Abstract: A method for performing an open wedge osteotomy, the method comprising: forming a cut in a bone; manipulating the portions of the bone adjacent to the cut so as to open the cut into a wedge-like opening; providing an osteotomy implant, wherein the osteotomy implant comprises: an elongated body characterized by a distal end and proximal end, the elongated body having a screw thread thereon; positioning at least the distal end of the elongated body into the wedge-like opening so that the screw thread engages the surrounding bone; and threadingly advancing the elongated body into the wedge-like opening until the portions of the bone assume the desired positioning, with the elongated body stabilizing the bone portions in this position.

Abstract: A device and method for use in a human spine to prepare a space between adjacent vertebral bodies and into the vertebral end plates to receive an implantable insert. The device includes a handle, a shaft, and a mounting member at one end of the shaft. An abrading element is mounted on the mounting member and is coupled to a drive mechanism. The drive mechanism is operable to move the abrading element in at least one degree of freedom to create surfaces having predetermined contours in the end plates of the adjacent vertebral bodies.

Abstract: A chisel system for harvesting an implantable graft from an area of a human having a cartilage overlying a condyle, according to which a module is provided that has one end connected to a handle. A cutting surface is formed at the other end of the module that cuts through the cartilage and condyle.

Abstract: A bone scoring device having a body, a scoring member configured to engage a bone surface and a first biasing member connected to and configured to rotate the scoring member is provided. The scoring member being axially movable between a first, non-rotatable position, such that the scoring member is engaged with the body and a second rotatable position such that the scoring member is released from engagement with the body and freely rotates. The scoring member having an abrasive surface to score the surface of the bone in which it is put in contact. A method for using the scoring device as well as a kit including the scoring device are also provided.

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: Flexible shavers and curved access ports that reduce access and trajectory problems associated with conventional lateral approaches to the lower spine. These devices and methods allow for preparing a disc space in the lower spine at an angle that is parallel to the disc space. Consequently, these devices and methods allow for preparing with less endplate damage.

Abstract: Several devices and methods for preparing the vertebral endplates while minimizing damage to the vertebral endplates. Each design incorporates flexible means to reduce endplate damage while enabling removal of the cartilage adhered to the endplate cortical bone.

Abstract: A tunnel notcher and guidewire delivery device is provided for creating a notch and positioning a guidewire within a bone tunnel. In general, the device includes an elongate member having proximal and distal ends with an inner lumen extending therebetween that is adapted to receive a guidewire. The device also includes a cutting element disposed on a distal portion of the elongate member that is adapted to remove bone within an opening of a bone tunnel. In use, the device 10 can be at least partially positioned within a bone tunnel containing a bone plug, and it can be manipulated to form a notch within or adjacent to an opening of the bone tunnel using the cutting element 18. The device 10 is also effective to deliver a guidewire 16 to the bone tunnel at a location adjacent to the notch.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Abstract: A spherical osteotomy device for the efficient surgical sectioning of bone includes a part spherical body and a shank. The part spherical body includes an outer surface, an inner surface, a cutting end between the outer surface and the inner surface, an axis extending from the outer surface through the inner surface, and an origin on the axis. The inner surface has a substantially constant radius extending from the origin. The shank extends outwardly from the outer surface of the body and is substantially aligned with the axis. Other embodiments of an osteotomy device are described. Also provided is a method of using the osteotomy device for performing spherical osteotomies.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

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: The invention relates to a device for penetratingly extending a blind hole into a hard tissue, particularly a jawbone. The device is characterized in that it comprises a tubular body (1) having a distal working opening (2) and an inlet (3) opposite the working opening (2), said inlet being closed by a sealing element (4) that is penetrated by a shaft (5) of a working tool, for example a milling tool (5, 6), and allows at least a feed motion, a drive motion and a steering motion of the working tool (5, 6), the tubular body (1) being provided with a connection (8) for applying an internal pressure.

Abstract: A technique and system is provided for efficiently, effectively and safely performing an interbody lumbar fusion. The technique and system utilizes: (1) a rotary shaver that provides a shaving cannula; (2) an outflow/insertion cannula which provides a dual purpose cannula; and (3) a fusible balloon which provides a biodegradable intervertebral bag. The patient's disc is shaved and cut out with the shaver while the shavings are sucked out with the dual purpose cannula. Afterwards, the balloon is inserted at the tip of the dual purpose cannula and the balloon is filled with a grafting substance. The balloon assumes the shape of the removed disc. The grafting substance will fuse to the balloon and to the adjacent vertebrae and provide a support where the removed disc was.

