Abstract: A percussion device for bone implantology includes a body housing an electromagnetic coil for the acceleration of a percussion anchor and from which a stem of a metal tool projects, a sonic rod which runs through the core of the electromagnetic coil and along which the percussion anchor is slidable, the sonic rod including a terminal head with which the stem of a metal tool is integrally engageable, a floating yoke arranged in the proximity of the terminal head which acts as travel end stop for the anchor, and wherein the electromagnetic coil is energized impulsewise with an electric current of a duration below 20 milliseconds and energy ranging between 0.8-1.2 KW, to produce an impact of the anchor on the yoke which develops an energy transferred to the tool stem through a sonic wave and a translational momentum, the force developed ranging between 60 and 260 daN.

Abstract: A tool for placing or removing joint sockets of an artificial joint, especially a hip joint, and a tool for placing or removing an artificial joint, has a handle, a joint socket or joint receiver or holder, and a connecting element arranged between the handle and the joint socket or joint holder. The connecting element comprises an arcuate portion in its longitudinal direction. A system for placing and removing joint sockets or joints using such a tool includes a position-determining and navigation device.

Abstract: An insertion tool for positioning intervertebral spacers into disc spaces. The insertion tool has a proximal end and a distal end, a T-handle secured to the proximal end and a pair of alignment rails extending to the distal end. The insertion tool includes a handle secured to the proximal end of the guide rails, and a shaft that extends through the handle, whereby the shaft has a threaded portion that extends to the T-handle. The insertion tool also includes a blocker that is secured to the distal end of the shaft. The blocker includes stop arms that guide the blocker through the guide rails and toward the distal end of the shaft. The blocker may be provided in a plurality of different sizes corresponding to the sizes of the implants to be inserted into a disc space. A lock is provided for locking the implant to the shaft.

Abstract: A system and method for inserting an implant into a cavity is disclosed, which may include advancing an implant insertion instrument toward a pair of adjacent bodies, the implant insertion instrument having two opposed ramps, wherein each ramp has a distal tip and wherein the longitudinal axes of the opposed ramps are separated by an initial angle; inserting the distal tips of the opposed ramps between the adjacent bodies, thereby creating an initial interbody cavity between the adjacent bodies; expanding the interbody cavity while maintaining the initial angle between the longitudinal axes of the opposed ramps; placing the implant in a final location between the adjacent bodies; transferring a compressive force urging the adjacent bodies together from the opposed ramps to the implant; and extracting the implant insertion instrument from the interbody cavity.

Abstract: A spinal facet fusion device is provided. The device includes a working sleeve having a first surface with a first port and a second port extending there through. The first port has a first perimeter and the second port having a second perimeter, wherein the first port is larger than the second port. A guide wire sleeve having a body with a proximal end and a distal end and a first outer perimeter is provided. The first outer perimeter is sized and shaped to be slidingly disposed within the second port, the guide wire sleeve having a channel extending longitudinally from the proximal end through the distal end, the body further having a stop feature on the distal end. An implementing device having a second outer perimeter is sized to be slidingly received within the first perimeter.

Abstract: A fracture reduction implant for treating a vertebral compression fracture and instruments and methods for implanting the fracture reduction device utilizing a minimally invasive lateral approach are described. The implant may be inserted into a fractured vertebra through a T-shaped cut formed in the vertebral wall. The T-shaped cut may be formed in the lateral aspect of the wall. After insertion, a portion of the implant may be elevated within the vertebral body to reduce the fracture. The implant may include a base assembly with an elevator plate and a support column. The support column may be configured for guided insertion into the base assembly. The support column may be locked to the base assembly after insertion.

Abstract: A targeting device used in the insertion of an intramedullary nail into a bone. The targeting device includes a guide barrel having a frame portion formed of a non-radiolucent material. The guide barrel also includes a radiolucent material molded over the frame. In addition, the frame includes openings configured to allow a surgeon to view a relatively greater area around the guide barrel in an image of the assembly during surgery.

