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.

A spinal implant comprises a proximal member including a body having a first diameter and a head having a second diameter. The body includes an outer surface disposed for non-fixation with a superior facet of a vertebra, and the second diameter being greater than the first diameter. The spinal implant comprises a distal member having a third diameter and being configured for fixation with an inferior facet of an adjacent vertebra. Systems, surgical instruments and methods are disclosed.

An artificial functional spinal unit including an expandable intervertebral implant that can be inserted via a posterior surgical approach and used with one or more facet replacement devices to provide an anatomically correct range of motion is described. Lordotic and non-lordotic expandable, articulating implants and cages are described, along with embodiments of facet replacement devices and instruments for insertion. Methods of insertion are also described.

A bi-directional fixating transvertebral (BDFT) screw/cage apparatus is provided. The BDFT apparatus includes an intervertebral cage including a plurality of internal angled screw guides, a plurality of screw members, and a novel screw locking mechanism which consists of leaf springs which mechanically interact with BDFT screws which have ratcheted screw heads. The small leaf springs allow the ratchet teeth of the screw heads to rotate only in the penetrating direction. Due to the geometric orientation of the ratchet teeth vis-a-vis the adjacent spring leaf, rotation of the screw head in the opposite direction is prevented by the insertion of the string leaf in the space between the ratchet teeth (trough) of its final rotation. The uni-rotational interaction between the screw head-ratchet teeth/troughs and adjacent leaf spring is the mechanical basis for this novel locking mechanism. The internal angled screw guides orient a first screw member superiorly and a second screw member inferiorly in some embodiments, and orient a second screw member and a third screw member superiorly, and a first screw member and fourth screw member inferiorly in other embodiments. The intervertebral cage is adapted for posterior lumbar intervertebral placement, anterior lumbar intervertebral placement, anterio-lateral thoracic intervertebral placement, or anterior cervical intervertebral placement.

The present invention discloses single level fusion systems and methods of use. The single level fusion systems include a first fastener, a second fastener, and a connector to secure the first fastener to the second fastener. The method of assembling a single level fusion system including obtaining a first fastener, a second fastener, and a connector, securing the first fastener to the connector, and securing the second fastener to the connector. Methods of using the single level fusion systems are also disclosed.

The present invention relates to an implant, an instrument for implanting the implant, and a method for manufacturing the implant which includes an elongated body between a free end and a head along a longitudinal axis on the one hand and turns of at least one threading on at least one portion of said body in proximity to the free end, along the longitudinal axis on the other hand, characterized in that the body includes a longitudinal internal conduit in at least one portion to along the longitudinal axis, obtained by at least one first central machining operation parallel to the longitudinal axis and at least one second machining operation in a so-called transverse plane, not parallel to the longitudinal axis and crossing the wall of the body as far as the longitudinal internal conduit by making windows communicating between said longitudinal internal conduit and the outside of the body.

Methods and apparatus for accessing and repairing a vertebral disc include a pad with a central cut-out mounted to the skin of a patient or, alternatively, a pedicle-mounted support. An incision is made and then a corridor is created using an elongated guide and a series of dilating tubes. An access to the disc space is created through the superior articular process and the facet joint using the corridor defined by the dilating tubes. Nucleus material is removed from the disc space and the vertebral endplates are prepared. The disc space may be sized to select a suitable implant, which is advanced through the corridor and into the disc space following discectomy and endplate preparation. Bone graft material may be inserted into the disc space following installation of the implant and then posterior rigid fixation may be achieved using percutaneous pedicle screws, followed by closure of the site.

A plate and an installation tool are provided for preventing a spinal facet joint implant from expulsing from its implant location between a superior and an inferior vertebra. A k-wire is used in cooperation with the plate and installation tool to guide them to the desired location. The plate includes a central threaded bore situated between one or two superior bone screw or bone connection barb bores and one or two inferior bone screw or bone connection barb bores. The installation tool includes a threaded plug at one end for receipt by the plate's central threaded bore for releasably holding the plate during installation. The installation tool has a superior structure and an inferior structure that can be a cannula or tang depending on the plate's form.

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.

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.