Abstract: An expandable implant includes an upper main support, a lower main support, an upper pivoting support, and a lower pivoting support. The upper main support and the upper pivoting support are configured to engage a first portion of bone, and the lower main support is coupled to the upper main support and configured to engage a second portion of bone. The upper main support is adjustable relative to the lower main support to adjust height of the implant. The upper pivoting support is rotatably movable relative to the upper main support. The lower pivoting support is coupled to the upper pivoting support, configured to engage the second bone portion, and is rotatably movable relative to the lower main support. Adjusting the upper main support relative to the lower main support causes adjustment of the upper pivoting support relative to the lower pivoting support.

Abstract: A plate and an installation tool are provided for preventing a spinal facet joint implant from expulsing from its implant location between a superior and an inferior vertebra. A k-wire is used in cooperation with the plate and installation tool to guide them to the desired location. The plate includes a central threaded bore situated between one or two superior bone screw or bone connection barb bores and one or two inferior bone screw or bone connection barb bores. The installation tool includes a threaded plug at one end for receipt by the plate's central threaded bore for releasably holding the plate during installation. The installation tool has a superior structure and an inferior structure that can be a cannula or tang depending on the plate's form.

Abstract: A lateral spine implant has a lateral spine cage and an associated lateral spine plate with one or more folding vertebral attachment arms, each arm configured for attachment to vertebral bone. The ability of the one or more arms to fold allows the lateral spine plate to be inserted/implanted at a lower profile height than traditional lateral spine plates. The lateral spine plate is meant to be used at times of intended or unintended compromise of the anterior longitudinal ligament (ALL) to prevent interbody cage migration, but may be adapted for any lateral plating application. Once expanded, each attachment arm is configured to receive a bone screw for securing the attachment arm to a vertebra, the bone screw retained by rotating cam lock nuts of the attachment arm.

Abstract: A two-piece medical instrument for installing an expandable interbody (intervertebral) spine implant via an endoscope, has a handle assembly and a shaft assembly configured for extension through the endoscope, the shaft assembly holding an expandable interbody spine implant when the shaft assembly is fully received by a head of the handle assembly, and releasing the spine implant upon retraction of the shaft assembly from the head of the handle assembly. The shaft assembly has a rod with a longitudinal bore and a sleeve situated on the rod that axially moves relative to the rod in response to the reception into and retraction from the handle assembly head, with the sleeve controlling capture and release of the implant by the rod. The distal end of the rod has a clamp formed by jaws that flex to capture and release the implant.

Abstract: A pituitary rongeur medical instrument has jaws that can controllably articulate radially from a longitudinal axis of a shaft assembly of the pituitary rongeur and beyond a perimeter of a cannula during use. The pituitary rongeur is characterized by a handle, a shaft assembly defining a proximal end extending from the handle, a distal end, and a longitudinal axis, with the jaws pivotally connected to the distal end of the shaft assembly for articulating radial movement of the jaws relative to the longitudinal axis of the shaft assembly, a jaw controller associated with the shaft assembly and configured to controllably close and open the jaws, and an articulation controller associated with the shaft assembly and configured to controllably articulate the jaws. The handle is formed by a handgrip portion configured to receive a palm of a user and a lever portion with a finger loop configured to receive fingers of the user.

Abstract: A medical instrument fashioned as an articulating curette for decorticating vertebral endplates of vertebrae of a spine via a cannula has a handle, a controller connected to the handle, two opposing arms extending from the controller, a control shaft between the two opposing arms and coupled to the controller for longitudinally axial movement thereof by the controller relative to the two opposing arms, a bladed decorticating head for decorticating vertebral endplate bone material from vertebral endplates and pivotally connected to the two opposing arms for articulation from 0° to 90° relative to the longitudinal axis of the control shaft, and a pivot mechanism between the bladed decorticating head and the control shaft providing controlled articulation of the bladed decorticating head through longitudinally axial movement of the control shaft. Rotational movement of the controller moves the control shaft axially relative to the two opposing arms to articulate the bladed decorticating head.

