A medical implant has a textured tissue contact surface comprising a roughened surface that includes a plurality of macroscale and microscale projections and recesses and a plurality of nanostructures on the projections and within the recesses. The nanostructures comprise a plurality of spaced elongated waves, each wave having a crest and a trough. Each wave and recess comprise a plurality of individual polygonal structures, some of which comprise pyramidical-type shapes. The textured tissue contact surface is formed by initially laser ablating a tissue contact surface on the implant with a nanosecond pulsed laser followed by laser ablating the initially ablated surface with a femto-second pulsed laser.
A medical implant has a textured tissue contact surface comprising a roughened surface that includes a plurality of macroscale and microscale projections and recesses and a plurality of nanostructures on the projections and within the recesses. The nanostructures comprise a plurality of spaced elongated waves, each wave having a crest and a trough. Each wave and recess comprise a plurality of individual polygonal structures, some of which comprise pyramidical-type shapes. The textured tissue contact surface is formed by initially laser ablating a tissue contact surface on the implant with a nanosecond pulsed laser followed by laser ablating the initially ablated surface with a femto-second pulsed laser.
A medical implant has a textured tissue contact surface comprising a roughened surface that includes a plurality of macroscale and microscale projections and recesses and a plurality of nanostructures on the projections and within the recesses. The nanostructures comprise a plurality of spaced elongated waves, each wave having a crest and a trough. Each wave and recess comprise a plurality of individual polygonal structures, some of which comprise pyramidical-type shapes. The textured tissue contact surface is formed by initially laser ablating a tissue contact surface on the implant with a nanosecond pulsed laser followed by laser ablating the initially ablated surface with a femto-second pulsed laser.
A61C 8/00 - Moyens destinés à être fixés à l'os de la mâchoire pour consolider les dents naturelles ou pour y assujettir des prothèses dentairesImplants dentairesOutils pour l'implantation
A system for delivering bone graft material into an interbody fusion device (IBFD) in an intradiscal space of a spine, the IBFD having an open-frame with a hollow interior and an opening through its proximal end communicating with the interior. Included is an elongate channel having a lumen extending therethrough, the distal end being in engagement with the IBFD to align the lumen with the opening through the proximal end of the IBFD. An adjustable block is movably attached to the channel, the block having plural chambers containing bone graft material, the chambers being individually sequentially alignable with the lumen. A plunger pushes graft material from each chamber, through the lumen and into the IBFD. A distal end of a tamper is configured to be inserted through each chamber and the lumen and into the IBFD interior for tamping graft material deposited into the interior of the IBFD.
A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.
A modular apparatus for extending a rod in an existing spinal construct comprises a modular rod connector for attachment to the existing rod and a modular rod extender that may be selectively attached to the rod connector. Each rod connector includes a spherical head that is formed to have the same size and configuration such that any selected modular rod extender may be attached to a selected rod connector. Each rod connector comprises an attachment portion having an opening for receipt of a portion of the rod of an existing spinal construct. Each modular rod extender comprises an extender body including a common modular attachment feature at one end for receipt of the spherical head of the selected rod connector, and an extension rod extending from an opposite end to extend the existing spinal rod.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
8.
Bellows shaped spinal implant having gyroid lattice structures
A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.
An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.
An expandable spinal implant comprises a body having a hollow interior, a proximal end and a distal end, the body supporting an endplate movable relative to the body in a first direction away from said body. An actuatable expansion mechanism, supported within the hollow interior is coupled to the body and the movable endplate to move the movable endplate relative to the body. The expansion mechanism comprises a rotatable drive gear and a rotatable follower supported spaced from the drive gear, and a transmission belt rotatively coupling the drive gear and the follower to transfer rotative motion from the drive gear to the follower upon actuation of the expansion mechanism. The transmission belt is formed in a continuous loop extending in an oblong shape around the drive gear and the follower and has an inward curve on one side of the loop between said drive gear and the follower.
A steerable expandable spinal implant comprises a body and a movable endplate. The implant including an actuatable expansion mechanism coupled to the body, the expansion mechanism comprising a rotatable drive gear and a follower spindle coupled by a transmission belt. The drive gear is rotatable in a first direction to rotate the body about an axis adjacent a body proximal end, and in a second opposite direction to actuate the expansion mechanism to move the endplate away from the body and expand the spinal implant. A brake shoe is rotatably supported by the body adjacent the proximal end, the brake shoe being operable in a first mode to allow the body to rotate about the axis, and in the second mode to constrain movement of the body relative to brake shoe thereby allowing actuation of the expansion mechanism to move the endplate away from the body and expand the implant.
A steerable expandable spinal implant comprises a body and a movable endplate. The implant including an actuatable expansion mechanism coupled to the body, the expansion mechanism comprising a rotatable drive gear and a follower spindle coupled by a transmission belt. The drive gear is rotatable in a first direction to rotate the body about an axis adjacent a body proximal end, and in a second opposite direction to actuate the expansion mechanism to move the endplate away from the body and expand the spinal implant. A brake shoe is rotatably supported by the body adjacent the proximal end, the brake shoe being operable in a first mode to allow the body to rotate about the axis, and in the second mode to constrain movement of the body relative to brake shoe thereby allowing actuation of the expansion mechanism to move the endplate away from the body and expand the implant.
05 - Produits pharmaceutiques, vétérinaires et hygièniques
10 - Appareils et instruments médicaux
Produits et services
Bone cement for medical purposes; surgical and medical apparatus, namely a kit comprising surgical bone cement and surgical devices in the nature of applicators for use with surgical bone cement Surgical and medical apparatus and instruments, namely, a kit comprising surgical devices and instruments in the nature of applicators for use with surgical bone cement; injectors for medical use, namely, medical fluid injectors; medical apparatus, namely, surgical mixing and injection device used exclusively for mixing and injecting surgical bone cement; syringes for medical use
14.
