulator. The control system includes at least one joint controller having a sliding mode control for reducing stick-slip behavior on its controlled joint during fine motions of the joint. The sliding mode control computes a distance to a sliding surface, computes a reaching law gain, and processes the distance and reaching law gain to generate a sliding mode control action that is in absolute value less that a maximum desired feedback control action. The sliding mode control action is then further processed to generate a feedback torque command for the joint motor.

Abstract: It comprises a supporting structure in which at least one arm is slidably attached. Each arm comprises first and second members hinged to each other. The first member is rotatably hinged to the supporting structure and it can be rotated about a longitudinal axis and the second member may receive a joint having at least two degrees of freedom for attaching a tool. The longitudinal axis of the first member is substantially perpendicular to an axis joining the first member and the second member to each other. A simplified architecture is obtained allowing for accurate and efficient spatial movement of the tool holding arm.

Abstract: Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

Abstract: A surgical manipulator for manipulating a surgical instrument and an energy applicator extending from the surgical instrument. The surgical manipulator further includes a switch and at least one controller configured to control operation of the surgical manipulator in a first operating mode or a second operating mode. The at least one controller is also configured to determine a commanded pose to which the energy applicator is advanced based on a summation of a plurality of input forces and torques and transition between the operating modes by adjusting the plurality of input forces and torques in response to actuation of the switch.

Abstract: A thromboembolic removal system for treating ischemic stroke, including a guide and occlusion catheter, a delivery and aspiration catheter, an aspiration pump, a thromboembolic receiver, and a thromboembolic separator.

Abstract: A surgical instrument may include an end effector, an input drive shaft, a closure drive, and/or a firing drive. The end effector may comprise a jaw assembly including a first jaw member and a second jaw member. The end effector may comprise an I-beam member axially translated between a proximal position and a distal position within the end effector. In one embodiment, the input drive shaft may selectively engage the firing drive and/or the closure drive. In one configuration, the closure drive is threadedly engaged with the firing drive allowing the input drive shaft, during a firing stroke, to simultaneously move the closure drive and the firing drive until the closure drive is disengaged from the firing drive. On a reverse stroke, the closure drive may be reengaged with the firing drive.

Abstract: An ultrasonic surgical blade has a blade body and a shank. The shank is fixed at one end to the blade body and is operatively connectable at an opposite end to a source of ultrasonic vibrations. The shank has a longitudinal axis. The blade body is eccentrically disposed relative to the axis.

Abstract: A safe and efficient cutting heads for removing a target tissue from a subject during a surgical procedure are provided, the cutting heads composing a part of systems that address several problems, including clogging of state-of-the-art systems during removal of such tissue, for example. The target tissue can include any tissue that is accessible through a small surgical opening, for example, a joint tissue such as a meniscus or an intervertebral tissue, such as a nucleus pulposus. The devices can be referred to as orthopedic tissue removal devices having cutting heads associated with vacuum systems, making the systems useful in several procedures, including X-LIF (lateral approach to an intervertebral fusions) procedures, T-LIF (transforaminal approach to intervertebral fusions) procedures, P-LIF (posterior approach to intervertebral fusions), and a percutaneous, transforaminal approach (Kambin triangle access).

Abstract: An atherectomy device is disclosed, which is rotationally driven by an electric motor. In some designs, the device includes features unavailable on gas turbine-driven systems, such as the storing in memory of low/medium/high preset rotation speeds for particular models of handle, calculations of the amount of saline left in the IV and associated warnings when it gets sufficiently low, and automatic adjustment of the IV pump rate to a predetermined or calculated level when the rotational speed of the motor is changed. The electric motor has far more rotational inertia than a comparable gas turbine, so the system includes a control mechanism that helps prevent damage from excessive torque being applied to the distal end of the drive shaft. When an obstruction at the distal end is detected, by a drop in the motor rotational speed, the motor is released and is allowed to spin freely as a flywheel.

