Abstract: A power tool for removing an intervertebral disc and preparing vertebral endplates is described. The power tool may include a cutting element, and the height of the cutting element may be adjustable. The cutting element may be a braided cable and may include one or more beads to enhance the effectiveness of the cable. The cutting element may have a minimum height requirement, which may not be satisfied in patients with a collapsed disc due to degenerative disc disorder. For these patients, also described are bone tamps for increasing the intervertebral distance and providing access to tissues distal to the tamp. One type of bone tamp features an inflatable balloon with an inner lumen. Another type of bone tamp includes an expanding distal end and an inner cannula. Also described is a manual expander scraper tool that is compatible with both types of bone tamp.

Abstract: An instrument for removing material from within the body includes a distal portion that includes an adjustable length relative to a proximal portion and a flexible member that circulates through the distal portion. The exposed portion of the flexible member extends from the distal portion to remove the material.

Abstract: Provided is a minimally invasive cavity formation instrument for forming tissue cavities. The instrument includes an end effector having an aperture through which a cutting element is laterally extended and retracted. The cutting element may be retracted for minimally invasive insertion into a tissue region and extended to form a tissue cavity. The end effector of the instrument may be articulated or rotated to facilitate cavity formation.

Abstract: Systems and methods for planning surgical procedures involving custom medical implants that can involve the selection, design and/or creation of custom medical implants and/or the selection, modification, and/or design of custom surgical procedures related to those implants. Certain embodiments allow implants to be selected, designed, created, or otherwise customized and then placed in patients using non-standard surgical techniques. The invention provides greater flexibility in implant use by allowing a surgeon to revise, create, or otherwise select surgical techniques for custom implants and, ultimately, provide better treatment in a greater variety of medical circumstances. Certain embodiments of the invention involve computer assisted surgery to provide for implant-related surgery involving non-standard surgical steps and/or implants.

Abstract: An undercutting system for preparing a region between ilium and sacrum for sacroiliac fusion. The undercutting system includes an insertion apparatus and a cutting assembly. The cutting assembly is operably attached to the insertion apparatus. The cutting assembly is movable with respect to the insertion apparatus between a retracted configuration and an extended configuration.

Abstract: A bone mill including a base and a mill head that is removably attached to the base. A cutting disc is rotatably disposed in the mill head. When the mill head is attached to base, the cutting disc is rotated by a motor internal to the base. A plunger mounted to the mill head urges the bone against the cutting disc. The cutting disc and an impingement plate internal to the mill head shear the bone into chips. The chips are discharged from an opening in the mill head into a catch tray removably attached to the mill head.

Abstract: The present disclosure relates to devices and methods for creating channels within bone. One method for treating bone generally includes traversing an elongated member through cancellous bone of a vertebral body along a first generally non-linear path and then retracting the elongated member, thereby leaving a generally non-linear channel. The elongated member then is traversed through the cancellous bone along a second generally non-linear path, which second path does not completely coincide with the first path and then retracted along the second generally nonlinear path, thereby leaving a second generally non-linear channel. Optionally, bone filler material is deployed into the channels.

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 radial opening at or near the distal end of the trocar. The system includes a curveable cannula sized to be received in the central channel, the curveable cannula comprising a curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar. The curveable 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: 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 radial opening at or near the distal end of the trocar. The system includes a curveable cannula sized to be received in the central channel, the curveable cannula comprising a curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar. The curveable 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 positioning an S-shaped tool against inner annular walls of the disc that particularly facilitates reaching posterior and postero-lateral portions of the inner annulus of the disc by arthroscopy. An elongated, arcuate and S-shaped tool such as a catheter is positioned against the inner annular wall of the disc, and particularly on the posterior and postero-lateral portions of the inner annulus of the disc, which are portions of the disc to be treated. The deformable, arcuate and S-shaped tool retains its predetermined arcuate, S-shape when no pressure or force is applied to the tool.

Abstract: A milling tool system for accurately preparing a portion of the tibia preparatory to making femoral resections. The milling too system provides a minimally invasive procedure to provide an aperture within an exposed surface of the tibia, the aperture then being used as a referencing surface to accurately resect the femur. Once the femur resections have been made, the remaining uncut portions of the tibia are exposed and easily accessible for the tibial resections.

