Abstract: A minimal incision maximal access system allows for maximum desirable exposure along with maximum access to the operative field utilizing a minimum incision as small as the METRx and Endius systems. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing hinged bi-hemispherical or oval working tubes applied over an introducer obturator which is controllably dilated to slowly separate muscle tissue. Deeper end working and visualization areas with maximum proximal access and work dimensions are provided to makes the operative procedure safer in application and shorten the surgeons's learning curve because it most closely approximates the ability to use open microdiskectomy techniques. a dual frame system enables full or partial spreading of a working tube set, while an open frame facilitates a four point retraction system.

Abstract: A polyaxial drill guide includes a body, a collet and a stem. The collet includes a collet shaft having distal and proximal ends and a longitudinal bore. The body includes a conical bore having narrow and wide ends. The distal end of the collet shaft rotatably mounts within the narrow end of the conical bore, with the collet shaft extending toward the wide end of the conical bore, such that the collet shaft (and consequently the longitudinal bore) can be angled within the conical bore at a plurality of angles. The stem includes a shaft having distal and proximal ends and a longitudinal bore. The distal end of the stem shaft mounts to the proximal end of the collet shaft such that the longitudinal bores are co-linear and a drill bit can be inserted into and rotated within the longitudinal bores during a drilling procedure.

Abstract: Provided is a novel rod reducing device for use in spinal fixation procedures. The device is capable with a single action of securely grasping the head of a bone screw while reducing a connecting rod into the head of the bone screw and while in position on the bone screw provide a cannula access for a bone screw locking cap and tightening instrument and securing the bone screw during the tightening of the locking cap so as to provide an anti-torque effect. The device is also capable of releasing from the bone screw with a reversal of the single action used to activate the device. A method of using the device and a kit wherein the device is one component is also provided.

Abstract: A minimal incision maximal access system allows for maximum desirable work space exposure within the incision along with maximum access to the operative field utilizing a minimum incision as small as the width of the working tube. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing retractors depending from a bi-hinged frame having internal or external controls to control the angle and separation of the retractors. Interchangeable retractor blades can be attached to the frame. At least one retractor blade is independently controlled.

Abstract: A device, system and method for orthopedic spine surgery using a novel screw-based retractor, disclosed herein, that allows for access to the spine through a minimally or less invasive approach. The retractor device is designed to be coupled to a pedicle screw and then to have opposed arms of the retractor spread apart to open the wound proximally. The retractor is removed by pulling it out of the wound whereby the retractor is deformed to pass over the pedicle screw head. The retractor is intended to be made of a stiff plastic material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

Abstract: A pedicle screw construct includes a pedicle screw, a coupling, and a collet. The pedicle screw includes a shank having a helical thread formed thereon and a head at one end. The collet is positioned atop the head of the pedicle screw. The collet and pedicle screw are inserted into the coupling. The pedicle screw is rotatable and pivotable relative to the collet and coupling assembly. The collet and the coupling each have a saddle that is adapted and configured for receiving a rod member.

Abstract: A dynamic cervical plate includes a first end section and a second end section. In embodiments, the dynamic cervical plate may include one or more middle sections positioned between the first and second end sections. Each section may be longitudinally repositionable. Each section may include a plurality of openings for receiving threaded fasteners such as a self-starting screw or a self-tapping screw. In addition, each section may include an orifice for releasably mating with a drill guide. Each of the end sections may include a notch at one end for aligning with the drill guide or fixation pins. In one embodiment, a pin is used to interconnect the sections. In other embodiments, support bars are used to limit flexure between sections. In embodiments, one or more locking elements and/or one or more support bars may operably interconnect each section.

Abstract: Provided is a novel rod reducing device for use in spinal fixation procedures. The device is capable with a single action of securely grasping the head of a bone screw while reducing a connecting rod into the head of the bone screw and while in position on the bone screw provide a cannula access for a bone screw locking cap and tightening instrument and securing the bone screw during the tightening of the locking cap so as to provide an anti-torque effect. The device is also capable of releasing from the bone screw with a reversal of the single action used to activate the device. A method of using the device and a kit wherein the device is one component is also provided.

Abstract: A screw and coupling element assembly for use with an orthopedic rod implantation apparatus includes a screw with a head and a shaft extending from the head, a coupling element with a seat within which the head is seatable such that the shaft protrudes from the coupling element, and a locking element mateable with the coupling element and when mated is selectively movable through a plurality of positions including unlocked and locked positions. When in the unlocked position, the locking element presents a rod-receiving channel and the head is movable in the seat such that the shaft is directable in a plurality of angles relative to the coupling element. When in the locked position, a rod disposed within the rod-receiving channel is fixed relative to the coupling element and the head is immovable in the seat such that the shaft is fixed at an angle relative to the coupling element.

Abstract: A novel cross-connector assembly for interconnecting first and second bracing members or rods, one to the other. The cross-connector assembly is capable of multi-directional articulation in three dimensions, length, azimuth, and elevation and is also capable of having one end rotated along its longitudinal axis in relation to the other end so as to custom fit and securely connect the assembly to two opposing bracing members or rods. Also provided is a kit including the device and ancillary instrumentation to facilitate the method of the present invention.

