Abstract: A shape memory material-based minimally invasive implantation with multi-axis curl self-expanding structure, and an implant having said structure: the implant comprises an actuating member, and the implant has a first shape and a second shape, the second shape having a larger area than that of the first shape; the implant is provided with a plurality of curling portions, and the actuating member may cause a curling portion to expand along a curling axis thereof, thereby transforming the implant from the first shape to the second shape. Different self-expanding structures may be designed by using the elasticity and memory effect of shape memory materials. Deploying functional modules, such as a circuit, a battery, a sensor, an energy collector and the like, on the structures may achieve more functions.

Abstract: An expandable interbody spacer includes a first endplate surface located on a first side of the spacer and adapted to contact a vertebral endplate surface of a first vertebral body, a second endplate surface located on a second, opposed, side of the spacer and adapted to contact a vertebral endplate surface of a second, opposed, vertebral body and an expansion mechanism adapted to selectively apply a distracting force between the first endplate surface and the second endplate surface, whereby actuation of the expansion mechanism causes the spacer to transition between a compressed insertion configuration to an expanded fusion configuration. The spacer also includes one or more of a deformable surface, a porosity to promote bone on-growth or through-growth, a stiffness substantially equivalent to cortical bone, and structure distributing loads through the spacer substantially without transferring the loads through higher-stiffness structures.

Abstract: An expandable implant system is configured to increase the height of a target bone, for instance that has been subjected to a compression fracture. The expandable implant system includes an implant assembly that can be inserted into the target bone, and subsequently expanded so as to increase the height of the target bone. The expandable implant system further includes an and insertion assembly that is configured to create an insertion channel into the target bone, such that the implant assembly can be inserted in a collapsed configuration into the target bone along the insertion channel, and subsequently expanded.

Abstract: A composite implant is provided for repairing a tissue defect in a patient. In one embodiment, the implant is a porous tissue scaffold having at least one pocket formed therein and adapted to contain a viable tissue. The tissue scaffold can have a variety of configurations, and in one embodiment it includes top and bottom portions that can be at least partially mated to one another, and in an exemplary embodiment that are heated sealed to one another around a perimeter thereof to form an enclosed pocket therebetween. The pocket is preferably sealed with a viable tissue disposed therein. In another embodiment, the tissue scaffold is substantially wedge-shaped and the pocket comprises a hollow interior formed in the tissue scaffold, and/or at least one lumen extending into the tissue scaffold. The tissue scaffold can also optionally include at least one surface feature formed thereof to promote blood vessel formation.

Abstract: A spinal implant includes a body having an inner surface and a connecting wall. The inner surface defines at least one cavity and the connecting wall is disposed about the at least one cavity. The connecting wall defines at least one opening. An agent is disposable with the at least one cavity. Spinal constructs, surgical instruments, systems and methods are disclosed.

Abstract: The present invention relates to a discal annular assistance device and the surgical instruments necessary for the insertion and removal thereof. This new device assists the annulus fibrosus following the exeresis of the nucleus pulposus of a lumbar intervertebral disc, to stop accelerated progression towards the discoligamentous instability of a vertebral unit operated on for a nucleus pulposus hernia.

Abstract: The present invention relates generally to a prosthetic spinal disc for replacing a damaged disc between two vertebrae of a spine. The present invention also relates to prosthetic spinal disc designs that have interlocking components.

Abstract: Systems and methods for navigation and control of an implant positioning device are discussed. For example, a method can include operations for accessing an implant plan, establishing a 3-D coordinate system, receiving tracking information, generating control signals, and sending the control signals to the implant positioning device. The implant plan can include location and orientation data describing an ideal implant location and orientation in reference to an implant host. The 3-D coordinate system can provide spatial orientation for the implant positioning device and the implant host. The tracking information can identify current location and orientation data within the 3-D coordinate system for the implant positioning device and implant host during a procedure. The control signals can control operation of the implant positioning device to assist a surgeon in positioning the implant according to the implant plan.

