Abstract: A system for dilating tissue includes a retractor having a pair of retractor blades that are movable towards and away from each other to retract tissue of a patient. The retractor blades have longitudinal guide channels. A first pin is attachable to a first vertebra. The system also includes an interbody spacer insertion device that has a guide channel for slidably engaging the longitudinal channel guide and is releasably attachable to an interbody spacer. The interbody spacer insertion device is configured to guide the interbody spacer into a space between adjacent vertebrae. A method for using the system includes advancing the retractor blades towards first and second vertebrae. The first retractor blade is attached to the first vertebra using the first pin and the retractor blades are moved away from each other. The interbody spacer insertion device is translated towards the vertebrae to position the interbody spacer between the vertebrae.

Abstract: Embodiments herein are generally directed to spinal implants, systems, apparatuses, and components thereof that can be used in spinal fusion and/or stabilization procedures, as well as methods of installation. The spinal implants may be expandable. In some embodiments, the spinal implants may be configured to be backfilled with bone graft material after insertion.

Abstract: An implant including a cage configured to be implanted between two vertebrae, including a first deployable keel, including a first blade, a first flange extending substantially perpendicularly from a first edge of the first blade, and a second flange extending substantially perpendicularly from a second edge of the first blade, such that the cross-section of the first deployable keel is in the shape of half of an I-beam. The implant further includes a second deployable keel, including a second blade, a third flange extending substantially perpendicularly from a first edge of the second blade, and a fourth flange extending substantially perpendicularly from a second edge of the second blade, such that the cross-section of the second deployable keel is in the shape of half of an I-beam. The first keel is configured to deploy in a superior direction, and the second keel is configured to deploy in an inferior direction.

Abstract: This invention is the method of treating an ailment associated with the cervical portion of the spine by performing an intravertebral corpectomy that includes the steps of removing the vertebral corpus to define a working channel for the surgeon to gain access to the epidural space so as to attend to and perform a procedure on the pathology. This method obviates the problems incidental to more radical cervical spine operations such as discectomy or corpectomy which requires removal of a portion of the vertebra and adjacent intervertebral discs for decompression of the cervical spinal cord and spinal nerves and using a bone graft with or without a metal plate and screws to reconstruct the spine and provide stability. Prior to terminating the surgery, the opening formed by the removed vertebral corpus is fitted and/or filled with a suitable implant.

Abstract: An instrument may be coupled to a multi-axis expandable intervertebral cage so that the cage may be inserted into an intervertebral space, expanded along multiple different directions, filled with bone graft, and locked with a fastener. The instrument may be part of an instrument set that includes auxiliary instruments to determine implant size, insert bone graft into the cage, and deliver the fastener.

Abstract: A posterior lumbar interbody fusion (PLIF) implant that comprises a body with substantially parallel posterior and anterior sidewalls, and a pair of superior and inferior faces. The implant is inserted via an insertion tool within a depression in the sidewalls of the implant. The insertion tool is secured to the side walls of the implant to prevent any bending or breaking of the implant or the inserter during implantation. Once inserted, the implant may be rotated approximately 90 degrees within the disc space. Because of the shape and size of the implant, the effective height of the implant within a patient's disc space is increased upon rotation.

Abstract: Embodiments of the present disclosure relate to devices and methods for treating one or more damaged, diseased, or traumatized portions of the spine, including intervertebral discs, to reduce or eliminate associated back pain. In one or more embodiments, the present disclosure relates to an expandable interbody spacer. The expandable interbody spacer may comprise a first jointed arm comprising a plurality of links pivotally coupled end to end. The expandable interbody spacer further may comprise a second jointed arm comprising a plurality of links pivotally coupled end to end. The first jointed arm and the second jointed arm may be interconnected at a proximal end of the expandable interbody spacer. The first jointed arm and the second jointed arm may be interconnected at a distal end of the expandable interbody spacer.

Abstract: A spinal fusion implant including a body and a jacket is disclosed. The jacket includes at least two radiopaque markers extending therefrom for use in determining the position of the implant after placement between intervertebral bodies. Methods of implanting and evaluating positioning of the implant are also disclosed.

