Abstract: Disclosed is a bone fracture fixation device, such as for reducing and compressing fractures in the proximal femur. The fixation device includes an elongate body with a helical cancellous bone anchor on a distal end. An axially moveable proximal anchor is carried by the proximal end of the fixation device. The device is rotated into position across the fracture or separation between adjacent bones and into the adjacent bone or bone fragment, and the proximal anchor is distally advanced to apply secondary compression and lock the device into place. The device may also be used for soft tissue attachments.

Abstract: A surgical fastener comprises a head including a wall and a drive interface oriented in a first axial direction. At least one tissue penetrating element extends from the wall in a second axial direction. The at least one element is provisionally disposed with tissue and the wall overlaps a surface of an implant to selectively position and orient the implant relative to tissue. Systems and methods are disclosed.

Abstract: Interspinous/inter-laminar spinal spacers are configured to be placed between bony structures of adjacent vertebrae. In one form, spinal spacers are defined by a unitary body comprising a first contoured plate and a second contoured plate. The first contoured plate comprises first and second wings configured to engage first and second vertebra, and a post extending from the contoured plate and having a bullet nose and an outer surface with a curved portion and a planar portion. The second contoured plate is slidably coupled to the post of the body and comprises first and second wings configured to engage first and second vertebra, a rear portion extending between the first wing and the second wing, and a front portion extending between the first wing and the second wing. The first wing, second wing, rear portion, and front portion define a first bore configured to receive the post.

Abstract: Internal pedicle insulator apparatuses and methods are provided. A representative method includes: providing an internal pedicle insulator implant; inserting the implant into a pedicle such that the implant is positioned between a nerve and material that is to be applied in a vicinity of the nerve; applying the material in the vicinity of the nerve; and using the implant to prevent the material from contacting the nerve.

Abstract: The present invention provides cervical implant (30) comprising an upper surface (38), a lower surface (40), a posterior portion (34) and an anterior portion (36) and including a perimeter (42) and one or more apertures (44,46) within said anterior portion for receiving securing means, said apertures having respective longitudinal axes M1, M2, characterized in that said axes extend in a direction substantially through said anterior portion (36) and converge at a point in a plane outside of said perimeter (42).

Abstract: An artificial disk replacement device includes opposing plate members with a pivoting assembly disposed therebetween. The pivoting assembly allows the plate members to pivot relative to each other in a first direction, but inhibit movement of the plate members in a second direction. The plate members may be installed prior to installing the pivoting assembly. An installation tool for use with the artificial disk replacement device is also disclosed.

Abstract: A posterior spinal fusion system may include pedicle screws and one or more segments designed to be attached to the implanted pedicle screws via nuts to fuse spinal motion segments in a modular fashion. The pedicle screws may have semispherical receiving surfaces, and each segment may have mounting portions at both ends, with corresponding semispherical engagement surfaces. The nuts may also have semispherical surfaces. The semispherical surfaces permit polyaxial adjustment of the relative orientations of the segments and pedicle screws. Each mounting portion may have a passageway therethrough to receive the proximal end of the corresponding pedicle screw; each passageway may intersect the edge of the corresponding engagement surface to facilitate percutaneous placement. Such placement may be carried out through cannulae to provide a minimally invasive (MIS) implantation procedure.

Abstract: The present invention relates to a brace installation instrument placement that is mounted to anchors secured in an animal subject. The installation instrument includes anchor extensions coupled to the anchors. The instrument is movable with respect to the anchors to position a brace in a position more proximate the anchors. The brace can be indexed for insertion at a predetermined orientation with respect to the installation instrument. Methods and techniques for using the installation instrument are also provided.

Abstract: This invention is a minimally-invasive device, including bone-moving members and motion-measuring members, that can help surgeons to obtain objective, quantitative information concerning spinal flexion, extension, lateral bending, decompression, compression and torsion in order to select the best therapy for each patient. The prior art does not offer surgeons the opportunity to objectively and independently measure each of these movements. As a result, currently there is tremendous variation concerning which therapies are selected for which conditions. It is very unlikely that quality is being optimized and costs are being best managed with such high variation in practice patterns. This variation may be greatly reduced by the availability of objective information concerning spinal motion from this device. In this manner, this device can help surgeons to select the optimal therapy, to improve the quality of care, and to reduce the risk and expense of unnecessary spinal procedures and hardware.

