Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member and a second passage (44) extending transverse to the first passage. The fastener extends through an opening (50) in the housing into the second passage. A longitudinal axis (18) of the fastener is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage. A spacer (60) received in the second passage of the housing is engageable with the fastener and the longitudinal member. A positioning member (70) applies a force to prevent relative movement between the fastener and the housing and permit manual movement of the fastener relative to the housing against the force when the longitudinal member is disengaged from the spacer.

Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60).

Abstract: A method of fixing first and second vertebrae of a patient together at a surgical site includes inserting a first cannula into the body of the patient. A fusion device is moved through the cannula and inserted between the first and second vertebrae. A first fastener is moved through the cannula and secured to the first vertebra. A second fastener is moved through the cannula and secured to the second vertebra. A first fixation element is moved through the cannula. The first fixation element is fixed to the first and second fasteners. The fusion device has first and second ends, upper and lower surfaces for engaging the first and second vertebrae, and first and second side surfaces extending between the upper and lower surfaces. Each of the first and second side surfaces extend along an arc from the first end of the fusion device to the second end.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: Methods and cannulae for providing access to a surgical location within a patient are described. A cannula (10) receives surgical instruments (120) for performing a surgical procedure on a body (130). The cannula (10) comprises a tube structure (12) defining a passage (16) through which the surgical instruments (120) are inserted into the body (130). The tube structure (12) has a proximal end (20) and a distal end (62). The tube structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16) at the distal end (62). The expandable portion (40) of the tube structure (12), when expanded, has a conical configuration.

Abstract: A housing (40) has a first passage (42) through which a longitudinal member (12) extends and a second passage (44) extending transverse to the first passage. A fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). An axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to an axis (46) of the second passage (44). A spacer (60) received in the second passage (44) engages the fastener (16) and the longitudinal member (12). A pin member (70) fixedly connected to the housing (40) extends into engagement with the spacer (60) to retain the spacer and the fastener (16) in the housing and maintain the spacer in frictional engagement with the fastener to prevent relative movement between the fastener (16) and the housing when the longitudinal member (12) is disengaged from the spacer. The fastener (16) and the housing (40) are manually movable relative to each other in opposition to the frictional engagement.

Abstract: A cannula (10) receives surgical instruments (120) for performing a surgical procedure on a body (130). The cannula (10) comprises a tube structure (12) defining a passage (16) through which the surgical instruments (120) are inserted into the body (130). The tube structure (12) has a proximal end (20) and a distal end (62). The tube structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16) at the distal end (62). The expandable portion (40) of the tube structure (12), when expanded, has a conical configuration.

Abstract: An apparatus (100) supports an endoscope (99) for viewing a surgical site in a patient during surgery on the patient. The apparatus (100) includes a base (110), a first part (200), a second part (300), and a mechanism (400). The base (110) has a guide portion (130). The first part (200) is adapted to be fixed to the endoscope (99). The second part (300) engages the guide portion (130) and is movable relative to the guide portion (130). The second part (300) is secured to the first part (200) such that the first part (200) is movable relative to the guide portion (130). The mechanism (400) is connected between the base (110) and the second part (300). At least a portion of the mechanism (400) is rotatable to slide the first and second parts (200, 300) relative to the guide portion (130) to change a position of the endoscope (99) relative to the patient.

Abstract: A method of performing a surgical procedure on a body includes providing a cannula having a tubular structure with first and second tubular portions defining first and second passages for receiving surgical instruments. The second tubular portion is inserted inside the body and the first tubular portion is inserted so that the first tubular portion extends from an exterior of the body to inside the body. The second tubular portion expands to increase the cross-sectional area of the second passage in the second tubular portion while the second tubular portion is inside the body. The cross-sectional area of the first passage in the first tubular portion is maintained. The first tubular portion has a first thickness and the second tubular portion has a second thickness different than the first thickness.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: A method of performing a surgical procedure on a body includes providing a cannula having a tubular structure with first and second tubular portions defining first and second passages for receiving surgical instruments. The second tubular portion is inserted inside the body and the first tubular portion is inserted so that the first tubular portion extends from an exterior of the body to inside the body. The second tubular portion expands to increase the cross-sectional area of the second passage in the second tubular portion while the second tubular portion is inside the body. The cross-sectional area of the first passage in the first tubular portion is maintained. The first tubular portion has a first thickness and the second tubular portion has a second thickness different than the first thickness.