Abstract: A spinal fixation device includes a coupling, a pedicle screw, and a collet. The coupling has an opening extending therethrough. The pedicle screw has a head mounted to a shank that is positionable within a first vertebral body. The collet is receivable in the opening of the coupling and engagable with the head of the pedicle screw. The collet is selectively positionable between a first position and a second position where the collet engages a spinal rod and prevents one or both of axial and rotational movement of the spinal rod. The collet is adapted to facilitate the connection of the spinal rod to a second vertebral body. The collet defines a saddle having one or more locking features for engaging the spinal rod.

Abstract: A pedicle screw construct includes a pedicle screw, a coupling, a collet, and a set screw. The pedicle screw includes a shank having a helical thread formed thereon and a head at one end. The collet is positioned atop the head of the pedicle screw. The collet and pedicle screw are inserted into the coupling. The set screw is positioned in the collet such that the set screw contacts a portion of the rod and is releasably secured to the pedicle screw via a gripping tool. The pedicle screw is rotatable and pivotable relative to the collet and coupling assembly.

Abstract: A lock indicator gauge is provided to provide an indication as to whether a bone screw construct is in a locked or an unlocked condition when the lock indicator gauge is operatively engaged with the bone screw construct. A plunger longitudinally disposed within a housing of the lock indicator gauge translates within the housing by a distance that corresponds to the relative positions of inner and outer housings of the bone screw construct, wherein the relative positions of the inner and outer housings is dependent on whether the bone screw construct is in a locked or an unlocked condition.

Abstract: A spinal fixation assembly includes a spinal rod, a first spinal fixation device, and a locking element. The spinal rod defines a longitudinal axis. The first spinal fixation device includes a coupling, a screw, and a collet. The coupling has an opening extending therethrough. The screw is mounted to the coupling and positionable within a first vertebral body. The collet is receivable in the opening of the coupling and defines a saddle for engaging the spinal rod. The locking element is mounted to the spinal rod and is configured to prevent axial translation of the spinal rod in one or both directions along the longitudinal axis thereof.

Abstract: An insertion tool for placing a spinal implant in an intervertebral space includes a handle assembly, a jaw assembly having first and second jaw members movable with respect to each other, and a holding member adapted to hold and release an implant in response to a manipulation of the handle assembly. The holding member is configured to move longitudinally with respect to the jaw assembly upon manipulation of the handle assembly.

Abstract: A spinal buttress plate includes a body having a top surface and a bottom surface and including an annular lip, a ledge, and a pair of teeth. The annular lip defines an opening. The annular lip and the opening are adapted to engage a screw for facilitating the securement of the buttress plate to one or more vertebrae. The ledge defines an aperture. The ledge and aperture are adapted to engage an instrument for positioning the buttress plate adjacent a spinal bone graft. The teeth are disposed in spaced-apart relation on the bottom surface of the body and are positionable within the one or more vertebrae.

Abstract: A bone anchor assembly includes a bone fixation member and a bone screw. The bone fixation member includes at least one opening therethrough for receiving the bone screw. Two pairs of legs extend from a plate portion of the bone fixation member and are configured for insertion into bone. A lip of the opening is configured for engaging a set of threads on the bone screw such that the bone screw and the bone fixation member are affixed to one another once the bone screw is inserted through the opening of the plate portion. An installation tool for inserting the bone fixation member into bone includes a proximal region, a tubular member, a rotatable collar, and a gripping mechanism.

Abstract: A semi-constrained screw and a cervical plate assembly that engages to a cervical area of the human vertebrae system are disclosed. The semi-constrained screw and cervical plate assembly includes a cervical plate and one or more semi-constrained bone screws. Each semi-constrained bone screw includes an elongated shank, which is mechanically and releasably coupled to a head portion. The head portion includes one or more threaded segments which define one or more slits therebetween. As the semi-constrained bone screw is driven through the screw opening in the cervical plate and into the bone, the head portion allows poly-axial movement of the shank relative to the head portion.

Abstract: An adjustable occipital plate includes a central body portion having a plurality of arms extending therefrom in a generally Y-shaped configuration. Two of the arms include elongate slots for slidably receiving retaining members therein. Each retaining member includes a U-shaped channel for receiving a spine rod and a set screw. The central body portion and one arm include openings for receiving bone screws therein. Each of the arms may be angled with respect to the central body portion.

Abstract: A spinal spacer for engagement between vertebrae includes a body extending between a substantially contoured first end surface and a second end surface to define side surfaces and opposing top and bottom vertebral engaging surfaces substantially symmetrical about a centerline axis. At least one opening defines a hollow inner body and includes first and second intersecting openings extending through the top and bottom vertebral engaging surfaces. The second intersecting opening extends through the side surfaces. The second end surface includes at least one aperture formed therethrough in communication with the hollow inner body. A screw opening is defined through at least one plate insert configured to be removably coupled to the second end surface to substantially align the screw opening with the at least one aperture. The bone screw is configured to be threadingly secured within the at least one plate insert.