Abstract: Retaining mechanisms are attachable to a bone plate to retain one or more bone engaging fasteners relative to the bone plate. The retaining mechanisms include a retaining element engaged to an attachment element. One or both of the retaining element and the attachment element are moveable relative to the plate to position and/or maintain the retaining element in contact with one or more bone engaging fasteners.

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: 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: An interbody spinal fusion implant for insertion across a disc space between adjacent vertebral bodies of a human spine has a body two top side and two bottom side junctions, with at least a pair of diagonally opposed junctions having a distance therebetween that does not significantly exceed the implant body height. The implant also includes one or more bone penetrating protrusions extending outwardly from at least the upper and lower walls of the implant. The implant is inserted on its side between adjacent vertebral bodies and then rotated 90 degrees into place. The protrusions penetrate the endplates upon rotation, thereby securing the implant within the spine. The implant has at least one passage therethrough from the upper wall to the lower wall to promote fusion through the implant. Because of the specialized opposed junctions overdistraction between the adjacent vertebral bodies is avoided when the implant is rotated from an initial insertion position to a final deployed position.

Abstract: Embodiments of the invention include instrumentation and methods for treatment of a spinal structure or other orthopedic structures. An elongate member including a deformable distal portion having an initial configuration for placement within a spinal structure or other orthopedic structures, and a deformed configuration wherein the distal portion is outwardly deformed is provided. The elongated member may be used to access the interior of the spinal structure or other orthopedic structures and to manipulate tissue within the structure.

Abstract: The present invention is a specialized orthopedic implant having an exterior surface for engaging bone. The surface comprises arrayed projections having at least one forward facing facet directed at least in part toward the leading end of the implant and at least one rearward portion directed at least in part toward the opposite trailing end of the implant. Each of the forward facet and rearward portion has a length and a slope. The length of the forward facet is longer than the length of the rearward facet. The slope of the rearward facet is steeper than the slope of the forward facet. The surface projections also have opposed side facets directed generally toward the sides of the implant. The side facets are located between the forward facet and rearward facet and converge toward each other in a direction away from the base of the surface projections. The surface may also include projections having left and right forward side facets and a rearward facet.

Abstract: Techniques for spinal surgery include accessing at least one vertebral element of the spinal column. At least one loading member is engaged to the at least one vertebral element. The loading member is allowed to integrate with the bony structure of the vertebral element over time. The integrated loading member is accessed in a second surgical procedure, and can be loaded and/or attached to a construct.

Abstract: A fixation device for use in association with ALIF procedures includes a couple of spaced plates having integral spikes on facing surfaces thereof for pressing into spinal processes of adjacent vertebrae. One of the plates has a spherical socket which captures a spherical head end of a post whose other end is received through an aperture in the other plate. The socket mounting is arranged to enable the post to pivot therein for at least two degrees of freedom to a limited extent, enabling angulation between the two plates so as to accommodate the different thicknesses and orientations of the spinal processes on adjacent vertebrae. The reception of the post in the second plate enables adjustment of spacing between the plates to accommodate effective installation of the assembly on the spinal processes by a compression instrument, and permanent reliable maintenance of that spacing following removal of the compression instrument.

Abstract: An anterior cervical plating system having moveable plate segments to vary the overall length of the plate, moveable to allow and/or cause intersegmental compression of vertebral bodies, and coupled together by a non-detachable fastener. The plating system includes locking elements, each locking element adapted to lock at least two bone screws to the plate, instrumentation, and method for installation thereof. The plating system is capable of both passive and active dynamization and the ability to produce the former from the latter.

Abstract: A vertebral endplate preparation assembly is disclosed for preparing an endplate of a single vertebral body in a vertebral column to receive an implant. The assembly comprises a datum block for connecting to the single vertebral body, measuring instruments, and a cutting guide attached to the datum block. A cutting instrument is used for preparing the endplate, and an instrument coupling assembly is connected between the cutting instrument and the cutting guide.

