1. A method of loosening ingrown bone from an intervertebral implant using an ultrasonic instrument having a self tapping connector, the method comprising:
surgically accessing the intervertebral implant, wherein the intervertebral implant includes first and second endplate assemblies, and wherein the first endplate assembly includes an unthreaded aperture;
tapping the unthreaded aperture of the first endplate assembly with the self-tapping connector;
passing an ultrasonic energy through the self tapping connector to the first endplate assembly; and
ultrasonically vibrating the first endplate assembly to break a first portion of the ingrown bone from the intervertebral implant.
2. The method of claim 1 further comprising:
passing the ultrasonic energy through first endplate assembly to the second endplate assembly, wherein the first endplate assembly is movable with respect to the second endplate assembly in at least one degree of freedom.
3. The method of claim 1 wherein the second endplate assembly includes an unthreaded aperture, the method further comprising:
tapping the unthreaded aperture of the second endplate assembly with the self-tapping connector;
passing the ultrasonic energy through the self tapping connector to the second endplate assembly;
ultrasonically vibrating the second vertebral assembly to break a second portion of the ingrown bone from the intervertebral implant.
4. The method of claim 1 wherein the ultrasonic energy has a frequency of at least 30 kilohertz.
5. The method of claim 1 wherein surgically accessing the intervertebral implant includes surgically accessing an anterior portion of the intervertebral implant.
6. The method of claim 1 further comprising:
removing the intervertebral implant from between a pair of vertebral bodies.
7. The method of claim 1 wherein the intervertebral implant is an intervertebral motion preserving disc replacement.
8. The method of claim 1 wherein the intervertebral implant is a fusion implant.
9. A method of separating a vertebral implant from a pair of adjacent vertebral bodies, the method comprising:
ultrasonically agitating a revision instrument;
ultrasonically agitating the adjacent vertebral bodies;
breaking up a layer of bone ingrowth extending between the vertebral bodies and the vertebral implant; and
separating the vertebral implant from the adjacent bone.
10. The method of claim 9 further comprising:
coupling the revision instrument to an endplate assembly of the vertebral implant; and
introducing an ultrasonic vibratory motion from the revision instrument to the vertebral implant.
11. The method of claim 10 wherein the revision instrument is coupled to a cobalt-chromium alloy endplate assembly of the vertebral implant.
12. The method of claim 10 wherein the revision instrument is coupled to a titanium alloy endplate assembly of the vertebral implant.
13. The method of claim 10 wherein the revision instrument is coupled to a stainless steel alloy endplate assembly of the vertebral implant.
14. The method of claim 10 wherein coupling the revision instrument to the vertebral implant includes self-tapping the revision instrument to an unthreaded through bore in the endplate assembly of the vertebral implant.
15. The method of claim 10 wherein coupling the revision instrument to the vertebral implant includes hooking the revision instrument to the endplate assembly of the vertebral implant.
16. The method of claim 10 wherein coupling the revision instrument to the vertebral implant includes clamping the revision instrument to the endplate assembly of the vertebral implant.
17. The method of claim 9 further comprising:
locating an interface between the vertebral implant and the adjacent vertebral bodies;
positioning the revision instrument at the interface between the vertebral implant and the adjacent vertebral bodies; and
introducing an ultrasonic vibratory motion to the interface to break up the layer of bone ingrowth.
18. The method of claim 17 wherein the revision instrument includes a straight osteotome.
19. The method of claim 17 wherein the revision instrument includes a curved osteotome.
20. The method of claim 17 wherein the revision instrument includes a file.
21. The method of claim 9 further comprising projecting a lavage fluid from the revision instrument.
22. An implant revision instrument for loosening a bony interface between a vertebral implant and an adjacent vertebral body, the instrument comprising:
an ultrasonic actuator;
an implant engagement portion driven by the ultrasonic actuator and adapted for self-tapping an unthreaded aperture in the vertebral implant,
wherein the ultrasonic actuator creates ultrasonic motion in the implant engagement portion for deteriorating the bony interface and loosening of the vertebral implant.
