The guidance and positioning device may be a system for creating a passage in tissue, positioning fasteners or other implants, and tensioning an elongated fastening member, like a suture, thread, wire, or pin. In some embodiments, the device may allow for the implantation of multiple sutures and fasteners in tissue. A fastener may be positioned at the distal end of a flexible pushrod. The fastener may be connected with the pushrod or may be loosely fitted with the distal end of the pushrod. A suture may be looped through or connected with the fastener such that one, two, or more sections, legs, strands, or portions of the suture extend from the fastener.

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 intervertebral implant has a hollow space formed within the implant and accessible through an elongate opening extending through a recessed portion of the side wall, and the hollow space is shaped to receive an engagement portion of a drive shaft of an insertion tool; and the intervertebral implant includes at least two guiding surfaces facing each other and being configured for sliding engagement by a portion of a sleeve of the insertion tool movably holding the drive shaft.

An artificial replacement disc includes a pair of substantially parallel plates formed to occupy a space defined by vertebral endplates, each of the plates including a plurality of spikes on a first surface and a concave trough formed on a second surface opposite of the first surface. A mobile core includes a core rim with opposing convex surfaces extending from opposite sides of the core rim, the mobile core being capable of being disposed between the pair of plates to permit the vertebral endplates to move relative to one another. The spikes on each of the plates extend substantially away from the mobile core and the convex surfaces are formed to integrally fit within the concave trough of at least one of the plates. The core rim limits lateral movement of the mobile core relative to the parallel plates. One or more insertion tools for inserting and implanting the replacement disc are also described.

Embodiments herein are generally directed to vertebral implants and implant trials for use with vertebral implant assemblies. In some embodiments, these implants and implant trials may be used in conjunction with corpectomy procedures.

Methods and apparatus for posterior lumbar interbody fusion (PLIF) surgical procedures. The apparatus includes a sleeve assembly for guiding an interbody graft into position between adjacent anatomical structures. The sleeve includes a first piece having a first internal ramp and a second piece having a second internal ramp opposite the first internal ramp, and an elastic band configured to connect the first and second pieces together. The first and second internal ramps comprise a V shape with an opening therebetween through which the interbody graft is urged during the surgical procedure.

The present invention provides a supporting member for implanting into a vertebra of a subject, including: a hollow body including an upper surface and a lower surface opposite the upper surface; a first guiding part formed on the upper surface; a second guiding part corresponding to the first guiding part and formed on the lower surface; a first engaging part formed on the upper surface; and a second engaging part corresponding to the first engaging part and formed on the lower surface; wherein the second guiding part extends out an extending part from a side of the hollow body, and the extending part is configured to be slidably coupled to a first guiding part of another supporting member sliding to the lower surface of the supporting member, as a result two supporting members are slidably coupled to each other and engaged to each other. According to the invention, one single supporting member can be implanted into a vertebra of a subject, or two or more supporting members can be in sequence introduced into a vertebra of a subject and combined together therein.

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

Expandable spinal implants and drivers connected by a bendable joint are disclosed. The flexible connector allows the implant and driver to move to different angular orientations with respect to each other, and to apply rotational force or torque from the driver to the implant and its expansion mechanism. During insertion of an implant into the desired position, the driver may be oriented in the same or different direction than the long axis of the implant. After the spinal implant is placed in the desired position, the driver is used to expand the implant in selected dimensions.

An expandable intervertebral implant having an upper body portion, a lower body portion opposite the upper body portion, a wedge member connecting the upper body portion to the lower body portion, a nose member having a tapered distal end and a proximal end opposite the distal end, and an actuator disposed between the nose member and the wedge member, for translation of the wedge member along a longitudinal axis of the implant. A pin disposed in a center of the nose member connects to the actuator for centering the nose member with the actuator. Translation of the wedge member along the longitudinal axis of the implant displaces the upper body portion and the lower body portion away from each other, thereby expanding the intervertebral implant.