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, each having convex walls. A second distractor includes a shaft and distal tip including a recessed area at least along the tip. The first distractor is at least partially received within the recessed area of the second distractor when the first and second distractors are in side-by-side relation and a reduced overall width of the distractors is obtained. Preferably, the first and second distractors are used with the guide sleeve. Methods using the disclosed instruments are also provided.

Abstract: An implant for placing in the spine is disclosed. The implant has a tool engaging surface on its trailing end configured for intimate engagement with an insertion tool. The insertion tool configuration is particularly suited for implants made of brittle materials including bone and bone substitutes. Also disclosed is an insertion tool having a gripping end adapted for intimate engagement with an implant. In one embodiment, the insertion tool is operable by axial movement of one gripping arm with respect to the other.

Abstract: Surgical techniques and instruments are provided for performing surgical procedures in a disc space. The instrument includes a sleeve having a distal end and an opposite proximal end and a working channel extending therebetween. The working channel includes a first portion and an adjacent second portion configured to receive surgical instruments therethrough. A cap member is secured to the sleeve at the proximal end. The cap member has a sealable access port substantially aligned with a corresponding one of the first or second portions. The cap member is movable with respect to the sleeve to substantially align the access port with the other of the first and second portions while the working channel remains sealed. Various techniques using various surgical instruments in laparoscopic procedures are also disclosed.

Abstract: This invention relates to devices and instruments for implant insertion through a posterior lateral opening to the disc space. The instruments include an implant inserter, and the devices include a spinal fusion implant engageable by the implant inserter. The implant provides bilateral support of the adjacent vertebrae when inserted into the disc space from a postero-lateral approach.

Abstract: A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

Abstract: A vertebral replacement device for supporting adjacent vertebrae includes a vertebral body member having at least one of an upper or lower disc replacement member engaged thereto at one end thereof. The disc replacement device can be positioned in a spinal disc space when disengaged from the vertebral body member.

Abstract: Instrument and implants are disclosed which provide for insertion of an implant into an intervertebral disc space from multiple approaches to the spine. Specifically, as a preferred aspect of the invention the implant includes a tapered portion and the implant may be inserted from multiple approaches to the spine with the orientation and taper properly oriented in the disc space regardless of the approach.

Abstract: The surgical instrumentation system is adapted to provide an operative approach to the spinal column and maintain distraction of adjacent vertebrae. The system includes at least one retractor and a pair of opposite distractor mechanisms mounted to a frame. The distractor mechanisms each include an adjustment mechanism permitting the distractor mechanism to be pivoted relative to the vertebra and secured to the frame after being repositioned.

Abstract: A vertebral replacement device for supporting adjacent vertebrae includes a vertebral body member having at least one of an upper or lower disc replacement member engaged thereto at one end thereof. The disc replacement device can be positioned in a spinal disc space when disengaged from the vertebral body member.

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, each having convex walls. A second distractor includes a shaft and distal tip including a recessed area at least along the tip. The first distractor is at least partially received within the recessed area of the second distractor when the first and second distractors are in side-by-side relation and a reduced overall width of the distractors is obtained. Preferably, the first and second distractors are used with the guide sleeve. Methods using the disclosed instruments are also provided.

Abstract: Instruments and techniques separate or spread adjacent bony structures by inserting a distal spreader assembly into the space between the adjacent bony structures and actuating the spreading members with a proximal actuator assembly.

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, each having convex walls. A second distractor includes a shaft and distal tip including a recessed area at least along the tip. The first distractor is at least partially received within the recessed area of the second distractor when the first and second distractors are in side-by-side relation and a reduced overall width of the distractors is obtained. Preferably, the first and second distractors are used with the guide sleeve. Methods using the disclosed instruments are also provided.

Abstract: Instrument and implants are disclosed which provide for insertion of an implant into an intervertebral disc space from multiple approaches to the spine. Specifically, as a preferred aspect of the invention the implant includes a tapered portion and the implant may be inserted from multiple approaches to the spine with the orientation and taper properly oriented in the disc space regardless of the approach.

Abstract: A tip for a medical device that distracts two opposing vertebral bodies. The tip has a hub, a boss, and a first longitudinal fin. The boss is attached the hub and has a body, a tapered portion, and a vertex. The first fin is attached to the boss, and projects from at least a portion of the boss's external surface. The first fin then extends over at least a portion of the length of the body and substantially extends over the length of the tapered portion.

Abstract: Surgical techniques and instruments are provided for performing surgical procedures in a disc space. The instrument includes a sleeve having a distal end and an opposite proximal end and a working channel extending therebetween. The working channel includes a first portion and an adjacent second portion configured to receive surgical instruments therethrough. A cap member is secured to the sleeve at the proximal end. The cap member has a sealable access port substantially aligned with a corresponding one of the first or second portions. The cap member is movable with respect to the sleeve to substantially align the access port with the other of the first and second portions while the working channel remains sealed. Various techniques using various surgical instruments in laparoscopic procedures are also disclosed.

Abstract: A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

Abstract: Surgical techniques and instruments are provided for performing surgical procedures in a disc space. The instrument includes a sleeve having a distal end and an opposite proximal end and a working channel extending therebetween. The working channel includes a first portion and an adjacent second portion configured to receive surgical instruments therethrough. A cap member is secured to the sleeve at the proximal end. The cap member has a sealable access port substantially aligned with a corresponding one of the first or second portions. The cap member is movable with respect to the sleeve to substantially align the access port with the other of the first and second portions while the working channel remains sealed. Various techniques using various surgical instruments in laparoscopic procedures are also disclosed.

Abstract: This invention relates to devices and instruments for implant insertion through a posterior lateral opening to the disc space. The instruments include an implant inserter, and the devices include a spinal fusion implant engageable by the implant inserter. The implant provides bilateral support of the adjacent vertebrae when inserted into the disc space from a postero-lateral approach.

Abstract: A valve assembly for a patient support having a mattress including a bladder comprises an interior housing formed to include a supply chamber, an exhaust chamber, a plenum, and an exterior housing surrounding the interior housing. A supply valve and an exhaust valve are located in the interior housing and connect the supply chamber and the exhaust chamber, respectively, to the plenum. A supply solenoid and an exhaust solenoid are coupled to the interior housing and covered by the exterior housing. The supply solenoid and the exhaust solenoid are coupled to the supply and exhaust valves respectively.

Abstract: A valve assembly for a patient support having a mattress including a bladder comprises an interior housing formed to include a supply chamber, an exhaust chamber, a plenum, and an exterior housing surrounding the interior housing. A supply valve and an exhaust valve are located in the interior housing and connect the supply chamber and the exhaust chamber, respectively, to the plenum. A supply solenoid and an exhaust solenoid are coupled to the interior housing and covered by the exterior housing. The supply solenoid and the exhaust solenoid are coupled to the supply and exhaust valves respectively.