The present disclosure relates to an expandable interbody that includes superior and inferior shells enclosing a control mechanism that includes interlocking proximal and distal cages as well as an adjustment screw that longitudinally translates the distal cage relative to the proximal cage and thereby expands interbody by pushing apart the distal ends of the superior and inferior shells.
Disclosed herein are methods, devices, and systems for obtaining, sometimes in an automated manner, from a patient a combination of subcortical and cortical somatosensory evoked response potentials, EEG, and Brainstem auditory evoked responses using ear electrodes and surface electrodes. These methods, devices, and systems may be employed during a surgical procedure in conjunction with or separate from other monitoring modalities to monitor the patient's health generally and/or with respect to specific aspects of the patient's health prior to, during, and/or after the surgical procedure.
Disclosed rod reduction systems include an elongated housing having a longitudinal bore and a transverse channel extending through the elongated housing at a non-zero degree angle relative to the longitudinal bore. An insert is slideable within the transverse channel between an outwardly displaced position and an inwardly biased position. The insert includes a threaded portion and a longitudinal bore alignable with the longitudinal bore of the elongated housing. A reducer is slidably receivable within the longitudinal bore of the elongated housing. The reducer may have a longitudinal bore therethrough, a drive shaft positioned within the longitudinal bore of the reducer.
Disclosed herein are methods, devices, and systems for obtaining, sometimes in an automated manner, from a patient a combination of subcortical and cortical somatosensory evoked response potentials, EEG, and Brainstem auditory evoked responses using ear electrodes and surface electrodes. These methods, devices, and systems may be employed during a surgical procedure in conjunction with or separate from other monitoring modalities to monitor the patient's health generally and/or with respect to specific aspects of the patient's health prior to, during, and/or after the surgical procedure.
Disclosed rod reduction systems include an elongated housing having a longitudinal bore and a transverse channel extending through the elongated housing at a non-zero degree angle relative to the longitudinal bore. An insert is slideable within the transverse channel between an outwardly displaced position and an inwardly biased position. The insert includes a threaded portion and a longitudinal bore alignable with the longitudinal bore of the elongated housing. A reducer is slidably receivable within the longitudinal bore of the elongated housing. The reducer may have a longitudinal bore therethrough, a drive shaft positioned within the longitudinal bore of the reducer.
The present disclosure provides a device to restrict interspinous motion across multiple segments of a spinal column in a patient, comprising at least a first ligamentous line attached to a spinous process, a soft tissue in proximity to posterior aspects of a spinal vertebrae, or a pre-existing spinal fixation device or system.
Disclosed herein are retractor blade devices, such as blade extenders and tissue shims, as well as drivers and kits for utilizing such retractor blade devices. Exemplary retractor blade devices include a retractor blade engagement portion having a body portion configured to sit at least partially in a channel of a retractor blade. The body portion has a first retention component extending therefrom. Exemplary retractor blade devices also include an extension portion extending from the body portion of the retractor blade engagement portion.
A retractor assembly that includes a base portion in slidable engagement with two or more retractor arms with at least one of the retractor arms releasably securing a retractor blade configured to be anchored to a bone anchor. The retractor blade includes an elongate blade portion with a retractor engagement portion positioned at the proximal end of the elongate blade portion and an anchor mechanism positioned at the distal end of the elongate blade portion. The anchor mechanism includes a first jaw and second jaw configured to engage the bone implant. When closed around or anchored to the bone implant—which may be a shank of a modular screw system—the components of the modular screw are able to be assembled to the shank without adjusting, loosening, or opening the anchor mechanism.
Tracked mobile X-ray imaging equipment is used to produce single or stereo long calibrated views of the anatomy of a patient on the operating table. The system estimates the position and orientation of the anatomical planes, virtually places measurement grids over these reference planes, and transforms any radiographic views taking by the X-ray imaging system onto these calibrated planes. The system may apply information about the depth of the anatomy to remove parallax artifacts. This system enables displaying and evaluation of the entire radiographic length of the anatomical planes using a mobile X-ray equipment. It also provides a platform for overlaying the real time X-ray images taken during operation with radiographic images of the patient or schematic of the surgical plan developed before the surgery for quick evaluation of a surgical plan.
Certain aspects of the present disclosure provide techniques for automated risk assessment during surgery on a patient. A method includes determining one or more baseline neurological response waveforms of the patient prior to performing a surgery on the patient. The method includes automatically collecting procedural data during the surgery. The method includes automatically collecting physiological data of the patient during the surgery. The method includes automatically collecting neurological response waveform data of the patient. The method includes automatically providing the procedural data, the physiological data, and neurological response waveform data to a risk assessment system. The method includes comparing, by the risk assessment system, the neurological response waveform with the baseline neurological response waveform. The method includes assessing a level of risk of injury to the patient based on the comparison and further based on the procedural data and the physiological data.
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
G16H 50/30 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indicesICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for individual health risk assessment
11.
ADOLESCENT IDIOPATHIC SCOLIOSIS PATIENT POSITIONING SYSTEM
A patient positioning system includes a thoracic bolster assembly and a pelvic bolster assembly, each of which may be comprise of a base having a lower portion and an upper portion, the upper portion in rotatable connection with the lower portion to adjust the upper portion in a coronal plane. The thoracic bolster assembly may also include a top patient support portion pivotably connected to the base, with a vertical adjustment mechanism in connection with the base and the top patient support portion to allow the top patient support portion to be adjusted vertically relative to the base to adjust kyphosis of a patient.
