Abstract: A system and method for the minimally invasive insertion of an intervertebral rod into the vertebrae of a subject, according to a preoperative surgical plan also defining positions for the insertion of rod clamping screws into the vertebrae. The rod shape for connecting the heads of the screws is calculated, and a path planning algorithm used to determine whether the distal end of the rod can be threaded through the screw heads by longitudinal and rotational manipulation of the proximal end of the rod. If so, instructions are provided for forming that rod shape and for the robotic insertion of the screw holes and the rod. If not, either or both of the screw positions and the rod shape are adjusted, to moderate the bends in the rods, until insertion becomes possible. The insertion can be performed robotically, or, if a navigation tracking system is added, manually.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Abstract: A method of inserting a spinal stabilization system into a patient generally comprises inserting a first positioning tool through a first location on a patient's skin and along a path generally toward a first vertebral anchor, coupling an end of the first positioning tool to the first vertebral anchor, positioning at least a portion of a delivery device over a connecting element, and inserting the delivery device and the connecting element through the patient's skin at the first location and along at least a portion of the first positioning tool. The first positioning tool is configured to facilitate directing the delivery device and connecting element generally toward a second vertebral anchor within the patient's body.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Abstract: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to a device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body. Guidewire exchange systems, devices and methods are also described. A guidewire may be exchanged between different surgical devices and may be releaseably or permanently coupled.

Abstract: Implant for stabilizing a spinal column including a pedicle screw, an elongated member, and a retainer for a stabilizing rod. The elongated member can be polyaxially movably connected to the pedicle screw, and have external threads over a longitudinal periphery thereof. The retainer can be one piece, or can include an upper retainer portion and a lower retainer portion. The retainer, or the upper and lower retainer portions, can each have an opening therethrough to receive a stabilization rod to fix one implant to another. In one aspect, the upper retainer portion is internally threaded to engage external threads of the elongated member, the upper retainer portion threadably translating longitudinally along the elongated member by rotation of the elongated member about a longitudinal axis thereof. The upper retainer portion translates toward the lower retainer portion to secure and retain the rod therebetween.

Abstract: Photodynamic devices for stabilizing a joint are provided. In some embodiments, a photodynamic joint spacer is provided that includes an expandable member configured for attachment to a bone having an excised region; a formable bar configured for attachment to the bone along at least a portion of the expandable member; and a light-sensitive liquid passed into the expandable member to expand the expandable member, wherein the expandable member is shaped by the formable bar to a shape resembling the excised region of the bone, and wherein the light-sensitive liquid is curable upon exposure to light energy to set the expandable member in the shape resembling the excised region to form a photodynamic joint spacer.

Abstract: Orthopedic implant devices are positioned at a desired in vivo site by positioning a device that is non-rigid, i.e., flexible and/or malleable, in a first form, and then transformable after insertion to the in vivo site into a rigid, or hardened, form for providing a load-bearing function or providing other structural and/or mechanical function after implant. The device includes a biocompatible sheath and a curable material sealed within the sheath. The curable material is provided in a first form that provides flexibility to the device and is structured to rigidize in a second form after application of a quantity of an initiating energy to the material.

Abstract: A spinal rod having first and second end members. The end members may be flexible or rigid. An expandable intermediate section is positioned between the first and second end members. The intermediate section may be axially expandable upon the introduction of a substance into a port that may be located in either of the first and second end members or the intermediate section. The intermediate section may be expandable between a first size, where the first and second end members are spaced a first distance apart, and a second enlarged size, where the first and second end members are spaced a second greater distance apart.

Abstract: Photodynamic bone stabilization systems are disclosed herein. In an embodiment, a photodynamic bone stabilization system includes a catheter having an elongated shaft with a proximal end adapter, a distal end releasably engaging an expandable portion, and a longitudinal axis therebetween; a light-conducting fiber configured to transmit light energy to the expandable portion; a light-sensitive liquid monomer comprising an initiator, wherein the initiator is activated when the light-conducting fiber transmits the light energy to initiate polymerization of the light-sensitive liquid monomer; and a cooling medium configured to control polymerization temperature, wherein the catheter comprises an inner void sufficiently designed to pass the light-sensitive liquid monomer into the expandable portion, and wherein the catheter comprises an inner lumen sufficiently designed to pass the light-conducting fiber into the expandable portion and configured to circulate the cooling medium.

