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Orthopedic surgical instrument

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US3486505A
US3486505A US3486505DA US3486505A US 3486505 A US3486505 A US 3486505A US 3486505D A US3486505D A US 3486505DA US 3486505 A US3486505 A US 3486505A
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graft
bone
bodies
vertebral
tips
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Gordon M Morrison
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Gordon M Morrison
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • A61B2017/0256Joint distractors for the spine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4601Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2835Bone graft implants for filling a bony defect or an endoprosthesis cavity
    • A61F2002/2839Bone plugs or bone graft dowels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4622Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof having the shape of a forceps or a clamp
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4627Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4628Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping

Description

Dec. 30, 1969 a. M. MORRISON ORTHOPEDIC SURGICAL INSTRUMENT Filed May 22, 1967 uuummu INVENTOR.

GORDON M- MORRISON Wifdr/ AT TORNEY United States Patent 3,486,505 ORTHOPEDIC SURGICAL INSTRUMENT Gordon M. Morrison, 77 N. San Mateo Drive, San ,Mateo, Calif. 94401 Filed May 22, 1967, Ser. No. 640,272 Int. Cl. A61b 17/00, 17/18; A61m 29/00 US. Cl. 128--303 4 Claims ABSTRACT OF THE DISCLOSURE An instrument to distract (separate) two closely adjacent objects (as bodies of the vertebrae) and at the same time inserting an object (as a bone graft) between the distracted objects. The instrument acts as a protective guide and channel to the inserted object ,(as in inserting a bone graft between adjacent vertebral bodies) and at the same time acting as a protective retractor to adjacent soft tissues. The depth of insertion is controlled.

BACKGROUND OF THE INVENTION At the present time, it is common practice for orthopedic surgeons to apply a sling around a patients neck and then draw the sling so as to distract or separate adjacent vertebral bodies; and while the patient is under such traction, a bone graft is actually hammered into a final position between the distracted vertebral bodies, and the implanted bone graft will unite the adjacent vertebral bodies.

SUMMARY An object of this invention is to provide an orthopedic surgical instrument that may be readily used to distract two closely adjacent vertebral bodies and at the same time inserting a bone graft therebetween, with the depth of insertion being controlled, and obviating the need of hammering the bone graft in place. Moreover, the instrument is so designed as to act as a protective guide and channel to the inserted bone graft and serving as a protective retractor to adjacent soft tissue of an incision that is made in the patient to expose the vertebral bodies to be repaired.

BRIEF DESCRIPTION OF THE DRAWING For a better understanding of the invention, reference should be had to the accompanying drawing, forming part of this specification, in which:

FIG. 1 is a side elevational view of my orthopedic surgical instrument with the tips thereof disposed in proximate relationship with respect to each other;

FIG. 2 is another elevational view disclosing the instrument being used to insert a bone graft between two distracted adjacent vertebral bodies;

FIG. 3 is a further elevational view of the instrument with part of a lateral guide broken away and a sliding block being shown in section;

FIG. 4 is a top plan view of the orthopedic surgical instrument; and

FIG. 5 is a transverse sectional view taken along the vertical plane 5-5 of FIG. 3.

While I have shown only the preferred embodiment of my invention, it should be understood that various changes, or modifications, may be made within the scope of the appended claims without departing from the spirit of the invention.

DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to the drawing in detail, it will be noted that a fragmentary portion of a patients spinal column has been shown in FIG. 2. It is well known that such a Patented Dec. 30, 1969 spinal column is composed of an articulated series of vertebrae connected by ligaments and separated by elastic intervertebral fibrocartilages. In this view of the drawing, two adjacent vertebral bodies A that are normally disposed in closely adjacent relation have been distracted (separated) by my orthopedic surgical instrument B, with a bone graft C being inserted between these distracted vertebral bodies so that the latter may be fused or united together.

The orthopedic surgical instrument B is provided with a supporting frame 10 having a pair of arms 11 mounted for movement toward and away from one another, the arms extending generally lengthwise with respect to each other, each arm being provided with a tip 12 at its forward end, the tips being movable into proximate (close) relationship relative to one another (see FIG. 1) so that they may be inserted between closely adjacent vertebral bodies A. The arms 11 define a channel 13 into which the bone graft C may be placed, with the tips 12 in contact with one another, as in FIG. 1.

