Abstract: An improved joint fusion screw for transiliac fixation has a screw head and extending therefrom an elongate hollow shaft. The hollow shaft has an externally threaded end portion extending to a tip end and a non-externally threaded shank portion having a plurality of window openings. At or near the tip end is a start of a thread with a bone cutting flute. The bone cutting flute has a cutting edge on a circumferential exterior of the threaded tip to cut bone and directs the cut bone internally into a bone receiving opening in the hollow shaft directly in front of the cutting flute. The cutting edge lies at the start of the thread extending radially above the bone receiving opening at least partially overhanging the opening configured to cut bone.

Abstract: A modular tulip assembly has a rod receiving tulip and a saddle. The saddle is interlockingly held inside a distal portion of the tulip. The saddle has a locking projection. The tulip has a pair of grooves or recesses. The locking projection is positioned into the proximal tulip groove or recess and holds the saddle in a pre-loaded unlocked state ready to be pushed onto a head of an implanted bone screw. Upon receiving the head of the bone screw, the saddle can be moved distally relative to the tulip to a locked state by moving the locking projection distally into the distal tulip locking groove or recess.

Abstract: A modular tulip assembly has a rod receiving tulip and a saddle. The saddle is interlockingly held inside a distal portion of the tulip. The saddle has an external locking groove or recess. The tulip has a locking projection. The locking projection is positioned into the external locking groove or recess and holds the saddle in a pre-loaded unlocked state ready to be pushed onto a head of an implanted bone screw. Upon receiving the head of the bone screw, the saddle can be moved distally relative to the tulip to a locked state by moving the locking groove or recess distally past the locking projection to where the proximal end of the saddle is past abutting the locking projection.

Abstract: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on (or formed from) rungs that are flexibly connected. The rungs are typically rigid, somewhat flat and wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used. The blades (on the rungs) may be arranged in a staggered arrangement. A tissue-collection or tissue capture element may be used to collect the cut or modified tissue.

Abstract: A detachable vertical cutter for insertion into a cylinder or tube is formed as a single unitary structure. The single blade has a pair of tool attachment end portions and a cutting blade extending in a loop between the attachment ends. The cutting blade is inclined vertically relative to a longitudinal axis of a cylinder or tube into which the attachment ends can slide into. The cutting blade has a cutting edge, a portion of which when extended free of the cylinder or tube will extend a distance greater than the tube outside diameter. The cutting edge when pushed inwardly and pulled outwardly between adjacent vertebrae scrapes and cuts disc material. When retracted the cutting blade deflects into the cylinder or tube for insertion or extraction into or from the disc space.

Abstract: A screw extension assembly for use in minimally invasive spinal surgery, the assembly has an inner slotted shaft and an outer shaft, a rod reducer and a removable nut. The combination when assembled is configured to move a spinal fixation rod into a slotted rod receiving spinal implant where it is seated and affixed thereto. The screw extension assembly further has a locking knob rotationally coupled to a proximal end of the outer shaft, wherein the inner shaft has one or more cam grooves and the locking knob has a pin extending into and guided by said cam groove causing the outer shaft to translate longitudinally upon rotation of the locking knob relative to the inner shaft toward an engaged position locking the deflectable legs in the coupled position to the slotted rod receiving implant.

Abstract: A clip-on reducer tool assembly for seating a spinal fixation rod in a rod receiving implant, the tool assembly has an outer sleeve. The outer sleeve has a proximal end with a cylindrical portion having a threaded opening, a first leg extension extending therefrom to a distal end, and a second leg extension joined to the first leg extension at an intermediate location between the distal end and proximal end. The second leg extension extends from the distal end toward the proximal end to a lever end spaced from the cylindrical portion. The leg extensions at the distal end have grasping members to engage an outer surface of a rod receiving implant and a fulcrum proximally located near the intermediate location configured to enlarge the space between the leg extension at the distal end as the lever end is depressed inwardly relative to a longitudinal axis of the outer sleeve.

Abstract: A bone anchor locking device for receiving a bone anchor having a shank and an enlarged head, the device has a bone anchor, a dome and a conical split washer. The receiving portion has a base extending radially outward and inwardly to a wall. The dome has a center aperture sized to pass a bone anchor. The split washer has an inner conical surface sloped to slide and expand against at least a portion of the base on insertion of a bone anchor to allow a maximum diameter of a head of a bone anchor to pass and thereafter the split washer retracts overlying the maximum diameter of the head to prevent a bone anchor from backing out.

Abstract: An angled offset tulip has an angled offset tulip with a rod receiving portion and a bone screw receiving portion. The bone screw receiving portion has a distal opening on a distal end. The rod receiving portion is positioned offset a distance from a center of the distal opening and elevated above the distal opening to form an angle ?. The angle ? is defined as a line passing through the center of the distal opening and a slotted end center. The rod receiving portion has a slotted opening defined by a pair of sides, each side having a proximal end with threads for engaging a set screw to secure a rod. The angled offset tulip can be an angled offset tulip assembly having a collet for receiving, holding and fixing the head of a bone screw.

Abstract: An expandable implant device (100) for insertion between two vertebrae (400) is disclosed. The device (100) has an upper body (20), a lower body (40) and an external retainer band (60). The external retainer band (60) holds the upper body (20) and lower body (40) and has an inner surface having a plurality or set of upper ratchet teeth (80U) sloped for allowing upward movement and a plurality or set of lower ratchet teeth (80L) for allowing downward movement. The ratchet teeth (80) of the upper body (20) are mated or fitted to the upper teeth (80) of the retainer band (60) and the ratchet teeth (82) of the lower body (40) are mated or fitted to the lower ratchet teeth (82) of the retainer band (60). The height of the device (100) is increased by upward movement of the upper body (20) and downward movement of the lower body (40).

