Abstract: An anchor can be coupleable to a bone, where the anchor includes a head, a shank, a first extension, and a second extension. The head can include a distal head portion and a proximal head portion, where the proximal head portion can be open at a proximal end of the head. The shank can extend distally from the distal head portion, where the shank including a threaded portion configured to engage the bone. The second extension can be opposing the first extension, and the second extension can include a second proximal support coupled to a second end of a first elongate portion, where a first proximal support can extend transverse to the longitudinal axis, and the first proximal support portion and the second proximal support portion can be separated in a first condition and can be engaged to transfer forces there between in a second.

Abstract: Implementations described herein include a system that may include a deliver device, an annular anchor and an implant. The delivery device may include a distal end, a proximal and a lumen extending from the distal end to the proximal end. The annular anchor may be removably coupleable to the distal end of the delivery device. The annular anchor may be implantable at a target site in a patient via manipulation of the delivery device. The delivery device may be extendable outside the patient when the anchor is implanted at the target site. The implant may be deliverable through the delivery device to the target delivery site and implantable through the annular anchor. The delivery device may be coupled to the annular anchor to control a trajectory of the implant to the target site.

Abstract: An implant-trialing instrument for objectively determining a recommended implant size based at least in part on results of inserting a pressure sensitive trial implant into the intervertebral space. The trial implant instrument can include a handle coupled to a pressure sensitive trial. The handle can include an elongate shaft. The pressure sensitive trial implant can be disposed on a distal end of the elongate shaft and include a superior end plate surface configured to engage a first end plate of a first vertebral body and an inferior end plate configured to engage a second end plate of a second vertebral body. The pressure sensitive trial implant also includes a pressure sensitive film disposed on at least one of the superior end plate and the inferior end plate.

Abstract: A bone anchor system can comprise a fastener, a rod housing and a first directional component configured for connection to the fastener. The fastener can comprise a shaft having a shaft diameter, an anchoring projection on the shaft, and a head at an end of the shaft. The rod housing can be connected to the head of the fastener. The first directional component can comprise a first body portion having a first outer diameter larger than the shaft diameter, a first bore extending through the first body portion, the first bore sized to receive the shaft diameter, and a first locking component extending from the first body portion configured to engage the rod housing to limit movement of the housing.

Abstract: Retractors for surgical procedures such as spinal surgical procedures includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction. Methods of use for the retractors during surgical procedures are also disclosed.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: An expandable intervertebral implant comprises an expandable cage comprising a central frame, a superior endplate, an inferior endplate, an anterior adjustment mechanism and a posterior adjustment mechanism. The central frame including an anterior (distal) threaded bore and a posterior (proximal) bore. The superior (upper) end plate movably coupled along a posterior portion of the central frame. The inferior (lower) end plate movably coupled along the posterior portion of the central frame opposite the superior end plate. The anterior adjustment mechanism including an anterior wedge coupled to an anterior screw movable within the anterior threaded bore. The posterior adjustment mechanism including a posterior wedge coupled to a posterior screw movable within the posterior bore.

Abstract: A device or system to adapt navigation trackers from various manufacturers to a variety of instruments to be navigated during a surgical procedure is disclosed. An adapter for coupling a navigation tracking array to an instrument including a drive shaft and a tracking device holder. The drive shaft can include a handle interface, an instrument connection, and an intermediate section including a circular locking groove extends proximally from a positioning flange. The tracking device holder can be configured to secure a navigation tracking array to the drive shaft and include an elongated body and a locking button. The elongated body can include an inner bore extending along a longitudinal length of the elongated body and adapted to receive the intermediate section of the drive shaft. The locking button can retain the tracking device holder along the drive shaft while allowing for rotation about the longitudinal axis.

Abstract: An interbody implant can comprise a cage and a porous structure. The cage can comprise an anterior segment, a medial segment, a posterior segment and a lateral segment contiguously connected to each other to define an interior space. The porous structure can be located in the interior space and can be bounded by the cage. The porous structure can comprise opposed superior and inferior surfaces exposed through the cage, an internal cavity located in an interior of the porous structure, and a plurality of ports connecting the internal cavity to the superior and inferior surfaces. A superior-inferior stiffness of the interbody implant can be defined by the porous structure. The porous structure can be compressed within a patient by movement of the spine to biologically stimulate bone growth in vertebrae adjacent the interbody implant. The implant can be configured for lateral, anterior and posterior insertion at different spine levels.

Abstract: Spinal surgical procedures can benefit from a rod reduction instrument with a ratchet lock-out mechanism. The instrument can include an inner shaft, an outer housing and a ratchet mechanism. The inner shaft can include a threaded proximal portion and a distal end that includes a plurality of engagement members adapted to receive a pedicle screw. The outer housing can be slidably received over the inner shaft, and include a top sleeve and a bottom sleeve. The top sleeve can include the ratchet mechanism to selectively engage the threaded proximal portion of the inner shaft and the bottom sleeve can engage a connecting rod. The ratchet mechanism can include an engagement feature to selectively engage the threaded proximal portion of the inner shaft, and a locking mechanism to selectively lock the engagement feature of the ratchet mechanism against the threaded proximal portion of the inner shaft.

