Abstract: A system for fusing together opposing vertebra of a spine that defines a disc space therebetween. The system comprises a disc preparation instrument and an inserter assembly for use in the interbody fusion procedure. Disc preparation instrument comprises an elongate handle supporting a trial device at one end thereof. Inserter assembly comprises an elongate inserter supporting at one end thereof an interbody cage implant for insertion into the disc space. Disc preparation instrument provides a scoring element that scribes vertebral endplates at an appropriate scored location for anchor blades on the cage implant to engage the vertebral bodies. Inserter is used to introduce cage implant with anchor blades into the disc space to an appropriate depth so that the blades will be precisely positioned at the scored location created by the scoring element for penetration into the vertebral endplates.

Abstract: 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.

Abstract: A system for fusing together opposing vertebra of a spine that defines a disc space therebetween. The system comprises a disc preparation instrument and an inserter assembly for use in the interbody fusion procedure. Disc preparation instrument comprises an elongate handle supporting a trial device at one end thereof. Inserter assembly comprises an elongate inserter supporting at one end thereof an interbody cage implant for insertion into the disc space. Disc preparation instrument provides a scoring element that scribes vertebral endplates at an appropriate scored location for anchor blades on the cage implant to engage the vertebral bodies. Inserter is used to introduce cage implant with anchor blades into the disc space to an appropriate depth so that the blades will be precisely positioned at the scored location created by the scoring element for penetration into the vertebral endplates.

Abstract: A cup impactor (1, 1?, 1?) is provided, adapted to assist a surgeon in controlling implantation of a cup prosthesis (9). The impactor has an impactor body (8), a drive train assembly (71), an impactor nose (38), and a clamping handle (5). The impactor body (8) has on its proximal end, an impaction plate (7) connected thereto, and an impactor handle (6) formed thereon for handling by the surgeon and, on the distal end, an impactor cup support portion (8a) having a receiver recess (8b) therein. A drive train assembly (71) has a prosthesis engaging interface (11) at a distal end thereof, and a proximal end on which a positioning knob (2) is formed. The assembly (71) received and rotatably mounted in the receiver recess (8b) of the body (8) so as to expose the prosthesis engaging surface (11). An impactor nose (38) mounts on the distal end of the impactor body (8), through which the prosthesis engaging interface (11) extends.

Abstract: An implant delivery system for delivering a sheet-like implant is disclosed. The device includes an implant spreader assembly disposed proximate the distal end of a delivery shaft. The implant spreader assembly includes a first arm and a second arm. The arms are coupled to the delivery shaft such that the first arm and second arm are moveable between a closed position and an open position. When the first and second arms are in the closed position, the arms extend generally in the longitudinal direction. When pivoting to the open position the distal end of each arm travels in a generally transverse direction to spread a sheet-like implant.

Abstract: A system and method for allowing any surgeon, including those surgeons who perform a fewer number of a replacement procedure as compared to a more experienced surgeon who performs a greater number of procedures, to provide an improved likelihood of a favorable outcome approaching, if not exceeding, a likelihood of a favorable outcome as performed by a very experienced surgeon with the replacement procedure. Force sensing is included to aid in quantifying installation of an implant, particularly a cup into a pelvic bone.

Abstract: An adjustable implant includes a telescopic body with first and second portions in sliding engagement, and a deflectable linkage formed from a first linking segment, an intermediate segment and a second linking segment pivotally interconnected so that adjustment of a length of the telescopic body causes a corresponding deflection of the deflectable linkage. The first linking segment and the second linking segment are formed with projecting features that provide a partial gear engagement between the first and second linking segments such that, during adjustment of a length of the telescopic body and corresponding deflection of the deflectable linkage, pivotal motion of the first and second linking segments relative to the intermediate segment about the first and second pivot axes occurs in a fixed ratio defined by the partial gear engagement.

Abstract: A spinal implant system includes at least one interbody implant having a first member including a tissue engaging surface and at least one mating element. A second member includes a tissue engaging surface and at least one mating element. An intermediate member includes at least one mating element. An intra-operative surgical tool is connectable with at least one of the members to engage adjacent mating elements and fix the intermediate member with at least one of the first member and the second member. Implants, surgical instruments and methods are disclosed.

