Abstract: A method and instrumentation particularly adapted for disc space preparation from an anterior approach to the spine. In one aspect, an expandable template is provided having guides to guide a cutting device for bilateral formation of openings in the disc space. In another aspect, an improved guide member is provided for guiding a cutting tool. Still further, the invention provides an improved double barrel guide sleeve with a central distraction extension and lateral non-distracting extensions. Optionally, the guide sleeve includes windows and covers to selectively cover the windows. An improved reamer with an internal chamber and optional modular coupling is also provided. A depth stop is provided to selectively engage a tool shaft and a guide sleeve to control tool penetration into the disc space. A method of using the disclosed instruments is also provided.

Abstract: This invention relates to methods and instruments for performing a surgical procedure in a disc space between adjacent vertebrae. The instruments include a distractor and a cutting instrument. In one embodiment the distractor includes a body portion and a pair of flanges extending along opposite sides of the body portion such that a slot is formed between the flanges and the body portion. The cutting instrument is positionable over the body portion and into the slots of the distractor so that the flanges are positioned between the cutting instrument and the adjacent tissue.

Abstract: This invention provides a vertebral implant for impaction in a disc space to restore and/or maintain desired disc space height and spinal orientation. The implant has an elongated basis body having a generally lens-shape provided by convex upper and lower surfaces. Bearing surfaces are provided on the cross-edge surfaces of the endwalls. Grooves are provided in the upper and lower surfaces positioned between the bearing surfaces. The implant can be prepared from a wide variety of materials including metallic materials, synthetic materials, polymeric materials, ceramic materials, and composite materials including reinforced materials i.e. glass, fiber, and/or carbon fiber reinforced materials (CFRP). These preferred materials for fabricating implants in the present invention reduce costs, increase service life and provide excellent physiological compatibility. The non-metallic material can be selected to be either a substantially permanent material, a biodegradable material or a bioerodable material.

Abstract: This invention relates to a spinal implant for promoting fusion of adjacent vertebrae and restoration of normal disc height. The spinal implant includes an upper and lower surface adapted to engage cancellous bone tissue in the vertebral bodies. The spinal implant also includes at least two opposing bearing surfaces adapted to bear against cortical bone tissue in the endplates of adjacent vertebrae. This invention also provides an instrumentation to prepare the intervertebral space to receive the spinal implant and techniques for treating patents in need of corrective spinal surgery.

Abstract: One embodiment is directed to instrumentation for performance of a spinal implantation procedure. In one form, this instrumentation includes: a tube device with an inner surface defining a passage from a proximal end portion to a distal end portion, a conveyor including a threaded conveying rod to be received in the passage of the tube device that can be rotated in the tube or moved in translation along the passage, and a deformable prosthesis structured to move through the passage of the tube by rotating the threaded conveying rod while at least a portion of the deformable prosthesis is positioned between the inner surface and the rod. Optionally, a tool to maintain position of the tube device can be included that has a jaw mechanism, among other things.

Abstract: This invention relates to a spinal implant for promoting fusion of adjacent vertebrae and restoration of normal disc height. The spinal implant includes an upper and lower surface adapted to engage cancellous bone tissue in the vertebral bodies. The spinal implant also includes at least two opposing bearing surfaces adapted to bear against cortical bone tissue in the endplates of adjacent vertebrae. This invention also provides an instrumentation to prepare the intervertebral space to receive the spinal implant and techniques for treating patents in need of corrective spinal surgery.

Abstract: A disc preparation system includes an oscillating rasp for preparation of vertebral endplates and a central reamer for reaming a pair of kidney-shaped grooves into the vertebral endplate. The oscillating rasp is powered by a rotary power source. A linkage assembly is coupled to the rotary power source to convert the rotary motion into a reciprocating motion. A pair of rasps plates, which are linked to the linkage assembly, linearly reciprocate in opposite directions in response to the reciprocating motion of the linkage assembly. In one form, the central reamer includes a pair of cutting elements that are coupled to the rotary power source in order to rotate in response to rotational movement from the rotary power source. In another form, the central reamer includes a single cutting element coupled to an angled reamer handle and a reamer guide.

Abstract: A method and instrumentation particularly adapted for disc space preparation from an anterior approach to the spine. In one aspect, an expandable template is provided having guides to guide a cutting device for bilateral formation of openings in the disc space. In another aspect, an improved guide member is provided for guiding a cutting tool. Still further, the invention provides an improved double barrel guide sleeve with a central distraction extension and lateral non-distracting extensions. Optionally, the guide sleeve includes windows and covers to selectively cover the windows. An improved reamer with an internal chamber and optional modular coupling is also provided. A depth stop is provided to selectively engage a tool shaft and a guide sleeve to control tool penetration into the disc space. A method of using the disclosed instruments is also provided.

Abstract: An intervertebral implant has two-plates intended to come into contact with a patient's vertebral end-plates. One of the plates has a cut-out delineating webs converging toward a zone where the plates are connected to one another.

