Abstract: An ultrasound probe for percutaneous insertion into an incision and related methods are disclosed herein, e.g., for imaging neural structures at a surgical site of a patient. An exemplary ultrasound probe can be a portable ultrasound probe configured to be passed percutaneously into an incision and can have an imaging region extending distally from a distal tip of the probe. In one embodiment the ultrasound probe can be a navigated portable ultrasound probe. The ultrasound probe can be connected to a computing station and configured to transmit images to the computing station for processing. In another embodiment, an ultrasound probe can be part of a network of sensors, including at least one external sensor, where the network of sensors is configured to transmit images to the computing station for processing. The computing station can process and display images to visualize and/or highlight neurological structures in an imaged region.

Abstract: Surgical access port stabilization systems and methods are described herein. Such systems and methods can be employed to provide ipsilateral stabilization of a surgical access port, e.g., during spinal surgeries. In one embodiment, a surgical system can include an access port configured for percutaneous insertion into a patient to define a channel to a surgical site and an anchor configured for insertion into the patient's bone. Further, the access port can be coupled to the anchor such that a longitudinal axis of the access port and a longitudinal axis of the anchor are non-coaxial. With such a system, a surgeon or other user can access a surgical site through the access port without the need for external or other stabilization of the access port, but can instead position the access port relative to an anchor already placed in the patient's body.

Abstract: Surgical visualization systems and related methods are disclosed herein, e.g., for providing visualization during surgical procedures. Systems and methods herein can be used in a wide range of surgical procedures, including spinal surgeries such as minimally-invasive fusion or discectomy procedures. Systems and methods herein can include various features for enhancing end user experience, improving clinical outcomes, or reducing the invasiveness of a surgery. Exemplary features can include access port integration, hands-free operation, active and/or passive lens cleaning, adjustable camera depth, and many others.

Abstract: Connectors are disclosed herein that can be used to attach a rod to a bone anchor assembly that is already occupied by a separate rod. Various ways of attaching the connector to the bone anchor assembly are disclosed, including arrangements in which the connector is locked to the bone anchor, arrangements in which the connector is constrained in one or more degrees of freedom relative to the bone anchor, arrangements in which the connector is adjustable in one or more degrees of freedom relative to the bone anchor, and arrangements that include a spherical articulation joint. In some embodiments, attachment of the connector to a bone anchor can be aided with the use of a positioner. The geometry of the connector can be selected to minimize the offset between a first rod received in the bone anchor assembly and a second rod received in the connector, for example using an angled or curved rod recess and/or a fastener, or set screw, that is offset from the center of the rod or angled relative to the bone anchor.

Abstract: Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a biceps tenodesis system is provided and includes a sheath inserter tool, an expandable sheath configured to couple to the sheath inserter tool, an expander inserter tool, and an expander configured to couple to the expander inserter tool. The sheath inserter tool is configured to advance the expandable sheath, with a tendon disposed therearound, into a bone hole, and the expander inserter tool is configured to advance the expander through an outer shaft of the sheath inserter tool and to drive the expander into the sheath. The expander is configured to be received within a lumen extending at least partially through the expandable sheath to thereby expand the sheath. In this way, the system delivers the tendon or ligament into the bone hole and locks the sheath and tendon within the bone hole.

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 and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a plate that is seated between the receiver member and the rod and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a hook that extends out from the receiver member to hook onto an anatomical structure or another implant to augment the fixation of the assembly's primary bone anchor. Surgical methods using the bone anchor assemblies described herein are also disclosed.

Abstract: Devices and methods for bending or cutting implants are disclosed herein. In some embodiments, an instrument can convert a rotational input force (e.g., supplied by a powered driver tool) into movement of a first rod holder with respect to a second rod holder. Such movement can form a bend in a rod or other implant held by the first and second rod holders. Various mechanisms for converting this movement are disclosed, such as a worm drive mechanism and a conical gear mechanism, as are various types of rod holders, including orbiting rollers, lid-type rod holders, fixed and pivoting half-pipe rod holders, and full-pipe rod holders. In some embodiments, the instrument can also be used for cutting, for example by rotating a cutting wheel with respect to a cutting plate to cut a rod or other implant inserted through openings formed in the cutting wheel and the cutting plate.

Abstract: Camera position indication systems and methods are disclosed herein for conveying a camera's position to a user and/or adjusting a camera view display to match a user's perspective during a surgical procedure. In one embodiment, an example method can include receiving an output view from a camera placed within a channel of an access device to view a surgical site within a patient, receiving an input of camera position from a user, and showing on a display the output view from the camera and an indication of camera position based on the input of camera position.