Bellows shaped spinal implant having gyroid lattice structures
A bellows shaped spinal implant, comprising an upper plate, a lower plate and a bellows shaped shell extending between and joining the upper and lower plates. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending therearound that defines a hollow interior. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper and lower plates to provide stiffness mimicking the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant. The upper and lower plates each comprise porous contact regions including a three-dimensional gyroid lattice structure defined by a plurality of struts and pores in communication with the hollow interior. The outer surfaces of at least a portion of the struts may comprise a laser ablated textured surface.
An inserter for attaching a modular yoke to a bone screw and for providing an indication of attachment, comprises a tubular body having a central lumen, distal and proximal ends, and an attachment portion for releasable attachment to a yoke having a bottom opening for receipt of a head of said bone screw. The inserter includes an inner shaft having a distal end configured to be received into the yoke, the shaft being axially movable within the lumen from first to second axial positions in response to the introduction of the bone screw head into the yoke bottom opening. An indicator button supported by the body is movable in response to axial movement of the shaft from a first indicator position indicating the first axial position of the shaft relative to the body to a second indicator position indicating the second axial position of the shaft relative to the body.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A bellows shaped spinal implant, comprising an upper plate having an upper opening therethrough, a lower plate having a lower opening therethrough, and aa bellows shaped shell extending between and joining the upper plate and the lower plate. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending continuously therearound that defines a hollow interior in communication with the upper opening and the lower opening. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper plate and the lower plate to provide stiffness that mimics the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant.
A bellows shaped spinal implant, comprising an upper plate having an upper opening therethrough, a lower plate having a lower opening therethrough, and aa bellows shaped shell extending between and joining the upper plate and the lower plate. The bellows shaped shell is formed of titanium or an alloy comprising titanium and includes a wall extending continuously therearound that defines a hollow interior in communication with the upper opening and the lower opening. The wall has a thickness in the range of 0.5 mm to 1.0 mm to provide for radiographic imaging through the wall. The wall is angled or curved inwardly or outwardly between the upper plate and the lower plate to provide stiffness that mimics the stiffness properties of a similarly sized polyetheretherketone (PEEK) implant.
An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.
A modular apparatus for extending a rod in an existing spinal construct comprises a modular rod connector for attachment to the existing rod and a modular rod extender that may be selectively attached to the rod connector. Each rod connector includes a spherical head that is formed to have the same size and configuration such that any selected modular rod extender may be attached to a selected rod connector. Each rod connector comprises an attachment portion having an opening for receipt of a portion of the rod of an existing spinal construct. Each modular rod extender comprises an extender body including a common modular attachment feature at one end for receipt of the spherical head of the selected rod connector, and an extension rod extending from an opposite end to extend the existing spinal rod.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
20.
Modular apparatus for extending an existing spinal construct
A modular apparatus for extending a rod in an existing spinal construct comprises a modular rod connector for attachment to the existing rod and a modular rod extender that may be selectively attached to the rod connector. Each rod connector includes a spherical head that is formed to have the same size and configuration such that any selected modular rod extender may be attached to a selected rod connector. Each rod connector comprises an attachment portion having an opening for receipt of a portion of the rod of an existing spinal construct. Each modular rod extender comprises an extender body including a common modular attachment feature at one end for receipt of the spherical head of the selected rod connector, and an extension rod extending from an opposite end to extend the existing spinal rod.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
21.
Expandable TLIF device and related insertion and grafting instrumentation
An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano-second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.
An expandable interbody fusion device and an associated instrument for inserting the device into an intervertebral disc space, expanding the device and for use in delivering graft material into the device once expanded in the disc space. The device is small enough to fit through Kambin's triangle yet is capable of expanding both in the vertical direction to accommodate spinal lordosis and in the lateral direction to provide sufficient structural support for opposing vertebral bodies laterally within the disc space. A process of forming textured top and bottom surfaces of the device by initially laser ablating each surface with a nano- second pulsed laser followed by laser ablating those surfaces with a femto-second pulsed laser.
A system for delivering bone graft material into an interbody fusion device (IBFD) in an intradiscal space of a spine, the IBFD having an open-frame with a hollow interior and an opening through its proximal end communicating with the interior. Included is an elongate channel having a lumen extending therethrough, the distal end being in engagement with the IBFD to align the lumen with the opening through the proximal end of the IBFD. An adjustable block is movably attached to the channel, the block having plural chambers containing bone graft material, the chambers being individually sequentially alignable with the lumen. A plunger pushes graft material from each chamber, through the lumen and into the IBFD. A distal end of a tamper is configured to be inserted through each chamber and the lumen and into the IBFD interior for tamping graft material deposited into the interior of the IBFD.
A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A modular inserter assembly for use in inserting an interbody fusion cage into the disc space between opposing vertebrae comprises a depth stop and a modular inserter tip releasably attached thereto. The modular inserter assembly includes a cage attachment surface for releasable attachment to an interbody fusion cage, the depth stop including a movable stop axially movable relative to the inserter tip and being sized and configured to engage an exterior surface of one of the vertebrae to establish the depth to which the interbody fusion cage is to be inserted in the disc space. A plurality of modular inserter tips, each being configured for selective releasable attachment to differently sized interbody fusion cages are provided in a kit with the depth stop.
A disc preparation instrument for use in fusing spinal vertebrae comprises a modular scoring trial and a depth stop releasably attached to the scoring trial. The trial includes an elongate stem supporting a trial device at its distal tip. The trial device is insertable into a disc space and includes a rotatable rasp for scoring opposing vertebral endplates at a scored location. A stop, sized to engage an exterior surface of the vertebrae, is movable on the depth stop stem by rotation of an adjustment knob to a plurality of selectable distances between the proximal end of the trial device and the movable stop. An actuator releasably attached to the trial is operable to rotate the rasp. A plurality of modular trials, each having a trial device of different heights may be provided in a kit. Each scoring trial is selectively releasably attachable to a single depth stop.
