Abstract: An interbody fusion device for engagement between vertebrae includes a pair of lateral spacers for spacing the vertebrae, and a connecting member adapted to couple together the lateral spacers when inserted between the vertebrae. The connecting member, individual lateral spacers, or the entire spinal spacer can be made of bone in order to promote fusion of the vertebrae. The modular construction permits use of bone segments otherwise unsuitable due to size or strength in stable fusion devices.

Abstract: This invention relates to arthodesis for stabilizing the spine. More specifically, the present invention is directed to an intervertebral spacer formed of a bone material and to methods of treating patients having spinal deformities. The invention provides a spinal implant assembly comprising bone-derived components. The bone-derived components can be formed into modular units that can be assembled to provide a wide variety of implant configurations. In addition, the bone-derived components can form scaffold that can withstand the shear and impact forces necessary to insert the assembled implant into a disc space between adjacent vertebrae. In preferred forms the implants define an open spacer that serves as a depot for receipt of an osteoconductive material. The ostoegenic material is preferably a moldable filler that can form a molded reinforced implant.

Abstract: A system and method is provided for maintaining a proper intervertebral disc height during the replacement or augmentation of the spinal disc. In one embodiment, a cannulated distractor is used to distract the adjacent vertebrae and maintain a proper disc space height . The cannulated distractor is fluidly connected to a source of fluent material for injection into the disc space. The distraction includes a distraction tip resident within the disc space that includes a central lumen and a number of openings communicating with the lumen to dispense the fluent material within the disc space.

Abstract: Intervertebral spacers and methods of promoting fusion bone growth in the space between adjacent vertebrae are provided. The spacers include an elongated body having a first end, a second end and an outer surface. Side walls connect the first and second ends. The elongated body also defines an interior cavity. The side wall defines an opening to the interior cavity in a side of the elongated body. At least one of the first and second ends has a discontinuity, such as a concave surface, for nesting with an adjacent spacer. The methods of promoting fusion bone growth include utilizing the inventive spacers described herein.

Abstract: A dynamic stabilization system includes a stabilization element, such as a spinal rod, a plurality of bone anchors, such as bone bolts, and a like plurality of connectors for connecting the bolts to the spinal rod. At least some of the connectors include a flexible element between the bone anchor and the rod and an adjustment element for adjusting the flexibility of the flexible element, to thereby adjust the dynamic flexibility between the rod and the bone anchor. In one embodiment, the flexible element is a flexible bearing element of a rod end bearing.

Abstract: A system and method is provided for maintaining a proper intervertebral disc height during the replacement or augmentation of the spinal disc. In one embodiment, a cannulated distractor is used to distract the adjacent vertebrae and maintain a proper disc space height. The cannulated distractor is fluidly connected to a source of fluent material for injection into the disc space. The distraction includes a distraction tip resident within the disc space that includes a central lumen and a number of openings communicating with the lumen to dispense the fluent material within the disc space.

Abstract: Intervertebral spacers, tools for implanting intervertebral spacers and methods of promoting fusion bone growth in the space between adjacent vertebrae are provided. The spacers include an elongated body having a first end, a second end and an outer surface. Side walls connect the first and second ends. The elongated body also defines an interior cavity. The side wall defines an opening to the interior cavity in a side of the elongated body. At least one of the first and second ends has a discontinuity, such as a concave surface, for nesting with an adjacent spacer. The tools include spacer engaging means for engaging a spacer and occlusion means for blocking an opening defined in the spacer. In some embodiments, the occlusion means includes a plate extendible from the housing. In one specific embodiment the plate defines a groove which is disposed around a fastener attached to the housing so that the plate is slideable relative to the housing.

Abstract: This invention relates to devices and instruments for implant insertion through a posterior lateral opening to the disc space. The instruments include an implant inserter, and the devices include a spinal fusion implant engageable by the implant inserter. The implant provides bilateral support of the adjacent vertebrae when inserted into the disc space from a postero-lateral approach.

Abstract: A removable protective covering is provided that can be secured about an external fixation device on the upper or lower extremity of a patient. The covering includes a fabric form that is sized and configured to accommodate varying sizes of external fixation devices and uses readily engageable/releasable closure elements or fasteners to securely engage the covering about the fixator and the extremity. A drawstring closure may be provided at the open ends of the covering to tighten the end about the patient's limb. Ventilation features may be provided including vents with and without additional devices to generate air flow through the covering. The covering for a lower extremity fixation device may be configured for removably attachment to a foot plate and the foot plate itself may be configured to support or attach to the fixation device.

Abstract: This invention relates to implants formed from donor bone for use in lumbar interbody fusion procedures and instruments for performing such procedures. The implants are formed to include a concave surface formed from a portion of the medullary canal of a long bone. The concaved surface defines a recess in the implant that serves as a depot for osteogenic material. Specific instruments for inserting the implants prepared according to this invention and for preparing the intervertebral space to receive the implants are also provided.

