Abstract: A guard and method for guiding a bone removal device to form an implantation space in the human spine and, if desired, for inserting a spinal implant into the implantation space.

Abstract: A spinal distraction assembly is provided for distracting the disc space between a pair of vertebrae, the vertebrae each having been implanted with a bone anchor. The spinal distraction assembly includes a first anchor engaging element and a second anchor engaging element. The first anchor engaging element includes a body having a channel extending through the longitudinal axis of the body. The second anchor engaging element includes a guide bar. The guide bar is dimensioned to translate through the body channel. Anchor engaging arms extend laterally from each of the body and guide bar.

Abstract: A distractor suitable for measuring a force, pressure, or load applied by the muscular-skeletal system is disclosed. An insert couples to the distractor. The insert has at least one articular surface allowing movement of the muscular-skeletal system when the distractor is inserted thereto. The insert can be a passive insert having no measurement devices. A sensor array and electronics are housed within the distractor. The distractor can dynamically distract the muscular-skeletal system. A handle of the distractor can be rotated to increase or decrease the spacing between support structures. The measurement system comprises a sensor array and electronic circuitry. In one embodiment, the electronic circuitry is coupled to the sensor array by a unitary circuit board or substrate. The sensors can be integrated into the unitary circuit board. For example, the sensors can comprise elastically compressible capacitors or piezo-resistive devices.

Abstract: A distractor suitable for measuring a force, pressure, or load applied by the muscular-skeletal system is disclosed. In one embodiment, the distractor includes a measurement device that couples to the distractor. In a second embodiment, the sensor array and electronics are placed within the distractor. The distractor can dynamically distract the muscular-skeletal system. A handle of the distractor can be rotated to increase or decrease the spacing between support structures. The measurement system comprises a sensor array and electronic circuitry. In one embodiment, the electronic circuitry is coupled to the sensor array by a unitary circuit board or substrate. The sensors can be integrated into the unitary circuit board. For example, the sensors can comprise elastically compressible capacitors or piezo-resistive devices. The distractor wirelessly couples to a remote system for providing position and magnitude measurement data of the force, pressure, or load being measured.

Abstract: Instrumentation for implanting an artificial intervertebral disc includes static trials, the static trials including first and second trial baseplates immovably coupled to one another via a trunk extending therebetween, each trial baseplate having an outwardly facing surface approximating a contour of a corresponding outwardly facing surface of an artificial intervertebral disc baseplate, at least one of the trial baseplates having a plurality of engagement holes extending into the at least one of the trial baseplates in a direction substantially perpendicular to each of a plurality of a surgical approach directions used to insert the trial into the intervertebral space, each of the plurality of engagement holes being disposed on the at least one of the trial baseplates to correspond to a respective one of the surgical approach directions such that selection for use of one of the plurality of engagement holes corresponds to, selection of the respective surgical approach.

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 intervertebral distraction tool has a clamshell head with upper and lower halves, each having a curvate outer surface and a flat inner surface. The distal side of the head is hinged so that the head opens and closes from the proximal side of the head. The hinge is a separating hinge that allows the halves to not only angulate with respect to one another about the hinge axis, but also to vertically separate from one another at the hinge. A distraction separator has decreasing taper at its distal end and a longitudinal bore that accommodates the elongate shaft of the trial so that the separator can be moved longitudinally relative to the shaft. Upon forward movement of the separator, the tapered upper and lower surfaces engage the flat inner surfaces of the head, causing the halves to angulate about the hinge axis of the head, thereby opening the head.

Abstract: An apparatus and method is provided for 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: An apparatus and method is provided for 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 system and method is provided for distracting opposite surfaces from the interior of a bone, such as a vertebral body. A working channel cannula provides a working channel through which an inserter and an injection cannula can simultaneously pass. The inserter transports a plurality of wafers into the interior of the bone to form a load-bearing stack bearing against the opposite surfaces. The injection cannula is used to inject a fluent material into and/or around the stack. In certain embodiments, the fluent material is a load-bearing or hardenable material, such as bone cement. In other embodiments, the fluent material can be a BMP, HAP, or other osteo-inductive, osteo-conductive, or pharmaceutical compositions. A syringe containing the fluent material is engaged to the injection cannula and is operable to inject the fluent material into the vertebral body under controlled pressure.