Abstract: Medical devices suitable for implantation in spaces between bones are described. An example medical device suitable for use as an intervertebral spacer includes a main body having an exterior proximal wall, an exterior distal wall, a first exterior lateral wall, a second exterior lateral wall, an upper surface, a lower surface, an interior proximal wall, an interior distal wall, a first interior lateral wall, a second interior lateral wall, and a longitudinal axis. The interior proximal wall, the interior distal wall, the first interior lateral wall, and the second interior lateral wall cooperatively define an interior cavity. The first and second exterior lateral walls are outwardly directed at an angle from the lower surface to the upper surface relative to the longitudinal axis.

Abstract: An intervertebral spacer and stabilization implant includes a plate having sockets configured for retaining a fastener passable through the socket and into an adjacent vertebral body. One or more connecting projections extend from a side of the plate, to mate with projections extending from a spacer body. A plurality of teeth project from at least one of the upper or lower surfaces of the spacer body, and a chamber is formed through the spacer body to enable bone fusion between the vertebrae. The combined plate and spacer may be inserted to lie completely within the intervertebral space, or a portion of the plate may overlie a vertebral body.

Abstract: An implant for interbody fusion of vertebrae comprising a unibody cage structure having an enveloping cage volume and a minimized material volume. The cage structure comprises a first and a second generally planar ring member, each ring member formed from an opposing pair of lengthwise joists and an opposing pair of cross joists, the joists together forming a large opening through the ring member. The ring members are fixedly sandwiched on a plurality of support members, the support members holding the ring members in a spaced apart relationship to thereby provide a large void volume relative to the enveloping cage volume, to thereby allow for receipt of a large volume of bone graft within the cage structure.

Abstract: An intervertebral cage with an outer frame, an open inner core region and a porosity gradient within the outer frame is provided. The outer frame includes a posterior wall, an anterior wall, a pair of side walls extending between the posterior wall and the anterior wall and the porosity gradient may comprise at least one of: a decreasing average pore diameter in a direction from an outer surface to an inner surface of at least one of the pair of side walls; an increasing average pore diameter in a direction from an outer surface to an inner surface of at least one of the pair of side walls; a decreasing average pore diameter in a direction from an upper surface to a lower surface of at least one of the side walls; and an increasing average pore diameter in a direction from an upper surface to a lower surface of at least one of the side walls.

Abstract: An intervertebral implant comprising a body formed as an open truss structure, the body having a generally annular shape with a superior surface, an inferior surface, and a perimeter surface extending around an outer periphery of the body. The body has a central portion and a peripheral portion, the peripheral portion extending inward from the perimeter surface toward the central portion. The peripheral portion includes a first set of trusses having a first density of trusses, and the central portion includes a second set of trusses having a second density of trusses. The first density of trusses in the peripheral portion is greater than the second density of trusses in the central portion. The first set of trusses includes a first strut and a first node, and the second set of trusses includes a second strut, wherein the first node connects the first strut with the second strut.

Abstract: The invention is an improved packaging assembly for storing, distributing, treating, mixing, and dispensing tissue and/or cellular material and/or implantable material. The packaging assembly may include pouches, tubes, and a bag made of a sealable, flexible polymeric material that is open at one end and a needle-free swabable connector attached to the pouch at the other end and acting as a port to allow for the introduction or discharge of biological solutions, rinsing solution, and/or preservation solutions into the packaging assembly. The designed thickness of the wall of the packaging assembly facilitates efficient heat/cold transfer, which is useful for successful controlled rate freezing, quick thawing, and resuscitation of viable cells or tissue. The invention is also useful for combining additional biological fluids with the cellular material or tissue, and for efficient mixing of the biological fluids with the tissue and/or cellular material in the assembly.

Abstract: Stand-alone interbody fusion devices for engagement between adjacent vertebrae. The stand-alone interbody fusion devices may include a spacer or endplates and one or more inserts, members, or frames coupled to the spacer or endplates. The inserts, members, or frames may be configured and designed to provide the apertures which are designed to retain bone fasteners, such as screws or anchors, and secure the implant to the adjacent vertebrae.

