Devices used to hold a tissue access device, such as a bone cannula, at an access site are disclosed. The devices may be configured to hold the access device in a stable orientation while keeping the hand of a medical practitioner outside of an x-ray radiation field. The devices further include a patient contact member to facilitate orientation of the tissue access device.

A method of using a robotic guidance system for performing surgery on a spine is provided. The method includes utilizing a computerized tomographic scan image of a location on a spinal column of a patient, such that the computerized tomographic scan image is connected to a computer and visible on a monitor connected to the computer. The method also includes attaching a coupling component to the spinal column of the patient, coupling a marker to the coupling component, and imaging, with a fluoroscope, the view of the spinal column of the patient, wherein the fluoroscope image is transmitted to the computer and visible on the monitor and the at marker is clearly visible in the fluoroscope image. The method also includes positioning a cannula, with a robotic mechanism, to a first position relative to a vertebra in the spinal column of the patient, drilling a passage through the cannula into bone of the vertebra in the spinal column of the patient, inserting a guidewire through the cannula into the passage in the bone of the vertebra in the spinal column of the patient, and positioning a screw into the bone of the vertebra in the spinal column of the patient.

Devices and methods provide for measuring applied pressure on an article, such as a patella construct during a surgical procedure. Embodiments include a clamp having an upper frame arm, a lower frame arm and a clamp assembly, and further include a clamp with a knob assembly and a pressure monitor assembly. Differently sized bushing adapters can be interchangeably employed with a clamp stem to adapt to the relative sizes of objects being clamped.

The invention provides a system for the preshearing based control of the flow and deformation behavior, i.e., the setting kinetics, and the time dependent shear viscosity, elasticity of aqueous cementitious suspensions that can be used for bone repair and regeneration. The dynamic cement microstructure is tailored to the demands of the surgical tasks (faster/slower setting) or additive manufacturing tasks (lower/higher viscosity) by application of various preshearing conditions. The relationships between the preshearing and pressurization conditions and the setting kinetics and the time dependent changes in elasticity and viscosity are complex and characterization of viscoelastic properties using advanced rheological characterization techniques including small-amplitude oscillatory and steady torsional rheometry is needed a priori to enable such tailoring. The preshearing system is intended to give control on the injectability and setting time of any calcium phosphate cement formulation to the surgeon during an orthopedic surgery where a batch of bone cement is processed. Other possible utilizations of the system include controlling the setting kinetics, shear viscosity and facilitating the resultant flow stability of cementitious ceramic suspensions processed in direct ink writing assemblies for additive manufacturing of cement constructs, in injection systems for restoration and fracking.

A system for the amelioration of a recess (56) in a porous material, said system comprising an element (2) for coupling in mechanical energy, and a cylindrical collar (4, 40) having a central recess (44,45) for a guide pin (8), wherein the pin (8), having a cannulation (35), is provided to be inserted as far as the bottom of the recess (56) using a wire (52), wherein the pin (8) is surrounded by an amelioration sleeve (7), wherein the external cylindrical jacket surface of the sleeve (7) has substantially the same external diameter as the collar (4, 40), and wherein the pin (8) is received movably in the central recess (44,45) such that, when mechanical energy is applied, the collar (4,40) can be moved relative to the guide pin (8) in the direction toward the bottom of the recess (8) while liquefying and displacing the material of the sleeve (7).

A system for the amelioration of a recess (56) is disclosed, particularly of a recess in a porous, perforate material having cavities freed by the recess, said system comprising an element (2) for generating or coupling in mechanical energy, and a cylindrical collar (4, 40) having a central recess (44,45) for receiving a guide pin (8), wherein the guide pin (8), having a cannulation (35), is provided to be inserted substantially as far as the bottom of the recess (56) under positioning using a wire (52) before mechanical energy is applied, wherein the guide pin (8), in the area of the end thereof directed toward the bottom of the recess (56), is surrounded by an amelioration sleeve (7), wherein the external cylindrical jacket surface of the amelioration sleeve (7) has substantially the same external diameter as the collar (4, 40), and wherein the guide pin (8) is received movably in the central recess (44,45) such that, when mechanical energy is applied, the collar (4,40) can be moved relative to the guide pin (8) in the direction toward the bottom of the recess (8) while liquefying and laterally and/or longitudinally displacing the material of the amelioration sleeve (7).

The invention provides a system for the preshearing based control of the flow and deformation behavior, i.e., the setting kinetics, and the time dependent shear viscosity, elasticity of aqueous cementitious suspensions that can be used for bone repair and regeneration. The dynamic cement microstructure is tailored to the demands of the surgical tasks (faster/slower setting) or additive manufacturing tasks (lower/higher viscosity) by application of various preshearing conditions. Since the relationships between the preshearing and pressurization conditions and the setting kinetics and the time dependent changes in elasticity and viscosity are complex, a priori characterization of viscoelastic properties using the advanced rheological characterization technique of small-amplitude oscillatory rheometry is needed to enable such tailoring. The preshearing system is intended to give control on the injectability and setting time of any calcium phosphate cement formulation to the surgeon during an orthopedic surgery where a batch of bone cement is processed. Other possible utilizations of the system include controlling the setting kinetics, shear viscosity and facilitating the resultant flow stability of cementitious ceramic suspensions processed in direct ink writing assemblies for additive manufacturing of cement constructs, in injection systems for oil wells, restoration and fracking.

The risk of bone cement extravasation can be reduced by delivering a calcium-dependent polymerizing sealant into a bone structure prior to delivery of bone cement into that structure. The polymerization of the sealant in response to the calcium within the bone structure can fill cracks and any other potential cement leakage paths, thereby minimizing the potential for subsequent extravasation. The benefits of the use of a calcium-dependent polymerizing sealant can be provided in any procedure involving the use of bone cement, such as spinal fixation, vertebroplasty, and kyphoplasty, among others.

An orthopaedic prosthesis including a tibial tray is disclosed. The tibial tray includes a distal pocket and a plurality of inner pockets. Each inner pocket includes a channel sized to receive bone cement. The tibial tray includes distal-facing surfaces that have a surface roughness (Ra) equal to about 5.0 microns.

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.