Abstract:
A spacer for use in spine fusion surgical procedures is disclosed. The spacer includes an enclosure having a wall that is configured to enclose a hollow interior. The wall is further configured to include a plurality of openings spaced throughout the wall. The openings are configured to connect an exterior of the enclosure to the hollow interior. The enclosure further includes an indication cutting line configured to allow adjustment of a height of the enclosure.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    The present application claims priority to U.S. Provisional Patent Application No. 60/846,474 to Murillo et al., filed Sep. 22, 2006, entitled “Titanium Mesh Vertebral Body Replacement”, and incorporates its disclosure herein by reference in its entirety. 
     
     BACKGROUND OF THE INVENTION 
       [0002]    1. Field of the Invention 
         [0003]    The present invention is directed to systems, methods, and devices applicable to spinal surgery. More specifically, the present invention relates to spine fusion procedures. Specifically, the present invention relates to a vertebral body replacement assembly. 
         [0004]    2. Background of the Invention 
         [0005]    Vertebrae are the individual irregular bones that make up the spinal column (aka ischis)—a flexuous and flexible column. There are normally thirty-three vertebrae in humans, including the five that are fused to form the sacrum (the others are separated by intervertebral discs) and the four coccygeal bones which form the tailbone. The upper three regions comprise the remaining 24, and are grouped under the names cervical (7 vertebrae), thoracic (12 vertebrae) and lumbar (5 vertebrae), according to the regions they occupy. This number is sometimes increased by an additional vertebra in one region, or it may be diminished in one region, the deficiency often being supplied by an additional vertebra in another. The number of cervical vertebrae is, however, very rarely increased or diminished. 
         [0006]    A typical vertebra consists of two essential parts: an anterior (front) segment, which is the vertebral body; and a posterior part—the vertebral (neural) arch—which encloses the vertebral foramen. The vertebral arch is formed by a pair of pedicles and a pair of laminae, and supports seven processes, four articular, two transverse, and one spinous, the latter also being known as the neural spine. 
         [0007]    When the vertebrae are articulated with each other, the bodies form a strong pillar for the support of the head and trunk, and the vertebral foramina constitute a canal for the protection of the medulla spinalis (spinal cord), while between every pair of vertebrae are two apertures, the intervertebral foramina, one on either side, for the transmission of the spinal nerves and vessels. 
         [0008]    Conventional systems for vertebral body replacement are used in spinal fusion procedures to repair damaged or incorrectly articulating vertebrae. Spinal fusion employs the use of spacer assemblies having a hollow mesh spacer tube and end caps that space apart and fuse together adjacent vertebrae. These mesh spacer tubes are often formed of titanium and are available in varying shapes and sizes. In addition, they can be trimmed on site by the surgeon to provide a better individual fit for each patient. Conventional spinal spacer assemblies come in different cross sections. These spacer assemblies are generally hollow and include openings in the side thereof to provide access for bone to grow and fuse within the mesh tube. 
         [0009]    There exists a need for further improvements in the field of vertebral body replacement assemblies of the present type. 
       SUMMARY OF THE INVENTION 
       [0010]    In some embodiments, the present invention relates to a titanium mesh vertebral spacer that can be used with the Transforaminal Lumbar Interbody Fusion (“TLIF”) and Posterior Lumbar Interbody Fusion (“PLIF”) instruments for an initial discectomy. The spacer can be configured to fit in an anterior portion of the body. The spacer can have variable cross-section. The cross-section can be circular, oval, or other desired shape. Further, the spacer can also include a variable shape mesh pattern. The pattern can consist of circles, ovals, squares, rectangles, polygons, ellipses or other shapes. 
         [0011]    In an embodiment, the wall of the spacer mesh has a 1.6 mm wall thickness. In an embodiment, the spacer can include an indication on the outer side of the wall for cutting the spacer. 
         [0012]    In some embodiments, the present invention relates to a spacer for use in spine fusion surgical procedures. The spacer includes an enclosure having a wall that is configured to enclose a hollow interior. The wall is further configured to include a plurality of openings spaced throughout the wall. The openings are configured to connect an exterior of the enclosure to the hollow interior. The enclosure further includes an indication cutting line configured to allow adjustment of a height of the enclosure. 
         [0013]    In some embodiments, the present invention relates to a spinal vertebral replacement assembly. The assembly includes a spacer having an enclosure having a wall that is configured to enclose a hollow interior. The wall is further configured to include a plurality of openings spaced throughout the wall. The openings are configured to connect an exterior of the enclosure to the hollow interior. The enclosure further includes an indication cutting line configured to allow adjustment of a height of the enclosure. 
