Abstract: Systems and methods for en bloc derotating a spinal column are provided. In one exemplary embodiment, the method can include manipulating first and second frames coupled respectively to a first set of vertebrae and a second set of vertebrae to derotate the first and second sets of vertebrae relative to one another, and subsequently locking a linkage assembly coupled respectively to the first and second frames to maintain the first and second sets of vertebrae in a derotated position.

Abstract: Systems and methods for en bloc derotating a spinal column are provided. In one exemplary embodiment, the method can include manipulating first and second frames coupled respectively to a first set of vertebrae and a second set of vertebrae to derotate the first and second sets of vertebrae relative to one another, and subsequently locking a linkage assembly coupled respectively to the first and second frames to maintain the first and second sets of vertebrae in a derotated position.

Abstract: Bone screw drivers are disclosed that apply torque to a threaded shank of a bone screw assembly and receive a cement delivery device to introduce bone cement through the threaded shank. Also disclosed are driver adapters that couple to a driver in order to facilitate application of torque thereto. The driver adapter can decouple from the driver after implanting a bone screw shank to allow the subsequent use of a cement delivery device in combination with the driver. The devices can be reusable and can employ a number of additional components, including retaining and counter-torque sleeves, driving handles, etc. Further, the devices can allow setup of a bone screw inserter assembly outside a surgical field, such that a completed assembly can be passed to a surgeon or other user for immediate use.

Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: Systems and methods for en bloc derotating a spinal column are provided. In one exemplary embodiment, the method can include manipulating first and second frames coupled respectively to a first set of vertebrae and a second set of vertebrae to derotate the first and second sets of vertebrae relative to one another, and subsequently locking a linkage assembly coupled respectively to the first and second frames to maintain the first and second sets of vertebrae in a derotated position.

Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: A surgical access device includes a proximal frame of fixed construction and a plurality of tissue engaging blades connected to the frame. The plurality of tissue engaging blades may include a first blade that is rotatable, independent of other blades, about an axis that is oriented approximately parallel to a plane defined by the proximal frame.

Abstract: Bottom-loading, for assembly, bone anchor assemblies for fixing a spinal connection element to bone and methods of assembly are described, which are particularly suited for, but not limited to, large diameter bone screws. The assembly includes a receiver member for receiving the spinal connection element, a bone-engaging shank for engaging bone and a retaining member for retaining the head of the shank within the receiver member.

Abstract: An instrument for manipulating a spinal fixation element relative to a bone anchor includes a bone anchor grasping mechanism, a first adjustment mechanism, and a second adjustment mechanism. The bone anchor grasping mechanism includes a first arm having a distal end configured to engage an opening provided in the bone anchor. The first adjustment mechanism includes a second arm pivotally connected to the first arm. The second arm has a distal end configured to engage an opening provided in the bone anchor and is operable to adjust a spinal fixation element in a first direction upon pivoting relative to the first arm. The second adjustment mechanism is removably and replaceably coupled to the bone anchor grasping mechanism and is movable relative to the bone anchor grasping mechanism to adjust the spinal fixation element in a second direction, perpendicular to the first direction, relative to the bone anchor.

Abstract: A surgical retractor includes a plurality of blade assemblies interconnected by a plurality of racks. One or more of the blade assemblies is movable along a rack to selectively expand the retractor. At least one of the blade assemblies includes a blade that is rotatably connected to the blade assembly and that is rotatable independent of other blades of the retractor.

Abstract: A surgical access device includes a proximal frame of fixed construction and a plurality of tissue engaging blades connected to the frame. The plurality of tissue engaging blades may include a first blade that is rotatable, independent of other blades, about an axis that is oriented approximately parallel to a plane defined by the proximal frame.

