Abstract: A speculum comprising a lower member including a handle having a proximal end and a distal end, and a lower blade extending from the proximal end of the handle, an upper blade configured to be movable with respect to the lower member, and an illumination assembly including at least one light source, at least one power source housed in the handle and an ejection mechanism for removal of the at least one power source from the handle, wherein the at least one power source is housed in the handle at a position closer to the proximal end of the handle than to the distal end, and wherein the ejection mechanism is configured to remove the at least one power source via an opening formed in the distal end of the handle.

Abstract: An apparatus is provided for performing spinal surgery having a handle assembly, a screw guide, and a retractor. A shaft is provided with a handle, a neck portion and a connecting portion. The screw guide is provided with a connecting element coupled to the connecting portion of the handle assembly. A retractor for retracting tissue is coupled to the screw guide, wherein the neck portion of the handle assembly is provided with a spring loaded sleeve adapted to engage one of a plurality of holes positioned on a portion of the connecting element. The connecting portion is pivotably coupled to the connecting element.

Abstract: A bone fixation system with variable z-axis translation is provided. The system includes an outer tulip coupled to a bone fastener via a screw retainer. An inner tulip is coupled to the outer tulip such that the inner tulip is longitudinally movably relative to the outer tulip. The inner tulip includes a lock that provides a seat for a connecting rod. The inner tulip together with a seated rod is permitted to translate along the z-axis inside the outer tulip when in an unlocked position. Also in the unlocked position, the bone fastener is free to angulate relative to the outer tulip. The z-axis position of the inner tulip and rod relative to the outer tulip is fixed in a locked position. Also, in the locked position, the bone fastener is locked with respect to the outer tulip. The system may be adjusted between the locked and unlocked positions by way of a set screw.

Abstract: A pivotal bone anchor assembly includes a bone anchor having a capture portion and an anchor portion opposite the capture portion, and a receiver assembly in a pre-assembled configuration that includes a receiver, a retainer, and a pressure insert. The receiver has an internal cavity for receiving the capture portion through a bottom opening and an axial bore with inwardly facing interference wedging surfaces. The pre-assembled retainer is configured to separate to receive the capture portion of the bone anchor within the internal cavity during its uploading through the bottom opening, after which the pre-assembled insert is downwardly deployable with tooling, prior to the installation of an elongate rod and closure, until an outer surface of the insert comes into forced interference wedging contact with the interference wedging surfaces of the axial bore so as to inhibit the pressure insert from moving back up within the receiver.

Abstract: A surgical instrument includes spinal implant reduction instrument defining a longitudinal axis. The spinal implant reduction instrument includes a first member connected to a body. The first member includes a tapered projection configured to interlock to a first mating recess of a bone fastener. A second member is connected to the body. The second member includes a tapered projection configured to interlock to a second mating recess of the bone fastener. At least one of the members is rotatable relative to the longitudinal axis for connecting the members to the bone fastener. Systems, spinal constructs, implants and methods are disclosed.

Abstract: An implant system for use in orthopaedic surgery for fixation of bone includes an intramedullary nail and a coupling member. The intramedullary nail includes a proximal portion defining a longitudinal axis. The proximal portion includes an axial bore defining an axis substantially parallel to the longitudinal axis of the proximal portion and a transverse bore configured to receive a bone fastener. The coupling member includes a through hole and is movably arranged within the axial bore of the proximal portion. Further, the coupling member includes a drive portion and a bone fastener engagement portion. The drive portion is in one variant non-rotatably coupled to the bone fastener engagement portion. The bone fastener engagement portion is configured to engage the bone fastener penetrating the transverse bore. In one variant the engagement is realized via an extended contact region.

Abstract: Apparatus and devices for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.

Abstract: The present application is directed to various spinal stabilization systems and methods. The systems can include a plurality of spinal screws each having a screw head. The systems can also include one or more wires directly or indirectly connected to the screw heads of each of the spinal screws. The systems can also include one or more towers that is configured to be removably advanced over the wires. The spinal implant of the system can be configured to be positioned within the screw heads of the plurality of spinal screws.

Abstract: An expandable support device for tissue repair is disclosed. The device can be used to repair hard or soft tissue, such as bone. The expandable support device can have interconnected struts. A method of repairing tissue is also disclosed. The expandable support device can be inserted into a damaged bone and radial expanded. The radial expansion of the expandable support device struts can cause the struts to cut mechanically support and/or the bone.

Abstract: Coupling device for connecting an annular fixation member to a bone pin, wherein the coupling device comprises pin connecting means arranged for connecting the bone pin to the coupling device and ring connecting means arranged for removably connecting the annular fixation member to the coupling device, wherein the coupling device further comprises fixator connecting means arranged for removably connecting a fixator to the coupling device, wherein the ring connecting means and the fixator connecting means are arranged for simultaneously connecting the annular fixation member and the fixator while the pin connecting means are connected to the bone pin.

