Abstract: A measurement system for capturing a transit time, phase, or frequency of energy waves propagating through a propagation medium (702) is disclosed. The measurement system comprises two different closed-loop feedback paths. The first path includes a transducer driver (726), a transducer (704), a propagation structure (702), a transducer (706), and a zero-crossing receiver (740). The series and parallel resonance of the transducer (704) does not overlap the series and parallel resonance of the transducer (706). A second path includes a transducer driver (1126), a transducer (1104), a propagation medium (1102), a reflecting surface (1106), and an edge-detect receiver (1140). Each positive closed-loop path maintains the emission, propagation, and detection of energy waves in the propagation medium (702, 1102). In either path, a propagation tuned oscillator maintains positive closed-loop feedback of the system that sustains detection, emission, and propagation of energy waves or pulses in a medium.

Abstract: The present invention relates to an implant system comprising implantable material in at least partially uncured form, contained in a closed casing, under vacuum and sterilised, and a closed bag containing the casing. The system is characterised in that at least 5% of the surface of the casing comprises sheet-like material having a thickness of 0.05-5 mm and having an original form, the sheet-like material being selected from the group consisting of metallic materials, polymers, bioceramic materials and composites thereof, provided that the material, once deformed from its original form to a changed form, is capable of maintaining that changed form unless subjected to external forces.

Abstract: A multi-blade curette tool for use in spinal surgery. The curette tool includes an elongated member having a first end and a second end. A handle is disposed at the first end. A curette head is disposed at the second end. The curette head is generally tapered toward the first end and the second end. The curette head includes a convexly-shaped and generally tapered nose portion, a base portion, and a plurality of blades. Each blade extends between the base portion and the nose portion, and each of the plurality of blades is provided with at least one cutting element. A drive stem connects the handle and the curette head. At least one cutting element of each blade is adapted to remove spinal disk material upon rotation of the curette tool in at least one direction.

Abstract: A pre-assembled orthopaedic implant adapted for improved gas sterilization. The implant includes a first component adapted for assembly with a second component such that a mating surface of the first component is in close proximity with a mating surface of the second component. At least one gas conduit associated with the mating surface of the first component facilitates a sterilizing gas to penetrate into and dissipate from the interface defined by the mating surfaces.

Abstract: A method for inserting an artificial implant between two adjacent vertebrae along a coronal plane.

Abstract: Various methods and devices are provided for navigating through bone. In one embodiment, a bone navigation device is provided and includes a bone penetrating member configured to be implanted in bone and having at least one optical waveguide extending therethrough. The optical waveguide is adapted to illuminate tissue surrounding the device and to receive reflected/transmitted light from the tissue to determine the optical characteristics of the tissue, thus facilitating navigation through the tissue. At least one window can be formed in the bone penetrating member for allowing light from the at least one optical waveguide to illuminate the tissue, and for receiving the reflected light.

Abstract: Instruments and methods are provided for securing a spinal rod in one or more coupling devices secured to the spine by one or more anchor members. The instruments include members for grasping the coupling device and members for shifting one or more elements along a linear path to fix the position of an anchor member and/or fix the position of the rod with respect to the vertebra.

Abstract: An electrical bone growth promotion apparatus for the delivery of electrical current to an implant surgically implanted between adjacent bone masses to promote bone growth to areas adjacent to the implant is disclosed. The apparatus of the present invention comprises a self contained implant having a surgically implantable, renewable power supply and related control circuitry for delivering electrical current directly to the implant and thus directly to the area in which the promotion of bone growth is desired. The desired areas of bone growth promotion may be controlled by conducting negative charge only to the desired location of bone growth promotion.

Abstract: A surgical instrument for applying a rotational force to a structural element during a surgical procedure. The instrument may be designed for increasing an input force to produce an enlarged output force adequate for fracturing an excess section of the elongated element from a remainder of the structural element. The instrument may include an input mechanism that receives an external rotational input force, a cycloidal gear system that multiples the input force, and an output mechanism that attaches to and delivers the multiplied rotational output force to the excess section of the structural element. The output mechanism may also be configured to capture the separated excess section. The instrument may include a housing and a handle for grasping and manipulating during the surgical procedure.