         [0014]    Further features and advantages of the invention, as well as structure and operation of various embodiments of the invention, are disclosed in detail below with references to the accompanying drawings. 
     
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0015]    The present invention is described with reference to the accompanying drawings. In the drawings, like reference numbers indicate identical or functionally similar elements. 
           [0016]      FIGS. 1A-1D  are prospective views of an exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0017]      FIG. 1E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 1A-1D . 
           [0018]      FIG. 1F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 1A-1D . 
           [0019]      FIGS. 1G-1J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 1A-1D . 
           [0020]      FIGS. 2A-2D  are prospective views of another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0021]      FIG. 2E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 2A-2D . 
           [0022]      FIG. 2F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 2A-2D . 
           [0023]      FIGS. 2G-2J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 2A-2D . 
           [0024]      FIGS. 3A-3D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0025]      FIG. 3E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 3A-3D . 
           [0026]      FIG. 3F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 3A-3D . 
           [0027]      FIGS. 3G-3J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 3A-3D . 
           [0028]      FIGS. 4A-4D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0029]      FIG. 4E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 4A-4D . 
           [0030]      FIG. 4F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 4A-4D . 
           [0031]      FIGS. 4G-4J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 4A-4D . 
           [0032]      FIGS. 5A-5D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0033]      FIG. 5E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 5A-5D . 
           [0034]      FIG. 5F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 5A-5D . 
           [0035]      FIGS. 5G-5J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 5A-5D . 
           [0036]      FIGS. 6A-6D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0037]      FIG. 6E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 6A-6D . 
           [0038]      FIG. 6F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 6A-6D . 
           [0039]      FIGS. 6G-6J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 6A-6D . 
           [0040]      FIGS. 7A-7D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0041]      FIG. 7E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 7A-7D . 
           [0042]      FIG. 7F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 7A-7D . 
           [0043]      FIGS. 7G-7J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 7A-7D . 
           [0044]      FIGS. 8A-8D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0045]      FIG. 8E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 8A-8D . 
           [0046]      FIG. 8F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 8A-8D . 
           [0047]      FIGS. 8G-8J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 8A-8D . 
           [0048]      FIGS. 9A-9D  are prospective views of yet another exemplary vertebral body replacement assembly, according to embodiments of the present invention. 
           [0049]      FIG. 9E  is a top view of the exemplary vertebral body replacement assembly shown in  FIGS. 9A-9D . 
           [0050]      FIG. 9F  is a detailed view of a portion of the exemplary vertebral body replacement assembly shown in  FIGS. 9A-9D . 
           [0051]      FIGS. 9G-9J  are side views of exemplary vertebral body replacement assembly shown in  FIGS. 9A-9D . 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0052]    The present invention relates to spinal fusion procedures and surgeries. In particular, the present invention relates to a vertebral body replacement assembly.  FIGS. 1A-9J  illustrate various embodiments of the vertebral body replacement assembly, which will be also referred to as a spacer. Such reference is for ease of description and is not intended to limit the scope of the invention. 
         [0053]      FIGS. 1A-1J  illustrate exemplary embodiments of the spacers  100 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  100  have an outer diameter R. In some embodiments, R=12 mm. As can be understood by one skilled in the art, other diameters of the spacers  100  are possible. 
         [0054]      FIGS. 1A-1D  are perspective, cross-sectional views of variable height spacers  100  (a, b, c, d). The spacer  100  includes a wall  104  having a thickness W. As shown in of  FIG. 1E , which is a top view of the spacers  100 , the thickness W can be 1.6 mm. The wall  104  encloses a hollow interior  106  and also includes an exterior  108 . Each of the embodiments in  FIGS. 1A-1D  include an indication cutting line  102  on the exterior  108 , where the cutting line  102  is located towards the top of the spacers  100 . As can be understood by one skilled in the art, the cutting line  102  can be located anywhere on the outer wall of the spacer  100 . Further, there can be more than one indication cutting line on the spacers  100 . The cutting line  102  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  100  either prior to installation of the spacer  100  or subsequent to installation of the spacer. In some embodiments, the cutting line  102  can be configured to be an indentation in the exterior  108  of the wall  104 . The cutting line  102  can be configured to connect openings  112 , as illustrated in  FIGS. 1A-1D  and  1 G- 1 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  100  to a specific height. 
