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.

An interspinous posterior device (IPD) is described. The IPD has a body and bone fixation elements on either side of the body, each of said bone fixation elements having a ratchet locking mechanism for fixing the body to successive spinous processes of a mammalian vertebra. Each of the bone fixation elements is independently adjustable by ratcheting it separately and independently of the other bone fixation elements. The body of the IPD has a dynamic configuration and a non-dynamic configuration, wherein the dynamic configuration allows for both extension and flexion of the successive spinous processes and the non-dynamic configuration prohibits extension of the successive spinous processes. The IPD also includes a removable extension restriction block, wherein the extension restriction block can optionally be inserted in the body to prohibit extension or can be removed from the body to allow extension.

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 will help share the stress created on the spinal levels caused by the fixed levels below. In specific embodiments the soft zone is provided by terminating the construct with one of a flexible tether or a dampening rod.

Bone anchor assemblies and related methods are disclosed herein that can provide for improved fixation of a primary bone anchor. A bone anchor assembly can include a wing with a distal portion that can define a plurality of auxiliary bone anchor openings. Each auxiliary bone anchor opening can receive an auxiliary bone anchor that can augment fixation of a primary bone anchor of the bone anchor assembly. The plurality of auxiliary bone anchor openings can be oriented such that, when the wing is coupled to a primary bone anchor assembly of a vertebral level in a first configuration, at least one auxiliary bone anchor can be driven to extend across a facet plane of the vertebral level and, when coupled in a second configuration, each auxiliary bone anchor received within the wing can be driven to conform to the vertebral level.

An apparatus configured to attach a first vertebral body and a second vertebral body is disclosed. The apparatus includes a fastener including an anchor and a polyaxial head rotatably attached to the anchor, the anchor configured to be fastened to the first vertebral body, and an anchor assembly configured to be received in an aperture of the second vertebral body. The anchor assembly is configured to be received in a head aperture of the polyaxial head. The polyaxial head has three rotational degrees of freedom relative to the anchor based on the rotatable attachment of the polyaxial head to the anchor.

Disclosed are laminoplasty devices and systems, kits that include such laminoplasty devices or systems or components thereof; and methods of assembling and using such laminoplasty devices and systems. In particular, articulating laminoplasty devices are provided that allow lamina plates to be adjusted angularly and transitionally with respect to a cage connecting the lamina plates. Also provided are laminoplasty plates that are configured so as to be assembled with a bone graft housing, and which provide an opening configured to facilitate bone graft insertion into the housing. Further provided are expandable laminoplasty fixation systems that include a lateral mass plate, a lamina plate and a set screw that when screwed and unscrewed, allows one to contract and expand the plates with respect to one another.

An implantable device and method for fixation of spinous processes is presented. The device has first and second spaced plates, the first plate having a surface facing a surface of the second plate. The plates are configured for placement on either side of two adjacent spinous processes. The plates are held in place adjacent each side of the two spinous processes by a post connected to each of the plates and extending substantially therefrom the facing surface of the first plate to at least the facing surface of the second plate.

The present invention provides a spinal implant for placement between adjacent processes of the human spine. In some embodiments the spinal implant includes a spacer and one or more retention members. In some embodiments, the retention members are fixed relative to the spacer and in other embodiments the retention members are deployable from a first or compact or stowed position to a second or expanded or deployed position. In some embodiments the spacer is expandable from a first size to a second size. In some embodiments the spacer has a tapered body.

Methods, systems and apparatuses are provided for torsionally stabilizing a spinal motion segment. One or more implants are placed between two vertebrae to provide torsional stabilization. In particular, one or more implants may be fixed between a superior vertebral body, such as at the spinous process, and an inferior vertebral body. The implants may be connected to the superior vertebral body using a fixation device such as a turnbuckle, an outrigger, a thimble, an endobutton, a suture plug or combinations thereof. The implant may also be connected to the inferior vertebral body using various types of hardware, including staples, screws and anchors. The implant may be kept in tension to provide torsional stabilization and may be comprised of one or more sutures. A multi-functional instrument having one or more arms having holes can be used to clamp onto the superior vertebral body and guide one or more implants to various locations for fixation in accordance with the methods described herein.

Spinal implants for limiting flexion of the spine are implanted between a superior spinous process and an inferior spinous process or sacrum. The implants include upper straps which are placed over the upper spinous process, while the lower portions of the implant are attached to the adjacent vertebra or sacrum. The attachments may be fixed, for example using screws or other anchors, or may be non-fixed, for example by placing a loop strap through a hole in the spinous process or sacrum.