Abstract: The present disclosure provides an implant extraction tool for removing either cemented or non-cemented intramedullary stem implants from bones. The tool includes an elongated handle section having proximal and distal end sections with a cap section affixed to the distal end section of the elongated handle section, and cap section has a hole extending therethrough. The tool includes an attachment member having opposed ends, one of these opposed ends is configured to grip a cemented or non-cemented intramedullary implant stem in a bone. The attachment member has a size and shape to be received into the hole and the other of opposed end includes at least one hook feature for gripping the implant. The tool includes an elongated lever having an elongate proximal section and a shorter distal end section with a pivot fulcrum at a transition from the distal end section to the elongate proximal section.

Abstract: A method of distracting adjacent vertebral bodies includes inserting a first pin into a first vertebral body, inserting a second pin into a second vertebral body adjacent the first vertebral body, positioning a first retractor blade over the first pin, positioning a second retractor blade over the second pin, attaching a first arm of a frame to the first retractor blade and a second arm of the frame to the second retractor blade, displacing the second arm of the frame away from the first arm to distract the first and second vertebral bodies, inserting prongs of a lateral protector into respective channels defined in the first and second retractor blades, and retracting tissue by a transverse blade of the lateral protector.

Abstract: A device for bone regeneration includes a fill element adapted to be inserted, during use, in a cavity present in a bone of a patient; the fill element being made of PGA fibers.

Abstract: Disclosed are devices and methods used to customize the length of fasteners used during orthopedic surgeries, comprising creating a hole of the desired depth in a bone, measuring the depth of the hole using a depth measuring device, calculating, using the depth measuring device, the optimal length dimension of the fastener, transferring the calculated fastener optimal length dimension to a fastener cutting device, inserting a fastener having a length exceeding the optimal length dimension into the fastener cutting device, and cutting the fastener to the optimal length dimension using the fastener cutting device.

Abstract: A composite interbody bone implant device is provided including a body having a non-bone composition, such as a polymer, formed into a shape and including one or more cavities. An osteoinductive material, such as bone allograft tissue, may be retained in the one or more cavities of the body. The body is formable via injection molding and/or machining into a shape and size adapted for implantation at a surgical site. The dimensions of the body include a length, a width and a thickness, and the thickness of the body may be less than at least one of the length and width.

Abstract: Instruments, kits, and methods are disclosed for installing an implant spacer through an incision and down a surgical corridor. The instruments also serve to align a drill guide and align and insert a spacer stabilizer for stabilization of adjacent bone portions. An inserter instrument comprises an elongated guide bar body having a guide portion for aligning instruments with said spacer and for introducing a stabilizer to secure the spacer in a predetermined position between the bone portions. In preferred embodiments a stabilizer implant portion comprising a base wall separated by a retaining member by a web wall is introduced into a pre-bored hole in a bone and secured with a stabilizer anchor extending through a central bore. Included is a retractable graft block for securing graft material within an aperture of a spacer during insertion of the spacer.

Abstract: Embodiments of instrumentation and methods are provided for the insertion of intervertebral disc prosthesis. The instrumentation of the embodiments comprises a guide comprising at least two lateral faces, at least one upper plate, at least one lower plate, at least one retainer, a cage defining an insertion axis for the prosthesis, and an angle adjuster adapted to adjust an angle formed by the insertion axis and an antero-posterior sagittal axis; and at least one separator sized to maintain a gap between the upper vertebra and the lower vertebra. Methods for implanting a prosthesis using the disclosed instrumentation comprise implanting a pin in the median sagittal axis of a vertebrae; measuring the dimensions of the intervertebral space; choosing the prosthesis; choosing the guide; adjusting the angle adjuster; positioning the guide adjacent to the intervertebral space; inserting the prosthesis into the guide; and inserting the prosthesis into the intervertebral space.

Abstract: An instrument for use in a procedure for inserting a spinal implant between human vertebrae may include a shaft and an end member. The end member may rotate with respect to the shaft. An angle of the end member with respect to the shaft may be varied when the end member is in a disc space between the human vertebrae. The instrument may include a slide for securing the end member at selected angles relative to the shaft. The end member may be separable from the shalt when the end member is in a selected orientation with the shaft. An instrument kit may include a shaft assembly and modular end members for various steps in a surgical procedure, such as disc space preparation, disc space evaluation, and spinal implant insertion.

