Abstract: A method of treating a patient's joint having opposing joint surfaces includes providing an elongate member having a proximal end, a distal end and an expandable member near the distal end. The expandable member is positioned in the joint between the joint surfaces and expanded so as to separate the joint surfaces away from one another into a distracted position. The joint is manipulated while in the distracted position so that the joint is distracted and in flexion. A diagnostic or therapeutic procedure is then performed on the joint while maintaining the joint in the flexed and distracted position.

Abstract: The subject disclosure is directed to systems, apparatuses, devices and methods for vertebral and spinal correction. In some embodiments, an expandable implant is provided which may be inserted inside the vertebral body and/or between two vertebrae, for instance, for maintenance and/or restoration of a space therein or there between. In certain embodiments, the implant includes a mechanical resistance that prevents the expandable implant from contracting once it has been expanded. Methods of treatment and methods of use of such implants for the alleviation of back pain (for example) are also provided herein.

Abstract: The present disclosure provides for a system for mandibular distraction which includes a rod and a first pin clamp assembly coupled adjacent a first end of the rod. Furthermore, the first pin clamp assembly includes a first clamp. The system further includes a second pin clamp assembly which includes an advancement mechanism that moveably couples the second pin clamp assembly to the rod and a second clamp. Furthermore, a swivel joint is disposed between the advancement mechanism and the second clamp whereby the second clamp is enabled to rotate relative to the advancement mechanism.

Abstract: Modular medical instruments and kits are provided, having, a tool body portion with a first mating element at one end. A removable and replaceable modular end effector having a second mating element is matable with the first mating element. The instrument further includes a selectively engageable locking mechanism having a lever arm with a first portion associated with the body portion and a claw portion matingly engageable with a portion of the second mating element of the end effector, the locking mechanism being effective to secure the end effector to the body portion of the modular medical instrument. The invention can be particularly useful for providing a secure connection between the modular end effector and the body portion, yet provide ease of interchangeability between modular end effectors.

Abstract: Devices, systems and methods for minimally open orthopedic spine surgery are disclosed. A first flexible screw-based retractor is designed to be coupled to each pedicle screw inserted into adjacent vertebral bodies. A retractor system is provided in which a first retractor blade is mounted to one of the screws and a second movable retractor blade is moved away from the first blade, in a medial direction, to create a working channel through which the disc space may be accessed for passing instruments and implants. Light may be incorporated into the device to illuminate the surgical field. One or all of the retractor blades may be made of a sterilizable plastic or metal and be disposable or reusable.

Abstract: A surgical tool includes a pair of pivotally coupled operating handles and working distal ends connected thereto configured to engage bone fixation elements. A toothed ratchet member is arranged across the handles and includes a first and second tooth rack. The first tooth rack includes a plurality of teeth angled in a first direction and the second tooth rack includes a plurality of teeth angled in a second direction. The ratchet member is rotatable with respect to the handles to selectively present the first or second tooth rack to a pawl disposed on one of the handles. The handles are operable for closing or spreading movement via selective engagement of the pawl with the first or second tooth rack, which correspondingly closes or spreads the working distal ends. A method for operating the tool is also disclosed.

Abstract: An implant for orthopedic surgery includes an impaling member (101,102), which is separable into portions (102a, 102b) for impaling and attaching to tissue, for example, bone. Once the portions (102a, 102b) of the impaling member (101,102) are separated and attached to the requisite tissue, they may accommodate stabilizing members for fixation, or other instrumentation for procedures such as fusion.

Abstract: A bone elevator system includes: a bone hook; a first coupling device; an elevator arm member including a substantially straight first elongate arm and a substantially straight second elongate arm which is offset from and fixedly coupled with the first elongate arm, the first coupling device coupling the first elongate arm with the bone hook, the second elongate arm configured for being coupled, by way of a second coupling device, with an anchoring post.

Abstract: An apparatus and method is provided for interbody fusion including distracting, in a given direction, and supporting opposing vertebral bodies. A plurality of wafers are consecutively inserted between the vertebral bodies to create a column of wafers. The column of wafers is oriented between the vertebral bodies so as to expand in the given direction as the wafers are consecutively added to the column.

