Abstract: A transverse coupling for connecting multiple implant extensions includes at least a first sleeve and a second sleeve. The first sleeve defines a first aperture adapted to axially receive a first implant extension through the first aperture. The second sleeve defines a second aperture adapted to axially receive a second implant extension through the second aperture. The transverse coupling also includes a central housing. A first shaft connects the first sleeve to the central housing, and a second shaft connects the second sleeve to the central housing. The central housing includes at least one joint for connecting the central housing to at least one of the first and second shafts in a movable arrangement that allows the shaft(s) to move through one or more degrees of freedom relative to the central housing.

Abstract: A persuader instrument for advancing a fixation rod into a vertebral implant includes a housing and at least one arm. The at least one arm can include detents for detachable connection to the vertebral implant. The persuader instrument can also include a shaft coupled to an anchor. The anchor can include a fixation rod engagement surface. The shaft can be axially displaceable through the housing to axially displace the anchor and a rod engaged by the anchor. The persuader instrument can further include an auto-locking ratchet assembly in releasable engagement with the shaft. The auto-locking ratchet assembly can control axial displacement of the shaft through the longitudinal passage of the housing.

Abstract: A universal drill guide system includes a universal drill guide, interchangeable drill tubes, and interchangeable drill bits. Each interchangeable drill tube corresponds to one of the interchangeable drill bits, and can be detachably coupled to the universal drill guide. A cannulated drill with K-wire retention features a drill bit with a retention mechanism that prevents axial advancement of a K-wire during drilling. A drill removal tool includes a drill remover that can be placed around a drill bit to remove it from bone after a hole is drilled, while leaving a K-wire in place in the bone. A bone screw driver with K-wire retention includes a shaft that can be passed over a K-wire, a distal end for attachment to a cannulated bone screw, and a K-wire retention module for preventing advancement of the K-wire as the screw driver drives the cannulated bone screw into bone.

Abstract: A surgical instrument for correcting spinal deformities includes a tubular body adapted to receive a second instrument through the tubular body. The tubular body forms a transverse passage adapted to receive a longitudinal fixation element through the tubular body. The tubular body further includes first and second arms for connecting the surgical instrument to a vertebral anchor. The first and second arms include one or more anti-splaying features adapted to mate with anti-splaying features on the second instrument to prevent the first and second arms from splaying as the second instrument is inserted into the tubular body.

Abstract: A transverse coupling for connecting multiple implant extensions includes at least a first sleeve and a second sleeve. The first sleeve defines a first aperture adapted to axially receive a first implant extension through the first aperture. The second sleeve defines a second aperture adapted to axially receive a second implant extension through the second aperture. The transverse coupling also includes a central housing. A first shaft connects the first sleeve to the central housing, and a second shaft connects the second sleeve to the central housing. The central housing includes at least one joint for connecting the central housing to at least one of the first and second shafts in a movable arrangement that allows the shaft(s) to move through one or more degrees of freedom relative to the central housing.

Abstract: A vertebral body replacement device includes a first member and a first footplate detachably connectable to the first member, a second member and a second footplate detachably connectable to the second member, and a central member detachably connectable to the first member. The first member is displaceable relative to the second member in response to rotation of the central member relative to the first member to adjust the length of the vertebral body replacement device. The first footplate includes a first surface oriented toward the first member, a second surface oriented away from the first member, and a sidewall extending between the first surface and the second surface. The first surface includes an alignment slot facing the first member. The alignment slot is open through the sidewall of the first footplate and configured to slidingly engage the first member to orient the first footplate relative to the first member.

Abstract: A vertebral body replacement device includes a first member and a first footplate detachably connectable to the first member, a second member and a second footplate detachably connectable to the second member, and a central member detachably connectable to the first member. The first member is axially displaceable relative to the second member in response to rotation of the central member relative to the first member to adjust the length of the vertebral body replacement device. The first member includes a pair of first fastener holes and a pair of second fastener holes angularly offset from the first fastener holes. The first footplate includes an aperture configured to align with one of the first fastener holes to orient the footplate in a first position or one of the second fastener holes to orient the footplate in a second position.

Abstract: A spinal interbody device, system and method can include use of an interbody cage and plate. The interbody cage can include at least one of a key and a keyway configured to mate with at least one of a mating keyway and key located on the plate. The key and keyway can be configured such that the cage and plate are quickly and easily attached and detached from each other, and such that positional relationship between the cage and plate can be arrived at quickly, accurately, and with tactile and/or audile notice to the practitioner.

Abstract: A spinal interbody device, system and method can include an interbody device configured to stabilize or otherwise support adjacent vertebrae. The interbody device can include a central opening and can be shaped as a trapezoid as viewed from a position on the central axis located above a superior or upper surface of the interbody device. In addition, the upper surface of the interbody device can include at least one keel or spike to facilitate locking of the interbody device with adjacent vertebrae. The at least one spike can be removable and can be adjustable relative to the superior or inferior surface(s) when installed.

