Abstract: An orbitally or lineally oscillating orthopedic resurfacing tool having multiple interchangeable resurfacing heads and having a sealed debris flushing system to be used for the resurfacing of bone ends in an anatomical joint in preparation for the installation of prosthetic components in the orthopedic surgical repair or reconstruction of the hip, knee, ankle, shoulder, elbow, wrist, and other joints.

Abstract: A microfracture instrument for applying microfracture therapy to a bone, the microfracture instrument comprising: an elongated shaft comprising a distal end and a proximal end; a needle comprising a body terminating in at least one sharp point, the needle being movably mounted to the distal end of the shaft for movement between an extended position for engaging the bone with the at least one sharp point of the needle and a retracted position for withdrawing the at least one sharp point of the needle from the bone; and a drive shaft movably mounted to the elongated shaft, the drive shaft being connected to the body of the needle so that movement of the drive shaft relative to the elongated shaft moves the needle between its extended position and its retracted position.

Abstract: The invention provides instruments and methods for prophylactic treatment of an osteoporotic vertebral body or for treating a vertebral compression fracture (VCF). In one exemplary method, a probe system uses a high speed rotational elastomeric cutter having an optional expandable abrasive surface for abrading or cutting at least one path or region within vertebral cancellous bone. Irrigation and aspiration sources are included in the probe system for removing abraded bone debris. In one embodiment, the high speed rotational abrader uses a tissue-selective abrading surface that abrades or cuts bone but does not cut soft tissue. In another embodiment, an expandable abrading surface allows the treatment of bone with low pressures to create paths or spaces without explosive expansion forces known in prior art balloon procedures that are designed to crush and compact cancellous bone in a vertebra.

Abstract: A cannulated compression screw is used as an orthopedic implant and has a threaded distal end with an insertion tip that includes at least one and preferably two, three or four flutes to allow the screw to be self-tapping. Optionally, the screw also includes one or more reverse cutting flutes proximal to the insertion tip. The distal threads are cancellous threads having a generally constant minor diameter and a generally constant major diameter and a generally constant thread pitch. An intermediate portion of the screw is non-threaded and the proximal end includes a compression wedge or taper that has at least one, and preferably two to five flutes that terminate before the top of the screw. The proximal end further includes a radiused bevel to the terminal surface that includes a hexagonal torque driving recess. The diameter of the non-threaded shaft section is constant distal from the compression wedge to the distal tip where it defines the minor diameter of the threaded portion.

Abstract: An apparatus (10) for cutting bone includes a shaft member (12) having a central axis (14) and extending between a proximal end portion (16) and a distal end portion (18). The proximal end portion (16) has a first surface (32) adapted to receive repetitive impacts. The distal end portion (18) includes a cutting blade (40) extending in a first plane between a shield section (46) and a guide portion (60). The shield section (46) and the guide section (60) project axially beyond the cutting blade (40) to recess the cutting blade (40) in the distal end portion (18). The shield section (46) includes an inwardly facing shield surface (48) which extends in a second plane that is transverse to the first plane of the cutting blade (40). The apparatus (10) is a form of an osteotome that is particularly useful for certain spine-related surgical procedures.

Abstract: A guide for cutting a bone comprising an anterior portion and a distal portion orientated at about a right angle to the anterior portion. The distal portion includes a guiding side, a distal surface at the guiding side, a box-cut shaped opening defined by the guiding side, a plurality of first cutting surfaces disposed at the guiding side at an acute angle relative to the distal surface of the guiding side operable to guide a cutting device to the bone to form chamfer cuts in the bone, and a second cutting surface disposed at the guiding side at at least about a right angle to the distal surface operable to guide a cutting device to the bone to form a posterior cut in the bone.

Abstract: Instruments and methods for treating vertebral endplates are disclosed. The instrument includes one or more treatment members movable from a reduced profile position for insertion to the operative site to a deployed position for providing treatment to the vertebral endplates.