Abstract: Embodiments of the invention include systems and methods for replacing at least a part of a vertebral body. Systems may include end components for interfacing with adjacent vertebrae and a central component for placement between end components. Instruments for placing system components and preparing anatomical structures to receive system embodiments may also be included.

Abstract: A method of positioning an arcuate device against the inner walls of the disc, and particularly on the posterior and postero-lateral portions of the inner annulus of the disc. The arcuate device retains its predetermined arcuate shape when no pressure or force is applied to the catheter. In an embodiment, an arcuate cutter is used to remove tissue from the inner annulus of the disc. In another embodiment an arcuate device is used to progressively remove material from the interior of the mammalian intervertebral disc. In yet another embodiment, an arcuate device is used to remove the entire intervertebral disc and place supports to maintain a disc space.

Abstract: A chisel with U.V-shaped, saw tooth or other shaped opposing blades is used to form channels in adjacent vertebrae. The chisel has a projection extending from at least one of the top and bottom surfaces to limit depth of penetration into the vertebrae. A guide member may be attached to the forward tip of the chisel to guide the chisel into the disc space to uniformly chisel both adjacent vertebrae simultaneously to form a channel in the vertebrae. The so formed channels serve as sa guide for a second chisel having no guide member. The second chisel, which may be a box chisel, is used to complete the channels to the desired depth to receive an associated implant, typically of cortical bone. Other embodiments are disclosed in which a two step box chisel has a retractable guide member for initially guiding the chisel as it forms partial channels in the vertebrae disc space. The guide member is then retracted and the channels formed to the desired depth.

Abstract: Tools and methods for preparing an intervertebral disc space with an emphasis on abrading the vertebral endplates to promote controlled bleeding of the vertebral endplate without compromising the structural integrity of the vertebral endplate. The abrading process may be used to remove cartilage from the vertebral endplate if this remains to be done. Various mechanisms are discussed to either statically or dynamically alter blade angle of the cutter blade. Cutter blades may come in a variety of configurations including cutter blades with abrading heads for preparing endplates. Abrading heads may be used on upcutters or down cutters. Also disclosed is a cutter assembly adapted to resist unwanted changes in blade angle.

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 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: Disclosed herein are tissue-removal devices and methods for treating spinal diseases using such devices. The tissue-removal devices may comprise a cable and/or extendable elements with a retracted and a deployed configuration. The cable and/or extendable elements may be distally supported and restrained by a support element such that the support element may be pushed transversely away when the extendable element is distally extended into its deployed configuration. An annular cutting element may be provided about the distal end of the extendable element or the support element. Various configurations of the extendable and support elements are described herein, as well as methods of using tissue-removal devices with extendable and support elements coupled by an annular cutting element for treating spinal diseases.

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: 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 method for modifying tissue in a patient may involve one or more of the following steps: advancing at least a distal portion of at least one elongate, at least partially flexible tissue modification device into a patient and between one or more target tissues and one or more non-target tissues; positioning at least one tissue modifying member of the tissue modification device adjacent the target tissue such that the tissue modifying member(s) face the target tissue and do not face the non-target tissue; applying an anchoring force to the tissue modification device at or near the distal portion or a proximal portion of the device; applying a tensioning force to the tissue modification device at or near an opposite end of the device relative to the end to which anchoring force is applied, while maintaining the anchoring force, to urge the tissue modifying member(s) against the target tissue; and modifying the target tissue, using the tissue modifying member(s), while preventing the tissue modifying member(s)

Abstract: Embodiments of the surgical chisel assembly comprise a wedge shaped surgical chisel designed to eliminate the square shape and sharp corners from a forward edge of a chisel. One embodiment of the chisel assembly comprises a chisel body and a grip. The chisel body comprises a wedge-shaped blade portion and a handle portion. In one embodiment, the handle portion is substantially flat about two generally parallel principal surfaces and is generally shaped to be able to be comfortably held by a surgeon in their hand. The blade portion of the chisel comprises a forward edge created by a blunting of the angle of intersection of the forward edge surfaces and a curving of the forward edge along the width of the forward edge.