Abstract: This invention relates to methods and instruments for performing disc space preparation and implant insertion from a unilateral approach to the spine through a posterior lateral opening to the disc space. The instruments include spreaders, distractors, reamers, scrapers, cutters, chisels, pushers and implant inserters. A surgical procedure is provided that allows bilateral support of the adjacent vertebrae with at least one interbody fusion device inserted into the disc space via a unilateral approach. Implants for insertion into the disc space are also provided.

Abstract: A laparoscopic surgical technique is provided for preparing a site for implantation of a fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope includes a laparoscopic port at its opposite end through which instruments and implants are inserted. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. The laparoscope is alternately engaged within bilateral locations in the disc space for insertion of a pair of fusion implants. A switching sleeve extends through the laparoscope to protect the tissue at the surgical site as the laparoscope is moved between the bilateral fusion locations.

Abstract: An interbody fusion device in one embodiment includes a tapered body defining a hollow interior for receiving bone graft or bone substitute material. The body defines exterior threads which are interrupted over portions of the outer surface of the device. The fusion device defines truncated side walls so that on end view the body takes on a cylindrical form. The side walls are provided with vascularization openings, and the body wall device includes opposite bone ingrowth slots extending through the interrupted thread portion of the body. In another embodiment, the tapered body is solid and formed of a porous biocompatible material having sufficient structural integrity to maintain the intradiscal space and normal curvature. The material is preferably a porous tantalum having fully interconnected pores to facilitate complete bone tissue ingrowth into the implant.

Abstract: A method and instrumentation particularly adapted for disc space preparation from an anterior approach to the spine. In one aspect, an expandable template is provided having guides to guide a cutting device for bilateral formation of openings in the disc space. In another aspect, an improved guide member is provided for guiding a cutting tool. Still further, the invention provides an improved double barrel guide sleeve with a central distraction extension and lateral non-distracting extensions. Optionally, the guide sleeve includes windows and covers to selectively cover the windows. An improved reamer with an internal chamber and optional modular coupling is also provided. A depth stop is provided to selectively engage a tool shaft and a guide sleeve to control tool penetration into the disc space. A method of using the disclosed instruments is also provided.

Abstract: A plate of biocompatible material is provided having curvature in two planes such that it conforms to the curvature of the L5 vertebral body and to the patient's lordotic curve. Holes are provided receiving screws for anchorage in the vertebral body and sacrum. A flange or foot portion on the plate provides a wider base end area for support in the L5-S1 interspace. The foot portion is also arranged for appropriate entry angle of screws into the sacrum such as to improve anchorage in the sacrum. Anti-backout and low profile features are incorporated. The anterior lumbar plate is situated to maintain the anterior interbody bone graft in compression by resisting tensile forces during extension.

Abstract: A system and method is provided for maintaining a proper intervertebral disc height during the replacement or augmentation of the spinal disc. In one embodiment, a cannulated distractor is used to distract the adjacent vertebrae and maintain a proper disc space height. The cannulated distractor is fluidly connected to a source of fluent material for injection into the disc space. The distraction includes a distraction tip resident within the disc space that includes a central lumen and a number of openings communicating with the lumen to dispense the fluent material within the disc space.

Abstract: Implantable devices useful for creating bony fusion particularly in intervertebral spinal fusion. The device is formed of bone and has an at least partially demineralized portion between two rigid bone portions creating an area of flexibility. In one application, the area of flexibility may be used to move the device between a reduced size insertion configuration and an expanded implanted configuration. In another use, the area of flexibility may be useful to dampen shock applied to the implant. A method is also disclosed for making the implants and inserting the implants into an intervertebral disc space to promote interbody fusion.

Abstract: An interbody fusion device for engagement between vertebrae includes a pair of lateral spacers for spacing the vertebrae, and a connecting member adapted to couple together the lateral spacers when inserted between the vertebrae. The connecting member, individual lateral spacers, or the entire spinal spacer can be made of bone in order to promote fusion of the vertebrae. The modular construction permits use of bone segments otherwise unsuitable due to size or strength in stable fusion devices.

Abstract: Laterally expanding vertebral spacer devices are provided for repairing damaged vertebral discs. The vertebral spacer devices maintain the height of a distracted vertebral disc space while providing stability to the spine. In one form of the invention, a vertebral spacer device is provided with a first arm movably coupled to a second arm. The first and second arms are laterally expandable from a first width for insertion into the disc space to a second width after insertion into the disc space. The first and second arms also define a cavity therebetween for placement of bone growth material.

Abstract: This invention relates to methods and instruments for performing disc space preparation and implant insertion from a unilateral approach to the spine through a posterior lateral opening to the disc space. The instruments include spreaders, distractors, reamers, scrapers, cutters, chisels, pushers and implant inserters. A surgical procedure is provided that allows bilateral support of the adjacent vertebrae with at least one interbody fusion device inserted into the disc space via a unilateral approach. Implants for insertion into the disc space are also provided.