Abstract: A bone awl is provided for preparing a bone for implantation with a screw. The awl includes a shaft having a first end and a second end opposed to the first end. A handle is fixed to the first end, and an extension extends from the second end. The extension includes a first cutting portion configured to form a hole in bone and a second cutting portion configured to form an internal screw thread in the bone along the surface of the hole. The awl also includes an axial through passage that extends from the handle to the first cutting portion and is dimensioned to receive a Kirshner pin therein.

Abstract: A tissue removal device and method of using the device to remove tissue from a patient is provided. The tissue removal device comprises a tissue removal probe and a sheath slidable relative to the probe. The probe has a tissue removal element, and the sheath has a portion that exposes the tissue removal element. The sheath distal end may be pre-shaped to bend when slid distal to the probe. The probe may have a window through which the tissue removal element is exposed.

Abstract: A device for removing material from within the body, includes an elongated element formed from hollow segments sequentially interconnected at effective hinges. The device assumes an insertion configuration for insertion of the segments sequentially through an opening of a first dimension into the body. A portion of the elongated element inserted into the body progressively assumes a material removing configuration in which a relative position of each segment relative to an adjacent segment is delineated by the effective hinge together with additional abutment surfaces defining a fully deflected state of the effective hinge. The material removing configuration has at least two dimensions exceeding the first dimension. At least two of the segments are formed with at least one opening, typically provided with a cutting configuration, deployed so as to receive material into a hollow volume of the segment during progressive formation of the material removing configuration as the elongated element is advanced.

Abstract: A method of removing bone material including the steps of drivingly connecting a bone removal tool to an output shaft; and rotating a plurality of drive shafts in an open frame, one of the plurality of drive shafts being connected to the output shaft.

Abstract: Methods for creating holes in the articular process of the vertebra using a vertebral facet joint drill tool are provided. Methods of using the resulting holes to anchor or stabilize facet joint prosthesis, and also altering the spacing and motion at the facet joints of the vertebral column, are provided.

Abstract: A system for cleaning bone that includes a base unit with a motor, a cleaning head (56) with a brush (58) and mill head with a mill element. Both the cleaning head and the mill head are designed to be coupled to the base unit. Both the brush and mill element have features that facilitate their coupling to the motor. When the cleaning head is attached to the base unit, a motor in the base unit rotates the brush to clean the bone. When the mill head is attached to the vase unit, the base unit motor actuates the mill element to convert the cleaned bone into bone chips.

Abstract: A tissue repair device. The tissue repair device includes a tubular shaft having a longitudinal bore for delivering biological material to a soft tissue defect, and an awl having a distal end configured for microfracturing bone underlying the defect. The tubular shaft and the awl are movable relative to one another such that the awl is at least partially positioned within the longitudinal bore of the tubular shaft.

Abstract: A cutting instrument and method of use for preparing an osteochondral plug for implantation into a bone defect site. The instrument includes a dual function cutting block, a base holder, a rod mechanism and a trimming mechanism. The cutting block has a bore sized to receive the plug, at least one trimming channel and a transverse paring slot. The cutting block functions to hold the plug within the bore to allow for length and cross-sectional sizing. The base holder is constructed to fix the cutting block in a first orientation that allows the rod mechanism to position the plug within the cutting block for accurate length sizing. The base holder is also constructed to fix the cutting block in a second orientation which aligns the cutting block with the trimming mechanism so that an angled blade may engage the trimming channel and cut at least two sides of the plug.

Abstract: A surgical device can include a torque limiting device or system. The surgical device can include a rod attached on one end to a rotatable handle and attached on the opposite end to a surgical implement. A first torque limiting element can be connected to the handle, and a second torque limiting element can be operably connected to the rod and surgical implement and releasably engageable with the first torque limiting element. When the first and second torque limiting elements are engaged, rotation of the handle can cause rotation of the rod and surgical implement. When a rotational force that exceeds a predetermined torque limit is applied to the handle, the first torque limiting element can disengage from the second torque limiting element, so that the handle is rotatable without rotation of the rod and surgical implement. The first and second torque limiting elements can be re-engageable so that further rotation of the handle can cause rotation of the rod and surgical implement.