Abstract: An apparatus (10) includes a member (12) and a fastener (16) that connects the member to a bone portion. The fastener (16) has a first end portion (22) engageable with the bone portion, a second end portion (26) extending through an opening (50) in the member (12), and an intermediate portion (32) engageable with the member between the first and second end portions. A connecting ring (42) connects the member (12) to the fastener (16). The connecting ring (42) extends into the opening (50) in the member (12). The connecting ring (42) has a passage (54) with a longitudinal axis (56) through which the second end portion (26) of the fastener (16) extends. A clamping member (28) engages the second end portion (26) of the fastener (16) and the connecting ring (42) to connect the connecting ring to the member (12) and connect the fastener to the connecting ring in any one of a plurality of angular positions relative to the connecting ring.

Abstract: A surgical instrument extendable through a cannula for moving a first bone portion relative to a second bone portion includes a first portion having a longitudinal axis engageable with a first member connected with to the first bone portion. A second portion is engageable with a second member connected with the second bone portion. The second portion is movable relative to the first portion from a first position toward a second position to move the first and second bone portions away from each other. An actuator connected with the second portion moves the second portion relative to the first portion in a direction extending transverse to the longitudinal axis.

Abstract: A surgical tool (112, 410) for use in expanding a cannula (10, 150, 250) includes a first leg (114, 414) having a first end (118, 418) engageable with an inner surface (70, 212, 322) of the cannula. A second leg (114, 414) is connected with the first leg (114, 414). The second leg (114, 414) has a second end (118, 418) engageable with the inner surface (70, 212, 322) of the cannula (10, 150, 250). The first and second ends (118, 418) are movable away from each other to apply a radially outwardly directed force to the inner surface (70, 212, 322) of the cannula (10, 150, 250) and cause expansion of the cannula.

Abstract: A surgical instrument comprises a first device including an actuatable clamp for clamping on a fastener fixed to a first bone portion and a carriage that is movable relative to the clamp when subjected to a predetermined axial load. A second device includes a portion adapted for threaded engagement with the carriage and an end portion for supporting a member for securing a rod connected to a second bone portion to the fastener. Relative rotation between the first and second devices causes relative axial movement between the second device and the carriage of the first-device. The carriage is stationary relative to the clamp of the first device when a force necessary to produce relative movement between the first and second bone portions is below the predetermined axial load so that relative rotation between the first and second devices first bone portion relative to the second bone portion.

Abstract: A surgical instrument (10) includes a handle (12) and a member (30) for acting on tissue of a patient. A flexible stem (20) extends between the member (30) and the handle (12). The flexible stem (20) includes a tubular member (60) having a longitudinal axis (70) and radially inner and outer cylindrical surfaces (62 and 64) extending generally parallel to each other. The tubular member (60) has wedge-shaped slots (80 and 90) extending through the inner and outer cylindrical surfaces (62 and 64). Each of the wedge-shaped slots (80 and 90) is defined by first and second ring portions (92 and 94) extending at an angle to each other and transverse to the longitudinal axis (70). An actuator mechanism (14) connected with the handle (12) bends the flexible stem (20).

Abstract: An apparatus (10) includes a member (12) having an elongate slot (50). A fastener (16) engageable with a bone portion has an end portion (26) extending through the elongate slot (50). A connecting ring (42) connects the member (12) to the fastener (16). The connecting ring (42) is positionable in any one of a plurality of positions along the elongate slot (50). The connecting ring (42) has a passage (54) through which the end portion (26) of the fastener (16) extends. The fastener (16) is positionable in any one of a plurality of angular positions relative to the connecting ring (42). First and second portions (64, 66) of the connecting ring (42) engage each other to connect the first and second portions together and prevent relative movement between the first and second portions.

Abstract: A surgical instrument includes a tubular stem section which extends from a handle. A tubular articulated section connects a surgical instrument with the stem section. An actuator assembly is connected with the handle and is operable to bend the articulated section to change the orientation of an instrument on an outer end portion of the articulated section relative to body tissue. The instrument on the outer end of the articulated section may be a rotatable cutting tool which is driven by a tubular drive element having a flexible section which extends through the articulated section. The articulated section is bent or flexed by a plurality of flexible elongated elements (wires). In one embodiment of the invention, a pair of elongated elements are provided to flex the articulated section in opposite directions. In another embodiment of the invention, four flexible elongated elements are provided to flex the articulated section in any one of four directions.

Abstract: A surgical instrument includes a handle, a first stem section having a longitudinal axis and extending from the handle, and a tissue engaging member for engaging tissue. A second stem section, connected between the first stem section and the tissue engaging member, has a portion which is bendable and supports the tissue engaging member for movement between a plurality of orientations relative to the axis and to the first stem section. The surgical instrument includes a system for bending the bendable portion of the second stem section to change the orientation of the tissue engaging member relative to the axis and to the first stem section from a first orientation to a second orientation. The bendable portion of the second stem section includes a member for enabling bending movement of the bendable portion to locate the tissue engaging member at the same angle relative to the longitudinal axis of the first stem section at more than one location along the length of the bendable portion.