Abstract: Various exemplary methods and devices are provided for fixing bone anchors to bone. In general, the methods and devices can allow for a bone anchor to be fixed to a bone at a desired angle to a surface of the bone. In an exemplary embodiment, a bone anchor assembly is provided that includes a bone anchor configured to engage bone, a receiver member for seating a head of the bone anchor, and a compression member for securing the bone anchor at fixed angle with respect to the receiver member when the compression member is seated within the receiver member. Corresponding engagement features of the compression member and the receiver member can be engaged in a secured configuration to inhibit or prevent removal of the compression cap from the receiver member and optionally to substantially prevent longitudinal and/or rotational movement of the compression member with respect to the receiver member.

Abstract: Various angularly-adjustable spinal fixation systems are provided and generally include an articulating connector having first and second elongate rods extending therefrom, and first and second polyaxial bone screw assemblies configured to seat the first and second rods therein. The rods are configured to be seated within receiver heads of the polyaxial bone screw assemblies when the screws are implanted in opposed lateral sides of a vertebra, thereby allowing the receiver heads to be manipulated relative to the rods to reduce one or more posterior fractures. A joint on the articulating connector can also be manipulated to reduce one or more anterior fractures. The entire construct can be locked to maintain the fractures in the reduced configuration.

Abstract: Instruments and related methods for breaking reduction tabs are disclosed herein, e.g., for breaking reduction tabs of a bone anchor or other implant. In some embodiments, the instrument can be configured to minimize the space needed to operate the instrument. For example, the instrument can be configured to receive a reduction tab that is to be broken while the instrument is coaxially positioned with respect to a bone anchor receiver to which the reduction tab is attached. As another example, the instrument can have a maximum outer transverse dimension that is less than, equal to, or only slightly greater than a corresponding dimension of a bone anchor from which a reduction tab is to be broken. Guide rods for positioning a tab breaker instrument over a reduction tab are also disclosed.

Abstract: Methods, systems, and devices are provided for the alignment of implants or fastener members. For example, a surgical driver device is provided that has a driver head with a sidewall, a bore extending into a distal end of the driver head that is configured to receive an implant therein, and an alignment post that is disposed within the bore and extends distally beyond a distal opening of the bore. A retention member is disposed along a perimeter of the driver head and is configured to provide an interference fit between the driver head and an implant. A surgical caddie is also provided that has a housing, a plurality of implants on a mounting station, and a removal post that external threads that are matable with internal threads on each of the plurality of implants.

Abstract: Instruments and related methods for breaking reduction tabs are disclosed herein, e.g., for breaking reduction tabs of a bone anchor or other implant. In some embodiments, the instrument can be configured to minimize the space needed to operate the instrument. For example, the instrument can be configured to receive a reduction tab that is to be broken while the instrument is coaxially positioned with respect to a bone anchor receiver to which the reduction tab is attached. As another example, the instrument can have a maximum outer transverse dimension that is less than, equal to, or only slightly greater than a corresponding dimension of a bone anchor from which a reduction tab is to be broken. Guide rods for positioning a tab breaker instrument over a reduction tab are also disclosed.

Abstract: A bone anchor assembly includes a bone anchor, a receiver member for receiving a spinal fixation element to be coupled to the bone anchor, a compression member positioned within the receiver member, and a closure mechanism including an outer set screw and an inner set screw. The outer set screw delivers a distal force to the compression member to fix the bone anchor relative to the receiver member. The proximal surface of the compression member has a shape configured to restrict deformation of the compression member arms including motion of the compression member arms relative to each other. The distal surface of the outer set screw has a shape that is complementary to the shape of the proximal surface of the compression member.

Abstract: Kerrison-style rod reducers, inline-style rod reducers, and related methods of using the disclosed rod reducers for holding a spinal implant and seating a fixation rod in a rod-receiving portion of the spinal implant are provided for herein. The disclosed rod reducers can also be configured for applying a set screw or other closure mechanism to secure the rod within the rod-receiving portion of the spinal implant. The disclosed embodiments can be easy to use, not require significant force to operate, and be efficient, thereby reducing the time and expense necessary to perform spinal surgery. The disclosed rod reducers can be readily dissembled, thereby making these surgical instruments easy to clean and sterilize.

Abstract: Kerrison-style rod reducers, inline-style rod reducers, and related methods of using the disclosed rod reducers for holding a spinal implant and seating a fixation rod in a rod-receiving portion of the spinal implant are provided for herein. The disclosed rod reducers can also be configured for applying a set screw or other closure mechanism to secure the rod within the rod-receiving portion of the spinal implant. The disclosed embodiments can be easy to use, not require significant force to operate, and be efficient, thereby reducing the time and expense necessary to perform spinal surgery. The disclosed rod reducers can be readily dissembled, thereby making these surgical instruments easy to clean and sterilize.

Abstract: Surgical methods and devices are provided for bending spinal rods. In one embodiment, a handheld tool is provided having an elongate shaft with a lumen formed therein that is configured to accommodate a spinal rod. The tool can include an opening in a proximal end that is configured to permit the loading of the spinal rod into the lumen, and a plurality of openings spaced along a longitudinal axis thereof that intersect the lumen for allowing a user to view and/or grasp a rod extending through the rod-receiving lumen and positioned within one of the plurality of openings. The tool can further be configured to permit a bent spinal rod to be received within the lumen. For example, the tool can include a channel in a lower surface thereof that allows a rod to exit the lumen and to extend laterally away from the tool.