Abstract: An assembly for distraction of spinal vertebrae and which can optionally accommodate retraction blades. The assembly includes a pair of pins each having a first end adapted for vertebral bone engagement and a second end. A pair of sleeves respectively and concentrically engage said pins. A frame includes respective openings which receive the pins and a first end of each said sleeves. The first end of each said sleeve including a portion offset relative to a longitudinal axis of said sleeve such that when the first end of each said pins is anchored in bone, axial rotation of each said sleeves enables said first end of each said pins to move between a first position in which said vertebral bones are not distracted and a second position in which said vertebral bones are distracted.

Abstract: A tensor for use with a surgical navigation system is provided. The tensor comprises a first bone engaging member engageable with a first bone and a second bone engaging member engageable with a second bone. A force-applying mechanism is configured to forcibly move the first and second bone engaging members relative to one another and a sensor detects the value of the force applied by the force-applying mechanism. A transmitter communicates a parameter associated with the tensor to the surgical navigation system.

Abstract: A medical clamp, in particular a spinal clamp, includes two clamp limbs connected to a grip part. The grip part executes a clamping movement of the clamp limbs and the clamp limbs are connected to the grip part in a releasable manner. The clamp permits particularly safe, minimally invasive percutaneous interventions, especially in the area of the spinal column. A device for using a medical clamp for providing a reference position for a positioning system for percutaneous interventions and a method for determining a reference position for a positioning system for percutaneous interventions, are also provided.

Abstract: Implants, instruments, and methods for performing surgical procedures on the spine, including one or more of creating an operative corridor to the spine, delivering implants to the spine, fusing one or more segments of the spine, and fixing one or more segments of the spine. A method for attaching a fixation system to the spine of a patient, the fixation system including at least two bone anchors and a spinal rod linking the at least two bone anchors.

Abstract: A minimally invasive spacer for positioning between vertebral members. The spacer is adjustable between a first orientation having a reduced size to facilitate insertion between the vertebral members. A second orientation has an enlarged size for contacting the vertebral members. The spacer includes linkages that are attached to a pair of plates. A pull arm is operatively connected to the linkages for adjusting the spacer from the first orientation to the second orientation. A indicator gauge indicates the height of the spacer.

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: An apparatus for use with a spinal implant includes a handle structure with a passage. A shaft with a screw thread is moveable within the passage in the handle structure. A pusher block is linked to the shaft, and has a forward surface configured to engage the spinal implant. A screw-threaded clutch member is supported on the handle structure for movement into and out of engagement with the screw thread on the shaft.

Abstract: Improved implant devices and methods for interspinous distraction distribute the load of interspinous distraction so that the entire load is not bearing on the interspinous surfaces. The implant device has a narrow midsection and two wider, flange-shaped outer sections. The wider, flange-shaped outer sections can be tightened to bear against the thicker bony portions of the spinous processes to support some of the load. Optionally, the wider, flange-shaped outer sections can be configured with pins that will penetrate and engage the thicker bony portions of the spinous processes, which will increase the load bearing potential of the wider, flange-shaped outer sections. Additionally, the wider, flange-shaped outer sections and the pins will help to stabilize the joint. The joint stabilization may help to prevent further dislocation of the vertebra that occurs with spondylolisthesis.

Abstract: Techniques for spinal surgery include accessing at least one vertebral element of the spinal column. At least one loading member is engaged to the at least one vertebral element. The loading member is allowed to integrate with the bony structure of the vertebral element over time. The integrated loading member is accessed in a second surgical procedure, and can be loaded and/or attached to a construct.

