Abstract: A system and method for anterior fixation of the spine utilizes a cylindrical implant engaged in the intradiscal space at the cephalad and caudal ends of the construct. The implants are cylindrical fusion devices (10) filled with bone material to promote bone ingrowth and fusion of the disc space. An attachment member (40) is connected to each of the fusion devices (10) and a spinal rod (50) is connected to each of the attachment members using an eyebolt assembly (53, 54, 55). In a further inventive method, a revision of the construct is achieved by removing the fusion devices. Each fusion device is engaged by an elongated guide member (62) over which a cylindrical trephine (70) is advanced. The trephine (70) is used to extract a core (84) of bone material around the fusion implant, while the guide member (62) is used to remove the bone core (84) containing the fusion implant (10). In another aspect of the invention, a removal insert (90, 90') is provided that engages an implanted fusion device (10).

Abstract: A bone plug removal tool is described. The tool includes a cylindrical cutting element having an external surface and having an internal surface defining an internal bore extending along a longitudinal axis of the cutting element from a proximal end to a distal end. A cutting tooth is located at the proximal end of the cutting element and extends into the internal bore. A replaceable outer cylindrical sheath is arranged concentrically around the external surface of the cylindrical cutting element.A bone plug emplacement tool to be used in conjunction the removal tool is also disclosed. The emplacement tool includes a cylindrical element having an internal surface defining an internal bore extending along a longitudinal axis of the element from a proximal end. The internal surface further defines an internal step adjacent a distal end of the element. A stem is disposed for co-axial movement within the element, the stem having a proximal end disposed within the internal bore.

Abstract: An instrument set 20 and method for preparing a site between adjacent bones for insertion of an implant includes an alignment probe 22 with a head end 24 and a cutter 34 which fits over the alignment probe 22. The alignment probe 22 can be appropriately positioned using imaging techniques and then given a quarter turn in order to anchor the head end 24 in the bones at the appropriate depth and with the appropriate alignment. The cutter 34 is then inserted over the alignment probe 22 in order to sever bone and tissue. After this is accomplished, the head end 24 is given another quarter turn freeing itself from the bone, and then the alignment probe 22 and the cutter 34 are removed with the tissue and bone captured therebetween.

Abstract: A multi-plane curvilinear saw, corresponding guide and related method are provided for shaping the end of a bone that forms one member of a joint, such as a bone in a digit. The finished end is hemispherical in shape so as to better engage the mating bone end. The saw includes a hollow, hemispherically shaped body with a row of arcuately disposed cutting teeth along an exposed edge of the front, and an open rear portion. A shank extends from the other side of the body for attachment to the chuck of a hand piece with a high-speed oscillating motion. The guide is formed from an elongated inverted channel with parallel curved slots in a terminal portion. The curvature of the slots corresponds to the curvature of the saw and the row of cutting teeth. The method includes the steps of securing the guide to the top of the digit above the joint and oscillating the saw, pitching forward and slightly tilting within the guide slots to shape and finish the bone end.

Abstract: A method of and apparatus for performing endoscopic or laparoscopic surgery on a patient's spine is provided. The apparatus includes a trochar which is specifically design for spinal applications. The trochar includes of a first transparent tubular member of a predetermined diameter and a second transparent tubular member of a slightly larger diameter than the first transparent tubular member. The first transparent tubular member fits slidingly within the second transparent tubular member in a telescoping manner. The first transparent tubular member has two ends: an end for remaining in side-to-side contact with said second tubular member and a free end which has an attached metal fitting with serrated teeth for anchoring in the patient's vertebrae when the trochar is inserted through a incision made in the patient's abdomen or chest. The trochar also includes a collar and set screw arrangement. The collar is made up of a short tubular portion having a flanged end.

Abstract: The surgical saw blade and hub of this invention includes a saw blade and instrument hub which connect the saw blade to the instrument such that no portion of the instrument extends beyond the blade. The blade includes a washer having a plurality of radially extending slots in communication with the central bore of the washer. Alternating slots of the washer are truncated or otherwise do not fully extend through the washer. The truncated slots form shoulders or lans within the washer. The center opening of the washer is in alignment with a base opening in the blade and accommodates a hub from the powered instrument. The hub of the powered instrument includes a plurality of radial fins extending outwardly therefrom. The fins abut against the shoulders of the washer to lock the blade to the hub. A helical spring is provided to maintain pressure against the blade and thereby retain the blade and hub in a locked configuration.

Abstract: A coring reamer and method for creating a tibial tunnel and producing a bone graft for arthroscopic anterior cruciate ligament reconstruction. A conventional guide pin is drilled through the tibia and removed. A collared guide pin is then inserted through the guide pin tunnel until the collar abuts against the tibia. A cannulated core saw is slid over the guide pin and collar to engage the tibia. The tibial tunnel is reamed by driving the core saw into the tibia.

Abstract: A biopsy device for obtaining biopsy specimens from hard or soft tissue includes a biopsy extracting member which may be inserted into a cannula and a removable biopsy specimen holder which is preferably threaded into the biopsy extracting member. The specimen holder preferably includes a cutting edge (e.g., serrated for hard tissue, slicing for soft tissue), and retaining fishscales or scallop members for securely holding The biopsy specimen. Once the biopsied specimen is cut from the tissue, it may be sent, within the removable specimen holder, to the pathologist for analysis.

Abstract: A device to rapidly and safely excise tissue samples from a living body including a means to prevent lateral movement of the cutting edge as it engages the tissue and a means to control the depth of excision. The device also features an external sheath which is driven into the tissue with the coring shaft and which provides the operator with continued access to the sampling site after removal of the tissue core.

Abstract: Laparoscopy organ retrieval apparatus and procedures are presented for minimum invasion surgery inclusive of laparoscopic nephrectomy, cholecystectomy and other organ dissection, morsellation removal from the abdomen through a keyhole incision. The apparatus and procedures permit the safe and total removal of an organ from a body cavity in a morsellated condition through the combination utilization of an entrapment envelope sheath. The entrapment envelope having an apparatus for opening and closing, the apparatus controlled from an exterior position of the body cavity wherein the entrapment envelope after entry of the sheath is extruded from the sheath which has been inserted through a laparoscopic port in place in a keyhole surgical opening. The entrapment envelope is constructed of flexible, relatively low bulk fluid impermeable materials having sufficient strength to contain morsellator entry, organ fragmentation and removal.

Abstract: A bone biopsy instrument kit includes a hollow needle with an annular cutting edge which is rotated to cut a core of bone sample which is retained in the internal passage of the needle. A semi-circular portion of the needle wall is removable to withdraw the core sample without compressing or otherwise changing the consistency of the sample. The annular cutting edge has a sawtooth configuration with a side rake angle causing bone dust to be expelled radially without contaminating the core sample. An elongated obturator and an elongated trocar may be inserted through the needle to direct the annular cutting edge through tissue and to center and guide the instrument into the surface of the bone.

Abstract: A hollow trephine cutter unit capable of disassembly to provide damage-free access to the collected sample or to permit size changes of the cutting element. Disassembly by sliding movement of one element of the apparatus with respect to the other and multiple torque transmission paths between prime mover and cutting element are also disclosed. Multiple function use of the prime mover chuck and easy cutter unit disassembly despite the presence of organic fouling are also provided.