Abstract: Instruments and methods for distracting an intervertebral space and inserting and impacting artificial intervertebral discs. A wedge distractor employing opposing ramps through which an inserter/impactor holding an artificial intervertebral disc is admitted, the passage of which through the distractor results in distraction of the intervertebral space simultaneous with insertion of the artificial intervertebral disc. A method of distracting an intervertebral space comprising the steps of inserting a distractor having opposing ramped surfaces into an intervertebral space and inserting an inserter/impactor holding an artificial intervertebral disc between the opposing ramped surfaces of the distractor to insert/impact the artificial intervertebral disc in the intervertebral space. A system for distracting an intervertebral space employing a wedge distractor, inserter/impactor and artificial intervertebral implant.

Abstract: A method of inserting an intervertebral disc implant into a disc space includes accessing a spinal segment having a first vertebral body, a second vertebral body and a disc space between the first and second vertebral bodies. The method includes securing a first pin to the first vertebral body and a second pin to the second vertebral body, using the first and second pins for distracting the disc space, and providing an inserter holding the intervertebral disc implant. The method also desirably includes engaging the inserter with the first and second pins, and advancing the inserter toward the disc space for inserting the intervertebral disc implant into the disc space, whereby the first and second pins align and guide the inserter toward the disc space.

Abstract: A method for replacing at least a portion of an intervertebral disc in a spinal column includes: removing the portion of the intervertebral disc from the spinal column; and inserting an apparatus for replacing the portion of the intervertebral disc into an intervertebral disc space defined substantially between adjacent vertebral bones of the spinal column, and positioning the apparatus between the vertebral bones, wherein the apparatus is operable to permit the adjacent vertebral bones to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located outside the intervertebral disc space, and (ii) a second center of rotation for lateral bending that is located outside the intervertebral disc space.

Abstract: Instrumentation for implanting a cervical disc replacement device includes cervical disc replacement trials for determining the appropriate size of replacement device to be implanted, an insertion plate for maintaining the elements of the replacement device in fixed relation to one another for simultaneous manipulation, an insertion handle for attachment to the insertion plate for manipulation of the elements, an insertion pusher for releasing the insertion handle from the insertion plate, a drill guide that cooperates with the insertion plate to guide the drilling of tap holes for bone screws to be placed through bone screw holes in the flanges of the replacement device, clips that are applied to the flanges after placement of the bone screws to resist screw backout, and a clip applicator for applying the clips to the flanges.

Abstract: Instrumentation for implanting an artificial intervertebral disc includes static trials and a dynamic trial for determining the appropriate size of disc to be implanted, static trial holders for manipulating the static trials, inserter/impactors for inserting and removing the static trials and for inserting the artificial intervertebral discs, repositioners/extractors for repositioning and extracting the static trials or the artificial intervertebral discs, and a leveler for setting the proper position of the artificial intervertebral disc. Methods for using the same are also disclosed. Features for artificial intervertebral discs and intervertebral spacer devices useful for manipulation by the instrumentation are also disclosed.

Abstract: A method for replacing at least a portion of an intervertebral disc in a spinal column includes: removing the portion of the intervertebral disc from the spinal column; and inserting an apparatus for replacing the portion of the intervertebral disc into an intervertebral disc space defined substantially between adjacent vertebral bones of the spinal column, and positioning the apparatus between the vertebral bones, wherein the apparatus is operable to permit the adjacent vertebral bones to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located outside the intervertebral disc space, and (ii) a second center of rotation for lateral bending that is located outside the intervertebral disc space.

Abstract: An intervertebral spacer has curvate upper and lower rough surfaces that stimulate bone growth and is formed from a porous material that facilitates bone growth thereinto. The spacer has a plurality of smooth linear grooves to facilitate insertion of the spacer into an intervertebral space using a spacer insertion tool that has a scissor-style body. Each of the insertion tool's arm's heads has an inner surface having a pair of smoothed linear protrusions that fit within the linear grooves of the spacer when the heads are closed about the spacer. When the spacer is held, spaces are present between the spacer's rough surfaces and the heads' inner surfaces so that when the protrusions are longitudinally slid from the grooves to leave the spacer in the intervertebral spacer, the rough surfaces are not disturbed.

Abstract: A wedge plate inserter/impactor instrument is provided primarily for holding, inserting, repositioning, removing, impacting, extracting, and otherwise manipulating an artificial intervertebral disc having features suitable for being manipulated thereby. A spring-loaded holding pin of the instrument can be used to engage a corresponding hole on the disc and confront the angled surfaces of the disc to enable the holding and manipulation of the disc. A forward wedge extension of the inserter/impactor has upper and lower surfaces that engage inwardly facing surfaces of the disc to hold the baseplates of the disc at a preferred lordosis angle with respect to one another. The instrument can engage the disc from a variety of surgical approach angles.

Abstract: An intervertebral spacer device includes a first plate and a second plate, each plate having an outer surface for seating against opposing vertebral bone surfaces. The device includes a ball captured in a central opening of a coupling element, the coupling element being maintained against the first plate by a retaining ring coupled with the first plate.