A spinal rod reducer for reducing a rod into a rod-receiving opening of a bone anchor comprises an elongate tubular body having a lumen extending therethrough and a pair of spaced flexible anchor attachment members at the distal end of the tubular body. A threaded rod reduction member having a rod contacting surface is supported for axial movement within the lumen. A threaded rotatable reduction knob is threadably engaged with the rod reduction member rotation of which causes the rod reduction member with the rod contacting surface to move axially distally toward the bone anchor. A locking sleeve is configured to axially slide on the tubular body over the attachment members, the locking sleeve including a locking element for releasably coupling the locking sleeve and the rod reduction member for selective independent and joint movement relative to the tubular body.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
An inserter for attaching a modular yoke to a bone screw and for providing an indication of attachment, comprises a tubular body having a central lumen, distal and proximal ends, and an attachment portion for releasable attachment to a yoke having a bottom opening for receipt of a head of said bone screw. The inserter includes an inner shaft having a distal end configured to be received into the yoke, the shaft being axially movable within the lumen from first to second axial positions in response to the introduction of the bone screw head into the yoke bottom opening. An indicator button supported by the body is movable in response to axial movement of the shaft from a first indicator position indicating the first axial position of the shaft relative to the body to a second indicator position indicating the second axial position of the shaft relative to the body.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
A posterior cervical fixation system includes a facet lock comprising an elongate member having distal and proximal ends. A tapered wedge projects axially from the distal end and defines a wedge axis, the wedge being sized and configured for insertion into a facet joint of a cervical spine. The facet lock includes opposing first and second dovetail recesses. The system further includes a tubular guide having distal and proximal ends and a lumen extending therethrough along a central axis. The tubular guide has a plurality of dovetail projections extending exteriorly outwardly, each dovetail projection terminating in an engagement surface that is spaced respectively at a different radial distance from the central axis. Each dovetail projection is configured for individual releasable attachment to one of the facet lock first or second dovetail recesses to selectively space the wedge axis and the central axis at different distances for lateral mass screw placement.
A61B 17/16 - Instruments pour réaliser une ostéoclasieForets ou ciseaux pour osTrépans
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
A61B 17/17 - Dispositifs de guidage pour les forets
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A drill tap dilator comprises a dilator body having a central lumen extending therethrough, an elongate sleeve slidably received with the lumen, and a control knob coupled to the sleeve. The control knob is movable rotatably and axially relative to the dilator body. The sleeve includes docking teeth that are extendable from a retracted position within the body lumen to a deployed position outside the body lumen upon rotation of the control knob relative to the dilator body in one rotational direction. Adjustment of the length of drill tap dilator is allowed upon rotation of the control knob in an opposite rotational direction relative to the dilator body and manual axial movement of the control knob relative to the dilator body.
An access system for spinal surgery through a lateral approach comprises a tissue retractor including a center body supporting a centering guide having an elongate opening defining an alignment axis. A pair of retractor blades are movably supported by the center body one blade each on either side of said the centering guide, each retractor blade having a proximal end and a distal end, the distal ends of each retractor blade being configured for placement adjacent a spinal column of a patient. A plurality of elongate disc anchors is provided, each disc anchor being sized for individual removable receipt through the centering guide opening. Each disc anchor has a length such that the distal end of each disc anchor extends distally beyond the distal ends of the retractor blades when each disc anchor is respectively disposed in the centering guide opening.
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A system for delivering bone graft material into an interbody fusion device (IBFD) in an intradiscal space of a spine, the IBFD having an open-frame with a hollow interior and an opening through its proximal end communicating with the interior. Included is an elongate channel having a lumen extending therethrough, the distal end being in engagement with the IBFD to align the lumen with the opening through the proximal end of the IBFD. An adjustable block is movably attached to the channel, the block having plural chambers containing bone graft material, the chambers being individually sequentially alignable with the lumen. A plunger pushes graft material from each chamber, through the lumen and into the IBFD. A distal end of a tamper is configured to be inserted through each chamber and the lumen and into the IBFD interior for tamping graft material deposited into the interior of the IBFD.
Bioactive coating and treatment preparations for application to the surface of interbody fusion devices and spinal implants comprised of artificial material, namely, titanium which is designed to promote bone growth and sold as an integral component of the interbody fusion devices and spinal implants
40.
Rod connector for attachment to an existing spinal rod
Apparatus and devices for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
A spinal stabilization system comprises a bone screw including a bone engaging portion and a yoke, the yoke having top surface and bottom surfaces. The yoke has a rod receiving channel defined by a pair of opposed arms, an elongate connecting rod being received within the channel. A head to head cross connector comprises a connecting element having one end in connection with the bone screw and an opposite other end. The one end defines a connecting portion having an opening therethrough and a connecting bar communicating with the opening. The connecting bar, having upper and lower surfaces, resides within the channel, the lower surface contacting the rod. The connecting bar in a non-secured position is movable within the channel in at least two degrees of freedom. A set screw supported by the yoke rigidly secures the connecting bar to the rod and the rod to the yoke.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
Bone substitutes for surgical use; artificial biomaterials for augmentation of bone for medical purposes, namely, bone tissue for surgical use; surgical implants comprising artificial material and associated surgical instruments and surgical instrument sets
44.
Apparatus for dilating bodily tissue and for monitoring neural activity in the dilated bodily tissue
An apparatus is provided herein for dilating bodily tissue and for monitoring neural activity in the distracted bodily tissue. In one aspect of the invention, the apparatus includes a first dilator having a tubular body with a distal end, a proximal end, and at least one electrode mounted about a circumference thereof; and, a second dilator having a tubular body of electrically-insulative material, the tubular body having a distal end, a proximal end, and a lumen extending therebetween sized to permit the second dilator to subsequently telescopically slide over the first dilator and come into overlapping coaxial alignment with the first dilator. A discrete window is formed through the tubular body, at or near the distal end, in communication with the lumen. With the second dilator being in overlapping coaxial alignment with the first dilator, the window is located to come into registration with at least one electrode such that, upon rotation of the second dilator relative to the first dilator, the window is positionally adjustable about the circumference of the first dilator. Advantageously, in addition to detecting the proximity of a nerve to the first dilator, the apparatus permits determination of the direction of the nerve from the first dilator. This facilitates more efficient re-positioning of the apparatus for avoidance of nerves, if a new path is necessary.