Abstract: A bone-anchored surgical mesh has slot-like anchoring members that allow for the variable placement of screws and other bone fasteners. This permits the surgeon discretion in the placement of bone fasteners used to attach the mesh to the patient's bone. The elongate openings of the anchoring members allow for a sliding motion between the bone fasteners and the anchoring members, and facilitates positioning and articulation of the mesh. The anchoring members may include bushings to aid the sliding motion of the anchoring member on the bone fastener. In one embodiment, the mesh consists of shorter modular strips that overlap each other such that a single bone fastener is passed through two overlapping anchoring members to lock the two modular mesh strips together. Additional modular mesh strips can be added on at either end, as desired, to provide the desired length of dural coverage.

Abstract: A surgical instrument configured to introduce a spinal fixation rod into a vertebral implant. When the spinal fixation rod is engaged with the surgical instrument and the surgical instrument is put into a retention configuration, the spinal fixation rod cannot be removed from the surgical instrument until the spinal fixation rod is properly oriented with respect to the surgical construct and the surgical instrument is released from the retention configuration. The surgical instrument includes a surgical instrument body, an actuator, an engagement assembly, and a transfer assembly that extends between the actuator and the engagement assembly. The surgical instrument can also be used as part of a method for introducing a spinal fixation rod or part of a kit for introducing a spinal fixation rod.

Abstract: Polyaxial and uni-planar bone screw assemblies include a multi-threaded shank body having an integral upper portion receivable in a one piece receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A compression insert and open retaining ring located in the receiver may be made of cobalt-chrome and the compression insert may provide a diametric interference fit with the receiver. Receivers or inserts may include resilient arm portions. The open ring cooperates with the shank to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra.

Abstract: The disclosed embodiments provide a system including an implant assembly and an instrument configured to work in conjunction to manipulate vertebral bodies to affect derotation. The implant assemblies include a removable attachment element that allows for the attachment of the instrument. The instrument is configured to attach to two implant assemblies that have been inserted bilaterally into a vertebral body. When the instrument is attached to the implant assemblies, forces applied to the instrument are translated and transferred to the implant assemblies and the vertebral body into which the implant assemblies have been inserted thereby providing a rotational force on the vertebral body.

Abstract: A method for manipulating a vertebra includes connecting a first bone anchor to a first vertebra, connecting a second bone anchor to a second bone anchor, positioning a spinal rod in a receiving member of the first bone anchor and in a receiving member of the second bone anchor, connecting a first instrument to the receiving member of the first bone anchor, and manipulating the first instrument to rotate first bone anchor and the first vertebra relative to the second vertebra.

Abstract: An expandable support device for tissue repair is disclosed. The device can be used to repair hard or soft tissue, such as bone or vertebral discs. A method of repairing tissue is also disclosed. The device and method can be used to treat compression fractures. The compression fractures can be in the spine. The device can be deployed by compressing the device longitudinally resulting in radial expansion.

Abstract: Various methods and devices for replacing damaged, injured, diseased, or otherwise unhealthy posterior elements, such as the facet joints, the lamina, the posterior ligaments, and/or other features of a patient's spinal column, are provided. In one exemplary embodiment, the methods and devices are effective to mimic the natural function of the spine by allowing flexion, extension, and lateral bending of the spine, while substantially restricting posterior-anterior shear and rotation of the spine.

Abstract: A spinal correction system comprises a first member defining a longitudinal axis and including an inner surface that defines a first cavity and a second cavity. A second member defines a longitudinal axis and includes an inner surface that defines a first cavity and a second cavity. The members are connected along a first axis disposed in substantially parallel relation to the longitudinal axes. At least one first implant support is configured for disposal within the first cavities. At least one second implant support is configured for disposal within the second cavities. The members are rotatable about the first axis to space apart the members such that the inner surfaces forcibly engage the supports in releasable fixation. Methods of use are disclosed.

Abstract: An intersomatic cage, an intervertebral prosthesis, an anchoring device and an instrument for implantation of the cage or the prosthesis and the anchoring device are provided. An intersomatic cage or an intervertebral prosthesis fit closely to the anchoring device, which includes a body of elongated shape on a longitudinal axis, of curved shape describing, along the longitudinal axis, an arc whose dimensions and radius of curvature are designed in such a manner that the anchoring device may be implanted in the vertebral plate of a vertebra by presenting its longitudinal axis substantially along the plane of the intervertebral space, where the anchoring device is inserted, by means of the instrument, through a slot located in at least one peripheral wall of the cage or on at least one plate of the intervertebral disc prosthesis to penetrate into at least one vertebral plate.