Abstract: A vertebral endplate preparation (decorticating) tool has height adjustable blades at a distal end of a shaft assembly for decorticating/shaving vertebral endplate material from spinal vertebrae, translates axial movement of a control rod of the shaft assembly of the vertebral endplate preparation tool with height adjustable blades into radial blade height change (extension and retraction) through a controller of a handle assembly. The blades may also be configured for collecting and removing shaved vertebral endplate material. The blades controllably move outward radially from the distal end of the shaft assembly and controllably move inward radially into the distal end of the shaft assembly upon manipulation of the controller. Radial blade extension and retraction from the distal end may be accomplished via mutual angled dovetail features of the blades and the distal end, or via pins of the distal end of the shaft assembly situated in angled slots of the blades.

Abstract: A medical instrument for dislodging vertebral disc material from a vertebral disc in a vertebral disc space via a cannula has a pivoting scoop structure with a scoop that provides a 180° pivot sweep outside of the diameter of the cannula. The medical instrument has an elongate body defining a longitudinal axis with the pivoting scoop structure situated at a distal end of the elongate body. The elongate body has a first elongate shaft and a second elongate shaft situated on and configured for longitudinal axial translation relative to the first elongate shaft. Axial movement of the second elongate shaft controllably swivels the pivoting scoop structure from, through, and between 0° to 180° relative to the longitudinal axis of the elongate body. The scoop structure may also allow for collection and removal of dislodged vertebral disc material.

Abstract: A spine implant for a TLIF surgical procedure is configured to be guided into place during implantation in conjunction with a complementary insertion instrument. The cage of the implant is constrained to a limited range of rotation about a pivoting post carried by the cage. The insertion instrument is configured to hold the post while controllably rotating the cage relative to the post in order to angularly position the implant during implantation. Range of rotational motion is controlled by the configuration of an opening in and end of the cage and a groove in the pivot post. A retaining pin of the implant extends from the cage into the groove of the post to rotationally connect the cage to the post.

Abstract: A spine implant for receipt between and fastened to a lower vertebra and an adjacent upper vertebra is characterized by an expandable cage and an expandable plate attached to the expandable cage. When the expandable cage is expanded, both the expandable cage and the expandable plate expand together at a uniform rate of movement. Engagement features of the expandable cage cooperate with engagement features of the expandable plate such that expansion of the expandable cage carries the expandable plate along during its expansion. The engagement features of the expandable cage may be configured as notches, cavities, or recessed pockets, while the engagement features of the expandable plate may be configured as tangs, flanges, or protuberances styled to be received by the configured notches of the expandable cage. Cam locks on the expandable plate help bone fastener backout.

Abstract: A spine implant for receipt between and fastened to a lower vertebra and an adjacent upper vertebra is characterized by an expandable cage and an expandable plate attached to the expandable cage. When the expandable cage is expanded, both the expandable cage and the expandable plate expand together at a uniform rate of movement. Engagement features of the expandable cage cooperate with engagement features of the expandable plate such that expansion of the expandable cage carries the expandable plate along during its expansion. The engagement features of the expandable cage may be configured as notches, cavities, or recessed pockets, while the engagement features of the expandable plate may be configured as tangs, flanges, or protuberances styled to be received by the configured notches of the expandable cage. Cam locks on the expandable plate help bone fastener backout.

Abstract: A steerable expandable implant having a lower support member and an upper support member, the upper support member movable relative to the lower support member between a collapsed position and an expanded position. The implant also includes a first control member coupled to the lower support member, where manipulation of the first control member causes the lower support member to move relative to the upper support member. The implant further includes a pivot member configured to receive a tool, the tool and the pivot member rotatable relative to the lower support member between a first position and a second position, where the pivot member includes an aperture and an axis of the aperture is angularly offset from an axis of the first control member in the first position and the axis of the aperture is angularly aligned with the axis of the first control member in the second position.

Abstract: A steerable expandable implant including a base member, an adjustable member coupled to the base member, the adjustable member movable between a collapsed position and an expanded position, a pivot member rotatably received by the base member and configured to receive a tool such that the tool and the pivot member are rotatable relative to the base member between a first position and a second position, wherein the pivot member is translationally fixed relative to the base member, and a first control member received by the base member, wherein manipulation of the first control member causes the adjustable member to move between the collapsed position and the expanded position.