A61M 29/00 - Dilatateurs avec ou sans moyens pour introduire des agents, p. ex. des remèdes
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 5/296 - Électrodes bioélectriques à cet effet spécialement adaptées à des utilisations particulières pour l’électromyographie [EMG]
A screw-based retractor comprises an elongate rack having a rack axis, a plurality of arms slidably supported for translational movement on the rack, and a plurality of blades, one each supported by a respective arm at a distal portion thereof. At least one of the arms includes at its distal portion a blade releasably attached thereto. Such at least one arm comprises a plurality of links each of which is configured to allow the blade supported by such arm to be moved in plural incrementally discrete positions with each such discrete position being selectively lockable. The blade may have a fixed or variable length. Such blade may be attached to a blade receptacle movably attached to the at least one arm in a manner to provide articulation of the blade receptacle and hence the attached blade about an articulation point spaced from and not located on such arm.
An expandable device for expanding and supporting body tissue comprises an inferior endplate having an outer surface configured to contact one body tissue surface and a superior endplate having an outer surface configured to contact an opposing body tissue surface. The inferior endplate and the superior endplate are movable relative to each other in a direction of expansion. The device includes an elevator captively supported between the inferior endplate and the superior endplate for independent movement along the direction of expansion. In the first direction the elevator is moved toward said superior endplate to lift the superior endplate and expand the device. In the second direction the elevator moves away from said superior endplate toward said inferior endplate to create a space for insertion of an insert into the expanded device.
An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of interlocking expansion members or wafers. The like-configured 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. One of the interlocking features includes a plurality of prongs projecting from an upper surface of the wafers and into a recess defined in the lower surface of an adjacent previously inserted like-configured wafer. The prongs and recesses are configured to prevent retrograde movement of each new wafer in a direction opposite the direction of insertion. Other interlocking features prevent movement in the direction of insertion, transverse to the insertion direction and vertically within the stack.
A polyaxial bone screw for attaching a rod to a vertebra comprises a fastener having a threaded shank and a head. A yoke has a rod receiving channel for receiving the rod. A screw support rotatably attached to the yoke has a cavity articulatingly and rotatably supporting the fastener head, a hole receiving the threaded fastener shank therethrough, and a plurality of slots for maximum screw angulation. A crown has an upper rod receiving surface, a lower surface in contact with the fastener head and a projecting surface in contact with the yoke. A biasing element between the screw support and the yoke applies biasing forces among the fastener, the crown, and the yoke to provide sufficient friction to retain the yoke in a manipulable position relative to the fastener. A set screw is supported by the yoke to overcome the bias and to rigidly secure the components.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A screw-based retractor comprises an elongate rack having a rack axis, a plurality of arms slidably supported for translational movement on the rack, and a plurality of blades, one each supported by a respective arm at a distal portion thereof. At least one of the arms includes at its distal portion a blade releasably attached thereto. Such blade is attached to a blade receptacle movably attached to the at least one arm in a manner to provide articulation of the blade receptacle and hence the attached blade about an articulation point spaced from and not located on such arm. Such blade is additionally movable relative to the rack in multiple degrees of freedom.
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
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.
05 - Produits pharmaceutiques, vétérinaires et hygièniques
Produits et services
Biological bone tissue, namely, allogenic tissue intended for subsequent implantation in medical and surgical procedures, namely, bone matrix, viable cell, amniotic membrane and structural allografts; human allograft tissue, namely, allogenic tissue intended for subsequent implantation in medical and surgical procedures, namely, bone matrix, viable cell, amniotic membrane and structural allografts
A spinal fusion system may include an interbody fusion cage, a fixation plate, and an implanter. The interbody fusion cage may include a proximal region, a distal region opposite the proximal region, a superior region, an inferior region opposite the superior region, and an open volume between the proximal and distal regions. The superior and inferior regions are located between the proximal and distal regions and are configured such that, when the interbody fusion cage is implanted in the disc space, the superior region contacts the inferior end plate and the inferior region contacts the superior end plate. The fixation plate is receivable in the open volume of the interbody fusion cage and includes a superior blade and an inferior blade. At least one of the blades includes a first opening defined therein. The fixation plate is displaceable between a non-deployed state and a deployed state.
An expandable anterior lumbar interbody fusion device comprises a multiple piece construction that includes an outer shell, movable upper and lower endplates and a pair of laterally spaced supports therebetween. The endplates are initially nested within the outer shell and telescope through the outer shell when expanded by a secondary instrument. Each endplate includes fixation elements to anchor the expanded device in an intervertebral disc space. Bilateral internal pockets are formed within each of the endplates to fully contain the supports. Once the device is expanded, the supports are pushed into place by the instrument in a manner to maintain the expanded position. After the supports are in place, the expander instrument is removed, and the device remains anchored in the expanded state.
A screw-based retractor comprises an elongate rack having a rack axis, a plurality of arms slidably supported for translational movement on the rack, and a plurality of blades, one each supported by a respective arm at a distal portion thereof. At least one of the arms includes at its distal portion a blade releasably attached thereto. Such blade is attached to a blade receptacle movably attached to the at least one arm in a manner to provide articulation of the blade receptacle and hence the attached blade about an articulation point spaced from and not located on such arm. Such blade is additionally movable relative to the rack in multiple degrees of freedom.
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
An expandable anterior lumbar interbody fusion device comprises a multiple piece construction that includes an outer shell, movable upper and lower endplates and a pair of laterally spaced supports therebetween. The endplates are initially nested within the outer shell and telescope through the outer shell when expanded by a secondary instrument. Each endplate includes fixation elements to anchor the expanded device in an intervertebral disc space. Bilateral internal pockets are formed within each of the endplates to fully contain the supports. Once the device is expanded, the supports are pushed into place by the instrument in a manner to maintain the expanded position. After the supports are in place, the expander instrument is removed, and the device remains anchored in the expanded state.