Abstract: An atherectomy device is disclosed, which is rotationally driven by an electric motor. In some designs, the device includes features unavailable on gas turbine-driven systems, such as the storing in memory of low/medium/high preset rotation speeds for particular models of handle, calculations of the amount of saline left in the IV and associated warnings when it gets sufficiently low, and automatic adjustment of the IV pump rate to a predetermined or calculated level when the rotational speed of the motor is changed. The electric motor has far more rotational inertia than a comparable gas turbine, so the system includes a control mechanism that helps prevent damage from excessive torque being applied to the distal end of the drive shaft. When an obstruction at the distal end is detected, by a drop in the motor rotational speed, the motor is released and is allowed to spin freely as a flywheel.

Abstract: A catheter having a tubular body and a rotatable shaft disposed within a lumen of the tubular body. A cutting element is coupled to the rotatable shaft, the cutting element having a cutting edge, the cutting element and rotatable shaft being longitudinally moveable within the tubular body between a stored position in which the cutting element is positioned distal of a side opening and a cutting position in which the cutting element is contained within the lumen of the tubular body and longitudinally aligned with the side opening. The cutting element is configured to extend through the side opening and to cut material from the wall of a vessel at a treatment site as the catheter is pulled proximally through the treatment site. The catheter may optionally have a rotating distal tip with an abrasive surface. The catheter includes a collection chamber positioned proximally of the cutting window.

Abstract: A hybrid cannula may comprise a rigid portion overmolded with a flexible portion. The rigid portion at its proximal end may comprise a rigid flange for preventing the proximal end of the hybrid cannula from being pushed through the portal. The flexible portion may comprise a dam within the passage of the hybrid cannula, the dam defining interior spaces thereof between the proximal and distal ends of the hybrid cannula. The flexible portion's distal end may comprise a variety of features extending therefrom, including a flange and/or a cannulated tip. The flexible portion's proximal end may further comprise a membrane to prevent liquid from projecting during insertion of a tool into the dam and/or removal of the tool from the dam. The hybrid cannula can be useful in minimally invasive surgical procedures, including arthroscopic and endoscopic surgeries.

Abstract: A surgical apparatus includes a seal anchor member. The seal anchor member includes a first end, a second end, at least one longitudinal port extending between the two ends, and a seal assembly disposed within the at least one longitudinal port. The seal assembly can be positioned at any location along the length of the at least one longitudinal port. The seal assembly comprises a seal housing which is dimensioned to receive a surgical instrument inserted into the at least one longitudinal port and form a substantially fluid-tight seal therewith. The seal housing may comprise a pivotable member to pivot the surgical instrument inserted therein. The at least one longitudinal port may define two gradually enlarging openings to facilitate the maneuverability of the surgical instrument inserted therein. The at least one longitudinal port may comprise a protective sleeve to protect it from accidental penetration by the surgical instrument.

Abstract: A surgical access device includes a body having a first member and a second member relatively movable between open and closed configurations. Each member is positionable within an opening in tissue to provide access to an interior space of a patient. Each member includes a top surface, a bottom surface, a leading end, and a trailing end. The top surfaces are positioned in close cooperative alignment when the first and second members are in the closed configuration. The trailing ends are positioned in close cooperative alignment when the first and second members are in the open configuration. In the open position, the first and second members define a passage therethrough to permit access to the interior space for passage of a surgical instrument therethrough.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity is adapted to tissues having different thicknesses. The surgical apparatus includes an anchor member and a flexible sleeve integrated with the anchor member. The anchor member defines at least one longitudinal port for reception of a surgical instrument. The surgical apparatus defines an adjustable length to accommodate tissues with different thicknesses.

Abstract: An identification device adapted to be attached to a tool comprising a holder formed as a curved stratum having a C-shaped cross-section, the stratum having at least one opening thereon, and the internal surface of the holder being micro-etched; an identification tag placed within the holder; and hardening material for fixing the identification tag within the holder. The identification device is created from a holder, shaped as a curved stratum having a C-shaped cross-section and at least one opening thereon, micro-etching the internal surface of the holder; and fixing an identification tag within the holder by a hardening material. Fixing the tag within the holder may comprise placing the holder within a container; filling the holder to about half the height with a hardening material; placing the identification tag within the holder; filling the holder with the hardening material; and hardening the hardening material.

