Abstract: Various embodiments of unilateral implant holders and related methods are disclosed herein. An exemplary unilateral implant holder can include a surgical instrument that includes a unilateral locking mechanism arranged at a distal end of the instrument for rigidly holding onto a unilateral portion of the implant. The locking mechanism can be configured to lock onto a unilateral portion of the implant such that access to the implant is not blocked. By engaging the instrument's locking mechanism with a counterpart locking interface defined in an implant, sufficient clamping force can be applied by the locking mechanism to resist multi-directional forces exerted on the implant during a surgical procedure. The surgical instrument can be a stand-alone unilateral implant holder. The surgical instrument can be configured to perform a surgical task while concurrently holding the implant in place using the unilateral locking mechanism.

Abstract: Drill guides and related methods are disclosed herein, e.g., for use in surgical procedures. In some embodiments, a drill guide can include an adjustment mechanism that permits one-handed adjustment of the guide depth and does not require that the drill guide be removed from the patient or that the drill be removed from the drill guide when making an adjustment. The adjustment mechanism can include a trigger that moves first and second detents into and out of engagement with a guide stem to allow step-wise adjustment of the guide depth.

Abstract: Surgical support instruments are described herein that can couple to, e.g., an implanted anchor and provide a platform for coupling other surgical implements thereto. In one embodiment, an instrument can include an elongate body having opposed projections extending laterally from a distal portion thereof that can at least partially surround a shank of an implantable anchor such that a longitudinal axis of the elongate body is laterally offset from a longitudinal axis of the anchor. The instrument can further include a lock configured to exert a drag force on a head of the anchor to control polyaxial movement of the instrument relative to the anchor. Further, a proximal portion of the elongate body can be configured to receive a retractor assembly including a plurality of tissue manipulating implements and selectively lock the retractor assembly at any of a plurality of positions along a length of the elongate body.

Abstract: An expandable intervertebral fusion cage is independently expandable vertically and laterally. The fusion cage includes a cage body that can receive an expansion member that causes the fusion cage to expand vertically. The cage body is responsive to a compressive force to move to an expanded lateral position, whereby the fusion cage defines a substantially circular annular profile.

Abstract: Systems and methods for anatomical alignment are disclosed herein. In some embodiments, the systems and methods can provide accurate and continuous intraoperative validation of anatomical alignment, e.g., of the spine, hips, pelvis, and/or shoulders. An exemplary system can include a sensor and marker arrangement for measuring coronal imbalance. Another exemplary system can include a sensor and marker arrangement for shoulder or pelvic leveling. Yet another exemplary system can include a mechanical frame for establishing a simulated ground plane and projecting a plumb line from the simulated ground plane.

Abstract: A handle assembly for use in conjunction with a surgical cutting device is provided. The handle assembly can generally include two, detachable pieces or housings. The first housing can include electrical and mechanical components for driving a cutting assembly, such as a motor, while the second housing can include a fluid flow path that allows fluid to flow from the surgical site to a location outside of the cutting device. At least a portion of the fluid flow path can extend substantially adjacent to at least a portion of one or more components used to drive the cutting assembly to help manage the heat output of the components. The fluid flow path allows the fluid to exit the device without coming into contact with components like a motor, while also helping to cool the handle assembly. Systems and methods for cutting tissue are also provided.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument can include a feedback mechanism configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor. The feedback mechanism can be triggered by a movable shaft of the instrument that is displaced by the shank portion of the bone anchor as the surrounding bone is reamed.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably connected, to the filament engagement feature of the anchor. The first and second noose limbs emerge from the anchor as first and second free filament limbs which are capable of being passed through tissue to be repaired and then passable through the noose. The noose, such as one or more half-hitches, is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after the anchor is fixated. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs at least through the tissue as a single unit.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: Bone anchors and related methods are disclosed herein. In some embodiments, a bone anchor can include a drag interface. Exemplary drag interfaces include (i) friction between a shank and a bushing, (ii) friction between a bushing and a drag ring, (iii) friction generated by a biased saddle, and (iv) combinations of the above. The drag interface can help maintain the relative position between a receiver member and a shank of the bone anchor prior to locking the bone anchor, preventing unintended movement while still allowing free movement when intended by the user. In some embodiments, a bone anchor can include over-rotation blocking features, such as a groove, lip, or protrusion formed on a bushing of the bone anchor. Various other bone anchor features are also disclosed, including high aspect ratio drag rings and compressible drag posts.

