Abstract: The present application generally relates to orthopedic systems, and in particular, to systems including independent plates and spacers. A plating system can include a spacer and a plate that is independent from the spacer. A number of locking mechanisms can be provided to secure the plate to the spacer. In some cases, the spacer includes a pair of notches that extend on an outer surface of the spacer. The plate can include a pair of lateral extensions that can engage the notches to secure the plate to the spacer. In other cases, the spacer includes an opening including a pair of inlets. The plate can include an enclosed posterior extension that can be received in the pair of inlets to secure the plate to the spacer.

Abstract: Embodiments of apparatus, systems, and methods relating to spinal implants. In some embodiments, the spinal implant may comprise a first sidewall, a second sidewall opposite from the first sidewall, a pair of opposed frictional surfaces each comprising a plurality of raised structures, a first end wall joining the pair of opposed sidewall surfaces, and a second end wall joining the first sidewall and the second sidewall. The second end wall may comprise a recess formed by a first wall portion and a second wall portion arranged at an angle to one another to form a fish-tailed structure configured to be engaged with an inserter instrument. The interface between the recess and the inserter instrument may be configured to at least substantially eliminate any point or line contacts between the inserter instrument and the spinal implant during a flip maneuver of the spinal implant within an intervertebral space of a patient.

Abstract: A device for treatment of spondylotic disease includes a distractor for distracting vertebral facets of first and second vertebrae located adjacent each other. The distractor includes a first abutment surface for interfacing with an inferior articular facet of the first vertebra. The distractor also includes a second abutment surface for interfacing with the superior articular facet of the second vertebra corresponding to the inferior articular facet of the first vertebra. The first and second abutment surfaces of the distractor engage with each other and are separated by a predetermined distance.

Abstract: A medical device (10) includes an implant body (20) with a number of segments (30) hingedly interconnected so as to assume a straightened state for delivery and a flexed or roughly curved deployed state. Implant body may have engagement elements on at least two different segments, for example on a majority of segments. An elongated locking element anchored at the distal segment of the implant body may have projections for at least each engagement element. Tension applied to the locking element biases the implant body from the straightened state to the flexed deployed state. When the locking element is deflected to reach the curved deployed state, flexing segments of the implant body lock by matching engagement elements of the implant body with projections of the locking element. A very secure lock may be formed to prevent opening after deployment.

Abstract: A two part annulus repair rivet for repairing a defect in the annulus of an intervertebral disc includes a first part delivered through a port and adapted to be positioned at an internal surface of an annulus adjacent a defect and a second part adapted to be positioned on an external surface of the annulus adjacent the defect. The first and second parts are secured together, repairing the defect.

Abstract: The present invention provides a novel way to replenish the disc using retooled disc compositions to repair degenerative discs. There is no better source of proteoglycans than the actual disc material (6) itself. To this end, there has been developed a technique to remove the nucleus pulposus and retool the morphology of the nucleus pulposus to create a powder material (10) that is dry and can be stored at room temperature for long periods of time. This powder (10) can then be reconstituted with a variety of fluids, the most suitable being normal saline or lactated ringers to form a flowable mixture (20).

Abstract: In various exemplary embodiments, the present invention provides devices, implants, and methods for distracting and/or stabilizing a facet joint of the spine of a patient or other similar joint or bony structures, optionally including modifying the facet joint and implanting an implant in the facet joint so as to distract the foramen in order to reduce compression on nerve roots.

Abstract: The present invention involves a system and methods for assembling and implanting a vertebral body implant. The vertebral body implant includes, but is not necessarily limited to, an expandable core body and endplates that can be attached at both ends. Endplates of various shapes, sizes and angles are attachable to the expandable core so that a suitable vertebral body implant can be implanted between vertebrae.

Abstract: The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectably detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area. In one embodiment, the integrated fusion cage is an expandable integrated fusion cage.

Abstract: A protective cover prevents undesired leakage of materials out of a spinal implant. In one embodiment, the implant is a lateral interbody fusion implant that accommodates biologically active material to promote bone ingrowth. The protective cover prevents unintended migration of the biologically active material out of the implant and into surrounding tissue.

Abstract: A radially expandable spinal interbody device for implantation between adjacent vertebrae of a spine is deliverable to an implant area in a radially collapsed state having minimum radial dimensions and once positioned is then radially expandable through and up to maximum radial dimensions. The expanded radially expandable spinal interbody device is configured to closely mimic the anatomical configuration of a vertebral face. The radially expandable spinal interbody device is formed of arced, pivoting linkages that allow transfiguration from the radially collapsed minimum radial dimensions through and up to the radially expanded maximum radial dimensions once deployed at the implant site (i.e. between adjacent vertebrae). The pivoting linkages have ends with locking features that inhibit or prevent overextension of the linkages.