Abstract: Artificial disc replacements (ADRs) and total disc replacements (TDRs) are based upon two, directly articulating components, resulting in a restricted-motion system that better approximates more normal spinal flexion, extension, and lateral bending. Both components are preferably made of a hard material and are highly polished to reduce friction.

Abstract: This invention improves upon prior art total disc replacements (TDRs) by more closely replicating the kinematics of a natural disc. The preferred embodiments feature two or more fixed centers of rotation (CORs) and an optional variable COR (VCOR) as the artificial disk replacement (ADR) translates from a fixed posterior COR that lies posterior to the COR of the TDR to facilitate normal disc motion. The use of two or more CORs allows more flexion and more extension than permitted by the facet joints and the artificial facet (AF). AF joint-like components may also be incorporated into the design to restrict excessive translation, rotation, and/or lateral bending.

Abstract: A method of inserting an intervertebral disc implant into a disc space includes accessing a spinal segment having a first vertebral body, a second vertebral body and a disc space between the first and second vertebral bodies. The method includes securing a first pin to the first vertebral body and a second pin to the second vertebral body, using the first and second pins for distracting the disc space, and providing an inserter holding the intervertebral disc implant. The method also desirably includes engaging the inserter with the first and second pins, and advancing the inserter toward the disc space for inserting the intervertebral disc implant into the disc space, whereby the first and second pins align and guide the inserter toward the disc space.

Abstract: Instrumentation for implanting an artificial intervertebral disc includes repositioners/extractors for repositioning and extracting the static trials or the artificial intervertebral discs, each of the repositioners/extractors including a shaft and at least two pins coupled to the shaft distal end and extending in a same direction and perpendicular to a plane passing through the shaft longitudinal axis, each pin being parallel to all others of the pins, wherein the disc includes at least two holes, at least two of the pins being sized, directed, and spaced for simultaneous engagement with at least two of the holes, and wherein such simultaneous engagement enables repositioning of the implant via application of pressure to the shaft.

Abstract: An orthopedic device set, including: a plurality of intervertebral spacer elements, each spacer element having a different axial thickness from each other element, the axial thicknesses being selected to increase by an increment from one element to another; and an instrument for holding ones of the intervertebral spacer elements, the instrument comprising a shaft having a distal end, a selectively grasping subassembly for alternatively rigidly holding each spacer element at the distal end so that the spacer element cannot move relative to the instrument, and releasing the spacer element.

Abstract: An instrument for inserting an implant between vertebral bodies, including a holder adapted to hold the implant during insertion of the implant between the vertebral bodies, a retractor adapted to retract the holder away from the implant after the insertion, and a guard adapted to prevent the implant from being removed from between the vertebral bodies during the retraction.

Abstract: Spacerless artificial disc replacements (ADR) are disclosed. One preferred embodiment includes two saddle-shaped components to facilitate more normal spinal flexion, extension, and lateral bending while limit axial rotation, thereby protecting the facet joints and the annulus fibrosus (AF). Either or both of the superior and inferior components are made of a hard material such as chrome cobalt, titanium, or a ceramic including alumina, zirconia, or calcium phosphate. The articulating surfaces of the ADR are also preferably highly polished to reduce friction between the components. Metals, alloys or other materials with shape-memory characteristics may also prove beneficial.

Abstract: An instrument for holding an intervertebral spacer is provided. The instrument includes a compression assembly and a fixed shaft forming a handle and a compression surface. The compression assembly includes a selectively engageable shaft axially movable relative to a longitudinal axis of the fixed shaft. The engageable shaft forms a hook having a surface complimentary to the compression surface to define an enclosure for engagement with an annular groove of the spacer. The compression assembly includes a compression trigger mechanically connected to the engageable shaft for axially moving the hook from a first position relative to the fixed shaft in which the enclosure engages the spacer such that the spacer is held by the enclosure to a second position relative to the fixed shaft in which the spacer is disengaged from at least one of the hook surface and the compression surface such that the enclosure disengages the spacer.

Abstract: An intervertebral spacer device includes a first plate and a second plate, each plate having an outer surface for seating against opposing vertebral bone surfaces. The device includes a ball captured in a central opening of a coupling element, the coupling element being maintained against the first plate by a retaining ring coupled with the first plate.

Abstract: An instrument for inserting an implant between vertebral bodies, including a holder adapted to hold the implant during insertion of the implant between the vertebral bodies, a retractor adapted to retract the holder away from the implant after the insertion, and a guard adapted to prevent the implant from being removed from between the vertebral bodies during the retraction.

Abstract: An orthopedic device set, including: a plurality of intervertebral spacer elements, each spacer element having a different axial thickness from each other element, the axial thicknesses being selected to increase by an increment from one element to another; and an instrument for holding ones of the intervertebral spacer elements, the instrument comprising a shaft having a distal end, a selectively grasping subassembly for alternatively rigidly holding each spacer element at the distal end so that the spacer element cannot move relative to the instrument, and releasing the spacer element.