Abstract: A percutaneous path is created into a bone having an interior volume occupied, at least in part, by a cancellous bone, e.g., a vertebral body. An expandable structure is introduced into the cancellous bone by deployment of a tool through the percutaneous path into the cancellous bone. The expandable structure is expanded and the tool withdrawn, leaving the expandable structure expanded inside the cancellous bone. Expansion of the expandable structure within cancellous bone can, e.g., compact cancellous bone, and/or create a cavity in cancellous bone, and/or move fractured cortical bone.

Abstract: An interbody fusion device having an accordion-like structure, wherein the device in inserted into the disc space in its collapsed configuration and then expanded into its expanded configuration by compressing the accordion-like portion of the device. In some embodiments, a pre-formed tube with an accordion-like structure over a portion of its length is inserted in a relaxed (collapsed) configuration, giving the tube a minimum possible diameter. This tube has a cable running through it that is fixed to a distal end portion of the tube and extends past the proximal end portion of the tube to the outside of the patient. Once the tube is positioned on the rim of the endplate, the proximal end of the cable is pulled, thereby tensioning the cable and causing the accordion portion of the tube to become shorter in length but larger in diameter.

Abstract: A method and system for fusing a region in the spine involve the use of at least one guide tube to pass instruments and substances into the spinal region in a minimally invasive manner. In the preferred practice of the method, a guide tube is anchored to a vertebra and the guide tube is moved to thereby position the vertebra. A steerable drilling tool is passed through the guide tube and steered into position to abrade at least a portion of an intervertebral disc and thereby create a cavity in the disc. A flowable substance is passed into the cavity and permitted to solidify to establish fusion in the cavity. Optionally, an uninflated balloon is inserted into the cavity and the balloon is filled with the flowable substance to contain the flowable substance.

Abstract: The invention relates to an implantable combination comprising a barrier (12), and a macromolecular bio-compatible material (14). The barrier (12) is porous to allow moieties of the macromolecular bio-compatible material (14), when implanted, to be exposed through the barrier, whereby the surface of the barrier is experienced by the body as an essentially non-foreign object. It also relates to an implant made from a barrier material and a bio-compatible material, the implant being suitable as e.g. a breast implant.

Abstract: An implantable container is used to stabilize or restore height in a vertebral body. After insertion the container is filled with a bone filler material such as bone cement.

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: Disclosed are devices and methods for the placement of a bone fusion implant between vertebral bodies in a human or animal subject. In an exemplary method a pathway is formed in the first sacral vertebrae along a trajectory that has a starting point between the inferior aspect of the facet joint and the first posterior sacral foramen and transverses at least one pedicle, at least a portion of the first sacral vertebra and the disc space immediately superior to the sacrum. A fusion implant is placed into the formed pathway. Additional bone fasteners and inter-connecting rods are added to the fusion implant in order to further strengthen the construct. Embodiments that can be used to fuse an additional level are also disclosed.

Abstract: A system for sealing a hole in a body, comprising a generally cylindrical mesh formed from a plurality of helical strands which is inserted into the hole, with at least one end of the cylindrical mesh being moved least partially through an interior portion of the cylindrical shaped mesh such that the mesh expands radially outwards against sides of the hole.

Abstract: An interbody fusion cage having a generally symmetric, annular cage body surrounding a central void extending from a lower surface to an upper surface in which to retain graft material in contact with adjacent vertebra. A lateral channel extending into each half from the cage perimeter contains a worm drive screw. One or more longitudinal channels extending from the upper surface to the lower surface intersect each lateral channel and house a pin which is provided with a series of helically cut worm gear teeth on its external surface for engaging the worm drive screw. The pins are simultaneously externally threaded and engaged to the cooperatively threaded internal surface of the longitudinal channel such that rotation of the drive screw by the surgeon after implantation causes the pins to rotate with the longitudinal channel and advance into the adjacent bone.

Abstract: In one embodiment, the improved implantable prosthetic cage includes a hollow body, insertable into a human or any other animal, which includes an open receptacle adapted to hold a bone-growth promoting substance and at least one cover coupled to the body with a coupling mechanism to selectively seal the opening in the receptacle. The implantable prosthetic cage is preferably used for spinal fusion, but may be implanted in other parts of a human or other animal. In another embodiment, the method of utilizing an implantable prosthetic cage includes the steps of substantially sealing a bone-growth promoting substance within an implantable body, implanting the body between two bones while maintaining the seal and preventing contact between the substance and a bone, and disabling the seal, thereby allowing contact between the substance and a bone.