         [0055]    The wall  104  further includes a mesh pattern  110  that consists of variable-shaped openings  112  that extend from the exterior  108  to the hollow interior  106  of the spacer  100 . The opening  112  is shown in more detail in  FIG. 1F . In the embodiment of  FIGS. 1A-1J , the opening  112  has a hexagonal shape. In this embodiment, the distance D from the center of the opening  112  to one of its sides is approximately 2.5 mm.  FIGS. 1G-1J  are side views of variable-height spacers  100 . As shown in  FIG. 1G , spacer  100   a  has a total height H 2  and a height H 1  to the indication cutting line  102 . In some embodiments H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 1H , spacer  100   b  has a total height H 4  and a height H 3  to the indication cutting line  102 . In some embodiments H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 1I , spacer  100   c  has a total height H 6  and a height H 5  to the indication cutting line  102 . In some embodiments H 5 =12 mm, H 2 =14 mm. As shown in  FIG. 1J , spacer  100   d  has a total height H 8  and a height H 7  to the indication cutting line  102 . In some embodiments H 7 =16 mm, H 2 =18 mm. As shown in  FIGS. 1G-1J , the total heights of the spacers  100  range from 6 mm to 18 mm (as shown in  FIGS. 1G-1J , the height of the spacers  100  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 1G-1J , the cutting line  102  is located 2 mm from the top of the spacers  100 . As can be understood by one skilled in the art, the spacers  100  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0056]      FIGS. 2A-2J  illustrate exemplary embodiments of the spacers  200 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  200  have an outer diameter R. In some embodiments, R=12 mm. As can be understood by one skilled in the art, other diameters of the spacers  200  are possible. 
         [0057]      FIGS. 2A-2D  are perspective, cross-sectional views of variable height spacers  200  (a, b, c, d). The spacer  200  includes a wall  204  having a thickness W. As shown in of  FIG. 2E , which is a top view of the spacers  200 , the thickness W can be 1.6 mm. The wall  204  encloses a hollow interior  206  and also includes an exterior  208 . Each of the embodiments in  FIGS. 2A-2D  include an indication cutting line  202  on the exterior  208 , where the cutting line  202  is located towards the top of the spacers  200 . As can be understood by one skilled in the art, the cutting line  202  can be located anywhere on the outer wall of the spacer  200 . Further, there can be more than one indication cutting line on the spacers  200 . The cutting line  202  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  200  either prior to installation of the spacer  200  or subsequent to installation of the spacer. In some embodiments, the cutting line  202  can be configured to be an indentation in the exterior  208  of the wall  204 . The cutting line  202  can be configured to connect openings  212  and  220 , as illustrated in  FIGS. 2A-2D  and  2 G- 2 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  200  to a specific height. 
         [0058]    The wall  204  further includes a mesh pattern  210  that consists of variable-shaped openings  210  and  220  that extend from the exterior  208  to the hollow interior  206  of the spacer  200 . The opening  212  is shown in more detail in  FIG. 2F . In the embodiment of  FIGS. 2A-2J , the opening  212  has an oval shape. In this embodiment, the first diameter D 1  of the oval shaped opening  212  is approximately 3.5 mm and the second diameter D 2  of the oval shaped opening  212  is approximately 2.5 mm. The opening  220  has a round shape with a diameter D 3 . In some embodiments, D 3  is equal to 2.5 mm.  FIGS. 2G-2J  are side views of variable-height spacers  200 . As shown in  FIG. 2G , spacer  200   a  has a total height H 1  and a height H 2  to the indication cutting line  202 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 2H , spacer  200   b  has a total height H 4  and a height H 3  to the indication cutting line  202 . In some embodiments H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 2I , spacer  200   c  has a total height H 6  and a height H 5  to the indication cutting line  202 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 2J , spacer  200   d  has a total height H 8  and a height H 7  to the indication cutting line  202 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 2G-2J , the total heights of the spacers  200  range from 6 mm to 18 mm (as shown in  FIGS. 2G-2J , the height of the spacers  200  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 2G-2J , the cutting line  202  is located 2 mm from the top of the spacers  200 . As can be understood by one skilled in the art, the spacers  200  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0059]    Additionally, the oval-shaped openings  212  can be aligned in different directions as shown in  FIGS. 2A-2D  and  2 G- 2 J. Also, some of the openings  212  (or  220 ) can be circular or any other shape. The openings  212  can have a diameter that varies from the exterior  208  to the interior  206 . The oval shaped openings  212  and the circular openings  220  can be arranged in a pattern as illustrated in  FIGS. 2A-2D  and  2 G- 2 J. Further, one opening  212  can be perpendicularly arranged to the other opening  212 . Alternatively, the openings  212  can be arranged at different angles with regard to each other. 
         [0060]      FIGS. 3A-3J  illustrate exemplary embodiments of the spacers  300 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  300  have an outer diameter R. In some embodiments, R=12 mm. As can be understood by one skilled in the art, other diameters of the spacers  300  are possible. 
