Abstract: A method is disclosed and can include engaging a harvest guide with bony tissue and placing a cutting device within the harvest guide. The harvest guide can maintain the cutting device substantially perpendicular to a tangent through a point on the bony tissue aligned with the cutting device. The cutting device can be an osteochondral chisel, a trephine, or a combination thereof.

Abstract: The description, among other things, concerns a Surgical Tool for the preparation of bones, comprising a tool shank, designed to be inserted into a rotatable tool holder and having a duct for conducting the flow of a cooling or rinsing fluid, a machining part driven by the tool shank and rotatable around an axial rotation axis and placed at the proximal axial end of the tool shank, a guide element extending in axial direction of the Surgical Tool, placed at the proximal axial end of the machining part, axially movable relative to the machining part and designed for insertion into a pilot drilling, having at its surface one or several rinsing slots extending in axial direction for conducting the cooling or rinsing fluid, wherein the Surgical Tool and the rinsing slots are designed in such a manner that the exit point at which the cooling or rinsing fluid exits the duct into the rinsing slots, is placed in the area of the passage between the proximal axial end of the machining part and a distal axial area of th

Abstract: A bone mill including a base and a mill head that is removably attached to the base. A cutting disc is rotatably disposed in the mill head. When the mill head is attached to base, the cutting disc is rotated by a motor internal to the base. A plunger mounted to the mill head urges the bone against the cutting disc. The cutting disc and an impingement plate internal to the mill head shear the bone into chips. The chips are discharged from an opening in the mill head into a catch tray removably attached to the mill head.

Abstract: A surgical device (1) for bone surgery including a body (2) able to be gripped by the user and a tip (3) mounted at the head of the body and set in vibration at a modulated ultrasonic frequency to operate on bone tissue, the surgical device (1) being particularly suitable for oral surgical procedures such as bone sampling, excision of cysts, third molar extraction, preparation of alveolar sites, creation of an opening into the maxillary sinus (Caldwell Luc), elevation of the maxillary sinus by the crestal route and orthopedic and neurosurgical procedures such as osteoplasty, ostectomy and osteotomy.

Abstract: A device for trimming an osteochondral plug graft to an implantable configuration includes a blade assembly terminating in a configured leading cutting blade and a plug graft housing comprising a substantially longitudinal holding sleeve having a bore and oriented complementarily to the longitudinal structure of the blade assembly to receive the longitudinal structure within the sleeve bore with the assembly cutting blade in close tolerance along an inner bore surface of the longitudinal housing structure.

Abstract: A bone preparation device for shaping endplates forming an intervertebral disc space between two adjacent vertebrae includes a cutter component and a cutter-positioner component. The cutter-positioner is arranged to limit the distal travel of the cutter component and to restrict the range of motion of the distal end of the cutter component. The bone preparation device also includes a rotational interface between the cutter component and the cutter-positioner component. The rotational interface is structurally arranged to permit the cutting blade to be rotated at the same time the cutter component is restricted in its range of motion.

Abstract: An acetabular instrument has a handle portion having one or more solid nonflexible drive shaft elements therethrough. The shaft elements are connected by a U-joint at one of both ends to form a flexible curved drive shaft. One end of a solid shaft element is connected to a knob so that rotation of the knob drives the flexible shaft. The flexible shaft is housed within a hollow curved body preferably made of stainless steel. One end of the curved body it is connected to the handle portion and at the other end to an acetabular cup or acetabular reamer holder. The reamer holder is rotatably driven by the flexible drive shaft. The knob may be made so that it may receive blows from a mallet allowing the instrument to be used as an impactor. The drive shaft may be used to actuate a locking mechanism within the cup or reamer holder which connects the reamer cup to the instrument.

Abstract: A milling instrument assembly is provided for vertebral endplate preparation along a cutting path obliquely oriented to the axis of approach to the vertebra. The milling instrument assembly provides control of the anterior-posterior depth of endplate removal by guiding cutting assembly in the disc space as it moves transversely across a housing assembly. Methods and techniques are included for using the milling instrument assembly in spinal surgery.

Abstract: A device for modifying tissue in a spine may include: a shah having a proximal portion and a distal portion, the distal portion having dimensions which allow h to be passed into an epidural space of the spine and between target and non-target tissues at least one distal force application member extending from the distal portion of the shall and configured to facilitate application of at least one of anchoring force and tensioning force to the shaft; at least one movable tissue modifying member coupled with the shaft at or near its distal portion; at least one drive member coupled with the at least one tissue modifying member to activate the at least one tissue modifying member; and at least one power transmission member coupled with the at least one drive member to deliver power to the at least one drive member.

