公开(公告)号：USRE37005E

公开(公告)日：2000-12-26

申请号：US487040

申请日：2000-01-19

申请人： Gary K. Michelson ,  Lawrence M. Boyd ,  Thomas McGahan

发明人： Gary K. Michelson ,  Lawrence M. Boyd ,  Thomas McGahan

IPC分类号： A61B17/58 ,  A61B17/16 ,  A61B17/70 ,  A61F2/00 ,  A61F2/28 ,  A61F2/30 ,  A61F2/44 ,  A61F2/46 ,  A61B17/88

CPC分类号： A61B17/1671 ,  A61B17/1637 ,  A61B17/7032 ,  A61B17/7041 ,  A61F2/446 ,  A61F2/4611 ,  A61B17/7011 ,  A61F2/442 ,  A61F2/4455 ,  A61F2002/2835 ,  A61F2002/30224 ,  A61F2002/30235 ,  A61F2002/30785 ,  A61F2002/30787 ,  A61F2002/30797 ,  A61F2002/3085 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/449 ,  A61F2002/4619 ,  A61F2002/4627 ,  A61F2002/4681 ,  A61F2230/0069

摘要： A system and method for anterior fixation of the spine utilizes a cylindrical implant engaged in the intradiscal space at the cephalad and caudal ends of the construct. The implants are cylindrical fusion devices (10) filled with bone material to promote bone ingrowth and fusion of the disc space. An attachment member (40) is connected to each of the fusion devices (10) and a spinal rod (50) is connected to each of the attachment members using an eyebolt assembly (53, 54, 55). In a further inventive method, a revision of the construct is achieved by removing the fusion devices. Each fusion device is engaged by an elongated guide member (62) over which a cylindrical trephine (70) is advanced. The trephine (70) is used to extract a core (84) of bone material around the fusion implant, while the guide member (62) is used to remove the bone core (84) containing the fusion implant (10). In another aspect of the invention, a removal insert (90, 90') is provided that engages an implanted fusion device (10). The removal insert (90, 90') can be used to guide the trephine (70) around the fusion device, and is connected to a removal tool (100) once the bone core is created. The removal tool (100) includes a shaft (101) attached to the removal insert (90, 90'), and a slap hammer (104) slidably mounted on the shaft.

公开(公告)号：US06139551A

公开(公告)日：2000-10-31

申请号：US86931

申请日：1998-05-29

申请人： Gary K. Michelson ,  Lawrence M. Boyd ,  Thomas McGahan

发明人： Gary K. Michelson ,  Lawrence M. Boyd ,  Thomas McGahan

IPC分类号： A61B17/58 ,  A61B17/16 ,  A61B17/70 ,  A61F2/00 ,  A61F2/28 ,  A61F2/30 ,  A61F2/44 ,  A61F2/46 ,  A61B17/88

CPC分类号： A61B17/1671 ,  A61B17/1637 ,  A61B17/7032 ,  A61B17/7041 ,  A61F2/446 ,  A61F2/4611 ,  A61B17/7011 ,  A61F2/442 ,  A61F2/4455 ,  A61F2002/2835 ,  A61F2002/30224 ,  A61F2002/30235 ,  A61F2002/30785 ,  A61F2002/30787 ,  A61F2002/30797 ,  A61F2002/3085 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/449 ,  A61F2002/4619 ,  A61F2002/4627 ,  A61F2002/4681 ,  A61F2230/0069