Abstract: An improved cage that has an anchoring system and method of use thereof. The anchoring system has movable/expandable jaw portions that can expand vertically (i.e., upward and downward relative to the respective superior and inferior surfaces of the cage) so that the cage can be more securely implanted in position. The superior and inferior expandable portions of the anchoring system move vertically by the rotation of one or more spindles that is incorporated in the jaw mechanism (and/or by the rotation of a lead screw that is incorporated in the cage). In some embodiments, the medical implant (such as a cage) is itself non-expandable (i.e., the height of the medical implant does not change). In other embodiments, the medical implant (such as a cage) can be expanded independently of the anchoring system.

Abstract: Intervertebral implants, assemblies, and methods thereof. An intervertebral implant includes opposing chamfered edges to reduce a diagonal distance between the edges. The reduced diagonal distance minimizes distraction of an intervertebral disc space during insertion of the implant. A tool for insertion and rotation of the implant is also provided.

Abstract: An implantable medical device, such as an intervertebral spacer, may comprise a polymeric component and a metallic component. The metallic component can contain both porous metal and substantially-solid metal. The polymeric material can contain particles of an osseointegrative material. The metallic component can be more protruding toward bone than the polymeric component while having a smaller dimension of roughness than the polymeric component. In embodiments, the pin may press-fit against substantially solid metal. The porous metal may surround solid metal which in turn may surround the pin. The pin may have a press-fit with metal and a looser fit with polymeric component, if the metal components and polymeric components are trapped. A pin may connect superior and inferior metal components by a press-fit. The central opening may be exposed to porous metal and also to substantially-solid metal and to polymer. Specific geometries of implants are disclosed.

Abstract: Orthopedic implants constructs include one or two rigid monolithic plates and a core that is integrally formed within an interior space within a rigid monolithic plate. An exemplary construct that includes two plates between which is a core that is interengaged with each plate, the two plates thereby forming a generally disc-like shaped construct with opposing tissue contacting surfaces. The constructs are suitable, for example for spinal interbody fusion and artificial disc applications.

Abstract: Pathology of the human spine can arise from excessive and/or uneven loading of regions within the spinal vertebrae and the intervertebral disc. Methods and apparatus are disclosed that enable displacement of soft tissue around the spine in a less invasive manner, thereby altering the mechanical load distribution within the spine to achieve a therapeutic effect.

Abstract: Intervertebral implants for implanting into an intervertebral space are provided. The implants can comprise one or more layers that are operably attached to one another. An implant can comprise a first layer having a first mating surface that mates with a second mating surface of a second layer. The first mating surface and the second mating surface can have features that allow them to complement each other. The implants can include one or more bore holes for receiving a fixation member. The bore holes can be horizontal, vertical or diagonal. In some cases, the bore holes will be blind bore holes.

Abstract: A bone cage may include first and second spaced apart frames defining a bone ingrowth cavity therebetween, a plurality of first protrusions each having a proximal end coupled to the first frame and a distal end extending into the cavity toward the second frame but not contacting the second frame, and a plurality of second protrusions each having a proximal end coupled to the second frame and a distal end extending into the cavity toward the first frame but not contacting the first frame. Furthermore, the distal ends of the first protrusions may be laterally offset from the distal ends of the second protrusions.

Abstract: An intervertebral implantation system for restoring disc height and vertebral alignment, while allowing dynamic mobility and stabilization of the vertebral segment, and minimally invasive methods of implanting the same. The implantation system includes an annular reinforcement implant, including an elastomeric balloon inserted into the hollow or interior of a tubular sleeve, and secured only at a first and second neck portions to a securement element coupled to an attachment fixture, forming an annular structure attached to the outer margin of the annulus fibrosus. When the prosthetic implant is in a contracted state the tubular sleeve is redundant and undulated, forming folds, gathered loosely around the circumference of the inner balloon. Upon pressurized inflation with in-situ curable polymer, the elastomeric balloon elongates and expands circumferentially, and the tubular sleeve stretches and unfolds, constraining further expansion and elongation of the elastomeric balloon.

