Abstract: The invention relates to a surgical device, the device comprising a probe part and means to generate a Shockwave in the probes sufficient to separate, adjust of attach two or more, parts when the probe is applied to one of the part in vivo, the arrangement being such as to allow the application of a Shockwave that is regulated in amplitude and repeatable.

Abstract: An impacting device for inserting, positioning and/or removing an implant and/or performing other impacting applications. The impacting device may have a head having at least one recess. The recess may have a insertion channel and a locking chamber. In one embodiment, the insertion channel and the locking chamber may be connected by an axial channel. The recess may pass through a lateral surface of the head so that the base surface may remain cohesive or unobstructed. A guide means, such as a guide rod, may be positioned though the recess so that the head may be moveable on the guide means and not disengage the guide means. A shaft having a handle may be attached to the head to assist a surgeon in moving the head on the guide means.

Abstract: Implants, tools and methods for performing unilateral posterior lumbar interbody fusion are provided. An interbody implant includes a body having a top and bottom surface extending along a length thereof; and first and second side surfaces extending between the top and bottom surfaces on opposite sides of the body. The height of the first side surface is greater than the height of the second side surface.

Abstract: An orthopedic instrument for compression and distraction of bone segments includes a first receiver, a second receiver, a positioner member, and a guide member. The first receiver includes a first receiver aperture that receives a first screw extender. The second receiver includes a second extender aperture that receives a second screw extender. The positioner member translates the second receiver relative to the first receiver to apply one of a compression and a distraction force on the screw extenders. The guide member parallel to the positioner member guides the second receiver relative to the first receiver.

Abstract: A novel inserter for inserting a prosthetic cervical motion disc, wherein the distal end portion of the inserter features a pair of projections that are adapted to move slidably and transversely relative to one another (like a wrench) in order to engage a prosthetic cervical motion disc.

Abstract: An impactor for connection to a concave surface of an implant has a shaft extending along a first axis from a first end to a second end. The shaft first end includes a pivot surface surrounding an internal shaft bore. The internal bore extends along the first axis and is open at the first end and extends towards the second end about the first axis. The internal bore has a pin extending through the shaft and intersecting the bore. A resilient element is mounted in the shaft bore spaced towards the shaft second end. A post is mounted in the shaft bore along the first axis. The post has a first end engaging a threaded bore in the concave surface of the implant. The post has a second end engaging the resilient element and a slot therein slidably engaging the pin and a collar pivotally mounted on the shaft.

Abstract: A surgical triangulation device and method of use is disclosed. The surgical triangulation device includes an elongate member, the elongate member defining a longitudinal axis and being adapted for insertion through a surgical access portal. The surgical triangulation device also includes a platform pivotably attached near a distal end of the elongate member, the platform defining a plurality of lumens and a central opening therethrough. The platform has a first position, where a first end of the platform is positioned proximate to the elongate member and a second end of the platform extends distally past a distal end of the elongate member, and a second position, where the platform is nearly orthogonal to the longitudinal axis.

Abstract: A helicoil interference fixation system comprising: a helicoil comprising a helical body comprising a plurality of turns separated by spaces therebetween, the helical body terminating in a proximal end and a distal end, and at least one internal strut extending between at least two turns of the helical body; and an inserter for turning the helicoil, the inserter comprising at least one groove for receiving the at least one strut; the helicoil being mounted on the inserter such that the at least one strut of the helicoil is mounted in the at least one groove of the inserter, such that rotation of the inserter causes rotation of the helicoil.

Abstract: A method for measuring a spinal implant comprises the steps of: providing a device including a gauge configured to measure an angle in a measuring plane and extending to an engagement surface; disposing the engagement surface with a first selected position of an implant or an anatomy, the first selected position being disposed at a first orientation; calibrating the gauge to a zero angle measurement at the first orientation; disposing the engagement surface with a second selected position of the implant or the anatomy, the second selected position being disposed at a second orientation; and measuring an angle of the second orientation relative to the first orientation such that the gauge determines the angle relative to the zero angle measurement. Various devices are disclosed.