Abstract: The invention relates to a distractible intervertebral implant having a first assembly (10) constituted by a first prosthetic plate (16) and a first spacer element (18), the prosthetic plate being secured to the first spacer element; a second assembly (12) constituted by a second prosthetic plate (22) and by a hollow second spacer element (24), having a first end secured to the second prosthetic plate and the first spacer element being suitable for sliding in the second spacer element; and means (14) for preventing the spacer element from moving in translation or in rotation relative to each other, the means having a clamping collar (28) surrounding a portion of the outside surface of the second spacer element, and a lock screw (30) for tightening the collar onto the second spacer element.

Abstract: A system for sealing a hole in a body, comprising a generally cylindrical mesh formed from a plurality of helical strands which is inserted into the hole, with at least one end of the cylindrical mesh being moved least partially through an interior portion of the cylindrical shaped mesh such that the mesh expands radially outwards against sides of the hole.

Abstract: A device includes a first reservoir configured to include a degradation agent, a first control element configured to provide access to the first reservoir, and an expandable component configured to extend to engage an osteal structure.

Abstract: An implant made of at least two different materials. The implant may include materials with varying radiolucency and mechanical properties. Such a hybrid implant may offer controlled radiographic visibility and optimized structural properties for implant placement, including placement for use in spinal arthrodesis.

Abstract: A cervical fixation device, for insertion between a pair of adjacent cervical vertebrae, includes a frame comprised of a first material. The frame has a generally rectangular proximal end and a generally rectangular distal end. The distal end is connected to the proximal end by at least one upper arch and at least one lower arch. The upper and lower arches are spaced apart from each other. The frame has a generally hollow interior, substantially open lateral sides between the upper and lower arches and a substantially open proximal end.

Abstract: A system for implanting an inter-body device between adjacent vertebrae comprises an inter-body device having a plurality of cans secured to a flexible bridge and having a relief portion therebetween. An inserter tube and complementary bullnoses are advantageously secured to the vertebrae by an extension arm for securing the assembly precisely in place. A plurality of articulating trial implants are provided to test fit a disc space for the proper sized inter-body device.

Abstract: The spinal fusion device (100) of the invention is implanted within an intervertebral space between adjacent upper and lower vertebrae and secured to the vertebrae with cement. The fusion device includes upper and lower endplate facing surfaces (150, 160) each having at least one opening (120) for delivering cement material to adjacent contact surfaces of the vertebrae above and below the implant. Utilizing quick-setting cement compositions with the device <:an allow for almost immediate fusion of the vertebrae, thus, reducing or eliminating the need for adjuvant fixation devices such as screws, plates, and/or rods, while also simultaneously providing precise delivery of cement to contact surfaces between the fusion device and vertebrae.

Abstract: Disclosed is a spinal stabilization device having a plurality of elongate arms having a distal end portion and a proximal end portion, wherein the elongate arms define an interior volume between the distal end portion and the proximal end portion; at least one limit band coupled circumferentially to one or more of the plurality of elongate arms; and a tensioning element positioned within the interior volume. The plurality of elongate arms can transition from a constrained, delivery configuration that is radially contracted and axially elongated to a relaxed, deployment configuration that is radially expanded and axially shortened.

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 method for treating a diseased or damaged spinal disc comprises the steps of: (a) providing access to the nucleus pulposus through the annulus; (b) removing at least a portion of the nucleus pulposus to create an intradiscal space; (c) determining the size of the intradiscal space; and (d) sealably introducing under pressure a curable biomaterial through the annulus directly into the intradiscal space. The step of determining the size of the intradiscal space may be accomplished by expanding a compliant balloon within the intradiscal space using a contrast medium capable of visualization under fluoroscopy. The curable material is sealably introduced through a vented needle inserted through the opening. The curable biomaterial is introduced until a quantity of the material flows into the vent.

Abstract: An instrument for inserting an elongated hydrogel prosthesis into an intervertebral disc includes an insertion cannula that is inserted through the annulus fibrosus of an intervertebral disc to provide access to the nucleus region of the disc, an elongated hydrogel prosthesis packaged within a tubular container adapted to be coupled to a proximal end of the insertion cannula, and a source of fluid pressure adapted to be coupled to a proximal end of the tubular container. Auxiliary instruments for use in convenient insertion of the insertion cannula through the nucleus pulposus and providing for a complete and controlled passage of the hydrogel prosthesis through the insertion cannula are provided in a kit with the insertion cannula.