A sliding block 14 is disposed between the arms 11 and is anchored to the forward end of a threaded rod 15 in a position to engage with and advance the bone graft C between and forwardly of the tips 12. As this block is advanced from the position disclosed in FIG. 1 to the position shown in FIG. 2, the arms 11 and their tips 12 will be spread apart by the advancing block, resulting in distracting the adjacent vertebral bodies A to provide sufiicient space therebetween for reception of the bone graft C, and at the same time advancing the bone graft into a final position between the distracted vertebral bodies A. The arms 11 and tips 12 are located to engage with and guide the -bone graft C forwardly to its final position.

Moreover, the supporting frame is U-shaped and is made from resilient material, with the arms 11 and their tips 12 being biased toward one another so as to yieldingly maintain contact with the bone graft C as the latter is advanced between and projects beyond the tips.

A pair of spaced lateral guides 16 are provided on opposite sides of the supporting frame, and have been shown as being welded to the lowermost arm. These guides are located to hold the bone graft C between the arms 11 as the bone graft is advanced, the later-a1 guides and arms acting as a protective retractor to adjacent soft tissues of an incision made in the patient to reach and expose the vertebral bodies A. These lateral guides define forward ends that are located to engage with one of the vertebral bodies A to limit or control insertion of the tips 12 between the vertebral bodies (see FIG. 2), thereby preventing damage to the spinal cord.

It will be seen that a handle 17 is provided on the supporting frame 10 that may be grasped by a surgeon to hold the instrument in place.

The rod 15 previously mentioned is threaded through the handle 17 and has its forward section projecting into the channel 13 between the arms 11, the rod being advanced toward the tips 12 when the rod is turned in one direction and retracted relative to the tips when the rod is turned in the opposite direction. The sliding block 14 may be anchored to the forward end of the rod 15 by set-screws 18 that extend into an annular groove 19 formed in the rod (see FIGS. 3 and 4), with the rod being free to rotate relative to the block 14. Cross-bar 20 may be used to rotate the rod 15 and forward movement of the rod is limited by adjustable nuts 21 on the rod, thereby limiting insertion of the bone graft between the distracted vertebral bodies.

It will be apparent from FIGS. 4 and 5 that the lateral guides 16 are welded to the lower arm 11 (or otherwise secured thereto), and that the upper arm 11 will pass between these guides as the tips 12 are moved into proximate relationship (see FIG. 1). Also, the lateral-guides act as a gauge to the width of the implanted objected (as a bone graft).

Although I have described my instrument in detail with respect to orthopedic surgery, it may be used in other applications Where it is desired to distract (separate) closely adjacent objects and move an insertable object into a final position between the distracted objects.

I claim:

1. In an orthopedic surgical instrument:

(a) a supporting frame having a pair of arms mounted for movement toward and away from one another, the arms extending generally lengthwise with respect to each other, each arm being provided with a tip at its forward end, the tips being movable into proximate relationship relative to one another so that they may be inserted between closely adjacent vertebral bodies;

(b) the arms defining a channel therebetween into which a bone graft may be inserted;

(0) operating means actuatable to spread the tips apart so as to distract said adjacent vertebral bodies to provide suificient space therebetween for reception of the bone graft, and at the same time advancing the bone graft into a final position between the distracted vertebral bodies, the arms and tips being located to engage with and guide the bone graft forwardly to its final position;

(d) a pair of spaced lateral guides provided on opposite sides of the supporting frame and located to hold the bone graft between the arms as the bone graft is advanced, the lateral guides and arms acting as a protective retractor to adjacent soft tissues of an incision made in the patient to reach said vertebral bodies;

(e) the lateral guides defining forward ends that are located to engage with one of said vertebral bodies to limit insertion of the tips between the vertebral bodies;

(f) and the lateral guides being secured to one of the arms and disposed so that the other arm will pass between these guides as the tips are moved into proximate relationship.

2. The orthopedic surgical instrument, as set forth in claim 1;

(g) and in which the supporting frame is made from resilient material, with the arms and their tips being biased toward one another so as to yieldingly maintain contact with the bone graft as the latter is advanced between and projects beyond the tips.

3. The othopcdic surgical instrument, as set forth in claim 1;

(g) and in which adjustable means are provided to limit the depth of insertion of the bone graft between said distracted vertebral bodies.