         [0061]      FIGS. 3A-3D  are perspective, cross-sectional views of variable height spacers  300  (a, b, c, d). The spacer  300  includes a wall  304  having a thickness W. As shown in of  FIG. 3E , which is a top view of the spacers  300 , the thickness W can be 1.6 mm. The wall  304  encloses a hollow interior  306  and also includes an exterior  308 . Each of the embodiments in  FIGS. 3A-3D  include an indication cutting line  302  on the exterior  308 , where the cutting line  302  is located towards the top of the spacers  300 . As can be understood by one skilled in the art, the cutting line  302  can be located anywhere on the outer wall of the spacer  300 . Further, there can be more than one indication cutting line on the spacers  300 . The cutting line  302  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  300  either prior to installation of the spacer  300  or subsequent to installation of the spacer. In some embodiments, the cutting line  302  can be configured to be an indentation in the exterior  308  of the wall  304 . The cutting line  302  can be configured to connect openings  312 , as illustrated in  FIGS. 3A-3D  and  3 G- 3 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  300  to a specific height. 
         [0062]    The wall  304  further includes a mesh pattern  310  that consists of variable-shaped openings  312  that extend from the exterior  308  to the hollow interior  306  of the spacer  300 . The opening  312  is shown in more detail in  FIG. 3F . In the embodiment of  FIGS. 3A-3J , the opening  312  has an elliptical shape. In this embodiment, the first diameter D 1  of the elliptical shape opening  312  is approximately 4.5 mm and the second diameter D 2  of the elliptical shape opening  312  is approximately 1.5 mm.  FIGS. 3G-3J  are side views of variable-height spacers  300 . As shown in  FIG. 3G , spacer  300   a  has a total height H 2  and a height H 1  to the indication cutting line  302 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 3H , spacer  300   b  has a total height H 4  and a height H 3  to the indication cutting line  302 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 31 , spacer  300   c  has a total height H 6  and a height H 5  to the indication cutting line  302 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 3J , spacer  300   d  has a total height H 8  and a height H 7  to the indication cutting line  302 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 3G-3J , the total heights of the spacers  300  range from 6 mm to 18 mm (as shown in  FIGS. 3G-3J , the height of the spacers  300  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 3G-3J , the cutting line  302  is located 2 mm from the top of the spacers  300 . As can be understood by one skilled in the art, the spacers  300  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0063]      FIGS. 4A-4J  illustrate exemplary embodiments of the spacers  400 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  400  have an outer diameter R. In some embodiments, R=10 mm. As can be understood by one skilled in the art, other diameters of the spacers  400  are possible. 
         [0064]      FIGS. 4A-4D  are perspective, cross-sectional views of variable height spacers  400  (a, b, c, d). The spacer  400  includes a wall  404  having a thickness W. As shown in of  FIG. 4E , which is a top view of the spacers  400 , the thickness W can be 1.6 mm. The wall  404  encloses a hollow interior  406  and also includes an exterior  408 . Each of the embodiments in  FIGS. 4A-4D  include an indication cutting line  402  on the exterior  408 , where the cutting line  402  is located towards the top of the spacers  400 . As can be understood by one skilled in the art, the cutting line  402  can be located anywhere on the outer wall of the spacer  400 . Further, there can be more than one indication cutting line on the spacers  400 . The cutting line  402  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  400  either prior to installation of the spacer  400  or subsequent to installation of the spacer. In some embodiments, the cutting line  402  can be configured to be an indentation in the exterior  408  of the wall  404 . The cutting line  402  can be configured to connect openings  412 , as illustrated in  FIGS. 4A-4D  and  4 G- 4 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  400  to a specific height. 
         [0065]    The wall  404  further includes a mesh pattern  410  that consists of variable-shaped openings  412  that extend from the exterior  408  to the hollow interior  406  of the spacer  400 . The opening  412  is shown in more detail in  FIG. 4F . In the embodiment of  FIGS. 4A-4J , the opening  412  has a hexagonal shape. In this embodiment, the distance D from the center of the opening  412  to one of its sides is approximately 2.0 mm.  FIGS. 4G-4J  are side views of variable-height spacers  400 . As shown in  FIG. 4G , spacer  400   a  has a total height H 2  and a height H 1  to the indication cutting line  402 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 4H , spacer  400   b  has a total height H 4  and a height H 3  to the indication cutting line  402 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 4I , spacer  400   c  has a total height H 6  and a height H 5  to the indication cutting line  402 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 4J , spacer  400   d  has a total height H 8  and a height H 7  to the indication cutting line  402 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 4G-4J , the total heights of the spacers  400  range from 6 mm to 18 mm (as shown in  FIGS. 4G-4J , the height of the spacers  400  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 4G-4J , the cutting line  402  is located 2 mm from the top of the spacers  400 . As can be understood by one skilled in the art, the spacers  400  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0066]      FIGS. 5A-5J  illustrate exemplary embodiments of the spacers  500 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  500  have an outer diameter R. In some embodiments, R=15 mm. As can be understood by one skilled in the art, other diameters of the spacers  500  are possible. 
