Abstract: A tool for driving pedicle screws into vertebrae of the human spine has a shaft preferably with a handle at one end and, at the opposite end, a holder for receiving a preferably ring-shaped head which is flattened on opposite sides. The tool has a first clamping jaw (18) secured to the shaft (12), and a second loose clamping jaw (20) including a lateral projection which is tiltably received by the first clamping jaw (18). The tool has an axially slidable actuating member (32) which is guided along the shaft (12). The front end of the actuating member (32) engages the rear end of the second clamping jaw (20) and is preferably axially urged towards the second clamping jaw (20) by a threaded driving means.

Abstract: An awl suitable for both opening up a bone canal and for sizing that bone canal so as to obviate the use of a Charnley awl and the use of 4 to 5 distal reamers comprises (a) a tapered distal cutting head having a pointed first end, and a second end; and (b) a shaft attached to the second end, such that the shaft has a multiplicity of grooves calibrated so as to indicate the diameter of the isthmus of the bone canal. Also provided is a method of opening up a bone canal and of measuring the diameter of the isthmus of the bone canal with a single instrument.

Abstract: A method and apparatus for injecting an elastic spinal implant into a cavity in a spinal disc so as to treat disc degeneration are given. The method and apparatus can be used in a variety of surgical approaches with respect to the patient. An elastic spinal nucleus prosthesis is very quickly inserted into the cavity through a small opening in the disc so that permanent deformation of the prosthesis is avoided.

Abstract: A new cutting tip and a very simple method for making the tip are given. The tip has no flutes but has a built-in chip clearance. It is self-drilling, self-tapping, and self-locating and can be positioned on a threaded or unthreaded member. When it is the tip on a suture anchor, it maximizes holding strength of the anchor.

Abstract: A modular femoral internal implant system for use in the treatment of femoral disorders resulting from injury, disease or congenital defect includes at least three interconnectable components: 1) an elongated epiphyseal/metaphyseal implant, 2) an intramedullary rod and 3) an angled side plate having an elongated plate portion adapted to be secured to the outer cortical wall and a hollow sleeve adapted to extend into the femur. The epiphyseal/metaphyseal implant can be connected to either the angled side plate or the intramedullary rod. The system may also include an elongated bone plate connectable to the angled side plate, one or more additional epiphyseal/metaphyseal implants of variable length, an additional angled side plate, a distal buttress plate connectable to the elongated bone plate, and a plurality of bone screws of a universal design. Preferably, many or all of the components of the system are made of an inert, resilient titanium-base alloy.

Abstract: A repositioning tool for handling pedicle screws which have annular heads with parallel clamping faces is provided. The tool has a tongue-shaped portion connected to a handle, which tongue-shaped portion is brought into engagement with the head of a pedicle screw in the axial direction thereof. The tool can apply a tilting moment perpendicular to the length axis of the pedicle screw and can apply a torque. The tool comprises pliers with jaws (22, 24) including inwardly extending projections (28, 30) to engage opposite indentations (70, 72) provided along the periphery of the annular head (64) of the pedicle screw (60).

Abstract: A method of dehydration of bulky hydrogel samples of polyvinyl alcohol (i.e., PVA) and a method of preparation of prosthetic nuclei for vertebral discs are given. A method of gamma irradiation sterilization of PVA gel samples which does not incur the side effects of discoloration and of increased crystallinity (i.e., further reduction of water content) is also given.A method of dehydrating bulky hydrogel samples of polyvinyl alcohol (i.e., PVA) so that no significant distortion in the samples results, comprises:(a) subjecting the sample to a solvent system comprising at least one organic solvent which(1) has a solubility for PVA which is less than the solubility of water for PVA and(2) is miscible with waterfor a length of time generally from about 2 to about 10 days so that the dehydration rate of the hydrogel samples is sufficiently slow so as not to cause any distortions on the dehydrated samples.

Abstract: An apparatus for correcting a spinal column having damaged vertebrae comprises a fastener (which is preferably a pedicle screw) having a receiving slot for holding a distracting or compressing bar. The bar is positioned within the slot in a manner permitting adjustment and is then locked in a fixed position, both functions achieved by a special two-part locking element which first holds and then rigidly locks the bar and fastener together. A method for correcting a spinal column having damaged vertebrae is also given.

Abstract: An endoprosthesis for a shoulder joint that provides for an adjustable distance between the head portion and the shank portion is provided. The head portion of the endoprosthesis is connected through a threaded connection to the proximal end of the shank portion such that the distance between the head portion and the shank portion can be varied. In operation, the head portion is screwed into the shank portion until the desired distance is obtained.