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: A method and apparatus for percutaneous and/or minimally invasive implantation of a construct. The construct may be implanted using a navigation system for planning and execution of a procedure. A plurality of portions of the construct may be interconnected using locations and paths determined and navigated with the navigation system.

Abstract: A bone anchor assembly may include a fixation member securable to a bone, a coupling member, a compressible member and a locking member. The fixation member may be formed monolithically with the coupling member, and the coupling member may have a loop portion shaped to receive the compressible member. The compressible member may comprise a compressible sphere with a bore extending therethrough, the bore shaped to receive an elongated member. The locking member may be actuable through an aperture in the coupling member to urge compression of the compressible member to lock the elongated member in a fixed position. The compressible member may be polyaxially adjustable relative to the coupling member.

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 device may be used to limit flexion of the spine without substantially limiting extension of the spine. Various accessories, instruments, and methods may be used to help deploy the flexion limiting device, manipulate, and adjust it.

Abstract: Posterior spinal stabilization devices that engage vertebral structures of at least two verterbrae and increase the stability between the two vertebrae. In some embodiments the stabilization devices engage laminae of at least two vertebrae. The devices can be adapted, however, to engage at least one of a variety of vertebral structures (e.g., spinous process, lamina, transverse process, etc.) of a plurality of vertebrae to decrease vertebral motion between at least two vertebrae.

Abstract: A system and method for ameliorating spinal column anomalies, such as scoliosis, includes bone screws which are to be implanted in the pedicle region(s) of individual to-be-derotated vertebrae and in vertebrae to which balancing forces must be applied as the spinal column is derotated en mass to achieve an over-all correction of the condition. A pedicle screw cluster derotation tool simultaneously engages multiple pedicle screws and transmits rotative forces to multiple vertebrae to effect a whole-spine correction. Precontoured spinal rods are engaged post-derotation to secure the correction.

Abstract: There is disclosed a system for positioning a connecting element adjacent one or more bones or bony portions, such as the spinal column, through a minimally invasive surgical approach. The system generally includes at least one bone anchor engageable to the one or more bones or bony portions and at least one anchor extender removably engaged to the bone anchor. A connecting element is movable along a longitudinal axis of the anchor extender. In response to movement of the connecting element along the longitudinal axis toward the bone anchor, the anchor extender flexes, bends or otherwise reconfigures to allow a leading end of the connecting element to be rotated away from the longitudinal axis so that the connecting element can be positioned in a transverse orientation to the longitudinal axis along the one or more bones or bony portions at a location adjacent the bone anchor.

Abstract: A method of inserting and positioning an intervertebral spacer is provided. The spacer includes a longitudinal axis, an on-axis interface coincident with or parallel to the longitudinal axis, and an off-axis interface angled to the longitudinal axis. The spacer's front end may be curved. The method may include inserting the spacer into the disc space utilizing a tool to engage an on-axis interface and then to engage one or more of the off-axis interfaces, which may be used for further modification of the spacer. The tool is moved substantially along a single insertion direction, which may be substantially parallel to a posterior-anterior axis of the disc space. The method may result in the longitudinal axis of the spacer being perpendicular to the insertion direction, or substantially parallel to a medial-lateral axis of the disc space. The spacer may also be positioned in an anterior aspect of the disc space.

Abstract: A distraction screw includes a proximal portion secured to a first vertebra, a distal portion secured to a second vertebra and an intermediate portion. The intermediate portion is coupled to the proximal and distal portions and is positioned in an intervertebral space. The intermediate portion is configured and adapted to enable distraction of the first vertebra relative to the second vertebra.

Abstract: In some embodiments, provided is an apparatus including a first elongated member, the first elongated member including a distal end and a proximal end. The distal end of the first elongated member is coupled to a first bone portion during use. The apparatus further includes a second elongated member including a distal end and a proximal end. The distal end of the second elongated member is coupled to a second bone portion during use. The proximal end of the second elongated member comprises a surface that is shaped complementary to a surface of the proximal end of the first elongated member. The apparatus still further includes a locking mechanism coupling the proximal end of the first elongated member to the proximal end of the second elongated member.

Abstract: Systems, methods and devices for providing stabilization between first and second vertebrae are provided. More particularly, in one form a system includes an implant configured to be positioned in a disc space between the first and second vertebrae and a freestanding plate for engagement with extradiscal surfaces of the first and second vertebrae. The system also includes an insertion instrument with an engaging portion configured to releasably engage with the implant and the plate such that the implant and plate can be positioned together relative to the first and second vertebrae. In one aspect, an angular orientation of the implant relative to the plate is adjustable when the implant and the plate are engaged by the instrument. In this or another aspect, the implant and plate are held in a contiguous relationship when engaged by the instrument. However, different forms and applications are also envisioned.

