Abstract: The present application is directed to devices with expandable lengths for treating bony members. The device may include an elongated member with two sections that are movable relative to each other. An expansion chamber may be positioned between the first and second sections. A pump may move fluid from a reservoir and through a conduit into the expansion chamber. The expansion chamber expands upon receiving the fluid to cause the first and second sections to move apart and increase the length of the elongated member. The device may include multiple expansion chambers along the length, and the elongated member may include multiple sections.

Abstract: Systems and methods for treating conditions and diseases of the spine are disclosed herein. A device includes a balloon catheter comprising at least one inner lumen incorporated within an elongated shaft; a distal end having an inner balloon positioned inside and completely surrounded by an outer balloon; and a proximal end having an adapter for passage of at least one of an inflation fluid or a medical instrument; and an optical fiber comprising an outer diameter sized to pass through the inner lumen of the elongated shaft; a nonlinear light-emitting portion of a given length, wherein a portion of a cladding material from the nonlinear light-emitting portion has been removed so that light energy may be emitted along the length of the nonlinear light-emitting portion; and a linear elongated portion for guiding light towards the nonlinear light-emitting portion.

Abstract: Instruments and methods for reducing and stabilizing bone fractures are presented, which include providing a cavity in bone, such as a vertebra, wherein the cavity is proximate to an endplate of the bone, such as a vertebra endplate, and wherein the cavity extends radially from a passage into the cavity. The methods further include providing a device, such as an inflatable device, into the cavity and manipulating the device for expansion. The cavity may be expanded thereby reducing and/or stabilizing the fracture. The fracture may be further reduced and/or stabilized by adding a material into the cavity.

Abstract: The subject invention provides a modular six-degrees-of-freedom spatial mechanism for spinal disc prosthesis, with up to three rotational and up to three translational degrees-of-freedom within the entire workspace of a Functional Spinal Unit (FSU). The prosthetic disc mechanism consists of up to three independent cylindrical joints, each joint providing one linear and one rotational degree of freedom. The superior and inferior vertebral plates of the device anchor to the superior and inferior vertebrae of an FSU and the device maintains an inseparable mechanical linkage between those vertebrae for all normal motions and positions of the FSU. The device utilizes resilient spring elements, components that self-adjust in position and orientation, in conjunction with a fiber reinforced boot and toroidal belt, as well as a unique hydraulic damping system to accommodate dynamic and static forces and sudden shocks on the FSU.

Abstract: The invention provides a device and technique to seal an annular defect of an intervertebral disc, determine the in-situ volume of nucleus pulposus material removed, for example from a discectomy of a herniated disc, and facilitate injection of nuclear replacement material.

Abstract: A device (12) for implanting a tissue prosthesis comprises an elongate support member (14) having a proximal end (16) and a distal end (13), the support member (14) defining a recessed receiving zone 20 at a distal region for receiving at least a part (22) of the implant in a collapsed configuration. A cover member (24) having a proximal end (26) and a distal end (28) is arranged on the support member (14) to over at least the receiving zone (20) of the support member (14), the cover member (24) being removably arranged relative to the support member (14) to provide access to the receiving zone (20), the cover member (24) and the support member (14) together defining an insertion assembly (32).

Abstract: Systems and methods for injecting bone filler into a vertebra, wherein a spinous process and/or lamina can be strengthened by injecting the bone filler into the spinous process and/or lamina. An insertion device including a needle can be positioned proximal to the junction between the spinous process and the lamina of the vertebra when inserting the bone filler. Various embodiments of the needle and needle guide devices can be used to facilitate the process.

Abstract: Embodiments of the invention include a medical implant for delivering photodynamic therapy. A device that includes a vertebral interbody device, alone or in combination with other complimentary elements, may be configured to deliver one or more therapeutic substances in combination with light emissions to provide photodynamic therapy.

Abstract: Systems, methods and devices for providing stabilization between first and second vertebrae are provided. More particularly, in one form an implant assembly includes first and second end members configured to engage with the first and second vertebrae, respectively, and a support body configured to extend between and engage with the end members. In one aspect of this form, one or both of the end members is configured to facilitate injection of a material into one or both of the vertebrae. In another aspect, one or both of the end members includes a mesh material extending across a hollow interior to facilitate bone growth through the end member toward the support body. In another form, techniques for providing stabilization and support to vertebrae on opposite sides of a space created by removal of one or more vertebral elements are provided. However, different forms and applications are also envisioned.

