An implantable device may be provided. The implantable device may comprise an upper assembly comprising a ramped base and a pair of opposing windows. The pair of opposing windows may extend upward from either lateral side of the ramped base. A gripping assembly may be disposed in each window. The implantable device may further comprise a lower assembly comprising a ramped base and a pair of opposing windows. The pair of opposing windows may extend down from either lateral side of the ramped base. A gripping assembly is disposed in each window. The implantable device may further comprise a ramped actuator assembly disposed between the upper assembly and the lower assembly. The ramped actuator may be configured to transition the implantable device from a collapsed form having a first height to an expanded form having a second height and wherein the second height is greater than the first height.

An interspinous, interlaminar space expander and measurement instrument for preparing an interspinous, interlaminar space between adjacent vertebrae to receive an implantable interspinous, interlaminar stabilization device is provided. The instrument includes an indicator which measures both height of the space and applied force to maintain that height.

Technologies are generally provided for devices, systems, and methods to provide spinal fixation, spinal stabilization, and/or spinal fusion. Example devices may include a first end and a second end with a middle portion extending between the first and second end. The first end may be configured to be in contact with a portion of a first or upper vertebra and the second end may be configured to be in contact with a portion of a second or lower vertebra in an adjacent vertebral pair. Portions of the vertebra which may be in contact with the device may include lamina, processes, vertebral bodies, and facet joints. The example devices may include bone engagement features, such as screws or similar fasteners, to enhance stabilization and fixation when in contact with the vertebrae. Additionally, the devices may include a bone integration feature to promote bone growth and to facilitate fusion between the vertebrae.

Systems and methods are disclosed for maintaining spacing between a superior spinous process and a superior lamina, and an inferior spinous process and an inferior lamina of adjacent vertebrae of a spine. A system may include an implant having a proximal superior surface with a superior concavity shaped to receive the superior spinous process, a proximal inferior surface with an inferior concavity shaped to receive the inferior spinous process, a distal superior surface, distal to the proximal superior surface, that faces the superior lamina, and a distal inferior surface, distal to the proximal inferior surface, that faces the inferior lamina. The implant may further have a threaded member extending along a proximal-distal direction, that rotates to urge the implant to move from a retracted configuration to a deployed configuration by urging the distal superior surface and the distal inferior surface to move apart.

Systems for distracting a facet joint and positioning a permanent implant in the joint are disclosed. The implants serve to retain a distracted position of the facet joint which is achieved with positioning of the leading end of a distraction tool in the facet joint and then distracting or enlarging the joint a desired amount. The permanent implant could be part of the distraction mechanism which can be separated from the delivery tool once the joint has been distracted or an auxiliary implant may be positioned before the distraction mechanism is removed from the distracted joint. The permanent implants can be solid, mechanical devices that may have fixation means thereon to hold them in place or injected fluids such as hydrogels or fluids confined within balloons.

Systems, methods and devices for spinal fusion are disclosed. In particular, certain disclosed embodiments are configured to permit the addition of lordosis to a spinal fusion cage after implantation through the use of various expansion mechanisms to spread arms of the spinal fusion cage. Disclosed embodiments may include the use of a threaded wedge to expand the arms, the use of a keel within a series of detents, the use of supplemental fixation screws, and the use of a rotating cam.

A system for spinal fixation with a non-rigid portion at least one of the caudal or cephalad terminus. Various devices and techniques are described for transition from a rigid fixation construct to a less rigid support structure applied to a “soft zone” that helps share the stress created on the spinal levels caused by the fixed levels below. In some embodiments, the soft zone is provided by terminating the construct with one of a flexible tether or a dampening rod.

An insertion instrument for inserting an implant includes an elongated main body having a proximal handle and a distal portion that selectively couples to the implant. A plunger is slidably engaged in a central passage of the elongated main body configured to fix the implant to the elongated main body by selectively filling the central passage within the distal portion. A hex nut driver is concentrically located about the plunger and elongated main body to deploy an actuation plunger of the implant. The proximal handle portion of the main body includes a staggered path therethrough for accepting a tab of the plunger therein. Advancement and retraction of the plunger tab within the staggered path alternates the insertion instrument between an unlocked position configured to mount the implant on the distal portion of the elongated main body, a locked position configured to lock the implant on the distal portion, and a deployed position configured to secure the implant.

An interspinous fusion device includes a central body defining a longitudinal direction and configured to be inserted between two adjacent spinous processes; and a proximal body and a distal body, opposite to each other with respect to the central body and configured to relatively translate towards each other along the longitudinal direction. A pair of proximal jaws and a pair of distal jaws opposite to each other with respect to the central body are spaced apart from each other along the longitudinal direction, and have a first end connected by hinges to the proximal body or to the distal body and a second end configured to abut against a spinous process. An actuation system percutaneously actuates the proximal and distal bodies to cause relative translation and rotation of the jaws about the proximal body and the distal body, thereby opening and closing the jaws.

A system and method for providing a spinal implant having a main body, a proximal anchor, a distal anchor, and an internal plunger. The proximal anchor comprises a nut having an internal bore. The distal anchor comprises a plurality of wings having a first closed configuration and a second open configuration. The internal plunger is housed within a central bore of the main body. The distal end of the internal plunger is operatively connected to the first wing and the second wing to selectively move the wings between the first closed configuration and the second open configuration, and vice versa.