A patient positioning system includes a thoracic bolster assembly and a pelvic bolster assembly, each of which may be comprise of a base having a lower portion and an upper portion, the upper portion in rotatable connection with the lower portion to adjust the upper portion in a coronal plane. The thoracic bolster assembly may also include a top patient support portion pivotably connected to the base, with a vertical adjustment mechanism in connection with the base and the top patient support portion to allow the top patient support portion to be adjusted vertically relative to the base to adjust kyphosis of a patient.
Surgical apparatus namely, a surgical navigation system comprised of computer hardware, computer peripherals, sensors, tracking arrays and recorded computer software used to locate, display and track the position of patients and instruments during image guided surgery; surgical robots; surgical devices and instruments used for surgical navigation and image-guided surgery
14.
INTRA-OPERATIVE LOWER SPINE MOTOR INTEGRITY MONITORING THROUGH TRANS-SPINAL STIMULATION
Certain aspects of the present disclosure provide techniques for monitoring reflexive motor responses in a patient during a surgery on the patient. A method includes stimulating at least one cathodal electrode over a thoracic spinal region of the back of the patient with at least one anodal electrode over at least one anterior superior iliac crest area of the patient. The method includes detecting, with at least one recording electrode on at least one leg of the patient, one or more resulting muscle response electrical waveforms from one or more muscles of one or more lower extremities of the patient.
Certain aspects of the present disclosure provide techniques for monitoring reflexive motor responses in a patient during a surgery on the patient. A method includes stimulating at least one cathodal electrode over a thoracic spinal region of the back of the patient with at least one anodal electrode over at least one anterior superior iliac crest area of the patient. The method includes detecting, with at least one recording electrode on at least one leg of the patient, one or more resulting muscle response electrical waveforms from one or more muscles of one or more lower extremities of the patient.
A method of forming a composite titanium body for use in forming spinal implant interbodies includes selecting a metal alloy body, carving out a top portion and a bottom portion from the metal alloy body, and bonding a porous material to the carved-out top and bottom portions. Multiple pieces may be cut from the composite titanium body, each having a front face formed of the metal alloy, top and bottom portions formed of the porous material, and with a medial portion of the metal alloy extending from the front face to the back. Methods and devices for spinal interbodies having locking mechanisms to prevent bone screw back-out are also described.
B23K 20/02 - Non-electric welding by applying impact or other pressure, with or without the application of heat, e.g. cladding or plating by means of a press
A lateral patient positioning system may include a pelvic bolster assembly and a thoracic bolster assembly. Each of the assemblies may be attached to a conventional surgical table frame by the surgical table frame's longitudinal rails. A plurality of adjustment mechanisms and components are provided to allow for easy and safe manipulation of a patient before and during surgery, including sagittal and/or coronal adjustment of a patient in a lateral position.
A lateral patient positioning system may include a pelvic bolster assembly and a thoracic bolster assembly. Each of the assemblies may be attached to a conventional surgical table frame by the surgical table frame's longitudinal rails. A plurality of adjustment mechanisms and components are provided to allow for easy and safe manipulation of a patient before and during surgery, including sagittal and/or coronal adjustment of a patient in a lateral position.
The present disclosure relates to expandable interbodies that include superior and inferior shells and a control assembly positioned between and inside of the shells, the control assembly including nested cages operably connected to each other with an adjustment screw. Rotation of the adjustment screw translates the cages relative to each other, which in turn causes the shells to open or expand.
An instrument includes a distraction mechanism having a proximal end and an opposed distal end. The distal end includes opposed first and second end members. A first vertebral endplate spreader includes a proximal spreader section mounted to the first end member of the distraction mechanism. The first spreader also includes a distal spreader section operatively connected to the proximal spreader section for lateral movement relative to the proximal spreader section. A second vertebral endplate spreader is mounted to the second end member of the distraction mechanism. The distraction mechanism is configured and adapted to distract the spreaders apart and to retract the spreaders together along a distraction axis. The distal spreader section of the first spreader is configured to move relative to the second spreader in a lateral direction relative to the distraction axis for correction of vertebral alignment, as in treatment of spondylolisthesis, scoliosis, and the like.
Tracked mobile X-ray imaging equipment is used to produce single or stereo long calibrated views of the anatomy of a patient on the operating table. The system estimates the position and orientation of the anatomical planes, virtually places measurement grids over these reference planes, and transforms any radiographic views taking by the X-ray imaging system onto these calibrated planes. The system may apply information about the depth of the anatomy to remove parallax artifacts. This system enables displaying and evaluation of the entire radiographic length of the anatomical planes using a mobile X-ray equipment. It also provides a platform for overlaying the real time X-ray images taken during operation with radiographic images of the patient or schematic of the surgical plan developed before the surgery for quick evaluation of a surgical plan.
A surgical navigation method utilizing a computer system. The method includes the steps of: (a) fixing a camera relative to a surgical site on a patient such that the camera does not move relative to the surgical site; (b) restraining the body portion of the patient which includes the surgical site relative to an operating table supporting the patient, such that the body portion does not move relative to the operating table; and (c) detecting with the camera the position of a medical instrument having a tracker array.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Disclosed herein are occipital plates that include a fixation plate portion and at least two extensions integrally connected to the fixation plate portion and extending away from the fixation plate portion. The fixation plate portion has a plurality of through-holes for receiving bone screws that secure the occipital plate to a patient's skull or, specifically, the occiput. Each extension includes a slot for removably receiving a rod connector or a rod-to-rod connector, the slots having an entry area or portion for receiving a connector and a holding area or portion for maintaining the connector in the slot.