Abstract: A surgical lamp for illuminating an operating site includes a lamp body that includes first and second light sources that respectively generate first and second light fields of different diameter on the operating site. When a change in a distance between the lamp body and the operating site is detected, the first and second light intensities of the first and second light sources, respectively, can be controlled such that the predetermined diameter (dx) at which the preset relative central illuminance (Ecx) of the resultant light field is generated is maintained at a substantially constant value as the distance changes.

Abstract: A medical tracking system includes a localization system operative to spatially localize medical instruments; a computer operative to assign absolute and/or relative positions of said instruments in a coordinate system; and at least one localizable gamma camera operative to detect gamma radiation emitted from a tracer material.

Abstract: Systems and methods for surgical guidance and image registration are provided, in which three-dimensional image data associated with an object or patient is registered to topological image data obtained using a surface topology imaging device. The surface topology imaging device may be rigidly attached to an optical position measurement system that also tracks fiducial markers on a movable instrument. The instrument may be registered to the topological image data, such that the topological image data and the movable instrument are registered to the three-dimensional image data. The three-dimensional image data may be CT or MRI data associated with a patient. The system may also co-register images pertaining to a surgical plan with the three-dimensional image data. In another aspect, the surface topology imaging device may be configured to directly track fiducial markers on a movable instrument. The fiducial markers may be tracked according to surface texture.

Abstract: A fixation assembly for spinal vertebrae has an anchor fixedly seatable in a spinal vertebrae and formed with an outwardly open socket, and a pedicle rod having a front end fixedly seated in the socket and a dynamic portion adjacent the front end that is shiftable relative to the anchor.

Abstract: Systems and devices for providing dynamic stabilization of one or more spinal motion segments are provided. The systems include a connecting element between two or more bone anchor assemblies that can be attached to two or more vertebral bodies of at least one spinal motion segment. The connecting element includes a first end, a second end, an intermediate resilient element and a sheathed tether extending from the first end to the second end and through the resilient intermediate element.

Abstract: In a rod fixation system of the type used to treat various spinal conditions, the same fastener is used to lock both a polyaxial screw and a rod in position. A spinal correction device according to the invention, adapted for use with a rod and a polyaxial screw having a ball-shaped head and a threaded end, comprises a head-body and a cap. The head-body includes a lower internal cavity to receive the ball-shaped head of the screw, an upper bore to receive a fixation rod therethrough, and an upper end configured to receive the cap. The head-body and the cap are configured such that a first rotation of the cap locks the polyaxial screw in position, and a second rotation of the cap locks the rod in position. In the preferred embodiment, the head-body includes one or more gaps to facilitate flexion of the head-body as a rotational torque is placed on the cap. The gap or gaps may be horizontal, vertical or other angles relative to the axis of the entrapped rod.

Abstract: A bone anchoring device includes a shank to be anchored in a bone or vertebra, a head, and a receiving part receiving the head for connecting the shank to a rod. The shank and the head are separate parts. The head has a bore with a cylindrical inner surface, a ring-shaped groove provided on the inner surface, and at least one slit extending from the inner surface to the outer surface of the head. The shank has a first portion for anchoring in the bone or vertebra and a second portion with a cylindrical outer surface adjoining a free end. A projection is provided on the cylindrical outer surface which engages with the ring-shaped groove of the head, when the cylindrical second portion of the shank is inserted in the bore of the head.

Abstract: A transverse fixation device is disclosed. The device includes one or more connecting bodies disposed substantially between two elongate rods. Each connecting body includes a receptacle that is capable of engaging with the two elongate rods. A c-ring comprising an outer surface having a spherical curvature is also included. A third rod may be inserted into the c-ring. A clamp included in the connecting bodies may then be disposed about the c-ring and third rod to allow the connecting bodies to slidingly engage with the third rod.

Abstract: Various methods and devices are provided for bone screw fixation. In one exemplary embodiment, the methods and devices provide a bone fixation device that includes a receiving head having a recess adapted to seat a spinal rod therein and a shank extending distally from the receiving head. An anti-rotation mechanism can be located distal of a distal end of the receiving head and around a proximal portion of the shank, and it can be configured to interact with bone to prevent rotation of at least a portion of the bone fixation device relative to the bone.