Abstract: A surgical instrument comprises a member connected with a spinal implant defining an axis. A first image guide is connected with the member and oriented relative to a sensor to communicate a signal representative of a position of the member. A second image guide is connected with the member and oriented to represent an angle measuring a second orientation of the axis relative to a first orientation. Systems, implants and methods are disclosed.

Abstract: An orthopaedic surgical instrument for use in disassembling an orthopaedic prosthesis includes a main component, a rod, and a spindle. The main component has a housing and an elongated body extending from the housing with a passageway is defined in the elongated body. The rod has an elongated shaft, with a greater length than the elongated body, extending from the head of the rod and configured to pass through the main component. The spindle threads into the housing to move the rod along a longitudinal axis.

Abstract: A disassembly tool for disassembly of a first component of a prosthesis to a second component of the prosthesis for use in joint arthroplasty. The tool includes a first member having a radial portion operably associated with the first component and adapted to exert a radial force on the first component. A second member operably associated with the second component is also included and the second member has a second member longitudinal axis. A drive mechanism is coupled to the second member, such that as the drive mechanism is activated, the second member exerts a force against the second component in the direction of the longitudinal axis. Such exertion of force against the second member further causes the second member to move relative to the first member along the second member longitudinal axis.

Abstract: The disclosed subject matter relates a medical instrument having a rotational drive mechanism that can be integrated into a variety of medical devices, including a tool used as an external retaining ring removal tool or as a non-marring bushing inserter, or in a spinal interbody device. The tool can include a knob portion at a proximal end and a drive mechanism at the distal end. The drive mechanism can include a plurality of drive pins that can be actuated to extend outward by rotating the knob portion. The spinal interbody device can include a drive mechanism configured to translate rotational motion into a linear driving motion to cause locking projections to move into engagement with vertebrae.

Abstract: An implant positioning device including a guide and holder for fasteners used in orthopedic fixation for use in affixing a plate-like member to a bone or other part of a patient. The guide and holder includes a base adapted to align with the plate in a manner to orient fasteners with the plate for fixation. A plurality of fastener holders are on the base and adapted to releasably hold a fastener in a manner where the fastener is exposed at a proximal end for access by a fastener driver and aligned at a distal end with an aperture on the plate through which the fastener is to be driven.

Abstract: A spinal rod insertion instrument includes a hollow, monolithic body having a proximal end and a distal end. The body defines a passageway that extends along a first axis between the proximal and distal ends. The distal end includes first and second arms defining a slot therebetween. The first and second arms are configured to releasably retain a spinal rod therebetween. Also provided is a method of securing a spinal rod to a coupling element attached with a pedicle screw.

Abstract: A surgical instrument includes a first member and at least one lock. A second member includes at least one ramp that is translatable relative to the first member to engage and rotate the at least one lock relative to the first member between a locked orientation and a non-locked orientation with an interbody implant. The second member is engageable with the interbody implant to move at least a portion of the interbody implant between a contracted configuration and an expanded configuration. Implants, systems and methods are disclosed.

Abstract: A geared cam expandable spinal implant. Rotational motion of a rotating portion is translated into linear motion of a yoke, which moves geared cams at the distal end of the implant to mate with, and walk along, teeth of corresponding racks. The walking of the gear cam teeth along the rack teeth creates a regular rate of implant expansion, reduces initial excessive expansion force applied to the implant, and provides fine adjustment of the expansion rate and force.

Abstract: Various surgical devices and methods are disclosed herein. Also disclosed is multi-component prosthesis, which can be used as an ankle prosthesis. One of the disclosed surgical alignment systems includes a guide arm, a ratchet arm frame configured to be coupled slidably to the guide arm, a ratchet arm configured to be coupled to the ratchet arm frame, and a sagittal sizing guide body configured to be coupled to the ratchet arm. The sagittal sizing guide body includes a first radiopaque object disposed at a first position and a second radiopaque object disposed at a second position that is spaced apart from the first position.