Disclosed herein are expandable interbodies with modular endplates. An expandable interbody has an outer column, an inner column threadedly coupled and translatable relative to the outer column along the longitudinal axis, and an expansion ring to adjust a body length of the expandable interbody. The expansion ring has a plurality of teeth, and the outer column has at least one arm for engaging a tooth of the plurality of teeth to lock the expansion ring. The inner column and/or outer column can include a connector for connection to a modular endplate that has a substantially hollow core. The modular endplate includes a plate with a set screw entrapped therein. The modular endplate has an aperture to receive the connector of the inner and/or outer column.
Disclosed herein are expandable interbodies with modular endplates. An expandable interbody has an outer column, an inner column threadedly coupled and translatable relative to the outer column along the longitudinal axis, and an expansion ring to adjust a body length of the expandable interbody. The expansion ring has a plurality of teeth, and the outer column has at least one arm for engaging a tooth of the plurality of teeth to lock the expansion ring. The inner column and/or outer column can include a connector for connection to a modular endplate that has a substantially hollow core. The modular endplate includes a plate with a set screw entrapped therein. The modular endplate has an aperture to receive the connector of the inner and/or outer column.
This disclosure discloses a line coupled to a spine of a user at two points such that the line can be movable relative to those two points. The line can be encased by a protective member between those two points. The line can be covered by a compound between those two points. The line can be guided between those two points.
A retractor assembly that includes a base portion in slidable engagement with two or more retractor arms with at least one of the retractor arms releasably securing a retractor blade configured to be anchored to a bone anchor. The retractor blade includes an elongate blade portion with a retractor engagement portion positioned at the proximal end of the elongate blade portion and an anchor mechanism positioned at the distal end of the elongate blade portion. The anchor mechanism includes a first jaw and second jaw configured to engage the bone implant. When closed around or anchored to the bone implant—which may be a shank of a modular screw system—the components of the modular screw are able to be assembled to the shank without adjusting, loosening, or opening the anchor mechanism.
A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non-removably attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radio-opaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.
A tissue retractor device within the scope of the present invention generally includes a frame, an actuating mechanism, and a plurality of blades. The actuating mechanism generally includes at least one cam that encourages automatic toe-out of the blades. The tissue retractor eliminates the need for bulky secondary blade mechanisms to prevent undesired blade deformation at the surgical site. The toe-out motion occurs simultaneously along with the opening of the blades. The present invention further provides for depth adjustment of the blades by means of an adjustable screw assembly.
Disclosed is a method for execution by an SSEP (Somatosensory Evoked Potentials) system. The method involves acquiring at least one SSEP recording from a subject, and determining if the baseline potential is monitorable based on the at least one SSEP recording. The method also involves acquiring ongoing SSEP recordings from the subject, comparing the ongoing SSEP potentials to the monitorable baseline potential, and upon the ongoing SSEP potentials deviating from the monitorable baseline potential according to a defined criteria, executing an alert. This can allow a medical worker to decide whether to take any corrective action, such as repositioning the subject, with a goal of preventing or mitigating iatrogenic injury to a nervous system of the subject. The SSEP system can be substantially automated, such that there is little reliance on discretion by the medical worker. Also disclosed is a SSEP system configured to implement the method summarised above.
Disclosed is a method for execution by an SSEP (Somatosensory Evoked Potentials) system. The method involves acquiring at least one SSEP recording from a subject, and determining if the baseline potential is monitorable based on the at least one SSEP recording. The method also involves acquiring ongoing SSEP recordings from the subject, comparing the ongoing SSEP potentials to the monitorable baseline potential, and upon the ongoing SSEP potentials deviating from the monitorable baseline potential according to a defined criteria, executing an alert. This can allow a medical worker to decide whether to take any corrective action, such as repositioning the subject, with a goal of preventing or mitigating iatrogenic injury to a nervous system of the subject. The SSEP system can be substantially automated, such that there is little reliance on discretion by the medical worker. Also disclosed is a SSEP system configured to implement the method summarised above.
A patient support system may include a pelvic bolster assembly and a thoracic bolster assembly. Each of the assemblies may be attached to a conventional surgical table frame by the surgical table frame's longitudinal rails. A plurality of adjustment mechanisms and components are provided to allow for easy and safe manipulation of a patient before and during surgery.
A method for facilitating acquisition of a motor evoked potential (MEP) may include facilitating an MEP stimulation sequence to obtain the MEP. The facilitating may include delivering a first stimulation pulse to one or more peripheral nerves of a patient. The method may also include delivering, after the facilitating, the MEP stimulation sequence to one or more cranial nerves of the patient to obtain the MEP. The method may also include determining, based on the MEP, a physiological response has occurred. The method may also include indicating that the physiological response has occurred. The facilitating may reduce an intensity of the train of stimulation pulses of the MEP stimulation sequence, limit movement of the patient to the region of interest during the delivery of the MEP stimulation, and improve an accuracy of determining that the physiological response has occurred.
Disclosed herein are retractor blade devices, such as blade extenders and tissue shims, as well as drivers and kits for utilizing such retractor blade devices. Exemplary retractor blade devices include a retractor blade engagement portion having a body portion configured to sit at least partially in a channel of a retractor blade. The body portion has a first retention component extending therefrom. Exemplary retractor blade devices also include an extension portion extending from the body portion of the retractor blade engagement portion.