Abstract: A suture anchor, and a surgical filament assembly using same, capable of being fixated in a hole formed in a bone of a patient. The suture anchor preferably includes an anchor body having a distal end, a proximal end, a passage extending from the proximal end toward the distal end, at least one feature disposed on the exterior of the anchor to engage bone, and a filament knot patency element disposed within the passage and defining a channel having a sufficient minimum cross-sectional area to allow movement of a portion of a surgical filament therethrough when a removable sliding knot is formed, using the surgical filament, about the filament knot patency element. The surgical filament assembly preferably includes a first filament having a sliding knot removably positioned about the knot patency element, with a shortening limb and a tightening limb each extending from the sliding knot.

Abstract: An endoscope handpiece and system may include an angle of view selector, a depressible button, which may be connected to a lock disposed within a port of the endoscopic handpiece. The system may further provide an endoscope, which may be connected to the handpiece via the port and locked in place by the lock.

Abstract: Devices and methods are provided for identifying a location of a bore in bone when inserting a suture anchor into bone. One exemplary embodiment of a suture anchor includes an elongate cylindrical body having a proximal terminal end surface, a distal terminal end surface, a lumen extending from the proximal terminal end surface to the distal terminal end surface, at least one bone engaging feature formed on an outer surface of the body, and a bore identification feature incorporated as part of the body. In some instances, the bore identification feature results from opposed sides of an outer surface having disparate lengths, with the side having the longer length serving as the bore identification feature. In other instances, the bore identification feature includes a protrusion that extends from, or is part of, the distal terminal end surface. Other exemplary embodiments, as well as methods for identifying a bore in bone, are also provided.

Abstract: Coupling devices and related methods are disclosed herein, e.g., for coupling a surgical instrument to a navigation array or other component. The coupling device can reduce or eliminate movement between the instrument and the navigation array, improving navigation precision. The coupling device can be quick and easy to use, reducing or eliminating the need for extra steps or additional tools to attach or detach the instrument from the coupling device. In some embodiments, the single step of inserting an instrument into the coupling device can automatically lock the instrument within the coupling device in a toggle-free manner. The coupling device can include features for consistently attaching instruments thereto at a known or predetermined location and/or orientation.

Abstract: Various bone screws configured to be implanted into bone and methods of use are provided. In an exemplary embodiment, a bone screw is provided with an elongate shank having at least two threads thereon, and having a distal facing surface with at least two cutting edges. The cutting edges can be configured to cut bone as the bone screw is rotated into bone, thereby forming a path for the threads.

Abstract: Instruments and related methods for breaking reduction tabs are disclosed herein, e.g., for breaking reduction tabs of a bone anchor or other implant. In some embodiments, the instrument can be configured to minimize the space needed to operate the instrument. For example, the instrument can be configured to receive a reduction tab that is to be broken while the instrument is coaxially positioned with respect to a bone anchor receiver to which the reduction tab is attached. As another example, the instrument can have a maximum outer transverse dimension that is less than, equal to, or only slightly greater than a corresponding dimension of a bone anchor from which a reduction tab is to be broken. Guide rods for positioning a tab breaker instrument over a reduction tab are also disclosed.

Abstract: Systems, devices, and methods for cutting a filament or suture having an extrudable inner core member are provided. In one exemplary embodiment, a device includes a compression element to compress an inner core away from a knot disposed at a distal end of the suture, and a cutting element disposed within a portion of the compression element to cut the inner core after it has been compressed. As a result, an amount of extrudable inner core that extends distally beyond the knot is minimized without negatively impacting the integrity of the knot. In other embodiments, the compression and cutting elements are separately provided as two different devices. The actions of compressing and cutting can be performed using a variety of techniques, including those known to those skilled in the art. Methods for clamping the inner core and then cutting a portion of the inner core are also provided.

Abstract: Systems and methods are provided for determining an emotional state of a medical professional and dynamically generating clinical procedures that are adapted to the medical professional's emotional state, as well as an assessment of a medical device based on the determined emotional state. Observation data corresponding to a medical professional associated with a clinical procedure can be received and processed to determine an emotional state of the medical professional. The emotional state can be predicted using a first predictive model trained in a machine learning process. The determined emotional state can be provided to a second predictive model to provide one or more adapted clinical procedures. Device assessment data can also be used with the determined emotional state to determine an assessment of a medical device. The one or more adapted clinical procedures and the assessment of the medical device can be provided as an output.

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: 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: 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: A spinal fixation device is provided having first and second elongate members that are angularly adjustable relative to one another. Each elongate member can include a connecting feature formed on a terminal end thereof, and each connecting feature can be coupled to one another to allow angular movement of the first and second elongate members. The device can also include a locking mechanism that is adapted to couple to the connecting feature on each of the first and second elongate members to lock the elongate members in a fixed position relative to one another.