Abstract: Disclosed herein is an injector device for delivering an implant, the device including a retracting element, a cannula needle, and a plunger. The device may comprise an latch that, when actuated by a user, causes the retracting element to move the cannula needle away from the delivery site, allowing the plunger to eject the implant into the site. The device may be configured for intraocular drug delivery.

Abstract: An intervertebral cage, an implanting apparatus and an operating method thereof are provided. The intervertebral cage for being implanted between two adjacent vertebral bodies includes a body and a connecting portion. The body has a lateral convex surface, an inclined surface, a lateral concave surface and a connecting surface connected sequentially. The connecting portion includes a main portion and a protrusion. The main portion connected to the connecting surface has a through hole. The protrusion is protruded from the main portion into the through hole to form first and second inner arc surfaces. The maximum width of the intervertebral cage is a distance between first and second lines. The first and second lines are substantially parallel to a tangent line of the lateral convex surface and the first line, respectively. The distance between the inclined surface and the first line decreases gradually along a direction away from the connecting portion.

Abstract: A distance indicator for indicating the distance that a device has traveled includes an elongate housing with a guidewire connector configured for operative connection to a guidewire to hold the housing stationary with respect thereto. A plunger is operatively connected to the housing for longitudinal motion with respect to the housing. A first plunger end is configured to operatively contact the device. As the guidewire connector is holding the housing stationary with respect to the guidewire, the first plunger end is placed into operative contact with the device with the plunger and housing in a first relative plunger/housing position. The device moves longitudinally. The plunger moves into a second relative plunger/housing position assisted by the operative connection between the first plunger end and the device. The longitudinal difference between the first and second relative plunger/housing positions indicates a distance that the device has moved longitudinally with respect to the guidewire.

Abstract: A medical screwdriver configured to avoid disengaging from a screw during implantation of the screw at a surgical site, the screwdriver including an outer shaft having a housing in which is located a piston and a spring, an inner shaft, and a collar. When the collar is rotated in a first direction the collar is positioned at a first position and the inner shaft is rotationally coupled to the outer shaft. When the collar is rotated in a second direction opposite the first direction, the collar moves to a second position and the inner shaft is unlocked from the outer shaft.

Abstract: Apparatus and methods for accessing an inferior vertebra, a superior vertebra, and a disc space therebetween via a transpedicular approach in the inferior vertebra that may include creating a channel normal to the pedicle and using an offset guide to create a second transpedicular channel at an angle to the first, normal pedicle channel where the second transpedicular channel passes into the inferior vertebra, superior vertebra, or the disc space therebetween.

Abstract: An orthopedic instrument designed to engage a rod within a fixation element during a surgical procedure is described. The present invention has a distal end portion designed to hold a fixation element such as a pedicle screw while the rod is positioned within the fixation element. The instrument comprises a series of arms which form the grasping and handle portions of the device.

Abstract: An interlock driving instrument is configured to be releasably lockable to a fastener, such as a bone anchor. A bone anchor can be locked to the interlock driving instrument by inserting an expandable distal end of the shaft of the interlock driving instrument into the driving opening of the bone anchor and expanding the distal end within the driving opening by translating an expansion member into the expandable distal end. Alternatively, the bone anchor can be locked to the interlock driving instrument by inserting the distal end of the shaft of the interlock driving instrument into the driving opening of the bone anchor and translating a sliding member along a sloped surface defined in a channel extending into the shaft.

Abstract: A method of inserting an intervertebral disc implant into a disc space includes accessing a spinal segment having a first vertebral body, a second vertebral body and a disc space between the first and second vertebral bodies. The method includes securing a first pin to the first vertebral body and a second pin to the second vertebral body, using the first and second pins for distracting the disc space, and providing an inserter holding the intervertebral disc implant. The method also desirably includes engaging the inserter with the first and second pins, and advancing the inserter toward the disc space for inserting the intervertebral disc implant into the disc space, whereby the first and second pins align and guide the inserter toward the disc space.