Abstract: Spinal interbody cages are provided that include a bulk interbody cage, a top face, a bottom face, a top mesh structure, a bottom mesh structure, pillars, and slots. The top and bottom faces are exterior surfaces of the bulk interbody cage having a top central opening and a bottom central opening, respectively. The top and bottom mesh structures extend from the bulk interbody cage across the top central opening and the bottom central opening, respectively. The pillars are for contacting vertebral bodies. The slots are to be occupied by bone of the vertebral bodies and/or by bone of a bone graft. The spinal interbody cage has a Young's modulus of elasticity of at least 3 GPa, and has a ratio of the sum of (i) the volumes of the slots to (ii) the sum of the volumes of the pillars and the volumes of the slots of 0.40:1 to 0.90:1.

Abstract: Internal bone fixation devices and methods for using the devices for repairing a weakened or fractured bone are disclosed herein. A device for use in repairing a fractured bone includes a delivery catheter having an elongated shaft with a proximal end, a distal end, and a longitudinal axis therebetween, wherein the delivery catheter has an inner void for passage of at least one reinforcing material and an inner lumen for passage of a light source; a conformable member releasably engaging the distal end of the delivery catheter, wherein the conformable member moves from a deflated state to an inflated state when the at least one reinforcing material is delivered to the conformable member; and an adapter releasably engaging the proximal end of the delivery catheter for receiving the light source and the at least one reinforcing material.

Abstract: An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.

Abstract: A dynamic intervertebral spacer includes a ring which is split on an anterior portion. A posterior portion of the ring acts as a torsion spring. After implantation, the ring is able to act as a spring between superior and inferior vertebral bodies, thus allowing dynamic bone growth in fusion procedures.

Abstract: An motion preserving intervertebral disc replacement/fusion prosthesis, including an inferior component, including a first top surface, a first bottom surface, a chamber arranged between the first top surface and the first bottom surface, and a plurality of apertures extending from the first bottom surface to the chamber, a superior component, including a second top surface, and a second bottom surface, and a spacing element arranged between the first top surface and the second bottom surface. The prosthesis is arranged to allow a fusion or similar stable union between the prosthetic surfaces and adjacent vertebra elements, while allowing for normal motion between adjacent vertebrae once stable union between the prosthesis and the juxtaposed vertebral endplate and the prosthesis occurs, such union being facilitated by bio absorbable struts that prevent motion until device/endplate union is solid, but permitting fully normal range of motion of the device once strut dissolution has occurred.

Abstract: A revision instrument for positioning and securing an intervertebral implant in an intervertebral space between vertebrae is provided. The revision instrument includes a shaft having a body extending from a first end to a second end. A first port and a second port extend through the body of the shaft and a connection tool having a first end and second end is positioned within the first port. The connection tool extends through the first end of the shaft through the second end of the shaft. The first end of the connection tool includes a mating feature configured to couple with an expandable implant and the second end of the connection tool includes a rotation feature configured to rotate the connection tool to engage or disengage the connection tool with the expandable implant. The second port is configured to receive an expansion driver for expanding or compressing the expandable implant.

Abstract: Described here are deformable, monolithic, stabilization implants suitable for use within bone and between bones to fuse vertebral bodies, to repair herniated discs, or to repair spinal compression fractures. The implants are introduced into a chosen site at a first, smaller height and then plastically deformed to achieve a second, but unique, pre-selected, larger height. Variations of the device provide one or more specific larger heights. The devices are suitable as intervertebral spinal fusion implants for the immobilization of adjacent vertebral bodies. Methods of and instruments for deployment of the implants are also described. Also described are variations of the device suitable as sizing instruments.

Abstract: A system for implanting an expandable interbody implant into an intervertebral space includes an elongated tool, the distal end of which is removably securable to the implant. The proximal end of the tool has an attachment interface for detachable securement to a plurality of different modules, each of which is adapted to effectuate a different function of the delivery system. The different functions include: grasping the implant delivery tool, providing an impaction surface for driving the advancement of the implant, supplying a graft material into the implant, and actuating the expansion of the implant. One of the modules may include a fluid delivery system for supplying hydraulic fluid to expand the implant. A fluid reservoir of the fluid delivery system may be oriented transverse to the cannula that delivers the fluid to the implant. A grafting block can be used to help pre-pack the implant with graft material.