Abstract: A surgical tool holder 12 and tool system 10 is provided. The surgical tool holder (12) is adapted to connect to a tool support (14) having an interface receiver (36). The tool support provides a mount for a surgical tool head. The tool holder (12) includes a center rod (20), a tool interface (28) and a quick connect mechanism (50). The center rod (20) has a first shank end (24) and a second tool end (26). The tool interface (28) is disposed on the tool end (26) of the center rod (20). The tool interface (28) has at least one transversely extending portion (44, 44a), extending radially outward, beyond the diameter of the center rod (20) at the tool end (26). The interface (28) is adapted to engage with the interface receiver (36). The quick connect mechanism (50) is disposed on the center rod (20) to move in a rotationally-constrained manner thereon proximate the tool interface (28).

Abstract: The invention proposes a device for minimally invasive intervention in the skeletal region, in particular on the spinal column, having at least the following two elements: a cannula with a distal end generally bevelled in shape (22) relative to a symmetrical axis of the cutting tool (2); and an optical probe (endoscope) for insertion through the cavity of the cannula. The device is further characterized in that the cannula takes the form of a hollow cutting tool (2), in which the most distal region of the distal end comprises a cutting edge (26), which is incorporated into the edge of the wall of the cutting tool (2).

Abstract: Methods and devices for sculpting bones, particularly in preparation for implanting prosthetic devices to replace articulating bone joint surfaces. Improved bone removal devices including burr mills driven by gears and loop drives are provided. Reciprocating cutters and belt cutters are also provided. Some devices have either integral or removable expandable portions to vary the force and bone resection depth. Devices can have irrigation ports and plenums to remove bone fragments. Some cutters are dual cutters, adapted to remove bone in two or more regions, such as the knee joint, simultaneously.

Abstract: A device for removing material from within the body, includes an elongated element formed from hollow segments sequentially interconnected at effective hinges. The device assumes an insertion configuration for insertion of the segments sequentially through an opening of a first dimension into the body. A portion of the elongated element inserted into the body progressively assumes a material removing configuration in which a relative position of each segment relative to an adjacent segment is delineated by the effective hinge together with additional abutment surfaces defining a fully deflected state of the effective hinge. The material removing configuration has at least two dimensions exceeding the first dimension. At least two of the segments are formed with at least one opening, typically provided with a cutting configuration, deployed so as to receive material into a hollow volume of the segment during progressive formation of the material removing configuration as the elongated element is advanced.

Abstract: A method for use in a vertebral spine to prepare a space between adjacent vertebral bodies to receive an implant. The method is performed using a bone removal device including a shaft and a mounting member at one end of the shaft. A working end is mounted on the mounting member and is coupled to a drive mechanism adjacent to the working end. The drive mechanism is operable to move the upper and lower cutters of the working end to create surfaces having predetermined contours in the end plate region of the adjacent vertebral bodies. A guard provides protected access to the disc space and the adjacent vertebral bodies for the working end of the bone removal device through a passageway.

Abstract: An undercutting system for preparing a region between ilium and sacrum for sacroiliac fusion. The undercutting system includes an insertion apparatus and a cutting assembly. The cutting assembly is operably attached to the insertion apparatus. The cutting assembly is movable with respect to the insertion apparatus between a retracted configuration and an extended configuration.

Abstract: A system and method of processing bone is disclosed. A tissue separator is utilized to separate tissue comprising at least one of muscle, periosteum and connective tissue from bone in a safe, sterile and efficient manner. In one aspect, the particle reducer can include an impeller positioned with respect to a cutting surface on a drum. At least one of the impeller and the drum is rotated by a power source such that harvested tissue frictionally engages the cutting surface. In another aspect, a source of pressurized fluid can be directed at tissue to separate bone from non-bone tissue.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In some embodiments, a surgical tissue removal device includes a flexible elongate body that is adapted to conform with the target anatomy and a guidewire connector at the distal end region of the flexible elongate body configured to removably connect to the end of a guidewire so that the guidewire and flexible elongate body can be pulled distally. The body may have at least one blade edge, and the flexible elongate body may be a thin, flat, ribbon shaped flexible body that comprises a profile having a width that is substantially greater than a height.

Abstract: A method for preparing a femoral neck for receiving a neck implant includes obtaining image data of a proximal femoral bone and femoral neck of a patient by a medical imaging method and constructing a three-dimensional image model of the proximal femoral bone and neck of the patient using the image data. The method further includes identifying a three-dimensional cortical boundary surface at an interface between cortical and cancellous bone of the patient using the image model. A patient-specific broach having a three-dimensional cutting surface closely matching and complementary to the cortical boundary surface of the patient using the image model is designed and manufactured.