摘要： A system and method for anterior fixation of the spine utilizes a cylindrical implant engaged in the intradiscal space at the cephalad and caudal ends of the construct. The implants are cylindrical fusion devices (10) filled with bone material to promote bone ingrowth and fusion of the disc space. An attachment member (40) is connected to each of the fusion devices (10) and a spinal rod (50) is connected to each of the attachment members using an eyebolt assembly (53, 54, 55). In a further inventive method, a revision of the construct is achieved by removing the fusion devices. Each fusion device is engaged by an elongated guide member (62) over which a cylindrical trephine (70) is advanced. The trephine (70) is used to extract a core (84) of bone material around the fusion implant, while the guide member (62) is used to remove the bone core (84) containing the fusion implant (10). In another aspect of the invention, a removal insert (90, 90') is provided that engages an implanted fusion device (10). The removal insert (90, 90') can be used to guide the trephine (70) around the fusion device, and is connected to a removal tool (100) once the bone core is created. The removal tool (100) includes a shaft (101) attached to the removal insert (90, 90'), and a slap hammer (104) slidably mounted on the shaft.

摘要翻译： 用于脊柱前固定的系统和方法利用啮合在椎间盘内空间中的圆柱形植入物在构造体的头端和尾端。 植入物是填充有骨材料的圆柱形融合装置（10），以促进椎间盘的向内生长和融合。 连接构件（40）连接到每个融合装置（10），并且使用吊环组件（53,54,55）将脊柱杆（50）连接到每个附接构件。 在另一发明的方法中，通过去除融合装置来实现构建体的修订。 每个融合装置由细长的引导构件（62）接合，圆柱形环钻（70）在该引导构件上前进。 所述环钻（70）用于在所述融合植入物周围提取骨材料的芯（84），同时所述引导构件（62）用于移除含有所述融合植入物（10）的骨芯（84）。 在本发明的另一方面，提供了一种与植入的融合装置（10）接合的移除插入件（90,90'）。 移除插入物（90,90'）可以用于引导围绕融合装置的环钻（70），并且一旦产生骨芯就连接到移除工具（100）。 拆卸工具（100）包括附接到移除插入件（90,90'）的轴（101）和可滑动地安装在轴上的敲击锤（104）。

公开(公告)号：US5797917A

公开(公告)日：1998-08-25

申请号：US799792

申请日：1997-02-12

申请人： Lawrence M. Boyd ,  Thomas McGahan

发明人： Lawrence M. Boyd ,  Thomas McGahan

IPC分类号： A61B17/58 ,  A61B17/16 ,  A61B17/70 ,  A61F2/00 ,  A61F2/28 ,  A61F2/30 ,  A61F2/44 ,  A61F2/46 ,  A61B17/88

CPC分类号： A61B17/1671 ,  A61B17/1637 ,  A61B17/7032 ,  A61B17/7041 ,  A61F2/446 ,  A61F2/4611 ,  A61B17/7011 ,  A61F2/442 ,  A61F2/4455 ,  A61F2002/2835 ,  A61F2002/30224 ,  A61F2002/30235 ,  A61F2002/30785 ,  A61F2002/30787 ,  A61F2002/30797 ,  A61F2002/3085 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/449 ,  A61F2002/4619 ,  A61F2002/4627 ,  A61F2002/4681 ,  A61F2230/0069

摘要： A system and method for anterior fixation of the spine utilizes a cylindrical implant engaged in the intradiscal space at the cephalad and caudal ends of the construct. The implants are cylindrical fusion devices (10) filled with bone material to promote bone ingrowth and fusion of the disc space. An attachment member (40) is connected to each of the fusion devices (10) and a spinal rod (50) is connected to each of the attachment members using an eyebolt assembly (53, 54, 55). In a further inventive method, a revision of the construct is achieved by removing the fusion devices. Each fusion device is engaged by an elongated guide member (62) over which a cylindrical trephine (70) is advanced. The trephine (70) is used to extract a core (84) of bone material around the fusion implant, while the guide member (62) is used to remove the bone core (84) containing the fusion implant (10). In another aspect of the invention, a removal insert (90, 90') is provided that engages an implanted fusion device (10). The removal insert (90, 90') can be used to guide the trephine (70) around the fusion device, and is connected to a removal tool (100) once the bone core is created. The removal tool (100) includes a shaft (101) attached to the removal insert (90, 90'), and a slap hammer (104) slidably mounted on the shaft.