Abstract: An intervertebral instrument includes a shaft having distal and proximal ends. The proximal end of the shaft includes an attaching feature connected to handle. The shaft defines a pair tracks disposed along a portion of the surface thereof. The distal end includes a pair of wings. Each track guides instruments and implants along the intervertebral instrument. The implants are configured to receive bone graft or bone enhancers. The distal end of the shaft may include a removably attachable tip configured to engage the implants. The implants and the removably attachable tip form an implantable intervertebral disk. An intervertebral instrument and implant kit is also disclosed. A method of inserting intervertebral implants is also disclosed.

Abstract: A method of implanting a prosthetic component is disclosed that includes attaching a guide rod to the prosthetic component, removably coupling the guide rod to a shaft extending from a handle, and positioning the prosthetic component in an anatomical feature. The method also includes impacting an impaction portion of the handle and uncoupling the guide rod from the shaft, leaving the guide rod attached to the prosthetic component. The method further includes positioning a reamer over the guide rod to create a reamed opening in the anatomical feature.

Abstract: Equipment for placing an implant comprising an instrument for gripping the implant comprising two portions able to adopt a position of holding the implant and an open position allowing gripping or release of the implant once the latter is implanted, and an element for locking the portions in the holding position, the locking element comprising an attachment device arranged to come into engagement with a complementary attachment device provided in a reception housing formed by the portions in the implant-holding position, the attachment device and the complementary attachment device forming a sliding connection.

Abstract: In an insertion instrument for a three-piece intervertebral implant that includes an upper part that can be placed against a vertebra, a lower part that can be placed against the adjacent vertebra, and a pivot element that can be inserted between these two parts, the instrument having two arms, disposed side by side and supported pivotably relative to one another on one end, which at their free ends each have one retention device for the upper part and lower part, respectively, of the intervertebral implant, it is proposed that a longitudinal guide for the pivot element is disposed in one of the arms.

Abstract: A device for holding a surgical instrument having a body, an instrument engagement device and a knob. The body has a proximal end, a distal end and a passageway positioned through the body. The instrument engagement device is positioned in the passageway and has at least two prongs moveable relative to each other to hold the surgical instrument therebetween. The knob is preferably positioned on the proximal end of the body and operatively associated with the at least two prongs so that movement of the knob causes movement of the prongs. The prongs may further include at least one ridge for engaging at least one slot on the surgical instrument. The knob may further comprise a cap at its proximal end positioned and designed for impact, for example, by a hammer, to facilitate movement of the surgical instrument into the patient. The knob may also include a locking mechanism to fix the position of the prongs.

Abstract: A surgical instrument comprises a first member having a first surface defining a first cavity for disposal of a first implant. A distal end is configured to mate with a recess of a connector and defines a second cavity. A second member is configured for movable disposal in the second cavity. A third member is connected to the proximal end of the second member and the first implant. The second member is axially movable in a first direction to tension the first implant and in a second direction to release tension from the first implant. Methods of use are disclosed.

Abstract: The present invention relates to a method of inserting an implant comprising providing an expandable vertebral implant. The method further may comprise providing an angling inserter tool. The angling inserter tool comprises a handle portion, a base portion, and a tip assembly, the base portion being disposed between the handle portion and the tip assembly. The method further may comprise distally advancing a central shaft of the tip assembly with rotation into an opening in the expandable vertebral implant to secure the angling inserter tool to the expandable vertebral implant. The method further may comprise positioning the expandable vertebral implant in a patient's spine. The method further may comprise for causing the tip assembly to angulate with respect to a longitudinal axis of the angling inserter tool, wherein the internal shaft is coaxial with an outer cylinder of the base portion.

Abstract: An apparatus and method of performing a minimally invasive posterior spine fusion. More specifically an apparatus with a handle and a forked head on the distal end of the handle is used to grasp implant material and introduce the material to an implant site. The shaft of the apparatus is shaped so as to allow the affixation of a drill guide and drill while simultaneously holding the implant material in the implant site. After removal of the boring tools and assembly of the fusing element, the apparatus can be selectively removed from the implant site. A method of achieving facet joint fusion with near simultaneous fixation is also disclosed.