Abstract: Bone plates and bone plate systems are provided in which a bone plate includes a plurality of bone screw holes formed therein and positioned in laterally adjacent pairs. Positioned between the laterally adjacent pairs of bone screw holes are stabilizing strut. The bone plate system can additionally include windows positioned between longitudinally adjacent struts. Transverse bone screw planes can extend across the superior and inferior edges of the bone screw holes and define the minimum longitudinal boundaries of the windows. A guide device adapted for mating with the bone plate is also disclosed.

Abstract: Facet fixation implants include a cap member with a circular base portion and an eccentric raised portion. The raised portion includes first and second lobes and is smoothly contoured to provide an unobtrusive profile when implanted. Beveled teeth project from the implant to provide fixation and compression across the facet joint. The cap member includes an offset aperture which receives a fastener. Tools, guiding instruments and methods for implantation of the implants are disclosed.

Abstract: A dynamic spine prosthesis (such as a facet joint prosthesis having an articulation surface configured to articulate with a corresponding facet joint element) that has a fixation element with an elongated bone entry portion defining a longitudinal axis and a dynamic spine prosthesis component connected to the fixation element at a connection location by an adjustable connection. The adjustable connection has first and second washers each rotatably supported by the fixation element and each having an angled contact surface in a plane not perpendicular to the longitudinal axis of the fixation element, with the connection location being between the bone entry portion and the first and second washers.

Abstract: An implantable spacer for placement between adjacent spinous processes is provided. The spacer includes a body and a wing rotatably connected to the body. The wing includes two U-shaped configurations that together define a substantially H-shaped configuration for retaining the spacer between adjacent spinous processes. An actuator assembly is connected to the body and to the wing with the proximal end of the spacer being connectable to a removable driver that is configured to engage the actuator assembly. While connected to the spacer, the driver is rotatable in one direction to deploy the wing from an undeployed to a deployed configuration and in an opposite direction to undeploy the wing. In the deployed configuration, the spacer acts as a space holder opening up the area of the spinal canal, maintaining foraminal height, reducing stress on the facet joints and relieving pain for the patient.

Abstract: An embodiment of the invention provides for a system, such as a cervical plate fusion system, that has mechanisms for preventing bone screws from backing out of the plate. The system prevents both counter-rotation of the screw and axial backing out of the screw. Other embodiments are described herein.

Abstract: The described apparatus and method include a bone plating system comprising a plate longitudinally extending between a first plate end and a second plate end, wherein the plate further comprises a first plate surface spaced apart from an opposing second plate surface. Further, the bone plating system further includes a first spacer segment longitudinally extending between a first spacer end and a second spacer end, wherein the first spacer segment is shaped to adapt the plate to conform to an adjacent bone segment surface.

Abstract: Spinal implants and methods of inserting the implants into an interspinous space and into engagement with spinous processes. The implants may include first and second arms that are separately inserted into the patient. The arms may be attached together within the patient in an overlapping arrangement and pivotally connected at a joint. The arms may be moved about the joint with first ends of each of the arms on a first side of the joint contacting against opposing lateral sides of a first spinous process and second ends of each of the arms on a second side of the joint contacting against opposing lateral sides of a second spinous process. A securing member may contact against the arms and secure the orientation of the arms.

Abstract: Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).

Abstract: A surgical instrument includes a first member extending between a proximal end and a distal end. The distal end includes a plurality of fingers extending radially outward in a tapered configuration. A second member extends between a proximal end and a distal end. The proximal end of the second member is configured for mating with the distal end of the first member. A third member has an inner surface defining a cavity configured for disposal of the first member and engagement with the first member to fix the first member with the second member. Systems and methods are disclosed.

Abstract: A handle for removably attaching to a moldable orthosis positions the orthosis in boiling water. The handle includes an arm with an oral orthosis engaging member at one end. The engaging member includes one of a tab or slot which removably engages the oral orthosis. In a preferred embodiment, the arm further includes a hook-like member for supporting the oral orthosis on the rim of a container of boiling water during the molding process. In one embodiment, the handle forms the cover of a storage case for the orthosis.

Abstract: A method of manufacturing a functionalized implant, in particular a dental implant, is provided, including first providing a substrate for the implant and applying a highly porous, hydrophilic coating which contains at least one of the following materials for functionalization: zirconium or titanium or zirconium alloy or titanium alloy, zirconium oxide or titanium oxide, calcium phosphate, calcium titanate or calcium zirconate. Further provision is made for a functionalized implant, in particular a dental implant.