A spinal surgical system includes a tissue protector (105) with an elongate body, and a dilator (200) sized and shaped to be removably inserted into the lumen of the tissue protector. The dilator includes a connector for engaging a tracking array (300) of a robotic navigation system, and the tissue protector is also engageable with a robot (400) of the robotic navigation system. For example, the robot may have a guide tube and the tissue protector can be inserted into the guide tube. The tracking array can include a body with a plurality of arms, with tracker(s) connectable to the plurality of arms.
A method for determining a lowest stimulation threshold current level in a group of channels of a neuromonitoring device. The method includes stimulating tissue at a current level from a predetermined range of current levels as a sequence of pulses delivered at a frequency. The stimulating includes increasing the current level of each pulse in the sequence of pulses from an immediately preceding pulse by a first current increment. The method includes determining that a first evocation pulse from the sequence of pulses evokes a first muscular response. The method includes stimulating the tissue with a second evocation pulse from the sequence of pulses to evoke a second muscular response. The stimulating includes decreasing the frequency of the delivery of each pulse in the sequence of pulses and increasing the current level of each pulse in the sequence of pulses from the immediately preceding pulse by a second current increment. The method includes determining that the second evocation pulse from the sequence of pulses evokes the second muscular response.
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
G16H 20/30 - ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
A method for facilitating acquisition of a motor evoked potential (MEP) may include facilitating an MEP stimulation sequence to obtain the MEP. The facilitating may include delivering a first stimulation pulse to one or more peripheral nerves of a patient. The method may also include delivering, after the facilitating, the MEP stimulation sequence to one or more cranial nerves of the patient to obtain the MEP. The method may also include determining, based on the MEP, a physiological response has occurred. The method may also include indicating that the physiological response has occurred. The facilitating may reduce an intensity of the train of stimulation pulses of the MEP stimulation sequence, limit movement of the patient to the region of interest during the delivery of the MEP stimulation, and improve an accuracy of determining that the physiological response has occurred.
The present disclosure relates to an expandable interbody that includes superior and inferior shells enclosing a control mechanism that includes interlocking proximal and distal cages as well as an adjustment screw that longitudinally translates the distal cage relative to the proximal cage and thereby expands interbody by pushing apart the distal ends of the superior and inferior shells.
09 - Scientific and electric apparatus and instruments
10 - Medical apparatus and instruments
Goods & Services
Recorded software for detecting and evaluating evoked electrical responses from the nervous system Medical device for stimulating, detecting, evaluating, and recording electrical responses within the nervous system, and component parts and fittings specially adapted therefor; Medical device accessories, namely, pre-packaged medical electrodes with electrical cables packaged therewith and sold as a unit; medical apparatus configured to detect and evaluate evoked electrical responses from the nervous system and related recorded software for detecting and evaluating electrical responses from the nervous system sold as a unit
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.
The present disclosure relates to expandable interbodies that include superior and inferior shells and a control assembly positioned between and inside of the shells, the control assembly including nested cages operably connected to each other with an adjustment screw. Rotation of the adjustment screw translates the cages relative to each other, which in turn causes the shells to open or expand.
A surgical screw configured to expand and prevent or minimize bone growth inside of the surgical screw is provided. Accordingly, the surgical screw is configured to increase the purchase of the surgical screw with respect to the bone, but also to be withdrawn from the bone without damaging the bone as a result of bone ingrowth. The surgical screw includes a center post with an inner bore and an outer sleeve concentric to the center post. An outer surface of the outer sleeve includes a thread to engage bone. The outer sleeve includes a cut pattern defining an expandable region configurable between a first state with a first radius measured from a longitudinal axis of the surgical screw to the outer surface and a second state having a second radius measured from the longitudinal axis to the outer surface.
Disclosed herein are surgical retractors and methods of using such surgical retractors where the surgical retractors include a base portion and two retractor blades. The base portion has (a) two extensions, each extension having a receiving area, and (b) and one or more engagement portions. Each retractor blade includes both a blade portion with proximal and distal ends and an arm portion extending from the proximal end of the blade portion. Each arm portion is received by a respective receiving area.
A61B 17/02 - Surgical instruments, devices or methods for holding wounds open, e.g. retractorsTractors
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Disclosed herein are surgical retractors and methods of using such surgical retractors where the surgical retractors include a base portion and two retractor blades. The base portion has (a) two extensions, each extension having a receiving area, and (b) and one or more engagement portions. Each retractor blade includes both a blade portion with proximal and distal ends and an arm portion extending from the proximal end of the blade portion. Each arm portion is received by a respective receiving area.
A61B 17/02 - Surgical instruments, devices or methods for holding wounds open, e.g. retractorsTractors
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A method for detecting and identifying a patient physiological response includes stimulating, via a stimulating electrode coupled to a patient, one or more nerves of the patient. The method includes recording, via a recording electrode coupled to the patient, a plurality of resultant electrical waveforms. The method includes determining, based on the plurality of resultant electrical waveforms, whether at least a subset of the plurality of resultant electrical waveforms includes a patient physiological response. The determining includes comparing the subset of resultant electrical waveforms of the plurality of resultant electrical waveforms to a model waveform from a database of a plurality of model waveforms. The determining includes determining, based on the comparison, a comparison feature. The comparison feature indicates whether the patient physiological response exists in the subset. The method includes displaying, via a display, an indication that the patient physiological response exists in the subset of resultant electrical waveforms.
