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: Apparatus and methods for preparing a disc space and inserting an intervertebral disc implant therein are disclosed. Among the various instruments disclosed are a midline marker, a reference pin drill and insertion guide, a pin drill guide, a chisel guide, a sizer, a serrated broach, an implant dispenser, and an implant insertion tool. Methods of utilizing these tools are also disclosed.

Abstract: Instrumentation for implanting an artificial intervertebral disc includes a leveler for setting the proper position of the artificial intervertebral disc, the leveler including at least two tines extending parallel to one another from the leveler shaft distal end, wherein the tines are spaced and sized to be insertable and fittable between baseplates of the disc and to substantially fill at least a height of a separation space volume between the baseplates, and to straddle a central coupling of the baseplates during the insertion and when so fitted, such that when the baseplates are substantially non-parallel to one another in the intervertebral space, insertion of the tines into the intervertebral space between the baseplates and straddling the central coupling forces the baseplates into a substantially parallel orientation relative to one another.

Abstract: An insertion tool for inserting an intervertebral spacer is provided. The tool includes first and second pincers. The first pincer is fixed and the second pincer is pivotably coupled to the first pincer at a pivot location in open-biased opposition to the first pincer. The tool includes a compression slide which may be selectively translated into and out of engagement with the second pincer. When the compression slide is in a predetermined engagement position with the second pincer, the first and second pincers are in a closed position for holding the intervertebral spacer. When the compression slide is out of engagement with the second pincer, the first and second pincers are in an open position for releasing the intervertebral spacer.

Abstract: Apparatus and methods for preparing a disc space and inserting an intervertebral disc implant therein are disclosed. Among the various instruments disclosed are a midline marker, a reference pin drill and insertion guide, a fin drill guide, a chisel guide, a sizer, a serrated broach, an implant dispenser, and an implant insertion tool. Methods of utilizing these tools are also disclosed.

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: 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: 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. One component may have a concave articulating surface, and the other a convex articulating surface. The radius of curvature of the articulating surface may be smaller in the anterior-to-posterior direction of the ADR than the radius of curvature of the articulating surface in the left-to-right direction of the ADR. 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: 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: An artificial intervertebral disc having a pair of opposing baseplates, for seating against opposing vertebral bone surfaces, uses a semispherical, bored bearing that is secured to the baseplates with compression locking posts and one or more retaining caps. The compression locking posts extend through the bearing bore and baseplate apertures such that the bearing is between the baseplates' inwardly facing surfaces. Retaining caps are attached to the compression locking posts, securing the baseplates to the bearing. Bearing surfaces on the inwardly facing side of each baseplate allow each baseplate to rotate relative to the bearing, however, rotation of each baseplate is limited by the interference of each baseplate and its respective retaining cap. Rotation of the baseplates about the longitudinal axis of the spine can be limited via a notch in the retaining caps and a groove in the baseplates, or vice versa.

Abstract: This invention improves upon prior aft 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: 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: An intervertebral space distraction and implantable device assembly provides sequentially axially wider spacers that are to be sequentially inserted into and removed from an intervertebral space to widen the space until a desired anatomical spacing of the adjacent vertebral bones is restored. The set of spacers includes a porous spacer that is as wide as the spacer that restores the desired anatomical spacing. The porous spacer can therefore be left implanted in the intervertebral space to promote fusion of the adjacent vertebral bones.

Abstract: Instrumentation for implanting an artificial intervertebral disc includes static trials, the static trials including first and second trial baseplates immovably coupled to one another via a trunk extending therebetween, each trial baseplate having an outwardly facing surface approximating a contour of a corresponding outwardly facing surface of an artificial intervertebral disc baseplate, at least one of the trial baseplates having a plurality of engagement holes extending into the at least one of the trial baseplates in a direction substantially perpendicular to each of a plurality of a surgical approach directions used to insert the trial into the intervertebral space, each of the plurality of engagement holes being disposed on the at least one of the trial baseplates to correspond to a respective one of the surgical approach directions such that selection for use of one of the plurality of engagement holes corresponds to, selection of the respective surgical approach.

Abstract: An instrument for holding an intervertebral spacer, the instrument comprising a shaft having a proximal end and a distal end, the proximal end forming a handle and the distal end forming a spacer engaging subassembly, the spacer engaging subassembly comprising at least one selectively expanding and contracting enclosure into which at least a portion of the spacer is introduced when the engaging subassembly is expanded and an actuating mechanism, extending from the proximal end to the distal end, by which the spacer member engaging subassembly may be selectively expanded and contracted.

Abstract: An intervertebral distraction tool has a clamshell head with upper and lower halves, each having a curvate outer surface and a flat inner surface. The distal side of the head is hinged so that the head opens and closes from the proximal side of the head. The hinge is a separating hinge that allows the halves to not only angulate with respect to one another about the hinge axis, but also to vertically separate from one another at the hinge. A distraction separator has decreasing taper at its distal end and a longitudinal bore that accommodates the elongate shaft of the trial so that the separator can be moved longitudinally relative to the shaft. Upon forward movement of the separator, the tapered upper and lower surfaces engage the flat inner surfaces of the head, causing the halves to angulate about the hinge axis of the head, thereby opening the head.

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 orthopedic spacer device comprising a spacer body having an external surface that includes at least two relative angle designation marks such that a rotational angle of the spacer body relative to a known reference is determinable.

Abstract: An adjustable pin drill guide and method for using an adjustable pin drill guide to prepare a vertebral body space to receive an implant are disclosed. The method includes providing an adjustable pin drill guide, producing a gap by removing tissue between a first vertebral body and a second vertebral body, inserting into the gap first and second extensions of the guide in a first position, moving the first extension and the second extension to a second position, drilling a first hole in the first vertebral body through a first opening in the guide, drilling a second hole in the second vertebral body through a second opening in the guide, placing a first pin into the first hole, and placing a second pin into the second hole. The first and second extensions are preferably in parallel planes when in the first and second positions.