Abstract: A holding device for retaining and transporting a dental implant, particularly a dental implant stored in an ampule having preserving fluid, is provided. The holding device has a securing section, which has a force transmission element for rotationally securing the dental implant and an attachment element having one or more resilient arms formed integrally with and distally of the force transmission element, for longitudinally retaining the dental implant. The resilient arms do not extend beyond the radial perimeter of the force transmission element. The resilient arms can be transformed between a first operative configuration and a second compressed configuration under forces during operation, to allow a radially enlarged end of the arms to releasably engage an undercut of the dental implant.

Abstract: A tool for insertion and removal of an archwire into low-profile orthodontic brackets includes a handle section and at least one end section having a pair of claws separated by a gap. Each of the pair of claws has a pair of lobes with internal pathways for accommodating an archwire. This enables the archwire to be alternately pushed into and pulled away from an orthodontic bracket.

Abstract: A fluid-operated medical or dental handheld element is disclosed, having a connecting device for connecting the handheld element to a fluid source so that a first impeller can be induced to rotate by a fluid stream to cause a tool to execute a driving motion, a fluid conducting device arranged between the connecting device and the first impeller for conveying a fluid stream away from or toward the first impeller, and a generator for generating electric power. The generator includes a second rotatable impeller that can be driven by at least a substream of the fluid stream conveyable in the first fluid conducting device. One result is more constant generation and output of power by the generator independent of the rotational speed of the first impeller, thereby insuring a more constant power supply to a power consuming device connected to the generator.

Abstract: The present invention provides orthodontic appliances and systems, and related methods, for applying a force to a target tooth as an appliances is worn by the patient. One positioning appliance includes a tooth positioning appliance having teeth receiving cavities shaped to apply a positioning force to the patient's teeth. The appliance includes a spring-loaded tooth movement device disposed in the appliance so as to engage an attachment mounted on a surface of a patient's tooth and apply a force to the tooth.

Abstract: The invention provides methods of making provisional and long-term dental restorations, particularly dental veneers, implants, crowns and bridges. A shell or restoration form made of polymerizable material having good dimensional shape-stability in its uncured condition is used to make the dental restoration. A polymerizable material is introduced into the cavity of the shell form. The outer shell and injected polymerizable material are polymerized and bond together to form a hardened crown structure. In one embodiment, the restoration can be fabricated indirectly by a dental laboratory. In another version, a dental practitioner can make the restoration chairside for a patient in a dental office.

Abstract: This invention is an adjustable orthodontic bracket system which allows brackets to be adjusted for the particular angulations required for each individual tooth of any patient, while continuously attached to the tooth surface. The orthodontist manually adjusts the relationship of the bracket component with the frame and bracket base during treatment eliminating the necessity of repositioning bracket components due to erroneous positioning. The bracket component is positioned such that it can move completely in all directions to achieve the proper angulation for tooth repositioning. The base of the bracket component and the interior surface of the bracket compartment are textured to provide friction and secure the components once positioned for proper tooth movement. The exterior of the bracket component is also textured to provide more secure attachment to the surface of the tooth. This system will lead to lower treatment cost and quicker adjustments of the orthodontic bracket system.

Abstract: A photo-curing device includes a light source for initiating the curing of a photo-curable material. The light source has light-emitting diodes, each emitting light in a determined wavelength range, the wavelength ranges of the LEDs overlapping partially so as to cover a continuous wavelength range that is broader than the wavelength range of each LED. An activation device is provided for selectively activating each LED.

Abstract: A replaceable head part for an electric powered toothbrush comprising an elongate sleeve including a flexible portion, and containing a longitudinal drive shaft rotatable in oscillatory rotary motion. The drive shaft has a spherical bearing part received in a cavity in the sleeve. The head part incorporates a transmission system to convert the rotation of the head drive shaft into rotation of the bristle carrier comprising an eccentric pin extending from the head drive shaft to move the bristle carrier in oscillatory rotary motion, and having a spherical pin bearing part received in a receiving cavity in the bristle carrier.