Abstract: A method of loosening ingrown bone from an intervertebral implant using an ultrasonic instrument having a self tapping connector. The method comprises surgically accessing the intervertebral implant. The intervertebral implant includes first and second endplate assemblies and the first endplate assembly includes an unthreaded aperture. The method further comprises tapping the unthreaded aperture of the first endplate assembly with the self-tapping connector and passing an ultrasonic energy through the self tapping connector to the first endplate assembly. The method also comprises ultrasonically vibrating the first endplate assembly to break a first portion of the ingrown bone from the intervertebral implant.

Abstract: A spine stabilization system includes a flexible member attachable to a portion of the spinal column. The member includes components that are oriented and function similar to the natural fiber orientation of the anterior longitudinal ligament and annulus tissue. The use of components resist loading applied by extension and rotation of the spine, while the flexibility of the member does not subject it to the compressive loading of the spinal column segment to which it is attached.

Abstract: An anterior cervical plating system having moveable and modular plate segments that are assembleable to vary the overall length of the plate, moveable to allow and/or cause intersegmental compression of vertebral bodies, and coupled together by a detachable fastener. The plating system includes locking elements, each locking element adapted to lock at least two bone screws to the plate, instrumentation, and method for installation thereof. The plating system is capable of both passive and active dynamization and the ability to produce the former from the latter.

Abstract: An apparatus including an interbody spinal fusion implant having a leading end, a trailing end, and a length therebetween, and opposed upper and lower portions adapted to contact each of the adjacent vertebral bodies. Each of the upper and lower portions has at least one screw hole passing therethrough proximate the trailing end. The apparatus further includes bone screws adapted for placement through the screw holes of the upper and lower portions and into each of the adjacent vertebral bodies adjacent the disc space to be fused and into which the implant is adapted to be positioned. At least one lock may be used to prevent the bone screws from backing out of the vertebral bodies and implant.

Abstract: A system for removing an implant from between a pair of vertebral bodies comprises a removal shaft. The removal shaft includes a threaded shaft portion and is coupled to a spreader block. A connector body is threadedly coupled to the threaded shaft portion. The system further includes a first removal blade having a proximal end and a distal end. The proximal end is attached to the connector body and the distal end is attachable to the implant. A first spreader brace is attached to the spreader block. Rotation of the threaded shaft removes at least a portion of the implant from between the pair of vertebral bodies.

Abstract: An intervertebral implant has two-plates intended to come into contact with a patient's vertebral end-plates. One of the plates has a cut-out delineating webs converging toward a zone where the plates are connected to one another.

Abstract: An apparatus including an interbody spinal fusion implant having a leading end, a trailing end, and a length therebetween, and opposed upper and lower portions adapted to contact each of the adjacent vertebral bodies. Each of the upper and lower portions having at least one opening adapted to communicate with one each of the adjacent vertebral bodies and to communicate with one another to permit for the growth of bone from vertebral body to adjacent vertebral body through the implant. Each of the upper and lower portions has at least one screw hole passing therethrough proximate the trailing end. The apparatus further includes bone screws adapted for placement through the screw holes of the upper and lower portions and into each of the adjacent vertebral bodies adjacent the disc space to be fused and into which the implant is adapted to be positioned. At least one lock may be used to prevent the bone screws from backing out of the vertebral bodies and implant.

Abstract: A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

Abstract: An augmentation instrument for attaching a retaining device to a vertebral endplate comprises a drive housing having a distal end portion, a drive mechanism extending through the drive housing and including a flexible shaft portion, and an attachment mechanism at the distal end portion of the drive housing. The attachment mechanism is adapted for coupling to the retaining device.

Abstract: An expansion assembly expands a vertebral implant. The vertebral implant has an inner cylindrical assembly adapted for insertion into an outer cylindrical assembly having an outer wall. The vertebral implant is expandable along an implant axis defined by the outer and inner cylindrical assemblies. The expansion assembly comprises an axle having proximal and distal end portions and an axle axis defined between the proximal and distal end portions. The expansion assembly further comprises a gear arranged about the axle axis at the proximal end portion of the axle and adapted to rotate about the axle axis to cause the inner cylindrical assembly to expand the vertebral implant. The engagement assembly also comprising a first engaging portion adapted to engage the inner cylindrical assembly and a second engaging portion adapted to engage the gear externally of the outer wall of the outer cylindrical assembly.