Abstract: An interbody system for implanting between vertebrae, the interbody system comprises a cage having a cage body that includes a graft chamber having a volume that receives graft material, a sagittal wall that forms a portion of the graft chamber, and a wall membrane that forms another portion of the graft chamber. The interbody system may comprise an interbody device that includes an aperture that receives a bone fastener, wherein the wall membrane interacts with the bone fastener. The wall membrane may bend as result of a force applied by the bone fastener to a portion of the wall membrane, thereby providing directional support to the bone fastener and/or forcing graft material from the graft chamber.

Abstract: A kit of parts for inserting a deformable implant into a cavity in a bone of a patient is described. An inserter instrument comprises a body having a cavity extending along a longitudinal axis from a distal end to a proximal end. An attachment mechanism is provided at the distal end and to which a deformable implant can be releasably attached. A drive mechanism is provided at the proximal end of the body. An insertion stop is mounted on the body and arranged to control the depth of insertion of the inserter instrument into a guide tube. A push rod is freely and slidably arranged within the cavity and has a distal end engageable with a part of the deformable implant and a proximal end abutable by the drive mechanism. The drive mechanism is operable to drive the push rod toward the distal end of the body. The kit also includes an impactor dimensioned for slidable engagement within the cavity.

Abstract: Inflatable spinal implants are disclosed for intra-vertebral or inter-vertebral reduction and fixation of osteoporotic fractures in a spine. An inflatable implant may include an inflatable member having an interior for receiving a hardenable fluid and an expandable jacket to cause differential and directional expansion of the inflatable member. A one-way valve may be configured to prevent hardenable fluid from escaping out of the inflatable member. An inflatable implant may include a connection fixation device having a fluid coupling configured for releasable engagement with an inflation cannula and an anchoring portion configured for holding the implant in place within a vertebra. The fluid coupling may also be configured for releasable engagement with an anti-rotation device, which may be used to hold the implant stationary to facilitate engagement and disengagement of the inflation cannula with the fluid coupling. Related systems and methods are also described.

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: An implant positioning device and a method of using the device are described. The positioning device includes an end effector configured to contact an implant component during a surgical procedure, the end effector connected to an actuator for imparting an impact force to the implant component during the surgical procedure, a motor mechanically connected to the actuator and configured to move the actuator to produce one or more impacts on the end effector, thereby imparting the impact force to the implant component, and a control circuit coupled to the motor. The control circuit is configured to generate at least one motor control signal, transfer the at least one motor control signal to the motor, and, as a result of the at least one motor control signal, cause the motor to move the actuator to produce one or more impacts on the end effector.

Abstract: A nuclear disc implant includes an inner fillable enclosure and an outer fillable enclosure. After insertion into a enucleated disc cavity, the inner enclosure is filled with a fluid and the outer fillable enclosure is filled with a curable material. The curable material is allowed to cure and the fluid is removed from the inner enclosure to leave an inner enclosure surrounded by an cured outer enclosure. A reinforcing band may be provided around the nuclear disc implant. An inflation tool to fill the nuclear disc implant is provided.

Abstract: The present invention provides an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. The fusion device described herein is capable of being installed inside an intervertebral disc space at a minimum to no distraction height and for a fusion device capable of maintaining a normal distance between adjacent vertebral bodies when implanted.

Abstract: An expandable intervertebral implant (10) includes superior (20) and inferior (30) bone contacting members and at least one vertical wire netting (50) interconnecting the superior and inferior bone contacting members. The superior and inferior bone contacting members include at least two bone contacting components interconnected via one or more lateral wire nettings such that the implant is vertically and laterally expandable in situ from a first insertion configuration to a second expanded configuration. The vertical and lateral wire netting are preferably constructed of a plurality of individual link members. The present invention also preferably relates to an associated method of manufacturing the intervertebral implant such that the intervertebral implant can be manufactured as an integral component or part.

Abstract: An intervertebral prosthesis for insertion between adjacent vertebrae includes an upper plate, a lower plate and a core. The core is retained between the upper and lower plates by a retention feature in the form of central projections on the plates and a corresponding opening in the core. The retention feature is designed to allow the plates to slide over the upper and lower surfaces of the core in the anterior/posterior direction and in the lateral direction and to allow the plates to rotate with respect to each other and the core. The retention feature is also designed to prevent contact between the first and second plates during sliding movement of the plates over the core.