Abstract: The disclosed subject matter relates a medical instrument having a rotational drive mechanism that can be integrated into a variety of medical devices, including a tool used as an external retaining ring removal tool or as a non-marring bushing inserter, or in a spinal interbody device. The tool can include a knob portion at a proximal end and a drive mechanism at the distal end. The drive mechanism can include a plurality of drive pins that can be actuated to extend outward by rotating the knob portion. The spinal interbody device can include a drive mechanism configured to translate rotational motion into a linear driving motion to cause locking projections to move into engagement with vertebrae.

Abstract: The disclosed subject matter includes a fastener, a system and methods for use and manufacture. The fastener can include a head disposed at a proximal end of the fastener, a shaft connected to the head, and at least one of the head and the shaft can include a plurality of flat surfaces. A collar can extend about the longitudinal axis of the fastener and can have a proximal-most surface spaced in a longitudinal axis direction away from a proximal-most surface of the fastener. The collar can include a plurality of petals spaced about the longitudinal axis, each of the plurality of petals including a flat surface facing a respective one of the plurality of flat surfaces of the at least one of the head and the shaft. A plate and/or a cage can be included with the fastener for use in a spinal connection, kit or repair system.

Abstract: A vertebral body replacement device includes a body member and a central rod member having two threaded portions and configured to be operatively associated with the body member. The device also includes a first end member and a second end member with the end members configured to threadingly engage the threaded portions of the central rod member. The body member and the two end members are further constructed to inhibit rotational movement of the two end members when the device is positioned within a space within a spine as the two end members will engage the adjacent respective vertebral bodies following rotational actuation of the central rod member causing the end members to move in an axial direction relative to the body member, thereby allowing the two end members to apply a force to the two vertebral bodies. A surgical instrument and method for using the device are also disclosed.

Abstract: The disclosed subject matter relates a medical instrument having a rotational drive mechanism that can be integrated into a variety of medical devices, including a tool used as an external retaining ring removal tool or as a non-marring bushing inserter, or in a spinal interbody device. The tool can include a knob portion at a proximal end and a drive mechanism at the distal end. The drive mechanism can include a plurality of drive pins that can be actuated to extend outward by rotating the knob portion. The spinal interbody device can include a drive mechanism configured to translate rotational motion into a linear driving motion to cause locking projections to move into engagement with vertebrae.

Abstract: A rod inserter, system and method are provided which allows for insertion of a rod through a freehand method. The inserter can include an extension structure extending from a handle, the extension structure having a distal end, a proximal end, and a longitudinal axis. The inserter can also include a plurality of linkage structures located in a passageway in the extension structure. The linkage structures can cause a rod connection structure to connect to the rod when the distal linkage structure is moved in a first direction, and to cause the rod connection structure to disconnect from the rod when the distal linkage structure is moved in a second direction substantially opposite to the first direction.

Abstract: A flexible container, system and method of manufacture can include an in-line system that allows flexible containers of varying sizes to be manufactured in a single relatively high speed and efficient production line and in a single clean room through the use of transport and exchange equipment configured to adeptly handle flexible containers throughout the process.

Abstract: A rod inserter, system and method can include an inserter that has a handle and an extension structure extending from the handle. A knob and a lever can be located adjacent the handle. A rod connection structure can be located at the distal end of the extension structure, and configured to rotate with respect to the extension structure. The rod connection structure can include a first clamshell structure and a second clamshell structure configured to move towards and away from each other in order to connect and disconnect from a rod, such as a spinal rod. The knob can be configured such that when actuated the first clamshell structure and second clamshell structure move with respect to each other. The lever can be configured such that when actuated the first clamshell structure and second clamshell structure are prevented from rotating with respect to the extension structure.

Abstract: A surgical ratchet tool and system along with associated methods are disclosed. The surgical ratchet tool can include a relatively simple encompassing member that included a pawl extending into the opening for directly contacting a nut during surgery. The ratchet tool and system can be used for various types of surgery in which easy sterilization and a reduced profile for a ratchet tool is desired. For example, the ratchet tool can be used during surgery for adjustment of a spinal implant, where manipulation of a nut located on a downtube connected to a screw and/or spinal rod is desired. The encompassing member and pawl can be constructed/molded as a single piece unitary structure. A first handle and possibly a second handle can extend from an outer periphery of the encompassing member.

Abstract: A two step locking screw assembly includes a receiving member for receiving a fixation member and an anchor having an enlarged portion and a shank. The enlarged portion of the anchor may be seated in the receiving member. An insert may also extend inside the receiving member. An outer fastener may be positioned in the receiving member. The outer fastener may include a central opening and a pair of ramped flanges. An inner fastener may be disposed inside the central opening of the outer fastener.

Abstract: A spinal rod persuader, system and method can include an outer tube, an inner tube, and a locking element. A first actuation mechanism can be movable in a linear fashion along a longitudinal axis direction to cause the locking element to move in a linear fashion over the inner tube and to lock the inner tube onto a pedicle screw. A second actuation mechanism can be rotated to cause the outer tube to move in a longitudinal axis direction with respect to the inner tube to push the spinal rod into a final position with respect to the pedicle screw while the pedicle screw is locked to the inner tube. A slot and/or tab structure can be provided in the outer tube such that actuation of the slot/tab will allow disassembly of the inner tube, outer tube and locking element with respect to each other.