Abstract: Methods and apparatus provide for: coupling an elongate guide substantially at a first end to at least one vertebral body of a spinal column of a patient; and extending a second end of the guide to a structure of the patient spaced in an anterior direction away from the at least one vertebral body towards an entry incision.

Abstract: A modeling method for use in surgical navigation is provided. The method acquires a finite number of pre-defined points from a patient's bone and registers the points with a surgical navigation system. The navigation system generates and displays a three-dimensional image of a warped bone model that is manipulatable and accurate in at least the locations of the points taken and can be used to calculate the locations of bone cuts, implant positions and sizes, as well as display all of this information on the three-dimensional warped model.

Abstract: A flexible piece of barrier material for use in preventing or minimizing adhesions and fibrous attachments following anterior lumbar surgery. In one embodiment, the barrier structure comprises a multiple level device shaped as a generally wider tongue to function as a barrier at or above the L4-5 level, and a generally narrower lower section to function as a barrier at or below the L5-S1 level. The structure also can include a recessed waist section along an edge opposite the tongue to allow for easier placement in the L4-5 area. In another embodiment, a single level barrier for use at or above L4-5 is shaped as a tongue with a tapered outer extension to allow the barrier to extend laterally onto the psoas muscle to provide for identification of the barrier upon reoperation.

Abstract: An implant extends along a central axis, and includes first and second members spaced along the central axis. The implant can include a compliant interface. The compliant interface includes a plurality of spring members, the plurality of spring members arranged to space apart the first member from the second member along the central axis.

Abstract: Controlled release of biopharmaceutical growth factors from a hydroxyapatite coating on a bioresorbable interference screw used in cruciate ligament reconstruction surgery on a human. Biologically active scaffolds, such as interference bone screws used for ligament fixation, made by growing calcium phosphate-based hydroxyapatite coatings on bioresorbable poly(?-hydroxy ester) scaffolds that provide controlled mineral dissolution and controlled release of bone morphogenetic protein-2. The biologically active scaffold provides improved bioavailability of BMP-2 growth factor that in turn provides enhanced graft-bone healing in the tibial bone tunnel. The coating method uses surface hydrolysis and modified simulated body fluid incubation which does not require solvent or heat and is conducted at room temperature.

Abstract: An adjustable transverse connector connects orthopedic stabilization rods that may be parallel or skewed in orientation relative to each other The connector may include two sections that are joined together by a fastener. The connector may be adjustable in many ways. The overall length of the connector may be adjustable. The rod openings of the connector may be partially rotatable about a longitudinal axis of the connector. The two sections of the connector may be angulated. The connector may include cam locks that securely attach the connector to the rods. Rotating a cam lock may extend a rod engager into a rod opening. The rod engager may be a portion of the cam lock. The extension of the rod engager into a rod opening may push a rod against a body of the transverse connector to form a frictional engagement between the connector, the rod, and the rod engager.

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: An implantable device and method is provided for anchoring a drug depot to a site beneath the skin of a patient, the device and method comprising a head, a shaft and a tip, the head having a recess and/or at least one projection arranged to be engaged by an implantation tool, the shaft having an outer surface that engages the site in a manner that holds the device at the site beneath the skin, the head or shaft having members for attaching the drug depot thereto, and the tip disposed on the shaft opposite the head and capable of insertion into the site beneath the skin of the patient.

Abstract: A bone instrumentation cover or shield has a hollow cap or casing for encapsulating projecting parts of instrumentation installed in a bone, and a fastener portion provided at a lower edge of the cap or casing for securing it to the bone or to parts of the instrumentation where it is installed in the bone. The instrumentation shield or cover is designed to provide a medically-safe physical barrier for implantation between projecting parts of bone instrumentation constructs and surrounding bone and soft tissues, in order to minimize local irritation or injury and also serve as a barrier to ingrowth from bone and/or fibrous tissues. The shield or cover can be formed in a variety of forms, from rigid casing, to semi-pliable sheath-like structure, to soft pouch or cinch sack. The cap or casing is readily applied over the instrumentation, then cinched, tied or fastened to the instrumentation or adjacent areas, using a locking toothed edge, suture ties, suture strings, drawstrings and the like.

Abstract: A pre-assembled orthopaedic implant adapted for improved gas sterilization. The implant includes a first component adapted for assembly with a second component such that a mating surface of the first component is in close proximity with a mating surface of the second component. At least one gas conduit associated with the mating surface of the first component facilitates a sterilizing gas to penetrate into and dissipate from the interface defined by the mating surfaces.

