Methods and apparatus for forming one or more trans-sacral axial instrumentation/fusion (TASIF) axial bore through vertebral bodies in general alignment with a visualized, anterior or posterior axial instrumentation/fusion line (AAIFL or PAIFL) in a minimally invasive, low trauma, manner and providing a therapy to the spine employing the axial bore. Anterior or posterior starting positions aligned with the AAIFL or PAIFL are accessed through respective anterior and posterior tracts. Curved or relatively straight anterior and curved posterior TASIF axial bores are formed from the anterior and posterior starting positions. The therapies performed through the TASIF axial bores include discoscopy, full and partial discectomy, vertebroplasty, balloon-assisted vertebroplasty, drug delivery, electrical stimulation and various forms of spinal disc cavity augmentation, spinal disc replacement, fusion of spinal motion segments and implantation of radioactive seeds. Axial spinal implants and bone growth materials can be placed into single or multiple parallel or diverging TASIF axial bores to fuse two or more vertebrae, or distract or shock absorb two or more vertebrae.

Methods and apparatus for performing therapeutic procedures in the spine

One or more shaped axial bore extending from an accessed posterior or anterior target point are formed in the cephalad direction through vertebral bodies and intervening discs, if present, in general alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation/fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment. Preferably, curved anterior or posterior TASIF axial bores are formed in axial or parallel or diverging alignment with the visualized AAIFL or PAIFL, respectively, employing bore forming tools that can be manipulated from proximal portions thereof that are located outside the patient's body to adjust the curvature of the anterior or posterior TASIF axial bores as they are formed in the cephalad direction. Further bore enlarging tools are employed to enlarge one or more selected section of the anterior or posterior TASIF axial bore(s), e.g., the cephalad bore end or a disc space, so as to provide a recess therein that can be employed for various purposes, e.g., to provide anchoring surfaces for spinal implants inserted into the anterior or posterior TASIF axial bore(s).

Methods and apparatus for forming shaped axial bores through spinal vertebrae

Methods and apparatus for providing percutaneous access to vertebrae in alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner are disclosed. A number of related TASIF methods and surgical tool sets are provided by the present invention that are employed to form a percutaneous pathway from an anterior or posterior skin incision to a respective anterior or posterior target point of a sacral surface. The percutaneous pathway is generally axially aligned with an anterior or posterior axial instrumentation/fusion line extending from the respective anterior or posterior target point through at least one sacral vertebral body and one or more lumbar vertebral bodies in the cephalad direction. The provision of the percutaneous pathway described herein allows for the formation of the anterior or posterior TASIF bore(s) and/or the introduction of spinal implants and instruments.

Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae

Disclosed are methods of accessing and treating the spine, while minimizing trauma to surrounding tissue. A device is introduced through tissue, to an access point on the spine. The device is thereafter advanced axially within the spine, from the access point across a treatment zone. In one application, the access point is on the anterior surface of the spine, and, in another application, the access point is on the posterior surface of the spine. The lumen created through the spine across the treatment zone may be either substantially linear, or curved.

Methods of performing procedures in the spine

The invention provides an implantable spinal distraction/fusion rod with varied thread pitch and diameters along different portions of its length that it is capable of distracting two or more vertebral bodies relative to each other and/or facilitating the procedure of fusing the vertebral bodies together from within the spine. The present invention also provides for methods of using the rod to distract and/or fuse two or more vertebral bodies from within the spine.

Method and apparatus for spinal distraction and fusion

Spinal fixation devices are used in the thoracic and lumbosacral spine to stabilize the spine, reduce deformities and fractures, and replace abnormal vertebrae. A bone fusion is usually attempted along with placement of the instrumentation because in most cases the hardware would eventually fail if it were used alone. The thoracolumbar spine is inherently unstable, and early operative intervention improves mobilization and rehabilitation. In some cases of lumbar spinal pain, surgical intervention is necessary for the treatment of conditions such as herniated disks, spondylolysis with spondylolisthesis, and degenerative disease with scoliosis. Surgical procedures consist of posterior (posterior elements) and anterior (vertebral body) fixation. Radiologists face continual changes in both surgical technique and instrumentation and should be knowledgeable about the devices available and the biomechanical principles that direct their use. They need to work with their surgical colleagues to become familiar with the techniques used at their institutions.

Spinal fixation. Part 2. Fixation techniques and hardware for the thoracic and lumbosacral spine.

Orthopedic fixation devices are used in the treatment of fractures, soft-tissue injuries, and reconstructive surgery. After fracture reduction, internal, external, or intramedullary fixation devices may be used to provide stability and maintain the alignment of bone fragments during the healing process. They must be strong and secure enough to allow early mobilization of the injured part, as well as the entire patient. Compression is used whenever possible to increase the contact area and the stability between fragments and to decrease the stress on the implant. Screws are used primarily to provide interfragmental compression or to attach plates, which can then provide compression, prevent displacement, and support the fragments during healing. Pins and wires can be used for fixation of small fragments or fractures in small bones and for attachment of external fixation devices and traction. A basic understanding of the devices and principles of use is needed to interpret radiographs obtained after the treatment of musculoskeletal injuries.

Orthopedic fixation devices.

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Spinal fixation. Part 2. Fixation techniques and hardware for the thoracic and lumbosacral spine.

Orthopedic fixation devices.