Abstract: A surgical procedure and a device used in the procedure according to which one end portion of a guide rod is inserted into the condyle of a damaged area of a human. The rod is used as a guide for a drill bit and a chisel to cut an opening in the condyle.

Abstract: A surgical instrument for removing bone, cartilage, or similar tissue is described. The surgical instrument has a shaft that extends in a longitudinal direction and supports a cutting plate which is inclined perpendicular or relative to the longitudinal direction, and a cutting element which is movably mounted on the shaft and supports a blade at the distal end in which the blade is pointing in the direction of the cutting plate and being advanced to the cutting plate in order to cut tissue.

Abstract: A surgical blade assembly for use with a driver includes a blade with a distal cutting portion, and a proximal end has a first dimension which is less than what is applicable for use with a specific driver head. An insert is affixed to the blade proximal end and, when affixed to the blade proximal end, is configured to enable the blade for use with the driver head. A surgical cutting tool includes such a surgical blade assembly and a driver head receiving the blade assembly. A surgical cutting tool kit includes a driver with a head for receiving the blade assembly, and a plurality of such surgical blade assemblies for use with the driver, wherein the blades have different thicknesses (a) and/or widths and the corresponding inserts are configured such that the proximal ends of the surgical blade assemblies all include at least one same constant dimension (b).

Abstract: A rod reduction device includes a housing defining a longitudinal axis. The housing has first and second arms extending distally therefrom. The distal ends of the arms are configured to releasably attach to a bone anchor. An anvil is operatively associated with the first and second arms of the housing and translatable along the longitudinal axis for facilitating the insertion of a spinal rod into the bone anchor. The anvil and each arm are positionable between an open position and a closed position.

Abstract: Tooling and methodologies for separation and dissection of the subantral membrane from the floor of the maxillary sinus, and for packing bone and bone substitutes under the subantral membrane. The tooling and associated methodology employ a handle and one or more support structures extending therefrom. A thin member extends from the distal end of the support structure(s). The thin member has a first peripheral region disposed opposite a second peripheral region. The first peripheral region is joined to or integrally formed with the distal end of the support structure(s). The second peripheral region defines a thin blade-like section for dissecting the subantral membrane from the floor of the maxillary sinus. In the preferred embodiment, the blade-like section is angled downward away from the distal support structure, which aids in positioning the blade-like section on the floor of the maxillary sinus.

Abstract: A surgical instrument includes a deflectable cutting element extending from the distal end of the instrument. The deflection of the cutting element is controllable based on a user operating a moveable member of the instrument. The deflectable cutting element is normally disposed within a circumferential region defined by the distal end of the instrument. The moveable member can be moved in relation to the instrument to deflect the deflectable cutting element, such that the cutting element is at least partially outside of the circumferential region. The extent that the cutting element is outside of the circumferential region is a function of the position to which the moveable member is moved in relation to the instrument. The instrument further includes direct imaging of the distal end, such that the deflection of the cutting element for selective removal of bone tissue at the distal end of the instrument can be controlled in real-time.

Abstract: A boring tool for a bone, particularly the proximal femur, which has an elongate shank having a cutting portion at the front end, and a portion to mount a rotary driving device at the rear end of the shank. The tool has an axial through bore for receiving a guide wire, wherein the shank, in a rear portion, has at least one radial aperture which is open to the axial bore.

Abstract: A system for forming a tendon-bone graft. The system can include at least one support that is adapted to support the tendon-bone graft. The system can further include at least one clamp that is adapted to engage the tendon-bone graft to clamp the tendon-bone graft to the at least one support. The system can also include at least one cutting member that is operable to resect the tendon-bone graft. The at least one cutting member or the at least one support can be moveable relative to the other of the at least one cutting member or the at least one support to resect the tendon-bone graft.

Abstract: Embodiments of the invention include instruments, implants, and methods for surgically treating facet joints of vertebrae. An instrument may be advanced into one or more facet joints to one or both separate vertebrae and remove tissue from one or more articular processes. A stop on the instrument may be used to terminate advancement of the instrument by contacting a vertebra, and one or more implants may be placed into one or more facet joints.

Abstract: A method for supporting a spine of a person includes forming a pathway in a spine by removing a plurality of portions of a plurality of vertebrae of the spine with the pathway being configured to receive a supporting structure. The supporting structure is inserted into the pathway and through the plurality of vertebrae.

