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: A surgical instrument suitable for preparing an intervertebral disc space includes an outer sleeve, an instrument head, an inner shaft, a handle, a universal joint, a coupling member, and a drive mechanism. The outer sleeve includes a proximal end, a distal end and a longitudinal axis. The instrument head defines a longitudinal axis and is disposed at the distal end of the outer shaft. The inner shaft is slidably disposed within the outer sleeve and includes a proximal end, a distal end and a longitudinal axis coaxially aligned with the longitudinal axis of the outer sleeve. The drive mechanism is coupled between the outer sleeve and the inner shaft and actuates the outer sleeve axially relative to the inner shaft, thereby setting an angle of the longitudinal axis of the instrument head in relation to the longitudinal axis of the inner shaft.

Abstract: A bone fastener assembly for connecting a bone to a stabilizing construct includes a connecting member, a fastener seat, and a bone fastener. The connecting member includes a connecting member axis, a first opening, a second opening, and a first spherical surface. The connecting member axis extends from a proximal end to a distal end. The first opening is adjacent the proximal end. The second opening is adjacent the distal end. The fastener seat includes a first end, a second end, a passageway, and a second spherical surface. The passageway extends from the first end to the second end along a seat axis. The second spherical surface is configured to slidably engage the first spherical surface. The bone fastener includes a shank and a head. The shank extends though the passageway. The head engages a head-mating surface of the fastener seat.

Abstract: Implementations described herein include devices and systems for attenuation of increased spinal flexion loads post-fusion that include a transition member. The transition member may have a tension component coupleable to a fused vertebra of a plurality of fused vertebra of a fusion implant and to an adjacent unfused vertebra. The tension component may be tensionable to a selected value. The tension component may modulate a flexion range of motion of the adjacent unfused vertebra as a function of the selected value of tension of the tension component. The transition member may attenuate spinal flexion loads on adjacent unfused vertebra post-operatively.

Abstract: A rod reducer can comprise a reducing mechanism, a hinge mechanism, a handle mechanism and a bearing mechanism. The reducing mechanism can comprise a first elongate member extending along an axis to engage a bone anchor, and a second elongate member configured to slide along the first elongate member to engage a rod. The hinge mechanism can slidably couple the first and second elongate members such that the elongate members can translate against each other. The handle mechanism can comprise handles coupled to the hinge mechanism and configured to cause the first and second elongate members to translate relative to each other. The beating mechanism can be configured to permit the handles to rotate about the axis independent of the elongate members. Methods of using the rotating rod reducer can include rotating the handles out of the way of adjacent levels of a spinal column being simultaneously reduced.

Abstract: Implementations described herein include surgical distraction devices having a distal movement assembly having a pusher plate comprising a first slot extending along a first axis disposed in a first side and a second slot extending along a second axis disposed in a second side thereof. The first axis is oriented at an angle of from about 60 to about 160 degrees from the second axis. The device further includes a first and second paddles, each paddle having a corresponding engagement mechanism for movably coupling the respective first or second paddle to the pusher plate when engaged in the respective slot. Rotational actuation of the proximal drive assembly causes proximal or distal movement of the pusher plate, causing the first and second engagement members to move relative to their respective slots, thereby moving the first paddle and the second paddle in opposing directions. Methods of using such surgical distraction devices to determine size of an intervertebral space are also described.

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. The housing can include a proximal portion including an anchor bore and a distal portion including a secondary bore configured to engage the anchor to limit angulation of the anchor relative to the housing.

Abstract: The present teachings provide one or more surgical implements for repairing damaged tissue, such as through a fixation procedure. A system for a percutaneous procedure is provided. The system can include a bone fastener including a receiver. The system can include a device having a first end, a second end and a middle portion. The first end, middle portion and second end can be disposed along a longitudinal axis, and the second end can be connected to the receiver. The middle portion can have a pair of deformable leg members extending between the first and second ends. The leg members can define a channel having a width. The leg members can be selectively movable between a retracted state and an expanded state with the width of the channel greater in the expanded state than in the retracted state.

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: 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: The invention features bone screws having a threaded screw body and a screw head attached to one end of the screw body, the bone screw further including: a) an interior channel extending longitudinally through the screw head and through at least a portion of the screw body, wherein the interior channel has a width of less than 5.0 millimeters; and b) a plurality of radially-disposed delivery channels connecting the interior channel to the exterior of the screw body, each delivery channel having exterior openings. The invention further features devices that include a bone screw and a delivery manifold detachably attached to the screw head of the bone screw. In addition, the invention features methods of treating a patient having a bone defect by using a bone screw described herein.

Abstract: The present application provides a tool for minimally invasive surgical procedures. The tool includes a first and second portion where each portion has an outer blade and an inner blade that is slidable along the outer blade. A removable connector connects the first and second portions. When removed, the first and second portions are separated by a gap extending the length of the tool.

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 expandable intervertebral fusion device is provided including a core, an upper endplate for contacting a first vertebral body and a lower endplate for contacting a second vertebral body. The expandable intervertebral fusion device is configurable in a first state, a second state and a third state. In the first state, the upper and lower endplates are generally planar to one another and define a first height. In the second state, the upper and lower endplates remain generally planar to one another and define a second height greater than the first height. In the third state, a lordotic angle is defined between the upper and lower end plates.

Abstract: A method of implanting a bone anchor in a vertebra comprises engaging a tip of a flexible drill bit with boney structure of the vertebra, rotating the flexible drill bit at a slow speed, pushing the drill bit into exterior cortical bone of the boney structure of the vertebra, guiding the flexible drill bit into cancellous bone of the vertebra, receiving a tactile output generated by the flexible drill bit indicating resistance of interior cortical bone of the boney structure against the flexible drill bit, and reorienting a trajectory of the flexible drill bit toward the cancellous bone of the vertebra in reaction to the tactile output.

Abstract: An orthopedic implant screw driver includes drive shaft. A first gear is operably coupled to the drive shaft and in meshing engagement with a hollow gear which rotates in response to rotation of the drive shaft. The hollow gear includes a passage defining an inwardly facing screw engagement periphery configured to receive and drivingly rotate a threaded portion of the screw. A method of securing an orthopedic implant to a bone includes positioning a screw within the passage which is configured to drivingly engage a threaded portion of the screw and rotating a drive shaft in driving engagement with the gear causing the gear to engage the screw along the threaded portion of the screw and rotatably drive the screw via the threaded portion.

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: 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: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor 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.

Abstract: Implementations described herein may include a system for manipulating implants coupled by a cord. The system may include a tensioner and a counter tensioner. The tensioner may include a nose assembly and a cord lock assembly for applying tension to the cord. The nose assembly may include a piston having a lumen extending therethrough for receiving the cord and a spring positionable in contact with an indicator region of the piston. The counter may be releasably coupleable to a head of an implant at a proximal end thereof and may guide the cord to a port proximate the distal end thereof, the port for receiving the nose assembly. The counter tensioner may enable translation of the implant relative to another implant implanted in an adjacent or nearby vertebrae. The indicator region of the piston may be visible through a window in a tensioner main body and may indicate cord tension when the nose assembly of the tensioner is coupled to the port of the counter tensioner and engaged with the cord.