Abstract: An orthopedic device for implanting between adjacent vertebrae comprising: an arcuate balloon and a hardenable material within said balloon. In some embodiments, the balloon has a footprint that substantially corresponds to a perimeter of a vertebral endplate. An inflatable device is inserted through a cannula into an intervertebral space and oriented so that, upon expansion, a natural angle between vertebrae will be at least partially restored. At least one component selected from the group consisting of a load-bearing component and an osteobiologic component is directed into the inflatable device through a fluid communication means.

Abstract: An implant configured to completely replace degenerated or damaged nucleus pulposus in an intervertebral disc. The implant comprises a silicone elastomer shell that is implanted into a void within the annulus fibrosus created by at least partial removal of the nucleus pulposus therefrom. A colloidal suspension of platinum cured silicone-based polymer and carbon nanotubes is injected into the elastomer shell. The colloidal suspension is irradiated with electromagnetic radiation, particularly infrared or near infrared light, to the point that it hardens. The hardened implant becomes a mechanical replacement for the original nucleus pulposus in the intervertebral disc.

Abstract: A spinal implant which is configured to be deployed between adjacent vertebral bodies. The implant has at least one extendable support element with a retracted configuration to facilitate deployment of the implant and an extended configuration so as to expand the implant and effectively distract the disc space, stabilize the motion segments and eliminate pathologic spine motion. The implant has a minimal dimension in its unexpanded state that is smaller than the dimensions of the neuroforamen through which it typically passes to be deployed within the intervertebral space. The implant is provided with a locking system having a plurality of linked locking elements that work in unison to lock the implant in an extended configuration. Bone engaging anchors also may be provided to ensure secure positioning.

Abstract: An interbody system for implanting between vertebrae, the interbody system comprises a cage having a cage body that includes a graft chamber having a volume that receives graft material, a sagittal wall that forms a portion of the graft chamber, and a wall membrane that forms another portion of the graft chamber. The interbody system may comprise an interbody device that includes an aperture that receives a bone fastener, wherein the wall membrane interacts with the bone fastener. The wall membrane may bend as result of a force applied by the bone fastener to a portion of the wall membrane, thereby providing directional support to the bone fastener and/or forcing graft material from the graft chamber.

Abstract: A device for accessing and guiding at least one fixation device to a spine may include a distal portion configured to fit in a facet of the spine and a proximal portion extending from the distal portion. The proximal portion may be detachable from the distal portion and may be hollow or solid. A system for accessing and guiding at least one fixation device to a spine may include a distal portion configured to fit in a facet of the spine, a proximal portion extending from the distal portion, and a slidable guide device for sliding over the facet guide device to guide at least one instrument to the spine.

Abstract: A shoulder implant device includes one or more fixation features including an acromial intrusion element and an inflatable humeral balloon portion that receives a fluid through the acromial intrusion element. The intrusion element comprises a valve that can receive multiple needle sticks to add or remove fluid to or from the inflatable humeral balloon. The device is implanted in a subacromial space such that the one or more fixation features at least secure the device to the acromion and the inflatable balloon portion rests against the proximal end of the corresponding humerus. Fluid in the balloon portion maintains separation of the acromion and the humerus to reduce or prevent impingement.

Abstract: An intervertebral scaffolding system is provided having a central beam having a proximal portion having an end, a grafting portion having a top and a bottom, a distal portion having a end, a central beam axis, a graft distribution channel having an entry port at the end of the proximal portion, a top exit port at the top of the grafting portion, and a bottom exit port at the bottom of the grafting portion. These systems can also include a laterovertically-expanding frame operable for a reversible collapse from an expanded state into a collapsed state. The expanded state, for example, can be configured to have an open graft distribution window that at least substantially closes upon the reversible collapse.

Abstract: Spinal disk including a shell, first endplate, second endplate and core. The shell includes sidewalls, back wall, front wall, top wall, and bottom wall defining a compartment. The first endplate includes a first base, first top and first attachment. The first base is retained in the compartment. The first top is disposed about a first opening in the top wall to form a top contact surface. The first attachment extends from the first top portion. The second endplate includes a second base, second top and second attachment. The second base is retained in the compartment. The second top is disposed about a second opening in the bottom wall to form a bottom contact surface. The second attachment extends from the second top portion. The core includes a material injectable into a constrained space in the compartment between the first base and the second base.