Abstract: Photodynamic bone stabilization systems are disclosed herein. In an embodiment, a photodynamic bone stabilization system includes a catheter having an elongated shaft with a proximal end adapter, a distal end releasably engaging an expandable portion, and a longitudinal axis therebetween; a light-conducting fiber configured to transmit light energy to the expandable portion; a light-sensitive liquid monomer comprising an initiator, wherein the initiator is activated when the light-conducting fiber transmits the light energy to initiate polymerization of the light-sensitive liquid monomer; and a cooling medium configured to control polymerization temperature, wherein the catheter comprises an inner void sufficiently designed to pass the light-sensitive liquid monomer into the expandable portion, and wherein the catheter comprises an inner lumen sufficiently designed to pass the light-conducting fiber into the expandable portion and configured to circulate the cooling medium.

Abstract: Orthopedic implants include a device that is non-rigid, i.e., flexible and/or malleable, in a first form for insertion into a desired in vivo site, and then transformable into a rigid, or hardened, form for providing a load-bearing function or providing other structural and/or mechanical function after implant. The device includes a biocompatible sheath and a curable material sealed within the sheath. The curable material is provided in a first form that provides flexibility to the device and is structured to rigidize in a second form after application of a quantity of an initiating energy to the material. Related methods and kits are also provided.

Abstract: The present application is directed to tethers and methods of use. The tether is attached with anchors to bony members within the patient. The tether applies a tensile force to the bony members to reduce and/or eliminate the abnormality of the bony members. The tether includes a release mechanism with a resorbable material that initially maintains the tether in a shortened orientation. The release mechanism is eventually releases the tether to a lengthened orientation. The release mechanism may prevent the need for a subsequent surgery to release tension from the tether as the patient grows.

Abstract: The present invention is directed to a dynamic fixation system for engaging, via bone fixation elements, one or more parts of a patient's body. Preferably, the dynamic fixation system is used to engage one or more vertebrae for stabilizing the attached vertebrae with respect to one another while still permitting the vertebrae to move with respect to one another. The dynamic fixation system may include a first rod having first and second ends, a second rod having first and second ends, and a damping component and/or a damping mechanism for interconnecting the first and second rods. In one embodiment, the damping component is injection molded in-between the one of the ends of the first rod and one of the ends of the second rod so that the first and second rods are prevented from separating with respect to one another but are still permitted to move with respect to one another.

Abstract: A subcutaneously formed in place orthopedic fixation device is provided, such as for fixation of the spine or other bone or bones. The device comprises an inflatable member, such as a tubular balloon. The balloon is positioned at a treatment site in the body while in a flexible, low crossing profile configuration. The balloon is thereafter inflated with a hardenable epoxy media comprising one or more epoxy compounds and one or more amine curing compounds that cures rapidly in place with low to moderate exotherm. Methods and delivery structures are also disclosed.

Abstract: A spinal column implant for elastic stabilization of vertebrae, includes a pedicle screw and an elastic rod which is anchored in a frictional fashion in a receptacle of pedicle screws by means of a filling piece, and a clamping element. The frictional connection is supported additionally by an indirect form-fit portion.

Abstract: An orthopedic device is described for stabilizing the spinal column between first and second vertebral bodies. The device has first and second screws adapted for fixation to the first and second vertebral bodies, respectively. The device further includes an elongated ligament with a first end connected to the first screw and the second end operatively connected with the second screw. The ligament is made preferably of a nickel titanium alloy selected to have ductile inelastic properties at body temperature and is capable of plastic deformation to allow relative constrained motion between the vertebral bodies. The preferred nickel titanium has a martensite/austenite transition temperature above body temperature. In a preferred embodiment, the second pedicle screw includes a bearing for receiving the ligament in a slidably engageable relationship. The device further includes optional first and second dampening members surrounding the ligament for restraining the spinal column during flexion and extension.

Abstract: A spinal spacer or stenotic device is expandable, inflated and/or filled in situ or ex vivo through the addition of a biocompatible fill material into the spinal implant once inserted or implanted in like manner to an angioplasty bag. Once implanted, expansion or inflation of the present expandable spinal spacer distracts the spine (creates spacing). The present expandable spinal spacer can operate as an interspinous, interspinous process, or intralaminar spinal spacer. In general the present expandable spinal space creates and/or maintains spacing between vertebrae or components of vertebrae. The present expandable spinal spacer is formed of a generally pliable biocompatible material that is collapsible and expandable/fillable. Preferably, but not necessarily, the biocompatible material is a mesh or weave type material, although other materials may be used.