Abstract: A device for use as a portal in percutaneous minimally invasive surgery performed within a patient's body cavity includes a first elongated hollow tube having a length adjusted with a self-contained mechanism. The first elongated tube includes an inner hollow tube and an outer hollow tube and the inner tube is adapted to slide within the outer tube thereby providing the self-contained length adjusting mechanism. This length-adjustment feature is advantageous for percutaneous access surgery in any body cavity. Two or more elongated tubes with adjustable lengths can be placed into two or more adjacent body cavities, respectively. Paths are opened within the tissue areas between the two or more body cavities, and are used to transfer devices and tools between the adjacent body cavities.

Abstract: The present invention provides for a bone fixation device, illustrated as a spinal rod, for use in bone fixation surgeries. The bone spinal rod of the present invention is constructed and arranged to allow a surgeon to control proper placement while prohibiting the rod from passing out of a receiving component. In an illustrative embodiment, the spinal rod includes comprises a first end, a second opposing end, and a main body there between. At least one end contains a flange.

Abstract: A cervical plate is disclosed. The plate includes plate body with a first end adapted for attachment to a first vertebra in a cephalad relation to the plate body and a second end adapted for attachment to second vertebra in a caudad relation to the plate body. The plate body being of a first thickness at the first end and of a second thickness at the second end, the first thickness being smaller than the second thickness, and the plate body transitioning from the first thickness to the second thickness in a graduated manner.

Abstract: The present invention is directed to a variety of spinal implants.

Abstract: Skeletal stabilization systems include a base, a longitudinal member, and a retaining member. The base includes an engagement surface with a surface area that is positionable in contact with a bone to atraumatically or traumatically engage the base to the bone. The retaining member engages the base to retain the longitudinal member relative to the base so that the longitudinal member can provide a desired stabilization effect to one or more adjacent bony portions.

Abstract: Systems and methods for surgical spinal correction are disclosed. A system including a plurality of bone screws, spinal rods, manipulators, and/or transverse couplers is disclosed for the manipulation of the spinal column is disclosed. A method of achieving, in a single action, manipulation and/or rotation of the spinal column using the disclosed system is disclosed. Also disclosed is a method of conducting spinal surgery to correct spinal deformities wherein spinal rods are pre-bent in a physiological sagittal plane prior to attachment of the vertebrae using bone screws.

Abstract: A system and method for the stabilization and fixation of the lumbar spine. The system can include a plurality of pedicle screws, a support rod, a plurality of rod clamps, and a plurality of coupling members. In one aspect, each coupling member can be configured to engage a proximal portion of a pedicle screw and can have a socket portion that is configured to receive a socket engaging portion of the rod clamp, such that the coupling member and the pedicle screw can be pivoted three-dimensionally relative to the rod clamp and the support rod.

Abstract: A new intra-spinal decompression implant is introduced. One example for our presentation is a device with 2 or 3 pieces, with each piece with 2 clamps, symmetrically located on each side of each piece. The main piece has at least 2 screws which engage into 2 or more grooves in the side piece, to get attached to the side piece. The 3rd piece, as an optional piece, is the bottom piece, which is similar to the side piece, and gets attached to the main piece, using same or different screws. Each piece is attached to the human body, during back surgery, with corresponding clamps. This improves the quality of the surgery and the result for the patient. More examples are given here.

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: A spinal implant system and method of assembling the system. The system includes an implant, an integral holder/connector to grasp the implant and to connect to a plate before the assembly is inserted into a patient.

Abstract: An extender comprises an outer member including a lateral opening, first and second extensions defining first and second axial cavities, the axial cavities including a first portion, a second portion and a third portion. An inner member includes a body defining a tab, first and second arms having first and second projections. The inner member is configured for axial translation relative to the outer member between a first position, a second position and a third position. The tab is movable into at least one locking cavity of the lateral opening to fix the inner member relative to the outer member. Methods of use are disclosed.

Abstract: A system and associated method are provided for mechanically fixating a region of a skull to a portion of a spine. A plate is provided to contact a region of a skull and be secured thereto. A spinal rod is configured to extend from a location adjacent the plate to a location adjacent at least one vertebra. An adjustable housing is provided to secure the rod to the plate, and has a first position wherein the relative position of the rod to the plate can be adjusted and a second position wherein the relative position of the rod to the plate is secured.

