Devices and methods for placing an implant between two bone portions are disclosed. In some embodiments, a method comprises disposing a portion of a flexible member through a first bone portion, through an aperture in a trial implant, and through a second bone portion. The trial implant can be withdrawn to enable an implant to be coupled to the flexible member. The method includes applying tension to the flexible member to urge the implant into the space between two bone portions. In some embodiments, the two bone portions are facets.

A system for replacing at least a portion of a natural facet joint includes a fixation member implantable in a vertebra, an inferior facet articular surface and an inferior strut which may be formed separately from the inferior articular surface. The inferior strut has a first end securable to the fixation member and a second end which may comprise a sphere with a hemispherical surface. An attachment mechanism may include a capture feature shaped to receive the second end of the inferior strut, and the mechanism may provide an adjustable configuration, allowing polyaxial adjustment between the inferior articular surface and the second end. A locking member may be actuated to exert force on the second end to provide a locked configuration. The system may further include a superior facet joint implant with a superior articular surface shaped to articulate with the inferior articular surface.

A facet joint replacement system includes a facet joint replacement device including an enclosing body and an articulating body. The enclosing body includes an interior surface defining an inner cavity of the enclosing body. The interior surface includes a first articulating surface and a projection extending inwardly relative to a surrounding area of the interior surface. The articulating body is positioned within the inner cavity of the enclosing body and is configured to move within the enclosing body. The articulating body includes a second articulating surface and a recess extending inwardly relative to a surrounding area of the articulating body and aligned with the projection of the interior surface of the enclosing body so as to allow movement of the projection along the recess of the enclosing body while constraining rotational motion of the articulating body within the enclosing body.

A partial endoprosthesis device preserves the motion of a vertebral joint for implant into a spinal segment and includes an articular portion having a thickness that increases in the direction of introduction between the articular facets. The articular portion is elongated along a longitudinal axis with a opposite first and second faces. The first face has a central protrusion that is configured so that, by implanting the device with the articular portion inserted between an upper articular facet of a lower vertebra and a corresponding lower articular facet of upper vertebra adjacent to the lower vertebra, and with the first face in contact with either the upper or lower articular facet, and with the second face in contact with the other articular facet, the articular portion, with the first face, pushes against the first articular facet and finally becomes integral by osteointegration with the lower articular facet.

A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

A spinal implant for implantation within a spinal facet joint, the implant comprising: a main body including: opposing top and bottom surfaces; opposing front and rear surfaces; and opposing side surfaces; at least one retaining feature associated with at least one surface of the main body to frictionally engage the implant within the spinal facet joint; and two secure ment apertures extending through the main body to fixedly secure the implant within the spinal facet joint.

A spinal joint distraction system for treating a facet joint including articular surfaces having a contour is disclosed and may include a delivery device including a generally tubular structure adapted to engage a facet joint, an implant adapted to be delivered through the delivery device and into the facet joint, the implant comprising two members arranged in opposed position, and an implant distractor comprising a generally elongate member adapted to advance between the two members of the implant causing separation of the members and distraction of the facet joint, wherein the implant is adapted to conform to the shape of the implant distractor and/or the articular surfaces of the facet upon being delivered to the facet joint. Several embodiments of a system, several embodiments of an implant, and several methods are disclosed including a method for interbody fusion.

The shim-type implant for distraction and fusion of cervical facet joints is provided. The implant has a generally box-like shape with a blunt leading edge that may be centered or offset to the inferior face. The implant may include a graft window for enhanced osseous through-growth after implantation. The implant is coated with hydroxyapatite (HA) and/or tri-calcium phosphate (TCP) to allow for osteo-conduction, is porous, and has a roughened surface with serrations on the superior and inferior faces. The implant may be fabricated from a titanium or tantalum alloy. In an embodiment, a set of tools is provided with a chisel and one or tongs and one or more decorticators for inserting the implant.

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

In some embodiments, a method comprises disposing a portion of a flexible fastening band into contact with a first bone portion and into contact with a second bone portion. The portion of the flexible fastening band having a substantially uniform shape configured to substantially compliment a shape of the first bone portion and a shape of the second bone portion. The method further includes inserting the portion of the flexible fastening band into a fastener and advancing the portion of the flexible fastening band through the fastener until the first bone portion and the and the second bone portion are stabilized.