Methods for altering the natural history of degenerative disc disease and osteoarthritis of the spine are proposed. The methods focus on the prevention, or delayed onset or progression of, subchondral defects such as bone marrow edema or bone marrow lesion, and subchondral treatment to prevent the progression of osteoarthritis or degenerative disc disease in the spine and thereby treat pain.

Coiled spinal implants for disc, vertebral body, and spinal motion segment replacement or reconstruction comprise a plurality of loops and spaces between the loops, with the loops formed of a hollow material and having a plurality of apertures or a longitudinal gap that extend(s) through the sidewalls of the loops and into the hollow center. The coiled implants include one or more balloons within the hollow center, the spaces between the coil loops, and/or within the central void that the coil surrounds. Filling the balloon expands the loops and thereby increases the height of the coil. Bone graft material or bone cement may be deployed from the apertures or gap.

An expandable implant is disclosed having an adjustable height for insertion between two adjacent bony structures or joint surfaces, for example between two adjacent spinal vertebrae. The implant includes at least one gear associated with at least one threaded shaft. Rotation of the gear engages the threaded shaft to expand the implant. The implant can be inserted in a collapsed configuration and expanded in situ. The invention also provides methods for using the implant to facilitate arthrodesis or fusion of adjacent joint surfaces or spinal vertebrae.

A thin-film covered stent device may include a thin-film mesh and a stent backbone covered by the thin-film mesh, thereby forming a dual-layer stent structure. The thin-film covered stent device may have smaller pores and a high pore density compared to conventional stents. For example, the thin-film covered stent device may have a slit length of between 50 and 250 micrometers and a pore density of between 134 and 227 pores per mm.sup.2. The thin-film covered stent device facilitates rapid healing of tissue defects such as those encountered during the endovascular treatment of an aneurysm.

An expandable anterior lumbar interbody fusion device comprises a deformable monolithic body having posterior and anterior ends, an upper bone contact structure and a lower bone contact structure. The body is expandable along a height axis between a first smaller height to a second larger height. The body comprises a pair of opposed side structures, each including a translatable center section being movable in a direction transverse to the height axis, a first locator arm adjacent the posterior end, a second locator arm adjacent the anterior end and a pair of formable load-bearing columns supported by the upper bone contact structure, the lower bone contact structure and the center section. The columns are not formed at the first height but are operative upon expansion of the body to the second height to form load-bearing columns along the height axis between the upper and lower bone contact structures.

An apparatus and method is provided for interbody fusion including distracting, in a given direction, and supporting opposing vertebral bodies. A plurality of wafers are consecutively inserted between the vertebral bodies to create a column of wafers. The column of wafers is oriented between the vertebral bodies so as to expand in the given direction as the wafers are consecutively added to the column.

A modular anchor bone fusion cage is provided. The cage includes a spacer configured to fit into a space between the faces of two bones that are to be fused together. A fusion plate having at least a main body portion is coupled to the spacer by a connector. Fasteners extend through the fusion plate to engage the bone. At least some of the fasteners also extend through the spacer to engage the opposed faces of the bone. A cover plate is coupled to the fusion plate to inhibit the fasteners from backing out prior to fusion of the bones.

A valve prosthesis assembly for implantation into a native valve site. The valve prosthesis assembly includes a valve prosthesis with a prosthetic valve component and a frame. The frame of the valve prosthesis includes a central portion supporting the prosthetic valve component, the central portion being configured to fit within an annulus of the native valve site, and an inflow portion configured to engage an upstream side of the annulus and restrict movement of the valve prosthesis in a downstream direction of blood flow at the native valve site. The valve prosthesis assembly also includes a separate support flange configured to be attached to the frame after the valve prosthesis has been deployed in situ and a plurality of anchors configured to attach the support flange to the frame and configured to embed into the annulus to anchor the frame of the valve prosthesis to the native valve. The plurality of anchors may be attached to the support flange or may be separate from or unattached to the support flange.

The invention encompasses devices and methods for treating one or more damaged, diseased, or traumatized intervertebral discs to reduce or eliminate associated back pain. Specifically, the invention encompasses intervertebral nucleus and annulus implants that are resistant to migration in and/or expulsion from an intervertebral disc space. The invention further encompasses kits including the implantable devices of the invention and associated delivery tools to treat annular and nuclear tissue.

Coiled spinal implants for disc, vertebral body, and spinal motion segment replacement or reconstruction comprise a plurality of loops and spaces between the loops, with the loops formed of a hollow material and having a plurality of apertures or a longitudinal gap that extend(s) through the sidewalls of the loops and into the hollow center. The coiled implants include one or more balloons within the hollow center, the spaces between the coil loops, and/or within the central void that the coil surrounds. Filling the balloon expands the loops and thereby increases the height of the coil. Bone graft material or bone cement may be deployed from the apertures or gap.