Abstract: An apparatus (10) for cutting bone includes a shaft member (12) having a central axis (14) and extending between a proximal end portion (16) and a distal end portion (18). The proximal end portion (16) has a first surface (32) adapted to receive repetitive impacts. The distal end portion (18) includes a cutting blade (40) extending in a first plane between a shield section (46) and a guide portion (60). The shield section (46) and the guide section (60) project axially beyond the cutting blade (40) to recess the cutting blade (40) in the distal end portion (18). The shield section (46) includes an inwardly facing shield surface (48) which extends in a second plane that is transverse to the first plane of the cutting blade (40). The apparatus (10) is a form of an osteotome that is particularly useful for certain spine-related surgical procedures.

Abstract: A surgical procedure according to which a cutting blade is positioned over an area of the bone to be cut and indicia is projected onto the area. The blade is adjusted relative to the area until the indicia takes a predetermined configuration on the area corresponding to the desired position of the blade relative to the area. Then the blade can be driven to cut an opening in the bone.

Abstract: A skull cutting device for cutting a skull by means of laser comprises a body for emitting the laser introduced from a laser oscillator through an optical fiber from an exit opening arranged at a distal end thereof, a contact portion arranged in the body to determine the posture of the body such that a predetermined distance is set between a surface of the skull and the exit opening by touching the surface of the skull in a predetermined mode, a support bar of a predetermined length extending from the body toward the emitting direction of the laser while avoiding the optical path of the laser (R), and a light interception board arranged at a distal end of the support bar to block farther advance of the laser by interfering with the laser beam path.

Abstract: A drill is used on a jaw bone with overlying soft tissue and underlying, more solid bone. The drill comprises a first portion which is provided with one or more first cutting edges and with a first width or diameter. Arranged behind the first portion there is a second portion which is provided with one or more second cutting edges and with a second diameter exceeding the first width or diameter. The first portion can cooperate with soft tissues to form an initial hole, and the second portion can cooperate with the soft tissue and the more solid bone in order to enlarge said hole and create a countersunk hole in the more solid bone. The first portion is also depicted to cooperate with the more solid bone, during the second portion's formation of the countersunk hole, in order to provide a guidance hole or marker hole in the bottom of the countersink.

Abstract: A milling tool system for accurately preparing a portion of the tibia preparatory to making femoral resections. The milling too system provides a minimally invasive procedure to provide an aperture within an exposed surface of the tibia, the aperture then being used as a referencing surface to accurately resect the femur. Once the femur resections have been made, the remaining uncut portions of the tibia are exposed and easily accessible for the tibial resections.

Abstract: A surgical tool and monolithic frame therefore are disclosed. The monolithic frame defines a longitudinal axis between opposite first and second ends thereof, and is adapted to receive the flexible drive shaft of a surgical tool, and to support at an end thereof the rotary cutting tool of a surgical tool. The monolithic frame is characterized by greater flexibility in opposite directions along a first axis defined normal to the longitudinal axis than in opposite directions along a second axis defined normal to both the first axis and the longitudinal axis.

Abstract: A flexible inner member for rotation within an angled outer tubular member of a rotary tissue cutting instrument to cut anatomical tissue includes a flexible region for conforming to the configuration of an angled region of the outer tubular member. The flexible region comprises a cut having convoluted path areas formed through a cylindrical wall of a tubular body of the inner member. The convoluted path areas are rotationally spaced on the tubular body in alternating sequence with connecting path segments of the cut. The cut follows a convoluted path in the convoluted path areas forming the wall of the tubular body into a pair of complementary, mating hook formations of opposed curvature. The connecting path segments extend rotationally along the tubular body between the convoluted path areas.

Abstract: Spinal tools and methods are described herein. In some embodiments, an apparatus includes an elongate member and a tissue disrupter. The elongate member has a distal end portion and defines a lumen. The tissue disruptor is coupled to the distal end portion of the elongate member. The tissue disruptor is configured to rotate relative to the elongate member to disrupt a body tissue.

Abstract: Systems providing improved methods of performing a spinal fusion procedure and including a monorail instrument that protects the medial neural structures, includes a sliding platform for additional instrumentation and allows controlled delivery of various instruments for disc preparation and implant insertion. The monorail instrument engages other instruments, including various instruments utilized to prepare the disc space as well as spinal fusion implants, for guided and controlled insertion into the disc space. The monorail instrument may be a distractor, and may include flutes for preparation of the disc space.