Abstract: A plating system for stabilization of a bony segment includes a plate engageable to at least first and second bony elements. For spinal stabilization, the plate is attached at least to first and second vertebrae with at least one bone fastener in each vertebra. Retaining members are attachable to the plate to prevent the bone fasteners from backing out of the plate. One retaining member is a variable retaining member that allows the bone fasteners to toggle in the plate without interference. A second retaining member is a fixed retaining member that fixes the bone fasteners relative to the plate.

Abstract: A plating system for stabilization of a bony segment includes a plate engageable to at least first and second bony elements. For spinal stabilization, the plate is attached at least to first and second vertebrae with at least one bone fastener in each vertebra. Retaining members are attachable to the plate to prevent the bone fasteners from backing out of the plate. One retaining member is a variable retaining member that allows the bone fasteners to toggle in the plate without interference. A second retaining member is a fixed retaining member that fixes the bone fasteners relative to the plate.

Abstract: This invention relates to implants formed from donor bone for use in lumbar interbody fusion procedures and instruments for performing such procedures. The implants are formed to include a concave surface formed from a portion of the medullary canal of a long bone. The concaved surface defines a recess in the implant that serves as a depot for osteogenic material. Specific instruments for inserting the implants prepared according to this invention and for preparing the intervertebral space to receive the implants are also provided.

Abstract: Methods and instrumentation for surgical procedures relating to preparation of vertebral bodies and a disc space for insertion of spinal implants is disclosed. One instrument is a shim having a blade and a shaft having a first end connected with the blade. The blade is inserted into a distracted disc space to maintain distraction during subsequent procedures. Another instrument is a driver for driving the blade of the shim into the distracted disc space. Various methods contemplate the use of these instruments to maintain disc space distraction during disc space preparation for receiving an implant.

Abstract: An intersomatic implant (1a, 1b) maintains bone graft material in a receiving cavity formed in a disc in order to obtain intervertebral fusion. The implant (1a, 1b) includes of a plurality of parts provided with means for in situ connection of two consecutive parts. Instruments (33) are used to connect these implants (1a, 1b) and a tool assists in introducing these implants (1a, 1b) into the cavity formed in the disc.

Abstract: An instrument for separating adjacent vertebrae includes a handle assembly and a distal portion at a distal end of the handle assembly. The distal portion includes first and second members movable from an unexpanded configuration for insertion in the disc space toward an expanded configuration to separate the vertebrae. A cutting member of a cutting instrument can be guided by the instrument to prepare the vertebrae for engagement with an implant.

Abstract: Laterally expanding vertebral spacer devices are provided for repairing damaged vertebral discs. The vertebral spacer devices maintain the height of a distracted vertebral disc space while providing stability to the spine. In one form of the invention, a vertebral spacer device is provided with a first arm movably coupled to a second arm. The first and second arms are laterally expandable from a first width for insertion into the disc space to a second width after insertion into the disc space. The first and second arms also define a cavity therebetween for placement of bone growth material.

Abstract: Systems and methods for stabilizing the spine are provided. For stabilizing the L5-S1 junction, the system includes a plate (7) that has a generally triangular shape with an upper node (8a) and a pair of lower nodes (9a, 10a). The upper node (8a) has a hole (8) through the plate (7) to receive a screw (11) for passage into the L5 vertebra. The lower nodes (9a, 10a) each include a hole (9,10) through the plate (7) to receive screws (12, 13) for passage into the S1 vertebra. The system further includes a plate (7) having a retaining element (32) for preventing backout of screws inserted through the plate (9). Instruments and methods for attaching the plate to the spinal column are also provided.

Abstract: A hand-held instrument, with a rotary power input to a camshaft, has cam and follower arrangement to provide a reciprocating shaft output. A cutter is provided on the output shaft. In one example, rotating cam percussion is transmitted to the cutter by engaging the cutter with the tissue to be cut, and pushing the instrument forward toward the cutter. In another example, rotating cam percussion is transmitted to the cutter by engaging the cutter with the tissue to be cut, and pulling the instrument back toward the user while maintaining engagement of the cutter with the tissue. In both examples, the cutter remains in idle condition until an axially directed load, forward in the one example, or backward on the other example, is placed on the cutter by moving the instrument forward or backward, respectively, while the camshaft is rotating. A distractor with frame is used to spread and maintain space between vertebral bodies, enabling entrance of the cutter.

Abstract: Methods and instrumentation for surgical procedures relating to preparation of vertebral bodies and a disc space for insertion of spinal implants is disclosed. One instrument is a shim having a blade and a shaft having a first end connected with the blade. The blade is inserted into a distracted disc space to maintain distraction during subsequent procedures. Another instrument is a driver for driving the blade of the shim into the distracted disc space. Various methods contemplate the use of these instruments to maintain disc space distraction during disc space preparation for receiving an implant.

Abstract: Systems and methods for stabilizing the spine are provided. For stabilizing the L5-S1 junction, the system includes a plate that has a generally triangular shape with an upper node and a pair of lower nodes. The upper node has a hole through the plate to receive a screw for passage into the L5 vertebra. The lower nodes each include a hole through the plate to receive screws for passage into the S1 vertebra. The system further includes a plate having a retaining element for preventing backout of screws inserted through the plate. Instruments and methods for attaching the plate to the spinal column are also provided.