Abstract: An implant device is provided for implantation within an intervertebral space between adjacent vertebrae comprising an implant body, a rotatable portion and a piercing portion configured to pierce the adjacent vertebra.

Abstract: In one embodiment, a medical device includes a tissue anchor, and elongate member, a first needle, and a second needle. The tissue anchor has a first arm portion, a second arm portion, and a base portion extending between the first arm portion and the second arm portion. The first needle extends from the elongate member. The first needle defines a lumen configured to receive the anchor member of the first arm portion of the tissue anchor. The second needle extends from the elongate member. The second needle defines a lumen configured to receive the anchor member of the second arm portion of the tissue anchor.

Abstract: An expandable spinal implant configured for positioning within a space between adjacent vertebral bodies includes an upper body, a lower body, a ratchet mechanism, and a plurality of bone screws. The upper body and lower body are pivotably affixed at a first end and are capable of movement relative to each other. The ratchet mechanism is slidably disposed on one of the upper and lower body and is capable of engaging the opposite one of the upper and lower body thereby permitting movement of the upper and lower body relative to each other in a first direction, but not in a second direction. An insertion instrument capable of being attached to the expandable spinal instrument and a method of performing spinal surgery is also disclosed.

Abstract: An artificial functional spinal unit including an expandable intervertebral implant that can be inserted via a posterior surgical approach and used with one or more facet replacement devices to provide an anatomically correct range of motion is described. Lordotic and non-lordotic expandable, articulating implants and cages are described, along with embodiments of facet replacement devices and instruments for insertion. Methods of insertion are also described.

Abstract: The subject disclosure are directed to systems, apparatuses, devices and methods for vertebral and spinal correction. In some embodiments, an expansible implant is provided which may be inserted between two vertebrae, for instance, for maintenance and/or restoration of the distance/space between vertebrae. The implant may include first and second opposed plates that are intended to move away from one another, and which engage portions of vertebrae via a recess provided for on a bearing surface of the plates. The implant may additionally include at least first and second opposed end members, where at least one of the end members includes an aperture configured for receiving at least a portion of a retaining element adapted for retaining the implant in an expanded configuration once the implant is expanded. Methods of treatment and methods of use of such implants for the alleviation of back pain (for example) are also provided herein.

Abstract: A sacroiliac (“SI”) joint fastener apparatus, systems, and methods of using the device is described. The SI joint fastener apparatus can include a distal segment, a proximal segment, and an expandable portion. The expandable portion can be expanded by reducing the distance between the distal and proximal segments. The SI joint fastener apparatus can be used to fuse two bone portions together. The method can include steps of coupling the fastener apparatus to two bone portions, reducing the distance between the two bone portions to place the portions in compression, and applying an outwardly directed force proximate the location to be fused.

Abstract: An expandable spinal implant configured for positioning within the intervertebral space between adjacent vertebral bodies is disclosed. The spinal implant includes a first body, a second body, a ratchet, and a locking mechanism. The first and second bodies are pivotably affixed to each other on respective first ends thereof and are capable of movement relative to each other in a medial-lateral direction with respect to the adjacent vertebral bodies. The ratchet is pivotably supported within a slot defined in the first body and is capable of engaging the second body thereby permitting movement of the first and second body relative to each other in a first direction, but not in a second direction that is different than the first direction. A method of performing spinal surgery is also disclosed.

Abstract: In an exemplary embodiment, the present invention discloses interspinous process spacers that can be placed between adjacent spinous processes for minimally invasive surgical treatment of a spinal disease or defect. In particular, the present invention, in one embodiment, discloses an interspinous process spacer having a distraction end, a central support portion, and a trailing end. Also disclosed in the present invention are systems and kits including such implants, methods of inserting such implants, and methods of alleviating pain or discomfort associated with a spinal column disease or defect.

Abstract: Systems, methods and devices for providing stabilization between first and second vertebrae are provided. More particularly, in one form a system includes an implant configured to be positioned in a disc space between the first and second vertebrae and a freestanding plate for engagement with extradiscal surfaces of the first and second vertebrae. The system also includes an insertion instrument with an engaging portion configured to releasably engage with the implant and the plate such that the implant and plate can be positioned together relative to the first and second vertebrae. In one aspect, an angular orientation of the implant relative to the plate is adjustable when the implant and the plate are engaged by the instrument. In this or another aspect, the implant and plate are held in a contiguous relationship when engaged by the instrument. However, different forms and applications are also envisioned.