         [0067]      FIGS. 5A-5D  are perspective, cross-sectional views of variable height spacers  500  (a, b, c, d). The spacer  500  includes a wall  504  having a thickness W. As shown in of  FIG. 5E , which is a top view of the spacers  500 , the thickness W can be 1.6 mm. The wall  504  encloses a hollow interior  506  and also includes an exterior  508 . Each of the embodiments in  FIGS. 5A-5D  include an indication cutting line  502  on the exterior  508 , where the cutting line  502  is located towards the top of the spacers  500 . As can be understood by one skilled in the art, the cutting line  502  can be located anywhere on the outer wall of the spacer  500 . Further, there can be more than one indication cutting line on the spacers  500 . The cutting line  502  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  500  either prior to installation of the spacer  500  or subsequent to installation of the spacer. In some embodiments, the cutting line  502  can be configured to be an indentation in the exterior  508  of the wall  504 . The cutting line  502  can be configured to connect openings  512 , as illustrated in  FIGS. 5A-5D  and  5 G- 5 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  500  to a specific height. 
         [0068]    The wall  504  further includes a mesh pattern  510  that consists of variable-shaped openings  512  that extend from the exterior  508  to the hollow interior  506  of the spacer  500 . The opening  512  is shown in more detail in  FIG. 5F . In the embodiment of  FIGS. 5A-5J , the opening  512  has a hexagonal shape. In this embodiment, the distance D from the center of the opening  552  to one of its sides is approximately 3.0 mm.  FIGS. 5G-5J  are side views of variable-height spacers  500 . As shown in  FIG. 5G , spacer  500   a  has a total height H 2  and a height H 1  to the indication cutting line  502 . In some embodiments H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 5H , spacer  500   b  has a total height H 4  and a height H 3  to the indication cutting line  502 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 5I , spacer  500   c  has a total height H 6  and a height H 5  to the indication cutting line  502 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 5J , spacer  500   d  has a total height H 8  and a height H 7  to the indication cutting line  502 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 5G-5J , the total heights of the spacers  500  range from 6 mm to 18 mm (as shown in  FIGS. 5G-5J , the height of the spacers  500  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 5G-5J , the cutting line  502  is located 2 mm from the top of the spacers  500 . As can be understood by one skilled in the art, the spacers  500  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0069]      FIGS. 6A-6J  illustrate exemplary embodiments of the spacers  600 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  600  have an outer diameter R. In some embodiments, R=10 mm. As can be understood by one skilled in the art, other diameters of the spacers  600  are possible. 
         [0070]      FIGS. 6A-6D  are perspective, cross-sectional views of variable height spacers  600  (a, b, c, d). The spacer  600  includes a wall  604  having a thickness W. As shown in of  FIG. 6E , which is a top view of the spacers  600 , the thickness W can be 1.6 mm. The wall  604  encloses a hollow interior  606  and also includes an exterior  608 . Each of the embodiments in  FIGS. 6A-6D  include an indication cutting line  602  on the exterior  608 , where the cutting line  602  is located towards the top of the spacers  600 . As can be understood by one skilled in the art, the cutting line  602  can be located anywhere on the outer wall of the spacer  600 . Further, there can be more than one indication cutting line on the spacers  600 . The cutting line  602  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  600  either prior to installation of the spacer  600  or subsequent to installation of the spacer. In some embodiments, the cutting line  602  can be configured to be an indentation in the exterior  608  of the wall  604 . The cutting line  602  can be configured to connect openings  612  and  660 , as illustrated in  FIGS. 6A-6D  and  6 G- 6 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  600  to a specific height. 