Abstract: A polyaxial screw connection assembly includes a first longitudinal member comprising a bored fastener channel and a first bulbous body; a second longitudinal member comprising a cylindrical body to fit within the fastener channel, and a second bulbous body; a fastener with a bored cylindrical channel, connected to the first longitudinal member and the cylindrical body and securely couples the first longitudinal member to the second longitudinal member; a first fixation component directly connected to the first bulbous body; a second fixation component directly connected to the second bulbous body; a first pin engaged within the first longitudinal member via a bored first channel and contacting the first bulbous body causing the first bulbous body to outwardly expand; and a second pin engaged within the second longitudinal member via a bored second channel and contacting the second bulbous body causing the second bulbous body to outwardly expand.

Abstract: An implantable orthopedic assembly comprises an occipital plate and one or more repositionable clamping assemblies for securing a stabilizing rod to the plate. When unlocked, the clamping assembly may be laterally and rotationally repositioned along a supporting rail. Locking occurs when a stabilizing rod is secured in the clamping assembly. The rod exerts a force upon a locking component, causing the locking component to exert a force upon the supporting rail. This force pulls a surface of the clamping assembly base into contact with the rail, effectively locking the clamping assembly base at a fixed position. The clamping assembly may further comprise a loading component to exert a stabilizing force on the locking component, keeping the clamping assembly positionally stable while adjustments are made prior to locking.

Abstract: A method for stabilizing the spine at the level of one or more vertebrae includes the step of inserting a pedicle connector through the pedicle of a vertebra from one of the anterior side and posterior side of the vertebra to the other of the anterior side and the posterior side of the vertebra. The pedicle connector is secured to a stabilization construct positioned adjacent to either the anterior side or posterior side of the vertebra. The process is repeated for the opposite side of the pedicle connector. A system for stabilizing the spine and a pedicle connector are also disclosed.

Abstract: A spinal fixation device for securing to a spine includes a body having one or more longitudinal members extending between a pair of wedge members. Each wedge member defines one or more openings therethrough for the reception of a bone screw. The wedge members are disposed on opposite ends of the one or more longitudinal members. One of the wedge members is positionable within a first intervertebral space and the other wedge member is positionable within a second intervertebral space. The one or more longitudinal members define a length that spans one or more vertebrae. The one or more longitudinal members are positionable within the one or more vertebrae when the wedge members are positioned within the respective first and second intervertebral spaces to maintain the body in a minimal profile orientation relative to the spine.

Abstract: An apparatus for fixing a cervical spine having a self tension part used in orthopedic surgery or neurosurgery when executing an anterior fixation operation on cervical spines is disclosed, including: an extension groove formed through a plate between the insertion holes and the center of the plate; a channel groove formed with stepped surfaces at both sides at the boundary of the insertion holes and the extension groove; a guide that is connected to the channel groove, rotates left/rightward in the channel groove and locks the screw to be inserted into the insertion holes; and a tension part that gives a pushing force the guide to be pushed toward the center of the plate and allows the guide to be rotated in the channel groove.

Abstract: A spinal fixation element includes a screw and a washer. The screw comprises an elongated body of a first diameter and the body includes a threaded portion at a distal end and a semispherical head of a second diameter at a proximal end. The second diameter is larger than the first diameter. The washer comprises a semispherical through opening of a third diameter at the top, of a fourth diameter in the middle and of a fifth diameter at the bottom. The third diameter is slightly smaller than the second diameter, the fourth diameter is slightly larger than the second diameter and the fifth diameter is smaller than the second diameter. The washer surrounds the semispherical head, is non-removably attached to the semispherical head and is rotatable and positionable at an angle relative to the elongated body.

Abstract: Arcuate fixation members with varying configurations and/or features are provided, along with additional components for use therewith in provided intervertebral implants. The arcuate fixation members may be of different lengths, cross sectional geometries, and/or cross sectional areas. Applications of intervertebral implants utilizing arcuate fixation members are particularly suitable when a linear line-of-approach for delivering fixation members is undesirable.

Abstract: An implant system for implantation between adjacent spinous processes for the relief of pain associated with the spine. The implant has a series of spacers which may be inserted over a shaft located between adjacent spinous processes thus allowing the implant to be assembled in situ. The spacers may rotate on the shaft relative to the wings. To minimize trauma to the patient, each spacer has a tapered tissue expander to distract the opening between the spinous processes during assembly. The shaft is connected to a wing, and a second wing or deployable wing may be inserted over the shaft and locked into place.