Abstract: A method for fixating a dysfunctional sacroiliac joint for SI joint fusion including implanting a joint implant at the sacroiliac joint. The joint implant may include a body extending a length between a proximal end and a distal end, an exterior surface, an interior surface opposite the exterior surface and defining an internal volume therein, a wall thickness extending between the exterior surface and the interior surface, a proximal opening extending into the internal volume, and a first plurality of voids along the length and extending through the wall thickness from the exterior surface to the interior surface. The first plurality of voids may be arranged along the length in a repeating pattern of a group of voids, wherein each void of the first plurality of voids is generally polygonal in shape.

Abstract: A method of performing percutaneous interbody spinal fusion on adjacent vertebrae in a patient including the steps of: creating a percutaneous access opening on the patient, using indirect visualization to establish a surgical path through the access opening, creating a cavity in a disc space between the adjacent vertebra, without retraction, inserting an expandable implant into the cavity, the implant configured to fit through the access opening into the cavity, and expanding the implant within the cavity.

Abstract: An anchorage device comprising a mesh substrate coupled to an implantable medical device is disclosed, where the mesh substrate has a coating comprising a polymer, and the mesh further comprises at least one active pharmaceutical ingredient. The active pharmaceutical agent is designed to elute from the mesh over time. The mesh substrate can be configured to reduce the mass of the anchorage device such that tissue in-growth and/or scar tissue formation at the treatment site is reduced. In some embodiments, the mesh substrate can be formed with a mesh having a low areal density. In some embodiments, the mesh substrate can include one or more apertures or pores to reduce the mass of the substrate.

Abstract: A spinal implant comprises a body including an inner surface that defines a cavity. The inner surface includes a baffle. The body is disposable between a contracted configuration and an in vivo expandable configuration. Systems and methods are disclosed.

Abstract: The present invention provides artificial disc prostheses, methods and instrumentation for implantation and revision thereof. Each prosthesis may comprise superior and inferior end plates and a nucleus positioned between articular surfaces of the end plates. The end plates may have planar bone engagement surfaces with a plurality of self-cutting teeth. The articular surfaces of the end plates may be planar or include a flattened portion. The nucleus includes superior and inferior articular surfaces which may comprise flattened portions such that when the articular surfaces of the nucleus and the end plates are placed in cooperation in a preferred orientation, the flattened and/or planar portions are aligned. Each prosthesis may provide flexion/extension, anterior/posterior translation, lateral bending, and/or axial rotation degrees of freedom.

Abstract: An expandable implant for inserting within a skeletal space is provided, and a method for using the implant to expand the skeletal space. The implant is preferably designed to be inserted into an intervertebral space to replace at least part of an intervertebral disc between adjacent vertebral bodies. The expandable implant contains at least one first expansion compartment and at least one second expansion compartments, which compartments can be inflatable balloons that are inflated by a catheter. Inflating the first expansion compartment expands the implant in a first direction and inflating the second expansion compartment expands the implant in a second direction.

Abstract: A system for fixating a dysfunctional sacroiliac joint for SI joint fusion, the system including a sacroiliac joint implant and a delivery tool configured for approaching a sacroiliac joint. The system may include an implant having a porous 3D matrix structure and may be manufactured by laser or electron beam additive manufacturing. The delivery tool may include a radiolucent material. The SI fusion system may further include custom sacroiliac joint implants, anchors, alignment tools or targeting arms manufactured for a particular patient. Pre-surgical imaging studies, including 3D rendering, and their interpretation may assist in planning desired trajectories, anchor dimensions and implant dimensions and may provide details specific to the manufacture of particular sacroiliac joint tools or implants and their implantation into the sacroiliac joint. The system may be configured for use with surgical robots and may include an integrated nerve monitoring and stimulation system.