公开(公告)号：US6096044A

公开(公告)日：2000-08-01

申请号：US111203

申请日：1998-07-07

申请人： Lawrence M. Boyd ,  Eddie Ray, III ,  Thomas McGahan

发明人： Lawrence M. Boyd ,  Eddie Ray, III ,  Thomas McGahan

IPC分类号： A61B17/56 ,  A61B17/00 ,  A61B17/17 ,  A61B17/28 ,  A61B17/34 ,  A61B18/14 ,  A61B19/00 ,  A61F2/28 ,  A61F2/30 ,  A61F2/44 ,  A61F2/46 ,  A61B17/58

CPC分类号： A61B18/1482 ,  A61B18/1402 ,  A61B18/1445 ,  A61B90/39 ,  A61F2/446 ,  A61B17/1757 ,  A61B17/3421 ,  A61B18/14 ,  A61B2017/00261 ,  A61B2017/00349 ,  A61B2017/2927 ,  A61B2017/3488 ,  A61B2090/3904 ,  A61B2090/3937 ,  A61F2/442 ,  A61F2002/2835 ,  A61F2002/30963 ,  A61F2002/4475 ,  A61F2002/448

摘要： A template assembly is provided for marking locations on the disc annulus for the implantation of an interbody fusion device or the introduction of a working instrument. The template assembly includes a tubular body sized for percutaneous introduction into a patient and advancement to an affected intervertebral disc. An elongated shaft slidably extends through the tubular body and is threadedly engaged to the handle-mounted thumb wheel so that rotation of the thumb wheel relative to the tubular body retracts the shaft through the body. A guide foot with a rotatable cam near the distal end of the tubular body is operable by the shaft and may be pivoted from a first position aligned with the tubular body to a second deployed position oriented transversely to the tubular body. The guide assembly has an electrocautery projection for marking locations on the disc annulus.

摘要翻译： 提供了一种模板组件，用于标记椎间盘环上的位置，用于植入体内融合装置或引入工作器械。 模板组件包括尺寸适于经皮引入患者体内并进入受影响的椎间盘的管状体。 细长轴可滑动地延伸穿过管状主体并且螺纹地接合到手柄安装的拇指轮，使得拇指轮相对于管状主体的旋转使轴穿过主体缩回。 具有靠近管状体的远端的可旋转凸轮的引导脚可由轴操作，并且可以从与管状体对准的第一位置枢转到横向于管状体定向的第二展开位置。 引导组件具有用于标记盘环上的位置的电灼突起。

公开(公告)号：US20060241626A1

公开(公告)日：2006-10-26

申请号：US11378929

申请日：2006-03-17

申请人： Thomas McGahan ,  Steven DeRidder ,  Eric Lange

发明人： Thomas McGahan ,  Steven DeRidder ,  Eric Lange

IPC分类号： A61B17/00

CPC分类号： A61B17/025 ,  A61B17/1604 ,  A61B17/1671 ,  A61B17/1757 ,  A61B2017/0256 ,  A61B2017/1602 ,  A61B2090/033 ,  A61B2090/062 ,  A61F2/442 ,  A61F2/4455 ,  A61F2/4611 ,  A61F2002/30113 ,  A61F2002/30772 ,  A61F2002/30828 ,  A61F2002/30879 ,  A61F2002/4475 ,  A61F2002/4627 ,  A61F2230/0006