Abstract: Devices, systems and methods for dynamically stabilizing the spine are provided. The devices include an expandable spacer or member having an unexpanded configuration and an expanded configuration, wherein the expandable member in an expanded configuration has a size, volume and/or shape configured for positioning between the spinous processes of adjacent vertebrae in order to distract the vertebrae relative to each other. The systems include one or more expandable members and an expansion medium for injection within or for filling the interior of the expandable member via the port. The methods involve the implantation of one or more devices or expandable spacers.

Abstract: Effective devices and methods using a chemonucleolysis agent are provided for treating an intervertebral disc or treating spinal arachnoiditis. The devices and methods comprise a chemonucleolysis agent to degrade or to shrink at least a portion of the intervertebral disc. In some embodiments, the methods and devices are configured to immediately release an effective amount of the chemonucleolysis agent within 24 hours when the device comes in contact directly or indirectly with an activator and provide sustained release of the chemonucleolysis agent over a period of up to one year to treat the intervertebral disc. In some embodiments, the chemonucleolysis agent in the device is administered in or near the intrathecal space and/or thecal sac to treat spinal arachnoiditis.

Abstract: A method of augmenting a nucleus pulposus of an intervertebral disc comprises forming a first opening in an annulus of the intervertebral disc and forming a second opening in the annulus of the intervertebral disc. The method further comprises providing a space creation instrument including an expandable spacing device and introducing the spacing device through the first opening and into the nucleus pulposus. The method further comprises introducing a material delivery instrument through the second opening and into the nucleus pulposus and expanding the spacing device to create a space within the nucleus pulposus. The method also comprises injecting a biocompatible material from the material delivery instrument and into the space within the nucleus pulposus.

Abstract: An expandable vertebral prosthesis for replacement of a vertebral body includes opposed end plates that are respectively adapted to abut two other vertebral bodies for fastening engagement therewith and a hollow expandable body interconnecting the end plates. The end plates each define a central opening which extends therethrough for receiving bone growth. The hollow expandable body includes one or more annular body sections having concentric inner and outer side walls, the inner side wall of which defines therewithin a central channel axially extending between the central opening defined in each of the first and second end plates. The central openings have a bone graft or bone growth stimulating material therein and the central channel permitting bone growth therethrough. The hollow expandable body is axially expandable such as to extend from a collapsed position to an expanded position whereby a space left by the excised vertebral body.

Abstract: A percutaneous path is established into a selected bone, e.g., a vertebral body, having an interior volume occupied, at least in part, by cancellous bone. A first bone filling material is conveyed through the percutaneous path into a region of the cancellous bone. A second bone filling material is conveyed through the percutaneous path into the region. The second bone filling material is different than the first bone filling material.

Abstract: The present application relates to a prosthesis comprising a flexible portion (1) and at least one less flexible portion (2), which flexible portion comprises a fiber-reinforced hydrogel. In addition to that, the application relates to a prosthesis consisting of a fiber-reinforced hydrogel, which prosthesis is intended to replace cartilaginous materials. The application further relates to the use of the prosthesis and to a method for manufacturing the prosthesis. The application furthermore relates to a method of preparing the flexible portion for a prosthesis. Finally, the application relates to a fiber material apparently intended for use in the prosthesis.

Abstract: A system for treating an annular defect of an intervertebral disc is provided. The system comprises a cannula for accessing a nucleus pulposus of the intervertebral disc, an expandable spacing device, and a material delivery instrument. The expandable spacing device has a first deflated position and a second inflated position. The spacing device is sized to pass through the cannula when in the first deflated position and the spacing device has a predetermined shape in the second inflated position. The material delivery instrument is adapted to inflate the spacing device from the first deflated position to the second inflated position by injecting a biocompatible material into the spacing device. In another aspect, a method of treating at least one annular defect of an intervertebral disc 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. 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: Methods and devices are provided for performing surgical procedures using tissue retractors. In general, the methods and devices allow a surgeon to use a retractor to capture a large or small amount of tissue in the retractor and to move the retractor to relocate tissue to one or more convenient locations during a surgical procedure. The retractor can be configured from a pliable state to a substantially rigid state to hold the retractor and the tissue in a substantially fixed position during the procedure.

Abstract: Devices, systems and methods for dynamically stabilizing the spine are provided. The devices include an expandable spacer or member having an unexpanded configuration and an expanded configuration, wherein the expandable member in an expanded configuration has a size, volume and/or shape configured for positioning between the spinous processes of adjacent vertebrae in order to distract the vertebrae relative to each other. The systems include one or more expandable members and a mechanical actuation means for expanding the expandable member or an expansion medium for injection within or for filling the interior of the expandable member via the port. The methods involve the implantation of one or more devices or expandable spacers.