Abstract: A spinal distraction system includes a distraction rod having a first end and a second end, the first end being configured for affixation to a subject's spine at a first location, the distraction rod having a second end containing a recess having a threaded portion disposed therein. The system further includes an adjustable portion configured for affixation relative to the subject's spine at a second location remote from the first location, the adjustable portion comprising a housing containing a magnetic assembly, the magnetic assembly affixed at one end thereof to a lead screw, the lead screw operatively coupled to the threaded portion. A locking pin may secure the lead screw to the magnetic assembly. An o-ring gland disposed on the end of the housing may form a dynamic seal with the distraction rod.

Abstract: Devices and methods for implantation of an orthopedic device between skeletal segments using limited surgical dissection. The implanted devices are used to adjust and maintain the spatial relationship(s) of adjacent bones. Depending on the implant design, the motion between the skeletal segments may be increased, limited, modified, or completely immobilized.

Abstract: Devices and methods are disclosed for providing access to a central compartment of a hip joint. The devices can access the central compartment by distracting all or a portion of the labrum. The labrum can be distracted by advancing a device underneath the bottom edge of the labrum, and using the device to further distract the labrum. Some devices can move underneath the labrum to provide a gap for other devices to access the central compartment.

Abstract: A conic retractor for retraction of tissue of a mammal may comprise an at least partially hollow first truncated cone (20); a second truncated cone (30), having a similar apex angle and whose opening is wider than the first truncated cone, may be configured to at least partially enter the first truncated cone and to dilate at least a distal end of the first truncated cone as it is pushed to the distal end of the cone. A third truncated cone (40) can be inserted into the second truncated cone, etc. Cones can be dilated by having a longitudinal slit (29) or overlapping longitudinal wall surface edges, or by the nature of the material the cones are made of.

Abstract: Method and apparatus are disclosed for distracting tissue and particularly spinal tissue. The device and method may include insertion of at least one elongated member and an augmenting member to form a structure between the tissues to be distraction, such that a dimensional aspect of the structure is augmented upon movement of the augmenting structure.

Abstract: A joint distraction device for use in an arthroscopic surgery is provided. The device has a joint distraction mechanism, situated in between two bone fixation surfaces, and is capable of changing the relative distance between these two surfaces. The force generated by the mechanism should be sufficient to insert bone spikes affixed to the surfaces into bone, as well as distract the joint to create a sufficient enough gap to allow the intended procedure. With the surfaces and spikes engaged to bone at opposite sites of a joint, an increase in distraction force results in an increase in the relative distance results, hence increasing the space within the joint. Embodiments of this invention, compared to fracture table approaches, effectively eliminate the risk of pudendal nerve injury, allow for longer surgical times, and allow for much more controllable joint distraction.

Abstract: A joint-spacing balloon catheter comprising: a shaft having a distal end and a proximal end; first and second balloons mounted to the distal end of the shaft, the first balloon being disposed distal to, and spaced from, the second balloon, with the portion of the shaft between the first and second balloons being flexible; and a handle attached to the proximal end of the shaft.

Abstract: A positioning device for aligning at least one support on at least one structure includes a positioning tool configured to interface with a part of the structure, and a positioning element coupled to said positioning tool. The positioning element includes at least one holding part, wherein the at least one support is releasably coupled to said at least one holding part.

Abstract: A spine alignment system is provided to assess load forces on the vertebra in conjunction with overall spinal alignment. The system includes a spine instrument having an electronic assembly and a sensorized head. The sensorized head can be inserted between vertebra and report vertebral conditions such as force, pressure, orientation and edge loading. A GUI is therewith provided to show where the spine instrument is positioned relative to vertebral bodies as the instrument is placed in the inter-vetebral space. The system can distract vertebrae to a first height and measure the load applied by the spine region. The GUI can indicate that the load is outside a predetermined range. The spine region can be distracted to a second height where the load is measured within the predetermined load range.

Abstract: A flexible obturator configured to dilate soft tissue without abrading the adjacent bone surface area. The flexible obturator consists of at least one flexible strand (for example, flexible wire, suture or similar malleable flexible material) that is overmolded with a material that allows the device to bend/flex in multiple planes. The overmolded material has an increasing taper to provide graduated dilation through soft tissue.