Abstract: Various exemplary methods and devices are provided for the removal and retention of bone screw rod reduction tabs extending from one or more bone screws implanted in a spinal column during a surgical procedure. In one embodiment, a removal and retention tool is provided having an elongated shaft with a channel formed therein that is configured to receive a rod reduction tab. The elongate shaft can be advanced over a rod reduction tab on a screw, and moved laterally to detach the reduction tab from the screw. The tool can include features to engage and retain the detached tab within the channel. Moreover, the tool can be configured to receive and retain multiple tabs, thus eliminating the need to remove the tool from a surgical site. The tool can also include a release actuator for releasing any tabs stored within the elongate shaft as may be needed.

Abstract: Multi-function driver instruments and related methods are disclosed herein, e.g., for applying a fastener to a bone anchor. In some embodiments, a single instrument can include features for driving multiple different types of fasteners, independently driving multiple different components of a single fastener assembly, and so forth, with the instrument being switchable between multiple operating modes to select the feature needed for a particular function. The instrument can include features for retaining a fastener to the instrument, e.g., during initial insertion of the fastener.

Abstract: Multi-function driver instruments and related methods are disclosed herein, e.g., for applying a fastener to a bone anchor. In some embodiments, a single instrument can include features for driving multiple different types of fasteners, independently driving multiple different components of a single fastener assembly, and so forth, with the instrument being switchable between multiple operating modes to select the feature needed for a particular function. The instrument can include features for retaining a fastener to the instrument, e.g., during initial insertion of the fastener.

Abstract: Methods, systems, and devices are provided for the alignment of implants or fastener members. For example, a surgical driver device is provided that has a driver head with a sidewall, a bore extending into a distal end of the driver head that is configured to receive an implant therein, and an alignment post that is disposed within the bore and extends distally beyond a distal opening of the bore. A retention member is disposed along a perimeter of the driver head and is configured to provide an interference fit between the driver head and an implant. A surgical caddie is also provided that has a housing, a plurality of implants on a mounting station, and a removal post that external threads that are matable with internal threads on each of the plurality of implants.

Abstract: Devices and methods that allow a rod to be offset in a relatively small amount of space are disclosed herein. In some embodiments, first and second offset rods can be joined by a plate-type connector having a reduced thickness suitable for insertion into a small space, e.g., between adjacent bone anchors. In some embodiments, first and second offset rods can be joined by a curved connector that conforms to adjacent bone anchors and likewise has a reduced thickness.

Abstract: Various exemplary methods and devices are provided for fixing bone anchors to bone. In general, the methods and devices can allow for a bone anchor to be fixed to a bone at a desired angle to a receiver member. In an exemplary embodiment, a bone anchor assembly is provided that includes a bone anchor configured to engage bone, a receiver member that seats a spherical head of the bone anchor and a spinal fixation element, a compression member seated within the receiver member, proximally of the head of the bone anchor, and a closure mechanism seated within the receiver member, proximally of the compression member. One or more of the receiver member, the compression member, and the closure mechanism can have gripping features thereon configured to secure the bone anchor and/or the spinal fixation element within the receiver member, thereby reducing a risk of slippage of the bone anchor and/or the spinal fixation element with respect to the receiver member.

Abstract: Devices and methods that allow a rod to be offset in a relatively small amount of space are disclosed herein. In some embodiments, first and second offset rods can be joined by a plate-type connector having a reduced thickness suitable for insertion into a small space, e.g., between adjacent bone anchors. In some embodiments, first and second offset rods can be joined by a curved connector that conforms to adjacent bone anchors and likewise has a reduced thickness.

Abstract: A cannulated bone anchor assembly includes a bone anchor, a receiver member for receiving a spinal fixation element to be coupled to the bone anchor, and a closure mechanism to fix the spinal fixation element with respect to the receiver member. The bone anchor includes a distal shaft having a first threaded section distal to a proximal head, a second threaded section distal to and adjacent the first threaded section, and a third threaded section distal to and adjacent the second threaded section. The first threaded section having a constant major and minor diameter. The second threaded section having a tapering major and minor diameter. The third threaded section having a tapering major diameter and a constant minor diameter.

Abstract: Devices and methods for selectively converting polyaxial bone screws into monoaxial screws are described herein. In one embodiment, a spinal screw extension instrument is provided having an outer component configured to engage a receiving member of a polyaxial screw. The instrument further includes an inner component disposed within an inner lumen of the outer component and configured to translate longitudinally relative to the outer component such that the inner component can apply a distal force to a compression member of the polyaxial screw disposed within a distal portion of the receiving member to thereby convert the polyaxial screw to a monoaxial screw.

Abstract: Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a receiver member having an aperture formed in a distal end thereof through which the head portion of the shank can be received, the receiver member defining a polyaxial seat, a non-expandable outer ring configured to be polyaxially disposed within the polyaxial seat of the receiver member and defining a central opening through which the head portion of the shank can be received, and an expandable inner ring having an inner surface configured to mate with the head portion of the shank and an outer surface configured to mate with an inner surface of the outer ring to thereby lock the outer ring in a fixed position relative to the shank.

Abstract: Various exemplary methods and devices are provided for fixing bone anchors to bone. In general, the methods and devices can allow for a bone anchor to be fixed to a bone at a desired angle to a surface of the bone. In an exemplary embodiment, a bone anchor assembly is provided that includes a bone anchor configured to engage bone, a receiver member for seating a head of the bone anchor, and a compression member for securing the bone anchor at fixed angle with respect to the receiver member when the compression member is seated within the receiver member. Corresponding engagement features of the compression member and the receiver member can be engaged in a secured configuration to inhibit or prevent removal of the compression cap from the receiver member and optionally to substantially prevent longitudinal and/or rotational movement of the compression member with respect to the receiver member.