An implantable cranial medical device includes a first fluid flow path, a second fluid flow path, and upper flange portion, and a lower portion. The upper flange portion is configured to rest on a skull of a subject about a burr hole. The lower portion is configured to be placed within the burr hole. The first fluid flow path may extend from a first opening in the upper flange portion to a first opening in the lower portion. The second fluid flow path may extend from a second opening in the upper flange portion to a second opening in the lower portion.

Neurosurgical apparatus has a guidance device having a guide tube and a neurosurgical instrument for insertion into the guide tube. The inner surface of the guide tube is arranged, for example profiled, to at least partially engage the outer surface of the neurosurgical instrument when inserted therein. The guide tube thus guides the neurosurgical instrument along a predefined path through the guide tube. At least one of the guidance device and the outer surface of the neurosurgical instrument are configured to provide a fluid return path for carrying any fluid displaced from within the guide tube during insertion of the neurosurgical instrument into the guide tube. A seal may also be provided for sealing the fluid return path.

Anchors for securing a medical device relative to a body portal, wherein the anchors may accommodate most any implantation trajectory through the portal. Such anchors may further secure the device along any such trajectory without imparting undesirable biasing forces that may shift the device from its intended implanted location. In some embodiments, the anchor is configured as a burr hole anchor including a spherical member contained in a socket of the anchor such that orientation of the spherical member is permitted about three mutually perpendicular axes.

A neurosurgical apparatus includes a guide device and a neurosurgical instrument is disclosed. The guide device includes a tube for insertion into the brain and a head attached to the proximal end of the tube for affixing the guide device to a hole formed in the skull. The head has a passageway therethrough in communication with the bore of the tube such that the bore of the tube and the passageway through the head define an internal channel through which a neurosurgical instrument can be passed into the brain of the subject. The neurosurgical instrument is for insertion to a desired brain target through the internal channel of the guide device. The apparatus includes one or more sealing elements for providing a fluid tight seal between the internal channel of the guide device and the exterior of the neurosurgical instrument to prevent fluid leakage from guide tube.

An intracranial prosthesis comprised of a flat body having an interior ultrasound-compatible window and means about the outer portion capable of engaging a plurality of diagnostic instruments and/or intracranial delivery systems so that a practicing medical professional can monitor certain parameters of a patient or deliver therapeutic agents to the patient while using an ultrasound-monitoring device to image the patient's brain. The prosthesis is designed to allow for the continuous, uninterrupted, simultaneous monitoring of a number of parameters of a patient's brain at the patient's bedside.

Provided herein are magnetic resonance imaging (MRI) compatible, convection-enhanced delivery (CED) cranial implant devices and related methods for performing a wide array of therapeutic and/or monitoring applications. In one aspect, the cranial implant device includes a cranial implant housing configured for intercranial implantation in a cranial opening of a subject. The cranial implant housing comprises a substantially anatomically-compatible shape, at least first and second surfaces, and at least one fluidic circuit comprising at least one cavity and at least one port that fluidly communicates with the cavity through at least the second surface, in which the cavity comprises, or is capable of comprising, at least one fluidic therapeutic agent. The device also includes at least one CED pump operably connected to the fluidic circuit, which CED pump is configured to convey the fluidic therapeutic agent from the cavity through at least one fluid conduit when the fluid conduit is operably connected to the port to maintain at least one positive pressure gradient of the fluidic therapeutic agent at least proximal to an outlet of the fluid conduit. In addition, the device also includes at least one power source operably connected at least to the CED pump. The cranial implant housing, the CED pump, and the power source are typically fabricated from one or more MRI compatible materials. Other aspects relate to various methods of treating a neurologically-related disease using the cranial implant devices, methods of monitoring therapeutic agent administration in a plurality of subjects, and methods of fabricating a cranial implant device as well as surgical methods.

An intraosseous access system can include a hub coupled to a cannula that can be introduced into a bone of a patient. The system further includes a securement device that can couple with the hub when transitioned from an open orientation to a closed orientation. The securement device includes a first segment and a second segment that are spaced apart from each other when the securement device is in the open orientation and are approximated and secured to each other when the securement device is in the closed orientation. The first segment includes a first receptacle that receives a portion of the hub therein and contacts the hub to restrain movement of the hub relative to the securement device when the securement device is coupled with the hub in the closed orientation. The first segment also includes a first arm coupled to the first receptacle, the first arm biasing the first receptacle toward the hub when the securement device is coupled with the hub in the closed orientation.

A surgical access assembly and method of use is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath and obturator are configured to be delivered to an area of interest within the brain. Either the outer sheath or the obturator may be configured to operate with a navigational system to track the location of either within the brain. Once positioned at a desired location, the obturator is removed, leaving a distal end of the outer sheath adjacent an area of interest, and creating a working corridor. Interrogation of the area of interest may be performed to evaluate a disorder and/or abnormality, as well as evaluate treatment regimes. Interventional devices may also be introduced to the area of interest, as well as a variety of treatments.

An implantable device includes a low-profile housing having a cavity defined in a side thereof, and an element insertably removable with respect to the housing in a direction substantially parallel to a surgical plane of the implantable device. The element has a first portion adapted to be received in the housing cavity. The element further includes a second portion adapted to protrude from the housing upon insertion of the element into the housing cavity. The second portion includes at least one surface adapted for engagement with a surgical instrument for insertion and removal of the element with respect to the housing. A method for servicing the implantable device includes, at an incision proximate an implant location of the implantable device, insertably and removably accessing the element in a direction substantially parallel to a surgical plane of the implantable device.

A femoral hip joint spacer. The spacer has a prosthesis body with a ball head, a neck, a stem and an anchoring sleeve which encloses the stem on a proximal side of the stem with a circumferential fastening area, irrigation liquid inlet and outlet openings in the body surface, at least one irrigation liquid discharge opening on a distal side of the stem and at least one irrigation liquid intake opening on the ball head or on the neck. The discharge opening is connected in a liquid-permeable manner to the inlet opening but not to the outlet opening and the intake opening is connected inside the prosthesis body in a liquid-permeable manner to the outlet opening but not to the inlet opening. A cavity open on two sides is formed inside the anchoring sleeve and connects a proximal side to a distal side of the sleeve in a liquid-permeable manner.