Abstract: An implant and method for spinal facet joint stabilization uses a wedge and plate adapted to accept prongs of a surgical instrument for installing the implant into a posterior spinal facet joint. The wedge has an anterior end with a threaded bore. A notch in each lateral side of the plate aligns with a groove in each lateral side of the wedge. Each notch and groove pair receives a prong of the surgical instrument to hold the wedge and plate during implantation. A superior tube of the surgical instrument supports a superior rod having an end configured for installing a bone screw attaching the plate to the superior vertebra of the spinal facet joint. An inferior tube of the surgical instrument supports an inferior rod having an end configured to attach to the threaded bore of the wedge along with the plate during introduction of the implant into the spinal facet joint, and installing the set screw to attach the plate to the wedge.

Abstract: A retractor includes a body, a first handle pivotally coupled to the body, a first attachment assembly comprising a first button configured to allow detachment of a second handle portion from the first handle, a first arm assembly attached to the first handle, a first blade attached to the first arm assembly, wherein the first handle is configured to control distraction of the first blade in response to pivotal motion of the first handle, a second handle pivotally coupled to the body, a second attachment assembly comprising a second button configured to allow detachment of a fourth handle portion from the second handle, a second arm assembly attached to the second handle, and a second blade attached to the second arm assembly, wherein the second handle is configured to control distraction of the second blade in response to pivotal motion of the second handle.

Abstract: A spine implant for a TLIF surgical procedure is configured to be guided into place during implantation in conjunction with a complementary insertion instrument. The cage of the implant is constrained to a limited range of rotation about a pivoting post carried by the cage. The insertion instrument is configured to hold the post while controllably rotating the cage relative to the post in order to angularly position the implant during implantation. Range of rotational motion is controlled by the configuration of an opening in and end of the cage and a groove in the pivot post. A retaining pin of the implant extends from the cage into the groove of the post to rotationally connect the cage to the post.

Abstract: A steerable expandable implant including a base member, an adjustable member coupled to the base member, the adjustable member movable between a collapsed position and an expanded position, a pivot member rotatably received by the base member and configured to receive a tool such that the tool and the pivot member are rotatable relative to the base member between a first position and a second position, wherein the pivot member is translationally fixed relative to the base member, and a first control member received by the base member, wherein manipulation of the first control member causes the adjustable member to move between the collapsed position and the expanded position.

Abstract: A spine implant for receipt between and fastened to a lower vertebra and an adjacent upper vertebra is characterized by an expandable cage and an expandable plate attached to the expandable cage. When the expandable cage is expanded, both the expandable cage and the expandable plate expand together at a uniform rate of movement. Engagement features of the expandable cage cooperate with engagement features of the expandable plate such that expansion of the expandable cage carries the expandable plate along during its expansion. The engagement features of the expandable cage may be configured as notches, cavities, or recessed pockets, while the engagement features of the expandable plate may be configured as tangs, flanges, or protuberances styled to be received by the configured notches of the expandable cage. Cam locks on the expandable plate help bone fastener backout.

Abstract: A spinal interbody implant is fabricated using 3-D printing to provide an engineered structure of one or more porous, permeable, or non-solid portions with or without one or more solid, dense, or micro-dense portions. The porous, permeable, or non-solid structure can be a mesh, lattice, web, weave, honeycomb, simple cubic, tetrahedral, diamond, or otherwise with the number and size of its pores, holes, perforations, or openings, as well as the distance or thickness between them, can vary accordingly. Some portions of the porous, permeable, or non-solid structure(s) may have porosities and/or thicknesses different than other portions. The solid, dense, or micro-dense structure may be constant throughout the body of the implant or may be a range of densities throughout the body of the implant. Alternately, one or more portions of the implant may have a range of densities throughout its body ranging from solid to a maximum porosity.

Abstract: A spine retractor provides lateral access to the spine for distracting soft tissue and psoas muscle for spinal fusion procedures utilizing position controllable blades. The retractor allows concerted linear distraction of two lateral blades and separate linear distraction of one medial blade. Individual angulation assemblies associated with each blade provides separately controllable angulation. Handles attached to the two lateral blades control their distraction while a medial knob controls medial blade distraction. An expansion knob associated with each handle provides individually precise distraction of its associated blade. Each angulation assembly comprises an angulation knob that threads into a distal arm of a blade holder assembly and is received into a spherical ball seated in a spherical pocket in a mating proximal arm of the blade holder assembly. Torque applied to the spherical ball by the angulation knob causes distal arm angulation relative to the proximal.