Abstract: Devices and methods for enhancing the effectiveness of spinal stabilization, and particularly that of cervical spinal stabilization, are provided herein. More specifically, methods and systems are disclosed for effectively positioning occipital plates and spinal fixation assemblies within target vertebrae, while also reducing any associated patient trauma (e.g., muscle stripping, tissue damage, etc.). The systems and methods can utilize trans-lamina delivery of the spinal fixation assemblies to allow for the positioning of the fixation elements along the midline of the patient's spine.

Abstract: A pivotal bone anchor assembly includes a shank having an anchor portion and a head with a partially spherical outer surface, a drive socket, an annular planar top surface surrounding the drive socket, and a frusto-conical surface between the planar top surface and the partially spherical outer surface. The assembly further includes a receiver having a base defining an axial bore and an upper portion defining a channel configured to receive a rod, and an insert positionable within the axial bore having an upper surface engageable with the rod, a lower surface for transferring a downwardly-directed force toward the head, and a central aperture for accessing the drive socket, with the rod extending across the central aperture when the fixation rod is engaged by the upper surface. After the head, the insert, and the rod are positioned in the receiver, the frusto-conical surface remains spaced apart from the rod to in all pivotal orientations of the shank relative to the receiver.

Abstract: A vertebral column correction system for correcting a spinal deformity without fusing the joint segments is disclosed. The vertebral column correction system may have first and second vertebral anchors secured to first and second vertebrae. The vertebral column correction system may further comprise one or more intermediate vertebral anchors secured to vertebrae between the first and second vertebrae. A connection member may be disposed within a head portion of the vertebral anchors. At least a portion of the connection member may be a flexible member, such as a flexible cord, configured for tensioning between at least two vertebral anchors for providing a desired amount of tension to apply a correctional force to the spinal column. A spring member, or other tensioning member, may maintain the tension of the connection member.

Abstract: Sacroiliac (SI) joint implants for promoting SI joint fusion and methods of their delivery are described herein. The SI joint implant has a spacer operatively coupled to a planar member having tapered holes to receive fastening elements. When placed in the SI joint, the spacer engages the articular surfaces of the SI joint while the plate traverses the SI joint. The implant is held in place fastening elements, which are inserted through the tapered holes in the planar member. The implant is delivered via an inferior inlet MIS procedure, wherein the SI joint is accessed through an inlet inferior to the SI joint.

Abstract: A dynamic stabilization assembly includes a core, typically in the form of a tensioned cord, at least one pair of bone anchors, a spacer surrounding the core located between the bone anchors, at least one elastic bumper and at least one fixing or blocking member. The core is slidable with respect to at least one of the bone anchors, the spacer and the bumper. The bumper is compressed. Bone screws of the assembly include closure structures that lock against the bone screw independent of any fixing or sliding of the core with respect to the bone screw.

Abstract: A balloon dilator device, comprising an annularly shaped, cylindrical type structure having walls that are expandable from a radially collapsed state to a radially expanded state by inflation of a balloon inserted within the annular structure. Once the walls have been expanded, they remain in the expanded state even if the balloon is deflated, because the radially expanded state is a state of minimum mechanical potential energy, and in order to return to the collapsed state, the structure would have to pass a state of higher potential energy. The device walls require sufficient stiffness in their longitudinal direction to enable the device to be pushed into a minimally invasive incision made in the subject. This device stiffness can be achieved either by its mechanical material properties, or by its substantially closed wall structure, or by use of a stiff protector sheath used to protect the walls during insertion.

Abstract: Spinal plates with additional features to improve the stability of the interface between the plate and the underlying bone. A bone plate may include one or more sharp ridges along the periphery of its underside. When attached to bone, the ridge digs into the bone and increases stability. A bone plate may alternatively or additionally include one or more holes for optional spikes, which may be inserted once the plate is attached to the bone. By separating the spikes and including them as an optional component, the plate may enhance stability while reducing or eliminating the chance of the spike injuring the patient. Furthermore, bone screws may incorporate alternating notches and ridges into the head of the screw. The notches and ridges may interface with a set screw, thereby preventing rotation and loosening of the screw.