Abstract: The present application generally relates to orthopedic systems, and in particular, to systems including independent plates and spacers. A plating system can include a spacer and a plate that is independent from the spacer. A number of locking mechanisms can be provided to secure the plate to the spacer. In some cases, the spacer includes a pair of notches that extend on an outer surface of the spacer. The plate can include a pair of lateral extensions that can engage the notches to secure the plate to the spacer. In other cases, the spacer includes an opening including a pair of inlets. The plate can include an enclosed posterior extension that can be received in the pair of inlets to secure the plate to the spacer.

Abstract: A vertebral body replacement device includes a first member and a first footplate detachably connectable to the first member, a second member and a second footplate detachably connectable to the second member, and a central member detachably connectable to the first member. The first member is displaceable relative to the second member in response to rotation of the central member relative to the first member to adjust the length of the vertebral body replacement device. The first footplate includes a first surface oriented toward the first member, a second surface oriented away from the first member, and a sidewall extending between the first surface and the second surface. The first surface includes an alignment slot facing the first member. The alignment slot is open through the sidewall of the first footplate and configured to slidingly engage the first member to orient the first footplate relative to the first member.

Abstract: The embodiments provide various interbody fusion spacers, or cages, for insertion between adjacent vertebrae. The cages may have integrated ratchet assemblies that allow the cage to change size and angle as needed, with little effort. The cages may have a first, insertion configuration characterized by a reduced size to facilitate insertion through a narrow access passage and into the intervertebral space. The cages may be inserted in a first, reduced size and then expanded to a second, larger size once implanted. In their second configuration, the cages are able to maintain the proper disc height and stabilize the spine by restoring sagittal balance and alignment. Additionally, the intervertebral cages are configured to be able to adjust the angle of lordosis, and can accommodate larger lordotic angles in their second, expanded configuration. Further, these cages may promote fusion to further enhance spine stability by immobilizing the adjacent vertebral bodies.

Abstract: The present invention provides a next generation, closed profile, total disc replacement device with mechanical features designed to sustain, restrain and guide the larger motions required to preserve normal mechanical motion, while at the same time, providing a flexion component to guide and restrain the finer motions reached at the extremes of the mechanical motion preservation components.

Abstract: An implant assembly including a curved mesh cage and angled endplates. The implant assembly offers a safe and secure mesh cage while providing lordosis/kyphosis angling at the center of the construct instead of at the end of the cage only. One or more angled endplates may be included which allow the surgeon to make a construct unique to the patient's anatomy. The endplates press-fit into corresponding holes in the mesh cage for a secure fit.

Abstract: A spacer for separating bones of a joint, the spacer includes a frame having a longitudinal axis, and ramped surfaces. An endplate configured to engage a bone of the joint has ramped surfaces mateable with the ramped surfaces of the frame. When the endplate is moved relative to the frame in a direction along the longitudinal axis of the frame, the endplate is moved in a direction away from the frame to increase the height of the spacer. A second endplate configured to engage a second bone of the joint can be similarly configured.

Abstract: A surgical implant device configured to adjust in planar orientation or angular orientation or both to correspond to the structure of the lamina to be spanned at the site of a cut of the laminoplasty surgery. The device includes a base having slots extending adjacent thereto, and an extension having a head configured to be adjustably positionable within the slots.

Abstract: Embodiments of the invention include instruments, implants, and methods for surgically treating facet joints of vertebrae. An instrument may be advanced into one or more facet joints to one or both separate vertebrae and remove tissue from one or more articular processes. A stop on the instrument may be used to terminate advancement of the instrument by contacting a vertebra, and one or more implants may be placed into one or more facet joints.

Abstract: An expandable intervertebral spacer has a plurality of arms. The arms can be retracted or extended. The spacer has a width that is narrower than the width between the nerve roots near the posterior approach to an intervertebral space. Once inserted into the intervertebral space, the arms can be deployed. The deployed arms expand the height and width of the spacer. Once deployed, the spacer stabilizes two adjacent vertebrae. The arms are interconnected mechanically to deploy simultaneously.