Abstract: The apparatus of the invention is an adjustable intervertebral shaver with a handle portion and a blade portion that adjusts width while remaining in the disc space. The invention also includes methods using the adjustable intervertebral shaver to surgically prepare the intervertebral space. By changing the width of the blade portion, the surgeon adjusts the aggressiveness of the curetting and also determines the appropriate size for an intervertebral graft. By remaining in the disc space, this decreases the time it may take to appropriately prepare the disc space. In addition, since the blade portion remains in the disc space it reduces the number of times an instrument must be passed adjacent to nerves and neural elements, thus decreasing the likelihood of damage to these structures. The width of the blade portion adjusts via an adjustment knob on the handle portion of the adjustable intervertebral shaver.

Abstract: A method includes resecting a portion of an articulation surface of a bone at a joint. A guide template is positioned on the resected articulation surface. The guide template at least partially bounds an opening that is disposed over the resected articulation surface. A portion of the resected articulation surface of the bone bounded within the opening of the guide template is then removed through the opening of the guide template.

Abstract: A rotary abrader allowing for improved visibility during surgery and improved aspiration of waste material. This is accomplished by providing a hood or sheath formed of a clear material and available in various shapes and sizes. The clear hood or sheath is also provided with a flattened, angled portion at a tip of the hood, to assist with retraction of the labral tissue while burring the glenoid rim. Slots are provided on the cannulated tube to provide aspiration of waste material and used to attach the hood to the cannulated tube.

Abstract: An osteotome may include a handle; a shaft coupled to the handle; a cutting member coupled to the shaft, wherein the cutting member comprises a first cutting surface positioned perpendicular to a second cutting surface, and wherein said first and second cutting surfaces extend downward relative to the shaft; and a stop means configured to control the depth of cut by the cutting member.

Abstract: Osteotome for the removal of bone and of bone tumors, as well as of ligaments and fibrocartilagineous 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 broach instrument for preparing the proximal medullary canal of a femur for receiving a hip stem implant includes lateral and medial broach segments that may be assembled and disassembled along a longitudinal plane of separation defined by longitudinal sliding surfaces. A respective longitudinal shaft is connected to a proximal end of each broach segment. Each longitudinal shaft has a respective impact head connected to a respective proximal end. The broach segments and/or shafts positively engage one another to resist lateral separation of the broach segments. Each broach segment may be inserted separately and sequentially through a minimal posterior incision and through the gluteus maximus and then be assembled within the patient for broaching.

Abstract: An instrument for removing tissue from a bone to create a cavity consists of an approximately spherical body having cutting formations in its external surface for cutting a bone. The body has a connector by which it can be connected to a drive by which it can be rotated about an axis, and a recess at the pole, opposite the connector. When the instrument is applied to the surface of a bone and is rotated about its axis, bone is cut as a result of the action of the formations against the bone, and a circular region of bone adjacent to the polar recess in the body remains generally intact.

Abstract: An orthopaedic pin driver is presented for impacting bone during a surgical procedure.

Abstract: Apparatus for use as a surgical handpiece is disclosed. An exemplary apparatus includes a body, a rotatable shaft extending from the body and including a tissue contacting component such as a burr, and an outer tube connected to the body and surrounding at least a portion of the shaft. In some configurations, the minimum separation between the tissue contacting component and the outer tube is greater than the minimum separation between the shaft and the outer tube, thereby preventing the tissue contacting component from contacting the shaft upon the application of a force perpendicular to the axis of the shaft. The device may include stand-off elements positioned between the shaft and the outer tube to aid in preventing the tissue contacting component from contacting the outer tube during operation. The outer tube may be flexible with respect to the body, such as by being constructed of a relatively flexible material and/or by being flexibly connected to the body.

Abstract: A surgical instrument and method is provided for creating and preparing a cavity in a bony intervertebral body. Asymmetrical cutting structures selectively open a cavity which has a relatively large surface area in the vertical direction. One method pertains to the treatment of a vertebral compression fracture.