Abstract: The present invention relates to an intervertebral disc prosthesis and insertion instrumentation, the prosthesis comprising at least first and second osseous anchoring means, the first osseous anchoring means disposed proximal to the periphery of the plate on which it is situated and the second osseous anchoring means being offset along the antero-posterior axis, the second osseous anchoring means comprising a basal portion and a sharp-edged portion of width narrower than the basal portion. The instrumentation comprises a rod fitted with at least two feet forming a clip and sliding in a tube, sliding the rod in the tube, in the direction of the manipulation end, causing closing of the clip by contact between the exterior of the feet and a truncated portion of the tube and sliding the rod in the tube, in the direction of the prehension end, causing opening of the clip by contact between an axis and the interior of the feet of the rod.

Abstract: Orientation device for surgical use includes a frame and a level device attached to the frame. The feature may be oriented with a reference such as the Antero Superior Iliac Spine, the acetabulum or the operating table to position the pelvis or the device. The level device is adapted to define a reference plane. The device thus allows precise orientation with respect to the pelvis through use of a reference plane.

Abstract: A Lisfranc injury between a second metatarsal and medial cuneiform is repaired by gaining access to the injury site and placing two arm members of a novel drill guide around the two neighboring bones at the injury site, drilling a guide wire through the two bones guided by the drill guide to a desired depth, measuring the depth of the guide wire to determine the proper length for a bone screw for securing the two bones, drilling a cannulated drill bit into the two bones to a drill depth using the guide wire as a guide, and threading a bone screw into the two bones.

Abstract: An instrument guide with device coupler, a handle and one or more instrument guide lumens is detachably coupled to an orthopedic implant to facilitate drilling of the fastener holes or to facilitate insertion of self-tapping or self-dripping fasteners. The handle is preferably detachable to facilitate access to the instrument guide lumens. The device coupler detachably engages the implantable device and aligns the instrument guide lumens with the fastener openings on the device.

Abstract: Instrumentation for implanting an artificial intervertebral disc includes repositioners/extractors for repositioning and extracting the static trials or the artificial intervertebral discs, each of the repositioners/extractors including a shaft and at least two pins coupled to the shaft distal end and extending in a same direction and perpendicular to a plane passing through the shaft longitudinal axis, each pin being parallel to all others of the pins, wherein the disc includes at least two holes, at least two of the pins being sized, directed, and spaced for simultaneous engagement with at least two of the holes, and wherein such simultaneous engagement enables repositioning of the implant via application of pressure to the shaft.

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: An instrument including a grip portion, a first substantially rigid extension arm projecting outwardly from the grip portion along a first longitudinal axis, and a second substantially rigid extension arm projecting outwardly from the grip portion along a second longitudinal axis. The first has a straight portion adjacent the grip portion that lies substantially within a first plane, and a distal portion extending from the straight portion to a first distal end along a length of which the first extension arm extends upward relative to the first plane and rotates about its first longitudinal axis. The second has a second straight portion adjacent the grip portion that lies substantially within the first plane, and a second distal portion extending from the straight portion to a second distal end along a length of which the second extension arms extends downward relative to the first plane and rotates about its longitudinal axis.

Abstract: A spinal joint distraction system for treating a facet joint including articular surfaces having a contour is disclosed and may include a delivery device including a generally tubular structure adapted to engage a facet joint, an implant adapted to be delivered through the delivery device and into the facet joint, the implant comprising two members arranged in opposed position, and an implant distractor comprising a generally elongate member adapted to advance between the two members of the implant causing separation of the members and distraction of the facet joint, wherein the implant is adapted to conform to the shape of the implant distractor and/or the articular surfaces of the facet upon being delivered to the facet joint. Several embodiments of a system, several embodiments of an implant, and several methods are disclosed including a method for interbody fusion.

Abstract: A delivery device for an osteochondral graft comprising a tube, a plunger and a graft retention assembly is disclosed. The tube has a bore having an inside diameter and extends from a proximal end to a distal end. The inside diameter of the bore is sufficient to accept an osteochondral graft of a desired diameter. The tube has a set of apertures located adjacent the distal end of the tube. The plunger is slidably disposed within the bore of the tube. The graft retention assembly comprises a collar and a set of tabs. The graft retention assembly is attached to the tube such that the tabs are disposed within the apertures of the tube. The tabs are biased towards each other but are capable of being displaced away from each other to receive or release the osteochondral graft.