Abstract: A method for coupling a prosthesis to a spinal segment in a patient includes the steps of selecting first and second reference points disposed along the spinal segment and pre-operatively measuring a target distance. The target distance extends between the first and second reference points while the patient is in a preferred posture such as the standing position. A prosthesis is coupled to the spinal segment and the prosthesis is then intra-operatively adjusted in order to set the distance between the first and second reference points based on the target distance.

Abstract: A spinal bone graft includes one or more cortical bone portions forming a first unit. The first unit includes an engagement surface for contacting bone, and a mating surface. The mating surface forms at least one first undercut. The bone graft also includes one or more cortical bone portions forming a second unit. The second unit includes an engagement surface for contacting bone, and a mating surface. The mating surface forms either at least one second undercut, or at least one connector. In the former, at least one connector is received in each of the first and second undercuts to interconnect the first and second units. In the latter, the at least one connector of the second unit is received in the first undercut of the first unit to interconnect the first unit and second unit.

Abstract: An implant including a peripheral frame portion defining a periphery of the body; a first helical bone contacting member attached to the body and disposed within the superior half of the implant; and a second helical bone contacting member attached to the body and disposed within the superior half of the implant. The implant also includes a first support member extending inwardly of the bone contacting member into a central region of the implant; and a second support member extending inwardly of the bone contacting members. The first support member and the second support member are substantially U-shaped and are connected to one another at the bottoms of the two U-shapes in the central region.

Abstract: An implant may include a housing and a blade having a retracted position in the housing and an extended position where the blade extends outwardly from the housing. The implant also includes a blade actuating component, the blade actuating component comprising a driven shaft portion. The blade actuating component is configured to move the blade between the retracted position and the extended position. The housing may include a chamber portion receiving a portion of the driven shaft portion of the blade actuating component. The driven shaft portion may include an opening and a blocking pin received within the opening. In a first position, the blocking pin limits insertion of the blade actuating component. In a second position, the blade actuating component is unrestricted by the blocking pin.

Abstract: A continuous device for culturing mammalian cells in a three-dimensional structure for the transplantation or implantation in vivo is described. The culturing device comprises (a) a scaffold formed by a matrix of interconnected growth surfaces spaced at regular intervals and (b) a fluid distribution means at the inlet and the exit of the growth areas. The device is particularly useful for culturing bone cells for dental implants or bone reconstruction.

Abstract: An implant is provided for performing spinal fusion. The implant includes an implant body having a leading side and a trailing side at opposing ends along a longitudinal axis. Between the leading side and trailing side are an upper surface, a lower surface, an anterior side, and a posterior side. At least one keel structure is provided extending from the implant body for penetration into an adjacent vertebral body. A trial sizer and keel cutter may be utilized to form keel channels within the vertebral body to receive the keel structure.

Abstract: An implant is insertable in the joint space to separate bones of the joint. The implant has two endplates each configured to engage a separate articulating bone of the joint, and a threaded member positioned between the two endplates and configured to increase the space between the two endplates when the threaded member is rotated. A rotatable gear is engaged with the threaded member, and is engageable with a rotating gear of a connected implantation tool, so that rotation of the gear on the tool causes rotation of the threaded member and expansion of the implant to separate the bones. Connector portions on the tool and the implant may be rotated together to securely engage the implant and the tool so that the gears of the tool and the implant can be rotated using an actuator outside of the body, when the implant is inside the body.

Abstract: A spinal interbody cage implant includes a cage, an endplate, and flexible barbs. The endplate is separately attached to the cage and is configured to receive, hold and direct a flexible barb into an upper vertebral surface and a flexible barb into a lower adjacent vertebral surface. Each proximal leg of the cage is configured to receive the endplate, and has a lateral bore that receives a pin which retains the endplate. The endplate directs a first flexible barb upwardly toward an upper vertebral surface, and directs a second flexible barb downwardly toward a lower vertebral surface. Each flexible barb has a proximal head, a shaft extending from the head with a bore extending from the head to its distal end. Teeth are provided along the exterior surface of the shaft with two flats disposed on opposite sides thereof with a slit extending from the distal end towards the head.