摘要： A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

公开(公告)号：US07985258B2

公开(公告)日：2011-07-26

申请号：US12590739

申请日：2009-11-13

申请人： Thomas Zdeblick ,  Thomas McGahan

发明人： Thomas Zdeblick ,  Thomas McGahan

IPC分类号： A61F2/44

CPC分类号： A61B1/3132 ,  A61B1/3135 ,  A61B17/025 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/282 ,  A61B17/7059 ,  A61B17/86 ,  A61B2017/00238 ,  A61B2017/00261 ,  A61B2017/0256 ,  A61B2017/3488 ,  A61B2090/3904 ,  A61B2090/3937 ,  A61F2/442 ,  A61F2/446 ,  A61F2/4601 ,  A61F2/4611 ,  A61F2002/2835 ,  A61F2002/2839 ,  A61F2002/30123 ,  A61F2002/30153 ,  A61F2002/30179 ,  A61F2002/3021 ,  A61F2002/30217 ,  A61F2002/30329 ,  A61F2002/30433 ,  A61F2002/30507 ,  A61F2002/30604 ,  A61F2002/30774 ,  A61F2002/30777 ,  A61F2002/30785 ,  A61F2002/30787 ,  A61F2002/30789 ,  A61F2002/3082 ,  A61F2002/30858 ,  A61F2002/30863 ,  A61F2002/30871 ,  A61F2002/30874 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/4627 ,  A61F2002/4635 ,  A61F2220/0025 ,  A61F2220/0041 ,  A61F2230/0006 ,  A61F2230/0019 ,  A61F2230/0058 ,  A61F2230/0067

摘要： A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

摘要翻译： 提供了一种腹腔镜手术技术，用于制备用于植入新型融合装置或植入物的部位。 根据该技术的一个实施例，提供一种腹腔镜，其具有在一端具有分心指的外套筒以分散椎间盘空间。 腹腔镜为椎间盘空间提供了一个密封的工作通道，椎间盘空间被分散，椎骨终板和周围的椎间盘被延伸，并插入融合装置。 提供分心塞用于使外套定心，并用于提供椎间盘空间的中线分心。 在一个实施例中，融合装置包括穿过装置的端壁和上壁和下壁的分叉骨螺钉以接合相邻的椎骨。 在另一个实施例中，连接器板被接合以便双向地定位熔接装置以防止旋转并且阻止装置从盘片空间中排出。

公开(公告)号：US20060212120A1

公开(公告)日：2006-09-21

申请号：US11437392

申请日：2006-05-19

申请人： Thomas McGahan ,  Steven DeRidder ,  Dayna Buskirk ,  Eric Lange

发明人： Thomas McGahan ,  Steven DeRidder ,  Dayna Buskirk ,  Eric Lange

IPC分类号： A61F2/44 ,  A61F2/46 ,  A61B17/88

CPC分类号： A61F2/4465 ,  A61F2/28 ,  A61F2/442 ,  A61F2/4611 ,  A61F2002/2839 ,  A61F2002/3023 ,  A61F2002/30774 ,  A61F2002/30787 ,  A61F2002/30879 ,  A61F2002/30892 ,  A61F2002/30904 ,  A61F2002/4475 ,  A61F2002/4627 ,  A61F2230/0069 ,  A61F2310/00017 ,  A61F2310/00023 ,  A61F2310/00179 ,  A61F2310/00359

摘要： Instrument and implants are disclosed which provide for insertion of an implant into an intervertebral disc space from multiple approaches to the spine. Specifically, as a preferred aspect of the invention the implant includes a tapered portion and the implant may be inserted from multiple approaches to the spine with the orientation and taper properly oriented in the disc space regardless of the approach.

