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.

The present disclosure provides adjustable spinal devices, instruments for implanting the spinal devices, methods for adjusting the height and/or lordosis angles of the spinal devices and methods for implanting such devices. An adjustable spinal fusion device includes an upper plate having an outer surface for placement against a first vertebral body and a lower plate having an outer surface for placement against a second vertebral body. The device further includes a translation member configured to move longitudinally relative to the upper and lower plates to adjust an angle between the upper and lower plates. The translation member may include an angled surface or wedge for cooperating with a ramp on the device to pivot the proximal end of the upper endplate relative to the proximal end of the lower endplate and thereby adjust a distance between the distal ends of the endplates.

Disclosed are system and methods that use at least one non-threaded anchor and an implant with at least one aperture to join boney structures, where the interaction of the head of the anchor with the implant aperture causes the anchor to move transversely with respect to an initial trajectory. This movement causes compression or distraction of the boney structures which are coupled to the anchors.

Methods and systems are disclosed for accessing and treating the interior of the facet joint for vertebral distraction and immobilization. The systems include a number of tools that facilitate access to the facet joint, distraction of the articulating decortication of the articulating surfaces, and delivery of implants and agents into the facet joint for fusion.

An implant (100, 200, 300, 400) includes a base (10), and a sequence of at least two segments including a first segment (12) and a last segment (14). The first segment (12) is pivotally linked to base (10). Adjacent segments are interconnected at pivotal connections (18). A bolt (20) has a threaded shaft (22) and a head (24). The threaded shaft (22) is engaged in a threaded channel (26) of the base (10) so that rotation of the bolt (20) about a central axis of the threaded shaft (22) varies a degree of overlap between the base (10) and the bolt (20). The last segment (14) and the head (24) define therebetween a spherical bearing (28). Rotation of bolt (20) thus varies a distance between spherical hearing (28) and hinge pin (16), thereby causing deflection of the sequence of segments.

A two-piece medical instrument for installing an expandable interbody (intervertebral) spine implant via an endoscope, has a handle assembly and a shaft assembly configured for extension through the endoscope, the shaft assembly holding an expandable interbody spine implant when the shaft assembly is fully received by a head of the handle assembly, and releasing the spine implant upon retraction of the shaft assembly from the head of the handle assembly. The shaft assembly has a rod with a longitudinal bore and a sleeve situated on the rod that axially moves relative to the rod in response to the reception into and retraction from the handle assembly head, with the sleeve controlling capture and release of the implant by the rod. The distal end of the rod has a clamp formed by jaws that flex to capture and release the implant.

A cage holder includes an elongated body having a proximal end and a distal end, the elongated body extending from the proximal end to the distal end. The cage holder further includes means for transferring energy centrally from the proximal end to the distal end through the elongated body.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Implants and methods for augmentation of the disc space between two vertebral bodies to treat disease or abnormal pathology conditions in spinal applications. The implant includes a chain of biocompatible material suitable for insertion into a disc space between two adjacent vertebral bodies in a patient's spinal column, wherein the spinal disc space has a transverse plane. The chain comprises a plurality of adjacent bodies having a height configured to reside within the disc space between two adjacent vertebral bodies and a length configured to reside in the disc space between two adjacent vertebral bodies when the chain is curved in an orientation substantially along the transverse plane of the spinal disc 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.