A method for detecting and identifying a patient physiological response includes stimulating, via a stimulating electrode coupled to a patient, one or more nerves of the patient. The method includes recording, via a recording electrode coupled to the patient, a plurality of resultant electrical waveforms. The method includes determining, based on the plurality of resultant electrical waveforms, whether at least a subset of the plurality of resultant electrical waveforms includes a patient physiological response. The determining includes comparing the subset of resultant electrical waveforms of the plurality of resultant electrical waveforms to a model waveform from a database of a plurality of model waveforms. The determining includes determining, based on the comparison, a comparison feature. The comparison feature indicates whether the patient physiological response exists in the subset. The method includes displaying, via a display, an indication that the patient physiological response exists in the subset of resultant electrical waveforms.
A system for interchangeable retractor blades includes a shell, a first retractor blade, and a second retractor blade. The shell includes a rigid proximal end configured to attach to a surgical retractor and an opening, a distal closed end, and a pliable portion including a pocket in communication with the opening and extending along a length of the shell to the distal closed end. The first retractor blade includes a first geometry received through the opening into the pocket and that shapes the pliable portion to configure the shell in a first configuration. The second retractor blade includes a second geometry received through the opening into the pocket and that shapes the pliable portion to configure the shell in a second configuration.
The present disclosure provides a device to restrict interspinous motion across multiple segments of a spinal column in a patient, comprising at least a first ligamentous line attached to a spinous process, a soft tissue in proximity to posterior aspects of a spinal vertebrae, or a pre-existing spinal fixation device or system.
Disclosed herein are retractor blade devices, such as blade extenders and tissue shims, as well as drivers and kits for utilizing such retractor blade devices. Exemplary retractor blade devices include a retractor blade engagement portion having a body portion configured to sit at least partially in a channel of a retractor blade. The body portion has a first retention component extending therefrom. Exemplary retractor blade devices also include an extension portion extending from the body portion of the retractor blade engagement portion.
Disclosed herein are retractor blade devices, such as blade extenders and tissue shims, as well as drivers and kits for utilizing such retractor blade devices. Exemplary retractor blade devices include a retractor blade engagement portion having a body portion configured to sit at least partially in a channel of a retractor blade. The body portion has a first retention component extending therefrom. Exemplary retractor blade devices also include an extension portion extending from the body portion of the retractor blade engagement portion.
A retractor assembly that includes a base portion in slidable engagement with two or more retractor arms with at least one of the retractor arms releasably securing a retractor blade configured to be anchored to a bone anchor. The retractor blade includes an elongate blade portion with a retractor engagement portion positioned at the proximal end of the elongate blade portion and an anchor mechanism positioned at the distal end of the elongate blade portion. The anchor mechanism includes a first jaw and second jaw configured to engage the bone implant. When closed around or anchored to the bone implant-which may be a shank of a modular screw system-the components of the modular screw are able to be assembled to the shank without adjusting, loosening, or opening the anchor mechanism.
A retractor assembly that includes a base portion in slidable engagement with two or more retractor arms with at least one of the retractor arms releasably securing a retractor blade configured to be anchored to a bone anchor. The retractor blade includes an elongate blade portion with a retractor engagement portion positioned at the proximal end of the elongate blade portion and an anchor mechanism positioned at the distal end of the elongate blade portion. The anchor mechanism includes a first jaw and second jaw configured to engage the bone implant. When closed around or anchored to the bone implant—which may be a shank of a modular screw system—the components of the modular screw are able to be assembled to the shank without adjusting, loosening, or opening the anchor mechanism.
A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non-removably attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radio-opaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.
Disclosed herein are occipital plates that include a fixation plate portion and at least two extensions integrally connected to the fixation plate portion and extending away from the fixation plate portion. The fixation plate portion has a plurality of through-holes for receiving bone screws that secure the occipital plate to a patient's skull or, specifically, the occiput. Each extension includes a slot for removably receiving a rod connector or a rod-to-rod connector, the slots having an entry area or portion for receiving a connector and a holding area or portion for maintaining the connector in the slot.
A method of forming a composite titanium body for use in forming spinal implant interbodies includes selecting a metal alloy body, carving out a top portion and a bottom portion from the metal alloy body, and bonding a porous material to the carved-out top and bottom portions. Multiple pieces may be cut from the composite titanium body, each having a front face formed of the metal alloy, top and bottom portions formed of the porous material, and with a medial portion of the metal alloy extending from the front face to the back. Methods and devices for spinal interbodies having locking mechanisms to prevent bone screw back-out are also described.
Disclosed herein are occipital plates that include a fixation plate portion and at least two extensions integrally connected to the fixation plate portion and extending away from the fixation plate portion. The fixation plate portion has a plurality of through-holes for receiving bone screws that secure the occipital plate to a patient's skull or, specifically, the occiput. Each extension includes a slot for removably receiving a rod connector or a rod-to-rod connector, the slots having an entry area or portion for receiving a connector and a holding area or portion for maintaining the connector in the slot.
A method of forming a composite titanium body for use in forming spinal implant interbodies includes selecting a metal alloy body, carving out a top portion and a bottom portion from the metal alloy body, and bonding a porous material to the carved-out top and bottom portions. Multiple pieces may be cut from the composite titanium body, each having a front face formed of the metal alloy, top and bottom portions formed of the porous material, and with a medial portion of the metal alloy extending from the front face to the back. Methods and devices for spinal interbodies having locking mechanisms to prevent bone screw back-out are also described.