Abstract: A guide and a blade for contouring vertebral bodies. The guide is sized to be mounted between two vertebral members and includes a pair of edges for receiving the blade. The pair of edges are spaced a distance apart for the first edge to align with a first vertebral member, and the second edge to align with a second vertebral member. The blade includes a pair of arms with at least one cutting edge. The arms are sized to fit within the pair of edges respectively. Using the blade and guide comprises inserting the guide adjacent to two vertebral members, and inserting the arms through the pair of edges to contour the ends of the members. In an embodiment with cutting edges at the distal ends of each of the arms, the two vertebral members can be contoured simultaneously.

Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices are used in procedures to removal spinal tissue and in other embodiments, similar devices are used to remove thrombus from blood vessel.

Abstract: A method of implanting a vertebral implant in a void between a pair of vertebral endplates comprises positioning the vertebral implant between the vertebral endplates and coupling an implantation tool to the vertebral implant. The method further comprises actuating the implantation tool to generate alternating motion relative to the vertebral endplates. The alternating motion has a speed and creates a displacement of the vertebral implant. The method further comprises seating the vertebral implant into a profile formed in at least one of the vertebral endplates and decoupling the implantation tool from the vertebral implant. The vertebral implant remains implanted in the at least one vertebral endplate.

Abstract: Methods and apparatus for providing percutaneous access to vertebrae in alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner are disclosed. A number of related TASIF methods and surgical tool sets are provided by the present invention that are employed to form a percutaneous pathway from an anterior or posterior skin incision to a respective anterior or posterior target point of a sacral surface. The percutaneous pathway is generally axially aligned with an anterior or posterior axial instrumentation/fusion line extending from the respective anterior or posterior target point through at least one sacral vertebral body and one or more lumbar vertebral bodies in the cephalad direction. The provision of the percutaneous pathway described herein allows for the formation of the anterior or posterior TASIF bore(s) and/or the introduction of spinal implants and instruments.

Abstract: The present invention relates to a femoral condyle cutting and shaping center (10), which comprises a main driving shaft (15) provided in a transmission gearbox (4), and a main driving gear (14) mounted on the main driving shaft (15). At least a first driven gear (12) is engaged with the main driving gear (14), said first driven gear (12) being mounted on a first driven shaft (13), said first driven shaft (13) being supported in the transmission gearbox (4). One end of the first driven shaft (13) extends towards the outside of the transmission gearbox (4), and a bone shaping mill (21) is mounted on an extending end (22) of the first driven shaft (13).

Abstract: The present invention provides improved coupling arrangements for medical instruments. In one example, a coupling system for a medical dissection tool includes: an internal passage adapted for receiving a portion of a medical dissection tool; and at least one locking member movable through a first angled path into a locked position to prevent the medical dissection tool from moving along a longitudinal axis of the internal passage.

Abstract: A bone tapping kit for cutting an internal thread into bone defining a bore. The kit comprises 1) a guide component with a threaded aperture which, when in position, is aligned with the bore, and 2) a tap having a first portion with a first diameter and an external thread designed to engage with the threaded aperture of the guide component, and a second portion having a second diameter which is smaller than the first diameter and a helical cutting edge designed so that it can be received into the bore and cut an internal thread therein. The guide component and tap are dimensioned so that when the tap is introduced into the guide component the first portion engages with the threaded aperture in the guide component before the helical cutting edge of the second portion engages with the bore. Thus, the thread configuration that is cut into the bore forms a continuation of the same helix defined by the internal thread of the aperture of the guide member.

Abstract: The invention to which this application relates is to the provision of medical devices such as implants for use in hips, knees or the like and also tools which may be used in surgery or for medical treatment. At least a portion of the external surface of the device is provided with a particular external surface texture which in accordance with the invention is formed by exposing said portions to at least one power beam. The exposure and relative movement between the device and the beam cause specific controlled configurations of the surface to be created without the need to add additional material and therefore allow the formation of the surfaces to the required configuration while maintaining the integrity of the device.