A translating polyaxial bone screw assembly for anchoring a connecting rod to a spinal vertebra comprises a bone screw having a threaded shank and a head coupled to a yoke. The yoke has at one end a rod receiving channel for receiving a connecting rod and an opposite end that is coupled to the bone screw by a coupling assembly. The coupling assembly couples the yoke for polyaxial movement relative to the bone screw and for translational movement of the yoke in a direction transverse to the axis of the bone screw. The coupling assembly comprises a biasing element supported for joint movement with the yoke that provides a manually surmountable tension force between the yoke and bone screw head that is maintained during polyaxial and translational movement. A fastening element is supported by the yoke for securing the connecting rod between the fastening element and the coupling assembly.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A modular inserter assembly for use in inserting an interbody fusion cage into the disc space between opposing vertebrae comprises a depth stop and a modular inserter tip releasably attached thereto. The modular inserter assembly includes a cage attachment surface for releasable attachment to an interbody fusion cage, the depth stop including a movable stop axially movable relative to the inserter tip and being sized and configured to engage an exterior surface of one of the vertebrae to establish the depth to which the interbody fusion cage is to be inserted in the disc space. A plurality of modular inserter tips, each being configured for selective releasable attachment to differently sized interbody fusion cages are provided in a kit with the depth stop.
A modular inserter assembly for use in inserting an interbody fusion cage into the disc space between opposing vertebrae comprises a depth stop and a modular inserter tip releasably attached thereto. The modular inserter assembly includes a cage attachment surface for releasable attachment to an interbody fusion cage, the depth stop including a movable stop axially movable relative to the inserter tip and being sized and configured to engage an exterior surface of one of the vertebrae to establish the depth to which the interbody fusion cage is to be inserted in the disc space. A plurality of modular inserter tips, each being configured for selective releasable attachment to differently sized interbody fusion cages are provided in a kit with the depth stop.
A translating polyaxial bone screw assembly for anchoring a connecting rod to a spinal vertebra comprises a bone screw having a threaded shank and a head coupled to a yoke. The yoke has at one end a rod receiving channel for receiving a connecting rod and an opposite end that is coupled to the bone screw by a coupling assembly. The coupling assembly couples the yoke for polyaxial movement relative to the bone screw and for translational movement of the yoke in a direction transverse to the axis of the bone screw. The coupling assembly comprises a biasing element supported for joint movement with the yoke that provides a manually surmountable tension force between the yoke and bone screw head that is maintained during polyaxial and translational movement. A fastening element is supported by the yoke for securing the connecting rod between the fastening element and the coupling assembly.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A disc preparation instrument for use in fusing spinal vertebrae comprises a modular scoring trial and a depth stop releasably attached to the scoring trial. The trial includes an elongate stem supporting a trial device at its distal tip. The trial device is insertable into a disc space and includes a rotatable rasp for scoring opposing vertebral endplates at a scored location. A stop, sized to engage an exterior surface of the vertebrae, is movable on the depth stop stem by rotation of an adjustment knob to a plurality of selectable distances between the proximal end of the trial device and the movable stop. An actuator releasably attached to the trial is operable to rotate the rasp. A plurality of modular trials, each having a trial device of different heights may be provided in a kit. Each scoring trial is selectively releasably attachable to a single depth stop.
A disc preparation instrument for use in fusing spinal vertebrae comprises a modular scoring trial and a depth stop releasably attached to the scoring trial. The trial includes an elongate stem supporting a trial device at its distal tip. The trial device is insertable into a disc space and includes a rotatable rasp for scoring opposing vertebral endplates at a scored location. A stop, sized to engage an exterior surface of the vertebrae, is movable on the depth stop stem by rotation of an adjustment knob to a plurality of selectable distances between the proximal end of the trial device and the movable stop. An actuator releasably attached to the trial is operable to rotate the rasp. A plurality of modular trials, each having a trial device of different heights may be provided in a kit. Each scoring trial is selectively releasably attachable to a single depth stop.
Described here are deformable, monolithic, stabilization implants suitable for use within bone and between bones to fuse vertebral bodies, to repair herniated discs, or to repair spinal compression fractures. The implants are introduced into a chosen site at a first, smaller height and then plastically deformed to achieve a second, but unique, pre-selected, larger height. Variations of the device provide one or more specific larger heights. The devices are suitable as intervertebral spinal fusion implants for the immobilization of adjacent vertebral bodies. Methods of and instruments for deployment of the implants are also described. Also described are variations of the device suitable as sizing instruments.
Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of interlocking expansion members or wafers. The like-configured 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. One of the interlocking features includes a plurality of prongs projecting from an upper surface of the wafers and into a recess defined in the lower surface of an adjacent previously inserted like-configured wafer. The prongs and recesses are configured to prevent retrograde movement of each new wafer in a direction opposite the direction of insertion. Other interlocking features prevent movement in the direction of insertion, transverse to the insertion direction and vertically within the stack.
A translating polyaxial bone anchor for anchoring a connecting rod to a spinal vertebra comprises a fastener having a bone engaging portion and a head, the head defining a socket. An insert is captively retained in the socket and configured for swiveling polyaxial movement therein. The insert includes an elongate connecting element defining an axis, the connecting element projecting outwardly from and through the socket. A yoke having at one end a rod receiving channel for receiving a connecting rod is coupled to the fastener by a coupling member. The coupling member couples the yoke to the insert connecting element for joint polyaxial movement relative to the fastener and for translational movement of the yoke in a direction transverse to the axis of the connecting member. A fastening element is supported by the yoke for securing the connecting rod between the fastening element and the coupling member.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A spinal fusion system may include an interbody fusion cage, a fixation plate, and an implanter. The interbody fusion cage may include a proximal region, a distal region opposite the proximal region, a superior region, an inferior region opposite the superior region, and an open volume between the proximal and distal regions. The superior and inferior regions are located between the proximal and distal regions and are configured such that, when the interbody fusion cage is implanted in the disc space, the superior region contracts the inferior end plate and the inferior region contacts the superior end plate. The fixation plate is receivable in the open volume of the interbody fusion cage and includes a superior blade and an inferior blade. At least one of the blades includes a first opening defined therein. The fixation plate is displaceable between a non-deployed state and a deployed state.