Abstract: Devices to grasp a medical element that may include a first member, a second member that fits within the first member, and a locking element. The first and second members may move relative to one another to move the locking element between locked and unlocked positions. In an unlocked position, the device may move along the element. In the locked position, the device may lock to the element and motion is prevented. In one application, the device can be placed in the locked position to maintain a desired amount of tension on the element. Methods of grasping the medical element may include moving the first and second members relative to each other thereby moving the locking element to grasp and release the medical element.

Abstract: A surgical retractor and a method of minimally invasive surgery, wherein the surgical retractor includes ribs and a mechanism for transferring of linear and rotational movements of the ribs and wherein each rib can be easily replaced without use of any additional tools.

Abstract: A surgical tool for mounting a trackable target to a human bone, suitable for fixation to a human femur. The tool includes a removable bone clamp and a releasable coupling member which is integrated with the removable bone clamp. The releasable coupling member is arranged to mate with a compatible coupling member mounted on the trackable target to establish a predetermined spatial relationship between the bone clamp and trackable target. The releasable and compatible coupling members form a releasable connection which is mechanically constrained to re-engage only in a re-engaged position that accurately recaptures the predetermined spatial relationship.

Abstract: Methods of selecting and implanting prosthetic devices for use as a replacement meniscus are disclosed. The selection methods include a pre-implantation selection method and a during-implantation selection method. The pre-implantation selection method includes a direct geometrical matching process, a correlation parameters-based matching process, and a finite element-based matching process. The implant identified by the pre-implantation selection method is then confirmed to be a suitable implant in the during-implantation selection method. Methods of implanting meniscus prosthetic devices are also disclosed.

Abstract: A method for performing computer-assisted orthopaedic surgery includes the steps of: (1) producing and displaying three-dimensional geometrical models of first and second bones, the first and second bones forming a joint; (2) identifying a zone of impingement between the first bone and the second bone on at least one of the bones; and (3) generating and displaying a color map of at least one surface of at least one bone, the at least one surface being within the zone of impingement, the color map including different colors representing different depths of bone to be removed in order to achieve an increased range of motion between the first and second bones.

Abstract: A system for flexibly stabilizing a vertebral motion segment by connecting a first vertebra and a second vertebra is disclosed. The system includes a bumper with a resilient central member. The system is designed such that the resilient central member is compressed in both compression and extension of the bumper or vertebral motion segment. The system includes first and second means for connecting the bumper to the vertebrae.

Abstract: A surgical device and method used to assist in the surgical repair of damaged and/or severed tendons. In the present invention, the device is comprised of a distal conical member, having an inner and outer surface, a tapered tip, a rounded end, and windowed openings on either side of axial centerline passing through the inner and outer surfaces. In the same embodiment, the device is comprised of a proximal concave convex member with an inner and outer surface, a tapered tip, and a rounded end, tapering both in width and thickness to the tip.

Abstract: Devices and methods for temporarily retaining spinal rootlets within a dural sac are provided. In this regard, a representative device includes: a handle operative to be grasped by a user; an arm extending outwardly from the handle; and moveable fins supported at a distal end of the arm, the fins being moveable between an unbiased position and a biased position; in the biased position, free ends of the fins having been moved toward each other such that an extent of the fins along a major axis is decreased relative to an extent of the fins along the major axis in the unbiased position.

Abstract: An orthopedic tool having a one-way lock bearing and a one-way actuator bearing for tensioning surgical cables around a bone and a method for using the same.

Abstract: Methods are provided for access to a compressed space in the spinal anatomy. These methods may be used for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space. In one variation, a tissue abrasion device is provided. A cannulated probe may be placed through the neural foramina of the spine and used to position a guidewire around the anterior border of a facet joint. Once properly positioned, a medical practitioner may use the guidewire with an abrasion device to enlarge the lateral recess and neural foramina. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: An airway implant device for maintaining and/or creating an opening in air passageways is disclosed. Methods of using the device are also disclosed. The airway implant device includes a deformable element to control the opening of an air passageway and a tether. Preferably the deformable element is an electroactive polymer element. Energizing of the electroactive polymer element provides support for the walls of an air passageway, when the walls collapse, and thus, completely or partially opens the air passageway.