Abstract: A sliding intervertebral implant and method includes a first member that connects to an intervertebral space between two adjacent vertebrae. The first member includes a pair of curved side walls connected to each of a front wall, an upper curved wall, and a lower curved wall, wherein a length of a first curved side wall is less than a length of each of a second curved side wall, the upper curved wall, and the lower curved wall, and wherein an edge of the second curved side wall is offset from an edge of the front wall. A second member is slidably attached to the first member, and includes a top and bottom curved wall each connected to an inclined side wall and a guide wall, wherein the guide wall comprises grooves, wherein the second curved side wall of the first member slides in the grooves of the guide wall.

Abstract: A medical implant includes a flexible container having two layers of flexible surrounding walls, each surrounding wall being provided with a plurality of through holes; a tubular fitting being connected to an open end of the flexible container for inserting or infusing a medical filling material into the flexible container through the tubular fitting; and a thrust part connected to the flexible surrounding walls of the flexible container and at a distal end of the flexible container. The thrust part has a receiving seat and a ring, the receiving seat having a central bore and an annular groove surrounding the central bore and opposite to the central bore, wherein a tubular surrounding wall is inserted into the ring and is folded so that the two layers of flexible surrounding walls are formed with the ring imbedded between the two layers of flexible surrounding walls, and the ring with the two layers of flexible surrounding walls are received in the annular groove and detained therein due to friction.

Abstract: A method for treating a spinal disc comprises the steps of: determining the integrity of the annulus by subjecting the annulus to a first pressure applied internally of the annulus; providing access to the nucleus pulposus through the annulus without removing any tissue from the annulus or from the nucleus pulposus; and sealably injecting curable biomaterial through the annulus access directly into the nucleus pulposus at a second pressure correlated with the first pressure. The integrity of the annulus may be determined by a pre-operative discogram using a contrast medium that has a viscosity substantially similar to the viscosity of the biomaterial to be injected. The curable biomaterial may be injected under a pressure sufficient to distract opposing vertebral bodies communicating with the disc space.

Abstract: An intervertebral disc prosthesis (10) for total, partial, or nuclear replacement of an intervertebral disc space includes an anchoring member (20) and a cushioning member (30). The anchoring member is sized and configured to engage an inferior vertebra. The cushioning member is sized and configured to directly contact an endplate of the superior vertebra and to couple to the anchoring member, which is secured to the inferior vertebra. Thus, the prosthesis includes a single endplate for contacting the inferior vertebra and a cushioning member for directly contacting the superior vertebra. In use, the prosthesis facilitates movement between the vertebral bodies by (a) direct articulation via sliding or articulation between the vertebral bodies and the prosthesis, (b) indirect articulation via deformation (e.g., compression) of the prosthesis, or (c) a combination thereof.

Abstract: Intramedullary access or infusion devices that includes a tubular conduit having a distal end and a proximal end with a length sufficient to pass through the cortical region to the cancellous region of a bone; a flange circling the outside of the proximal end of the conduit; and a penetrable diaphragm positioned within the tubular conduit, are described. The devices may be placed in bone and later used, for example, as a site for administering a pharmacologically active agent.

Abstract: An expandable implant includes an implant body defining an internal void, the implant body including a plurality of interconnected linkages. A first plurality of the linkages has an expansion characteristic that is different from a second plurality of the linkages. An expandable bladder is sized to be disposed in the internal void. The bladder defines a bore configured to receive an expansion material, such that the expansion material applies an expansion force against the bladder, which thereby applies the expansion force against the implant body so as to cause the first linkage to expand greater than the second linkage. The expandable implant can be placed in a fracture location so as to restore height to a fractured target bone.

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 implant including a central axis, a bottom cover plate and a top cover plate, which are respectively provided with an exterior surface that extends transversal to the central axis, and a central part.

Abstract: A prosthetic implant for forming a support structure between adjoining vertebrae in a spinal column. The prosthetic implant includes a generally spherical or ellipsoidal body that at least partially engages a surface of adjacent vertebrae.

Abstract: A vertebral replacement implant includes two longitudinal elements slidably mounted with respect to each other, and locking elements. These locking elements include, on one of the longitudinal elements, an anchor surface, and on the other of the longitudinal elements, an anchor shoe guided in translation to take up a first position in which the elements slide freely with respect to each other, and a second position in which the anchor shoe cooperates with the anchor surface to lock the elements together, with a system converting a rotational movement into a translational movement transmitted to the anchor shoe.