Abstract: An attachment guide for an interbody cage and a spinal plate includes a guide body and a coupling element. The guide body includes a proximal end, a pair of flanges, and a distal end. The proximal end includes an inserter attachment element configured to removably receive an inserter instrument. The pair of flanges extends from the guide body and is configured to engage the spinal plate. The distal end includes a surface configured to contact an anterior surface of the interbody cage and a cage engagement element configured to extend distally from the surface and into a wall of the interbody cage. The coupling element extends through an aperture of the guide body from the proximal end to the distal end and is configured to draw the pair of flanges into greater contact with the spinal plate and the cage engagement element into greater contact with the interbody cage.

Abstract: Provided herein is a vertebral distractor-inserter comprising a pair of arms comprising a first arm having a proximal end and a distal end and a second arm having a proximal end and a distal end, wherein the distal end of the first opposing arm is laterally offset from the distal end of a second arm thereby comprising a pair of laterally offset opposing arms, a driving rod extending between the pair of laterally offset opposing arms, and a drive mechanism in mechanical communication with the driving rod. A vertebral distractor-inserter comprising a pair of opposing arms, a housing in mechanical communication with the arms and rotatable about an axis extending between the arms, and a driving rod extending through at least a portion of the housing and between the arms. A vertebral distractor-inserter adapted for single-handed use. A vertebral distractor-inserter having an implant depth adjustor. Methods for distracting adjacent vertebrae and inserting an implant using the device described herein.

Abstract: Various methods and devices are provided for implanting a motion segment repair system. In particular, exemplary methods and devices are provided for implanting a spinal disc implant and/or a PDS device using a posterior surgical approach, including methods and devices for distracting adjacent vertebrae using a posterior surgical approach, methods and devices for posteriorly introducing a spinal implant into a disc space between adjacent vertebrae, and methods and devices for coupling a PDS device to the adjacent vertebrae to provide a complete motion segment repair system that is implanted using a posterior surgical approach.

Abstract: A wedge plate inserter/impactor instrument is provided primarily for holding, inserting, repositioning, removing, impacting, extracting, and otherwise manipulating an artificial intervertebral disc having features suitable for being manipulated thereby. A spring-loaded holding pin of the instrument can be used to engage a corresponding hole on the disc and confront the angled surfaces of the disc to enable the holding and manipulation of the disc. A forward wedge extension of the inserter/impactor has upper and lower surfaces that engage inwardly facing surfaces of the disc to hold the baseplates of the disc at a preferred lordosis angle with respect to one another. The instrument can engage the disc from a variety of surgical approach angles.

Abstract: Methods and instrumentation for implantation of an intervertebral disc prosthesis are provided. A guide tool with sagittal and coronal reference features guides placement of guide pins relative to a sagittal plane and a coronal plane of the vertebrae. A retainer lockable to the guide pins has a ratcheting mechanism providing distraction or compression. A rasp, planer or other tools may be aligned to the retainer and inserted into the intervertebral space to prepare the vertebral endplates. An interoperatively adjustable trial is alignable to the retainer and measures an angularity of the intervertebral space. A prosthesis with keying features may be mounted to a prosthesis inserter with complementary features, held by pivotable arms and compressed between prongs. The inserter may be aligned to the retainer and advanced to implant the prosthesis in the intervertebral space. A prosthesis remover may grip one prosthetic end plate and extract the entire prosthesis.

Abstract: A spinal fixation element fixation reduction system is provided herein. In general, the system can include a cap element with a bore having a central axis extending therethrough wherein the cap element is configured to releasably engage any type of surgical device (e.g., an access sleeve, a vertebral body rotator, etc.). Further, the system can include a driver configured to be slidably and removably positioned through the cap element. The system can also include an actuator configured to apply a force to the driver substantially along the central axis of the cap element thereby moving the driver in a distal direction so as to effect reduction of a spinal fixation element into a bone anchor. Additionally, a method of reducing a spinal fixation element into a bone anchor is also provided wherein the method can be performed as a minimally invasive surgical procedure or as an open procedure.