Abstract: An instrument includes a distraction mechanism having a proximal end and an opposed distal end. The distal end includes opposed first and second end members. A first vertebral endplate spreader includes a proximal spreader section mounted to the first end member of the distraction mechanism. The first spreader also includes a distal spreader section operatively connected to the proximal spreader section for lateral movement relative to the proximal spreader section. A second vertebral endplate spreader is mounted to the second end member of the distraction mechanism. The distraction mechanism is configured and adapted to distract the spreaders apart and to retract the spreaders together along a distraction axis. The distal spreader section of the first spreader is configured to move relative to the second spreader in a lateral direction relative to the distraction axis for correction of vertebral alignment, as in treatment of spondylolisthesis, scoliosis, and the like.

Abstract: The invention relates to a knee spacer for temporary replacement of an artificial knee joint, whereby the knee spacer comprises a tibial component (11) and a separator (12), whereby the tibial component (11) comprises a running surface (14) by means of which the tibial component (11), in the patient-inserted state, can be placed against a femoral component (28) in mobile manner, and whereby the separator (12) comprises a contact surface (15) for placing on the tibia (22) and the contact surface (15) is adjustable at a variable distance from the running surface (14) of the tibial component (11).

Abstract: In some embodiments, an apparatus includes an elongated member, an expandable member coupled to the elongated member, and an outer sheath. The outer sheath, which can be constructed from a different material than the expandable member, is disposed about the expandable member such that an outer surface of the expandable member is in discontinuous contact with an inner surface of the outer sheath. The expandable member and the outer sheath are configured to cooperatively displace a bone structure when moving between a collapsed configuration and an expanded configuration.

Abstract: At least one embodiment is directed to an insert for measuring a parameter of the muscular-skeletal system. The insert can be temporary or permanent. In one embodiment, the insert is prosthetic component for a single compartment of the knee. The insert comprises a support structure and a support structure respectively having an articular surface and a load bearing surface. The height of the insert is less than 10 millimeters. At least one internal cavity is formed when support structures are coupled together for housing electronic circuitry, sensors, and the power source. The cavity is sterilized through a port. A membrane is between the port and the cavity. A sterilization gas permeates the membrane for sterilizing cavity. The membrane prevents ingress of solids and liquids to the cavity.

Abstract: A device for accessing and distending a joint comprises a distraction structure having a generally tapered distal portion adapted to penetrate a tissue region and create an access space within a joint. The distraction structure also includes a lumen extending from a proximal surface to a distal portion. The device further includes a distention structure deployable through the lumen and adapted to exert a force between a first joint surface and a second joint surface and create a working space. The distention structure may, in some embodiments, include an elongate member having a proximal end, a distal end, and a lumen extending along at least a portion of the length of the elongate member, a first expandable region deployable from a first substantially collapsed position to a second substantially expanded position, the first expandable region adapted to exert a force between the first joint surface from the second joint surface.

Abstract: A bone distractor assembly configured to distract first and second bone segments on opposite sides of a bone gap is provided. In one embodiment the distractor assembly includes a distractor having a first coupler and a second coupler, a first footplate releasably coupled to the first coupler, a second footplate releasably coupled to the second coupler, and a locking mechanism releasably coupling the first and second footplates to the first and second couplers. The first and second footplates releasably are each configured to attach to bone. The locking mechanism includes a tube, wherein removal of the tube releases the first and second footplates from the first and second couplers.

Abstract: A fluid joint spacer comprising a body having means for receiving a pressurized fluid from an external source and applying that pressurized fluid against a joint element so as to create a flowing fluid bearing within the joint.

Abstract: A central inflatable distractor and a perimeter balloon are inserted into the disc space in uninflated configurations. The central inflatable distractor is then expanded, thereby distracting the vertebral endplates to the controlled height of the central inflatable distractor. The perimeter balloon is then inflated with a curable substance. The perimeter balloon expands as it is filled with the curable substance and conforms to the void remaining in the disc space around the central inflatable distractor, thereby creating a horseshoe shape. Once the flowable material in the perimeter balloon has cured, the central inflated distractor can be deflated and removed. The remaining void (or inner space) is then packed with graft for fusion.