23. The implant revision instrument of claim 22 wherein the ultrasonic actuator is a transducer.
24. The implant revision instrument of claim 22 further comprising a power supply device for powering the ultrasonic actuator.
25. A revisable intervertebral implant comprising:
an exterior surface adapted for promoting adhesion to bone and
an instrument coupling portion including an unthreaded aperture adapted for receiving a self-tapping ultrasonic revision instrument,
wherein an ultrasonic vibration received from the ultrasonic revision instrument through the instrument coupling portion loosens the adhesion between the exterior surface and the bone.
26. The revisable intervertebral implant of claim 25 wherein the exterior surface includes a roughened surface texture for promoting bone ingrowth.
27. The revisable intervertebral implant of claim 25 wherein the exterior surface includes a smooth surface.
28. The revisable intervertebral implant of claim 25 wherein the exterior surface is coated with osteoconductive or osteoinductive material.
29. The revisable intervertebral implant of claim 25 wherein the instrument coupling portion is formed from a cobalt-chromium alloy.
30. The revisable intervertebral implant of claim 25 wherein the instrument coupling portion is formed from a titanium alloy.
31. The revisable intervertebral implant of claim 25 wherein the instrument coupling portion is formed from a stainless steel alloy.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
What is claimed is:
1. A medical monitoring system comprising:
a sensor unit configured to sense one or more physiological characteristics of a patient;
a monitoring unit in communication with the sensor unit and operable to communicate information relating to the sensed physiological characteristics to a central unit; and
a plurality of communications channels operable to communicate between the monitoring unit and the central unit, the monitoring unit operable to specify for transmission a data set that is tailored to a particular communications channel to be used to communicate the information relating to the sensed physiological characteristics to the central unit.
2. The system of claim 1 wherein the tailored data set for transmission comprises a subset of a full data set.
3. The system of claim 1 wherein the tailored data set for transmission comprises information derived from a data set.
4. The system of claim 1 wherein the monitoring unit is further operable to select a communications channel from among the plurality of communications channel.
5. The system of claim 4 wherein the monitoring unit selects the communication channel based on one or more predetermined criteria.
6. The system of claim 5 wherein the predetermined criteria include one or more of the communications channels’ relative availability, bandwidth, quality, latency, cost and reliability.
7. The system of claim 4 wherein the tailored data set comprises a data set that is adapted according to one or more parameters of the selected communications channel.
8. The system of claim 1 wherein the plurality of communications channels include one or both of wired and wireless communications channels.
9. The system of claim 1 wherein the plurality of communications channels include one or more of a land-line telephone network, a cellular telephone network, a paging network and a packet-switched data network.
10. A method of controlling a portable medical monitoring unit, the method comprising:
receiving sensor data from a sensor, the received sensor data representative of one or more physiological characteristics of a patient being monitored;
selecting a communications channel from among a plurality of potential communications channels;
specifying a data set for transmission to a central unit, the specified data set being adapted to the selected communications channel; and
transmitting the specified data set over the selected communications channel to the central unit.
11. The method of claim 10 wherein selecting the communications channel from among the plurality of potential communications channels is based on one or more predetermined criteria.
12. The method of claim 11 wherein the predetermined criteria include one or more of the communications channels’ relative availability, bandwidth, quality, latency, cost and reliability.
13. The method of claim 10 wherein specifying the data set for transmission to the central unit comprises adapting the data set according to one or more parameters of the selected communications channel.
14. The method of claim 10 wherein the specified data set for transmission comprises a subset of a full data set.
15. The method of claim 10 wherein the specified data set for transmission comprises information derived from a data set.
16. The method of claim 10 wherein the plurality of communications channels include one or both of wired and wireless communications channels.
17. The method of claim 10 wherein the plurality of communications channels include one or more of a land-line telephone network, a cellular telephone network, a paging network and a packet-switched data network.