         [0071]    The wall  604  further includes a mesh pattern  610  that consists of variable-shaped openings  610  and  660  that extend from the exterior  608  to the hollow interior  606  of the spacer  600 . The opening  612  is shown in more detail in  FIG. 6F . In the embodiment of  FIGS. 6A-6J , the opening  612  has an oval shape. In this embodiment, the first diameter D 1  of the oval shaped opening  612  is approximately 3.0 mm and the second diameter D 2  of the oval shaped opening  612  is approximately 2.0 mm. The opening  660  has a round shape with a diameter D 3 . In some embodiments, D 3  is equal to 2.0 mm.  FIGS. 6G-6J  are side views of variable-height spacers  600 . As shown in  FIG. 6G , spacer  600   a  has a total height H 1  and a height H 2  to the indication cutting line  602 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 6H , spacer  600   b  has a total height H 4  and a height H 3  to the indication cutting line  602 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 6I , spacer  600   c  has a total height H 6  and a height H 5  to the indication cutting line  602 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 6J , spacer  600   d  has a total height H 8  and a height H 7  to the indication cutting line  602 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 6G-6J , the total heights of the spacers  600  range from 6 mm to 18 mm (as shown in  FIGS. 6G-6J , the height of the spacers  600  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 6G-6J , the cutting line  602  is located 2 mm from the top of the spacers  600 . As can be understood by one skilled in the art, the spacers  600  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0072]    Additionally, the oval-shaped openings  612  can be aligned in different directions as shown in  FIGS. 6A-6D  and  6 G- 6 J. Also, some of the openings  612  (or  660 ) can be circular or any other shape. The openings  612  can have a diameter that varies from the exterior  608  to the interior  606 . The oval shaped openings  612  and the circular openings  660  can be arranged in a pattern as illustrated in  FIGS. 6A-6D  and  6 G- 6 J. Further, one opening  612  can be perpendicularly arranged to the other opening  612 . Alternatively, the openings  612  can be arranged at different angles with regard to each other. 
         [0073]      FIGS. 7A-7J  illustrate exemplary embodiments of the spacers  700 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  700  have an outer diameter R. In some embodiments, R=15 mm. As can be understood by one skilled in the art, other diameters of the spacers  700  are possible. 
         [0074]      FIGS. 7A-7D  are perspective, cross-sectional views of variable height spacers  700  (a, b, c, d). The spacer  700  includes a wall  704  having a thickness W. As shown in of  FIG. 7E , which is a top view of the spacers  700 , the thickness W can be 1.6 mm. The wall  704  encloses a hollow interior  707  and also includes an exterior  708 . Each of the embodiments in  FIGS. 7A-7D  include an indication cutting line  702  on the exterior  708 , where the cutting line  702  is located towards the top of the spacers  700 . As can be understood by one skilled in the art, the cutting line  702  can be located anywhere on the outer wall of the spacer  700 . Further, there can be more than one indication cutting line on the spacers  700 . The cutting line  702  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  700  either prior to installation of the spacer  700  or subsequent to installation of the spacer. In some embodiments, the cutting line  702  can be configured to be an indentation in the exterior  708  of the wall  704 . The cutting line  702  can be configured to connect openings  712  and  770 , as illustrated in  FIGS. 7A-7D  and  7 G- 7 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  700  to a specific height. 
         [0075]    The wall  704  further includes a mesh pattern  710  that consists of variable-shaped openings  710  and  770  that extend from the exterior  708  to the hollow interior  707  of the spacer  700 . The opening  712  is shown in more detail in  FIG. 7F . In the embodiment of  FIGS. 7A-7J , the opening  712  has an oval shape. In this embodiment, the first diameter D 1  of the oval shaped opening  712  is approximately 3.5 mm and the second diameter D 2  of the oval shaped opening  712  is approximately 2.5 mm. The opening  770  has a round shape with a diameter D 3 . In some embodiments, D 3  is equal to 2.0 mm.  FIGS. 7G-7J  are side views of variable-height spacers  700 . As shown in  FIG. 7G , spacer  700   a  has a total height H 1  and a height H 2  to the indication cutting line  702 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 7H , spacer  700   b  has a total height H 4  and a height H 3  to the indication cutting line  702 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 7I , spacer  700   c  has a total height H 7  and a height H 5  to the indication cutting line  702 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 7J , spacer  700   d  has a total height H 8  and a height H 7  to the indication cutting line  702 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 7G-7J , the total heights of the spacers  700  range from 6 mm to 18 mm (as shown in  FIGS. 7G-7J , the height of the spacers  700  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 7G-7J , the cutting line  702  is located 2 mm from the top of the spacers  700 . As can be understood by one skilled in the art, the spacers  700  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0076]    Additionally, the oval-shaped openings  712  can be aligned in different directions as shown in  FIGS. 7A-7D  and  7 G- 7 J. Also, some of the openings  712  (or  770 ) can be circular or any other shape. The openings  712  can have a diameter that varies from the exterior  708  to the interior  707 . The oval shaped openings  712  and the circular openings  770  can be arranged in a pattern as illustrated in  FIGS. 7A-7D  and  7 G- 7 J. Further, one opening  712  can be perpendicularly arranged to the other opening  712 . Alternatively, the openings  712  can be arranged at different angles with regard to each other. 