Abstract: A robotic surgical system includes a master controller with an input handle and robotic manipulator assemblies including a surgical end effector and an endoscopic camera. The input handle is translatable to provide a position and rotatable to provide an orientation. A control system couples the master controller to the first and second manipulator assemblies. The control system moves the surgical end effector in response to the position and orientation of the input handle. The control system moves the input handle to orient the input handle to correspond to an orientation of the surgical end effector from a viewpoint of the endoscopic camera during the repositioning of at least one of the input handle position, the end effector, or the endoscopic camera. The control system may move the surgical end effector only in a first mode and orients the input handle only in a second mode.

Abstract: An instrument for compression and distraction of a vertebral segment and reducing a surgical rod includes a first arm, a second arm, a coupler, and a reducer. The first arm includes a first aperture for receiving a first screw extender that attaches to a first vertebra. The second arm pivotably couples to the first arm and includes a second aperture for receiving a second screw extender that attaches to a second vertebra. The coupler links the first arm to the second arm to position the first arm relative to the second arm for compression and distraction of the first vertebra relative to the second vertebra. The reducer is received within the second aperture for reducing a surgical rod within the second screw extender.

Abstract: At least one embodiment is directed to a dynamic distractor (1 00) for distracting bones of a muscular-skeletal system. The dynamic distractor (100) includes at least one sensor (108, 110) which can provide loading, loading differential and position information as well as other measured parameters, a handle (112, 804), a lift mechanism (302), and one or more alignment aid (502, 802). The position and measurement sensors (108, 110) communicate with the processing unit (406) to display, process, and store measured data. A rod (604) couples a cutting block (602) to the distractor (100). The rod (604) also fixes a position of a cutting block (602) in relation to the distractor (100). The cutting block (602) is coupled to the distractor (100) to stabilize and align the muscular-skeletal system while shaping a bone.

Abstract: A set of instruments configured to deliver a therapy to a bone can include a cannulated syringe. The cannulated syringe can extend along a longitudinal axis between a proximal and a distal end. The cannulated syringe can have an inner tube and an outer tube that are interconnected at the distal end as a single fixed unit. A first cannulation can be formed along the longitudinal axis of the cannulated syringe within the inner tube and a second cannulation can be formed within an annular space between the inner and outer tubes. The outer tube can define an opening through a sidewall thereof. The cannulated syringe can be closed from fluid communication between the inner and outer tubes.

Abstract: A surgical distraction apparatus is disclosed. The surgical distraction apparatus includes a tissue distraction device adapted for implantation, the tissue distraction device including a plurality of distraction members, one or more actuators adapted for implantation and operatively coupled to the tissue distraction device, the one or more actuators being configured to drive the tissue distraction device and adjust the alignment of the plurality of distraction members, and an activator adapted to deliver one or more pulses to at least one actuator in the one or more actuators.

Abstract: A method for creating space in a joint, the method comprising: applying force to a body part so as to distract the joint and create an intrajoint space; inserting an expandable member into the intrajoint space while the expandable member is in a contracted condition; expanding the expandable member within the intrajoint space; and reducing the force applied to the body part so that the joint is supported on the expandable member.

Abstract: Apparatus and method for a shoulder implant, for example, for the glenohumeral joint. The implant is expandable and deflatable during implantation. The implant is sized for the glenoid fossa. In an exemplary embodiment of the invention, the selection and/or implantation of the implant include adapting the implant by size and function to a particular patient's need.

Abstract: A method of performing vertebral facet fusion by lateral approach and related devices. The lateral approach to facet fusion involves identifying the lateral mass and then introducing any of the fixation methods known or described herein laterally at one or more facets through the use of a hollow cannula. A surgical bone staple have a perforated bridge is used across the lateral facet joint where fixation is required. Where fusion is desired, a bone screw have lateral perforations of the shank is inserted through the bridge perforation at the joint to promote fusion. The staple and screw may be used in conjunction with one another or individually. The facet joint may be distracted prior to fixation to increase the foraminal space and decompress the neural structures to relieve pain. The method involves less surgical time, reduced blood loss and discomfort for the patient as compared to the posterior approach.