Abstract: A distraction wedge inserting and removing device, the device having an outer member with a handle and a shaft extending therefrom, the shaft having at least one collet formed between a pair of slots extending from a distal end of the shaft toward the handle, the at least one collet having a cammed surface on the interior surface thereof. The device also having an inner member with a roller and a rod extending therefrom from a proximal end of the inner member to a head at a distal end of the inner member, the rod being configured to interact with the handle to advance the rod within the outer member toward the distal end of the outer member, whereby the head interferes with the cammed surface of the at least one collet to move the at least one collet outwardly in a radial direction to secure a distraction wedge.

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: The invention relates to an apparatus for displacing tissue within the body, wherein the apparatus includes two or more attachment members selectively displaceable with respect to each other via a driving member. The driving member preferably is rotatable and is caused to rotate by manually activating an actuator by applying a depressing force from outside the body.

Abstract: The present invention relates to a bone dilator designed for treating compression fracture of vertebral body, and fractures of cancellous bones at other sites. The bone dilator comprises a head portion, a neck portion, a connecting tube, a handle and a rotary hilt. The head portion embodies different shapes for use at different locations. When the rotary hilt is rotated clockwise and the pull rod is pulled backwards, the upper and the lower parts of the head portion keep parallel or at a predetermined angle during expanding. When the rotary hilt is rotated counterclockwise and the pull rod is pushed forwards, the head portion and the neck portion completely join together, the distal end of the pull rod and the bar stays are completely or partially retracted in grooves inside the head portion and the neck portion.

Abstract: A spinal implant having a series of sections or units hinged together and a balloon connected to at least some of the sections, the balloon having a curved configuration. The implant has a first delivery configuration and a second curved placement configuration, wherein it has a more linear configuration in the first delivery configuration than in the second curved configuration. The implant assumes the first delivery configuration during delivery to the disc space and maintains the curved configuration after placement within the disc space. The curved configuration can result from filling or expanding the balloon.

Abstract: Embodiments of low profile distractor apparatuses are disclosed. The distractor apparatuses generally comprise a mounting body, a tensioning mechanism coupled to the mounting body and a distractor arm coupled to the tensioning mechanism and pivotally coupled to the mounting body for rotation relative to the mounting body. The tensioning axis of the tensioning mechanism is non-coaxial with an effector axis of the distractor arm and a distraction force applied with the distractor arm is translated to the effector axis. This enables the distractor apparatus to be positioned relative to a patient such that the tensioning mechanism is offset from the long axis of the limb of the patient thereby facilitating improved access to the distal portions of the limb.

Abstract: A spinal-column distractor (10) comprises a first pusher plate (1) intended to bear on a vertebra, a second pusher plate (2) intended to bear on an adjacent vertebra, and a slide (3). The slide (3) is connected to the first pusher plate (1) via a scissor linkage (4), and shiftable by a threaded spindle to change a spacing between the first pusher plate (1) and the second pusher plate (2), while the second pusher plate (2) forms a track for the slide (3).

Abstract: An expansion device is disclosed which, when mounted on an appropriate support, can make controlled advancement relative to the support in response to activation from a remote site. The device comprises first (6) and second (8) elements coupled for relative movement along an axis defined on a support 2. An expandable chamber is defined between the elements, in which chamber is a flexible and elastic membrane (24). A resilient mechanism urges the two elements towards each other to define a minimum volume for the chamber. The chamber can be expanded to separate the elements, and hold mechanisms typically in the form of latches, are provided for selectively restricting movement on the respective elements relative to the support.

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: An interbody spinal implant including a body having a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, a substantially hollow center, a single vertical aperture, and a roughened surface topography on at least the top surface. The posterior portion has a generally rounded nose profile, and has a shorter height than the anterior portion such that the spinal implant comprises a lordotic angle for aligning the spine of a patient. The junctions of the top and bottom surfaces and the anterior portion comprise a sharp edge to resist expulsion of the spinal implant upon implantation.

