Abstract: An instrument and method for cutting a pair of bridges connecting opposing extended tabs of a spinal bone anchor yoke receiver. The instrument includes a pair of opposing movable handles pivotally coupled to each other and a pair of opposing movable legs respectively at the distal end of the handles, each leg supporting a cutting blade facing the other cutting blade. A pair of anvil surfaces is disposed between the cutting blades and spaced therefrom for receipt of a respective bridge. Movement of the handles causes each cutting blade to move toward an anvil surface and compress a respective bridge between a respective cutting blade and an anvil surface until each bridge is severed. The method includes attaching the instrument to at least one of the extended tabs, cutting the bridges, and manipulating the instrument back and forth to remove the one extended tab from the yoke receiver.

Abstract: An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.

Abstract: A steerable expandable spinal implant comprises a body and a movable endplate. The implant including an actuatable expansion mechanism coupled to the body, the expansion mechanism comprising a rotatable drive gear and a follower spindle coupled by a transmission belt. The drive gear is rotatable in a first direction to rotate the body about an axis adjacent a body proximal end, and in a second opposite direction to actuate the expansion mechanism to move the endplate away from the body and expand the spinal implant. A brake shoe is rotatably supported by the body adjacent the proximal end, the brake shoe being operable in a first mode to allow the body to rotate about the axis, and in the second mode to constrain movement of the body relative to brake shoe thereby allowing actuation of the expansion mechanism to move the endplate away from the body and expand the implant.

Abstract: A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.

Abstract: A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.

Abstract: An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.

Abstract: An expandable spinal implant comprises a body having a hollow interior, a proximal end and a distal end, the body supporting an endplate movable relative to the body in a first direction away from said body. An actuatable expansion mechanism, supported within the hollow interior is coupled to the body and the movable endplate to move the movable endplate relative to the body. The expansion mechanism comprises a rotatable drive gear and a rotatable follower supported spaced from the drive gear, and a transmission belt rotatively coupling the drive gear and the follower to transfer rotative motion from the drive gear to the follower upon actuation of the expansion mechanism. The transmission belt is formed in a continuous loop extending in an oblong shape around the drive gear and the follower and has an inward curve on one side of the loop between said drive gear and the follower.

Abstract: A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.

Abstract: A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.

Abstract: A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.

Abstract: An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.

Abstract: An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.

Abstract: An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.

Abstract: A medical implant has a textured tissue contact surface comprising a roughened surface that includes a plurality of macroscale and microscale projections and recesses and a plurality of nanostructures on the projections and within the recesses. The nanostructures comprise a plurality of spaced elongated waves, each wave having a crest and a trough. Each wave and recess comprise a plurality of individual polygonal structures, some of which comprise pyramidical-type shapes. The textured tissue contact surface is formed by initially laser ablating a tissue contact surface on the implant with a nanosecond pulsed laser followed by laser ablating the initially ablated surface with a femto-second pulsed laser.

Abstract: A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.

Abstract: An inserter for attaching a modular yoke to a bone screw and for providing an indication of attachment, comprises a tubular body having a central lumen, distal and proximal ends, and an attachment portion for releasable attachment to a yoke having a bottom opening for receipt of a head of said bone screw. The inserter includes an inner shaft having a distal end configured to be received into the yoke, the shaft being axially movable within the lumen from first to second axial positions in response to the introduction of the bone screw head into the yoke bottom opening. An indicator button supported by the body is movable in response to axial movement of the shaft from a first indicator position indicating the first axial position of the shaft relative to the body to a second indicator position indicating the second axial position of the shaft relative to the body.

Abstract: A medical implant has a textured tissue contact surface comprising a roughened surface that includes a plurality of macroscale and microscale projections and recesses and a plurality of nanostructures on the projections and within the recesses. The nanostructures comprise a plurality of spaced elongated waves, each wave having a crest and a trough. Each wave and recess comprise a plurality of individual polygonal structures, some of which comprise pyramidical-type shapes. The textured tissue contact surface is formed by initially laser ablating a tissue contact surface on the implant with a nanosecond pulsed laser followed by laser ablating the initially ablated surface with a femto-second pulsed laser.

Abstract: A system for delivering bone graft material into an interbody fusion device (IBFD) in an intradiscal space of a spine, the IBFD having an open-frame with a hollow interior and an opening through its proximal end communicating with the interior. Included is an elongate channel having a lumen extending therethrough, the distal end being in engagement with the IBFD to align the lumen with the opening through the proximal end of the IBFD. An adjustable block is movably attached to the channel, the block having plural chambers containing bone graft material, the chambers being individually sequentially alignable with the lumen. A plunger pushes graft material from each chamber, through the lumen and into the IBFD. A distal end of a tamper is configured to be inserted through each chamber and the lumen and into the IBFD interior for tamping graft material deposited into the interior of the IBFD.

Abstract: A system for delivering bone graft material into an interbody fusion device (IBFD) in an intradiscal space of a spine, the IBFD having an open-frame with a hollow interior and an opening through its proximal end communicating with the interior. Included is an elongate channel having a lumen extending therethrough, the distal end being in engagement with the IBFD to align the lumen with the opening through the proximal end of the IBFD. An adjustable block is movably attached to the channel, the block having plural chambers containing bone graft material, the chambers being individually sequentially alignable with the lumen. A plunger pushes graft material from each chamber, through the lumen and into the IBFD. A distal end of a tamper is configured to be inserted through each chamber and the lumen and into the IBFD interior for tamping graft material deposited into the interior of the IBFD.

Abstract: A modular apparatus for extending a rod in an existing spinal construct comprises a modular rod connector for attachment to the existing rod and a modular rod extender that may be selectively attached to the rod connector. Each rod connector includes a spherical head that is formed to have the same size and configuration such that any selected modular rod extender may be attached to a selected rod connector. Each rod connector comprises an attachment portion having an opening for receipt of a portion of the rod of an existing spinal construct. Each modular rod extender comprises an extender body including a common modular attachment feature at one end for receipt of the spherical head of the selected rod connector, and an extension rod extending from an opposite end to extend the existing spinal rod.