公开(公告)号：US20100125333A1

公开(公告)日：2010-05-20

申请号：US12590739

申请日：2009-11-13

申请人： Thomas Zdeblick ,  Thomas McGahan

发明人： Thomas Zdeblick ,  Thomas McGahan

IPC分类号： A61F2/44 ,  A61B17/56

CPC分类号： A61B1/3132 ,  A61B1/3135 ,  A61B17/025 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/282 ,  A61B17/7059 ,  A61B17/86 ,  A61B2017/00238 ,  A61B2017/00261 ,  A61B2017/0256 ,  A61B2017/3488 ,  A61B2090/3904 ,  A61B2090/3937 ,  A61F2/442 ,  A61F2/446 ,  A61F2/4601 ,  A61F2/4611 ,  A61F2002/2835 ,  A61F2002/2839 ,  A61F2002/30123 ,  A61F2002/30153 ,  A61F2002/30179 ,  A61F2002/3021 ,  A61F2002/30217 ,  A61F2002/30329 ,  A61F2002/30433 ,  A61F2002/30507 ,  A61F2002/30604 ,  A61F2002/30774 ,  A61F2002/30777 ,  A61F2002/30785 ,  A61F2002/30787 ,  A61F2002/30789 ,  A61F2002/3082 ,  A61F2002/30858 ,  A61F2002/30863 ,  A61F2002/30871 ,  A61F2002/30874 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/4627 ,  A61F2002/4635 ,  A61F2220/0025 ,  A61F2220/0041 ,  A61F2230/0006 ,  A61F2230/0019 ,  A61F2230/0058 ,  A61F2230/0067

摘要： A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

摘要翻译： 提供了一种腹腔镜手术技术，用于制备用于植入新型融合装置或植入物的部位。 根据该技术的一个实施例，提供一种腹腔镜，其具有在一端具有分心指的外套筒以分散椎间盘空间。 腹腔镜为椎间盘空间提供了一个密封的工作通道，椎间盘空间被分散，椎骨终板和周围的椎间盘被延伸，并插入融合装置。 提供分心塞用于使外套定心，并用于提供椎间盘空间的中线分心。 在一个实施例中，融合装置包括穿过装置的端壁和上壁和下壁的分叉骨螺钉以接合相邻的椎骨。 在另一个实施例中，连接器板被接合以便双向地定位熔接装置以防止旋转并且阻止装置从盘片空间中排出。

公开(公告)号：US20090043394A1

公开(公告)日：2009-02-12

申请号：US12287902

申请日：2008-10-15

申请人： Thomas Zdeblick ,  William F. McKay ,  Larry Boyd ,  Eddie Ray, III ,  Thomas McGahan

发明人： Thomas Zdeblick ,  William F. McKay ,  Larry Boyd ,  Eddie Ray, III ,  Thomas McGahan

IPC分类号： A61F2/44 ,  A61F2/28

CPC分类号： A61F2/4455 ,  A61B17/1671 ,  A61B17/8877 ,  A61B17/8891 ,  A61F2/30744 ,  A61F2/30767 ,  A61F2/442 ,  A61F2/446 ,  A61F2/4611 ,  A61F2/4637 ,  A61F2002/2835 ,  A61F2002/30136 ,  A61F2002/30143 ,  A61F2002/30153 ,  A61F2002/30158 ,  A61F2002/3021 ,  A61F2002/30217 ,  A61F2002/30504 ,  A61F2002/30774 ,  A61F2002/30777 ,  A61F2002/30785 ,  A61F2002/3082 ,  A61F2002/3085 ,  A61F2002/30858 ,  A61F2002/30874 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/4627 ,  A61F2002/464 ,  A61F2002/4641 ,  A61F2220/0025 ,  A61F2230/0004 ,  A61F2230/0017 ,  A61F2230/0019 ,  A61F2230/0026 ,  A61F2230/0067 ,  A61F2310/00017 ,  A61F2310/00023 ,  A61F2310/00095 ,  A61F2310/00131 ,  A61F2310/00161 ,  A61F2310/00179 ,  A61F2310/00796 ,  A61L27/227 ,  A61L31/047 ,  A61L2430/38