Abstract: A bone preparing tool for use with a percutaneous bone access system. The bone access system penetrates the interior of a bone. The bone preparation tool allows a surgeon to prepare the interior of a bone for therapeutic treatments. The tool includes a handle, flexible rod and, bone preparation tip, which may include an off-set wedge, a banana wedge, a tapered tip, and a pedestal tip. Each tip has specialized functionality in bone preparation. The flexible rod and specialized tip are inserted through a curved cannula and employed for bone preparation. This tool is useful when implementing a variety of bone therapeutic treatments which benefit from internal bone access and preparation. Current tools are limited and cannot properly be used on bone that is healed or hardened. This invention allows a transpedicular or extrapedicular approach to a bone and provides sufficient tensile strength but flexibility to affect optimum functionality.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: A device for trimming an osteochondral plug graft to an implantable configuration, includes a blade assembly terminating in a configured leading cutting blade and a plug graft housing comprising a substantially longitudinal holding sleeve having a bore and oriented complementarily to the longitudinal structure of the blade assembly to receive the longitudinal structure within the sleeve bore with the assembly cutting blade in close tolerance along an inner bore surface of the longitudinal housing structure.

Abstract: The present invention provides instrumentation that facilitates access to both sides of the vertebral body from a single access point. More particularly, the present invention provides bendable access devices that can be steered so as to traverse the vertebral body from the point of entry into the vertebral body, through the cancellous bone within the vertebral body, and to the contralateral side of the vertebral body. This steerability is provided by forming the access device with a series of slots, grooves, or notches in the side of the access device near the distal end of the access device, which slots, grooves, or notches reduce the bending stiffness of the access device. As a result, the distal end of the access device bends as it is being advanced into the vertebral body.

Abstract: A cutting instrument and method of use for preparing an osteochondral plug for implantation into a bone defect site. The instrument includes a dual function cutting block, a base holder, a rod mechanism and a trimming mechanism. The cutting block has a bore sized to receive the plug, at least one trimming channel and a transverse paring slot. The cutting block functions to hold the plug within the bore to allow for length and cross-sectional sizing. The base holder is constructed to fix the cutting block in a first orientation that allows the rod mechanism to position the plug within the cutting block for accurate length sizing. The base holder is also constructed to fix the cutting block in a second orientation which aligns the cutting block with the trimming mechanism so that an angled blade may engage the trimming channel and cut at least two sides of the plug.

Abstract: A cutting instrument and method of use for preparing an osteochondral plug for implantation into a bone defect site. The instrument includes a dual function cutting block, a base holder, a rod mechanism and a trimming mechanism. The cutting block has a bore sized to receive the plug, at least one trimming channel and a transverse paring slot. The cutting block functions to hold the plug within the bore to allow for length and cross-sectional sizing. The base holder is constructed to fix the cutting block in a first orientation that allows the rod mechanism to position the plug within the cutting block for accurate length sizing. The base holder is also constructed to fix the cutting block in a second orientation which aligns the cutting block with the trimming mechanism so that an angled blade may engage the trimming channel and cut at least two sides of the plug.

Abstract: A surgical instrument holder has a head assembly and a drive spindle assembly. The head has a second coupling end with a coupling device and interface for receiving and holding a surgical instrument. The instrument is held by a releasable locking mechanism having a ring slideably biased against the coupling device by a spring, and a connection device retaining the spring in a fixed position during use. The spindle assembly has a drive spindle rotatably housed in a cylindrical tube. The connection device provides a quick-release connection between the head and drive spindle assemblies, such that unlocking the connection device enables quick disassembly of the connection for cleaning and component sterilization. A method of use of the instrument holder allows the surgical instrument to be installed through an incision in a least invasive orientation separate from the holder.

Abstract: A device for trimming an osteochondral plug graft to an implantable configuration includes a blade assembly terminating in a configured leading cutting blade and a plug grail housing comprising a substantially longitudinal holding sleeve having a bore and oriented complementarily to the longitudinal structure of the blade assembly to receive the longitudinal structure within the sleeve bore with the assembly cutting blade in close tolerance along an inner bore surface of the longitudinal housing structure.

Abstract: In one preferred aspect, a method is provided for inserting an instrument set having a tapered configuration into a patient. In another preferred aspect, a method is provided for inserting a cannula having an external threaded portion into bone. In yet another preferred aspect, a method is provided for forming and enlarging an opening in bone.