Abstract: A preferred acetabular reamer is disclosed for cutting a bone socket, defining an apex and rotatable about a drive axis. The reamer has a domed support portion adjacent the apex and a plurality of cutting members, which may be of the cheese grater or bladed type, each pivotally mounted on the support portion. A hub structure including a sleeve portion is movable along the axis toward and away from the apex. A plurality of spokes operatively connects the cutting members and the hub, respectively. Actuation of the hub, in turn, radially collapses the spokes causing the cutting members to assume an insertion profile during passage of the reamer through a surgical incision, and then radially expands the spokes causing the cutting members to assume a larger, cutting profile while reaming the bone socket. A surgical kit and method employing the inventive reamer are also disclosed.

Abstract: A broaching system is disclosed for creating a cavity in a bone such that 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 and such that the cavity is contiguous with a pre-existing conical cavity in the bone. The apparatus comprises a shaft and a broach. The shaft has a longitudinal axis. The broach is mounted to the shaft and has a first cutting side mounted at the acute angle relative to the longitudinal axis of the shaft. The first cutting side is formed to include teeth. The shaft and broach are configured so that when the longitudinal axis of the shaft is advanced into the bone along the axis of the bone, the teeth of the broach form the triangular cavity. A method for cutting a triangular cavity in bone is also described. The method comprises a providing a shaft step, an incising step and a cutting step.

Abstract: Cutter blades made of shape memory materials. Rotation of a cutter blade as part of a cutter assembly within an intervertebral disc space cuts the material present there for removal from the intervertebral disc space. Cutter blades with different attributes (such as throw length, cutter blade angle, type and location of blade edges) are adapted to achieve different objectives within the intervertebral disc space. The use of a hollow ground to enhance the cutting action of a blade edge is described in connection with the creation of cutter blades. A variety of thin cutter blades are described which may be used in the interior of a thin intervertebral disc (having a reduced distance between the endplates of the adjacent vertebral bodies).

Abstract: The invention is directed toward a surgical kit having component parts capable of use to prepare a cartilage implant plug from allograft condyle. The kit comprises a sizing gauge used to measure surface of the allograft condyle so that a cartilage implant plug can be removed that corresponds to the contours of the defect site excised on a patient. An adjustable guide member is mounted in a fixed orientation over the allograft condyle in which a cylindrical graft cutter for cutting a cylindrical allograft bone plug having a cartilage cap and a bone end portion. A chamfering tool is used for chamfering the bone end of the allograft bone plug.

Abstract: The invention is directed toward a surgical kit having component parts capable of use in excising a cartilage defect site on a patient to prepare the same for receipt of an implant plug, the kit comprising a cylindrical gauge with a central bore used to measure the defect area, a guide rod adapted to be driven through the gauge tube into the center of said defect area and a cartilage cutting assembly adapted to be mounted over the guide rod and used for excising the defect area and cutting a cylindrical bore into the defect area. The method for use of the kit comprises the steps of: marking the defect area to be cut; placing a guide rod into the center defect area and driving the same to a predetermined distance to secure the same in the defect area and placing a drill bit over the guide rod and rotating the drill bit to cut a cylindrical blind bore removing the cartilage defect.

Abstract: One or more tools for use in shaped axially oriented bores extending from an accessed posterior or anterior target point are formed in the cephalad direction through vertebral bodies and intervening discs, if present, in general alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation/fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment.

Abstract: A minimally invasive method for accessing a facet joint of the spine is provided. Embodiments of the method include creating a small incision directly over the facet joint and to allow direct access and visualization of the joint. A second incision, which may be a puncture wound, is provided at a distance from the first incision. A path between the second incision and the facet joint is then formed which may be curved or substantially straight. The path is preferably configured to intersect both facet surfaces. The path may be formed using an instrument which can be used to drill a hole across the facets, insert a fastener across the facets, or the like.