Abstract: Methods and apparatus provide for: coupling an elongate guide substantially at a first end to at least one vertebral body of a spinal column of a patient; and extending a second end of the guide to a structure of the patient spaced in an anterior direction away from the at least one vertebral body towards an entry incision.

Abstract: A bone reposition device includes first and second bone supports for supporting first and second portions of a fracture or osteotomize bone about a fracture or osteotomize site, a plurality of sequentially connected connection members and a plurality of joints each with at least a pair of adjacent parts for connecting the connection members therebetween and to the first and second bone supports. The plurality of joints includes at least six joints, each of which possesses one degree of freedom and allows controllable relative rotation or translation of said pair of adjacent parts about one of three axes respectively.

Abstract: Described herein are devices, systems and methods for determining if a nerve is nearby a device or portion of a device. The neural stimulation tools described herein are configured to be flexible and low-profile, so that they can be used within body regions that may be tortuous or difficult to reach, such as within a compressed or partially occluded neural foramen. In most cases, these tools described herein are ribbon-shaped and adapted to be manipulated bimanually, for example, by applying force to the ends of the devices from separate locations outside of the patient's body. Thus, in some of the exemplary neural localization devices described herein, the distal end region of the device are configured to couple to the proximal end of a guidewire. One or more surfaces of the devices may include an electrode or multi-polar network of electrodes configured to stimulate only nerves within a predetermined distance of a particular face of the device.

Abstract: Methods and apparatus are described for modifying unwanted tissue for cosmetic reasons. The methods provide a non-invasive manner to perform body contouring by destroying adipose tissue while simultaneously causing collagen contraction in a single procedure so that as destroyed tissue is removed from a treatment volume, the volume shrinks gradually to maintain the skin tone of the treatment area.

Abstract: Temporary, radiographically opaque, bone markers having first and second penetration members that are concentric with one another and are configured to pierce bone are provided herein. Bone markers can non-exclusively be used to help verify the correct surgical site along the vertebrae, locate the vertical midline, and as a fixed point for aligning surgical instruments. Insertion and extraction devices for use with the bone markers are also provided herein.

Abstract: The present invention is directed to a variety of interbody spinal fusion implants having at least a partially frusto-conical configuration. An external thread is employed to increase implant stability and implant surface area, and for the purpose of advancing the spinal fusion implant into the fusion site. The spinal fusion implants of the present invention may be relatively solid or hollow and may have surface roughenings to promote bone ingrowth and stability. The spinal fusion implants of the present invention may have wells extending into the material of the implant from the surface for the purpose of holding fusion promoting materials and to provide for areas of bone ingrowth fixation.

Abstract: A fixation pin, surgical assembly and method of fixing a cutting guide to a bone. The fixation pin includes a body having an interference portion which engages the wall of a hole in bone, a tip and a tool mating section. The surgical assembly includes an instrument for engaging the selected bone and a fixation pin operably interconnected with the instrument to engage the selected bone. Methods of fixing an instrument with a fixation pin are included. An incision is made to expose a bone. The instrument and fixation pin are interconnected and the assembly is mounted relative to a surgical site. The fixation pin is positioned in a rotationally fixed manner at a select position relative to the instrument to hold the instrument against the bone.

Abstract: Adjustable restraint includes a plantar plate surrounded by a peripheral element about which a plurality of supports can be positioned; a support system attachable to that plate or element for providing vertical and horizontal support; and a lower leg securing housing. The housing is attachable to the support system through adjustable fastener(s) such it can be adjusted vertically and secured in position with respect to the plantar plate. A sole portion of the plantar plate may be removable. The support system can include first support(s) and second support(s) attachable to the plate or element, and, through first adjustable fastener(s) and second adjustable fastener(s), respectively, the first adjustable fastener(s) and second adjustable fastener(s) be attachable to the housing.

Abstract: Gamma radiation sterilizable, reinforced polymer composition (C) comprising: at least one semi-aromatic polyamide (PA), at least one filler (F) selected from platy fillers, acicular fillers and fibrous fillers, and at least one inorganic pigment (IP) having a Mohs hardness of at most 4.5 and a refractive index of at least 1.70.

