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.

Abstract: An implant for use in spinal surgery comprises a resilient element having an inflatable cavity. It is formed of a biologically compatible material and is arranged for placement between end plates of adjacent vertebra. The implant may also include a wound disc replacement element. A method of performing spinal surgery on a patient comprises securely mounting a patient onto a patient support table; imaging a spinal region of the patient; building up a three-dimensional image file of the spinal region of the patient; storing the image file; and utilizing the image file for planning and carrying out computer controlled spinal surgery on the patient utilizing the implant. A computer-controlled surgical implant system comprises a steerable endosurgical implanting assembly operative to install the implant at a desired location in a patient; and a computerized controlled, which operates the steerable endosurgical implanting assembly.

Abstract: The present invention relates to a medical device. In particular, the present invention concerns a medical device which can be detected by means of magnetic resonance imaging (MRI).

Abstract: An expanding device for expanding the spacing between bones is provided. The expanding device includes a spacer configured to be expandable and disposed between the bones, a catheter provided with the spacer at a distal end thereof and adapted to introduce a filler into the spacer, and a sheath having a lumen through which the catheter is inserted and in which the spacer before expansion can be housed. The spacer includes a spacer body configured to be expandable, an introduction section through which a filler is introduced into a rear-end-side expansion section of the spacer body, and a bypass passage through which part of the filler in the introduction section is introduced into a distal-end-side expansion section of the spacer body.

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 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: The invention relates to a device intended to replace or partially replace one or more vertebral bodies or intervertebral discs in the cervical, thoracic or lumbar spine, and includes methods for its use and deployment. The invention may be used to restore biomechanical parameters correlating with improved patient outcomes and also involves a method for a more effective discectomy or corpectomy prior to graft deployment.

Abstract: The invention is directed to a spinal fusion cage for implantation between two adjacent vertebrae, wherein the total cage has, under a load, a maximum compression that is higher than 0.05% of the original height of the spinal fusion cage and the maximum compression does not change the structural integrity of the cage.

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 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: Intervertebral disc prostheses and methods of use. An intervertebral disc prosthesis for installation in a spinal column may include a first intervertebral plate, a second intervertebral plate, and a removable insert core. The first intervertebral plate may engage one or both of the inferior vertebral endplate and the inferior ring apophysis of a superior vertebral body. The second intervertebral plate may engage one or both of the superior vertebral endplate and the superior ring apophysis of an inferior vertebral body. The removable insert core is located between and engages the intervertebral plates. A projection projects from one of the intervertebral plates toward the other intervertebral plate. The removable insert core at least partially surrounds the projection when installed. The removable insert core is removable from between the intervertebral plates and from around the projection while the intervertebral plates and projection remain installed.

Abstract: An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the upper and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the upper and inferior endplates.

Abstract: Inflatable multi-chambered devices are provided for repairing or replacing spinal discs and distracting neighboring vertebral elements. Also included are cushioning devices that may be used in a joint replacement device cushioning system. Further included are kits and systems that include such devices, methods for making such devices, and methods of treating patients in need of such devices. Examples further include cosmetic augmentation and restoration devices.

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: A device for treating vertebral bone including a releasably closed, removable filling member which can be placed within a plane separating superior and inferior portions of a vertebral body and oriented to promote its stabilization and realignment upon expansion of the filling member along the plane via injection of filler material, while minimally compacting bone or creating unsupported voids within the interior of the vertebral body.

Abstract: Various features of spinal implants and systems and methods for implanting the same with or between tissue layers in the human body.

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: A bone filler delivery system comprises a longitudinal channel incorporates a perforated segment at least partially along, at or near its distal end. The channel can be sealed at its distal end so the filler material may be delivered only by the lumen and through the perforated segment. Optionally, said system comprises a permeable bag capable of being inserted into a bone while in collapsed configuration and then expanded when filled with bone voids filler. The mesh structure is designed to allow such permeable bag to expand to a predetermined size or shape under certain pressures and allows exudation of bone void filler through its walls. Extracting the permeable bag out of a treated body promotes flow of bone void filler through its pores into cancellous bone and/or cavity in the bone. The procedure promotes height restoration of the bone and introduces filler in a controlled manner.

Abstract: An expandable portion of an implant has a total volume and includes a plurality of chambers, each having a volume less than the total volume. At least one of the chambers includes a biocompatible media which is liquid at room temperature. The at least one chamber is closed, so that by increasing the temperature of the liquid, the pressure in the chamber increases.

Abstract: Spinal implants are disclosed. One spinal implant includes a support body, an articulating element, a blocking member and a motion limiting member. The support body includes a superior end surface and a lower end surface having teeth. In between the superior end surface and the lower end surface is a recess formed in a sidewall of the support body for receiving the articulating element. The blocking member can be received in the recess to prevent inadvertent back-out of the articulating element from within the recess. The articulating element can articulate in one or more directions, thereby allowing articulation of the spinal implant into a desired position within a disc space.