Abstract: A method and a system for cutting the knee joint using a robot. A cantilevered cutter is introduced into the knee joint from inside and outside of upper and lower bones of the knee joint to realize a tunnel cutting technique in which cutting is conducted such that tunnels are defined in bone and remnant bone is cleared. The cutter includes a shaft in which a substantial axial portion is fitted into a sleeve and a remaining axial portion serves as a cantilever extending out of the sleeve, and a head which is formed at a distal end of the shaft. A length of the cantilever and a diameter of the head are determined to have minimum sizes as long as the head can be introduced into bone in such a way as to define a tunnel and can be moved in the bone while cutting the bone.

Abstract: Embodiments of the invention include devices and methods for manipulating bone. Instruments of some of the embodiments are insertable into a vertebral body or between vertebral bodies to apply forces to the vertebral bodies to strengthen bone or prepare bone to be strengthened.

Abstract: Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient's positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

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: Apparatuses and methods for accessing and disrupting a tissue are disclosed herein. In one embodiment, a method includes inserting a distal end portion of an elongate member into a biological body. After inserting the elongate member, an actuator is manually actuated to produce translational motion of a drive element. The translational motion is converted into rotational movement of the distal end portion of the elongate member. In one embodiment, an apparatus includes an elongate member having a tissue interaction member at a distal end portion that is configured to be inserted within a biological body. A conversion mechanism is coupled to the elongate member and includes a drive element. An actuator is coupled to the conversion mechanism and is configured to cause translational motion of the drive element. The conversion mechanism is configured to convert the translational motion of the drive element into rotational motion of the elongate member.

Abstract: A surgical reamer (10) for cutting a bone socket is provided, defining a drive axis, an apex. The reamer (10) further includes (a) a fixed support portion (12) aligned with the drive axis and having at least one radial cutting blade (16c); (b) a pivoting portion (20) aligned with the drive axis and pivotable about this axis, the pivoting portion supporting at least one radial cutting blade (20c); and (c) a pivoting joint (22) wherein the pivoting portion may be pivoted toward and away from the fixed portion (12) so as to expand or contract the reamer in relative overall size and wherein the reamer has a cutting orientation in which the cutting blades (16c, 20c) are supported against relative rotational movement when cutting bone. A surgical kit and method employing the inventive reamer are also disclosed.

Abstract: A nuclectomy method for creating a nuclear cavity in an annulus located in an intervertebral disc space and for preparing the nuclear cavity to receive an intervertebral prosthesis. The method involves identifying a plurality of regions in at least a portion of the nucleus. A sequence for removing the regions is also determined. At least one annulotomy is formed in the annulus along an annular axis to provide access to the nucleus. A guide system is positioned relative to the annulotomy. The guide system is configured to limit motion of at least one surgical tool relative to the guide system. A portion of the nucleus is removed from a first region using the surgical tool. At least one of the guide system and the surgical tool are configured to remove a portion of the nucleus from a second region. A portion of the nucleus is removed from a second region using the surgical tool.

Abstract: A surgical tool includes a drive assembly including a head assembly and a cutting assembly coupled to the drive assembly. The cutting assembly includes a first blade having a first cutting surface and a first contact surface. The cutting assembly also includes a second blade pivotally coupled to the first blade. The second blade has a second cutting surface and a second contact surface.

Abstract: A system for positioning an element relative to an articular surface. An embodiment of the system may include a first element having a positional reference relative to an articular surface. The system may further include a second element capable of indicating the positional reference of the first element relative to said articular surface. Of course, many alternatives, variations, and modifications are possible without departing from this embodiment.

Abstract: Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient's positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

Abstract: A retrograde osteochondral autograft transfer system that ensures that grafted healthy bone is implanted into the recipient site in a retrograde manner as opposed to a conventional anterior manner, so that the grafted healthy bone is flush with the bone surface of the recipient size. The retrograde osteochondral autograft transfer system of the present invention employs two identically-sized harvesters which are aligned with each other for transfer and reversal of a harvested osteochondral core, such that the core can be introduced into the recipient site through a tunnel leading to the recipient site, with an articular surface of the core advanced in a leading position.