Abstract: Instruments for use in anterior approach total hip arthroplasty. Instruments according to certain embodiments of the invention connect to a shaping member such as a broach, reamer or osteotome that is used to prepare the intramedullary canal of a desired femur or other bone for total hip arthroplasty. Such an instrument according to such embodiments can be configurable to allow operation on either the left or right leg, and in doing so to provide lateral offset and anterior offset of the instrument handle relative to the shaping member so that the patient's gut, musculature or other bodily portions may be avoided while still providing desired leverage and control over the shaping member to prepare the intramedullary canal.

Abstract: In one embodiment, a bone-fastening system includes a handle, a barrel assembly connected to the handle, and a bridge assembly connected to the barrel assembly. The bridge assembly may be configured to receive a first connector element and a second connector element in axial alignment with the first connector element so as to receive a fastening element between the first and second connector elements. The system may also include a control configured to, upon actuation, approximate the first connector element and the second connector element so as to apply compressive pressure to bone portions positioned between the first connector element and the second connector element. A drive mechanism configured to advance the fastening element through the bone portions and connect the first connector element with the second connector element to fasten the bone portions under compression may also be provided with the system.

Abstract: A surgical instrument including an elongate member, a support for engaging a rod receiving element, and a connection between the elongate member and the support. This connection comprises a pivotal articulation, and the elongate member is connected to the support via the pivotal articulation so as to be able to pivot independently around at least two perpendicular axes. The elongate member is also longitudinally movable with respect to the support. The elongate member has, at a first end, a device for holding a rod.

Abstract: A patellar resection instrument has an integral depth adjustment assembly that is easily, intuitively, and intra-operatively adjustable between a plurality of discrete positions. Each position corresponds to a particular, known depth of resection, and this depth may optionally be inscribed on the depth adjustment knob for easy visual selection and/or confirmation of the resection depth. The depth adjustment assembly provides positive tactile feedback as the stylus is moved between positions. The unique configuration of the depth adjustment assembly maintains the resection depth stylus in a chosen position throughout the patellar resection procedure, even if the procedure causes vibration or other forces to be transmitted to the patellar resection instrument.

Abstract: A tool set for preparing a joint, inserting an implant or removing an implant from a joint in an open or less invasive procedure generally comprises a set of nested tools, pin guides, jigs, and/or immobilization elements. The nested tool set comprises at least one pin and at least one cannulated tool. In some embodiments, the cannula can comprise tangs that project from the distal end of the cannula. The tangs can be offset such that drilling would remove different amounts of bone relative to drilling through a centered drill guide. The cannulated tool kit generally can comprise at least one tool guide/cannula, drill bits/reamer, syringe, and/or inserter. With the pin positioned into the joint, at least one cannula is positioned over and around the pin. The channel of the cannula guides the other tools into the joint. A plurality of cannulae in a nested arrangement can be used to afford selectively sized channels for tools and/or implants based on selected cannulae configuration.

Abstract: Systems and methods for placing spinal implants within an intervertebral region. In some embodiments, a surgical positioning tool may be provided that allows for access to an implantation site to be gained along a first axis, and then allows a spinal implant to be repositioned from the first axis to a second axis at an angle with respect to the first axis. The spinal implant may, in some embodiments, comprise a recess comprising two adjacent bars configured to engage elements of the surgical positioning tool to allow for the aforementioned repositioning.

Abstract: A method of performing at least one surgical procedure is disclosed. The method includes: preparing a patient for a first surgical procedure; making a first incision through the skin of the patient in accordance with the first surgical procedure; exposing a target area for the first surgical procedure through the first incision; performing a step of the first surgical procedure on the target area for the first surgical procedure; placing a protective pad with a fluid pocket between a vulnerable anatomical part and the target area for the first surgical procedure; and closing the first incision in accordance with the first surgical procedure with the protective pad between the vulnerable anatomical part and the target area. A protective system for facilitating revision surgery is also disclosed.