B23K 20/02 - Non-electric welding by applying impact or other pressure, with or without the application of heat, e.g. cladding or plating by means of a press
The present disclosure relates to expandable interbodies that include superior and inferior shells and a control assembly positioned between and inside of the shells, the control assembly including nested cages operably connected to each other with an adjustment screw. Rotation of the adjustment screw translates the cages relative to each other, which in turn causes the shells to open or expand.
A system and a bone fixation plate for preventing a fastener from rotating so as to prevent the fastener from backing out is provided. The system includes a plate having an opening. A retention member having an arm extending into the opening is configured to engage the head of the fastener so as to prevent the fastener from rotating after the fastener is seated within a vertebral body or implant. In one embodiment, the retention member engages a top surface of the head of the fastener. In another embodiment, the retention member engages a side wall of the head of the fastener.
A tissue retractor device within the scope of the present invention generally includes a frame, an actuating mechanism, and a plurality of blades. The actuating mechanism generally includes at least one cam that encourages automatic toe-out of the blades. The tissue retractor eliminates the need for bulky secondary blade mechanisms to prevent undesired blade deformation at the surgical site. The toe-out motion occurs simultaneously along with the opening of the blades. The present invention further provides for depth adjustment of the blades by means of an adjustable screw assembly.
A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non- removabiy attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radiopaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.
A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non-removably attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radiopaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.
The present disclosure relates to an expandable interbody that includes superior and inferior shells enclosing a control mechanism that includes interlocking proximal and distal cages as well as an adjustment screw that longitudinally translates the distal cage relative to the proximal cage and thereby expands interbody by pushing apart the distal ends of the superior and inferior shells.
The present disclosure relates to expandable interbodies that include superior and inferior shells and a control assembly positioned between and inside of the shells, the control assembly including nested cages operably connected to each other with an adjustment screw. Rotation of the adjustment screw translates the cages relative to each other, which in turn causes the shells to open or expand.
The present disclosure relates to an expandable interbody that includes superior and inferior shells enclosing a control mechanism that includes interlocking proximal and distal cages as well as an adjustment screw that longitudinally translates the distal cage relative to the proximal cage and thereby expands interbody by pushing apart the distal ends of the superior and inferior shells.
A patient support system may include a pelvic bolster assembly and a thoracic bolster assembly. Each of the assemblies may be attached to a conventional surgical table frame by the surgical table frames longitudinal rails. A plurality of adjustment mechanisms and components are provided 5 to allow for easy and safe manipulation of a patient before and during surgery.
A patient support system may include a pelvic bolster assembly and a thoracic bolster assembly. Each of the assemblies may be attached to a conventional surgical table frame by the surgical table frame's longitudinal rails. A plurality of adjustment mechanisms and components are provided to allow for easy and safe manipulation of a patient before and during surgery.
An instrument includes a distraction mechanism having a proximal end and an opposed distal end. The distal end includes opposed first and second end members. A first vertebral endplate spreader includes a proximal spreader section mounted to the first end member of the distraction mechanism. The first spreader also includes a distal spreader section operatively connected to the proximal spreader section for lateral movement relative to the proximal spreader section. A second vertebral endplate spreader is mounted to the second end member of the distraction mechanism. The distraction mechanism is configured and adapted to distract the spreaders apart and to retract the spreaders together along a distraction axis. The distal spreader section of the first spreader is configured to move relative to the second spreader in a lateral direction relative to the distraction axis for correction of vertebral alignment, as in treatment of spondylolisthesis, scoliosis, and the like.
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.
A system for reducing deformities of the vertebrae in the spine includes a first reduction assembly, a second reduction assembly, and a reduction drive assembly. The first reduction assembly is configured for attachment to a first reduction tower that attaches to a first vertebra. The second reduction assembly is configured for attachment to a second reduction tower that attaches to a second vertebra. The reduction drive assembly includes an arcuate rack gear operably coupling the first reduction assembly to the second reduction assembly to translate the first reduction assembly relative to the second reduction assembly along an arcuate path in a first plane.
A surgical screw configured to expand and prevent or minimize bone growth inside of the surgical screw is provided. Accordingly, the surgical screw is configured to increase the purchase of the surgical screw with respect to the bone, but also to be withdrawn from the bone without damaging the bone as a result of bone ingrowth. The surgical screw includes a center post with an inner bore and an outer sleeve concentric to the center post. An outer surface of the outer sleeve includes a thread to engage bone. The outer sleeve includes a cut pattern defining an expandable region configurable between a first state with a first radius measured from a longitudinal axis of the surgical screw to the outer surface and a second state having a second radius measured from the longitudinal axis to the outer surface.
An implant insertion instrument, and an implant are provided. The instrument includes a handle, a sleeve mounted to a distal end of the handle, and an implant rod disposed within the sleeve. The implant rod includes a gripper disposed on a distal end of the implant rod. The gripper has a first prong spaced apart from a second prong, the second prong being longer than the first prong. The implant includes an implant body, the implant body having a convex surface opposite a concave surface wherein an outer surface of the implant is continuous so as to prevent bone growth within the implant. Accordingly, the instrument facilitates the engagement of the implant by a simple push of the sleeve. Further, the implant has a continuous surface so as to inhibit bone growth and facilitate removal of the implant from the surgical site.
An instrument and inserter kit for providing a load to insert or retract an implant 2000 is provided. The instrument includes a cover having an engagement end opposite a distal end. The engagement end is configured to mount to an engagement feature of a handle of an inserter. The cover is an elongated member having a C-shaped profile having a dimension configured to receive a sliding member. The sliding member is seated over the cover and is weighted. The sliding member is configured to slide between a first radial lip and a second radial lip so as to provide an impacting force or retracting force on the instrument.