Abstract: Various devices and methods are provided for spinal augmentation. In particular, the device can includes a connector element having a superior portion and an inferior portion that is adapted to support adjacent superior and inferior vertebrae and a first superior seating member and a second superior seating member associated with the connector element. The first seating member can be adapted to receive a portion of a lamina of the superior vertebra and the second seating member can be adapted to receive a portion of the lamina of the inferior vertebra. The device can have a variety of configurations, including the connector element and the first and second seating members being unitary and the first and second seating members being separately secured to the connector element.

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: 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: An intervertebral device for spacing apart vertebral members comprises a plurality of stackable shims including at least a first shim and a second shim. The first shim includes a first body with a first portion of a male-female connector, and a removable guide that is affixed to the first body and extends along at least a portion of the first body. The second shim includes a second body with a second portion of the male-female connector. A longitudinal passage extends through the second body and is sized to receive the guide on the first body. The second shim is moveable relative to the first shim with the guide disposed in the passage between a disengaged position and an engaged position. In the engaged position, the first shim is stacked on the second shim.

Abstract: A spinal implant for stabilizing two adjacent vertebrae having a damaged disc therebetween is assembled in situ. An elongated tool is used to insert a flat U-shaped distractor in the disc space through a low profile incision with both legs of the U-shaped distractor contacting both end plates of the adjacent vertebrae. The tool is rotated 90 degrees rotating the distractor 90 degrees so that each leg of the distractor contacts one end plate of the adjacent vertebrae, respectively, to restore intervertebral space. An elliptical bone tray is slid along the tool to seat within the U-shaped distractor. The tool is removed and a retainer replaces it to lock the bone tray and the distractor together. A screw is used to lock the bone tray to the distraction device, the screw slides down the cannula which is the tool inserted over the rod that the distraction implant is attached to.

Abstract: A vertebral distractor system includes a crossbar and a first distractor arm having a first end portion coupled to the crossbar and a second end portion with a first bore configured to axially receive a first coupling portion of a first pin. A second distractor arm includes a third end portion coupled to the crossbar and a fourth end portion with a second bore configured to receive a second coupling portion of a second pin. A first pin locking mechanism is configured to couple the first coupling portion and the first distractor arm within the first bore such that when the first coupling portion and the first distractor arm are coupled, movement of the first pin outwardly of the first bore is not allowed.

Abstract: A spinal implant including first spinal attachment member for attaching to a first spinal portion, second spinal attachment member for attaching to a second spinal portion, and a post-implantation variable dimension device disposed between the first and second spinal attachment members, which is operable after completing surgery in which said spinal implant was installed into a patient, to cause relative movement between the first and second spinal attachment members.

Abstract: An instrument set for an intervertebral expandable spacer having a pair of co-axial annuluses locked together by an engagement member, the set including an inserter/expander having both a rapid expansion mechanism and a fine tuning expansion mechanism.

Abstract: The invention related to a distraction and damping system which combines two devices, namely a first distractor device and one or more other damping devices. The aforementioned distractor device is for children's bones and can support and lengthen said bones by means of rods which are mounted to an adjustment means. Moreover, said distraction and damping system is hooked to the bones at the ends of the rods which are connected to hooks. The above-mentioned damping devices consist of flexible and rigid means. The inventive system, which results from the combination of said two devices, comprises the implantation of novel means such as serrated rods, one of the ends of which takes the form of a piston head.

Abstract: A medical instrument includes a base; an upper member; and a linkage mechanism coupled to the base and the upper member and being operable to maintain the upper member in a variable fixed position that is substantially parallel to the base and spaced a predetermined, variable distance therefrom, wherein the linkage mechanism includes at least three linkage elements that are arranged at angles relative to one another such that when one link element opens, the other link elements open with at an equal angle resulting in the upper member being constrained to remain parallel to the base.

Abstract: A distractor device (1) comprises a distracting element that includes a fixed plate (3) and a mobile plate (4), said mobile plate (4) being translatable by means of an actuator with respect to a body (2) of said distracting element between a first position where it is in contact with said fixed plate (3) and a second position where it is spaced therefrom.

