Abstract: An expandable implant pivotally movable between a collapsed position, an expanded position, and an angled position, is disclosed. The implant may include at least one first pivoting axis extending in a longitudinal direction and at least one second pivoting axis extending in a transverse direction of the implant. A frame may be pivotally coupled to at least one arm, a superior endplate, and an inferior endplate. The at least one arm may be pivotally coupled to one of the superior endplate or the inferior endplate. The implant may include at least one distraction wedge engaged with the at least one arm and at least one angulation wedge engaged with the at least one distraction wedge.

Abstract: A system includes a cannula that is configured to be inserted into a portion of a body and adjusted in length based on a depth measurement associated with the portion of the body; and an obturator having a handle and a shaft that can be moved relative to the handle to adjust a length of the obturator and a lock for locking the shaft in a plurality of positions relative to the handle, wherein the obturator is configured for receiving the cannula on the shaft and inserting the cannula into the portion of the body.

Abstract: A telescoping access cannula comprising: an outer tube; an inner tube carried by the outer tube, the inner tube being coaxial with the outer tube and longitudinally movable relative to the outer tube; and a rotatable member carried by the outer tube and connected to the inner tube, wherein rotation of the rotatable member causes longitudinal movement of the inner tube relative to the outer tube.

Abstract: A telescoping access cannula comprising: an outer tube; an inner tube carried by the outer tube, the inner tube being coaxial with the outer tube and longitudinally movable relative to the outer tube; and a rotatable member carried by the outer tube and connected to the inner tube, wherein rotation of the rotatable member causes longitudinal movement of the inner tube relative to the outer tube.

Abstract: An expandable implant may include a superior endplate and an inferior endplate hingedly coupled together. The superior endplate may have at least one track extending in a proximal-to-distal direction and an inferior endplate may have at least one track extending in the proximal-to-distal direction. The implant may further include a proximal plate having a superior engagement surface and an inferior engagement surface. At least one shim may be disposed within the at least one tracks of the superior endplate and interior endplate, and the at least one shim may define an angle of inclination between the superior endplate and interior endplate. The at least one shim may be insert between the superior and inferior endplates to effectuate expansion and angulation. In various embodiments, the superior endplate may be supported by the superior engagement surface and the inferior endplate may be supported by inferior engagement surface.

Abstract: An in-situ additive-manufacturing system for growing an implant in-situ for a patient. The system has a multi-nozzle dispensing subsystem and a distal control arm. The multi-nozzle dispensing subsystem in one embodiment includes first and second dispensing nozzles. The first and second nozzles include first and second printing-material delivery channels, respectively. In another embodiment, the in-situ additive-manufacturing system includes a multi-material subsystem having a dispensing nozzle including first and second printing material delivery channels. Controlling computing and robotics componentry are provided. In various aspects, respective storage for first and second printing materials, and one or more pumping structures, are provided.

Abstract: Methods for growing spinal implants in situ using a surgical additive-manufacturing system. In one aspect, the method includes positioning a dispenser at least partially within an interbody space, between a first patient vertebra and a second patient vertebra. The method includes maneuvering the dispensing component within the space to deposit printing material forming an interbody implant part, positioning the dispensing component adjacent the vertebrae, and maneuvering the dispenser adjacent the vertebrae to deposit printing material on an exterior surface of each vertebrae and in contact with the interbody implant part forming an extrabody implant part connected to the interbody implant part and vertebrae, yielding the spinal implant grown in situ connecting the first vertebra to the second vertebra. The extrabody part can be printed around anchors affixed to the vertebrae, and the anchors may be printed in the process.

Abstract: A telescoping access cannula comprising: an outer tube; an inner tube carried by the outer tube, the inner tube being coaxial with the outer tube and longitudinally movable relative to the outer tube; and a rotatable member carried by the outer tube and connected to the inner tube, wherein rotation of the rotatable member causes longitudinal movement of the inner tube relative to the outer tube.

Abstract: A surgical instrument includes at least one blade defining a longitudinal axis and includes a distal member. An actuator is engageable with the member to rotate the member relative to the longitudinal axis to space tissue adjacent a surgical site. Surgical systems, constructs, implants, and methods are disclosed.

Abstract: A build-plate with integrally-formed spinal implant constructs and a method used in forming spinal implant constructs on the build plate and machining the spinal implant constructs formed on the build plate to manufacture spinal implants is provided. The spinal implant constructs can be formed via additive manufacturing processes by adding material to an upper surface of the build plate, and then the spinal implant constructs can be subjected to subtractive manufacturing processes to form the spinal implants.