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 bi-directional fixating transvertebral (BDFT) screw/cage apparatus including an intervertebral cage for maintaining disc height, and a method of inserting the same is provided. The intervertebral cage includes a first internal screw guide and a second internal screw guide, a first screw member and a second screw member, and a central screw locking lever coupled to the intervertebral cage, wherein the central screw locking lever prevents the first screw member and the second screw from pulling-out of the first internal screw guide and the second internal screw guide. The central screw locking lever includes a rotatable handle and stem portion, or a screw locking horizontal bracket. A pliers device for inserting and removing the bi-directional fixating transvertebral (BDFT) screw/cage apparatus, a posterior cervical and lumbar facet joint staple, and a staple gun for a posterior cervical and lumbar facet joint staple also are provided.

Abstract: Surgical device and methods for using same for distraction of adjacent vertebrae and insertion of an intervertebral implant material there between are disclosed. In a method, a leading end of the surgical device having major and minor dimensions is inserted between adjacent vertebrae with the minor dimension aligned in the rostral-caudal direction, and then the leading end is rotated to a second orientation to align the major dimension with the rostral-caudal direction. The surgical device includes slots permitting expansion thereof to allow an implant to be disposed from the leading end into the intervertebral space. In another form, the a first member of a surgical device is initially inserted in an orientation, and second member is moved relative to the first member to expand the first member for distracting the vertebrae, the implant then being disposed from the leading end into the intervertebral space.

Abstract: Systems, apparatuses and methods for securing tissue to bone using a bone anchoring system are described. Methods and apparatuses may allow transformation between locked and unlocked states, thereby allowing adjustment of the tension in the suture. The apparatus and/or methods may allow unidirectional movement of a suture, while preventing slippage or movement of the suture and tissue in the opposite direction. Ends of a suture may be individually tensioned to adjust positioning of a tissue with respect to a bone.

Abstract: A spinal disc implant delivery device includes a blocking component having opposed distal and proximal ends. The proximal end of the blocking component includes an anchor member configured and adapted for movement between an undeployed position in which the anchor member can pass into and out of an opening in a disc annulus, and a deployed position in which the anchor member anchors the blocking component to the opening of the disc annulus. In the deployed position, the anchor member is configured to prevent extrusion of implant material from the opening of the disc annuls. An implant delivery needle is located radially within the blocking component and has opposed proximal and distal ends. The needle is configured to deliver implant material from the distal end thereof to an interior of a disc annulus.

Abstract: The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectably detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area.

Abstract: The present invention provides an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. In one embodiment, the fusion device includes a body portion, a first endplate, and a second endplate, the first and second endplates capable of being moved in a direction away from the body portion into an expanded configuration or capable of being moved towards the body portion into an unexpanded configuration. The fusion device is capable of being deployed and installed in both configurations.

Abstract: A prosthesis delivery and implantation system for tissue repair is disclosed. The implantation system includes provisions for manually applying a prosthesis to a treatment area. This system may be applied to heal any imperfections in various different types of tissue. The system also provides provisions for independently inserting two end portions of the prosthesis into tissue.

Abstract: A method and apparatus for percutaneous and/or minimally invasive implantation of a construct. The construct may be implanted using a navigation system for planning and execution of a procedure. A plurality of portions of the construct may be interconnected using locations and paths determined and navigated with the navigation system.

Abstract: The surgical instrument includes a handle assembly and an elongate body that has first and second ends with the first end being located adjacent to the handle assembly and the second end being moveably connected to an implant engagement assembly. The surgical instrument also has a length control mechanism that includes a gripping portion, a drive shaft and a gear assembly. The surgical instrument further has a locking mechanism that includes a gripping portion, a connecting rod and a coupling end. The length control mechanism functions to adjust the overall length of an implant that is held by the implant engagement assembly before being implanted in vivo. The locking mechanism operates to secure the overall length of the implant following final length adjustment and implantation. A surgical method for using the surgical instrument, a method of fabrication and a spinal implant insertion kit is also disclosed.