Abstract: Apparatus and methods for use in the performance of minimally invasive orthopaedic procedures, including apparatus and methods for use in the performance of such procedures under the visualization of an endoscope, are herein disclosed. Such procedures include a minimally invasive intramedullary nailing procedure, a minimally invasive bone graft harvesting procedure, a minimally invasive pelvic osteotomy procedure, an orthopaedic implant revision procedure, and a minimally invasive percutaneous bone plating procedure.

Abstract: A tool for implantation of a rod into a bone screw implanted in a human spine includes a guide member having a laterally opening channel disposed along an entire length thereof for side loading and receiving an implant fastener. A rod pushing member and a handle with a laterally opening channel are coaxial with the guide member, with the rod pushing member being rotatingly mateable to the guide member and the handle having a spring attachment mechanism for attaching the handle to the guide member. The guide member includes spring tabs for attachment to a bone screw, the tabs biased away from the bone screw. The rod pushing member includes a sleeve that extends substantially about the guide member, pressing the spring tabs toward the bone screw and into apertures on the bone screw arms. The rod pushing member sleeve also operatively functions as a rod pusher that abuts a rod as the sleeve is translated along the guide member and toward the bone screw.

Abstract: Setting instrument (10) for a hip socket or shoulder socket inlay, having a handle part (11) and a suction element (12) that can be brought into sealing contact with the joint surface. The suction element (12) comprises a flexible molded part (13) matched to the joint surface, which molded part is deformable by a pulling element (14) in such a way that, when applied to the joint surface, an (increased) partial vacuum is formed between the joint surface and the flexible molded part (13).

Abstract: An impacting device including a head having a longitudinal axis, a lateral surface and a base surface. The impacting device also includes a recess positioned in the head having a first channel and a second channel, the first and second channels being operably connected to each other. The first and second channels are at an angle with respect to each other when viewed in a plane parallel to the longitudinal axis.

Abstract: System for replacing a disk between two vertebrae includes an intervertebral cage having an oblong body including at least two portions and separated by a gap extending along a curved axis and opening out through an opening at a first end of the body, and at least one introducer guide rod, a curved longitudinal core having cross-sections substantially complementary to the cross-sections of the gap so as to enable the core and the two portions of the body to slide relative to one another, elements for mounting a first end of the core to co-operate with an end of the guide rod so that the curved core projects from the end, and a push rod mounted to move relative to the guide rod so as to come into contact via one end against the end of the body in order to push the body in translation relative to the core.

Abstract: A modular impactor head includes a load transfer member, a base, and a locking assembly. The base defines a space sized and configured to receive the load transfer member therein and to constrain movement of the load transfer member relative to the base in a plurality of directions. The locking assembly is sized and configured to constrain movement of the load transfer member with respect to the base in at least one direction such that the load transfer member is fixed to the base.

Abstract: A spinal cage is provided to be implanted in an intervertebral disc space. The spinal cage includes a first segment and a second segment movably connected with each other. The first segment is slidable with respect to the second segment, so as to elongate the spinal cage from a retracted state to an extended state.

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: An instrument of an instrument set is used to insert an implant into a disc space. The implant comprises a first cage and a second cage and the instrument comprises a distal end configured to push the cage first inserted into the disc space laterally in its proper anatomical location. Said distal end of the instrument has a tip, which is curved and has a curved inner side configured to contact an outer curved side of the first cage. The instrument set allows the insertion of two cages through a relatively small incision in the interdisc space in a simple yet safe procedure.

Abstract: A guide apparatus having a body having a central axis defined therethrough and a first channel and a second channel formed therethrough, a handle coupled to the body, the handle having a locking mechanism configured to prevent movement of the body relative to the handle in a first direction along the central axis of the body, and an arm coupled to the handle, the arm configured to engage at least a portion of a bone.

