The present invention provides a spinal implant structure. The spinal implant structure comprises a first part, a second part and at least one expansion arm. The second part is disposed on the horizontal orientation of the first part and does not overlap with the first part. The diameter of the first part is larger than that of the second part. One end of the expansion arm is connected to the first part, and the other end of the expansion arm is free end. The expansion arm includes a supporting arm. One end of the supporting arm is connected to the expansion arm, and the other end is connected the second part. The support arm includes a plurality of structure weakness. When the distance between the first part and the second part changes, the support arm bends from the structure weakness, thereby the spinal implant structure is expanded.

Methods of filling bone cavities are provided. The methods use a bone cement mixing and delivery device that includes a shaft extending along an axis from a first end to a second end and including a passageway. The first end includes an adapter having a first opening that is in communication with the passageway. The second end includes a second opening that is in communication with the passageway. The shaft includes a mixing portion between the first and second ends. A connector includes a central portion that that is coupled to the adapter. The central portion includes a channel that is in communication with the first opening. The connector includes first and second ports that extend from the central portion. The first port includes a first lumen that is in communication with the channel. The second port includes a second lumen that is in communication with the channel.

A bone cement mixing and delivery device includes a shaft extending along an axis from a first end to a second end and including a passageway. The first end includes an adapter having a first opening that is in communication with the passageway. The second end includes a second opening that is in communication with the passageway. The shaft includes a mixing portion between the first and second ends. A connector includes a central portion that that is coupled to the adapter. The central portion includes a channel that is in communication with the first opening. The connector includes first and second ports that extend from the central portion. The first port includes a first lumen that is in communication with the channel The second port includes a second lumen that is in communication with the channel. Methods of use are disclosed.

A combination of an implant (100) like a bone screw together with an augmentation sleeve (200) is suggested. The bone screw may comprise a trailing end portion with a plurality of lateral bores (120). The augmentation sleeve may comprise a leading end portion which is adapted to be coupled to the trailing end portion of the bone screw, and a lateral opening (220) at the leading end. The augmentation sleeve may be adapted to guide an augmentation tool to the trailing end portion of the bone screw and to the leading end portion of the augmentation sleeve so that the trailing end portion of the bone screw may be augmented by pressing augmentation material through the plurality of lateral bores at the trailing end portion of the bone screw and further through the lateral opening of the augmentation sleeve into the bone at the trailing end of the bone screw, or other implant. After the augmentation of the trailing end portion of the bone screw, the augmentation sleeve may be removed.

The embodiments provide provides devices, instruments, and associated methods for treating joint pain. A joint is evaluated using magnetic resonance imaging to detect any defects in the subchondral bone. For example, using T2-weighted MRI images, bone marrow lesions or edemas can be identified, and using T1-weighted MRI images, associated regions of sclerotic bone adjacent to the bone marrow lesion can be identified. The treatment method may involve introducing a bone void filler material at the site to address the bone marrow lesion or edema, and/or drilling and inserting an implant to address the sclerotic bone, bone marrow lesion or edema, and insufficiency or stress fractures. An access path is mapped to a location in the subchondral region where the insufficiency fracture resides. The access path attempts to preserve an articular surface of the joint. A reinforcing member that stabilizes the insufficiency fracture is then implanted via the access path.

A surgical instrument includes a first member defining an axis and including an end surface and a passageway. A second member is movably disposed within the passageway and includes a tip and a plurality of spaced apart markings. The second member is movable between a first configuration in which the tip extends parallel to the axis and a second configuration in which the tip extends transverse to the axis. The end surface is aligned with a first one of the markings when the second member is in the first configuration and the end surface is aligned with a second one of the markings when the second member is in the second configuration. Methods are disclosed.

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.

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.

In a bone cement mixing and delivery device, a plug can be removably disposable in an injection passage of a cylindrical container. A mixing screw can rotate in a chamber of the container and has a screw thread extending along an outer surface of the mixing screw as well as a return passage extending through the mixing screw from the proximal end to the distal end thereof. In a mixing mode of the device, a mixing rod engages and rotates the mixing screw about a longitudinal axis of the cylindrical container causing material disposed in the chamber to be moved distally and return to the proximal end of the chamber through the return passage of the mixing screw. In an injection mode of the device, the plug can be removed from the injection passage and an injection rod occludes the return passage of the mixing screw.

The embodiments provide devices and methods that both strengthen the bone and stimulate the bone. Bone fractures or non-unions are stabilized, integrated or healed, which results in reduction of a bone defect, such as a bone marrow lesion or edema. In addition, the distribution of forces in a joint are restored or altered to relieve pain. In general, a joint is evaluated by taking an image of the joint and one or more subchondral defects are detected. At least one of the subchondral defects may be diagnosed as the source of pain and an extent of treatment for the subchondral defect is determined. The disclosed devices and techniques are particularly suited for treating chronic defects or injuries, where the patient's natural healing response has not resolved the defect. The present disclosure also provides several exemplary treatment modalities for the different extents of treatment needed.