Abstract: Embodiments of the invention include implants and methods for connecting devices to bones, such as one or more endplates of vertebrae. Devices may include mechanisms for connecting to one or more vertebrae by extending portions of the devices through an aperture in a vertebral implant and expanding the implant within the one or more vertebrae. A fill material may be used to drive the expansion in some embodiments.

Abstract: A protective system for facilitating revision surgery includes a protective pad with a base portion and an overlying portion spaced apart from the base. A fluid pocket is formed between the base portion; and the overlying portion. The protective system prevents formation of adhesions or scar tissue in the area occupied by the protective pad. Thus a clean plane is obtained during revision surgery on the patient through an incision in the fluid pocket.

Abstract: The present invention provides both a device and a method. The device is a human made replacement for the soft discs in the spine. A fabric pouch encloses a central hydraulic element made up of small soft beads. Two pouches with beads are implanted into a prepared disc space to function as an intervertebral disc. The method is conversion of the device into a fusion element.

Abstract: Embodiments of the invention include a medical implant having a vertebral body replacement device, alone or in combination with other complimentary elements, configured to deliver one or more therapeutic substances. The one or more therapeutic substances may be contained in the medical implant or be ported to the medical implant.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: Methods and apparatus for treating bones, including, in one or more embodiments, methods and apparatus for treatment of vertebral fractures that include a containment assembly for cement containment and/or a balloon assembly for maintaining vertebral height. A containment assembly comprising a containment jacket adapted to be deployed inside bone; and a dividing wall that separates the interior of the containment jacket into a proximal region and a distal region, the dividing wall having an opening for providing access to the distal region from the proximal region.

Abstract: The present disclosure relates to a spinal fusion impactor tool that includes an attachment means for securing an implant device to the distal end of the tool, a means for adjusting the angle of the distal head relative to the handle to better position the implant for introduction into the implant site, means for remotely releasing the implant device at the distal end and a clamp device on the shaft of the tool to secure tabs, attachments and other devices. The impactor tool is preferably used in conjunction with implantation of an intervertebral fusion cage that is equipped with shims having tabs or other removing means, but may also be used to introduce, for example, an implant, graft, fusion device, wedge or distractor device into any joint space or bony region in preparation for implantation.

Abstract: Vertebral body replacement apparatuses, systems, and methods are provided. In various examples, an implantable device is configured to be inserted between a first vertebral body and a second vertebral body. The implantable device includes a first endplate configured to contact the first vertebral body. A second endplate is configured to contact the second vertebral body. An expansion bladder is disposed between and coupled to the first endplate and the second endplate. The expansion bladder includes a first chamber and a second chamber. The first chamber and the second chamber are sealed from fluid communication with one another. An injection port is disposed through one of the first endplate or second endplate. The injection port includes a first channel in fluid communication with the first chamber and a second channel in fluid communication with the second chamber.

Abstract: An implant for insertion between vertebral members may include a first member with a first contact surface to contact the first vertebral member, and a second member with a second contact surface to contact the second vertebral member. A material may be secured to and extend between each of the first and second members. An interior space may be formed between the first and second members and the material. An inflatable member may be positioned within the interior space and may be inflatable upon the introduction of a substance into inflatable member. The inflatable member may be inflatable between a first size to space the first and second members a first distance apart and an enlarged second size to space the first and second members a second greater distance apart.

Abstract: Corpectomy device comprising outer component, inner component and riser. The outer component includes a first endplate and first structure. The first structure includes a window and seat in communication with the window. The seat defines an opening to be pre-packed substantially with first grafting material. The inner component includes a second endplate and second structure at least partially disposed in the first structure in a first configuration. The second structure is to be pre-packed substantially with second grafting material. The riser has a third tubular structure to be received through the window into the seat to engage at least a portion of the second structure that extends the second structure into a second configuration with respect to the first structure. The third structure is to be pre-packed substantially with third grafting material such that first, second and third grafting material remain pre-packed substantially and in communication in the second configuration.

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 interspinous spacers, for example, corpectomy spacers that are suitable for insertion into an intervertebral disc space.