Abstract: Methods and instruments for preparing a disc space and for forming interbody devices therein are provided. The instruments include distractors having enlargeable portions positionable in the disc space for distracting the disc space. The enlargeable portions can also provide form about or against which an interbody device of a first material is placed. A second material may be placed in the disc space in the space previously occupied by the distractors.

Abstract: The present invention relates to a hydraulic, electric, remotely controlled device, which will act as internal distractor to correct spinal deformitites, and/or to lengthen long bones in humans. The object of the present invention is to provide an internal distractor that is totally different from those currently in existence on the market and one which successfully solves the problems and improves the results achieved with distracters and devices currently used for this purpose, but which have limited results, and many problems inherent in current devices. This object will be achieved by virtue of the novel design thereof and the way in which the distractor operates, which is likewise novel, and because the distractor has features that combine the advantages of various devices and techniques in existence on the market for the same purposes.

Abstract: A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

Abstract: A method for inserting an intervertebral disc prosthesis into a space between two vertebrae involves inserting the prosthesis partway into the space under constraint to prevent endplates of the prosthesis from articulating, releasing the prosthesis from constraint, and inserting the unconstrained prosthesis farther into the space. In some embodiments, the method involves grasping the prosthesis with a grasping device to insert the prosthesis partway under constraint, loosing the grasping device to release the prosthesis from constraint, and pushing the prosthesis farther into the disc space using the grasping device and/or one or more separate pusher devices. A system includes a grasping device, at least one separate pushing device, and optionally a vertebral spreading device and/or a vertebral midline indicator device.

Abstract: An apparatus and method for distracting, in a given direction, and supporting two tissue surfaces. An expandable implant includes a plurality of elements are consecutively inserted between the two tissue surfaces to create a column of elements. The column of elements is oriented between the tissue surfaces so as to expand in the given direction as the elements are consecutively added to the column. The expandable implant includes a constraint including a cooperative engagement structure between adjacent elements.

Abstract: An implant includes two implant components, each having at least two adjacent support arms, which are connected to one another at one end by means of a bridge and can be spread apart at their free ends, and at least one of which support arms forms a support surface, such that with the free ends of their support arms both implant components are directed towards the free ends of the support arms of the respective other implant component, and that both implant components have slide faces for the support arms of the respective other implant component which are arranged and shaped such that as the two implant components approach one another, the support arms slide on the slide faces of the respective other implant component, and are pivoted thereby, so that the spacing of the upper and lower support surfaces is thereby increased.

Abstract: An orthopaedic surgical device comprises a first sensor component and a second sensor component. Each sensor component includes a paddle set to contact a proximal tibia and a distal femur of a patient. The first sensor component and the second sensor component being movable with respect to one another to extend one paddle set beyond the other paddle set, and each paddle set includes cutouts for the clearance of the patellar tendon to avoid the need to avert the patella during use.

Abstract: A vertebral distractor system includes a crossbar and a first distractor arm having a first end portion coupled to the crossbar and a second end portion with a first bore configured to axially receive a first coupling portion of a first pin. A second distractor arm includes a third end portion coupled to the crossbar and a fourth end portion with a second bore configured to receive a second coupling portion of a second pin. A first pin locking mechanism is configured to couple the first coupling portion and the first distractor arm within the first bore such that when the first coupling portion and the first distractor arm are coupled, movement of the first pin outwardly of the first bore is not allowed.

Abstract: A system and method is provided for distracting opposite surfaces from the interior of a bone, such as a vertebral body. A working channel cannula provides a working channel through which an inserter and an injection cannula can simultaneously pass. The inserter transports a plurality of wafers into the interior of the bone to form a load-bearing stack bearing against the opposite surfaces. The injection cannula is used to inject a fluent material into and/or around the stack. In certain embodiments, the fluent material is a load-bearing or hardenable material, such as bone cement. In other embodiments, the fluent material can be a BMP, HAP, or other osteo-inductive, osteo-conductive, or pharmaceutical compositions. A syringe containing the fluent material is engaged to the injection cannula and is operable to inject the fluent material into the vertebral body under controlled pressure.

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.