Abstract: An nucleus prosthesis is disclosed having a plurality of linked segments configured to form, in a closed position, a disc shape. A method includes inserting a plurality of linked segments into an annulus fibrosus and closing the prosthesis so that a first segment inserted into the annulus fibrosus and a last segment inserted into the annulus fibrosus are substantially abutted. Another method includes inserting a plurality of linked segments into an intervertebral disc space and closing the prosthesis so that a first segment inserted into the intervertebral disc space and a last segment inserted into the intervertebral disc space are substantially abutted.

Abstract: A method and a device for anchoring a suture to an object includes a shuttle and a pin made of a material which can be liquefied by means of ultrasonic vibrations. A suture is attached to a rear end of the pin. The shuttle has a shuttle body, a shuttle arm and a suture reception, wherein the shuttle arm is suitable for releasably holding the pin in a predetermined position relative to the shuttle body such that the pin can be reliably introduced into a hole in an object.

Abstract: An intervertebral fusion implant comprises a body defining a longitudinal axis and extending between a first end and a second end. The body defines a first wall configured for engaging a first vertebral surface and a second wall configured for engaging a second vertebral surface. The first wall is connected to the second wall. The first wall is movable relative to the second wall such that the body is deformable from a first, initial implanted configuration such that the body is disposed between the first vertebral surface and the second vertebral surface for fixation thereof and a second configuration such that the body is deformed relative to the first configuration to adapt to an orientation of the first vertebral surface and the second vertebral surface. Methods of use are disclosed.

Abstract: A lead anchor including a body having a first end and a second end opposite to the first end is disclosed. The body defines a lead lumen extending from the first to the second end and can receive a lead. The lead anchor also includes a fastening mechanism disposed in the body and in communication with the lead lumen. The fastening mechanism can fasten the received lead to the lead anchor when actuated by a user. The lead anchor also includes tabs(s) extending from the body and tags. Each tag includes an anchor attachment element and a cylindrical implantation element coupled to the anchor attachment element. The anchor attachment element is affixed to one of the tabs. The cylindrical implantation element anchors the lead anchor into patient tissue by insertion of the implantation element into the patient tissue using a needle insertion tool.

Abstract: An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.

Abstract: Systems and methods for reducing pressure within a spinal disc are described. In accordance with one implementation, a spinal disc system comprises an aperture within a spinal disc body, and the aperture is configured to permit nucleus pulposus to flow from the disc body through the aperture. In accordance with another implementation, a method of reducing pressure within a spinal disc comprises forming an aperture within a spinal disc body, and permitting at least a portion of the nucleus pulposus to flow from the disc body through the aperture.

Abstract: Methods for forming an insert, such as a threaded or threadable insert, within a cavity in an implant, such as a spinal spacer. In some implementations, an implant body comprising a first, non-threadable, may be provided. A cavity may be formed in the implant body, after which an insert may be positioned within the cavity. Preferably, the insert comprises a second material distinct from the first material, wherein the second material has physical properties distinct from the first material. A female thread may then be formed within the insert, which may allow for threading an otherwise unthreadable, or relatively unthreadable, material.

Abstract: An intervertebral implant includes a first surface configured to engage a first vertebral body, a second surface configured to engage a second vertebral body, a side wall connecting the first surface and the second surface to define a hollow space of the implant, and a rotatable insert configured to be positioned in the space, wherein an elongate opening extends through the side wall into the space, and wherein the insert comprises a spring portion configured to hold the insert in the space by frictional engagement with the side wall and an engagement portion configured to engage with a tool through the opening when the insert is positioned in the space.

Abstract: In some embodiments, system and/or method may include an intervertebral implant for a human spine including an upper body, a lower body, first and second expansion members, and an expansion mechanism. A superior surface of the upper body may function to engage a first vertebra of the human spine. An inferior surface of the lower body may function to engage a second vertebra of the human spine. The first expansion member may include at least a first angled portion positionable, during use, between the upper body and the lower body. The second expansion member may include at least a second angled portion positionable, during use, between the upper body and the lower body. An expansion mechanism may convey, during use, the first and second angled portions in opposing directions increasing a separation distance between the upper body and the lower body.

Abstract: Flexible spinal stabilization apparatuses are provided. The apparatuses include a flexible support element configured to be attached to a first vertebra and a second vertebra. The apparatuses also include a bone growth promoter coupled to the flexible support element. The flexible support element spans one or more intervertebral spaces but the bone growth promoter does not.