A translating polyaxial bone screw assembly for anchoring a connecting rod to a spinal vertebra comprises a bone screw having a threaded shank and a head coupled to a yoke. The yoke has at one end a rod receiving channel for receiving a connecting rod and an opposite end that is coupled to the bone screw by a coupling assembly. The coupling assembly couples the yoke for polyaxial movement relative to the bone screw and for translational movement of the yoke in a direction transverse to the axis of the bone screw. The coupling assembly comprises a biasing element supported for joint movement with the yoke that provides a manually surmountable tension force between the yoke and bone screw head that is maintained during polyaxial and translational movement. A fastening element is supported by the yoke for securing the connecting rod between the fastening element and the coupling assembly.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
68.
Pedicle screw extension for use in percutaneous spinal fixation
A bone screw extension assembly for use in placing a connecting rod percutaneously into tissue of a patient comprises a multi-axial bone screw and a screw extension releasably coupled to yoke of the bone screw. The screw extension includes coaxially disposed outer sleeve and inner sleeves that are rotatable relative to each other. A screw engaging member projects radially from the distal end of the inner sleeve and is configured to engage an extension coupling surface on the outer sleeve upon relative rotation of the inner and outer sleeves. A securement member including cooperative surfaces is defined adjacent the distal end of the inner and outer sleeves that is operable upon relative rotation of the inner sleeve and outer sleeve to radially secure the sleeves together to thereby maintain the engagement of the screw engaging member and the bone screw.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
69.
Disc preparation instrument for use in spinal fusion
A system for fusing together opposing vertebra of a spine that defines a disc space therebetween. The system comprises a disc preparation instrument and an inserter assembly for use in the interbody fusion procedure. Disc preparation instrument comprises an elongate handle supporting a trial device at one end thereof. Inserter assembly comprises an elongate inserter supporting at one end thereof an interbody cage implant for insertion into the disc space. Disc preparation instrument provides a scoring element that scribes vertebral endplates at an appropriate scored location for anchor blades on the cage implant to engage the vertebral bodies. Inserter is used to introduce cage implant with anchor blades into the disc space to an appropriate depth so that the blades will be precisely positioned at the scored location created by the scoring element for penetration into the vertebral endplates.
A system for fusing together opposing vertebra of a spine that defines a disc space therebetween. The system comprises a disc preparation instrument and an inserter assembly for use in the interbody fusion procedure. Disc preparation instrument comprises an elongate handle supporting a trial device at one end thereof. Inserter assembly comprises an elongate inserter supporting at one end thereof an interbody cage implant for insertion into the disc space. Disc preparation instrument provides a scoring element that scribes vertebral endplates at an appropriate scored location for anchor blades on the cage implant to engage the vertebral bodies. Inserter is used to introduce cage implant with anchor blades into the disc space to an appropriate depth so that the blades will be precisely positioned at the scored location created by the scoring element for penetration into the vertebral endplates.
A polyaxial bone screw for attaching a rod to a vertebra comprises a fastener having a threaded shank and a head. A yoke has a rod receiving channel for receiving the rod. A screw support rotatably attached to the yoke has a cavity articulatingly and rotatably supporting the fastener head, a hole receiving the threaded fastener shank therethrough, and a plurality of slots for maximum screw angulation. A crown has an upper rod receiving surface, a lower surface in contact with the fastener head and a projecting surface in contact with the yoke. A biasing element between the screw support and the yoke applies biasing forces among the fastener, the crown, and the yoke to provide sufficient friction to retain the yoke in a manipulable position relative to the fastener. A set screw is supported by the yoke to overcome the bias and to rigidly secure the components.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A spinal stabilization system comprises a bone screw including a bone engaging portion and a yoke, the yoke having top surface and bottom surfaces. The yoke has a rod receiving channel defined by a pair of opposed arms, an elongate connecting rod being received within the channel. A head to head cross connector comprises a connecting element having one end in connection with the bone screw and an opposite other end. The one end defines a connecting portion having an opening therethrough and a connecting bar communicating with the opening. The connecting bar, having upper and lower surfaces, resides within the channel, the lower surface contacting the rod. The connecting bar in a non-secured position is movable within the channel in at least two degrees of freedom. A set screw supported by the yoke rigidly secures the connecting bar to the rod and the rod to the yoke.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A polyaxial bone screw for attaching a rod to a vertebra comprises a fastener having a threaded shank and a head. A yoke has a rod receiving channel for receiving the rod. A screw support rotatably attached to the yoke has a cavity articulatingly and rotatably supporting the fastener head, a hole receiving the threaded fastener shank therethrough, and a plurality of slots for maximum screw angulation. A crown has an upper rod receiving surface, a lower surface in contact with the fastener head and a projecting surface in contact with the yoke. A biasing element between the screw support and the yoke applies biasing forces among the fastener, the crown, and the yoke to provide sufficient friction to retain the yoke in a manipulable position relative to the fastener. A set screw is supported by the yoke to overcome the bias and to rigidly secure the components.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
An intervertebral insert member and an instrument for positioning the insert in a space between vertebral bodies in vivo. The insert member is advanced by the instrument into a prepared site located between adjacent vertebral bodies. Upon reaching the appropriate insertion point, the sleeve is retracted and a pivotal motion is imparted to the insert. The insert member is pivotally attached to the distal end of the delivery instrument such that it can be articulated about a pivot point that is located on the insert member until it is properly positioned. The positioning instrument is then released from the insert member and removed from the space between the vertebral bodies. An adjustment screw is available to expand the surfaces of the insert member by displacement of a wedge member within the insert.
An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.