         [0077]      FIGS. 8A-8J  illustrate exemplary embodiments of the spacers  800 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  800  have an outer diameter R. In some embodiments, R=10 mm. As can be understood by one skilled in the art, other diameters of the spacers  800  are possible. 
         [0078]      FIGS. 8A-8D  are perspective, cross-sectional views of variable height spacers  800  (a, b, c, d). The spacer  800  includes a wall  804  having a thickness W. As shown in of  FIG. 8E , which is a top view of the spacers  800 , the thickness W can be 1.6 mm. The wall  804  encloses a hollow interior  806  and also includes an exterior  808 . Each of the embodiments in  FIGS. 8A-8D  include an indication cutting line  802  on the exterior  808 , where the cutting line  802  is located towards the top of the spacers  800 . As can be understood by one skilled in the art, the cutting line  802  can be located anywhere on the outer wall of the spacer  800 . Further, there can be more than one indication cutting line on the spacers  800 . The cutting line  802  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  800  either prior to installation of the spacer  800  or subsequent to installation of the spacer. In some embodiments, the cutting line  802  can be configured to be an indentation in the exterior  808  of the wall  804 . The cutting line  802  can be configured to connect openings  812 , as illustrated in  FIGS. 8A-8D  and  8 G- 8 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  800  to a specific height. 
         [0079]    The wall  804  further includes a mesh pattern  810  that consists of variable-shaped openings  812  that extend from the exterior  808  to the hollow interior  806  of the spacer  800 . The opening  812  is shown in more detail in  FIG. 8F . In the embodiment of  FIGS. 8A-8J , the opening  812  has an elliptical shape. In this embodiment, the first diameter D 1  of the elliptical shape opening  812  is approximately 4.0 mm and the second diameter D 2  of the elliptical shape opening  812  is approximately 1.5 mm.  FIGS. 8G-8J  are side views of variable-height spacers  800 . As shown in  FIG. 8G , spacer  800   a  has a total height H 2  and a height H 1  to the indication cutting line  802 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 8H , spacer  800   b  has a total height H 4  and a height H 3  to the indication cutting line  802 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 8I , spacer  800   c  has a total height H 6  and a height H 5  to the indication cutting line  802 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 8J , spacer  800   d  has a total height H 8  and a height H 7  to the indication cutting line  802 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 8G-8J , the total heights of the spacers  800  range from 6 mm to 18 mm (as shown in  FIGS. 8G-8J , the height of the spacers  800  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 8G-8J , the cutting line  802  is located 2 mm from the top of the spacers  800 . As can be understood by one skilled in the art, the spacers  800  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0080]      FIGS. 9A-9J  illustrate exemplary embodiments of the spacers  900 ( a, b, c, d ) that include a plurality of openings that can be arranged in a mesh pattern. As illustrated in these embodiments, spacers  900  have an outer diameter R. In some embodiments, R=15 mm. As can be understood by one skilled in the art, other diameters of the spacers  900  are possible. 
         [0081]      FIGS. 9A-9D  are perspective, cross-sectional views of variable height spacers  900  (a, b, c, d). The spacer  900  includes a wall  904  having a thickness W. As shown in of  FIG. 9E , which is a top view of the spacers  900 , the thickness W can be 1.6 mm. The wall  904  encloses a hollow interior  906  and also includes an exterior  908 . Each of the embodiments in  FIGS. 9A-9D  include an indication cutting line  902  on the exterior  908 , where the cutting line  902  is located towards the top of the spacers  900 . As can be understood by one skilled in the art, the cutting line  902  can be located anywhere on the outer wall of the spacer  900 . Further, there can be more than one indication cutting line on the spacers  900 . The cutting line  902  can be configured to allow a surgeon (or other medical personnel, technician, etc.) to adjust the height of the spacer  900  either prior to installation of the spacer  900  or subsequent to installation of the spacer. In some embodiments, the cutting line  902  can be configured to be an indentation in the exterior  908  of the wall  904 . The cutting line  902  can be configured to connect openings  912 , as illustrated in  FIGS. 9A-9D  and  9 G- 9 J. This allows a surgeon (or any other authorized medical personnel) to evenly cut and adjust the spacer  900  to a specific height. 
