Bi-directional fixating transvertebral body screws and posterior cervical and lumbar interarticulating joint calibrated stapling devices for spinal fusion

A zero-profile, intervertebral cage sized and configured to be inserted into a disc space between adjacent vertebral bodies and to provide fusion of the adjacent vertebral bodies via biological bone fusion and screw fusion,

• the intervertebral cage comprising:
• a top wall;
• a bottom wall opposite the top wall;
• a first sidewall;
• a second sidewall opposite the first sidewall, each of the first sidewall and the second sidewall having a surface configured to contact one of the adjacent vertebral bodies when the intervertebral cage is inserted into the disc space,
• wherein at least the first sidewall and the second sidewall bound an open space capable of receiving bone filling for the biological bone fusion,
• wherein the top wall includes a top surface and a bottom surface opposite the top surface, the top surface configured to have a zero-profile with respect to the adjacent vertebral bodies when the intervertebral cage is inserted into the disc space, and the bottom surface facing the open space;
• and
• an internal screw trajectory guide for guiding a trajectory of a screw through the intervertebral cage, the internal screw trajectory guide having an entry opening and an exit opening, the entry opening formed at least partially in the top surface of the top wall, and the exit opening formed at least partially in a bottom surface of the top wall and at least partially in a side surface of the top wall, wherein a width of the top surface of the top wall is greater than a width of the bottom surface of the top wall, and wherein a perimeter of the entry opening does not extend beyond the width of the top surface of the top wall and a perimeter of the exit opening extends beyond the width of the bottom surface of the top wall.

An intervertebral combination internal screw guide and fixation apparatus configured to be inserted into a disc space between a first vertebral body and a second vertebral body and to provide fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, the apparatus comprising:

• an intervertebral spacer including a top wall, a bottom wall, and first and second sidewalls, wherein the intervertebral spacer defines:
• an open space between the top, bottom, first, and second sidewalls capable of receiving bone filling for biological bone fusion,
• a first slot on a first outer side of the first sidewall,
• a second slot on a second outer side of the second sidewall of the two sidewalls, wherein the second slot is positioned opposite of the first slot, wherein the first slot is positioned along a first centerline axis that bisects the first side wall and wherein the second slot is positioned along a second centerline axis that bisects the second side wall,
• an indentation in the top surface of the top wall,
• a first internal screw guide having a first entry opening and a first exit opening, the first entry opening of the first internal screw guide formed at least partially in a top surface of the top wall and the first exit opening formed at least partially in a bottom surface of the top wall and at least partially in a first side surface of the top wall,
• a second internal screw guide having a second entry opening and a second exit opening, the second entry opening of the second internal screw guide formed at least partially in the top surface of the top wall and the second exit opening formed at least partially in the bottom surface of the top wall and at least partially in a second side surface of the top wall so as to extend in a direction different than that of the first internal screw guide, and
• a plurality of surface features patterned on the first and second side surfaces of the top wall near the top surface of the top wall, wherein at least some of the plurality of surface features are positioned on the first side surface closer to the top surface of the top wall than is the first exit opening and at least some of the plurality of surface features are positioned on the second side surface closer to the top surface than is the second exit opening,
• a first screw having a first screw head and a first threaded body that is sized and configured to be inserted through the first internal screw guide;
• and
• a second screw having a second screw head and a second threaded body that is sized and configured to be inserted through the second internal screw guide;
• a tool for manipulating and inserting the intervertebral spacer into the disc space between the first vertebral body and the second vertebral body to provide fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, the tool comprising:
• an elongate shaft;
• first and second gripper prongs positioned such that the first gripper prong engages the first slot of the intervertebral spacer and the second gripper prong engages the second slot of the intervertebral spacer when the tool engages the intervertebral spacer;
• and
• a tool screw guide for controlling direction of the first screw and the second screw when inserted into the first internal screw guide and the second internal screw guide of the intervertebral spacer, wherein the tool screw guide is positioned between the plurality of prongs with distal ends of the prongs extending distally past the tool screw guide.