Orthopedic implants, systems, instruments, and methods. A bi-portal lumbar interbody fusion system may include an expandable interbody implant and minimally invasive pedicle-based intradiscal fixation implants. The interbody and intradiscal implants may be installed with intelligent instrumentation capable of repeatably providing precision placement of the implants. The bi-portal system may be robotically-enabled to guide the instruments and implants along desired access trajectories to the surgical area.

An intervertebral implant inserter, comprising: a) a elongated central body having a distal end, a proximal end, an outer surface, and a longitudinal throughbore therethrough, b) upper and lower blades, each blade having a distal end portion and a base portion, the base portion of each blade pivotally coupled to the elongated central body, c) a shaft having a longitudinal axis, wherein the shaft is advanceable within the throughbore and rotatable about the longitudinal axis, the shaft having a distal end forming a pusher having an acicular transverse cross-section, d) upper and lower endplates respectively detachably connected to the distal end portion of a respective blade.

A personalized intervertebral disc replacement for a subject includes a first element adapted to contact a first vertebra in the spine of the subject, a second element adapted to contact a second vertebra adjacent to the first vertebra in the spine of the subject, and a set of links coupling the first and second elements, the links arranged as a passive parallel mechanism, each of the links having a predetermined stiffness and length, and at least some of the links being oriented obliquely to a direction perpendicular to either of the first and second elements.

An expandable interbody spacer for placement between adjacent vertebrae having two or more upper and lower endplates and lateral expansion wedges configured to couple a drive means to expand both a height and a width of the expandable interbody spacer from a collapsed state to an expanded state.

A method includes tracking one or more of a plurality of vertebrae of a patient, planning a planned alignment of the plurality of vertebrae, creating an implant placement plan based on the planned alignment, and robotically preparing the plurality of vertebrae to receive an implant in accordance with the implant placement plan.

Methods for growing spinal implants in situ using a surgical additive-manufacturing system. In one aspect, the method includes positioning a dispenser at least partially within an interbody space, between a first patient vertebra and a second patient vertebra. The method includes maneuvering the dispensing component within the space to deposit printing material forming an interbody implant part, positioning the dispensing component adjacent the vertebrae, and maneuvering the dispenser adjacent the vertebrae to deposit printing material on an exterior surface of each vertebrae and in contact with the interbody implant part forming an extrabody implant part connected to the interbody implant part and vertebrae, yielding the spinal implant grown in situ connecting the first vertebra to the second vertebra. The extrabody part can be printed around anchors affixed to the vertebrae, and the anchors may be printed in the process.

A device for performing intervertebral body fusion between at a vertebral joint, and associated systems and methods for manufacturing the device are disclosed herein. In some embodiments, the device includes an expandable main body configured to be locked in a desired configuration between a superior and an inferior vertebrae at the vertebral joint to facilitate the intervertebral body fusion at the vertebral joint. A first endplate is connected to the main body. The first endplate can include a superior surface having one or more patient-specific features configured to engage and mate with an inferior surface of the superior vertebra. A second endplate is connected to the main body. The second endplate can include an inferior surface having one or more patient-specific features configured to engage and mate with a superior surface of the inferior vertebra.

Implants for vertebral body or functional spinal unit replacement comprise a bioactive surface roughening on one or more of the anterior, posterior, and lateral surfaces of the implant. The bioactive surface includes macro-, micro-, and nano-scale structural features that contact vertebral bone that lines a specialized channel in a vertebrae, and thereby facilitate bone growth and osteointegration of the implant with the vertebral bone.

The present disclosure describes an intervertebral disk replacement system. The system can include a tissue-engineered intervertebral disc that is combined with a bioresorbable stabilization system for structural guidance. The system can prevent or reduce intervertebral disk implant displacement and can increase the stiffness when compared to the implantation of the intervertebral disk implant without the stabilization system.

A prosthetic disc can take the form of a sensing artificial disc that includes a resilient core and at least one sensor configured to sense one or more conditions within and/or experienced by the disc. The sensing artificial disc can serve as a replacement to a failed or injured disc between two vertebrae of a spine. The sensing artificial disc can include at least one element configured to change a condition or property of the resilient core in response to a condition sensed by the at least one sensor. A prosthetic disc can include therapeutic system configured to deliver medication to the body, which can include a reservoir of medication.