Abstract: A pivotal spinal screw assembly includes a shank with an upper capture portion having a tapered upper surface, a curvilinear lower surface extending upwardly and outwardly from a neck, and a side outer surface extending between the curvilinear lower surface and the tapered upper surface with a first guide and advancement structure formed therein. The assembly also includes a head member with a central bore having a reduced cross-section adjacent a lower opening configured to maintain the capture structure within the central bore, and with the lower opening having a second guide and advancement structure that is threadably mateable with the first guide and advancement structure. The curvilinear lower surface of the capture portion is configured for pivotal engagement with an internal surface on the reduced cross-section when the capture portion is disposed within the lower portion of the central bore so as to provide for pivotal angular movement of the shank relative to the head member.

Abstract: A surgical derotator instrument comprises a shaft, a handle and an articulating coupler. The shaft comprises a first end portion having a bone anchor coupling and a second end portion opposite the first end portion. The handle comprises a body portion and a slot extending in the body portion. The articulating coupler connects the shaft and the handle. A method for coupling a plurality of derotator instruments into a series of derotator instruments comprises: attaching a plurality of derotator instruments to a plurality of adjacent bone anchor housings, each derotator instrument comprising: a shaft for connecting to a bone anchor housing, a handle having a slot, and an adjustable coupler connecting the shaft and the handle; adjusting one or more of the adjustable couplers to align at least one of the slots of the series with other slots of the series; and inserting an elongate member through the at least one slots that are aligned.

Abstract: A growing rod for mounting between attachment mechanisms that are secured to anatomical structures of a patient having scoliosis. The growing rod includes an outer housing and an inner housing disposed within the outer housing. The inner housing includes a magnet assembly including a magnet having a first pole and a second pole and a gear reduction mechanism coupled to the magnet. A first rod is secured to the inner housing and a second rod is secured to the outer housing. The gear reduction mechanism reduces an output rotation of the magnet to rotate a driver that operates to move the inner housing along a longitudinal axis with respect to the outer housing.

Abstract: A bone anchor having a rod housing including a base that has an internal groove oriented at an angle oblique to the longitudinal axis of the base, a capture ring situated within the groove and oriented at an angle oblique to the longitudinal axis, and a bone fastener extending into the rod housing and including a fastener head situated within the base and having a surface that mates with the capture surface of the capture ring to maintain a connection between the bone fastener and the rod housing.

Abstract: A distractible intervertebral implant configured to be inserted in an insertion direction into an intervertebral space that is defined between a first vertebral body and a second vertebral body is disclosed. The implant may include a first body and a second body. The first body may define an outer surface that is configured to engage the first vertebral body, and an opposing inner surface that defines a rail. The second body may define an outer surface that is configured to engage the second vertebral body, and an inner surface that defines a recess configured to receive the rail of the first body. The second body moves in a vertical direction toward the second vertebral body as the second body is slid over the first body and the rail is received in the recess.

Abstract: A “vascular-safe” pedicle screw and extension-ready spinal support system. The pedicle screw includes a self-tapping flute that recessed into a threaded shaft to define terminations of the threads at a face of said self-tapping flute. The terminations are curved to define a convex profile that extends from a root to a crest of the threads at said face of said self-tapping flute. The curved terminations tend to push soft tissue aside as opposed to slicing or tearing through the soft tissue, so that the self-tapping flute is less likely to slice into vascular vessels. The distal portion of the pedicle screw may also include depressions that reduce the circumferential contact area of the pedicle screw in the direction of rotation, which increases the applied pressure to the soft tissue for a given applied rotational force. The increased pressure augments penetration of the pedicle screw through tissue without resort to sharp cutting edges.

