A method of inserting a screw into a fusion cage, comprising the step of: i) attaching a screw head of a bone screw to a flexible bone screw driver comprising: a) a proximal handle, b) an intermediate shaft, c) a flexible distal end portion comprising a plurality of interlocking segments portion defining a periphery and a distal tip adapted to engage the screw head, and d) a flexible pre-bent sleeve that is configured to be placed radially over and around the plurality of interlocking segments to provide a loaded configuration,
wherein the plurality of interlocking segments portion is substantially straight in its unloaded configuration,
whereby the pre-bent sleeve pre-determines the trajectory of the tip in the loaded configuration, ii) inserting the bone screw into a threaded throughhole of a fusion cage comprising a front wall, a pair of opposing side walls, a back wall, and top and bottom surfaces adapted for gripping opposed vertebral endplates, wherein the front wall comprises the threaded throughhole.

In some embodiments, the present disclosure relates to a system that includes an insertion tool and a drill guide. The insertion tool includes a body with a distal portion and a distal end. The body has a first engagement feature extending longitudinally along the distal portion and two arms extending longitudinally from the distal end of the body. The drill guide includes two bores and an open faced channel therebetween. The open faced channel includes a second engagement feature slidably engageable with the first engagement feature on the body of the insertion tool. The two bores are adapted for the disposal of a fastener driver tool therethrough.

Various embodiments of intervertebral implants, anchoring devices for intervertebral implants, and implantation instrumentation are provided, along with various embodiments of methods for using one or more of the devices. Some embodiments of an anchoring device have a body comprising at least one curve and a rigid plate elongated along a longitudinal axis so that its front end enters at least one vertebra while its rear end remains in the passage of an implant. In some embodiments, the plate comprises at least one longitudinal slot separating at least one posterior portion of the plate into two branches, with at least one branch comprising at least one withdrawal stop configured to retain the device in the implant.

In some embodiments, the present disclosure relates to a system that includes an insertion tool and a drill guide. The insertion tool includes a body with a distal portion and a distal end. The body has a first engagement feature extending longitudinally along the distal portion and two arms extending longitudinally from the distal end of the body. The drill guide includes two bores and an open faced channel therebetween. The open faced channel includes a second engagement feature slidably engageable with the first engagement feature on the body of the insertion tool. The two bores are adapted for the disposal of a fastener driver tool therethrough.

An insertion assembly may include a flexible tool and a DTS guide configured to engage an intervertebral spacer having a fastener channel oriented at a first angle. The DTS guide may include a DTS guide channel oriented at the first angle which may be aligned with the fastener channel. The flexible tool may include a flexible shaft and a working member disposed at a distal end of the flexible shaft. The working member may be received through the DTS guide channel at the first angle. At least a portion of the flexible shaft adjacent the DTS guide member may flex while the working member is received through the DTS guide channel, such that a distal portion of the flexible shaft may be at a greater absolute angle relative to a DTS guide shaft than a proximal portion of the flexible shaft.

An insertion assembly may include a DTS guide and an inserter tool configured to couple an intervertebral spacer having a fastener channel configured to receive a fastener and a locking member channel with a first engagement feature. The inserter tool may include a second engagement feature configured to engage the first engagement feature and removably couple the inserter tool with the intervertebral spacer. The DTS guide may include a shaft lumen configured to receive the inserter tool and slidably couple with the inserter tool. The DTS guide may also include a DTS guide channel configured to receive the fastener and a DTS guide wing. The DTS guide wing may abut against a surface of the intervertebral spacer to align the DTS guide channel with the fastener channel and guide the fastener through the DTS guide channel and into the fastener channel.

A long-pitch, helical anchor (where long pitch is greater than length, itself greater than twice maximum diameter; and very long, extra-long, or hyper pitch exceeding several lengths of such anchor, typically at least 2 and usually 5 or 6) includes splines radially extending and helically progressing circumferentially around and axially along an elongate core. The center line or axis may be solid, all splines meeting near the center line. In other embodiments, the center line passes along the center of a lumen or channel of a hollow core, while the splines extend radially outward from, and axially along a length of the core. Installation may be from a posterior access or a lateral-posterior access, fixing two bones in two degrees of freedom, three degrees of freedom, or multiple anchors fixing the bones firmly in three degrees of freedom.

A bone fusing implant device includes an elongated body extending along a longitudinal direction. The elongated body includes a first segment having an outer surface with cortical threads, a second segment having an outer surface with cancellous threads, a top segment and a bottom segment. The first segment is adjacent to the second segment along the longitudinal direction and is configured to engage a cortical bone with the cortical threads and the second segment is configured to engage a cancellous bone with the cancellous threads. The elongated body has one or more elongated fusing gutters extending along the longitudinal direction on an outer surface of the elongated body covering the first and second segments, a central opening extending along the longitudinal direction through the elongated body's center and one or more through-openings that extend horizontally and intersect with the one or more fusing gutters.

Disclosed are biomedical implants made of disparate materials, such as intervertebral implants and related methods and instruments. In some embodiments, the implant may comprise a first material and a second material having distinct physical properties relative to the first material. The first material may optionally be intermixed with other materials.

A spinal implant for implantation within a spinal facet joint is provided. The spinal implant may include a main body including opposing top and bottom surfaces, opposing front or distal and rear or proximal surfaces, and opposing side surfaces. At least one retaining feature may be associated with at least one surface of the main body to frictionally engage the implant within the spinal facet joint. At least one securement feature may be associated with at least one surface of the main body to selectively secure the implant within the spinal facet joint.