A spinal fixation system includes a rod and anchor devices that include a bone engaging fastener having a head defining a spherical socket. A ball insert is placed within the socket and rotated so that the ball insert is juxtaposed with the socket. The anchor device further includes a yoke defining a yoke channel for receiving the rod and a stem engaged to the ball insert captured within the socket. A sleeve disposed between the yoke channel and the fastener head supports the rod. A set screw is operable to clamp the rod against the sleeve and draw the insert into engagement within the socket. A releasable detent defined between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener. Portions of the releasable detent may also exert a frictional retention force against the fastener head.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
B25B 23/10 - Dispositions pour manipuler les vis ou écrous pour tenir ou présenter la vis ou l'écrou avant ou pendant sa rotation par des moyens mécaniques de prise
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
A system for fusing together opposing vertebra of a spine that defines a disc space therebetween. The system comprises a disc preparation instrument and an inserter assembly for use in the interbody fusion procedure. Disc preparation instrument comprises an elongate handle supporting a trial device at one end thereof. Inserter assembly comprises an elongate inserter supporting at one end thereof an interbody cage implant for insertion into the disc space. Disc preparation instrument provides a scoring element that scribes vertebral endplates at an appropriate scored location for anchor blades on the cage implant to engage the vertebral bodies. Inserter is used to introduce cage implant with anchor blades into the disc space to an appropriate depth so that the blades will be precisely positioned at the scored location created by the scoring element for penetration into the vertebral endplates.
An apparatus for use in spinal interbody fusion comprises, in combination, a spinal interbody fusion implant and an inserter releasably attached thereto. The implant comprises a hollow interior through which the inserter extends, the inserter having a tapered distal tip projecting exteriorly beyond the distal end of the implant to initially distract opposing tissue surfaces and to facilitate insertion of the implant into the intradiscal space between the vertebral bodies.
A system for delivering bone graft material during spinal interbody fusion comprises an interbody fusion device implanted in a spinal intradiscal space. The device has a distal end, a proximal end, opposing spaced side walls and opposing top and bottom surfaces defining a hollow interior A channel extends through the proximal end in communication with the hollow interior. An elongate guide pin is releasably attached to the device proximal end. An elongate cannula has a first lumen extending therethrough, the cannula including a mating feature at a distal end releasably secured to the device to substantially align the first lumen with the device channel. The cannula includes an axially offset receiving member receiving the guide pin and an axially spaced retention member securing the cannula to the guide pin and the device. A tamp advances graft material in the first lumen into the device through the channel.
An expandable anterior lumbar interbody fusion device comprises a deformable monolithic body having posterior and anterior ends, an upper bone contact structure and a lower bone contact structure. The body is expandable along a height axis between a first smaller height to a second larger height. The body comprises a pair of opposed side structures, each including a translatable center section being movable in a direction transverse to the height axis, a first locator arm adjacent the posterior end, a second locator arm adjacent the anterior end and a pair of formable load-bearing columns supported by the upper bone contact structure, the lower bone contact structure and the center section. The columns are not formed at the first height but are operative upon expansion of the body to the second height to form load-bearing columns along the height axis between the upper and lower bone contact structures.
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 id dislodged by sequential introduction of another wafer.
Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A polyaxial bone screw for attaching a rod to a vertebra comprises a fastener having a threaded shank and a head. A yoke has a rod receiving channel for receiving the rod. A screw support rotatably attached to the yoke has a cavity articulatingly and rotatably supporting the fastener head, a hole receiving the threaded fastener shank therethrough, and a plurality of slots for maximum screw angulation. A crown has an upper rod receiving surface, a lower surface in contact with the fastener head and a projecting surface in contact with the yoke. A biasing element between the screw support and the yoke applies biasing forces among the fastener, the crown, and the yoke to provide sufficient friction to retain the yoke in a manipulable position relative to the fastener. A set screw is supported by the yoke overcome the bias and to rigidly secure the components.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A system for delivering bone graft material into an interbody fusion device (IBFD) in an intradiscal space of a spine, the IBFD having an open-frame with a hollow interior and an opening through its proximal end communicating with the interior. Included is an elongate channel having a lumen extending therethrough, the distal end being in engagement with the IBFD to align the lumen with the opening through the proximal end of the IBFD. An adjustable block is movably attached to the channel, the block having plural chambers containing bone graft material, the chambers being individually sequentially alignable with the lumen. A plunger pushes graft material from each chamber, through the lumen and into the IBFD. A distal end of a tamper is configured to be inserted through each chamber and the lumen and into the IBFD interior for tamping graft material deposited into the interior of the IBFD.
Surgical apparatus and instruments for use by spinal surgeons in internal spinal fixation and/or spinal implant surgery, namely, bone screws, fixation rods, rod connectors, and locking screws for spinal fixation, devices to position surgical instruments and implants, bone taps, bone screw extensions, rod introducers, rod persuaders, screw drivers, compression/distraction devices, tissue dilators, retractors, rod detection devices and rod benders
A system for use in spinal surgery for interbody fusion and
vertebral body replacement, namely, expandable plastically
deformable spinal implants that may interlock upon expansion
and that are made of titanium and other metals and
non-metallic materials, non-expandable spinal implants
having a fixed dimension; and related instruments, namely,
endplate preparation tools, sizers, inserter tools, removal
and revision tools.
An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of interlocking expansion members or wafers. The like-configured 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. One of the interlocking features includes a plurality of prongs projecting from an upper surface of the wafers and into a recess defined in the lower surface of an adjacent previously inserted like-configured wafer. The prongs and recesses are configured to prevent retrograde movement of each new wafer in a direction opposite the direction of insertion. Other interlocking features prevent movement in the direction of insertion, transverse to the insertion direction and vertically within the stack.
An access system for use in spinal surgery, namely, a two-stage lateral access system, comprised of a retractor tube having a table arm attachment point and light cable ports for psoas muscle visualization, dilators, independently adjustable retractor blades supported by the retractor tube for psoas muscle splitting, a table arm, a table clamp and driving instruments for adjusting the retractor blades
89.
Expandable sizer instrument for spacing vertebral bodies
An expandable sizer instrument for distracting and spacing opposing vertebral bodies of a spine comprises an elongate hollow shaft defining a longitudinal axis and having opposed distal and proximal ends. An actuator is provided at the proximal end and an expandable distractor is provided at the distal end. An elongate push rod extends within the shaft, a proximal end of the push rod being coupled to the actuator and a distal end being coupled to the expandable distractor. The distractor comprises a lower plate immovably attached to the shaft, and an upper plate coupled to the lower plate by a linkage mechanism fully contained within the perimeter of the distractor and operable to move the upper plate away from the lower plate in an expansion direction substantially parallel to the lower plate. The linkage mechanism comprises two laterally spaced linkage pairs with a middle link disposed therebetween.
