A kit for preparing an intervertebral disc space for receiving an implant (100) includes a plurality of trials (152) having different sizes. Each trial (152) includes a body (154) insertible into an intervertebral disc space, the body (154) having a leading end (162), a trailing end (164), a top surface (156) and a bottom surface (160), the top surface of the body having a first groove (176) formed therein. Each implant also includes a flange (166) secured to the trailing end (164) of the body (154), the flange (166) having a first channel (180) aligned with the first groove (176), wherein each of the different sized trials has a different flange thickness. The flange thickness controls advancement of a cutting tool such as a chisel (192) into the first groove at the top surface of the trial body, which controls the depth of the cut into vertebral bone.

The guidance and positioning device may be a system for creating a passage in tissue, positioning fasteners or other implants, and tensioning an elongated fastening member, like a suture, thread, wire, or pin. In some embodiments, the device may allow for the implantation of multiple sutures and fasteners in tissue. A fastener may be positioned at the distal end of a flexible pushrod. The fastener may be connected with the pushrod or may be loosely fitted with the distal end of the pushrod. A suture may be looped through or connected with the fastener such that one, two, or more sections, legs, strands, or portions of the suture extend from the fastener.

Embodiments of the invention relate generally to tissue anchors and methods of delivering same to the intervertebral disc or other sites within the body. In some embodiments, the anchors provide pull-out resistance, stability and/or maximize contact with tissue involving a minimum amount of penetration. In some embodiments, delivery methods are minimally invasive and include linear, lateral, and off-angle implantation or driving of anchors along, against or within tissue surfaces.

A kit for preparing an intervertebral disc space for receiving an implant (100) includes a plurality of trials (152) having different sizes. Each trial (152) includes a body (154) insertible into an intervertebral disc space, the body (154) having a leading end (162), a trailing end (164), a top surface (156) and a bottom surface (160), the top surface of the body having a first groove (176) formed therein. Each implant also includes a flange (166) secured to the trailing end (164) of the body (154), the flange (166) having a first channel (180) aligned with the first groove (176), wherein each of the different sized trials has a different flange thickness. The flange thickness controls advancement of a cutting tool such as a chisel (192) into the first groove at the top surface of the trial body, which controls the depth of the cut into vertebral bone.

Dural repair devices that are configured to effectively and reliably repair the damage of a dural tear due to incidental durotomies are provided, along with methods of use. The devices and methods enhance the ability of a surgeon to repair a patent's dura mater, or dura, during surgery of the central nervous system. The dural repair device has a multi-layer structure configured to exert a pressure or tamponade effect to compress a patient's dura to its state prior to the spinal surgery. Thus, the dural repair devices and methods of use may reduce the patient's risk morbidity, further surgery, spinal headaches, or other injuries and discomforts.

An intervertebral implant is configured to be implanted in an intervertebral space in a first initial configuration. Subsequently, an actuator is configured to be driven in an actuation direction such that the actuator urges the implant to expand along a first expansion direction. Once the implant has been fully expanded along the first expansion direction, the actuator is configured to be further driven in the actuation direction so as to expand the implant in a second expansion direction that is perpendicular to the first expansion direction.

A prosthetic intervertebral disc joint assembly for replacing at least a portion of an intervertebral disc between first and second adjacent vertebrae comprising: a first component 20, 120 for engaging a first vertebra, the first component having an intervertebral portion 20a, 120a insertable between adjacent vertebrae and having a bone-engaging side for engaging an endplate of the first vertebra and an inner side opposite the bone-engaging side, the inner side of the intervertebral portion 20a, 120a having an articulating surface 22, 122 comprising a generally convex surface; a second component 30, 130 for engaging a second vertebra, the second component having an intervertebral portion 30a, 130a insertable between adjacent vertebrae and having a bone-engaging side for engaging an endplate of the second vertebra and an inner side opposite the bone-engaging side, the inner side of the intervertebral portion 30a, 130a having an articulating surface 32, 132 comprising a generally concave surface; wherein the convex articulating surface 22, 122 of the first component is sized and shaped to pivot in the concave articulating surface 32, 132 of the second component, and wherein the first component 20, 120 further comprises a fixation portion 20b, 120b for securing the first component to the anterior side of the first vertebra, said fixation portion 20b, 120b extending from the trailing end of the intervertebral portion 20a, 120a of the first component and wherein the second component 30, 130 further comprises a fixation portion 30b, 130b for securing the second component to the anterior side of the second vertebra, said fixation portion 30b, 130b extending from the trailing end of the intervertebral portion 30a, 130a of the second component.

A biocompatible implant, as well as method of fabricating the implant and repairing an annular defect in annulus fibrosus (AF) of an intervertebral disc (IVD) disposed in a functional spinal unit (FSU), includes an insert that provides faces that can interface with the defect to repair or treat the AF. The implant can deliver biological and mechanical factors to enhance healing in an annular defect and prevent recurrence of herniation symptoms. The implant can be fabricated using a hybrid of first fibrous scaffold structure including at least a first layer and a second layer of first fibers fabricated via three-dimensional fiber deposition (3FD) and second fibrous scaffold structure including a third layer and a fourth layer of second fibers formed via melt electrowriting (MEW). Suitable attachment methods, including bio-adhesives can be used to bond the implant to the IVD and/or FSU.

A two part annulus repair rivet for repairing a defect in the annulus of an intervertebral disc includes a first part delivered through a port and adapted to be positioned at an internal surface of an annulus adjacent a defect and a second part adapted to be positioned on an external surface of the annulus adjacent the defect. The first and second parts are secured together, repairing the defect.

An intervertebral implant is configured to be implanted in an intervertebral space in a first initial configuration. Subsequently, an actuator is configured to be driven in an actuation direction such that the actuator urges the implant to expand along a first expansion direction. Once the implant has been fully expanded along the first expansion direction, the actuator is configured to be further driven in the actuation direction so as to expand the implant in a second expansion direction that is perpendicular to the first expansion direction.