This disclosure discloses a line coupled to a spine of a user at two points such that the line can be movable relative to those two points. The line can be encased by a protective member between those two points. The line can be covered by a compound between those two points. The line can be guided between those two points.
An instrument with an implant holder disposed between a pair of tongs is provided. The implant holder may include a sleeve mechanically coupled to a distal end of a drive shaft and a pair of arms pivotably disposed within the sleeve. Movement of the sleeve in the distal direction pivots the pair of arms towards each other to grip the implant and movement of the sleeve in the proximal direction pivots the arms away from each other to automatically release the implant from the implant holder. The instrument may also include a dual mode drive shaft advancement mechanism that allows the implant holder to be advanced via an impact on the drive shaft from a tool such as a hammer or by rotation of the drive shaft.
A61B 17/58 - Surgical instruments or methods for treatment of bones or jointsDevices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
A61B 17/60 - Surgical instruments or methods for treatment of bones or jointsDevices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors or contractors
A61F 2/00 - Filters implantable into blood vesselsProstheses, i.e. artificial substitutes or replacements for parts of the bodyAppliances for connecting them with the bodyDevices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
A61F 2/46 - Special tools for implanting artificial joints
A61B 17/02 - Surgical instruments, devices or methods for holding wounds open, e.g. retractorsTractors
A61B 17/00 - Surgical instruments, devices or methods
Multi-mode torque drivers employing anti-backdrive units for managing pedicle screw attachments with vertebrae, and related systems and methods are disclosed. A spinal column includes vertebrae in an articulating structure protecting a spinal cord. Medical intervention may involve limiting the relative motion between vertebrae by fusing vertebrae together with mechanical assemblies, including pedicle screws attached to the vertebrae. A torque driver may be used to form the pedicle screw attachments with vertebrae. By including an anti-backdrive unit and a motor assembly enclosed within a handle body as part of a multi-mode torque driver, the user may apply sequential combinations of manual and motorized torques to the screws with high levels of tactile feedback as desired. In this manner, pedicle screw attachments may be efficiently achieved with fewer injuries to the patient and surgeon while minimizing screw attachment failures.
Tracked mobile x-ray imaging equipment is used to produce single or stereo long calibrated views of the anatomy of a patient on the operating table. The system estimates the position and orientation of the anatomical planes, virtually places measurement grids over these reference planes, and transforms any radiographic views taking by the x-ray imaging system onto these calibrated planes. The system may apply information about the depth of the anatomy to remove parallax artifacts. This system enables displaying and evaluation of the entire radiographic length of the anatomical planes using a mobile x-ray equipment. It also provides a platform for overlaying the real time x-ray images taken during operation with radiographic images of the patient or schematic of the surgical plan developed before the surgery for quick evaluation of a surgical plan.
Multi-mode torque drivers employing inner surfaces compatible with pedicle screw guide wires, and related systems and methods are disclosed. A spinal column includes vertebrae in an articulating structure protecting a spinal cord. Medical intervention may involve limiting the relative motion between vertebrae by fusing vertebrae together with mechanical assemblies, including pedicle screws attached to the vertebrae. A multi-mode torque driver may be used to form the pedicle screw attachments with vertebrae. By including a passageway for a guide wire along an output rotational axis of a pedicle screw torque driver, pedicle screws may be inserted into a vertebra along a desired trajectory previously defined using the guide wire. In this manner, pedicle screws may be inserted into vertebrae precisely and efficiently.
Spinal orthopedic implants made of artificial materials; Orthopedic joint implants for the spine made of artificial materials; Surgical and medical apparatus and instruments for use in spinal orthopedic surgery; Vertebral orthopedic apparatus
Medical instruments for use in spinal surgery, namely, trocars, cannulas, inserters, mechanical levers, curettes, dilators, retractors, and bone separators; spinal implant tools and positioners, namely, screw drivers, screw bushing positioning tools, rod reduction tools, distractors, surgical grippers and measuring gauges; measuring gauges for use in placement of spinal implants; spinal implant devices made of artificial materials, namely, stabilizing cords, screws, pedicle screws, plates, and expanders; spinal fusion devices made of artificial material, namely, rods, screws, expandable screws, plates, fusion cages, and cervical plates; spinal deformity corrective devices made of artificial material, namely, rods, screws, plates, fusion cages, and inter-vertebral disc prostheses
A surgical screw configured to expand and prevent or minimize bone growth inside of the surgical screw is provided. Accordingly, the surgical screw is configured to increase the purchase of the surgical screw with respect to the bone, but also to be withdrawn from the bone without damaging the bone as a result of bone ingrowth. The surgical screw includes a center post with an inner bore and an outer sleeve concentric to the center post. An outer surface of the outer sleeve includes a thread to engage bone. The outer sleeve includes a cut pattern defining an expandable region configurable between a first state with a first radius measured from a longitudinal axis of the surgical screw to the outer surface and a second state having a second radius measured from the longitudinal axis to the outer surface.
An instrument for spinal procedures is a vertebral endplate spreader device having a vertebral endplate spreader and a driver handle. The vertebral endplate spreader includes a linkage with a drive sprocket operatively connected for rotation relative thereto and with a secondary sprocket. The secondary sprocket is operatively connected for rotation relative to the linkage. The vertebral endplate spreader includes a belt operatively connected to the drive sprocket and the secondary sprocket to be driven about a belt axis. The driver handle has a distal end and a proximal end. The distal end is operatively connected to the drive sprocket to actuate rotation of the belt.