Abstract: Embodiments of the invention include expandable, implantable devices and methods. Devices expand linearly and laterally to provide secure fixation between or among anatomical structures. In some embodiments, an implant replaces one or more vertebral bodies, or portions of vertebral bodies, of the spine.

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: Embodiments of the invention include expandable, implantable devices and methods. Devices expand linearly within the volume of a membrane and laterally to provide secure fixation between or among anatomical structures. In some embodiments, an implant replaces one or more vertebral bodies, or portions of vertebral bodies, of the spine.

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 spine distraction implant alleviates pain associated with spinal stenosis and facet arthropathy by expanding the volume in the spine canal and/or neural foramen. The implant provides a spinal extension stop while allowing freedom of spinal flexion. An interspinous process implant with a selectably expandable spacer can be placed between adjacent spinous processes. a device implanted between the spinous processes of adjacent vertebrae of the spine can be used for relieving pain associated with the vertebrae and surrounding tissues and structures by maintaining and/or adding distraction between adjacent vertebrae. A tissue expander can be adapted to move from a first insertion position, for ease of implantation between spinous processes, to a second retention position that prevents displacement of the implant.

Abstract: The present invention is directed to a porous or permeable containment device for implanting into the interior volume of a targeted vertebral body for use in restoring the anatomy of the targeted vertebral body. The containment device is expandable from an insertion configuration to an expanded configuration via, for example, a bone filler material. The containment device preferably permits the bone filler material to flow out of the containment device via, for example, one or more pores, one or more flow-directing tentacles, etc. so that the bone filler material may interdigitates with the surrounding bone tissue. The containment device is preferably configured to have a pre-determined, ‘dog-bone’ shape, when in the expanded configuration.

Abstract: Spinal disc prosthetic devices are provided having up to six-degrees-of-freedom with three rotational and three translational degrees-of-freedom within the entire workspace of a Functional Spinal Unit (FSU). Certain embodiments of the prosthetic disc mechanisms attach to upper and lower plates anchored between vertebrae of an FSU allowing modularity of the devices. Scaling, conjoined mechanical programmability allow the devices to realize almost any nominal required spinal articulation, from the cervical to lumbar regions.

Abstract: A device for facilitating bone fusion of two vertebrae. The device is sized and shaped to at least extend between the two vertebrae to be fused, and includes an outer wall member disposed about an inner portion. A space between the outer wall member and the inner compartment is adapted to contain an osteogenic bone fusion material. The inner portion includes a compartment adapted to contain an inner fill material, such as a bone cement or an in situ curable polymer. The inner portion may operate as a structural member to maintain a desired amount of spacing between the vertebrae to be fused, and to support the spinal column prior to formation of the fused bone joint. The device is also configured to locate the osteogenic material away from the centers of the vertebrae to be fused, providing a fused joint with high bending and torsional rigidity.

Abstract: A spinal implant is provided that includes a first component for engaging a first vertebra, a second component for engaging a second vertebrae, and a damping member is positioned therebetween. The damping member has at least two chambers connected by an opening. A fluid is disposed within the chambers such that compression of the first and second components towards one another causes the fluid to be displaced from one of the chambers to another chamber through an opening. The opening has a reduced size relative to the chambers to restrict the flow of the fluid between the chambers and provide a dampening effect. In some instances, the rheologic properties of the fluid positioned within the chambers are dependent upon the strength a magnetic field passing through the fluid. In other aspects of the present disclosure, prosthetic devices, intervertebral implants, spinal systems, implantation methods, and treatment methods are provided.

Abstract: An intervertebral spacer is inserted between vertebral members in a compact configuration and expanded post-insertion to contact the adjacent vertebral members. The intervertebral spacer comprises a first member and a second member movable with respect to the first member between retracted and extended positions.

Abstract: A method for treating a diseased or damaged spinal disc comprises the steps of: (a) providing access to the nucleus pulposus through the annulus; (b) removing at least a portion of the nucleus pulposus to create an intradiscal space; determining the size of the intradiscal space; and (c) sealably introducing under pressure a curable biomaterial through the annulus directly into the intradiscal space. The method may include the additional steps of applying a force to distract the opposing vertebral bodies about the intradiscal space and then removing the distraction force after the biomaterial has cured. The step of determining the size of the intradiscal space may be accomplished by expanding a compliant balloon within the intradiscal space using a contrast medium capable of visualization under fluoroscopy. The curable material is sealably introduced through a vented needle inserted through the opening. The curable biomaterial is introduced until a quantity of the material flows into the vent.