Abstract: Surgical instruments and methods for delivering bone anchor assemblies into bone are disclosed herein. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. In general, a surgical instrument can include a handle assembly having an elongate shaft extending distally therefrom. The handle assembly can be configured to axially translate a carrier assembly that secures a stylet extending therethrough. Translation of the stylet can be made relative to a distal end of the elongate shaft. The surgical instruments can include various carrier assemblies for positioning the distal end of the stylet relative to the distal end of the elongate shaft based on a length of bone anchor to be installed by the surgical instrument.

Abstract: A coupling device is provided for coupling a rod to a bone anchoring element. The coupling device includes a receiving part having a first end, a second end, a central axis extending through the first end and the second end, and a channel for receiving a rod. The receiving part defines an accommodation space for accommodating a head of a bone anchoring element, the accommodation space having an opening for inserting the head. The coupling device further includes a pressure element arranged at least partially in the accommodation space, the pressure element having a flexible portion to clamp an inserted head, and a clamping element extending at least partially around the flexible portion of the pressure element. The clamping element is configured to move from a first position to a second position in which the clamping element exerts a clamping force onto the pressure element, where the movement includes rotating the clamping element around the central axis.

Abstract: A retractor device for breast reconstruction surgery which entails the effective exposure and visibility of the breast pocket and, at the same time, does not compromise the integrity of the subcutaneous flap, resulting in a positive outcome of the breast reconstruction procedure generally, but not exclusively, performed using a prepectoral (or sub-cutaneous) acellular biological matrix.

Abstract: A locking-cap module may include a locking-cap having a first connecting flange and a second connecting flange opposite the first connecting flange extending from a side surface of the locking-cap. The locking-cap may further include a first retaining rail and a second retaining rail opposite the first retaining rail. The locking-cap module may further include a set screw configured to engage with corresponding threads of the locking-cap. In some embodiments, the first connecting flange and second connecting flange are configured to engage with a connector such that the top surface of the locking-cap is flush with a top surface of the connector in an engaged position. In some embodiments, the set screw is initially coupled to the locking-cap by a pre-loaded connection. In some embodiments, a surgical tool is provided for rotating the locking-cap module into the engaged position.

Abstract: Devices for retracting tissue during a minimally-invasive, posterior spinal fusion procedure include a blade positionable along a passageway device connected to a connecting element implanted in a vertebra of the spine, such that the blade covers at least a portion of a longitudinal opening of the passageway device. The blade may be coupled to the passageway device by receiving the passageway device with a receiving portion. Systems for displacing the vertebrae of the spine include first and second extenders, the distal ends of each of which are configured to engage the connecting elements. Each extender may include a shaft configured to be securely engaged within a cage of the respective connecting element. The devices and systems of the present invention may be used in connection with an interbody fusion technique performed through an opening extending between the passageway devices, and an intermediate retractor blade may provide additional tissue retraction.

Abstract: Medical devices in accordance with various embodiments of the present invention employ one or more coaxial screw gear sleeve mechanisms. In various embodiments, coaxial screw gear sleeve mechanisms include a post with a threaded exterior surface and a corresponding sleeve configured to surround the post, the corresponding sleeve having a threaded interior surface configured to interface with the threaded exterior surface of the post and a geared exterior surface. A drive mechanism can be configured to interface with the geared exterior surface of the sleeve, causing the device to expand.

Abstract: An implantable body for a posterior stabilization system includes a lateral end, a medial end, an inwardly facing surface configured to abut against a lamina when the body is implanted along a vertebra. A lateral bone outrigger extends from the inwardly facing surface and may include a bone-abutting surface along a medial portion disposed to abut against a lateral mass of the vertebra when the body is implanted along a vertebra. The lateral bone outrigger may have a first height. A penetrating feature extends from the inwardly facing surface between the bone-engaging portion of the inwardly facing surface and the lateral bone outrigger. The penetrating feature may have a second height less than the first height. A fastener bore extends through the body at an angle toward the lateral bone outrigger.