Abstract: A fixation device is provided to immobilize a spinal motion segment and promote posterior fusion, used as stand-alone instrumentation or as an adjunct to an anterior approach. The device functions as a multi-level fusion system including modular single-level implementations. At a single-level the implant includes a pair of plates spanning two adjacent vertebrae with embedding teeth on the medially oriented surfaces directed into the spinous processes or laminae. The complementary plates at a single-level are connected via a cross-post passed through the interspinous process gap The freedom of rotational motion of both the cross-post and collar enables the complementary plates to be connected at a range of angles in the axial and coronal planes accommodating varying morphologies of the posterior elements in the cervical, thoracic and lumbar spine. To achieve multi-level fusion the single-level implementation can be connected in series using an interlocking mechanism fixed by a set-screw.

Abstract: A method of repositioning or fixing a first vertebrae or portion of a first vertebrae comprising fixing a bone screw in the first vertebrae and a bone screw in a second vertebrae, where each bone screw has a portal, and inflating an inflatable balloon between the portals, thereby creating a rigid structure between the bone screws.

Abstract: Insertion of a spinal stabilization element into a patient generally includes positioning a cord within a sheath and inserting the sheath and cord through the patient's body along a path generally toward an anchor member. An advancement member may be mounted on the leading end of the cord to further facilitate this insertion. The sheath is then retracted to expose a first portion of the cord within the patient's body, and the first portion of the cord is moved into a desired position relative to the anchor member. After advancing a spacer over the sheath and cord, the sheath is retracted to expose a second portion of the cord. The second portion of the cord is then moved into a desired position relative to another anchor member such that the spacer is positioned between the two anchor members.

Abstract: An implant for stabilizing adjacent vertebrae, the implant includes a stabilizing body expandable along a longitudinal axis from a first size state to a second size state. A cavity is defined in the stabilizing body for receiving a quantity of curable filler material sufficient to expand the stabilizing body from the first size state to the second size state. The implant further includes an attachment member for attaching the stabilizing body to the adjacent vertebrae. The stabilizing body is expandable along an arcuate axis to exert a restoring moment of movement on the attached vertebrae.

Abstract: An implantable inflatable orthopedic device is provided. The device comprises a flexible wall, defining an interior cavity, a reinforcing element exposed to the cavity, an inflation pathway in communication with the cavity, and a valve, for closing the pathway. A delivery catheter is also provided for removably carrying the orthopedic device to the treatment site.

Abstract: A subcutaneously formed in place orthopedic fixation device is provided, such as for fixation of the spine or other bone or bones. The device comprises an inflatable member, such as a tubular balloon. A heat source is provided in thermal communication with the interior of the balloon. The balloon is positioned at a treatment site while in a flexible, low crossing profile configuration. The balloon is thereafter inflated with a hardenable media, and heated to accelerate hardening of the media. Methods and delivery structures are also disclosed.

Abstract: A spinal rod having first and second end members. The end members may be flexible or rigid. An expandable intermediate section is positioned between the first and second end members. The intermediate section may be axially expandable upon the introduction of a substance into a port that may be located in either of the first and second end members or the intermediate section. The intermediate section may be expandable between a first size, where the first and second end members are spaced a first distance apart, and a second enlarged size, where the first and second end members are spaced a second greater distance apart.

Abstract: A subcutaneously formed in place orthopedic fixation device is provided, such as for fixation of the spine or other bone or bones. The device comprises an inflatable member, such as a tubular balloon. A heat source is provided in thermal communication with the interior of the balloon. The balloon is positioned at a treatment site while in a flexible, low crossing profile configuration. The balloon is thereafter inflated with a hardenable media, and heated to accelerate hardening of the media. Methods and delivery structures are also disclosed.

Abstract: A rod-shaped implant for spinal stabilization includes a first component comprising a first material, and a second component comprising a second material, wherein at least the first material is a plastic material, and wherein the first and the second component are connected by melting at least the first component to connect to the second component

Abstract: A subcutaneously assembled in place orthopedic construct is provided, such as for fixation of the spine. The construct includes a first bar and a second bar for attachment to the spine. A crossbar connects the first and second bar, to provide additional structural support. Each of the first bar, the second bar, and the crossbar may be inserted in a minimally invasive procedure, and constructed in place to form the orthopedic device. Each of the first bar, second bar, and crossbar may comprise an inflatable container, adapted for inflation with a hardenable media and cured in place. Methods and delivery structures are also disclosed.