Abstract: A method for inserting an intervertebral disc prosthesis into a space between two vertebrae involves inserting the prosthesis partway into the space under constraint to prevent endplates of the prosthesis from articulating, releasing the prosthesis from constraint, and inserting the unconstrained prosthesis farther into the space. In some embodiments, the method involves grasping the prosthesis with a grasping device to insert the prosthesis partway under constraint, loosing the grasping device to release the prosthesis from constraint, and pushing the prosthesis farther into the disc space using the grasping device and/or one or more separate pusher devices. A system includes a grasping device, at least one separate pushing device, and optionally a vertebral spreading device and/or a vertebral midline indicator device.

Abstract: A bone graft delivery system can include an elongate tube and a handle having a trigger and a ratcheting mechanism. The trigger is actuated to deliver bone graft material through the tube. The bone graft delivery system can further include a distal tip at a distal end of the tube. The tip has one or more openings to deliver the bone graft material to a desired location and includes a surface suitable to act as a rasp for decorticating bone. A method for delivering bone graft material to a desired surgical location includes providing a bone graft delivery device, positioning the device adjacent the surgical location, decorticating bone, and delivering bone graft material to the surgical location.

Abstract: An orthopaedic impactor includes an elongate member having an interface end; an impact head connected to the elongate member; an implant interface held at the interface end that is configured to connect to an acetabular cup; and a securing mechanism attached to the elongate member that includes an actuator and a pressing member at least partly covering the implant interface. The pressing member is connected to the actuator and slidable relative to the implant interface. The actuator is configured to slide the pressing member along the implant interface.

Abstract: The present invention provides an orthopedic surgical tool for moving an implant to a surgical sight and installing the implant. The tool allows the surgeon the ability to navigate the implant through a surgical tube, then rotate the implant after reaching the sight and effect installation of the implant, and then effect its release from the tool. The implant can be rotated at any time during its installation within the constraints of other surgical devices.

Abstract: Instruments, kits, and methods are disclosed for installing an implant spacer through an incision and down a surgical corridor. The instruments also serve to align a drill guide and align and insert a spacer stabilizer for stabilization of adjacent bone portions. The instrument comprises an elongated guide bar body, an inserter face at a distal end of said guide bar body for abutting an instrument attachment portion of a spacer, a connection tip portion for securing a spacer against an inserter face, and a guide portion of said elongated guide bar body for aligning instruments with said spacer and for introducing a stabilizer to secure the spacer in a predetermined position between the bone portions. Included is a retractable graft block for securing graft material within an aperture of said spacer during insertion of the spacer.

Abstract: Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).

Abstract: The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of a spinal fixation procedure. A cross connector system for use during a spinal fixation procedure is provided. The system includes at least one bridge defining a coupling bore and having a pair of downwardly extending arms for coupling to a first fastener. The system includes a contoured bar having a first end offset from a second end, and a bore having a central axis. The system includes an expansion ring received within the bore, and a locking device received through the expansion ring and the coupling bore. The locking device is operable in a first state in which the contoured bar is movable about the central axis of the bore and in a second state in which the contoured bar fixed relative to the central axis of the bore.

Abstract: The present invention is directed to methods and instrumentation for performing surgery on the spine along its lateral aspect (side) and generally by a lateral, anterior or an anterolateral surgical approach, such that the instruments enter the body from an approach that is other than posterior and make contact with the spine along its lateral aspect. The present invention provides for the entire surgical procedure to be performed through a relatively small incision and may be performed in either the thoracic or lumbar spine.

Abstract: An expandable intervertebral cage device includes a first base plate and a second base plate, a proximal block with internal threading that mechanically couples the first base plate and the second base plate, and a distal block comprising an internal passage. The device has exactly two arm assemblies, one on each side. Each arm assembly includes a first arm mechanically coupled to the first base plate and the distal block, and a second arm is mechanically coupled to the second base plate and the distal block. A screw is arranged partially within the internal threading of the proximal block and passes through the internal passage of the distal block, such that rotation of the screw relative to the proximal block causes a change in distance between the proximal block and the distal block, and a corresponding change in the spacing and lordosis of the device.

