Abstract: Orthopedic implants, particularly interbody spacers, have a combination of correct pore size and stiffness/flexibility. When the implants have the proper pore size and stiffness, osteocytes are able to properly bridge the pores of the implant and then experience a proper compressive load to stimulate the bone cells to form bone within the pores. An implant includes a body formed of an osteoconductive material and having a stiffness of between 400 megapascals (MPa) and 1,200 MPa. Additionally, the body includes a plurality of pores having an average size of between 150 microns and 600 microns. The pores permit the growth of bone therein. The body is formed of packs of coils which may be formed using an additive manufacturing process and using traditional orthopedic implant materials such as titanium and titanium alloys while still achieving desired stiffness and pore sizes of the implants.

Abstract: Add-on couplers and coupler systems for use in surgical procedures and methods for utilizing add-on couplers in surgical procedures are provided. In some implementations, the add-on coupler includes a coupler receptacle configured to receive and couple to a first coupler, the first coupler being configured, in some cases, to couple to an implant anchor. In some implementations, the add on coupler includes a rod receptacle configured to receive a rod of a second coupler. In some cases, the second coupler and add-on coupler are coupled to an existing component from an earlier surgical procedure, thereby removing the need to remove the existing component prior to installing a new component. Additional implementations are described.

Abstract: Systems and methods for stereotactic localization of components include a system for stereotactic localization of a component during a surgical procedure. In some cases, the system includes one or more of an instrument, a plurality of markers disposed on the instrument, one or more sensors configured to detect a position of each of the markers, and an output device. In some cases, the system is configured to calculate a digital 3-dimensional array based on the position of at least some of the plurality of markers, compute a location of the instrument, and communicate the location of the instrument to a user of the system through the output device. Other implementations are described.

Abstract: Systems and methods for spinal fusion revision allow extending prior spinal fusion constructs in revision surgery, in situ, while minimizing surgical exposure of the prior constructs. A revision system for extending spinal fusion implants includes a tulip assembly adapted to be fixedly secured to a pedicle screw as part of a first spinal fusion procedure and a construct extension protrusion extending from the tulip assembly. A revision system for extending spinal fusion implants in situ includes a tulip assembly adapted to be fixedly secured to a pedicle screw as part of a second spinal fusion procedure adjacent a site of a prior spinal fusion procedure. The tulip assembly includes a receptacle adapted to be fixedly secured to a construct extension protrusion of a spinal fusion construct from the prior spinal fusion procedure via a press or interference fit.

Abstract: An expanding, conforming interbody implant includes a plurality of superior and a plurality of inferior segments. The segments are adapted to individually expand, contact, and conform to endplates of vertebral bodies to distribute forces equally over the implant and across the vertebral endplates. Once a proper extension of the segments has been achieved, the segments are locked in position. The implant has a stiffness that approximates the stiffness of bone, and the implant minimizes problems with subsidence, endplate fractures, and stress shielding.

Abstract: Orthopedic implants, particularly interbody spacers, have a combination of correct pore size and stiffness/flexibility. When the implants have the proper pore size and stiffness, osteocytes are able to properly bridge the pores of the implant and then experience a proper compressive load to stimulate the bone cells to form bone within the pores. An implant includes a body formed of an osteoconductive material and having a stiffness of between 400 megapascals (MPa) and 1,200 MPa. Additionally, the body includes a plurality of pores having an average size of between 150 microns and 600 microns. The pores permit the growth of bone therein. The body is formed of packs of coils which may be formed using an additive manufacturing process and using traditional orthopedic implant materials such as titanium and titanium alloys while still achieving desired stiffness and pore sizes of the implants.

Abstract: An expanding, conforming interbody implant includes a plurality of superior and a plurality of inferior segments. The segments are adapted to individually expand, contact, and conform to endplates of vertebral bodies to distribute forces equally over the implant and across the vertebral endplates. Once a proper extension of the segments has been achieved, the segments are locked in position. The implant has a stiffness that approximates the stiffness of bone, and the implant minimizes problems with subsidence, endplate fractures, and stress shielding.

Abstract: Improved fixation or stabilization of implants is achieved via one or more deployable spikes or anchors. The deployable spikes or anchors may be present in the implant in a nested, collapsed, or retracted position while the implant is inserted into the human body, and may then be deployed (e.g., into adjacent bone) after the implant is in place, thereby fixing the implant's location against unwanted movement. Such fixation or stabilization of the implant may reduce patients' pain, may improve overall short-term and long-term stability of the implant, and may improve osteo-integration into the implant.

Abstract: Improved fixation or stabilization of implants is achieved via one or more deployable spikes or anchors. The deployable spikes or anchors may be present in the implant in a nested, collapsed, or retracted position while the implant is inserted into the human body, and may then be deployed (e.g., into adjacent bone) after the implant is in place, thereby fixing the implant's location against unwanted movement. Such fixation or stabilization of the implant may reduce patients' pain, may improve overall short-term and long-term stability of the implant, and may improve osteo-integration into the implant.

Abstract: A porous implant design method includes defining a design volume for a porous implant, a load to be borne by the design volume, and an objective function solution characteristic related to the design volume. Next, the load is divided into a plurality of sub-loads and an optimization procedure is performed: until all sub-loads have been applied, one of the plurality of sub-loads is applied to the material in the design volume, material from the design volume is removed such that remaining material within the design volume is capable of bearing one of the plurality of sub-loads while satisfying the objection function solution characteristic; the remaining material defines a void space without material, the void space is set as a new design volume for any remaining sub-loads, the new design volume is set as being full of material. Then, the remaining material from each cycle of the optimization is combined.

