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.

Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member. The distal portion of the wing can define a bone anchor opening through which one or more auxiliary bone anchors can be disposed to augment the fixation of the assembly's primary bone anchor. A distal surface of the distal portion of the wing can be obliquely angled relative to a proximal-distal axis of the spanning portion to face one of a caudal direction or a cephalad direction. A distal surface of the distal portion of the wing can be obliquely angled relative to the proximal-distal axis of the spanning portion to face one of a medial direction or a lateral direction. Surgical methods using the bone anchor assemblies described herein are also disclosed.

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.

The present invention is directed at minimally invasive systems in which the proximal end portion of the working channel has either zero or a limited range of movement in the lateral direction. A first embodiment has a slidable collar attached to a pair of flanges, wherein movement of the collar is bounded by an annular frame. A second embodiment has a substantially spherical element attached to the tube. A third embodiment has a plurality of caps. A fourth embodiment is adapted for a larger working channel.

For treating a fracture in a pars interarticularis, methods and apparatus provide for: (i) coupling a spinous process plate to a lateral side of a spinous process of a spine of a patient, the spinous process plate extending substantially parallel to a sagittal plane through the spine, the spinous process plate including a first fixation element configured to attach the spinous process plate to the lateral side; (ii) coupling a laminar plate to a laminar on the lateral side, the laminar plate extending transversely from the spinous process plate and transversely to both the sagittal plane and a coronal plane through the spine, the laminar plate including a second fixation element configured to attach the laminar plate to the laminar on the lateral side; (iii) engaging a sub-laminar hook to the laminar on the lateral side, the sub-laminar hook extending transversely from the laminar plate and substantially parallel to a transverse plane through the spine, the sub-laminar hook configured to extend and hook beneath the laminar on the lateral side; (iv) extending a rod toward a pedicle on the lateral side, the rod having proximal and distal ends and extending substantially perpendicular to a length of the fracture, from the laminar plate toward the pedicle; and (v) anchoring the rod in a configuration that prohibits movement of first and second parts of the fractured pars interarticularis relative to one another, by coupling the proximal end to the laminar plate, and the distal end to the pedicle on the lateral side.

Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a plate that is seated between the receiver member and the rod and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a hook that extends out from the receiver member to hook onto an anatomical structure or another implant to augment the fixation of the assembly's primary bone anchor. Surgical methods using the bone anchor assemblies described herein are also disclosed.

A method for the treatment of spinal stenosis that includes cutting off a muscle origin or insertion from a spinous process, cutting off the spinous process at the transition to the lamina arcus vertebrae, resecting at least a part of the lamina arcus vertebrae and thereby decompression of the spinal cord within the foramen vertebral, performing osteosynthesis of the spinous process and placing a suture anchor within the spinous process and reattaching the muscle origin or insertion to the spinous process.

A spinal stabilization system may include at least one pedicle screw comprising a threaded base to be connected to a superior pedicle of a vertebra and a screw head attached to the threaded base. The system may further include at least one pars interarticularis clamp comprising an elongate body defining a screw head connection point to be connected to the screw head of the pedicle screw, and a laminar hook coupled to the elongate body and configured to wrap around an edge of the lamina and compress the pars interarticularis of the vertebra when the screw head connection point is connected to the screw head.

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 translaminar pedicle anchor suspension system (referred as T-PAS system) applicable to vertebral surgeries is disclosed. The T-PAS system comprises: at least one pedicle anchor capable of being fixed to a pedicle of a lower vertebral segment, at least one suspension ligament having one end thereof fixed to the pedicle anchor, and at least one washer capable of fixing the other end of the suspension ligament to a contralateral side of a lamina of an upper vertebral segment. By using the suspension ligament to suspend the upper vertebral segment via a tunnel drilled on the lamina, not only the spine can be dynamically stabilized, but also the use of traditional pedicle screws and bone fusion can be avoided.