Abstract: The present invention pertains generally to a surgical tool for cutting and shaping bone, cartilage and other anatomical structures. In particular, described herein are surgical tools having at least two cutting surfaces.

Abstract: The present invention provides a discectomy instrument that is capable of removing portions of the spinal disc between adjacent vertebrae in a controlled manner that is efficient and easy to use. In an exemplary embodiment, the discectomy instrument includes a handle, a rotary scraper, a barrel, a drive shaft, an outer sleeve and a retaining clip.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Abstract: An apparatus for cutting bone is provided, the apparatus includes an elongate member having a central axis. The elongate member includes a tubular portion that extends between a proximal end portion and a distal end portion. The distal end portion includes an articulatable head section with a stop surface and a cutting edge projecting from the stop surface. The head section is articulatable about a pivot axis that extends transverse to the central axis. The apparatus further includes a mechanism for articulating the head section relative to the tubular portion.

Abstract: Discectomy or disc preparation system that includes a guide member that is changeable from a deployment configuration for insertion into an intervertebral disc space to a deployed configuration upon being deployed into the intervertebral disc. The system also includes at least one tissue manipulator, such as cutting, scraping and extraction elements, that can be moved or tracked longitudinally along the guide member into and through the intervertebral disc space.

Abstract: The invention relates to spinal fusion implants or grafts and to apparatus for the installation thereof. More specifically, the invention is a serrated cutting or abrading tool designed to be pushed into an intervertebral space and thereby remove and partially penetrate the cortical bone layer that defines the endplates of the respective mutually adjacent vertebral bodies.

Abstract: An instrument system, associated milling or drilling guide and method include use of a trial implant of a size corresponding to an actual implant for the intervertebral space, with a milling guide mounted on the trial implant. The milling guide includes a longitudinal guide chamber which is tapered from a forward end to a rearward end. The system also includes a cutting tool which is received in the guide chamber in order to form a cutout in an adjacent vertebra. This cutting tool includes a bearing member which pivotally engages the rearward end to form a pivot axis for the cutting tool in the tapered guide chamber. Either the milling guide can be inverted to form the cutout in the other vertebra; or the milling guide can be provided with two guide chambers, to be used with one cutting tool moved between them or two respective cutting tools.

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: This invention relates to implants formed from donor bone for use in lumbar interbody fusion procedures and instruments for performing such procedures. The implants are formed to include a concave surface formed from a portion of the medullary canal of a long bone. The concave surface defines a recess in the implant that serves as a depot for osteogenic material. Specific instruments for inserting the implants prepared according to this invention and for preparing the intervertebral space to receive the implants are also provided.

Abstract: The present invention provides an osteotome for sinus lifting and dental ridge expansion which includes an osteotome shank, a trepanelevation tip member, and a head. The trepanelevation tip member provides a cavity at a tip end and a prominence protruded from the bottom of the cavity. In this manner, during dental ridge expansion, the sharp edge of the trepanelevation tip member will secure the position and provide initial splitting of bones of sinus floor. Subsequently, the prominence will provide appropriate pressure for bone lifting. By applying the splitting force and compaction force alternatively in the same tip, the edge and prominence of the osteotome can lift the sinus in a much safer and more effective manner.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

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 flip retrograde cutting instrument and method of retrograde drilling using such an instrument. A method of forming a socket includes providing a flip retrograde cutter, inserting the cutter into a joint with a blade of the cutter in a straight position, pivoting the blade to a non-straight flip position, locking the blade in the flip position, and retrograde drilling a socket using the blade in the flip position.

Abstract: An instrument for preparation of vertebral endplates and a method of preparing a surface of a vertebral endplate are described. The instrument includes a body having a frame, an endplate preparation member supported by the body, and a pivot point. A tilt axis is perpendicular to and intersects a sweep axis at the pivot point. The endplate preparation member is coupled to the frame and controllably pivotable in an arc about the first tilt axis to change a tilt of the endplate preparation member. The endplate preparation member is also controllably pivotable in an arc about the sweep axis while maintaining the tilt of the endplate preparation member. By sweeping the endplate preparation member at incrementally larger tilt angles, recesses in a vertebral endplate surface are gradually formed, which may allow greater precision and control of a depth of the recesses and reduce stress on the vertebral endplate, as opposed to more aggressive techniques.