Abstract: A surgical instrument is described that is configured to apply a force to first and second surfaces to secure the first surface relative to the second surface during fixation of the first and second surfaces.

Abstract: Provided is a novel surgical instrument having an adjustable distal end that can securely engage an interbody for introduction of the interbody into an intervertebral space, can be adjusted before and during the surgical procedure to vary the angle of the distal end of the device and the angle of introduction of the interbody, and after positioning that interbody at the surgical site, can be easily disengaged and removed.

Abstract: A surgical implant deployment system for deploying and removing an implant into a vertebral body. Upon insertion of the implant into the vertebral body, the actuator handle is turned causing the actuation rod to expand or compress the implant.

Abstract: A retractor system and method for locating and placing a polyaxial screw while substantially simultaneously retracting tissue is shown and described. The retractor has a channel that facilitates introducing a rod into the polyaxial screw. Various embodiments are shown, including one which utilized a reducer for moving the rod in the retractor.

Abstract: A surgical fastener system includes a plurality of fasteners having a throughbore with a non-circular cross section portion. The fasteners may engage with a splined mandrel that passes through the throughbore of the fasteners and rotates the fasteners relative to the mandrel to move at least one of the fasteners along the mandrel, e.g., along the mandrel's longitudinal axis. A distal end of the mandrel may be inserted into a material, such as a tissue, prosthetic or other, and a fastener may be deployed from the distal end of the mandrel while the distal end is positioned in the material.

Abstract: A spine measurement system includes a plurality of sensored heads, a spinal instrument, and a remote system. The spinal instrument comprises a handle, a shaft, sensored heads, and a module. The sensored heads includes one or more sensors that couple to module and each has a different height. The module includes an electronic assembly for receiving, processing, and sending quantitative data from sensors in sensored heads. The module can be coupled to and removed from handle. Similarly, sensored heads can be coupled to and removed from shaft. A sensored head can be inserted between vertebra and report vertebral conditions such as force, pressure, orientation and edge loading. A GUI of remote system can display a workflow and report load and position of load during the workflow.

Abstract: An insertion instrument for inserting an expandable support device, where the insertion instrument includes an actuator device operable to rotate a component of an expandable support device to a rotated position, such that the rotation to the rotated position of the expandable support device causes a first longitudinally extending member of the expandable support device to be longitudinally fixed. The insertion instrument also includes a hollow body, where the hollow body includes a removable gear device or a removable screw driver device. The removable gear device is configurable to cause a first longitudinally extending member of expandable support device to longitudinally extend in a direction away from the center of the expandable support device. The removable screw driver device is configurable to insert a screw into the expandable support device to lock the rotated position into place.

Abstract: A method for preparing a proximal femoral canal of a patient during total hip replacement surgery uses an instrument having a handle, a shaping member including structure configured to shape bone, wherein the structure configured to shape bone comprises at least two cutting surfaces on opposite sides of the shaping member, and a connecting member connecting the handle and the shaping member, the connecting member having a plurality of transverse cross sections. The connecting member includes a dual offset including a first compound bend between the connecting member and the handle, wherein when following a direction from the connecting member to the handle, the first compound bend includes a bend in a posterior direction and a bend in a lateral direction. The connecting member also includes a second compound bend between the connecting member and the shaping member, the second compound bend in an anterior and a medial direction.

Abstract: An installation tool that is useful for the efficient and effective placement of an article, such as an artificial disc, between adjacent vertebral bodies is provided. The installation tool can be provided as a kit having modular components which allow the surgeon to select from among a variety of components to assemble an installation tool that is optimized for its intended use. The installation tool of the invention generally includes a pair of opposed levers, each of which has a proximal handle portion and a distal portion. A fulcrum is disposed between the two levers to enable proper operation of the tool. The tool further includes a pusher block that is positioned between the two levers and is selectively movable between an initial location distal of the fulcrum and a final location adjacent the distal end of the levers. The pusher block includes a proximal end, a distal end, and a bore extending at least partially therethrough.