摘要： An interbody fusion device in one embodiment includes a tapered body defining a hollow interior or chamber for receiving bone graft or bone substitute material. The body defines exterior threads which are interrupted over portions of the outer surface of the device. The fusion device includes truncated side walls so that on end view the body takes on a cylindrical form. In another embodiment, the tapered body is solid and formed of a porous biocompatible material having sufficient structural integrity to maintain the intradiscal space and normal curvature. The material is preferably a porous tantalum composite having fully interconnected pores to facilitate complete bone tissue ingrowth into the implant. In further embodiments, the fusion devices are provided with osteogenic material to facilitate bone ingrowth. A cap is also provided to block the opening of hollow fusion devices. The cap includes an occlusion body and an elongated anchor. In some embodiments the anchor includes a lip which is engageable to openings in the body wall. Tools are also provided for manipulating caps for interbody fusion devices. In one embodiment the tool includes a pair of prongs each having facing engagement surfaces for engaging the fusion device, and a shaft slidably disposed between the prongs. The shaft has a first end defining a cap-engaging tip for engaging a tool hole in the cap. In one embodiment the cap engaging tip defines threads. In another embodiment the prongs include a pair of releasing members on each of the facing engagement surfaces. The releasing members have a height and a width for being insertable into apertures in a body wall in the fusion device to disengage the elongate anchors from the apertures.

摘要翻译： 在一个实施例中的体内融合装置包括限定用于接收骨移植物或骨替代材料的中空内部或室的锥体。 主体限定了在装置的外表面的部分上被中断的外螺纹。 融合装置包括截顶侧壁，使得在端部视图上，身体呈圆柱形。 在另一个实施例中，锥形体是固体的并由具有足够结构完整性的多孔生物相容性材料形成，以保持椎间盘内空间和正常曲率。 该材料优选是具有完全相互连通的孔的多孔钽复合材料，以促进完整的骨组织向植入物中向内生长。 在另外的实施方案中，融合装置设有成骨材料以促进骨向内生长。 还提供盖以阻挡中空融合装置的开口。 帽包括闭塞体和细长锚。 在一些实施例中，锚固件包括可与体壁中的开口接合的唇缘。 还提供了用于操纵用于体内融合装置的帽的工具。 在一个实施例中，工具包括一对插脚，每个插脚具有用于接合熔接装置的面对的接合表面，以及可滑动地设置在插脚之间的轴。 轴具有限定用于接合盖中的工具孔的帽接合末端的第一端。 在一个实施例中，帽接合尖端限定螺纹。 在另一个实施例中，尖头包括在每个相对的接合表面上的一对释放构件。 释放构件具有高度和宽度，用于可插入到融合装置中的体壁中的孔中，以使细长的锚定件与孔脱离。

公开(公告)号：US20050119753A1

公开(公告)日：2005-06-02

申请号：US11030459

申请日：2005-01-05

申请人： Thomas McGahan ,  Steven DeRidder ,  Dayna Buskirk ,  Eric Lange

发明人： Thomas McGahan ,  Steven DeRidder ,  Dayna Buskirk ,  Eric Lange

IPC分类号： A61B17/56 ,  A61F2/00 ,  A61F2/28 ,  A61F2/30 ,  A61F2/44 ,  A61F2/46

CPC分类号： A61F2/4465 ,  A61F2/28 ,  A61F2/442 ,  A61F2/4611 ,  A61F2002/2839 ,  A61F2002/3023 ,  A61F2002/30774 ,  A61F2002/30787 ,  A61F2002/30879 ,  A61F2002/30892 ,  A61F2002/30904 ,  A61F2002/4475 ,  A61F2002/4627 ,  A61F2230/0069 ,  A61F2310/00017 ,  A61F2310/00023 ,  A61F2310/00179 ,  A61F2310/00359

摘要： Instrument and implants are disclosed which provide for insertion of an implant into an intervertebral disc space from multiple approaches to the spine. Specifically, as a preferred aspect of the invention the implant includes a tapered portion and the implant may be inserted from multiple approaches to the spine with the orientation and taper properly oriented in the disc space regardless of the approach.

摘要翻译： 公开了提供将植入物插入椎间盘空间的多个方法到脊柱的仪器和植入物。 具体地，作为本发明的优选方面，植入物包括锥形部分，并且植入物可以从多个方式插入到脊柱，其方向和锥度适当地定向在椎间盘空间中，而不管接近。