Methods for treating an annulus fibrosis having a defect include inserting a flexible device into the defect. The flexible device is advanced distally beyond an outer layer of the annulus fibrosus. The flexible device is then expanded such that a width of the flexible device is larger than the defect, where the flexible device prevents escape of nucleus pulposus through the defect. The flexible device may have at least two appendages made from a shape-memory metal. Alternatively, the flexible device may have a U-shaped structure that includes a central portion and two legs. The flexible device may also be anchored to the annulus fibrosis and/or the vertebrae.

A method of using a plurality of blades within a fixation device to attach to a vertebra is provided. Each blade includes a body having a central opening configured to rotate on a shaft within a housing of the fixation device, control openings on opposing sides of the central opening sized to engage prongs of a rotating tool, and at least one cutting extension with a sharp leading edge extending from the body in an orientation about an axis of the shaft, wherein upon rotation of the blade by the rotating tool about the shaft in a direction in which the at least one cutting extension is oriented, the at least one cutting extension will break an endplate of a vertebra and hook into the vertebra.

A central inflatable distractor and a perimeter balloon are inserted into the disc space in uninflated configurations. The central inflatable distractor is then expanded, thereby distracting the vertebral endplates to the controlled height of the central inflatable distractor. The perimeter balloon is then inflated with a curable substance. The perimeter balloon expands as it is filled with the curable substance and conforms to the void remaining in the disc space around the central inflatable distractor, thereby creating a horseshoe shape. Once the flowable material in the perimeter balloon has cured, the central inflated distractor can be deflated and removed. The remaining void (or inner space) is then packed with graft for fusion.

The present invention provides expandable devices and insertion tools for deploying the expandable devices. The expandable devices are capable of increasing in height and width when expanded from a closed configuration to an open configuration to occupy a larger volume and to present a larger surface area. The expandable devices are lockable and are capable of rigidly occupying a space after expansion. In some embodiments, the expandable devices are useful as interbody devices for spinal fusions.

A particulate composition for stimulating nucleus pulposus regeneration has a particulate composition made of vertebral end-plates having an osseous component wherein the composition is milled, ground or particulized into particles from 10 to 1000 microns in size. At least a part of the composition can be non-demineralized or demineralized or a mixture of demineralized and non-demineralized particles from the vertebral end-plates. Preferably, the non-demineralized part is not subjected to harsh chemical treating. To possibly enhance the release of growth factors and other similar substances from the osseous layer of the end-plate, the material may be treated with hydrochloric acid, ethylene diamine or other demineralizing agents or regimens.

Methods and compositions for the biological repair of cartilage using a hybrid construct combining both an inert structure and living core are described. The inert structure is intended to act not only as a delivery system to feed and grow a living core component, but also as an inducer of cell differentiation. The inert structure comprises concentric internal and external and inflatable/expandable balloon-like bio-polymers. The living core comprises the cell-matrix construct comprised of HDFs, for example, seeded in a scaffold. The method comprises surgically removing a damaged cartilage from a patient and inserting the hybrid construct into the cavity generated after the foregoing surgical intervention. The balloons of the inert structure are successively inflated within the target area, such as a joint, for example. Also disclosed herein are methods for growing and differentiating human fibroblasts into chondrocyte-like cells via mechanical strain.

A central inflatable distractor and a perimeter balloon are inserted into the disc space in uninflated configurations. The central inflatable distractor is then expanded, thereby distracting the vertebral endplates to the controlled height of the central inflatable distractor. The perimeter balloon is then inflated with a curable substance. The perimeter balloon expands as it is filled with the curable substance and conforms to the void remaining in the disc space around the central inflatable distractor, thereby creating a horseshoe shape. Once the flowable material in the perimeter balloon has cured, the central inflated distractor can be deflated and removed. The remaining void (or inner space) is then packed with graft for fusion.

Methods and compositions for the biological repair of cartilage using a hybrid construct combining both an inert structure and living core are described. The inert structure is intended to act not only as a delivery system to feed and grow a living core component, but also as an inducer of cell differentiation. The inert structure comprises concentric internal and external and inflatable/expandable balloon-like bio-polymers. The living core comprises the cell-matrix construct comprised of HDFs, for example, seeded in a scaffold. The method comprises surgically removing a damaged cartilage from a patient and inserting the hybrid construct into the cavity generated after the foregoing surgical intervention. The balloons of the inert structure are successively inflated within the target area, such as a joint, for example. Also disclosed herein are methods for growing and differentiating human fibroblasts into chondrocyte-like cells via mechanical strain.

Disc degeneration and chronic back pain are caused by a transport hindrance of oxygen, nutrients and pH buffer from capillaries in endplates into mid-layer of the intervertebral disc. A fluid absorbing conduit is inserted into the intervertebral disc, drawing and delivering the oxygen, nutrients and pH buffer in fluid of body circulation from capillaries at endplates into the mid-layer of the disc. The disc undergoes thousands of relaxation and compression cycles each day from daily activity of the patient. During relaxation phase, the fluid of body circulation containing oxygen, nutrients, and pH buffer is infused into the fluid absorbing conduit. During compression phase, the oxygen, nutrients, and pH buffer in the fluid absorbing conduit is dispersed into the mid-layer of the disc. The pH buffer, bicarbonate, neutralizes the lactic acid to relieve the discogenic pain. Oxygen inhibits hypoxic inflammation and production of lactic acid to further reduce the discogenic pain. Nutrients nourish the disc cells to rebuild or regenerate the disc matrix.

Therapeutic agents can be added into the fluid absorbing conduit or injected into the disc implanted with the fluid absorbing conduit to expedite pain relief and disc regeneration. The therapeutic agents can be pH buffering agent, antibiotic, anti-inflammatory drug, anesthetic, antacid, nutrient, sulfate, anti-depressant, calcium channel blocker, growth factor, cells or other.

The bone repair device (1) includes: an intervertebral cage (11) provided with a space inside into which a body fluid can flow from outside; and a nonwoven fabric (12) which is accommodated in the space of the intervertebral cage (11) and to which stem cells or osteoblasts differentiated from the stem cells are adhered. The stem cells may be mesenchymal stem cells collected from a patient in which the intervertebral cage (11) is to be implanted. The fiber diameter of the nonwoven fabric (12) may be within a range from 0.1 m to 30 m. The fiber density of the nonwoven fabric (12) may be within a range from 0.2 g/m.sup.2 to 150 g/m.sup.2.