Abstract: A fastener assembly for a spinal fixation system that is particularly useful in treatment of pediatric and small-statured patients includes a fastener, an attachment member, and a locking member. The fastener has a lower portion for contacting a bone and an upper portion integral with the lower portion. The upper portion has two open channels. Each channel is configured and dimensioned to receive a portion of a longitudinal or connecting member along its circumference. The attachment member is positionable on the fastener and at least partially covers the channel that receives the longitudinal or connecting member. The locking member is operatively associated with the upper portion of the fastener and secures the attachment member and the longitudinal or connecting member to the fastener.

Abstract: An instrument for manipulating a spinal fixation element relative to a bone anchor includes a bone anchor grasping mechanism, a first adjustment mechanism, and a second adjustment mechanism. The bone anchor grasping mechanism includes a first arm having a distal end configured to engage an opening provided in the bone anchor. The first adjustment mechanism includes a second arm pivotally connected to the first arm. The second arm has a distal end configured to engage an opening provided in the bone anchor and is operable to adjust a spinal fixation element in a first direction upon pivoting relative to the first arm. The second adjustment mechanism is coupled to the bone anchor grasping mechanism or the first adjustment mechanism and is movable relative to the bone anchor grasping mechanism to adjust the spinal fixation element in a second direction, perpendicular to the first direction, relative to the bone anchor.

Abstract: An instrument and method for bending a surgical implant, such as a spinal rod, includes a lever pivotally connected to a handle through a movable linkage system. The movable linkage system includes one or more bearing surfaces for applying a force to a first portion of the surgical implant while a rod seat connected to the handle holds an adjacent second portion of the surgical implant in a fixed position, thereby causing the surgical implant to bend between the first and second portion. The instrument can be easily operated using a single hand, is easy to control and requires a relatively small amount of force to bend a surgical implant. The instrument can include an automatic advancement means for advancing the surgical implant after bending to bend another portion of the surgical implant by a selected amount. The instrument can also be used for bending spinal rods having a non-circular cross-section in multiple planes.

Abstract: An instrument and method for bending a surgical implant, such as a spinal rod, includes a lever pivotally connected to a handle through a movable linkage system. The movable linkage system includes one or more bearing surfaces for applying a force to a first portion of the surgical implant while a rod seat connected to the handle holds an adjacent second portion of the surgical implant in a fixed position, thereby causing the surgical implant to bend between the first and second portion. The instrument can be easily operated using a single hand, is easy to control and requires a relatively small amount of force to bend a surgical implant. The instrument can include an automatic advancement means for advancing the surgical implant after bending to bend another portion of the surgical implant by a selected amount. The instrument can also be used for bending spinal rods having a non-circular cross-section in multiple planes.

Abstract: An instrument for engaging a bone anchor may include a first implant engaging member having a proximal end and a distal end and a second implant engaging member having a proximal end and a distal end. The second implant engaging member may be integrally connected to the first implant engaging member by a pair of opposed integral spring members located proximal to the distal ends of the first and second implant engaging members. Manipulation of the proximal ends of the first and second implant engaging member can cause each of the distal ends to rotate about the pair of opposed spring members to engage at least a portion of a bone anchor. A rod adjusting tool may be connectable to the bone anchor engaging tool and may be axially adjustable relative to the bone anchor tool to adjust a spinal rod relative to the bone anchor.

Abstract: An instrument for guiding a spinal rod into a rod-receiving portion of an implant comprises a linear portion comprising two relatively moveable shafts, an actuator portion coupled to the linear portion for moving the spinal rod relative to the implant and a handle portion for moving the shafts to actuate the actuator portion. The actuator portion holds the rod in place until the surgeon inserts a setscrew or other device for securing the rod to the anchor. The actuator portion further defines a path for inserting and securing a locking device, such as a setscrew, for securing the rod in the implant while also holding the rod in the implant. The path for the screw is aligned with the rod-holding portion of the implant. Using the instrument, a surgeon can guide a rod into a selected position in the implant, reposition the spine to match the contour of the rod, hold the rod in the selected position and secure the rod to the implant.