Abstract: A vertebral prosthesis (10) comprising opposed ends (14,16) interconnected by a tubular side wall (12), which enclose a cavity therewithin. An inlet port (18) in fluid flow communication with the cavity permits injection of a hardenable fluid into the cavity. The tubular side wall has an expanding bellows configuration which allows for expansion of the vertebral prosthesis in an axial direction (23) such that the ends are displaced away from each other when the cavity is filled with the hardenable fluid, thereby axially expanding the vertebral prosthesis from a collapsed position to an expanded position in order to fill a space between adjacent vertebral bodies (11,13). The vertebral prosthesis (10) has an expansion ratio, defined by a total axial height of the vertebral prosthesis in the expanded position divided by a total axial height of the vertebral prosthesis in the collapsed position, that is greater that 200 percent.

Abstract: A device includes a first reservoir configured to include a degrading agent, a first valve in fluid communication with the first reservoir, and a reservoir driver configured to manipulate the first reservoir to effect a first reservoir condition based on a first tissue condition. The first valve is configured to open in response to the first reservoir condition associated with the first reservoir.

Abstract: A method of treating a diseased or damaged intervertebral disc having a nucleus pulposus and an annulus. The method includes the steps of accessing and preparing the intervertebral disc for receipt of the biomaterial by removing at least a portion of the nucleus pulposus to create a nuclear cavity. A quantity of the curable biomaterial is delivered under pressure to the nuclear cavity. The delivered biomaterial is at least partially cured in such a manner to retain it in the nuclear cavity. The at least partially cured biomaterial is contoured to achieve a desired conformation approximating that of the nuclear cavity.

Abstract: An annulus repair system is provided. This repair system may cover a hole or opening in the annulus or repair a defect or damage to the annulus. In one embodiment, the annulus repair system comprises a blocking component that covers a hole in the annulus, a stabilizing component that helps stabilize the blocking component and a suturing material that connects the two components together. In certain embodiments, the annulus repair system may further comprise a cannula for guiding the blocking component, the stabilizing component and at least a portion of the suturing material through body tissue and into the disc space. Methods for utilizing the annulus repair system of the present invention also are provided.

Abstract: An intervertebral prosthesis implantable within a disc space and disposed between upper and lower vertebral endplates is provided. The prosthesis comprises a plurality of prosthesis modules insertable into the disc space, wherein the modules have at least one set of complementarily-shaped and sized surfaces, and wherein at least one of the modules is expandable. The modules have surfaces configured to engage within the disc space in a manner such that the modules form an assembled prosthesis of a size substantially preventing it from being outwardly expelled from the disc space, and the modules have bearing surfaces slidably engageable with the endplates to permit articulation between upper and lower vertebral endplates. In one embodiment, the at least one expandable module of the intervertebral prosthesis expands by inflation. In another embodiment, the at least one expandable module expands by unfolding into its intended form.

Abstract: A intervertebral body device for supporting adjacent vertebrae includes a vertebral body member having at least one containment portion and one communicating portion. The containment portion and communication portion provide two distinct functional regions within the cage. One region of the cage provides for the use of a biologic material, and the region of the cage provides holes in the side or the front of the cage in order to allow bony ingrowth into that portion of the cage. Where numerous segments are needed, these components can be arranged in any combination.

Abstract: An interbody implant system for use with a first vertebra having a first endplate and a second vertebra having a second endplate. The system includes an expandable implant that includes a plurality of supports and means for linking the plurality of supports. The plurality of supports are capable of moving apart from one another so that the expandable implant is in an expanded condition. A channel extends through the first vertebra from a pedicle or the body wall to the first endplate. An unexpanded diameter for the expandable implant is configured to permit passage of the expandable implant through the channel. An expanded diameter for the expandable implant is greater than the channel diameter at the first endplate. The support height is configured to permit the plurality of supports to be positioned between the first endplate and the second endplate. Methods for the use of the system are described.

Abstract: A flexible prosthetic cover shaped to form a replacement nucleus pulposis for an intervetebral disc with an aperture for the introduction of filling material therein, and an elongate introducer member configured to pass into the aperture is provided. The cover has a strengthened portion substantially opposite the aperture for engaging the distal end of the member, the strengthened portion and the distal end being arranged to interlock, for facilitating orientation of the cover, for example so as to prevent relative rotation there between.