Abstract: An expandable stabilization device is disclosed that is suitable for deployment within cancellous bone, including, for example, within a vertebral body of a spine. The device comprises: an elongate expandable shaft adapted to be positioned within a vertebral body having a first profile and a second profile; wherein the shaft is adapted to cut through cancellous bone within the vertebral body during expansion from the first profile to the second profile; and further wherein the shaft is adapted to abut a surface of cortical bone within the vertebral body without passing therethrough. The invention also includes a method for treating cancellous bone, such as cancellous bone of a vertebral body.

Abstract: Methods and instruments for use of a patient's native and existing cancellous bone as a packing material for the intramedullary canal in total hip arthroplasty and subsequent revision hip surgery. A series of tamps of progressively larger size are used to pack the native cancellous bone, the tamps having a shape substantially similar to that of the hip prosthesis. The methods and instruments are bone conserving. If the patient later needs a revision surgery, the doctor has more bone to work with and there is less risk of complications.

Abstract: An endplate for an intervertebral prosthesis includes an inner domed region (330) and a peripheral rim (332) wherein the inner domed region has a non-circular plan and has an area that is at least 50% of the area of the endplate. A surgical instrument for milling a recess in a vertebral endplate includes a cutting tool having a drive shaft with a positioning collar, a guard frame, and a pair of guide plates attached to the guard frame and space to confine the positioning collar and having guide slots for the drive shaft.

Abstract: The invention relates to the preparation of an intervertebral space with a trial implant (9), the insertion of an implant (5, 6, 7), the inserters (13, 16), and the method for feeding and inserting the implant (5, 6, 7) by means of an oblique anterior approach. In the novel improved method, the associated instruments (13, 16) for inserting an implant (5, 6, 7) into an intervertebral space, in particular for the lumbar spine at an oblique anterior angle of 45° was developed, the left side of the body being preferred for insertion of the implant (5, 6, 7). Either the implant (5, 6, 7) can be inserted all in one, or first the upper part (5) and lower parts (7) and then the inlay (6) may be inserted. By insertion by means of the left oblique anterior approach at 45°, optimum utilization of the area of the intervertebral space is ensured (footprint), and better retention of the implant is guaranteed by the exact chiselling at an angle of 90° normal to the respective intervertebral surface.

Abstract: A system for accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate the spine. The location may be at the L4-L5 vertebral level, and the curved path may lie in a plane oblique to the transverse, coronal and sagittal planes of the spine, and avoid the iliac crest. A targeting post may be inserted adjacent the spine to determine the location, and a guide member may be inserted to establish the curved path. A micrometer assembly may adjust a cephalad-caudal displacement between the post and the guide member. One or more intermediate cannulas may be inserted over the guide member to dilate tissues prior to insertion of the main cannula. An interbody device may be implanted into an intervertebral space through the cannula.

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 mitre instrument for use during surgery when cutting bone in connection with shortening or extension and/or correcting of the angle of the bone. The mitre instrument includes a body (9), in which there is at least one hole for a guide pin (13) for fixation of the instrument and at least two slots or scores (3) for a cutting tool (11). The slots (3) are provided in an oblique form relative each other and in predetermined, fixed angles, which converge in a common origin of coordinates (0), at the same time as the cutting tool (11) is extendable from the lower side of the body (9) at an outlet for a guide pin (13) in origin (0) without the wedge-shaped portions (2) of the body (9) therebetween falling off.

Abstract: A prosthesis (20) for use in performing joint arthroplasty is provided. The prosthesis (20) is to be fitted to a long bone (3). The prosthesis includes a first body (22) having a first body articulating surface (24) defining a generally circular outer periphery (26) of the first body articulating surface (24). The first body (22) has a support surface (28) opposed to the articulating surface (24). The support surface (28) is adapted to receive the head of the long bone (3). The prosthesis (20) also includes a second body (30) operably associated with the first body (22). The second body (30) has a second body articulating surface (32) extending from a portion of the circular outer periphery (26) of the first body articulating surface (24). A tool kit for preparing a humerus to receive a prosthesis is also disclosed.