Abstract: Systems and methods are described for correcting sagittal imbalance in a spine including instruments for performing the controlled release of the anterior longitudinal ligament through a lateral access corridor and hyper-lordotic lateral implants with detachable fixation tabs.

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 body, a first endplate, and a second endplate, a middle ramp piece, a stem, and two ramp pins. The middle ramped piece is operable to move to generate lordotic expansion of the first and second endplates followed by parallel expansion. The fusion device is operable to be deployed down an endoscopic tube.

Abstract: An expandable interbody fusion device includes superior and inferior plates that are configured to receive a sequentially inserted stack of expansion members or wafers. The superior and inferior plates include features that at least initially interlock the two plates until the superior plate is dislodged by pressure from the growing wafer stack. The wafers include features on their top and bottom surfaces that interlock the wafers in multiple degrees of freedom so that the wafer stack is not disrupted when the fusion device is fully expanded. Each wafer also includes features that interlock with the inferior plate until the wafer is dislodged by sequential introduction of another wafer.

Abstract: Disclosed are systems, devices, methods and surgical procedures for altering and/or correcting the alignment of adjacent bones, including bones of the spine.

Abstract: A vertebral body replacement device includes a first member and a first footplate detachably connectable to the first member, a second member and a second footplate detachably connectable to the second member, and a central member detachably connectable to the first member. The first member is axially displaceable relative to the second member in response to rotation of the central member relative to the first member to adjust the length of the vertebral body replacement device. The first member includes a pair of first fastener holes and a pair of second fastener holes angularly offset from the first fastener holes. The first footplate includes an aperture configured to align with one of the first fastener holes to orient the footplate in a first position or one of the second fastener holes to orient the footplate in a second position.

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: An orthopedic device for implanting between adjacent vertebrae comprising: an arcuate balloon and a hardenable material within said balloon. In some embodiments, the balloon has a footprint that substantially corresponds to a perimeter of a vertebral endplate. An inflatable device is inserted through a cannula into an intervertebral space and oriented so that, upon expansion, a natural angle between vertebrae will be at least partially restored. At least one component selected from the group consisting of a load-bearing component and an osteobiologic component is directed into the inflatable device through a fluid communication means.

Abstract: In intervertebral operative spinal procedures, using separate or pre-attached spreader blocks to control the directional growth of a distracting balloon.

Abstract: An expandable implant (100, 150, 160, 200, 250, 300, 400) has a base (10) and a displaceable element (12) hingedly interconnected at one end. At the other end, the base and the displaceable element are formed with complementary jaws (24, 26) which provide continuous overlap of facing surfaces over a range of angular positions of the displaceable element relative to said base. In some cases, the first end portion (16) of the displaceable element (12) is formed with projecting teeth (28) forming a partial gear centered on an axis (18) of the hinged interconnection with the base (12) for engaging a worm gear. In certain embodiments, the base is formed with a socket (30) for removably receiving a worm gear tool (32) for engaging the teeth (28) and displacing said displaceable element. After expansion, the worm-gear tool (32) can be removed.

Abstract: This disclosure provides vertebral implants, fastening devices for vertebral implants, and implant instrumentation, and various combinations thereof. In some embodiments, the implant comprises a peripheral wall extending according to a vertical axis between upper and lower surfaces of the implant, with each such surface configured to be placed in contact with a vertebral structure, respectively, at the top and the bottom of the vertebral segment replaced by the implant. Some embodiments comprise fastening means, deployment of which anchors the implant in the lower and upper vertebral structures. Some fastening means may be deployed by sliding parallel to the vertical axis of the implant, and may comprise a plate with at least one part remaining in contact with the peripheral wall of the implant when deployed and a pointed end projecting from one of the upper and lower surfaces of the implant to enter a vertebral structures on completion of deployment.