Abstract: A selectively expanding spine cage has a minimized diameter in its unexpanded state that is smaller than the diameter of the neuroforamen through which it passes in the distracted spine. The cage conformably engages between the endplates of the adjacent vertebrae to effectively distract the anterior disc space, stabilize the motion segments and eliminate pathologic spine motion. Angular deformities can be corrected, and natural curvatures restored and maintained. The cage enhances spinal arthrodesis by creating a rigid spine segment, or if filled with compressible substances, the cage can be used for motion preservation between vertebral bodies. Expanding selectively (anteriorly, along the vertical axis of the spine) rather than uniformly, the cage height increases and holds the vertebrae with fixation forces greater than adjacent bone and soft tissue failure forces in natural lordosis. Stability is thus achieved immediately, enabling patient function by eliminating painful motion.

Abstract: A surgical procedure and apparatus according to which force is applied to a member to compress the member, and the member is retained in its compressed state while it is inserted between two anatomical structures. The member is then allowed to move from its compressed state towards its original state and into engagement with the structures.

Abstract: Methods and devices for insertion between adjacent vertebrae in a spine following removing at least a portion of a nucleus from within a disc. In one embodiment, the device includes a member having a flexible wall surrounding an internal volume and a coupler that is secured to the flexible wall. The member is adapted to expand when filled with a first filler material to form an interior cavity. The coupler has a first access point, a second access point, a first coupler side hole, and an optional second coupler side hole. The first and second access points are adapted to removably receive one or more fill tubes. The fill tubes cooperate with the first and optional second coupler side holes to direct the first filler material into the internal volume and a second filler material into the interior cavity.

Abstract: An artificial ligament assembly for spinal stabilization includes an outer hollow elastic longitudinal member, a rigid inner member, a bone anchor mechanism, a bone anchor, and a buffered space. The artificial ligament assembly further includes a clamp that controls a torsional motion of the outer hollow elastic longitudinal member with respect to the bone anchor mechanism. The outer hollow elastic longitudinal member is at least as long as the inner rigid member. The rigid inner member is configured in a substantially same shape as the outer hollow elastic longitudinal member. The bone anchor mechanism is coupled to the outer hollow elastic longitudinal member. The bone anchor connector may further include an insert end. The bone anchor is coupled to the bone anchor mechanism. The buffered space allows any of a compression and an extension of the bone anchor mechanism inside the outer hollow elastic longitudinal member.

Abstract: An implantable spinal disk including an external shell, first endplate, second endplate and core component. The external shell includes sidewalls, a back wall, a front wall, a top surface and a bottom surface forming a compartment. The first endplate includes a first base, first top and first attachment devices. The first base is disposed in the compartment. The first top is disposed in a first opening in the top surface. The first attachment devices extend from within the first top portion. The second endplate includes a second base, second top and second attachment devices. The second base is disposed in the compartment. The second top is disposed in a second opening in the bottom surface. The second attachment devices extend from the second top. The core component is disposed in the compartment between the first endplate and the second endplate.

Abstract: An intervertebral spacer for positioning between vertebral members. The spacer may include contact surfaces that are configured to contact against the vertebral members. A fluid cylinder may be positioned between the first and second contact surfaces and configured to contain a fluid. The fluid cylinder may include an outer cylinder with an open first end that telescopingly receives an inner cylinder. The spacer is configured to maintain the distance between the contact surfaces at a desired amount.

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: The present invention relates to a device and method which may be used to reinforce the native annulus during spinal surgery. The device is a catheter based device which is placed into the inter-vertebral space following discectomy performed by either traditional surgical or endoscopic approaches. The distal end of the catheter is comprised of an expansile loop which may be increased in diameter by advancement of a portion of the catheter via its proximal end, such proximal end remaining external to the body. The expansile loop may be formed of a woven or braided material and may be made of a polymer such as nylon, polyurethane, polyester, polyethylene, polypropylene or any of the well known and biocompatible polymers. Alternatively the expansile portion of the catheter may be formed from a metallic braid of stainless steel, elgiloy, Nitinol, or other biocompatible metals.

Abstract: Adjustable base piece (1) that can be incorporated into a prosthesis replacing the corpus vertebrae and comprising—a plate (11) positioned in contact with an internal face of the adjacent corpus vertebrae; —a curved panel (12) that can be adjusted in multiple directions by virtue of a ball stem (120) housed in a head (111) of the plate (11) which allows it to adopt the optimal angle with respect to this fixed plate (11), so that the said curved panel (12), thanks to its possibilities of multi-axis adjustment, can press espousing the external shape of the corpus vertebrae adjacent to the prosthesis, —a clamping plug (13) which, once tightened, fixes the panel (12) to the plate (11) in the desired position, thus allowing this adjustable base piece (1) to be simultaneously in contact with an internal surface of the adjacent corpus vertebrae, thus giving this base piece, once attached to the corpus vertebrae, great bearing stability, with good adaptation to suit all shapes of vertebra encountered in real life.

