An arthroscopic cutting probe includes an elongated shaft assembly having a distal end, a proximal end, and a longitudinal axis therebetween. A working end at the distal end of the elongated shaft assembly includes a first active electrode and a second active electrode The shaft assembly is rotates the first electrode relative to the second electrode about the longitudinal axis, and a return electrode is carried on the shaft assembly proximal of the working end. The first and second active electrodes are electrically coupled to each other and electrically isolated from the return electrode.

A system for restricting flexion of a spinal segment in a patient comprises a constraint device having a tether structure and a compliance member coupled with the tether structure. The tether structure is adapted to be coupled with a superior spinous process and a sacrum. The system also includes an anchor member that is anchored to the sacrum. The anchor member has an attachment feature that is adapted to couple with the constraint device.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A surgical cutting instrument (3) having a proximal end (4), a distal end (5), opposing sides (6, 7), and a longitudinal axis (8) and comprising: (i) an instrument body (2); (ii) a pivotal cutting arm (10) having a pinion (20) with an axis of rotation, the pinion being integrally formed with the pivotal cutting arm, wherein the pivotal cutting arm is mounted for rotation relative to the instrument body about a pivot axis (11), the pivot axis being the axis of rotation of the pinion, so that, rotation of the pinion about the pivot axis, causes the pivot arm to pivot relative to the instrument body; (iii) a cutting blade (40) on the pivotal cutting arm for resecting tissue; (iv) a rack (25) that can be moved in a reciprocating linear motion forward towards the distal end and rearwards toward the proximal end, the rack and the pinion being meshed together to forming a rack and pinion mechanism so that linear motion of the rack effects pivotal movement of the pivotal cutting arm about the pivot axis. This provides a very simple yet robust device which can have a minimum cross-section. It can thus be used for minimally invasive procedures such as cutting material from the interior of a spinal disc.

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.

A resecting probe includes a shaft assembly having an outer sleeve and an inner sleeve. The outer sleeve has an axial bore and an outer window in a distal side thereof, and the inner sleeve has an axial extraction channel and inner window in a distal side thereof. The inner sleeve is rotationally disposed in the axial bore of the outer sleeve to allow the inner sleeve window to be rotated in and out of alignment with the outer sleeve window, and the shaft assembly forms a flow aperture in a distal portion when the inner cutting window and the outer cutting window are out of alignment. An electrode is carried on the inner sleeve, and a motor drive is coupled to rotate the inner sleeve relative to the outer sleeve. A controller is coupled to the motor drive and controls rotation of the inner sleeve.

Aspects of the invention include minimally invasive tissue modification systems. Embodiments of the systems include a minimally invasive access device having a proximal end, a distal end and an internal passageway. Positioned among the distal ends of the devices are a visualization element and an illumination element. Also provided are methods of using the systems in tissue modification applications, as well as kits for practicing the methods of the invention. Internal tissue visualization devices having RF-shielded visualization sensor modules are also provided. Minimally invasive RF tissue modulation devices are provided. In some aspects, the devices include a hand-held control unit and an elongated member. In some aspects, RF tissue modulation devices are provided and include an adapter that operably couples to a hand-held medical device. The adapter generates RF energy for delivery to a plasma generator on an elongated member.

A resecting probe includes a shaft assembly having an outer sleeve and an inner sleeve. The outer sleeve has an axial bore and an outer window in a distal side thereof, and the inner sleeve has an axial extraction channel and inner window in a distal side thereof. The inner sleeve is rotationally disposed in the axial bore of the outer sleeve to allow the inner sleeve window to be rotated in and out of alignment with the outer sleeve window, and the shaft assembly forms a flow aperture in a distal portion when the inner cutting window and the outer cutting window are out of alignment. An electrode is carried on the inner sleeve, and a motor drive is coupled to rotate the inner sleeve relative to the outer sleeve. A controller is coupled to the motor drive and controls rotation of the inner sleeve and can stop rotation of the inner sleeve in a stop position where the outer and inner windows are out of alignment, providing the flow aperture to allow cooling of fluid in a working space and cooling of the probe handpiece during use.

A distractor system for use in a joint between two bone surfaces of an anatomical structure includes, for example, distractor and at least one detachable tool comprising a body having a proximal portion and a distal portion, said proximal portion being releasably attachable to at least one of a first end of the distractor and/or a second end of the distractor. The distal portion of the detachable tool being operably positionable in the joint between the two bone surfaces of the anatomical structure. The detachable tools may include a detachable paddle.

An amputation system includes a cutting element having a cutting blade traversing a V-shape. The V-shape has a vertex and an angle in a range of 90-120°. A rod, rigidly coupled to the cutting element, has its longitudinal axis aligned with the vertex so it bisects the angle of the V-shape. A barrel having a bore receives at least a portion of the rod therein wherein the rod's outboard end resides in the bore. An energetic energy source, positioned in the bore adjacent to the rod's outboard end, generates a pressure force that is incident on the rod's outboard end. The pressure force is one that peaks within 0.5 milliseconds to propel the rod from the bore at a velocity in a range of 300 to 1000 feet per second.