Abstract: Devices and methods for soft tissue reconstruction are provided. One exemplary embodiment of a device includes a body a suture filament extending through through-holes formed in the body. The suture is formed into an overhand knot having three collapsible openings with filament limbs extending from the knot. The limbs can be passed through the thru-holes of the body and selectively into the collapsible openings of the overhand knot to form coils extending to an opposite side of the body. For example, one limb can be passed through first and second collapsible openings to form two coils, while the other limb can be passed through the first and third collapsible openings to form two coils. The collapsible openings are collapsed around the limbs disposed in the openings, resulting in a secured overhand knot. Other configurations of knots, as well as devices and methods for use in tissue reconstruction, are also provided.

Abstract: Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member. The distal portion of the wing can define a bone anchor opening through which one or more auxiliary bone anchors can be disposed to augment the fixation of the assembly's primary bone anchor. A distal surface of the distal portion of the wing can be obliquely angled relative to a proximal-distal axis of the spanning portion to face one of a caudal direction or a cephalad direction. A distal surface of the distal portion of the wing can be obliquely angled relative to the proximal-distal axis of the spanning portion to face one of a medial direction or a lateral direction. Surgical methods using the bone anchor assemblies described herein are also disclosed.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a suture anchor is provided that includes a proximal component, a distal component, and an intermediate component positioned between the distal component and the proximal component. The proximal and distal components can each be configured to move independent of one another and to move relative to the intermediate component. In this way, the proximal, intermediate, and distal components of the suture anchor can be configured to cooperate with one another to prevent removal of the suture anchor from a bone hole in which the suture anchor is disposed and to lock a suture relative to the suture anchor and to the bone hole.

Abstract: A discectomy tool comprising: a) a cannula having an outer surface having a longitudinal bore therein, a proximal end and a distal end; b) a steering wire disposed in the longitudinal bore; c) a flexible, hollow transmission shaft disposed in the cannula, the shaft having a throughbore, a proximal end portion, a distal end portion and an outer surface having a thread extending therefrom; d) an irrigation source fluidly connected to the throughbore; e) a cutting tip attached to the distal end portion of the transmission shaft.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Bone anchor assemblies and related instrumentation are disclosed herein. In some embodiments, a modular bone anchor assembly allows for a bone anchor to be driven into bone and a head or receiver member to be attached thereto at some later point in time. The bone anchor can have a smaller footprint than the complete assembly, which can improve visualization and anatomical spatial awareness during insertion of the bone anchor and during other surgical steps performed prior to attaching the head or receiver member to the bone anchor. A variety of modular head types are disclosed, as are various instruments for driving a bone anchor, attaching a head to a bone anchor, removing a head from a bone anchor, and making a unilateral attachment to a head of a bone anchor assembly. Drive interfaces for driving a bone anchor are disclosed, as are features that allow a bone anchor to act as a fixation point for soft tissue retraction, disc space distraction, derotation, and the like.

Abstract: Various exemplary methods, systems, and devices for joint to pump elevation level user interfaces, autocalibration for joint elevation, and joint pressure estimation are provided. In general, an arthroscopic pump can be configured to estimate fluid pressure at a surgical site, e.g., at a joint, to provide an accurate indication of fluid pressure to users. In an exemplary embodiment, the fluid pressure estimation is based on a fluid pressure measurement at the pump that is adjusted at the pump, e.g., by a processor at the pump that executes instructions stored in a memory at the pump, using one or more control algorithms that adjust for one or more factors, such as pressure loss in tubing and sheath through which fluid flows between the pump and the surgical site and elevation difference between the pump and the surgical site.

Abstract: Surgical instruments, methods, and systems are provided for securing spinal fixation elements to bone. For example, a spinal fixation system is provided that has a receiver with proximal and distal ends. The proximal end of the receiver is configured to receive various fixation members, such as spinal rods and set screws, therein. The distal end of the receiver has a hook member that is operably coupled thereto and has an opening that is configured to receive bone therein. The hook member is configured to be secured to bone without penetrating the bone.