Abstract: Intervertebral implant system for intervertebral implantation, are disclosed. An intervertebral implant system according to the present disclosure includes a frame having a peripheral wall defining a space therein, and a settable material introducible into the space of the frame. The settable material is a biocompatible load bearing material including and not limited to bone, composites, polymers of bone growth material, collagen, and insoluble collagen derivatives. The settable material is injectable into the space defined by the frame. The settable material may have an initial fluid condition wherein the fluid settable material cures to a hardened condition.

Abstract: The present invention is a system for a partially biological disc replacement that stimulates natural fibrous, cartilaginous or other tissue growth in the DDD cavity, resulting in a partial biological disc replacement. Multiplicities of fibronous pieces of fibro-cartilaginous tissue promoting material are inserted into the DDD cavity inducing tissue growth.

Abstract: The present invention provides an injectable annular ring useful in treating a deteriorating spinal disc. When used, the annular ring may be collapsed or folded in order for it to be placed through a small opening in a prepared intervertebral space within the annulus using minimally invasive techniques. Deployment or unfolding the ring in the intervertebral space provides an interior cavity bordered by the ring that is in direct contact with the vertebral endplates. When an internal volume of the ring is inject or filled with a load-bearing, hardenable material, the filled ring maintains the intervertebral spacing and prevents the ring from being expelled from the interior cavity through the small annular opening.

Abstract: A method and devices for facilitating fixating and joining of bone fractures utilizing expandable devices that are positioned within the bone and across the fracture site. The stress from the expanded may enhance and expedite bone healing.

Abstract: An intervertebral spacer for positioning between vertebral members. The spacer may include contact surfaces that are configured to contact against the vertebral members. A fluid cylinder may be positioned between the first and second contact surfaces and configured to contain a fluid. The fluid cylinder may include an outer cylinder with an open first end that telescopingly receives an inner cylinder. The spacer is configured to maintain the distance between the contact surfaces at a desired amount.

Abstract: The present application is directed to transformable implants for a variety of medical applications. The implants transform from a malleable pre-filled article into a more rigid device via hardening of the implant material. The malleable aspects of the implants facilitate delivery and insertion for implantation in a minimally invasive procedure. The hardened implants provide for load-bearing that maximizes in vivo performance. Activation for hardening the implant material may be accomplished by various means, and may occur prior to insertion into the patient, during insertion into the patient, or after insertion into the patient.

Abstract: The present invention relates to a device and method to perform 1) disk fusing, 2) an artificial replacement of the nucleus, 3) artificial replacement of the annulus, or 4), an artificial replacement of both the nucleus and annulus. The device is designed to be placed into the inter-vertebral space following discectomy. The invention includes a delivery catheter and an expandable continuous mesh that has a torus configuration with a lumen within the mesh and a center hole. The mesh can be diametrically expanded in diameter into the disc space whereby various materials can be injected into the lumen and/or the center hole.

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: A selectively expanding spine cage has a minimized diameter in its unexpanded state that is smaller that the diameter of the neuroforamen through which it passes in the distracted spine. The cage conformably engages between the endplates of the adjacent vertebrae to effectively distract the anterior disc space, stabilize the motion segments and eliminate pathologic spine motion. Angular deformities can be corrected, and natural curvatures restored and maintained. The cage enhances spinal arthrodesis by creating a rigid spine segment, or if filled with compressible substances, the cage can be used for motion preservation between vertebral bodies. Expanding selectively (anteriorly, along the vertical axis of the spine) rather than uniformly, the cage height increases and holds the vertebrae with fixation forces greater than adjacent bone and soft tissue failure forces in natural lordosis. Stability is thus achieved immediately, enabling patient function by eliminating painful motion.

Abstract: An expandable implant is disclosed having an adjustable height for insertion between two adjacent bony structures or joint surfaces, for example between two adjacent spinal vertebrae. The implant includes at least one gear associated with at least one threaded shaft. Rotation of the gear engages the threaded shaft to expand the implant. The implant can be inserted in a collapsed configuration and expanded in situ. The invention also provides methods for using the implant to facilitate arthrodesis or fusion of adjacent joint surfaces or spinal vertebrae.

Abstract: Systems are provided for reducing the complexity and invasiveness of spinal stabilization procedures and provide an expandable device deliverable to a spinal implantation location. The expandable device can be delivered through a minimally invasive access portal and expanded at the implantation location to manipulate one or more bony structures or maintain a configuration of one or more bony structures.