Abstract: A bone fastener system can comprise a fastener and a first sizing component. The fastener can comprise a shaft that provides an anchoring footprint. The first sizing component can be configured to be connected to the shaft and can include a first anchoring feature, or circumferential bone engaging feature, to increase a size of the anchoring footprint. The first anchoring feature can comprise a sleeve that radially expands a diameter of the threaded shaft. The first anchoring feature can comprise axially extending teeth. The system can further comprise a second sizing component including a second anchoring feature to increase the size of the anchoring footprint, the second anchoring feature being different from the first anchoring feature. The second anchoring feature can expand the diameter of the threaded shaft a greater amount than the first anchoring feature. The second anchoring feature can have a length greater than the first anchoring feature.

Abstract: A system, a method, and instruments for manipulating a surgical cord into spinal implants to assist in correcting a spinal deformity are described. The system may include a tensioner, a tensioner extension, and a counter tensioner. One of the instruments can include an elongate body, a dual coupler, and a nose member. The elongate body has a flexible cylindrical member adapted to carry tension along a longitudinal axis, where the flexible cylindrical member is sized to receive a surgical cord through a lumen within the flexible cylindrical member. The dual coupler is disposed on a proximal end of the elongate body, and include a bore for receiving a nose portion of a tensioner and for guiding the surgical cord into the tensioner. The nose member is disposed on a distal end of the elongate body, and be adapted to discharge the surgical cord from the elongate body.

Abstract: A surgical derotator instrument comprises a shaft, a handle and an articulating coupler. The shaft comprises a first end portion having a bone anchor coupling and a second end portion opposite the first end portion. The handle comprises a body portion and a slot extending in the body portion. The articulating coupler connects the shaft and the handle. A method for coupling a plurality of derotator instruments into a series of derotator instruments comprises: attaching a plurality of derotator instruments to a plurality of adjacent bone anchor housings, each derotator instrument comprising: a shaft for connecting to a bone anchor housing, a handle having a slot, and an adjustable coupler connecting the shaft and the handle; adjusting one or more of the adjustable couplers to align at least one of the slots of the series with other slots of the series; and inserting an elongate member through the at least one slots that are aligned.

Abstract: A surgical instrument for reducing a rod into a saddle of a fixation member includes a distal end for engaging the saddle and a proximal end. A reducing device is disposed between the distal end and the proximal end. The reducing device is operative to reduce the rod into the saddle. The reducing device defines a throughbore. The throughbore provides access there through by a first drive member to secure a plug to the saddle.

Abstract: A torque limiter can include a housing and a shaft. The housing can include a housing magnet enclosed within the housing. The shaft can be at least partially surrounded by the housing and can be rotatable within the housing. The shaft can include a shaft magnet integrated with the shaft to magnetically couple with the housing magnet to transmit a torque between the housing and the shaft and configured to uncouple from the housing magnet allowing the shaft to rotate within the housing when a threshold torque is reached.

Abstract: An anchor assembly can be couplable to a bone and can include an anchor and a housing. The anchor can include a shank securable to bone and a head coupled to a proximal portion of the shank.

Abstract: A sleeve can be adapted to reinforce a bone anchor, and can include a body, a lock, and an actuator. The body can include a first sleeve arm and a second sleeve arm, where each can extend longitudinally along opposing sides of a longitudinal bore open at a distal end of the sleeve. The lock can be coupled to the body and releasably securable to a channel of a head of the bone anchor to secure the sleeve to the anchor.

Abstract: An anchor extender can be couplable to a bone anchor and can include an outer sleeve, an inner sleeve, and a lock. The lock can be operable to translate the inner sleeve relative to the outer sleeve between a locked position and an unlocked position to secure the inner sleeve and the outer sleeve to a head of the bone anchor in the locked position and to release the inner sleeve and the outer sleeve from the head of the bone anchor in the unlocked position.

Abstract: A system for installing a vertebral stabilization system. The system includes an installation tool including a handle portion and a shaft extending distally from the handle portion. The shaft includes a conduit and a staple mechanism. The system also includes a flexible implant member extending along the conduit configured to be advanced out from a distal end of the shaft, and a staple housed in the staple mechanism. The staple is configured to secure the flexible implant member to a vertebra. The handle portion is configured to selectively advance the flexible implant member from the shaft and to selectively actuate the staple mechanism.

Abstract: The present invention provides a spinous process implant and associated methods. In one aspect of the invention, the implant includes a spacer that is connectable to two extensions. One of the two extensions is connectable to the spacer at a first end and coupled to the spacer by a rotational connection. The other of the two extensions is movably connectable to the second end of the spacer and translatable over the outer surface of the spacer from the second end.