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 invention provides cervical implant (30) comprising an upper surface (38), a lower surface (40), a posterior portion (34) and an anterior portion (36) and including a perimeter (42) and one or more apertures (44,46) within said anterior portion for receiving securing means, said apertures having respective longitudinal axes M1, M2, characterised in that said axes extend in a direction substantially through said anterior portion (36) and converge at a point in a plane outside of said perimeter (42).

Methods for securing a intervertebral cage to one or more levels of the spine with fixation. The fixation, which is typically a staple, is intended to be driven perpendicular to the proximal face of the cage and in-line with the inserter. After the cage is placed and positioned according to surgeon preference, a single piece fixation clip is then deployed and fixed in a manner that produces a zero-profile device.

A spinal implant is provided including an upper surface, a lower surface, a front surface and a back surface, two side surfaces extending between the upper surface and the lower surface, the two side surfaces extending between the front surface and the back surface and an opening positioned closer to the back surface than the front surface. The opening is provided to contain graft material that spans between a cortical rim of the upper vertebral body and the cortical rim of the lower vertebral body. The method includes packing the opening with graft material, wherein the graft, material spans between the decorticated cortical rim of the upper vertebral body and the decorticated cortical rim of the lower vertebral body.

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 invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectively detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area. In one embodiment, the integrated fusion cage is an expandable integrated fusion cage. In another embodiment, the bone graft material is loaded into a breech area in the hollow tube.

The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine, and methods for using same. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectively detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area. In one embodiment, the integrated fusion cage is an expandable integrated fusion cage. In another embodiment, the bone graft material is loaded into a breech area in the hollow tube.

Methods and apparatus are disclosed for distracting tissue. The devices and methods may include insertion of first and second elongated members into the space between two tissue layers, with an augmenting elongated member at least partially inserted therebetween to form a distraction device between the tissues to be distracted. At least one of the first and second elongated members may be formed of a flexible core member with a plurality of rigid veneer members spaced along the length of the core member. At least one of the elongated members may include a shaping member that automatically moves from a generally linear configuration to a generally less linear configuration. A deployment catheter may include a deformable distal end to allow augmentation of the tissue distraction device during implantation. An injection aid may be provided for introducing a filler material into an interior defined by a deployed tissue distraction device.

A spine implant for a TLIF surgical procedure is configured to be guided into place during implantation in conjunction with a complementary insertion instrument. The cage of the implant is constrained to a limited range of rotation about a pivoting post carried by the cage. The insertion instrument is configured to hold the post while controllably rotating the cage relative to the post in order to angularly position the implant during implantation. Range of rotational motion is controlled by the configuration of an opening in and end of the cage and a groove in the pivot post. A retaining pin of the implant extends from the cage into the groove of the post to rotationally connect the cage to the post.

A surgical instrument assembly includes a support frame system, and a surgical tool engageable with the support frame system. The support frame system is adapted for providing a surgical tool attachment and articulation locus that is maintained during the course of a surgical procedure to direct a fixed and repeatable delivery path for introduction and manipulation of one or more surgical instruments and implants at a surgical site in or on the patient's anatomy. The delivery path can be substantially curvilinear along an arc that is defined by a radius of curvature and length defined by the surgical tool, and a predetermined range of articulation of the tool at the articulation locus.