Abstract: A spinal surgery retractor with a slotted keyway for integrating a keyed spinal distractor. This retractor and distractor combination slide together to displace a portion of the intervertebral disk space to restore or maintain intervertebral spacing and facilitate retraction of surrounding soft tissues while disk space surgery is performed. The distractor head and mating portion of the retractors have matching profiles that enable the retractor to maintain distraction of the vertebra after removal of the distractor portion of the tool, permitting access to increase at the operating site. The retractor has convex curved surfaces that interface with a majority of retracted soft tissues during progression of the retraction process, which enhance retractor safety. In addition, the retractor portion of the tool has a proximally located section that is laterally flexible, which provides further progression in the retraction process while increasing relative access to the operating site.

Abstract: Provided are modular implant delivery systems, devices and methods. In some embodiments, spinal implant delivery devices and methods are provided. An exemplary delivery device may include a head supported by a handle. The head may have an opening defining an insertion axis. The handle may have a handle axis that traverses the insertion axis. The head may also be configured to releaseably couple one or more blades.

Abstract: An interbody distractor and geometry trial instrument to measure a height and an angle for an associated implant includes a height handle and an expansion head coupled to the height handle that is adapted to be positioned in a vertebral body. A wedge sleeve is coupled to the expansion head, to control an angle of a first surface plate and a second surface plate of the expansion head when the wedge sleeve interacts with the expansion head. A wedge sleeve knob is adapted to drive the wedge sleeve linearly towards the vertebral body when the wedge sleeve knob is actuated. A height of the expansion head and an angle of the first and the second surface plate are measured to determine the height and the angle of the associated implant when the height handle and the wedge sleeve knob are actuated.

Abstract: A combination of a first assembly for guiding resection of a femur and tibia of a knee joint and a second assembly including femoral and tibial knee components. The combination of the first assembly and the second assembly provides optimal placement and positioning of the femoral and tibial knee components to achieve near-normal knee kinematics and tension. The preparation for and placement of the prosthetic knee components provides medial-pivoting kinematics mimicking that of the natural knee thereby promoting improved outcome for the patient.

Abstract: A method for the removal of an intervertebral disc or parts thereof to be treated that includes: inserting a first longitudinal bone anchor into a pedicle of a first vertebra; inserting a second longitudinal bone anchor into a pedicle of a second vertebra; bridging the first and second anchors using a bridging element including a first and second clamp; attaching adjustable extension arms to each of the two clamps; introducing a longitudinal guiding element into the intervertebral disc or the subchondral bone of one of the vertebral bodies adjacent of intervertebral disc; fixing a retractororthogonally on the longitudinal guiding element; connecting the free ends extension arms to the retractor; immobilizing the extension arms to obtain a rigid assembly; and using the retractor as an anatomically positioned platform for performing the removal of the intervertebral disc to be treated or parts thereof, and a kit and apparatus for performing the method.

Abstract: Apparatus for distracting the hip joint of a patient, said apparatus comprising: a perineal post for engagement with a leg of the patient, said perineal post comprising a first portion and a second portion, wherein said first portion is configured for mounting to a table, and further wherein said second portion is movable relative to said first portion so as to change the geometry of the perineal post relative to a patient supported on the table.

Abstract: Provided herein is a vertebral distractor-inserter comprising a pair of arms comprising a first arm having a proximal end and a distal end and a second arm having a proximal end and a distal end, wherein the distal end of the first opposing arm is laterally offset from the distal end of a second arm thereby comprising a pair of laterally offset opposing arms, a driving rod extending between the pair of laterally offset opposing arms, and a drive mechanism in mechanical communication with the driving rod. A vertebral distractor-inserter comprising a pair of opposing arms, a housing in mechanical communication with the arms and rotatable about an axis extending between the arms, and a driving rod extending through at least a portion of the housing and between the arms. A vertebral distractor-inserter adapted for single-handed use. A vertebral distractor-inserter having an implant depth adjustor. Methods for distracting adjacent vertebrae and inserting an implant using the device described herein.

Abstract: An apparatus for elevating tissue within a body, including a tubular member having a proximal end and a distal end and a central axis defined therethrough, in which the tubular member comprises a first lumen and a second lumen, separately formed therein, a balloon secured to a region of the tubular member, in which a region of the tubular member is engagable with an injection mechanism, in which the engaged injection mechanism is engagable to be in communication with the first lumen of the tubular member, and in which the first lumen of the tubular member provides a path to an interior of the balloon.