Medical instruments for use in spinal surgery, namely, trocars, cannulas, inserters, mechanical levers, curettes, dilators, retractors, and bone separators; spinal implant tools and positioners, namely, screw drivers, screw bushing positioning tools, rod reduction tools, distractors, surgical grippers and measuring gauges; measuring gauges for use in placement of spinal implants; spinal implant devices made of artificial materials, namely, stabilizing cords, screws, pedicle screws, plates, and expanders; spinal fusion devices made of artificial material, namely, rods, screws, expandable screws, plates, fusion cages, and cervical plates; spinal deformity corrective devices made of artificial material, namely, rods, screws, plates, fusion cages, and inter-vertebral disc prostheses
A surgical screw configured to expand and prevent or minimize bone growth inside of the surgical screw is provided. Accordingly, the surgical screw is configured to increase the purchase of the surgical screw with respect to the bone, but also to be withdrawn from the bone without damaging the bone as a result of bone ingrowth. The surgical screw includes a center post with an inner bore and an outer sleeve concentric to the center post. An outer surface of the outer sleeve includes a thread to engage bone. The outer sleeve includes a cut pattern defining an expandable region configurable between a first state with a first radius measured from a longitudinal axis of the surgical screw to the outer surface and a second state having a second radius measured from the longitudinal axis to the outer surface.
A method for determining a lowest stimulation threshold current level in a group of channels of a neuromonitoring device. The method includes stimulating tissue at a current level from a predetermined range of current levels as a sequence of pulses delivered at a frequency. The stimulating includes increasing the current level of each pulse in the sequence of pulses from an immediately preceding pulse by a first current increment. The method includes determining that a first evocation pulse from the sequence of pulses evokes a first muscular response. The method includes stimulating the tissue with a second evocation pulse from the sequence of pulses to evoke a second muscular response. The stimulating includes decreasing the frequency of the delivery of each pulse in the sequence of pulses and increasing the current level of each pulse in the sequence of pulses from the immediately preceding pulse by a second current increment. The method includes determining that the second evocation pulse from the sequence of pulses evokes the second muscular response.
G16H 20/30 - ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
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.
An osteotomy instrument for compression and/or distraction spinal procedures includes a first leg and a second leg pivotally attached to the first leg. The first leg and the second leg each include a proximal portion, a distal portion with a distal end and a pocket extending within the distal end towards the proximal portion. The distal portion of each leg is configured to rotatably engage a bearing attached to a spine of a patient. The pocket may be generally hemispherical with an inner surface configured to engage the bearing and form a ball-in-socket joint with the bearing.
An imaging system such as a medical C-arm x-ray fluoroscopy machine includes a tracking system that tracks a position of an x-ray source and an x-ray detector using sensors which monitor positions of joints which allow relative motions of segments in a support for the x-ray source and detector. Sensor readings are used in a kinematic chain. One or more segments that behave in a non-rigid manner are replaced by a virtual rigid link in the kinematic chain that takes into account deformations of the segments (e.g. under the influence of gravity). Calibration methods permit calibration of the system using images of phantoms.
A system for reducing deformities of the vertebrae in the spine includes a first reduction assembly, a second reduction assembly, and a reduction drive assembly. The first reduction assembly is configured for attachment to a first reduction tower that attaches to a first vertebra. The second reduction assembly is configured for attachment to a second reduction tower that attaches to a second vertebra. The reduction drive assembly includes an arcuate rack gear operably coupling the first reduction assembly to the second reduction assembly to translate the first reduction assembly relative to the second reduction assembly along an arcuate path in a first plane.
An instrument and inserter kit for providing a load to insert or retract an implant 2000 is provided. The instrument includes a cover having an engagement end opposite a distal end. The engagement end is configured to mount to an engagement feature of a handle of an inserter. The cover is an elongated member having a C-shaped profile having a dimension configured to receive a sliding member. The sliding member is seated over the cover and is weighted. The sliding member is configured to slide between a first radial lip and a second radial lip so as to provide an impacting force or retracting force on the instrument.
Medical and surgical apparatus and instruments, namely, surgical implants composed of artificial materials for the treatment of diseases of the spine by means of dynamic stabilization, spinal fusion and spinal deformity devices with the use of expandable screws
An interspinous process spacer includes a main body, a first wing, and a screw. The main body includes a first securing member extending from a top portion of the main body that engages a first vertebra and a bottom portion of the main body that engages a second vertebra. The first wing pivotably couples to a distal portion of the main body and includes a second securing member extending parallel to the first securing member to form a first clamp. The screw is positionable within the main body and includes a distal end that positions the first wing between a first position and a second position. The first clamp includes a first diameter in the first position and a second diameter in the second position.
An instrument with an implant holder disposed between a pair of tongs is provided. The implant holder may include a sleeve mechanically coupled to a distal end of a drive shaft and a pair of arms pivotably disposed within the sleeve. Movement of the sleeve in the distal direction pivots the pair of arms towards each other to grip the implant and movement of the sleeve in the proximal direction pivots the arms away from each other to automatically release the implant from the implant holder. The instrument may also include a dual mode drive shaft advancement mechanism that allows the implant holder to be advanced via an impact on the drive shaft from a tool such as a hammer or by rotation of the drive shaft.