Abstract: This disclosure describes a guide assembly for guiding the installation of a spinal fusion implant to a surgical target site. The guide assembly includes a pair of arm members and a handle assembly that functions to clamp the arm members in locked and unlocked positions. The guide assembly interacts with an inserter to guide a spinal implant to the target site. Once the implant is inserted within the disc space, the guide assembly can be partially disassembled to facilitate removal from the surgical target site.

Abstract: An orthopaedic surgical instrument for use in disassembling an orthopaedic prosthesis includes a main component, a rod, and a spindle. The main component has a housing and an elongated body extending from the housing with a passageway is defined in the elongated body. The rod has an elongated shaft, with a greater length than the elongated body, extending from the head of the rod and configured to pass through the main component. The spindle threads into the housing to move the rod along a longitudinal axis.

Abstract: An instrument for penetrating an endplate of a vertebra having a first plate including a first endplate engaging surface and a second surface. The first endplate engaging surface and the second surface are oriented so as to face in opposing directions. The first plate has a plurality of extensions projecting from the first endplate engaging surface to form a first extension template. The first extension template includes a centrally disposed extension and at least one extension radially disposed about the centrally disposed extension. The first extension template is configured to penetrate an endplate surface of a first vertebra when advanced into the endplate surface of the first vertebra.

Abstract: An instrument assembly can include a handle and an instrument. The handle can include an inner member and an outer member. The inner member can include a rod and a first tip. The outer member can include a second tip and can define a cannulation. The instrument can define a pocket configured to receive the second tip of the outer member. The handle can be adjustable at a desired angle relative to the instrument when the second tip of the outer member is disposed in the pocket and the first tip of the inner member is positioned in the cannulation spaced apart from the second tip. The first tip can be configured to expand the second tip radially outward such that the second tip engages the pocket and locks the handle at the desired angle when the first tip is positioned in the cannulation in engagement with the second tip.

Abstract: A surgical instrument system comprises surgical instruments for use with an implantable interspinous device having at least one pair of wings for securing the implantable device to a spinous process. The instrument system may include a surgical instrument for expanding or spreading the pair of wings to accommodate the spinous process. Further, a surgical instrument may be provided for crimping or compressing the pair of wings against the spinous process for secure attachment of the device to a vertebra. The surgical instruments may be configured similar to pliers and apply force to the pair of wings within a predetermined range so as to avoid damage, weakening or breakage of the pair of wings. The surgical instrument system may also include interspinous devices of differing sizes.

Abstract: An implant storage and insertion system for a shape memory orthopedic implant allows the implant to be constrained in a deformed state, protected, insulated, held for insertion, and properly positioned in bone. The implant storage and insertion system includes a restraining block having an impact surface. The restraining block engages an implant at a first end, and further a medical instrument engages the restraining block and positions the restraining block at a bone such that the impact surface may be impacted to insert a second end of the implant into the bone.

Abstract: A tool for inserting an interspinous-process implant during surgery includes first and second elongate members. A post extending from the first elongate member may extend transverse to and cross the first elongate member's longitudinal axis. The second elongate member may be moveable longitudinally relative to the first elongate member, and a biasing member may bias the second elongate member toward a deployed position. The tool may further include an actuator to assist in moving the second elongate member.

Abstract: An elongate inserter has a distal end releasably connected to an expandable interbody fusion device and a proximal end including a trigger actuator. The interbody fusion device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other in the intradiscal space. The inserter includes a lifting platform and an elevator that define cooperatively engaging ramps and ramps surfaces that upon operation of the trigger actuator cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert into the expanded device between the superior and inferior endplates.

Abstract: A bone cage placement device used to insert and position a bone cage in the disc space. Once the bone cage is positioned, a selector tool is inserted into the center aperture of the bone cage placement device. The end of the selector tool has a cam lift driving feature which is used to rotate the cam lift of the bone cage and expand the bone cage to the desired height. The selector tool is removed, and a graft placement tool and plunger are used to insert bone graft material into the plug. An end plug installation tool and installer are then used to insert an end plug to prevent leakage of material from the bone cage. The bone cage is released from the bone cage placement device, which is then removed from the patient's body.