Abstract: Device for stabilizing, and/or compressing, and/or distracting certain portions of the spinal column is provided. The device utilizes pedicle screws, and an adapter is provided which may be connected by a screw device to the head of a pedicle screw. A roughened portion of the adapter cooperates with a roughened portion of the pedicle screw head to provide for a non-rotatable connection of the adapter with respect to the pedicle screw. The adapter has a circular opening or a recess for receiving the threaded rod which is fixed to the adapter by a threaded device.

Abstract: A ratcheting compression device is provided which is very strong, which can be customized in length, which can be retightened periodically to maintain compression, which allows precise placement and alignment of bones with both grossly tuned compression and finely tuned compression, and in which only a limited inventory of parts is required. The two-piece compression device comprises (a) a novel first piece having a bone screw located at a first end thereof and having a ratcheting member located near the second end thereof and comprising teeth having their crests lying substantially in a plane and (b) a novel second piece comprising an anti-rotation member which acts in cooperation with the ratcheting member of the first piece to compress two segments of bone together. In yet other embodiments, two embodiments of a driver are provided for quickly driving the stop onto the ratcheting member to a desired extent.

Abstract: A locking nail for treating femoral fractures has a generally cylindrical proximal portion to be positioned in the medullary canal. The proximal portion has an oblique bore for positioning and guiding a femoral neck screw. The nail has a distal portion provided with at least one cross bore for receiving a bone screw. The distal portion has an annular cross-sectional profile including an axial slot. The annular profile may be in the form of a clover leaf. A transition portion of said nail is located between the proximal and distal nail portions. The longitudinal slot extends from the transition portion to the distal tip of the distal portion.

Abstract: A device for bending a plate with an offset distance L and two angles simultaneously is provided, the device comprising special jaws which are replaceably attachable to the jaws of a pliers. A kit of a plurality of sets of bending jaws having a variety of offset lengths is provided.

Abstract: An awl suitable for both opening up a bone canal and for sizing that bone canal so as to obviate the use of a Charnley awl and the use of 4 to 5 distal reamers comprises (a) a tapered distal cutting head having a pointed first end, and a second end; and (b) a shaft attached to the second end, such that the shaft has a multiplicity of grooves calibrated so as to indicate the diameter of the isthmus of the bone canal. Also provided is a method of opening up a bone canal and of measuring the diameter of the isthmus of the bone canal with a single instrument.

Abstract: An osteotomy cutting guide is disclosed. The cutting guide utilities an angle cutting block which is removably and adjustably attached to a stabilizing base. Also utilized is a distal hole drill block which is removably and adjustably attached to the stabilizing base. The stabilizing base has at least one projecting element which can be inserted into an existing cut. The osteotomy cutting guide allows angled cuts and implant insertions to be performed with accuracy.

Abstract: A prosthetic nucleus for a vertebral disc is made of a hydrogel material. The hydrogel prosthetic nucleus has a shape generally conforming to the natural nucleus pulposus, and it exhibits diminished lateral bulging under high compressive loads. The hydrogel has a water content of from 30% to 90% and has a compressive strength of 4 MNm.sup.-2 or greater. When the hydrogel material is dehydrated, it has a dimension of less than half of that of the hydrated hydrogel nucleus. The prosthetic nucleus may be formed of two or more pieces of hydrogel material which pieces, when combined, have a shape generally conforming to the natural nucleus. The prosthetic nucleus may have a stiff posterior periphery and/or a thickened anterior wall.

Abstract: The invention is an elongated plate made of deformable, body-compatible material, which is to be anteriorly attached to at least a pair of adjacent vertebrae. The plate has specially placed holes to receive bone screws to be screwed into the vertebrae.

Abstract: Novel prosthetic nuclear implants for insertion into vertebral discs are prepared by dehydrating hydrated bulky hydrogel discs under specific conditions so as to reduce the water content as low as possible (down to about 10% by weight) but without distortion of the implants, without the formation of concavities and sharp edges, and without changing the shape of the hydrated implant.

Abstract: A surgical saw has a sector-shaped saw blade mounted on a shaft. The shaft is surrounded by a coaxial second shaft to which an eccentric member is mounted close to a saw blade and parallel therewith. Both shafts and thus the eccentric member and the cutting blade can be rotated with respect to each other and can be fixed in their rotational position. Depending on the rotational position, the saw blade is either covered by the eccentric member in a rest position to be inserted in a hollow bone, or is indexed in a position to be freely and gradually exposed to make a sawing operation possible.

Abstract: An implant comprising a specially adapted bone screw having a threaded shank portion and a sleeve which mates with and operates in cooperation with the threaded shank portion is provided. Also provided is a driver specially adapted for inserting and removing the implant of the invention. A method of compressing a fracture in a bone is also provided. The implant generates bone compression by itself and can be used either alone or with plates and washers. It is easily inserted into a fracture and also is easily removed from the fracture. The driver which is specially adapted to be used in combination with the implant of the invention aids in the ease of insertion and removal of the implant.