A spinal fixation system includes a rod and anchor devices that include a bone engaging fastener having a head defining a spherical socket. A ball insert is placed within the socket and rotated so that the ball insert is juxtaposed with the socket. The anchor device further includes a yoke defining a yoke channel for receiving the rod and a stem engaged to the ball insert captured within the socket. A sleeve disposed between the yoke channel and the fastener head supports the rod. A set screw is operable to clamp the rod against the sleeve and draw the insert into engagement within the socket. A friction element in the form of a wave spring is disposed between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.
An expandable device for expanding and supporting body tissue comprises an inferior endplate having an outer surface configured to contact one body tissue surface and a superior endplate having an outer surface configured to contact an opposing body tissue surface. The inferior endplate and the superior endplate are movable relative to each other in a direction of expansion. The device includes an elevator captively supported between the inferior endplate and the superior endplate for independent movement along the direction of expansion. In the first direction the elevator is moved toward said superior endplate to lift the superior endplate and expand the device. In the second direction the elevator moves away from said superior endplate toward said inferior endplate to create a space for insertion of an insert into the expanded device.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61F 2/46 - Outils particuliers pour l'implantation des articulations artificielles
A61F 2/44 - Articulations pour l'épine dorsale, p. ex. vertèbres, disques intervertébraux
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
An expandable device for expanding and supporting body tissue comprises an inferior endplate having an outer surface configured to contact one body tissue surface and a superior endplate having an outer surface configured to contact an opposing body tissue surface. The inferior endplate and the superior endplate are movable relative to each other in a direction of expansion. The device includes an elevator captively supported between the inferior endplate and the superior endplate for independent movement along the direction of expansion. In the first direction the elevator is moved toward said superior endplate to lift the superior endplate and expand the device. In the second direction the elevator moves away from said superior endplate toward said inferior endplate to create a space for insertion of an insert into the expanded device.
An elongate inserter has a distal end releasably connected to an expandable device for expanding body tissue and a proximal end including a trigger actuator. The expandable device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other between opposing tissue surfaces of a body. The inserter includes a lifting platform comprising ramp surfaces that upon operation of the trigger actuator cooperatively engage complementary surfaces of expansion structure within the device to cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert between the superior and inferior endplates after expansion of the device.
In one aspect, an instrument for placing a graft, implant and/or graft material at a target site for enhancing posterolateral fusion between two or more vertebrae is provided which includes a housing and an actuable trigger associated with the housing. A curved rigid access tube extends from the housing, the access tube terminating at a distal end. A sheath is disposed about, and moveable relative to the access tube, and a transmission is disposed in the housing. In an initial state, the sheath extends distally past the distal end of the access tube, a space being defined within the sheath distally of the distal end of the access tube to accommodate the graft, implant and/or graft material. The transmission is configured to cause an incremental displacement of the sheath relative to the distal end of the access tube upon an actuation of the trigger.
A61F 2/00 - Filtres implantables dans les vaisseaux sanguinsProthèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corpsAppareils pour les assujettir au corpsDispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p. ex. stents
An elongate inserter lias a distal, end rele&sably connected to an expandable device for expanding body tissue and a. proximal, end including a trigger actuator. The expandable device- comprises a superior endp!ate and an inferior emipiate that are movable In an expansion direction relative to each other between opposing tissue surikees of a body. The inserter includes a lifting piMform comprising ramp surfaces that upon operation of the trigger actuator -cooperatively engage -complementary surjkses of expansion structure within tbe device to cause the superior and inferior endpktes to move relatively away from each other. A driver is supported by the inserter for pushing an insert between the superior and inferior endplates after expansion of the device.
An expandable device for expanding and supporting body tissue comprises an inferior endplate having an outer surface configured to contact one body tissue surface and a superior endplate having an outer surface configured to contact an opposing body tissue surface. The inferior endplate and the superior endplate are movable relative to each other in a direction of expansion. The device includes an elevator captively supported between the inferior endplate and the superior endplate for independent movement along the direction of expansion. In the first direction the elevator is moved toward said superior endplate to lift the superior endplate and expand the device. In the second direction the elevator moves away from said superior endplate toward said inferior endplate to create a space for insertion of an insert into the expanded device.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
98.
Pedicle screw extension for use in percutaneous spinal fixation
A bone screw extension assembly for use in placing a connecting rod percutaneously into tissue of a patient comprises a multi-axial bone screw and a screw extension releasably coupled to yoke of the bone screw. The screw extension includes coaxially disposed outer sleeve and inner sleeves that are rotatable relative to each other. A screw engaging member projects radially from the distal end of the inner sleeve and is configured to engage an extension coupling surface on the outer sleeve upon relative rotation of the inner and outer sleeves. A securement member including cooperative surfaces is defined adjacent the distal end of the inner and outer sleeves that is operable upon relative rotation of the inner sleeve and outer sleeve to radially secure the sleeves together to thereby maintain the engagement of the screw engaging member and the bone screw.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
Described here are deformable, monolithic, stabilization implants suitable for use within bone and between bones to fuse vertebral bodies, to repair herniated discs, or to repair spinal compression fractures. The implants are introduced into a chosen site at a first, smaller height and then plastically deformed to achieve a second, but unique, pre-selected, larger height. Variations of the device provide one or more specific larger heights. The devices are suitable as intervertebral spinal fusion implants for the immobilization of adjacent vertebral bodies. Methods of and instruments for deployment of the implants are also described. Also described are variations of the device suitable as sizing instruments.
Apparatus and devices for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.
A61B 17/70 - Dispositifs de mise en position ou de stabilisation de la colonne vertébrale, p. ex. stabilisateurs comprenant un liquide de remplissage dans un implant
A61B 17/88 - Moyens ou procédés pour implanter ou pour extraire des dispositifs de fixation interne
A61B 17/02 - Instruments, dispositifs ou procédés chirurgicaux pour maintenir les blessures ouvertes, p. ex. rétracteursÉcarteurs
