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: A system and method for treating a bulge in an intervertebral disc annulus fibrosus adjacent to a vertebral body of a patient's spine using a repair device including a suture element, a patch element and a bone anchor. A bore is formed through a portion of the vertebral body, including an endplate thereof adjacent to the intervertebral disc. A suture picker is deployed through the bore and the annulus fibrosus, and the suture element is coupled to the suture picker. The suture picker is withdrawn from the bore. The suture element is pulled so as to draw the patch element against the bulge, and continued tension on the suture element urges the patch and the bulged anteriorly so as to re-approximate the natural shape of the annulus fibrosus. The suture element is secured to the vertebral body using the bone anchor.

Abstract: An artificial disc implant includes an upper shell, a lower shell, and a spacer therebetween. The spacer preferably has properties similar to that of a natural spinal disc, while the upper and lower shells form a rigid interface between the implant and the adjacent vertebral bodies. The upper and lower shells can be configured to prevent expulsion of the spacer from the disc space. The implant upper and lower shells may further be configured into partially cylindrical shapes for ease of insertion through an insertion tube as presently known for interbody fusion devices. The devices may further be configured for insertion through a double-barreled insertion tube. Methods and instruments for inserting an artificial disc implant are also provided.

Abstract: A system and method for treating a bulge in an intervertebral disc annulus fibrosus adjacent to a vertebral body of a patient's spine using a repair device including a suture element, a patch element and a bone anchor. A bore is formed through a portion of the vertebral body, including an endplate thereof adjacent to the intervertebral disc. A suture picker is deployed through the bore and the annulus fibrosus, and the suture element is coupled to the suture picker. The suture picker is withdrawn from the bore. The suture element is pulled so as to draw the patch element against the bulge, and continued tension on the suture element urges the patch and the bulged anteriorly so as to re-approximate the natural shape of the annulus fibrosus. The suture element is secured to the vertebral body using the bone anchor.

Abstract: A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

Abstract: A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

Abstract: An artificial disc implant includes an upper shell, a lower shell, and a spacer therebetween. The spacer preferably has properties similar to that of a natural spinal disc, while the upper and lower shells form a rigid interface between the implant and the adjacent vertebral bodies. The upper and lower shells can be configured to prevent expulsion of the spacer from the disc space. The implant upper and lower shells may further be configured into partially cylindrical shapes for ease of insertion through an insertion tube as presently known for interbody fusion devices. The devices may further be configured for insertion through a double-barreled insertion tube. Methods and instruments for inserting an artificial disc implant are also provided.

Abstract: A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

Abstract: A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

Abstract: A targeting surgical instrument for use in spinal disc replacement includes a first arm, a second arm and a body portion. The first arm is configured to be longitudinally aligned with a mid-line of a spine and to be at least partially received on an endplate of a lower vertebra of spinal cavity. The spinal cavity is defined by a lower vertebra and an upper vertebra of the spinal cavity. The second arm is positioned at an angle relative to the first arm. The second arm defines an insertion angle for a spinal implant. The body portion connects the first arm and the second arm. The body portion includes a plurality of radial opaque markers located to allow alignment of the first arm on the mid-line of the spine.

Abstract: An artificial disc implant includes an upper shell, a lower shell, and a spacer therebetween. The spacer preferably has properties similar to that of a natural spinal disc, while the upper and lower shells form a rigid interface between the implant and the adjacent vertebral bodies. The upper and lower shells can be configured to prevent expulsion of the spacer from the disc space. The implant upper and lower shells may further be configured into partially cylindrical shapes for ease of insertion through an insertion tube as presently known for interbody fusion devices. The devices may further be configured for insertion through a double-barreled insertion tube. Methods and instruments for inserting an artificial disc implant are also provided.

Abstract: A prosthetic device for anterior-oblique insertion into an intervertebral space is provided. The prosthetic device includes a first component having a first flange for engaging a first vertebra from an anterior-oblique approach, the first flange being angled relative to the longitudinal and transverse axes of the first component, and a second component having a second flange for engaging a second vertebra from an anterior-oblique approach, the second flange being angled relative to the longitudinal and transverse axes of the second component, and wherein the first and second components cooperate to permit articulating motion between the first and second components.

Abstract: An interbody fusion device in one embodiment includes a tapered body defining a hollow interior or chamber for receiving bone graft or bone substitute material. The body defines exterior threads which are interrupted over portions of the outer surface of the device. The fusion device includes truncated side walls so that on end view the body takes on a cylindrical form. In another embodiment, the tapered body is solid and formed of a porous biocompatible material having sufficient structural integrity to maintain the intradiscal space and normal curvature. The material is preferably a porous tantalum composite having fully interconnected pores to facilitate complete bone tissue ingrowth into the implant. In further embodiments, the fusion devices are provided with osteogenic material to facilitate bone ingrowth. A cap is also provided to block the opening of hollow fusion devices. The cap includes an occlusion body and an elongated anchor.

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: Instrumentation and techniques for preparing vertebral members for insertion of an implant. Foundation instruments provide a reference relative to the vertebral members. The foundation devices guide the placement of one or more instruments that prepare the vertebral members. The instruments operatively align with the foundation instruments in a specific orientation to ensure proper placement relative to the vertebral members. Preparatory instruments may be used to further remove bone from the vertebral members. The preparatory instruments may be used prior to or after the other instruments. An insert is inserted and mounted to the vertebral members after the bone has been removed. A holder may be used for holding and placing the implant relative to the vertebral members.

Abstract: A laparoscopic surgical technique is provided for preparing a site for implantation of a fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope includes a laparoscopic port at its opposite end through which instruments and implants are inserted. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. The laparoscope is alternately engaged within bilateral locations in the disc space for insertion of a pair of fusion implants. A switching sleeve extends through the laparoscope to protect the tissue at the surgical site as the laparoscope is moved between the bilateral fusion locations.

Abstract: An intervertebral device comprises a first endplate assembly including a first exterior surface, a second endplate assembly including a second exterior surface, and a bone in-growth area located on the first exterior surface. The bone in-growth area includes an osteoconductive surface. The intervertebral device also comprises a bone in-growth indicator located on the first exterior surface and an access guide on the first endplate. The access guide is adapted for directing a revision instrument to the bone in-growth area.

Abstract: The present invention is directed to a system for anterior fixation of the spine that utilizes an elongated fixation plate. The plating system stabilizes the spine and promotes fusion and incorporation of a graft or implant in a portion of the spinal column. In one aspect of the invention, the fixation plate has a first end with a pair of holes. Bone screws extend through the holes to rigidly secure the plate to a first vertebra. The second end of the plate is provided with a pair of slots through which bone screws extend for engagement with a second vertebra. The screws extending through the slots are translatable in the slot to maintain compression of the spinal column portion. The plating system includes a retainer assembly that prevents screw back out. Methods and instruments relating to the plating system are also described.

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 interbody fusion device in one embodiment includes a tapered body defining a hollow interior for receiving bone graft or bone substitute material. The body defines exterior threads which are interrupted over portions of the outer surface of the device. The fusion device defines truncated side walls so that on end view the body takes on a cylindrical form. The side walls are provided with vascularization openings, and the body wall device includes opposite bone ingrowth slots extending through the interrupted thread portion of the body. In another embodiment, the tapered body is solid and formed of a porous biocompatible material having sufficient structural integrity to maintain the intradiscal space and normal curvature. The material is preferably a porous tantalum having fully interconnected pores to facilitate complete bone tissue ingrowth into the implant.