         [0082]    The wall  904  further includes a mesh pattern  910  that consists of variable-shaped openings  912  that extend from the exterior  908  to the hollow interior  906  of the spacer  900 . The opening  912  is shown in more detail in  FIG. 9F . In the embodiment of  FIGS. 9A-9J , the opening  912  has an elliptical shape. In this embodiment, the first diameter D 1  of the elliptical shape opening  912  is approximately 4.5 mm and the second diameter D 2  of the elliptical shape opening  912  is approximately 1.5 mm.  FIGS. 9G-9J  are side views of variable-height spacers  900 . As shown in  FIG. 9G , spacer  900   a  has a total height H 2  and a height H 1  to the indication cutting line  902 . In some embodiments, H 1 =4 mm, H 2 =6 mm. As shown in  FIG. 9H , spacer  900   b  has a total height H 4  and a height H 3  to the indication cutting line  902 . In some embodiments, H 3 =8 mm, H 4 =10 mm. As shown in  FIG. 9I , spacer  900   c  has a total height H 6  and a height H 5  to the indication cutting line  902 . In some embodiments, H 5 =12 mm, H 6 =14 mm. As shown in  FIG. 9J , spacer  900   d  has a total height H 8  and a height H 7  to the indication cutting line  902 . In some embodiments, H 7 =16 mm, H 8 =18 mm. As shown in  FIGS. 9G-9J , the total heights of the spacers  900  range from 6 mm to 18 mm (as shown in  FIGS. 9G-9J , the height of the spacers  900  increases in 4 mm increments). Also, as shown in embodiments of  FIGS. 9G-9J , the cutting line  902  is located 2 mm from the top of the spacers  900 . As can be understood by one skilled in the art, the spacers  900  have variable diameters, heights, shapes of the mesh pattern, and thickness. 
         [0083]    The shape of the openings in the mesh pattern of the spacers can be changed as desired. This can be done with special instruments that are designed to configure the mesh pattern according to the desired shapes. For example, the shape can be changed from a circle to an oval or an “American football” shape. Further, the mesh can also include various shapes or a combination of various shapes, e.g., circles, ovals, polygons, squares, rectangles, ellipses, etc. 
         [0084]    As can be understood by one skilled in the art, the thickness W of the wall, the diameter D of the spacer can vary according to a particular design. As can be further understood by one skilled in the art, the diameter D can be configured as an outer diameter of the spacer as illustrated in  FIGS. 1A-9J , which means that the diameter D includes the thickness W. In some embodiments, the thickness W can be in the range of 1.0 mm to 2.0 mm. In some embodiments, the range can be from 1.5 mm to 1.7 mm. 
         [0085]    Further, the variable openings in the spacers illustrated in the above figures, are configured to allow bone growth once the spacer is installed in the vertebrae (or any other bone structure). This further secures the spacers to the bone matter and provides additional support. 
         [0086]    The indication cutting line shown in  FIGS. 1A-9J  is configured as an indentation in the wall of the spacer. Such indentation can be configured to have a depth in the range from 0.12 mm to 0.24 mm. In some embodiments, the depth can range from 0.15 mm to 0.20 mm. In some embodiments, the depth can be on the order of 0.18 mm. 
         [0087]    Additionally, the indication cutting line can be located a distance between 1.0 mm to 4.0 mm from the top of the spacer. In some embodiments, that distance can range from 1.5 mm to 3.5 mm. In yet other embodiments, the distance can range from 2.0 mm to 3.0 mm. Alternatively, the distance can be from 2.0 mm to 2.5 mm. In some embodiments, the distance from the top of the spacer to the indication cutting line can be 2 mm. 
         [0088]    In some embodiments, the present invention can be used with the Transforaminal Lumbar Interbody Fusion (“TLIF”) and Posterior Lumbar Interbody Fusion (“PLIF”) instruments for an initial discectomy. Such instruments include Disk Preparation Instruments, such as osteotomes, curettes, shavers, pituitary ronguers, distractors, implant insertion instruments, implant positioning instruments. The spacer can be configured to fit in an anterior portion of the body. In some embodiments, the spacer can be manufactured from titanium alloys, such as, Ti6Al-4V ELI, Ti6Al-4V, Ti6Al-7Nb, CP GRADE 2 TITANIUM and CP GRADE 4 TITANIUM. As can be understood by one skilled in the art, other materials can be used for manufacturing of the spacer. 
         [0089]    Example embodiments of the methods and components of the present invention have been described herein. As noted elsewhere, these example embodiments have been described for illustrative purposes only, and are not limiting. Other embodiments are possible and are covered by the invention. Such embodiments will be apparent to persons skilled in the relevant art(s) based on the teachings contained herein. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents.