An intervertebral spacing insert insertion tool for separating adjacent vertebrae and locating an intervertebral spacing insert within the adjacent vertebrae, the insertion tool includes an adjustable spacing arrangement configured for insertion between the adjacent vertebrae and for spacing the adjacent vertebrae apart to present an intervertebral space and a guide configured for guiding the intervertebral spacing insert into the intervertebral space.

A spacer for separating bones of a joint includes a frame and a carriage. The carriage has ramped surfaces, and is slideably moveable in relation to the frame. A screw support is moveably connected to the frame to form a changeable angular orientation with respect to the frame. An actuating screw is supported by the screw support, and is connected to the carriage to cause the carriage to slideably move in relation to the frame when the actuating screw is rotated. Opposing endplates are configured to engage opposing bone of the joint, and each has ramped surfaces mateable with the ramped surfaces of the carriage. When the carriage is moved by rotation of the actuating screw, the ramped surfaces of the carriage and the endplates slide against each other, causing the endplates to move relatively apart, to increase the height of the spacer.

Instrumentation for implanting a cervical disc replacement device includes cervical disc replacement trials for determining the appropriate size of replacement device to be implanted, an insertion plate for maintaining the elements of the replacement device in fixed relation to one another for simultaneous manipulation, an insertion handle for attachment to the insertion plate for manipulation of the elements, an insertion pusher for releasing the insertion handle from the insertion plate, a drill guide that cooperates with the insertion plate to guide the drilling of tap holes for bone screws to be placed through bone screw holes in the flanges of the replacement device, clips that are applied to the flanges after placement of the bone screws to resist screw backout, and a clip applicator for applying the clips to the flanges.

A method of inserting an intervertebral disc implant into a disc space includes accessing a spinal segment having a first vertebral body, a second vertebral body and a disc space between the first and second vertebral bodies. The method includes securing a first pin to the first vertebral body and a second pin to the second vertebral body, using the first and second pins for distracting the disc space, and providing an inserter holding the intervertebral disc implant. The method also desirably includes engaging the inserter with the first and second pins, and advancing the inserter toward the disc space for inserting the intervertebral disc implant into the disc space, whereby the first and second pins align and guide the inserter toward the disc space.

The present invention provides an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. In one embodiment, the fusion device includes body, a first endplate, and a second endplate, a middle ramp piece, a stem, and two ramp pins. The middle ramped piece is operable to move to generate lordotic expansion of the first and second endplates followed by parallel expansion. The fusion device is operable to be deployed down an endoscopic tube.

A central inflatable distractor and a perimeter balloon are inserted into the disc space in uninflated configurations. The central inflatable distractor is then expanded, thereby distracting the vertebral endplates to the controlled height of the central inflatable distractor. The perimeter balloon is then inflated with a curable substance. The perimeter balloon expands as it is filled with the curable substance and conforms to the void remaining in the disc space around the central inflatable distractor, thereby creating a horseshoe shape. Once the flowable material in the perimeter balloon has cured, the central inflated distractor can be deflated and removed. The remaining void (or inner space) is then packed with graft for fusion.

A method of delivering a medical device to a desired location at a surgical site includes the initial steps of providing a package including a hollow body that extends from a first opened end to a second opened end, and providing a medical device within the hollow body between the first opened end and the second opened end. The package is oriented such that the first opened end is disposed adjacent to a desired location at a surgical site. Lastly, the medical device is moved through the first opened end from the hollow body to the desired location.

An expandable, intervertebral spacer includes a top component and a base component in engagement with the top component, the base component defining at least one channel for receiving a hardening material, and placement of the hardening material within the channel causes the top component to move between a first position in which the top component is a first distance from the base component and a second position in which the top component is a second distance from the base component, the second distance being greater than the first distance. The hardening material can be removed from the channel by a flexible coring tool, and the top component forced toward the base component to collapse the spacer.

An intervertebral scaffolding system is provided having a laterovertically-expanding frame operable for a reversible collapse from an expanded state into a collapsed state, the laterovertically-expanding frame having a stabilizer that slidably engages with the distal region of the laterovertically-expanding frame and is configured for retaining the laterovertically-expanding frame from a lateral movement that exceeds the expanded state. The expanded state, for example, can be configured to have an open graft distribution window that at least substantially closes upon the reversible collapse.

Apparatus and associated methods relate to a spinal implant configured to expand both vertically and laterally at the same time when wedges coupled by a threaded post drive movable spinal implant endplates radially outward from the longitudinal axis of the threaded post, displacing the wedges and expanding the implant as the threaded post turns. In an illustrative example, the wedges may be a pair of wedges configured with dual inclined planes. The inclined planes may be, for example, disposed both vertically and laterally with respect to the threaded post longitudinal axis, permitting implant expansion both vertically and laterally simultaneously. In some examples, the wedges may be cones. Some embodiments may include a lock adapted to prevent the threaded post from turning. Various examples may advantageously provide improved stability and reduced subsidence, based on increased vertebral body contact area with an implant expanded in place to the desired height and width.