Abstract: Methods, surgical tools and a surgical system for performing spinal fixation using a lateral trans-psoas approach through a vertebral body into the disc space between that vertebral body and an adjacent vertebral body are provided. The approach, tools and system are adapted for use in fixing the L-5 and S-1 vertebral bodies. It should be understood that the methods and tools described can also be used for disc fusion where insertion proceeds from an inferior vertebral body to a superior vertebral body, and also cases where the fusion occurs across multiple disc spaces fusing more than two vertebrae.

Abstract: The disclosure provides a device to facilitate the insertion and attachment of an implant that includes a barrel assembly and a plate assembly in an interspinous space. The device comprises a main body, a first arm that is configured to hold the barrel assembly, and a second arm that is configured to hold a locking plate of the plate assembly, wherein the first and second arms are movably attached to the main body.

Abstract: This invention provides an isolated disc stem cell population, compositions, and methods of obtaining and growing the same. Moreover, this invention provides an isolated discosphere, compositions, and methods of obtaining and growing the same. An artificial disc containing the cells of the present invention is provided together with methods of making the same. This invention also provides a method of treating a subject having a herniated disc utilizing the cells and methods of the invention.

Abstract: In various embodiments, an intervertebral disc prosthesis is provided. The prosthesis may be provided with an insertion adapter, such as a head, holder, or other carrier of the prosthesis. The insertion adapter may be configured to retain the prosthesis and to engage an insertion tool body. In various embodiments, the prosthesis and the insertion holder are provided in a sterile pack, with the prosthesis components and the insertion holder sterilized and packaged in one or more types or layers of sterile packaging. In various other embodiments, the prosthesis and an insertion tool are provided in a sterile pack, with the prosthesis components and the insertion tool sterilized and packaged in one or more types or layers of sterile packaging.

Abstract: The use of red or near infrared light upon neurons of the lumbar plexus that are in distress due to retraction-induced ischemia. The surgeon may protect nerves made ischemic in the surgery by: a) making an incision in a patient, b) inserting an access device into the patient through the incision to at least partially create a path to a spine of the patient, and c) irradiating nervous tissue adjacent the path with an amount of NIR or red light effective to provide neuroprotection.

Abstract: Methods and apparatus are disclosed for distracting tissue. The devices and methods may include insertion of first and second elongated members into the space between two tissue layers, with an augmenting elongated member inserted therebetween to form a distraction device between the tissues to be distracted. The distraction device defines a generally annular configuration, with a locking member secured to one of the elongated members at a plurality of locations to maintain the distraction device in the generally annular configuration. The augmenting elongated member may be shorter than the first and second elongated members such that a window is defined between the proximal and distal ends of the augmenting elongated member when the distraction device and the first and second elongated members are in the generally annular configuration. Bone graft material or bone filler may be introduced into the interior of the distraction device through the window.

Abstract: A spinal implant comprises a first member including a wall that defines a first cavity and a second member including a wall defining a second cavity. At least one first expandable bone graft is disposable within the second cavity. The second member is axially translatable relative to the first member between a first configuration and a second, expanded configuration such that at least a portion of the at least one first graft is disposed within the first cavity and the first cavity includes a substantially void portion. At least one second bone graft has a selective configuration and dimension for disposal within the substantially void portion. Systems and methods are disclosed.

Abstract: Improved methods and apparatuses for vertebral body distraction and fusion in accordance with various embodiments of the present invention employ one or more coaxial screw gear sleeve mechanisms. In various embodiments, coaxial screw gear sleeve mechanisms include a post with a threaded exterior surface and a corresponding sleeve configured to surround the post, the corresponding sleeve having a threaded interior surface configured to interface with the threaded exterior surface of the post and a geared exterior surface. A drive mechanism can be configured to interface with the geared exterior surface of the sleeve, causing the device to distract.

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 medical device includes a base ring configured to be implanted within a body of a patient. The base ring provides a contact surface to a vertebrae. Multiple layers of multiple leveling plates are configured to equalize forces applied to the contact surface of the base ring, where at least one of the layers of the leveling plates engages an inner surface of the base ring. A layer of multiple pads is included with a top surface of the pads configured to maintain a parallel plane and a bottom surface of each of the multiple pads is configured to engage a top surface of one of the layers of the leveling plates. A cover is configured to enclose the multiple layers of the leveling plates, the layer of the multiple pads and the base ring. The cover provides a contact surface to a vertebrae.

Abstract: An intervertebral implant is configured to be fixed in an intervertebral space defined by a first vertebral body and a second vertebral body. The intervertebral implant includes an implant body sized to be inserted into an intervertebral space, and a fixation assembly configured to be attached to the implant body. The fixation assembly includes a housing that defines a first vertebral body facing surface and a second vertebral body facing surface spaced from the first vertebral body facing surface along a transverse direction. The fixation assembly further includes at least one fixation member supported by the housing and movable from a retracted position to an extended position, whereby in the extended position the fixation member extends out from the housing and into one of the vertebral bodies.