Abstract: An implant composed substantially of cortical bone is provided for use in cervical Smith-Robinson vertebral fusion procedures. The implant is derived from allograft or autograft cortical bone sources, is machined to form a symmetrically or asymmetrically shaped (e.g. a substantially “D”-shaped) implant having a canal running therethrough according to methods of this invention, and inserted into the space between adjacent cervical vertebrae to provide support and induce fusion of the adjacent vertebrae. Osteogenic, osteoinductive or osteoconductive materials may be packed into the canal of the implant to expedite vertebral fusion and to allow autologous bony ingrowth.

Abstract: Some introducer tools for bone portals have a handle coupled to a driving member by a force-limiting coupling. A bone portal comprising a bone-penetrating portion and a bone stop may be driven to a desired depth in bone when the force-limiting coupling allows application of force to the bone portal that is sufficient to drive the bone-penetrating portion of the portal into the bone but not sufficient to drive the bone stop significantly into the bone. Bone portals of various types are described herein. Various configurations for stylets suitable for use in introducing bone portals or otherwise penetrating bone and methods for inserting bone portals are also described herein.

Abstract: To provide a method with which expansion of the vertebral canal of vertebrae is possible with less stress for the patient than with the surgical methods used to date, it is proposed that herein the vertebral arch be split and an incision gap thereby be formed, and the incision gap bounded by opposed incision surfaces be expanded to a prescribed gap width and the bone substance of the resulting vertebral arch sections thereby be elastically/plastically deformed.

Abstract: A medical device removal system includes a vessel filter repositioning or removal device to remove and/or reposition a medical device, such as a vessel filter. The system includes a gripper to grip a medical device that is located within a body vessel, and a detector, linked to the gripper, to detect the proximity of the medical device to the gripper. The system may also include an output to indicate a signal from the detector.

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 bone resection device for use in resection of bone during joint replacement surgery includes a handle, an elongate shaft rotatably mounted to the handle, a cutting tool housing attached to the shaft at or towards the distal end of the shaft, at least one cutting tool fastened to the housing, and a pivot control member configured to be at least partially disposed about the elongate shaft, the pivot control member being attached at or toward the distal end of the pivot control member to the at least one cutting tool, the distal end of the pivot control member and the distal end of the shaft being configured to be axially displaceable with respect to one another a predetermined distance, during operation of the device.

Abstract: An ultrasonic surgical instrument has an ultrasonic transducer unit having an ultrasonic transducer for producing ultrasonic vibration, a transmission member which connects the ultrasonic transducer in the proximal end side, and transmits the ultrasonic vibration produced by the ultrasonic transducer from the proximal end side to the distal end side, a sheath, in which the transmission member is inserted, having an open part on one side of the distal end side, and a treatment portion which is provided at the distal end of the transmission member, and exposed to the open part for carrying out a surgical treatment on an object part by the ultrasonic vibration transmitted from the transmission member. The ultrasonic surgical instrument cuts or shaves hard tissues.

Abstract: A bone preparation device for preparing a bone surface for receiving an implant is disclosed, as is a method of using the device, wherein the device contains a gripping element for gripping a first bone surface and a abrading element for abrading an opposing bone surface.

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.

Abstract: A guide that facilitates the creation of two bone tunnels for use during a “double bundle” cruciate ligament repair. In the case of an anterior cruciate ligament repair the guide facilitates the formation of two tibial tunnels extending between a single aperture on the anterior tibia and two distinct apertures on the tibial plateau. The guide has a single angled throughbore for guiding a drill bit on a predetermined angle relative to the anterior portion of the tibial tunnel. In an alternative embodiment the guide has two independent and non-intersecting bores which allow the simultaneous placement into the tibial tunnel of two separate guide pins to guide the formation of two tibial tunnels on the tibial plateau.

Abstract: A method for manufacturing bone milling cutters, wherein a milling cutter toothing (12) is created at a distal face of a tubular milling cutter shaft (10) of a bone milling cutter at a given outer diameter (D) of the milling cutter shaft (10). The following steps are carried out: determining the tube circumference (U) of the milling cutter shaft (10); ascertaining an average desired tooth height (Hgew) of the milling cutter toothing (12); ascertaining the desired tooth period length (LZ?) of the milling cutter toothing from the desired tooth height (Hgew) at given parameters of a tooth period pattern; dividing the tube circumference (U) by the desired tooth period length (LZ); rounding the results to an even number value (Qz); and dividing the tube circumference (U) by the value (Qz) in order to obtain the tooth period length (LZ).