Abstract: An instrument for forming a cavity within a bone. The instrument comprises a shaft, a blade pivotally mounted on the shaft towards a first end of the shaft and a push rod extending within the shaft and coupled to the blade, the push rod being arranged to slide within the shaft to cause the blade to rotate about its pivot. The instrument further comprises a depth stop coupled to the shaft arranged such that when the shaft is inserted into a bore extending into a bone the depth stop is arranged to engage bone surrounding the bore to limit movement of the shaft into the bore. A spring couples the push rod to the shaft and is arranged to resist axial movement of the push rod within the shaft towards the first end of the shaft. When the depth stop engages bone surrounding a bore, axial force exceeding the spring resistance applied to the push rod causes the push rod to slide within the shaft.

Abstract: The present invention relates to surgical instruments particularly suitable for preparing vertebral endplates during spinal interbody surgical procedures. Methods of using such instruments are also disclosed.

Abstract: Abstract: A device and method for cutting and collecting bone debris. The device comprises a receptacle having an opening, the receptacle opening being disposed with respect to a cutting tool such that, in use, bone debris produced by the cutting tool is received by the receptacle. The opening of the receptacle may have dimensions corresponding to those of the cutting tool. The receptacle may be shaped so that it does not extend beyond the outer periphery of the cutting tool.

Abstract: A milling system is disclosed for creating a cavity in a bone. The cavity has a cross section which has a generally triangular profile having a first side generally parallel with an axis of the bone and a second side forming an acute angle with the first side. The cavity is contiguous with a pre-existing conical cavity in the bone. The system comprises a drive shaft, a frame for carrying a cutter and a cutter for cutting the cavity. The drive shaft has a proximal end configured for coupling to a drive means and a distal end configured to form a portion of a drive joint for coupling the drive shaft to a cutter. The frame includes a shaft and a cutter mount for mounting a cutter at a first angle approximating the acute angle with respect to the shaft. The mount includes a bracket extending laterally from the shaft to a bearing configured to receive a portion of a cutter and maintain the received cutter oriented at the first angle during rotation.

Abstract: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected and rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on for formed from) rungs that are flexibly connected and may be separated by one or more spacers. The rungs are typically wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used, or rungs with different cutting properties. In some variations the tissue modification devices may have a non-linear axial shape, or may be converted from a first axial shape to a second axial shape.

Abstract: A device for modifying tissue in a spine may include: a shaft having a proximal portion and a distal portion, the distal portion having dimensions which allow it to be passed into an epidural space of the spine and between target and non-target tissues; at least one distal force application member extending from the distal portion of the shaft and configured to facilitate application of at least one of anchoring force and tensioning force to the shaft; at least one movable tissue modifying member coupled with the shaft at or near its distal portion; at least one drive member coupled with the at least one tissue modifying member to activate the at least one tissue modifying member; and at least one power transmission member coupled with the at least one drive member to deliver power to the at least one drive member.

Abstract: A tissue processing device, including a housing defining a first passage through at least a portion thereof, the first passage defining a longitudinal axis; a first processing member rotatably coupled to the housing and extending across at least a portion of the first passage; and a second processing member rotatably coupled to the housing and extending across at least a portion of the first passage, the second processing member being substantially parallel to the first processing member, the second member being offset from the first processing member in a first direction substantially parallel to the longitudinal axis and in a second direction substantially transverse to the longitudinal axis.

Abstract: A surgical cutting instrument including an outer tube having a bearing sleeve disposed within a lumen thereof, along with an inner wire assembly extending through the outer tube and the bearing sleeve. A cutting tip is connected to the inner wire assembly distal the outer tube. Conversely, a coupling chuck is connected to a proximal section of the inner wire assembly, with a housing maintaining the outer tube and the coupling chuck. When mounted to a motor, the inner wire assembly is rotated to effectuate a surgical cutting procedure at the cutting tip, with the bearing sleeve supporting the inner wire assembly relative to the outer tube during rotation.

Abstract: Osteotome tier the removal of bone and of bone tumors, as well as of ligaments and fibrocartilaginous tissue, during surgery, comprising a pair of blades slidably coupled so that respective distal ends thereof be closable the one against the other for the removal of a bone fragment, pneumatic propelling means for the blades, and a trigger for the operation of the propelling means by a user.

Abstract: A reamer for reaming a portion of a long bone cavity for use in implanting a joint prosthesis. The reamer is used in cooperation with a portion of an orthopaedic implant component and includes an expandable body that is adapted to adjust between a plurality of diameters. A plurality of cutting edges are also included and extend outwardly from the body, the edges adapted for cooperation with bone, and the cutting edges expanding as the expandable body expands.