Abstract: The present invention concerns an intersomatic implant (2) comprising a body (4) suitable for being inserted between two vertebrae (1) to space them a predetermined distance apart, the body (4) being provided on either side, respectively, with a contact surface (5, 5?) with the corresponding vertebrae (1). The body (4) is formed from an oblong part of predetermined thickness provided at a first so-called proximal end with a gripping cam (9) mounted movable in rotation relative to the part about an axis perpendicular to the two surfaces (5, 5?), between two predetermined angular positions. The contact surfaces (5, 5?) are either parallel or substantially parallel to one another, and each contact surface (5, 5?) of the body (4) with a corresponding vertebra (1) comprises a set of curved longitudinal protrusions (7, 7?, 7?) which decrease in height towards the distal ends thereof.

Abstract: An instrument for assembling an implant on a neck. The implant and neck being coupled via a taper having a taper axis. The instrument includes a frame having a distal portion and a proximal portion, the distal portion of the frame including a retaining member adapted to engage a portion of the neck. The retaining member includes a pair of moveable arms extending from the distal portion of the frame, the pair of moveable arms adapted to engage a pair of recesses on opposing sides of the neck. The instrument also includes a force applier retained in the proximal portion of the frame. The force applier includes a screw having a screw axis that is coaxial with the taper axis, wherein the screw is adapted to engage the implant. As the screw is turned, the force applier applies a force on the implant while the neck is held in place by the frame, thereby causing the tapers of the implant and neck to engage.

Abstract: An apparatus for use in spinal interbody fusion comprises, in combination, a spinal interbody fusion implant and an inserter releasably attached thereto. The implant comprises a hollow interior through which the inserter extends, the inserter having a tapered distal tip projecting exteriorly beyond the distal end of the implant to initially distract opposing tissue surfaces and to facilitate insertion of the implant into the intradiscal space between the vertebral bodies.

Abstract: An embodiment includes a system comprising: a tulip including a slot to receive a linkage, first and second side walls that define a portion of the slot, and a ring that couples the first side wall to the second side wall; wherein the ring couples to the first side wall at a thinned first proximal fulcrum and to the second side wall at a thinned second proximal fulcrum and the ring pivots about the first and second proximal fulcrums when the ring is forced proximally; wherein the first side wall includes a first sidewall projection that projects past the first proximal fulcrum and the second side wall includes a second sidewall projection that projects past the second proximal fulcrum. Other embodiments are described herein.

Abstract: One embodiment disclosed provides a guide instrument for controlling the depth and trajectory of a surgical access device into a bone.

Abstract: An instrument for breaking off and retaining the tab of a reduction screw is provided. The instrument includes a breaking arm and a retaining mechanism. The breaking arm is configured to break off an excess portion of the tab of the reduction screw about a weakened section. The retaining mechanism is configured to retain the broken off tab and preventing the tab from falling into a surgical site. The retaining mechanism is further configured to allow the instrument to engage another tab while simultaneously holding a predetermined number of previously broken off tabs. Accordingly, the instrument reduces surgical time as the surgeon may simply move from one reduction screw to another while breaking off the tabs until the instrument can no longer retain additional broken off tabs.

Abstract: An instrument system, associated milling or drilling guide and method include use of a trial implant of a size corresponding to an actual implant for the intervertebral space, with a milling guide mounted on the trial implant. The system also includes a cutting tool which is used to form a cutout in an adjacent vertebra.

Abstract: A method for reducing a fixation rod is provided. The method minimizes the surgical corridor by performing fixation within the surgical corridor defined by the screw extender. The screw extender is attached to the spinal implant. The method includes the steps of coupling the proximal end of a first cannulated body with the screw extender and rotating a second cannulated body within the first cannulated body. The method proceeds to the step of actuating a rod pusher with a first driving feature so as to engage the rod pusher with the fixation rod. The rod pusher includes a bore. The method proceeds to the step of rotating an inserter shaft within first cannulated body, second cannulated body and bore of the rod pusher, the inserter shaft including a proximal end with a second driving feature and a distal end with a setscrew attachment feature.

Abstract: A rod reducer including a housing defining an opening, a body member defining an opening and a slot, a shaft disposed through the opening of the housing and coupled to the opening of the body member, an anvil including a linkage extending therefrom, the linkage coupled to the body member and the anvil, a plurality of arm members, and a biasing element disposed between the body member and the anvil. A pin of the linkage is slidably disposed within the slot, and the biasing element is configured to bias the anvil distally with respect to the body member. Rotation of the shaft translates into linear movement, relative to the housing, of the shaft, the body member, and the anvil. The arm members are coupled to the housing and movable towards a parallel configuration as the anvil is advanced away from the housing to engage a bone screw.

