Implants and methods for augmentation, preferably by minimally invasive procedures and means, of body tissue, including in some embodiments repositioning of body tissue, for example, bone and, preferably vertebrae are described. The implant may comprise one or more chain linked bodies inserted into the interior of body tissue. As linked bodies are inserted into body tissue, they may fill a central portion thereof and for example in bone can push against the inner sides of the cortical exterior surface layer, for example the end plates of a vertebral body, thereby providing structural support and tending to restore the body tissue to its original or desired treatment height. A bone cement or other filler can be added to further augment and stabilize the body tissue. The preferred implant comprises a single flexible monolithic chain formed of allograft cortical bone having a plurality of substantially non-flexible bodies connected by substantially flexible links.

Disclosed herein are expanding spinal fusion cage embodiments including an expandable cage assembly configured to expand from a collapsed state to an expanded state in an intervertebral space when inflated with a material. The assembly can include an inflatable section defining an interior volume configured to receive the material and expand the interior volume in response to a pressure from the received material to cause the expandable cage assembly to transition from the collapsed state to the expanded state, and a stabilization section configured to restrain the inflatable section during inflation.

An inflatable central distractor is inserted in to a disc space between two vertebral endplates. A perimeter balloon is inserted into the disc space in such a manner as to surround the central inflatable distractor. The perimeter balloon and the central inflatable distractor are simultaneously expanded such that as the central inflatable distractor expands the perimeter balloon surrounds the central inflatable distractor and such that the central inflatable distractor and the perimeter balloon, when expanded, contribute to forcing adjacent vertebral endplates apart.

According to some embodiments, a method of fusing a first vertebra to a second vertebra, said second vertebra being immediately adjacent and above the first vertebra, the method comprises creating a passage from a posterior end of a pedicle of the first vertebra through a superior endplate of the first vertebra, such that the passage extends into an intervertebral space located generally between the first and second vertebrae, removing native tissue located within the intervertebral space by advancing a tissue removal tool through the passage and selectively moving said tissue removal tool within the intervertebral space, and delivering an implant through the passage, wherein the implant is expandable and configured to promote fusion between the superior endplate of the first vertebra and an inferior endplate of the second vertebra.

A surgical implant fill system can include a fill tube and a tube twister. A flange of the fill tube can be keyed to the tube twister so that the fill tube does not rotate independent from the tube twister when the flange is engaged with the tube twister. A release mechanism secures the flanged end to the tube twister. Visual and tactile indications can be provided on the tube twister to show the direction of the dispensing end of the fill tube.

According to some embodiments, a method of accessing an intervertebral space of a patient's spine in a minimally invasive manner compromises creating a passage from a posterior end of a pedicle of a vertebral member using a probe, advancing the probe through the pedicle and to a main body portion of the vertebral member, advancing the probe through a superior endplate of the vertebral member and into the intervertebral space and enlarging the passage using at least one tap to create an enlarged passage from a posterior of the pedicle to the intervertebral space. In some embodiments, the enlarged passage traverses at least three cortical layers of the vertebral member.

A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. The fastener is provided with a groove that accommodates at least a portion of the fastening member to reduce the profile during the movement through the passage. The fastener is then pivoted to change its orientation. A second fastener can then be connected with the fastening member. While tension is maintained in the fastening member, the fasteners are secured against relative movement. This may be done by deforming the fastening member, either the first or second fasteners, or a bushing placed against the second fastener.

A device and method for a minimally invasive surgical implantation to reduce radicular symptoms by inserting an expandable cervical distraction implant in the facet joint and distracting the adjacent cervical vertebrae to increase the foraminal dimension. The implant, when positioned in the cervical facet joint, expands to via delivery of an inflation medium to increase the space between the vertebrae, thereby increasing the foraminal area or dimension, and reducing pressure on the nerves and blood vessels of the cervical spine.

Various embodiments of filling assemblies and methods are provided. The filling assembly can include a barrel and receiving block assembly configured to couple to a tube. The filling assembly can include a filling auger, wherein the filling auger is configured to rotate and translate to fill the tube with material. The method of filling a tube can include disposing flights of a filling auger within a barrel and receiving block assembly. The method can include coupling a tube to the barrel and receiving block assembly. The method can include rotating and translating flights of the filling auger within the barrel and receiving block assembly to fill the tube with material. The filling assemblies can be utilized for loading material into small diameter tubes, including small diameter tubes used for spinal

A balloon kyphoplasty surgical device including an extrusion tube having internal fluid channels and a support wire, a port arrangement positioned on a proximal end of the extrusion tube and a balloon arrangement positioned on a distal end of the extrusion tube, the balloon arrangement resulting in a cubic shape when inflated by the port arrangement.