Abstract: A spinal-correction system having (i) a receiver including a base and opposing arms extending proximally from the base forming a rod-receiving cavity, (ii) a pair of extender tabs, each extender tab having threaded inner walls for receiving threads of a setscrew, (iii) a pair of tab extenders each being connectable releasably to one of the extender tabs, (iv) a cap instrument connectable releasably to the tab extenders, and (v) a pair of breakoff sections, each connecting one of the extender tabs to one of the receiver arms, and each being readily breakable for separating the extender tab from the receiver arm. The distal base defines a bonescrew cavity to receive a bonescrew head so that the head can move relative to the base. Each receiver arm has threaded inner walls for receiving setscrew threads. The rod-receiving cavity has geometry corresponds to geometry of the setscrew and a spinal-correction rod.

Abstract: A spinal-surgery system having a rod receiver and/or a cap for use insertion and removal from the receiver. The cap has a generally cylindrical body, a set of opposing splay-resisting flanges, and set of opposing rotation-preventing wings, the flanges extending radially from the body along a first radial line of the body, and the wings extending radially away from the body along a second radial line of the body generally orthogonal to the first radial line. Each cap flange has a proximal-facing cap splay-resisting surface, and a distal-facing cap pop-on surface. Each receiver proximal protrusion has a proximal-facing sloped receiver pop-on surface, and a distal-facing sloped receiver splay-resisting surface. The receiver pop-on surfaces are spaced such that each cap pop-on surface contacts a respective receiver pop-on surface when the cap is centered, with the cap wings aligned between receiver arms, and moved distally to contact the receiver.

Abstract: A surgical fixation system including a base plate, a plurality of anchors and a locking element. The base plate has at least a pair of fixation apertures configured to receive at least a portion of the anchors therethrough. The fixation apertures are located within the base plate such that upon proper placement of the base plate within a surgical target site, one of the fixation apertures is positioned over a first bone segment (e.g., a first vertebral body), and the other fixation aperture is positioned over a second bone segment (e.g., a second vertebral body).

Abstract: A spinal correction apparatus comprises a body. A ratchet is disposed with the body. A longitudinal element is connected to the ratchet. A force is applied to at least a portion of the apparatus that causes dynamic incremental movement of the longitudinal element relative to the body in at least one direction. Methods of use are disclosed.

Abstract: A spinal construct comprises a fastener including a head. A member includes an inner surface defining a cavity configured for disposal of the head and a groove configured for disposal of a band that is engageable with the head to connect the fastener and the member. The member includes a transverse rod. A coupling member is engageable with the inner surface. Implants, systems, instruments and methods are disclosed.

Abstract: An expandable facet joint fixation device, including a first collar, a central shaft including a first end and a second end, the first end rotatably connected to the first collar, a second collar including a radially inward facing surface, the second collar concentrically arranged around the central shaft, and one or more expandable members, each of the one or more expandable members including a first arm hingedly connected to the first collar, a second arm hingedly connected to the second collar, the second arm hingedly connected to the first arm, wherein when the second collar is displaced in a first axial direction relative to the first collar, the one or more expandable members displace radially outward in a first radial direction.

Abstract: Methods and apparatus for affixing a retaining washer proximate an interbody region following a direct lateral interbody fusion (DLIF) procedure. The system includes an installation device characterized by a width dimension W and a length dimension L; a retaining washer having a substantially planar surface region, the retaining washer configured to retain an interbody graft within an interbody region; and a screw having a shaft configured to secure the retaining washer to a vertebral body. The screw and the washer are configured to orient the screw shaft along an angle ?, where ? is a function of W and L.

Abstract: The present invention includes a pedicle screw made with a bone fastener and a rod coupling head, the rod coupling head comprising an upper rod coupling: the lower rod coupling having a lateral rod opening adapted to receive a permanent rod; an angled bore extends into the lateral rod opening; and a permanent rod fastener in the angled bore to engage a permanent rod in the lateral rod opening; and a upper rod coupling having an upper rod opening adapted to receive a temporary rod, wherein the upper rod opening is formed to receive a temporary rod fastener; wherein the upper rod coupling is detachable from the lower rod coupling at a transition and a temporary rod is temporarily affixed into the upper rod opening during a bone realignment and a permanent rod is positioned in the lateral rod opening and engaged by the permanent rod fastener upon final bone alignment.

Abstract: A tool set for implanting bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws includes a pair of independently mountable and manipulatable elongate guide tools that form a unitary tool guide when desired. Each guide tool includes attachment structure for independent operable connection of the guide tool to an arm of the bone screw. The bone screw/guide tool attachment includes an undercut and/or recess so as to resist separation of the guide tool member from an attached bone screw. Further tools include a removable stabilizer, a cooperating bone screw driver with an attached stabilizer, a closure starter/reduction tool, a closure driver and a counter torque tool.

Abstract: Interbody fusion devices, insertion tools, methods for assembling an interbody fusion device, and methods for inserting a medical device between two vertebral bodies are disclosed. The interbody fusion device includes a base member, a top member, and at least one movement mechanism. The base member includes at least one of a pivotal cylinder and a hinge channel. The top member includes at least one of a pivot cylinder and a hinge channel. The at least one pivot cylinder of the base member engages the at least one hinge channel of the top member and the at least one pivot cylinder of the top member engages the at least one hinge channel of the base member. The at least one movement mechanism engages the top member and the base member. Also disclosed are a vertebral spacer device and an interbody spacer system including an insertion tool and an interbody fusion device.