Abstract: An orthopedic prosthesis for use in a hip replacement surgery. The orthopedic prosthesis includes an elongated stem component that has a proximal body, a neck extending superiorly and medially from the proximal body and a tapered stem extending inferiorly from the proximal body. An anchor is positioned on the neck and is configured to be engaged by a surgical instrument. A system for use in assembling the orthopedic prosthesis and a method of assembly are also disclosed.

Abstract: An intervertebral spacer inserter includes a sleeve having a longitudinal axis, a hollow sleeve bore extending through the sleeve along the longitudinal axis, a sleeve tip end and an opening of a passage disposed in the sleeve tip end. The passage extends into the sleeve to the sleeve shaft along a passage axis that intersects the longitudinal axis at an angle less than about 90°. A sliding tip with an elongated slot is in contact with the sleeve tip end and is moveable with respect to the sleeve tip end between a first position with the opening accessible through the elongated slot and disposed adjacent a first end of the elongated slot and a second position with the opening accessible through the elongated slot and disposed adjacent a second end of the elongated slot opposite the first end.

Abstract: A hip joint apparatus is described. The apparatus has an acetabular cup designed for both seated engagement within a patient's acetabulum, and articulatory reception of a matingly shaped femoral component, wherein the dome of the acetabular cup has holes configured for accepting wires and variable angle locking screws to facilitate attachment of the acetabular cup to the acetabulum, and wherein the rim of the acetabular cup has holes configured for accepting wires to provide provisional stability to the acetabular cup. The apparatus also has an insertion handle with a graspable portion and a mating portion, the mating portion attached to the graspable portion and configured for engaging with the rim of the acetabular cup, thereby coupling the insertion handle to the acetabular cup.

Abstract: An orthopedic device for implanting between adjacent vertebrae comprising: an arcuate balloon and a hardenable material within said balloon. In some embodiments, the balloon has a footprint that substantially corresponds to a perimeter of a vertebral endplate. An inflatable device is inserted through a cannula into an intervertebral space and oriented so that, upon expansion, a natural angle between vertebrae will be at least partially restored. At least one component selected from the group consisting of a load-bearing component and an osteobiologic component is directed into the inflatable device through a fluid communication means.

Abstract: A system for reducing deformities of the vertebrae in the spine includes a first reduction assembly, a second reduction assembly, and a reduction drive assembly. The first reduction assembly is configured for attachment to a first reduction tower that attaches to a first vertebra. The second reduction assembly is configured for attachment to a second reduction tower that attaches to a second vertebra. The reduction drive assembly includes an arcuate rack gear operably coupling the first reduction assembly to the second reduction assembly to translate the first reduction assembly relative to the second reduction assembly along an arcuate path in a first plane.

Abstract: A device for guiding a surgical instrument having one end for coupling to the head of a bone anchor element and a longitudinal channel, the head of the bone anchor element having a tapped longitudinal recess intended for receiving a screw cap, said longitudinal recess leading into a transverse channel capable of receiving a link rod, characterized in that said guiding device includes a rod for guiding the surgical instrument, with a longitudinal axis A, having one end comprising two semi-tubular tabs in which the outer section matches the inner section of said longitudinal recess and in which the inner section is at least equal to the diameter of the link rod, the cross-section of the guiding device being always smaller than the section of the longitudinal channel of the surgical instrument in order to allow the insertion and the removal of said device in the distal direction.

Abstract: An artificial replacement disc includes a pair of substantially parallel plates formed to occupy a space defined by vertebral endplates, each of the plates including a plurality of spikes on a first surface and a concave trough formed on a second surface opposite of the first surface. A mobile core includes a core rim with opposing convex surfaces extending from opposite sides of the core rim, the mobile core being capable of being disposed between the pair of plates to permit the vertebral endplates to move relative to one another. The spikes on each of the plates extend substantially away from the mobile core and the convex surfaces are formed to integrally fit within the concave trough of at least one of the plates. The core rim limits lateral movement of the mobile core relative to the parallel plates. One or more insertion tools for inserting and implanting the replacement disc are also described.