Abstract: A device for accessing and distending a joint comprises a distraction structure having a generally tapered distal portion adapted to penetrate a tissue region and create an access space within a joint. The distraction structure also includes a lumen extending from a proximal surface to a distal portion. The device further includes a distention structure deployable through the lumen and adapted to exert a force between a first joint surface and a second joint surface and create a working space. The distention structure may, in some embodiments, include an elongate member having a proximal end, a distal end, and a lumen extending along at least a portion of the length of the elongate member, a first expandable region deployable from a first substantially collapsed position to a second substantially expanded position, the first expandable region adapted to exert a force between the first joint surface from the second joint surface.

Abstract: An orthopedic surgical spine measurement system comprises a first tool, a second tool, and a remote system. The first tool is a distractor having a plurality of load sensors for measuring load magnitude and position of load of a distracted region of the spine. The first tool and second tool also includes circuitry to measure a position and trajectory. The remote system receives data from the first tool and can display the parameter being measured and the position and trajectory of the first tool. A second tool holds a spine component. The remote system supports placement of the spine component by comparing the position and trajectory of the second tool to the path of the first tool. The remote system and second tool can provide visual, audible, or haptic feedback to support directing the second tool similarly to the first tool.

Abstract: A dilator that facilitates implantation of an interspinous spacer is provided. The dilator includes a proximal portion and a tapered distal portion interconnected by an elongated body portion. The tapered distal portion is ideally suited for splitting ligamentous tissue for creating a posterior midline pathway through the supraspinous ligament as well as for distracting the adjacent spinous processes. Two oppositely located and longitudinally extending channels or grooves are formed in the outer surface of the dilator for stabilizing the dilator with respect to the spinous processes. An accompanying cannula together with the dilator form a system for the distraction of the adjacent spinous processes, stabilization of the spinous processes with respect to the system and creation of a working channel for the implantation of an interspinous spacer.

Abstract: A spinal joint distraction system for treating a facet joint including articular surfaces having a contour is disclosed and may include a delivery device including a generally tubular structure adapted to engage a facet joint, an implant adapted to be delivered through the delivery device and into the facet joint, the implant comprising two members arranged in opposed position, and an implant distractor comprising a generally elongate member adapted to advance between the two members of the implant causing separation of the members and distraction of the facet joint, wherein the implant is adapted to conform to the shape of the implant distractor and/or the articular surfaces of the facet upon being delivered to the facet joint. Several embodiments of a system, several embodiments of an implant, and several methods are disclosed including a method for interbody fusion.

Abstract: An interspinous process spacer diagnostic parallel balloon catheter and method. The balloon catheter has a plurality of main expandable members disposed one inside another, a distal expandable member and a proximal expandable member that all can be expanded from a collapsed configuration to an expanded configuration and then collapsed again to a collapsed configuration. The device can be used to determine whether a particular patient is a candidate for implantation of an interspinous process spacer to treat the symptoms of lumbar spinal stenosis and the size of such a spacer if indicated.

Abstract: A surgical probe and a method for forming and enlarging an access opening through a psoas muscle to provide for minimally invasive lateral approach for surgical access to a lumber intervertebral disc. A distal end portion of the probe is equipped with an electrode useful for confirming proper location of the probe and includes an inflatable dilator body for enlarging an access opening through tissue adjacent to a spinal column. The probe includes a cannula through which a K wire can be extended to anchor the probe to a patient.

Abstract: A device includes an inflatable member extending between a first end and a second end. An inner surface of the inflatable member defines a first passageway in the first end and a chamber in the second end. An inner member is disposed in the first passageway and extends through the chamber. The inner member includes an inner surface defining a second passageway. A second end of the inflatable member is bonded to an outer surface of the inner member. A guide is member disposed in the second passageway. An outer member includes a first end having a projection including a threaded outer surface. The outer member includes an inner surface defining a third passageway having the inflatable member disposed therein. A cap includes a threaded inner surface that engages the threaded outer surface of the projection. Methods of use are provided.