Abstract: The present invention relates to compositions comprising a pH-responsive microgel particle, wherein the particle is adapted to undergo a conformational change in response to a variation in pH. The compositions may be used as medicaments for treating a disease characterized by damaged or degenerated soft tissues (e.g. intervertebral discs).

Abstract: A spacer member is provided that is configured to be implanted adjacent an anatomical structure. The spacer member defines a curved bore, a first opening in a side wall of the spacer member and a second opening in one of a top wall and a bottom wall of the spacer member. Each of the first opening and the second opening are in fluid communication with the curved bore. A flexible anchoring member is configured to be inserted through the side opening and through the curved bore of the spacer member such that a distal end portion of the flexible anchoring member extends out of the second opening at an angle relative to the one of the top wall and the bottom wall of the spacer member.

Abstract: Methods and apparatus for treating disc herniation provide a conformable device which assumes a first shape associated with insertion and a second shape or expanded shape to occlude the defect which typically follows partial discectomy. The device may take different forms according to the invention, including patches size to cover the defect or plugs adapted to fill the defect. In a preferred embodiment, however, the device is a gel or other liquid or semi-liquid which solidifies to occlude the defect from within the body of the disc itself. In another preferred embodiment, a mesh screen is collapsed into an elongated form for the purposes of insertion, thereby minimizing the size of the requisite incision while avoiding delicate surrounding nerves.

Abstract: A tissue prosthesis 100 comprises an envelope 38 of a biologically inert, elastically deformable material capable of being expanded to conform to an interior surface of a cavity 36 formed at a site 10 in a patient's body. A filler material 60 is received in a fluent state in the envelope 38. The filler material 60 is of the same class of material as the envelope 38 to form, when cured, together with the envelope 38, a unified structure.

Abstract: A method of performing a procedure on an intervertebral disc includes inserting a cannulated delivery tube through an opening in an annulus fibrosus of the intervertebral disc, positioning an expandable portion of the tube within the opening in the annulus fibrosus, expanding the expandable portion into contact with the annulus fibrosus about the opening to create a seal between the expandable portion and the annulus fibrosus, performing a procedure through the cannulated delivery tube within the annulus fibrosis, removing the tube, and closing the opening in the annulus fibrosus.

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: Anisotropic hydrogels including poly(vinyl alcohol) and which have physical cross-links so as to form materials which exhibit anisotropic mechanical properties characteristic of soft biological tissues wherein the anisotropic hydrogel may be used for tissue reconstruction and/or replacement including vessels, arteries, valve components, cartilage, ligaments, skin, and other medical uses such as stents, medical phantoms, contact lenses, bandages, and the like.

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: 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 forming 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 forming a bottom contact surface. The second attachment extends from the second top portion. The core is disposed in the compartment between the first endplate and the second endplate.

Abstract: A nucleus pulposus replacement is described that includes a containment balloon that can sequester synthetic and/or tissue engineered fill material(s) in the nucleus pulposus region of the IVD thus mitigating migration and expulsion of the fill materials. The containment balloon can be formed of a biocompatible material that includes the structural proteins elastin and collagen. The containment balloon is joined to a closure device that can be used to deliver a fill material, e.g., a hydrogel, to the interior of the containment balloon following implantation of the replacement device in the intervertebral disc area.

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. In one embodiment, the fusion device includes a central ramp, a first endplate, and a second endplate, the central ramp capable of being moved in a first direction to move the first and second endplates outwardly and into an expanded configuration. The fusion device is capable of being deployed down an endoscopic tube.

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: A method of replacing a nucleus pulposus material wherein curable nucleus pulposus material is injected into a balloon in an intervertebral space. The balloon has an inlet port and an outlet port that are connected to a pressure-measuring device. After the catheter is placed in the intervertebral space, the balloon is filled with a radio-opaque solution until the desired balloon volume is attained. The nucleus replacement material is then fed into the inlet port of the balloon, while the radiopaque agent is allowed to leave via the outlet port. Once the balloon is completely filled and curing of the curable nucleus replacement material is accomplished, the catheter and ports are removed, and the annular defect can be sealed.

Abstract: Apparatuses and methods for single disc arthroplasty and multi-segmental spine replacement recreating the anterior and middle columns of the subaxial spine complete with adjacent motion segments are disclosed. The surgical implant assembly includes a first cage adapted to be rigidly attached to a first vertebra, a second cage adapted to be rigidly attached to a second vertebra, and a spinal disc replacement prosthesis positioned between the first and second cages. The spinal disc replacement prosthesis preferably includes a resilient plastic or elastomeric body having two or more adjustably fluid-filled compartments therein, the fluid-filled compartments each being adjustably fluid filled by a respective port defined in the prosthesis body.