4. The orthopedic surgical instrument, as set forth in claim 1;

(g) and in which a handle is provided on the supporting frame that may be grasped by a surgeon to hold the instrument in place;

(h) the operating means comprising:

(1) a rod threaded through the handle and having a forwarded section projecting into the space between-the arms, the rod being advanced toward the tips when the rod is turned in one direction and retracted relative to the tips when the rod is turned in the opposite direction;

(2) and a sliding block disposed between the arms and being anchored to the forward end of the rod in a position to engage with and advance the bone graft between and forwardly of the tips with sufficient force to insert the bone graft into its final position between the distracted vertebral bodies.

References Cited UNITED STATES PATENTS 242,443 6/1881 Foote 128-345 1,331,737 2/1920 Ylisto l28345 2,435,531 2/1948 Carmichael l28-345 3,136,040 6/1964 Bauer et al. l28354 X RICHARD C. PINKHAM, Primary Examiner RICHARD J. APLEY, Assistant Examiner US. Cl. X.R.

US3486505A 1967-05-22 1967-05-22 Orthopedic surgical instrument Expired - Lifetime US3486505A (en)

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Cited By (337)

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US3628535A (en) * 1969-11-12 1971-12-21 Nibot Corp Surgical instrument for implanting a prosthetic heart valve or the like
US3875595A (en) * 1974-04-15 1975-04-08 Edward C Froning Intervertebral disc prosthesis and instruments for locating same
EP0077159A1 (en) * 1981-10-14 1983-04-20 Brian Norman Atkins Vertebrae spreader
US4566466A (en) * 1984-04-16 1986-01-28 Ripple Dale B Surgical instrument
FR2570594A1 (en) * 1984-09-26 1986-03-28 Kehr Pierre Spinal prosthesis, particularly for cervical vertebrae
EP0269935A2 (en) * 1986-12-05 1988-06-08 ESKA medical GmbH & Co. Expander forcep for the vertabra
EP0333990A2 (en) * 1988-03-23 1989-09-27 Waldemar Link (GmbH & Co.) Surgical instrument set
US5059194A (en) * 1990-02-12 1991-10-22 Michelson Gary K Cervical distractor
US5163939A (en) * 1991-06-27 1992-11-17 Frederick Winston Disk flow and methods therefor
US5167223A (en) * 1989-09-08 1992-12-01 Tibor Koros Heart valve retractor and sternum spreader surgical instrument
EP0641547A2 (en) * 1993-08-26 1995-03-08 MAN Ceramics GmbH Vertebral fusion
WO1995008306A1 (en) * 1993-09-21 1995-03-30 Synthes Ag, Chur Implant for the intervertebral space
US5431658A (en) * 1994-02-14 1995-07-11 Moskovich; Ronald Facilitator for vertebrae grafts and prostheses
BE1007546A3 (en) * 1993-09-21 1995-08-01 Beckers Louis Francois Charles Dilator, series of dilators and equipment used with this
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US5653762A (en) * 1994-03-18 1997-08-05 Pisharodi; Madhavan Method of stabilizing adjacent vertebrae with rotating, lockable, middle-expanded intervertebral disk stabilizer
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US5772661A (en) * 1988-06-13 1998-06-30 Michelson; Gary Karlin Methods and instrumentation for the surgical correction of human thoracic and lumbar spinal disease from the antero-lateral aspect of the spine
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US5906616A (en) * 1994-09-15 1999-05-25 Surgical Dynamics, Inc. Conically shaped anterior fusion cage and method of implantation
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US6004326A (en) * 1997-09-10 1999-12-21 United States Surgical Method and instrumentation for implant insertion
US6063088A (en) * 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
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US6120502A (en) * 1988-06-13 2000-09-19 Michelson; Gary Karlin Apparatus and method for the delivery of electrical current for interbody spinal arthrodesis
US6123705A (en) * 1988-06-13 2000-09-26 Sdgi Holdings, Inc. Interbody spinal fusion implants
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US6152871A (en) * 1996-03-22 2000-11-28 Sdgi Holdings, Inc. Apparatus for percutaneous surgery
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US6245072B1 (en) 1995-03-27 2001-06-12 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6264655B1 (en) 1995-06-07 2001-07-24 Madhavan Pisharodi Cervical disk and spinal stabilizer
US6267763B1 (en) 1999-03-31 2001-07-31 Surgical Dynamics, Inc. Method and apparatus for spinal implant insertion
EP1153582A2 (en) * 2000-05-08 2001-11-14 DePuy Acromed, Inc. Medical installation tool
WO2001085033A2 (en) * 2000-05-05 2001-11-15 Osteotech, Inc. Intervertebral distractor and implant insertion instrument
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