Abstract: An interbody fusion device for engagement between vertebrae includes a pair of lateral spacers for spacing the vertebrae, and a connecting member adapted to couple together the lateral spacers when inserted between the vertebrae. The connecting member, individual lateral spacers, or the entire spinal spacer can be made of bone in order to promote fusion of the vertebrae. The modular construction permits use of bone segments otherwise unsuitable due to size or strength in stable fusion devices.

Abstract: Methods and instrumentation particularly adapted for disc space preparation for insertion of implants from an anterior approach to the spine are provided. The instruments include a guide sleeve defining a channel having overlapping cylindrical working channel portions and lateral non-distracting extensions extending from reduced thickness wall portions. The guide sleeve has an overall reduced width configuration. A pair of distractors are provided. A first distractor includes a shaft and distal tip, and the second distractor includes a shaft and distal tip. The first and second distractors can be used with the guide sleeve. Methods using the disclosed instruments are also provided.

Abstract: Spinal spacers 20 are provided for fusion of a motion segment. The spacers include a load bearing member 21 having a wall 22 sized for engagement within a space between adjacent vertebrae to maintain the space and an effective amount of an osteogenic composition to stimulate osteoinduction. The osteogenic composition includes a substantially pure osteogenic factor in a pharmaceutically acceptable carrier. In one embodiment the load bearing member includes a bone graft impregnated in an osteogenic composition. In another embodiment, the osteogenic composition 30 is packed within a chamber 25 defined in the graft. Any suitable configuration of a bone graft is contemplated, including bone dowels, D-shaped spacers and cortical rings.

Abstract: Methods and instrumentation for vertebral interbody fusion are provided. Sleeve assemblies can be provided with a reduced width portion adjacent the distal end to limit the amount of retraction of the surrounding vascular and neural structures required for the procedure. A sleeve assembly can be provided with a guide sleeve removably engaged to a guide sleeve housing. The guide sleeve can be removed during surgery to improve the surgeon's viewing of the operative site while the guide sleeve housing maintains disc space distraction. Methods and instruments for inserting and using the guide sleeve housing are also provided.

Abstract: Methods and instrumentation for spinal interbody fusion are disclosed. The instruments and methods are particularly adapted for interbody fusion in an unreamed disc space. One instrument is a distractor assembly including a first distractor and a second distractor configured to be inserted in side-by-side relation in the disc space. Fusion cages adapted for insertion into an unreamed disc space are provided to enhance load distribution between adjacent vertebral bodies and lateral stability of the spinal column. The fusion cages may be inserted after distracting the disc space with the distractor assembly. Instruments for preparing the disc space through the inserted fusion cages or for use with the distractor assembly are also provided.

Abstract: A method and instrumentation for spinal interbody fusion is disclosed. The instruments and methods are particularly adapted for interbody fusion from a posterior approach to the spine. One instrument is a retractor having a lockable pivotally mounted handle. Another instrument is a template for straddling the dura. A modular distractor is also provided and preferably includes a tapered shaft with a visualization window disposed therein. Yet another instrument is a depth gauge to verify bone opening depth and dimension, preferably including a radiopaque portion. A method contemplates the use of these instruments to prepare a disc space to receive an implant.

Abstract: A method and instrumentation for spinal interbody fusion is disclosed. The instruments and methods are particularly adapted for interbody fusion from a posterior approach to the spine. One instrument is a retractor having a lockable pivotally mounted handle. Another instrument is a template for straddling the dura. A modular distractor is also provided and preferably includes a tapered shaft with a visualization window disposed therein. Yet another instrument is a depth gauge to verify bone opening depth and dimension, preferably including a radiopaque portion. A method contemplates the use of these instruments to prepare a disc space to receive an implant.

Abstract: A surgical method for preparing a site for implantation of a spinal implant into a disc space in which the disc space is first distracted by a novel stepped distractor, followed by insertion of a novel guide sleeve including a proximal portion having an uninterrupted side wall and a distal portion having a side wall defining a longitudinal opening extending along its entire length. The guide sleeve is seated adjacent the disc space with the longitudinal opening positioned opposite the dural region of the spine to provide a working channel to the disc space. A cutting tool is then inserted through the guide sleeve to remove tissue and bone laterally extending into the interior of the guide sleeve through the longitudinal opening, but only as much as necessary for passage of the spinal implant.

Abstract: A guide sleeve with longitudinally offset bone engaging portions is provided for engagement with anterior-posterior offset vertebral bodies. In one aspect of the invention the guide tube has fixed bone engaging portions in a predetermined offset position. In another form of the invention, the guide sleeve is composed of at least two moveably connected portions adapted to permit adjustment of the offset between the bone engaging portions. Further, a method is provided for using a guide sleeve with offset bone engaging portions.

Abstract: An anterior cervical plating system is disclosed which includes an elongated plate having a pair of bone screw bores at opposite ends of the plate, and with bone screw slot configurations in the middle bridge portion of the plate. A single locking screw is provided at each end of the plate which engages the heads of the bone screws trapped within recesses of the plate. The locking screw provides a rigid fixation of the screws to the plate, while the heads of the screws are flush or recessed below the upper surface of the plate. The invention further contemplates a drill and tap guide assembly which can be mounted on the fixation plate to provide a firm foundation for accurately drilling and tapping screw holes into the vertebra to be instrumented. The drill and tap guide assembly includes an assembly support which is engaged to the plate by way of a positioning screw and cross pins mounting the positioning screw to the guide body.