Abstract: A mechanical cavity-creation surgical device and methods and kits for using such devices is described. In one variation, the mechanical cavity-creation surgical device contains a side window at the distal end of a shaft that allows the articulation of a blade, pick, or tip from a position that is inside the shaft to a position that protrudes at least partially from the side window.

Abstract: Instrument and method for removing material from an intervertebral disc. The instrument includes outer and inner tubular members. The outer tubular member defines a passage and a cutting window. The inner tubular member is coaxially disposed within the passage, and defines a central lumen and a cutting tip. The cutting tip forms an open mouth having a plurality of teeth. Upon assembly, the cutting tip is exposed within the cutting window combining to define a shaving head. A powered handpiece is coupled to the inner tubular member, and the shaving head is inserted into an intervertebral disc and positioned such that the cutting tip contacts targeted material (e.g., nucleus, annulus and/or end plate). The handpiece is activated to rotate the cutting tip relative to the cutting window. Contacted material is sheared between an edge of the cutting window and the teeth of the cutting tip.

Abstract: A two piece, adjustable angle handle for a surgical instrument, capable of easy adjustment to a number of angles, permitting the handle of the instrument to be grasped with one hand, and the other hand to guide the operating end of the instrument, said handle permanently affixed to an instrument, or capable if attachment to a number of different instruments by means of a firm but releasable fastening to the shaft of the instrument, as with a Hudson fitting; the adjustable angle fastening comprising a radial array of teeth as in a ratchet wheel and a reverse scissor pawl.

Abstract: An orthopaedic cutting instrument and associated methods are presented.

Abstract: A method of performing a sternal incision is disclosed. The method includes the employment of a surgical appliance for performing structured sternal incision. The surgical appliance is characterized by having an incising member for incising the sternal tissue and an actuating mechanism therefore. Upon actuating the incising member and driving the incising member of the surgical appliance relative to the sternum, the pattern of the structured sternal incision is formed.

Abstract: A surgical instrument system includes a tool (2) including an elongate shaft which defines the tool axis. The shaft bears a plurality of marker rings (10, 11, 12) arranged in a predetermined pattern on the surface of the shaft so that they extend around the shaft axis. The system includes at least two receiving devices (14) which are spaced apart for receiving stereoscopic signals from the rings on the tool, and a data processor (16) for analysing the signal from the rings and generating information relating to the position and orientation of the tool relative to the receiving device.

Abstract: A device and method for use in a vertebral spine to prepare a space between adjacent vertebral bodies to receive an implant. The device includes a shaft, and a mounting member at one end of the shaft. A working end is mounted on the mounting member and is coupled to a drive mechanism adjacent to the working end. The drive mechanism is operable to move the upper and lower cutters of the working end to create surfaces having predetermined contours in the end plate region of the adjacent vertebral bodies. A guard provides protected access to the disc space and the adjacent vertebral bodies for the working end of the bone removal device through a passageway.

Abstract: Methods are provided for access to a compressed space in the spinal anatomy. These methods may be used for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space. In one variation, a tissue abrasion device is provided. A cannulated probe may be placed through the neural foramina of the spine and used to position a guidewire around the anterior border of a facet joint. Once properly positioned, a medical practitioner may use the guidewire with an abrasion device to enlarge the lateral recess and neural foramina. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: A spinal disc prosthesis and method of placing a spinal disc prosthesis between adjacent vertebrae are provided. The inventive spinal disc prosthesis can comprise one or more solid, compressible prosthesis elements that are formed prior to the method of placing the prosthesis, or one or more solid prosthesis elements that are formed in situ. The inventive method of placing a spinal disc prosthesis between adjacent vertebrae of a patient is based on a posterior approach. The invention also includes a spinal disc prosthesis insertion apparatus and specially constructed surgical instruments for use in carrying out the method.

Abstract: In one preferred aspect, a method is provided for forming an opening in bone for the sequential dilation of tissue.

Abstract: Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Abstract: A tool for preparing vertebral surfaces following a discectomy has a body and a rotary cutting tool mounted at the distal end of a lever which extends through the body. The proximal end of the lever can be squeezed toward the body to force the cutting tool against the vertebral surface facing it, while the tool is rotated by turning a crank supported on the tool body, or by a motor. The cutting tool is preferably a flexible rasp or blade which can conform to and control the convexity of the prepared surface.

Abstract: A tubular member is sized and configured to establish an access path to bone having an interior volume occupied, at least in part, by cancellous bone. The tubular member includes a distal end portion having at least one opening. A structure is sized and configured to be carried by the tubular member and controllably advanced through the at least one opening to define a cutting surface that projects outside the distal end portion. The cutting surface has a dimension capable of cutting cancellous bone in response to rotation of the tubular member within the cancellous bone.