Abstract: A method is disclosed for introducing a spinal disc implant into an intervertebral space of a subject. The subject is placed in a lateral position, and the anterior face of the spinal disc intervertebral space is accessed, between the L5 and S1 vertebrae, from an anterior and lateral retroperitoneal approach. An operative corridor to the anterior face of the spinal disc space is established by introducing a retractor instrument anterolaterally to the spinal disc space between the anterior superior iliac spine and the anterior inferior iliac spine. The damaged spinal disc contents are removed from the intervertebral space through the operative corridor, and the implant is advanced into the intervertebral space at an oblique angle and pivoted to position the implant substantially laterally within the intervertebral space. Elongated retractor and insertion instruments, as well as a modified disc implant, are also disclosed for carrying out the method.

Abstract: A system for performing interbody fusion surgery including an expandable intervertebral spacer and specialized instruments for choosing the correct size of implant, implanting the device within the intervertebral space, and for delivery of bone graft or bone substitute to the interior of the implant.

Abstract: An enhanced artificial disk for stabilizing a pair of adjacent vertebrae. The enhanced artificial disk include a disk and a stabilizer. The stabilizer includes a substantially keyhole shaped opening for receiving a protrusion. By facilitating movement of the protrusion within the opening, the enhanced artificial disk is capable of exhibiting a normal range of motion associated with a healthy disk while limiting any abnormal range of motion.

Abstract: A cage for facilitating fusion of bones, such as vertebrae, or fusion of adjacent bone surfaces is disclosed. In one form, the cage includes a plurality of spaced apart walls comprising a biodegradable polymeric material (e.g., polycaprolactone); an osteoconductive mineral coating (e.g., a calcium compound) on at least a portion of the walls; and a bioactive agent (e.g., a bone morphogenetic protein) associated with the polymeric material and/or the coating. The bioactive agent is present in amount that induces ossification between the bones or adjacent bone surfaces. The cage may also include a fixation plate connected to at least one of the walls.

Abstract: An expandable spinal prosthesis is disclosed, including a first surface having a first plurality of tissue anchors; a second surface opposite the first surface, the second surface having a second plurality of tissue anchors; a first wall between the first and second surfaces, and a second wall between the first and second surfaces, the second wall located opposite the first wall and being movable with respect to the first wall. A surgical instrument is also provided, including an elongated shaft defining a proximal end and a distal end; a first prosthesis engagement element accessible from the proximal end and extending from the distal end; and a second prosthesis engagement element accessible from the proximal end and extending from the distal end, the second prosthesis engagement element including a plurality of gear teeth.

Abstract: Implantable devices for the surgical treatment of bone, and particularly to a bone defect at a joint region, and even more particularly at the subchondral bone level of the joint region, are disclosed. The implantable devices may be formed of a bone material, and configured to serve the dual functions of providing mechanical strength and structural integrity to the area to be treated, while also facilitating the dispersal of a flowable material in the same area. Associated delivery tools are also provided.

Abstract: A composite interbody vertebral implant for facilitating fusion of adjacent vertebrae. The implant includes a first endplate of a porous metal material and a second endplate of a porous metal material which are configured to allow bone in-growth. The implant also includes a polymeric body positioned between and bonded to the first and second endplates such that polymeric material of the polymeric body is impregnated into pores of the first and second endplates to bond the components together. The implant may include a cavity extending through the composite implant configured to receive bone growth material to facilitate fusion between a first vertebra and a second vertebra.

Abstract: A method (and the resulting product) of making a medical implant device for releasing self-contained drugs on a controlled basis wherein the method utilizes, at least in part, computer-controlled 3-D printing equipment to deposit via nozzles portions of one or more layers of the medical implant product. The implant has an outer impervious coating, an inner matrix core, an opening and an optional bonding layer.

Abstract: Spinal plates with additional features to improve the stability of the interface between the plate and the underlying bone. A bone plate may include one or more sharp ridges along the periphery of its underside. When attached to bone, the ridge digs into the bone and increases stability. A bone plate may alternatively or additionally include one or more holes for optional spikes, which may be inserted once the plate is attached to the bone. By separating the spikes and including them as an optional component, the plate may enhance stability while reducing or eliminating the chance of the spike injuring the patient. Furthermore, bone screws may incorporate alternating notches and ridges into the head of the screw. The notches and ridges may interface with a set screw, thereby preventing rotation and loosening of the screw.