Abstract: A computer assisted orthopaedic system includes a sensor module, a display, and a computer coupled to the display. The sensor module is configured to be positioned in a knee joint of a patient and transmit joint force data indicative of a joint force of the patient's knee joint. The computer includes a receiver circuit to receive the joint force data. The computer is configured to determine position data indicative of a position of a patient's femur and a patient's tibia and display an image of the patient's femur and the patient's tibia based on the position data. The computer is also configured to determine a medial force value and a lateral force value based on the joint force data and display the medial and lateral force values on the display.

Abstract: An orthopaedic surgical device for determining the joint force of a patient's knee joint includes a tibial paddle shaped to be positioned in the patient's knee joint and a handle extending from the tibial paddle. The tibial paddle includes a sensor array positioned therein and configured to generate sensor signals indicative of the joint force of the patient's knee joint. The orthopaedic surgical device also includes a control circuit configured to control a display located on the handle to provide a visual indication of the medial and lateral balance of the joint force.

Abstract: A surgical apparatus includes an orientation sensor that detects an actual orientation of a surgical tool. The apparatus also includes an orientation feedback device that selectively provides an orientation feedback signal. Moreover, the apparatus includes a controller that causes the orientation feedback device to provide the orientation feedback signal when the actual orientation of the surgical tool detected by the orientation sensor is substantially equal to a predetermined target orientation of the surgical tool.

Abstract: An orthopaedic surgical device for determining the joint force of a patient's joint includes a sensor housing and a handle. The sensor housing is shaped to be positioned in a patient's joint and includes a sensor array positioned therein and configured to generate sensor signals indicative of the joint force of the patient's joint. The handle includes a circuit positioned therein and configured to control a display located on the handle to provide a visual indication of the joint force of the patient's joint. The handle may be physically secured to the sensor housing or may be coupled thereto via a wire to facilitate communications between the sensor array and the circuit.

Abstract: An instrument for compacting bone material is provided. The instrument includes a first component defining a longitudinal axis of the first component and a second component. The second component is moveably associated with the first component. The second component is moveable at least partially in a radial direction outwardly from the longitudinal axis of the first component.

Abstract: A non-invasive method for determining the articular point of a knee joint is disclosed. The method uses a surgical navigation system having stereoscopic cameras which track the positions of infrared emitting or reflecting markers attached to leg portions on either side of the knee joint. A movable marker is used to palpate known landmarks on the leg portions to determine their positions. The leg portions are moved to determine the trajectories of the landmarks relative to the joint. Positional information from the cameras is fed to a data processing system with resident software which uses the positional information and trajectories to mathematically determine the positions of the knee joint articular point according to the laws of kinematics.

Abstract: Photodynamic therapy (PDT) is used in the case of bone. A photosensitizing drug is administered to a mammal. A bone insertion member is secured into bone. A fiber optic cable sheath extends from within the bone insertion member and is accessible. A fiber optic cable is inserted in the fiber optic cable sheath to deliver light to the bone. A locking member is then attached to the insertion member. Non-thermal light at a specific wavelength is then delivered to activate the drug. The insertion member and the fiber optic cable sheath may remain inside the mammal for further photodynamic therapy.

Abstract: A device is presented for temporarily mounting an image tracker to a patient during surgery. The device preferably includes a first aperture and a axially-align second aperture. The apertures are sized to receive a securing mechanism, such as a bone screw that is temporarily inserted into a patient's bone for holding the image tracker near the vicinity of a surgical site. The device further preferably includes at least one projection such as a pin to stabilize the device from rotating.

Abstract: A long bone axis finder has a shaft extending along an axis and a first and second end. A tip portion is provided for releasable coupling to the shaft first end. A wedge element having an open side is provided for lateral engagement with said shaft. The wedge element is slidable along said shaft in a direction from the second to the first end. The axis finder is inserted into a long bone medullary canal until the tip portion engages a narrower portion of the canal. The wedge portion which is larger than the tip is laterally placed on the shaft and engages a portion of the canal closer to the shaft second end.

Abstract: A universal coupler for coupling multiple orthopedic instruments is disclosed. The universal coupler includes a body having a boss and an internal bore, a locking shaft having a first portion and a second portion, a trigger including a trigger bore, and a connection portion. The trigger is operable between a first position and a second position, where in the first position the first portion and boss are misaligned and in the second position the first portion and the boss are aligned.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.