Abstract: A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Abstract: Methods are described for treating a target tissue with a radioisotope. Some methods include determining a distance between a target tissue and a surface of a matrix material to be positioned adjacent the target tissue and, based on the determined distance, determining an activity to be mixed with the matrix material to obtain a desired activity concentration. Some methods further include mixing the radioisotope with the matrix material. In some embodiments, the matrix material is a bone cement, and the target tissue is a tumor in a bone. The radioisotope may be a beta-emitting radioisotope mixed in the cement at a concentration to form a radioactive cement.

Abstract: Various embodiments of components, devices, systems and methods are provided for a pneumatic surgical instrument having a distal end of a probe configured to penetrate bone, resect or microfracture bone. The injury caused to the bone by the penetration, resection or microfracturing of same causes blood to flow to the injury site and promote the growth of new bone at the site. Holes or recesses in the bone may also be employed to treat arthritis in patient, to form holes or recesses in which one or more orthopedic implants are attached or anchored to same, form microfractures in bone, resect bone, perform osteotomies, or to carry out yet other surgical procedures in bone.

Abstract: A method of performing a tibial tubercle osteotomy includes cutting a bone portion of a tibial tubercle from a remaining portion of the tibial tubercle, at least a portion of a patella ligament being attached to the bone portion. The bone portion of the tibial tubercle is separated from the remaining portion of the tibial tubercle such that the patella ligament remains attached to the bone portion. After completing a surgical procedure, the separated bone portion of the tibial tubercle is reattached to the remaining portion of the tibial tubercle.

Abstract: The combination of a motor driven oscillating orthopedic reshaping and resurfacing tool and multiple surface-matching sheet metal prostheses minimally resurface bones of the knee and other joints. Said resurfacing tool incorporates multiple interchangeable cutting heads, each configured to conform to the anatomical surface of a different bone end of the knee joint or other joint, and incorporates a replaceable elastomeric cover having an annular containment cup with an incoming sterile-liquid tube and an out-going waste-liquid tube to flush debris from the surgical site. Each said prostheses, stamped from orthopedic metal sheet and having at least one mounting attachment, is configured to conform to the anatomical surface of a different bone end of the knee joint, or other joint, after said tool has resurfaced that bone end. When implanted onto said bone end, a prefect fit is achieved.

Abstract: In one preferred aspect, a method is provided for forming an opening in bone for the sequential dilation of tissue.

Abstract: Guidewire exchange systems, devices and methods, for positioning and actuating surgical devices in a desired position between two tissues in a patient's body are described. A guidewire may be coupled to a surgical device for positioning and actuating (e.g., urging against a target tissue). The guidewire may be exchanged between different surgical devices during the same procedure, and the guidewire and surgical devices may be releaseably or permanently coupled. The surgical device generally includes one or more guidewire coupling members. A system may include a guidewire and a surgical device having a guidewire coupling member. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures.

Abstract: A method for manipulating intervertebral tissue in one embodiment includes inserting at least one abrading member for abrading tissue into an area to be cleared, expanding at least one expandable member from a first condition to a second condition, wherein the volume defined by the at least one expandable member in the second condition is greater than the volume defined by the at least one expandable member in the first condition, moving the inserted at least one abrading member from a first position to a second position by the expansion of the at least one expandable member, manipulating the inserted at least one abrading member to loosen tissue, and removing the loosened tissue from the area to be cleared.

Abstract: A femoral condyle cutting and shaping device includes a first bone shaping and cutting tool and at least one assistant shaft which are mounted in a sliding gearbox; at least one driven shaft mounted in a sliding gearbox; a first connecting member and a second connecting member, with one end of the first connecting member joining with one end of the second connecting member so as to form a hinge fitting; at least one other bone shaping and cutting tool mounted on the relevant driven shaft; an adjusting mechanism, which is connected with one driven shaft to change the relative position between the first bone shaping and cutting tool and the at least one other bone shaping and cutting tool. A bone shaping and cutting tool is also disclosed, which has flat or helical structure.