Abstract: A bone fixation plate for fixation of fractures having a small terminal bone fragment, such as fractures of the distal radius. The plate includes an elongated body, and two hook members extending from a first end of the elongated body. A contoured region is configured to approximate the surface contour of the distal radius proximate the volar rim, the dorsal rim, or the radial arm. Each hook member is configured to provide subchondral support to a distal bone fragment, without causing shortening of the fragment into the metaphyseal bone, and without providing a bending torque directed to the base of the plate. The tooth members of the hook plate are preferably sharpened at their tips and edges to facilitate their impaction. A holder/impactor for gripping the radial hook plate, and for further facilitating impacting of the hook plate without the need to pre-drill pilot holes, is also provided.

Abstract: The tissue augment sheet delivery system includes a tube funnel adapter and a tissue augment sheet delivery instrument. The tube funnel adapter includes a oval/conical shaped funnel. The tissue augment sheet delivery instrument includes a handle. A cylindrical tube is connected to the handle. A wire is inserted in the tube. The wire is formed in a large loop with small loops formed in the large loop. A tissue augment sheet is attached to one side of the large loop using a monofilament. In use, the tube funnel adapter is inserted in body. The tissue augment sheet is placed in mouth of the oval/conical shaped funnel and gently moved down. While moving down, the tissue augment sheet conforms to the internal diameter of the tube funnel adapter. The handle is withdrawn to remove the large loop from the body leaving the tissue augment sheet in body.

Abstract: Systems and methods for repairing annulus defects include at least one blocking member positionable in or adjacent to the annulus defect, at least one attachment portion for securing the blocking member to adjacent tissue, and instruments for placing and engaging the blocking member in and/or adjacent to the annulus defect. The blocking member extends at least partially across the annulus defect for repair of the defect and/or retention of nucleus material, one or more implants, bio-compatible materials or device, and/or other objects positioned in the disc space.

Abstract: An apparatus for displacing an implant, such as a pacemaker or ICD generator or loop recorder, which can be used during surgical procedures to facilitates manipulation of the implanted device. The apparatus can be used to apply force to the implant in order for the operator to tug to loosen the implanted device without causing unnecessary movement or dislodgement of implanted leads that are connected to the implanted device. The apparatus can have features of various shapes and sizes depending on the size of the patient as well as size and shape of the implanted device.

Abstract: A device for repairing a bone fracture that is inserted intrafocally and deployed to properly position the facture. The device includes an implant inserted intrafocally as a low profile fold and is then deployed to positione the fracture.

Abstract: A tool for holding or driving an implant member having a recess is provided including an elongate tool shaft having a distal head portion for being received in the recess and a securing mechanism that keeps the head portion in the drive recess and which is disposed proximally up along the tool shaft from the distal head portion. In one form, the securing mechanism includes a plurality of resilient leg member having distal end locking portions. In another form, a drive system includes a drive tool and a driven member. The drive tool has a generally annular flange portion that is radially larger than the drive head portion. The driven member has a generally annular securing portion for receiving the flange portion in releasably locked engagement so that the circumferential extent of the locking engagement is maximized relative to the smaller radial size of the drive head portion.

Abstract: Insertion tool assemblies for positioning an implant at a target location in a patient. Insertion tool assemblies that comprise first and second jaw portions configured to engage an implant; a sleeve assembly coupled to the first and second jaw portions; and a handle coupled to the sleeve assembly.

Abstract: The present disclosure relates to a spinal fusion impactor tool that includes an attachment means for securing an implant device to the distal end of the tool, a means for adjusting the angle of the distal head relative to the handle to better position the implant for introduction into the implant site, means for remotely releasing the implant device at the distal end and a clamp device on the shaft of the tool to secure tabs, attachments and other devices. The impactor tool is preferably used in conjunction with implantation of an intervertebral fusion cage that is equipped with shims having tabs or other removing means, but may also be used to introduce, for example, an implant, graft, fusion device, wedge or distractor device into any joint space or bony region in preparation for implantation.