Abstract: Systems and methods for measuring and applying a spinal compression force are provided. Some implementations of the systems and methods include a compression instrument having one or more compressors or gauges. In some cases, the compressor is configured to apply the spinal compression force to a spine of a patient. In some cases, the gauge is configured to measure the spinal compression force. Other implementations are discussed herein.

Abstract: Systems and methods for providing a secure and durable implant are disclosed. For example, the systems and methods may include securely attaching an anchor to an implant body. In some cases, the anchor has an anchor head. In some cases, a coupler for coupling to the implant body is configured to receive the anchor. Some implementations of the disclosed systems and methods include a rivet for attaching the anchor to the coupler. In some implementations at least one of the anchor head and the rivet includes a projection, while the other includes a socket configured to receive the projection. Other implementations are discussed herein.

Abstract: A porous implant design method includes defining a design volume for a porous implant, a load to be borne by the design volume, and an objective function solution characteristic related to the design volume. Next, the load is divided into a plurality of sub-loads and an optimization procedure is performed: until all sub-loads have been applied, one of the plurality of sub-loads is applied to the material in the design volume, material from the design volume is removed such that remaining material within the design volume is capable of bearing one of the plurality of sub-loads while satisfying the objection function solution characteristic; the remaining material defines a void space without material, the void space is set as a new design volume for any remaining sub-loads, the new design volume is set as being full of material. Then, the remaining material from each cycle of the optimization is combined.

Abstract: A surgical implant includes a deployable, retractable, or removable ramped nose. During insertion of the implant, the ramped nose is deployed such that the ramped nose can serve to distract a space into which the implant is inserted. At some point during or after insertion, the ramped nose can be collapsed and removed or retracted so that it does not extend beyond the space into which the implant is inserted, while the implant extends at full height throughout the space into which the implant is inserted. The implant includes an implant body having a deployable ramped nose adapted to selectively extend from the body and transition from a first height proximate the implant body to a second, shorter, height distal from the implant body. The deployable ramped nose is adapted to distract an implant site upon insertion of the implantable medical device.

Abstract: An expanding, conforming interbody implant includes a plurality of superior and a plurality of inferior segments. The segments are adapted to individually expand, contact, and conform to endplates of vertebral bodies to distribute forces equally over the implant and across the vertebral endplates. Once a proper extension of the segments has been achieved, the segments are locked in position. The implant has a stiffness that approximates the stiffness of bone, and the implant minimizes problems with subsidence, endplate fractures, and stress shielding.

Abstract: An expandable interbody spacer includes a first endplate surface located on a first side of the spacer and adapted to contact a vertebral endplate surface of a first vertebral body, a second endplate surface located on a second, opposed, side of the spacer and adapted to contact a vertebral endplate surface of a second, opposed, vertebral body and an expansion mechanism adapted to selectively apply a distracting force between the first endplate surface and the second endplate surface, whereby actuation of the expansion mechanism causes the spacer to transition between a compressed insertion configuration to an expanded fusion configuration. The spacer also includes one or more of a deformable surface, a porosity to promote bone on-growth or through-growth, a stiffness substantially equivalent to cortical bone, and structure distributing loads through the spacer substantially without transferring the loads through higher-stiffness structures.

Abstract: An expanding, conforming interbody implant includes a plurality of superior and a plurality of inferior segments. The segments are adapted to individually expand, contact, and conform to endplates of vertebral bodies to distribute forces equally over the implant and across the vertebral endplates. Once a proper extension of the segments has been achieved, the segments are locked in position. The implant has a stiffness that approximates the stiffness of bone, and the implant minimizes problems with subsidence, endplate fractures, and stress shielding.

Abstract: A surgical implant includes a deployable, retractable, or removable ramped nose. During insertion of the implant, the ramped nose is deployed such that the ramped nose can serve to distract a space into which the implant is inserted. At some point during or after insertion, the ramped nose can be collapsed and removed or retracted so that it does not extend beyond the space into which the implant is inserted, while the implant extends at full height throughout the space into which the implant is inserted. The implant includes an implant body having a deployable ramped nose adapted to selectively extend from the body and transition from a first height proximate the implant body to a second, shorter, height distal from the implant body. The deployable ramped nose is adapted to distract an implant site upon insertion of the implantable medical device.

Abstract: A porous implant design method includes defining a design volume for a porous implant, a load to be borne by the design volume, and an objective function solution characteristic related to the design volume. Next, the load is divided into a plurality of sub-loads and an optimization procedure is performed: until all sub-loads have been applied, one of the plurality of sub-loads is applied to the material in the design volume, material from the design volume is removed such that remaining material within the design volume is capable of bearing one of the plurality of sub-loads while satisfying the objection function solution characteristic; the remaining material defines a void space without material, the void space is set as a new design volume for any remaining sub-loads, the new design volume is set as being full of material. Then, the remaining material from each cycle of the optimization is combined.

Abstract: Orthopedic plates (including anterior cervical plates), plate systems, and methods of use allow orthopedic screws to be placed with full visualization. This allows screw placement without use of specialized locating instruments or pins. The new plates are introduced to the surgical wound after the screws are placed and are secured by a press or interference fit. Because the screws are placed before the plates are introduced, the screws function as attachment points for distraction implements. The new plates and plate systems obviate the need to achieve a particular position and angulation of screws. The screws allow more angulation, and plate eyes adjust to screw position. Plate eyes translate to match the effective plate size to the screw placement, thereby allowing each plate to fit multiple screw spacings. Plates are adapted to adjust to bone remodeling or subsidence. Screw eyes can slide to maintain graft contact and compression.