Abstract: An expandable implant movable between a contracted position and an expanded position, is disclosed. In various embodiments, the implant may be defined by a superior endplate and an inferior endplate having proximal ramps and distal ramps disposed on an interior surface thereof, respectively. In various embodiments, a proximal set screw and a distal set screw may be independently coupled to a proximal wedge and a distal wedge. Upon rotation of the proximal set screw, the proximal wedge may act against the proximal ramps of the superior and inferior endplates and cause the implant to expand at the proximal end. Upon rotation of the distal set screw, the distal wedge may act against the distal ramps of the superior and inferior endplates and cause the implant to expand at the distal end. In some embodiments, both the superior and distal set screws may be rotated simultaneously.

Abstract: A surgical instrument includes at least one blade defining a longitudinal axis and includes a distal member. An actuator is engageable with the member to rotate the member relative to the longitudinal axis to space tissue adjacent a surgical site. Surgical systems, constructs, implants, and methods are disclosed.

Abstract: A geared cam expandable spinal implant. Rotational motion of a rotating portion is translated into linear motion of a yoke, which moves geared cams at the distal end of the implant to mate with, and walk along, teeth of corresponding racks. The walking of the gear cam teeth along the rack teeth creates a regular rate of implant expansion, reduces initial excessive expansion force applied to the implant, and provides fine adjustment of the expansion rate and force. Spikes, pivotally mounted on the yoke, pivot outward as the implant expands, to a fully-deployed position into engagement with surfaces of adjacent vertebral bodies. The engagement between the deployed spikes and the vertebral bodies prevents inadvertent backout of the expanded implant.

Abstract: An in-situ additive-manufacturing system for growing an implant in-situ for a patient. The system has a multi-nozzle dispensing subsystem and a distal control arm. The multi-nozzle dispensing subsystem in one embodiment includes first and second dispensing nozzles. The first and second nozzles include first and second printing-material delivery channels, respectively. In another embodiment, the in-situ additive-manufacturing system includes a multi-material subsystem having a dispensing nozzle including first and second printing material delivery channels. Controlling computing and robotics componentry are provided. In various aspects, respective storage for first and second printing materials, and one or more pumping structures, are provided.

Abstract: Methods for growing spinal implants in situ using a surgical additive-manufacturing system. In one aspect, the method includes positioning a dispenser at least partially within an interbody space, between a first patient vertebra and a second patient vertebra. The method includes maneuvering the dispensing component within the space to deposit printing material forming an interbody implant part, positioning the dispensing component adjacent the vertebrae, and maneuvering the dispenser adjacent the vertebrae to deposit printing material on an exterior surface of each vertebrae and in contact with the interbody implant part forming an extrabody implant part connected to the interbody implant part and vertebrae, yielding the spinal implant grown in situ connecting the first vertebra to the second vertebra. The extrabody part can be printed around anchors affixed to the vertebrae, and the anchors may be printed in the process.

Abstract: A build-plate with integrally-formed spinal implant constructs and a method used in forming spinal implant constructs on the build plate and machining the spinal implant constructs formed on the build plate to manufacture spinal implants is provided. The spinal implant constructs can be formed via additive manufacturing processes by adding material to an upper surface of the build plate, and then the spinal implant constructs can be subjected to subtractive manufacturing processes to form the spinal implants.

Abstract: A device for mixing and dispensing bone material is provided. The device comprises a tubular member having an interior surface configured to receive bone material and a fluid to mix the bone material disposed within the tubular member. The tubular member is flexible and has a proximal opening configured to slidably receive a plunger, and a distal opening configured to dispense a mixed bone material from the interior surface of the tubular member. The plunger is less flexible than the tubular member. Methods of mixing and dispensing bone material are also provided.

Abstract: A telescoping access cannula comprising: an outer tube; an inner tube carried by the outer tube, the inner tube being coaxial with the outer tube and longitudinally movable relative to the outer tube; and a rotatable member carried by the outer tube and connected to the inner tube, wherein rotation of the rotatable member causes longitudinal movement of the inner tube relative to the outer tube.

Abstract: A telescoping access cannula comprising: an outer tube; an inner tube carried by the outer tube, the inner tube being coaxial with the outer tube and longitudinally movable relative to the outer tube; and a rotatable member carried by the outer tube and connected to the inner tube, wherein rotation of the rotatable member causes longitudinal movement of the inner tube relative to the outer tube.

Abstract: A geared cam expandable spinal implant. Rotational motion of a rotating portion is translated into linear motion of a yoke, which moves geared cams at the distal end of the implant to mate with, and walk along, teeth of corresponding racks. The walking of the gear cam teeth along the rack teeth creates a regular rate of implant expansion, reduces initial excessive expansion force applied to the implant, and provides fine adjustment of the expansion rate and force. Spikes, pivotally mounted on the yoke, pivot outward as the implant expands, to a fully-deployed position into engagement with surfaces of adjacent vertebral bodies. The engagement between the deployed spikes and the vertebral bodies prevents inadvertent backout of the expanded implant.