Abstract: This specification describes technologies relating to an intervertebral disc prosthesis used to strengthen and stabilize the spine. Implementations of the technology described herein comprise a surgical device that is implanted through a small surgical incision into a portion of a human intervertebral disc, various support tools used to insert such a surgical device, and a method by which the device is used to strengthen and stabilize the spine.

Abstract: The present invention relates to minimally invasive graft delivery systems and devices. The systems and devices provide a means to deliver graft material minimally invasively, such as to a spacer within a disc space. A particular system can include a cannula, a syringe and an extrusion tool. The extrusion tool can be used to extrude material from the cannula and syringe, and can have multiple modes of operation to accommodate the extrusion of materials of different viscocities.

Abstract: A sacro-iliac implant system includes at least one implant including a body defining an outer surface and being disposed to space apart opposing articular surfaces of a sacro-iliac joint. The body is engageable with the opposing articular surfaces and the outer surface is compliant to a configuration of the opposing articular surfaces such that the body facilitates relative movement of the opposing articular surfaces. Methods of use are disclosed.

Abstract: Embodiments of the invention relate to a curable nucleus pulposus implant having water absorption and swelling capabilities, compositions for producing the curable nucleus pulposus implants, and methods of using the curable nucleus pulposus implants. The curable nucleus pulposus implant can be created from a polymer blend composition comprising a ratio of a curable material and at least one hydrophilic polymer. The resulting polymer blend composition may be used to generate curable nucleus pulposus implants to treat a number of disease and/or disorders, such as herniated discs. The curable nucleus pulposus implants may further contain polyelectrolytes and elastomer compounds, as well as pharmacological and biological agents.

Abstract: A minimally invasive system and method for vertebral body augmentation includes an expandable containment device, a chassis including an interior cavity for at least partially enclosing the expandable containment device, a first guidewire, a working cannula, a second guidewire having at least a partially flexible distal end portion and a sleeve for introducing bone filler material through a cannulated passageway of the sleeve and into an interior cavity of the containment device. The containment device preferably includes a plurality of pores for directing the outflow of bone filler material anteriorly within the vertebral body. The containment device and chassis are left interior to the vertebral body subsequent to height restoration and augmentation of the vertebral body.

Abstract: A method of performing percutaneous interbody spinal fusion on adjacent vertebrae in a patient including the steps of: creating an access opening on the patient, the access opening being less than 10 mm wide, using indirect visualization: establishing a surgical path through the access opening via neural monitoring, creating a cavity in a disc space between the adjacent vertebra, evaluating the created cavity, inserting a container sized and configured to fit through the less than 10 mm access opening into the cavity and filling the container with fill material.

Abstract: The kyphoplasty cement encapsulation balloon is a flexible, resilient silicone balloon having a catheter or filling tube disposed inside the balloon. The filling tube has a closed end and a plurality of orifices defined in the tube radially. The tube has an open mouth extending through a hole in the balloon, defining an inflation port. The inflation port is internally threaded, and preferably has a radiopaque marker band extending around the port. The inflation port has a one-way duck or duckbill valve that closes the inflation port when the inflation cannula is detached from the port, thereby encapsulating the bone cement in the balloon and preventing leakage of the cement. The inflation cannula and the kyphoplasty cement encapsulation balloon may be furnished as a kit.

Abstract: Devices and methods for preventing the migration or expulsion of a nucleus disc replacement implant are provided. In one embodiment, an anti-expulsion device includes a body that is movable between a compressed configuration where it is adapted to fit through an opening in an annulus of a spinal disc, and an expanded configuration where it has a size that is larger than a size of the opening in the annulus of a spinal disc. The body can also include one or more mating features that allow the body to interact with a nucleus disc replacement implant and/or an annular wall of an annulus. As a result, since the body is larger than the opening of the annulus in the expanded configuration, the interlocking connection between the body and the nucleus disc replacement implant and/or annular wall will allow the body to prevent the nucleus disc replacement implant from being expulsed from the opening in the annulus.

Abstract: A combination spacer insert and support for incorporating into a space defined between succeeding vertebrae. A first insert body is constructed of a composite material exhibiting at least one modulus of elasticity with a substantially cylindrical shape and is inserted within the space, such as established between a pair of previously non-consecutive vertebrae and corresponding to an absent vertebrae. An additional and exterior supported member engages locations associated with the (formerly) non-consecutive vertebrae and which, in combination with the insert body, provides a limited degree of mobility to the vertebrae.

Abstract: A process for making a polymeric product having a gradual variation in modulus through at least a portion of the product is disclosed together with an artificial spinal disc formed using the process.