A drill guide includes a working portion and a shaft, with a joint formed between the working portion and the shaft so that the shaft is movable relative to the working portion about the joint. The working portion includes at least one drill guide hole which receives a drill for making a hole in a bone. The joint isolates the working portion from unintentional movements of the shaft so that the working portion remains stable against a bone surface. The joint also enables the shaft to be used as a retractor or pry bar against surrounding anatomical structures if desired. The drill guide may be included in a system with an implant component and/or other surgical instruments.

In some aspects, the present invention is a medical implant with an independent endplate structure that can stimulate bone or tissue growth in or around the implant. When used as a scaffold for bone growth, the inventive structure can increase the strength of new bone growth. The independent endplate structures generally include implants with endplates positioned on opposite sides of the implant and capable of movement independent of one another. In most examples, the endplates have a higher elastic modulus than that of the bulk of the implant to allow the use of an implant with a low elastic modulus, without risk of damage from the patient's bone.

A method of designing independent endplate implants is also disclosed, including ranges of elastic moduli for the endplates and bulk of the implant for given implant parameters. Implants with elastic moduli within the ranges disclosed herein can optimize the loading of new bone growth to provide increased bone strength.

The variable or adjustable depth medical implants in this application are capable of depth adjustment prior to implantation. The variable depth implants permit a single implant to provide multiple footprint configurations, allowing a surgeon footprint adjustability in the operating room. The implants can comprise a metallic lattice designed for specific physical properties, such as an elastic modulus. In some examples, the main body of the implant is taller than the adjustable portion of the implant (also referred to as the second implant body) so that the physical properties of the main body of the implant are controlling at the implant site. In some embodiments, the variable implant is constructed in an additive process as a single unit.

Intervertebral disc prostheses and methods of use. An intervertebral disc prosthesis for installation in a spinal column may include a first intervertebral plate, a second intervertebral plate, and a removable insert core. The first intervertebral plate may engage one or both of the inferior vertebral endplate and the inferior ring apophysis of a superior vertebral body. The second intervertebral plate may engage one or both of the superior vertebral endplate and the superior ring apophysis of an inferior vertebral body. The removable insert core is located between and engages the intervertebral plates. A projection projects from one of the intervertebral plates toward the other intervertebral plate. The removable insert core at least partially surrounds the projection when installed. The removable insert core is removable from between the intervertebral plates and from around the projection while the intervertebral plates and projection remain installed.

A method of resurfacing a facet joint with a facet implant system. The facet joint includes a superior facet and an inferior facet that are adjacent to each other and movable with respect to each other. A first facet implant component is provided that has a first visualization marker. The first visualization marker includes a first marker section and a second marker section. The first marker section is oriented at an angle with respect to the second marker section. The first facet implant component between the superior facet and the inferior facet. A location and an orientation of the first facet implant component are determined using an imaging technique that locates the first visualization marker.

A surgical implant system includes a surgical implant for securing adjacent vertebrae of a spine to each other. The surgical implant includes a spacer having at least one implant eyelet. The surgical implant system also includes at least one vertebral anchor configured for insertion through the at least one implant eyelet to fasten the surgical implant to the spine. The vertebral anchor has a tip portion, a head portion, an elongate shank extending from the head portion, and an elongate fin extending from the head portion and along a surface of the elongate shank. The elongate shank and the elongate fin form a generally t-shaped cross-section.

A device and methods for intervertebral spinal fusion of adjacent intervertebral bodies. An intervertebral spacer is positioned within a narrow disc space between adjacent intervertebral bodies of a patient. The spacer is arranged with upper and lower guides. The guides are adapted to simultaneously guide the deployment of upper and lower anchors of an anchoring device into their respective intervertebral bodies. The spacer is also adapted to lock the upper and lower anchors to the spacer in the deployed position.

Methods and systems for treating a spinal joint with a facet joint replacement. The prosthesis can include a first component having a first articulating surface and a second component having a second articulating surface. The first component is attached to a superior articulating facet and the second component is attached to an inferior articulating facet. The first articulating surface and the second articulating surface articulate with each other and allow for multiple degrees of movement of the facet joint without fusing the joint.

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.

An intervertebral cage with an outer frame, an open inner core region and a porosity gradient within the outer frame is provided. The outer frame includes a posterior wall, an anterior wall, a pair of side walls extending between the posterior wall and the anterior wall and the porosity gradient may comprise at least one of: a decreasing average pore diameter in a direction from an outer surface to an inner surface of at least one of the pair of side walls; an increasing average pore diameter in a direction from an outer surface to an inner surface of at least one of the pair of side walls; a decreasing average pore diameter in a direction from an upper surface to a lower surface of at least one of the side walls; and an increasing average pore diameter in a direction from an upper surface to a lower surface of at least one of the side walls.