Abstract: A bone anchor locking device for receiving a bone anchor having a shank and an enlarged head, the device has a bone anchor, a dome and a conical split washer. The receiving portion has a base extending radially outward and inwardly to a wall. The dome has a center aperture sized to pass a bone anchor. The split washer has an inner conical surface sloped to slide and expand against at least a portion of the base on insertion of a bone anchor to allow a maximum diameter of a head of a bone anchor to pass and thereafter the split washer retracts overlying the maximum diameter of the head to prevent a bone anchor from backing out.

Abstract: An expandable implant device (100, 300, 600) for insertion between two vertebrae (400) is disclosed. The device (100, 300, 600) has a center body (10) one or more lift bodies (20, 40) and an external retaining band (60). The external retaining band (60) holds the sides (22, 42) of the one or more lift bodies (20, 40). The center body (10) has ramp surfaces (11) having a plurality or sets of ramps (11) sloped for allowing upward movement of the one or more lift bodies (20, 40). The sides (22, 42) have complimentary ramp surfaces that fit onto the ramps (11) of the center body (10). The height of the device (100, 300, 600) is increased by upward movement or downward movement or both of the one or more lift bodies (20, 40) driven by the lengthwise movement of the center body (10).

Abstract: An expandable interbody fusion implant device has a frame, two ramp assemblies and two overlying base plates driven by two independent drive shafts. The two ramp assemblies include a distal ramp assembly and a proximal ramp assembly. Each ramp assembly has a translating ramp, a first pivoting hinged ramp and a second pivoting hinged ramp. The two overlying base plates include a first base plate overlying a second base plate. Each base plate is hinged to the distal ramp assembly and the proximal ramp assembly at an end of one of said pivoting hinged ramps of each ramp assembly. The two independently driven drive shafts include a first drive shaft for translating the distal ramp assembly and a second drive shaft for translating the proximal ramp assembly to independently expand the implant proximally or distally or both.

Abstract: A detachable vertical cutter for insertion into a cylinder or tube is formed as a single unitary structure. The single blade has a pair of tool attachment end portions and a cutting blade extending in a loop between the attachment ends. The cutting blade is inclined vertically relative to a longitudinal axis of a cylinder or tube into which the attachment ends can slide into. The cutting blade has a cutting edge, a portion of which when extended free of the cylinder or tube will extend a distance greater than the tube outside diameter. The cutting edge when pushed inwardly and pulled outwardly between adjacent vertebrae scrapes and cuts disc material. When retracted the cutting blade deflects into the cylinder or tube for insertion or extraction into or from the disc space.

Abstract: An endoscopic portal protective shield assembly has an elongate portal shaft and an elongated protective shield. The elongate portal shaft has a viewing portal. The shaft has a slotted tubular body with interior surfaces. The shaft has a distal end and a proximal end and a slotted opening at the distal end extending partially along the slotted tubular body toward the proximal end. The elongated protective shield has a longitudinal shield body, a proximal end and a distal end. The protective shield is configured to be slid into the slotted opening of the tubular body with an interior portion of the longitudinal shield body being inserted inside the tubular body while maintaining the viewing portal open.

Abstract: An expandable implant device (100, 300, 600) for insertion between two vertebrae (400) is disclosed. The device (100, 300, 600) has a center body (10) one or more lift bodies (20, 40) and an external retaining band (60). The external retaining band (60) holds the sides (22, 42) of the one or more lift bodies (20, 40). The center body (10) has ramp surfaces (11) having a plurality or sets of ramps (11) sloped for allowing upward movement of the one or more lift bodies (20, 40). The sides (22, 42) have complimentary ramp surfaces that fit onto the ramps (11) of the center body (10). The height of the device (100, 300, 600) is increased by upward movement or downward movement or both of the one or more lift bodies (20, 40) driven by the lengthwise movement of the center body (10).

Abstract: Devices and methods of modifying tissue for low profile and ultra profile rongeur devices to treat spinal tissue. These devices may include a curved or curveable distal region; the cutting member may be configured to operate in the curved region. Also described herein are tissue modification devices that may be flexible or bendable for positioning in the tissue (including the spinal region) but can be made rigid once in position, or otherwise fixed in place to allow leverage when modifying the tissue.

Abstract: An improved handheld instrument assembly for penetrating into a patient's spine, the instrument assembly has a needle, an outer sleeve, and a removable handle. The needle has a shaft with a bone penetrating tip at a distal end and an enlarged head rotationally fixed to the needle shaft at a proximal end. The outer sleeve is for receiving the needle. The removable handle is configured to removably attach to and engage the handle attachment from the distal side or the proximal side at the discretion of a surgeon. The removable handle has a “T” shaped body. The removable handle has a slotted opening on a frontal side, the slotted opening being sized to pass over the outer sleeve between the distal end and the handle attachment when the needle is inserted into the patient.

Abstract: A facet screw system and method includes an implant assembly having a screw with a removable head, a locking nut, and a collet. An insertion instrument is used to insert the screw, compress the facet joint, locks the implant, and breaks off the head of the screw providing a lower profile implant.

Abstract: An endoscopic portal protective shield assembly has an elongate portal shaft and an elongated protective shield. The elongate portal shaft has a viewing portal. The shaft has a slotted tubular body with interior surfaces. The shaft has a distal end and a proximal end and a slotted opening at the distal end extending partially along the slotted tubular body toward the proximal end. The elongated protective shield has a longitudinal shield body, a proximal end and a distal end. The protective shield is configured to be slid into the slotted opening of the tubular body with an interior portion of the longitudinal shield body being inserted inside the tubular body while maintaining the viewing portal open.