Abstract: An inter-vertebral disc prosthesis intended for percutaneous deployment comprises an expandable annular enclosure and an expandable nuclear enclosure. The expandable annular enclosure incorporates a reinforcing annular band along its periphery and is filled with in-situ curable rubber. The expandable nuclear enclosure is filled with a gas. The nuclear prosthesis further incorporates a novel, integrally molded sealing valve assembly and is stretchable and collapsible into a minimal profile for ease of insertion into a specially designed delivery cannula, and is inflation-assisted expandable into an inter-vertebral disc in which complete percutaneous nuclectomy has been performed.

Abstract: This disclosure relates generally to an injection device having a plunger configured to advance a distance into a container of material, such as a viscoelastic container; a trigger mechanism configured upon an actuation of the trigger mechanism to apply a first force to a spring element; and the spring element coupled to the plunger and configured to apply a second force to the plunger and which is configured to prevent exceeding a threshold maximum force applied to the container.

Abstract: Disclosed is a cervical plate having a polyester staple fiber laminated within a polycarbonate urethane. The polyurethane provides a flexible, high resilience structure with a Dacron® material providing a flexible skeleton. The result is a cervical plate that is flexible but provides the necessary rigidity. An inflatable balloon can be used to mimic the properties of the natural disc by maintaining the intervertebral disc space through a full range of natural motion.

Abstract: A soft tissue repair system is provided for covering or filling openings in the annulus of an intervertebral disc. The soft tissue repair system uses a single plug or a combination of a first plug and a second plug. The second plug is a flowable plug such as an adhesive material or a material that hardens to a flexible plug material. Each plug is configured to close the opening in the annulus and can be positioned within the opening, over the opening at the exterior surface or over the opening at the interior surface. The plug can also be combined with a clamping mechanism that engages the annulus to secure the plug in the opening.

Abstract: Disclosed herein are minimally invasive systems and method for stabilizing the spine, while preserving a degree of spinal flexion and extension of the spine at the level of the stabilized vertebrae postoperatively. The systems and methods can include an expandable anchor and rod that span an intervertebral disc. The anchor can have interstices, and ends in two adjacent vertebral bodies. The system can also include a volume of bone cement media.

Abstract: A method of performing percutaneous interbody spinal fusion on adjacent vertebrae in a patient including the steps of: creating a percutaneous access opening on the patient, using indirect visualization to establish a surgical path through the access opening via neural monitoring, creating a cavity in a disc space between the adjacent vertebra, without retraction, evaluating the created cavity, inserting a container sized and configured to fit through the access opening into the cavity and filling the container with fill material.

Abstract: The invention encompasses devices and methods for treating one or more damaged, diseased, or traumatized intervertebral discs to reduce or eliminate associated back pain. Specifically, the invention encompasses intervertebral nucleus and annulus implants that are resistant to migration in and/or expulsion from an intervertebral disc space. The invention further encompasses kits including the implantable devices of the invention and associated delivery tools to treat annular and nuclear tissue.

Abstract: An implant configured to completely replace degenerated or damaged nucleus pulposus in an intervertebral disc. The implant comprises a silicone elastomer shell that is implanted into a void within the annulus fibrosus created by at least partial removal of the nucleus pulposus therefrom. A colloidal suspension of platinum cured silicone-based polymer and carbon nanotubes is injected into the elastomer shell. The colloidal suspension is irradiated with electromagnetic radiation, particularly infrared or near infrared light, to the point that it hardens. The hardened implant becomes a mechanical replacement for the original nucleus pulposus in the intervertebral disc.

Abstract: An intervertebral cage for spinal implants is provided. The intervertebral cage includes a front portion, a right lateral portion, a left lateral portion, a rear portion, a top portion and a bottom portion. A vertical dimension of the front portion is larger than a vertical dimension of the rear portion. A vertical dimension of the right portion is larger than a vertical dimension of the left portion. A vertical dimension of a connection between the left and rear portions is smaller than a vertical dimension of a connection between the right and front portions.

Abstract: Methods of performing procedures within an intervertebral disc are disclosed. The methods include performing procedures such as implant delivery, tissue manipulation, tissue diagnostics, and therapeutic and diagnostic agent delivery at selected locations within intervertebral discs. In one embodiment, a method includes delivering an anchor and an implant within a functional spinal unit using a surgical device having at least one depth stop.