Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60).

Abstract: A bone anchoring device including a clamping device and a flexible band configured to be secured a vertebra. The clamping device includes a base member and an upper member configured to be secured together with a fastener. The flexible band is configured to be passed around a bone portion and through a passage of the base member to position the flexible band between a clamping surface of the base member and a clamping surface of the upper member. The flexible band is tensioned to urge the clamping device against the bone portion and then clamped between the clamping surfaces of the base member and the upper member. A stabilization member of a vertebral stabilization construct may be secured to the vertebra with the bone anchoring device without invasively altering or impairing the structural integrity of the vertebra.

Abstract: A method of inserting a spinal stabilization system into a patient generally comprises inserting a first positioning tool through a first location on a patient's skin and along a path generally toward a first vertebral anchor, coupling an end of the first positioning tool to the first vertebral anchor, positioning at least a portion of a delivery device over a connecting element, and inserting the delivery device and the connecting element through the patient's skin at the first location and along at least a portion of the first positioning tool. The first positioning tool is configured to facilitate directing the delivery device and connecting element generally toward a second vertebral anchor within the patient's body.

Abstract: A spinal stabilization system may include a pair of structural members coupled to at least a portion of a human vertebra with connectors. Connectors may couple structural members to spinous processes. Some embodiments of a spinal stabilization system may include fasteners that couple structural members to vertebrae. In some embodiments, a spinal stabilization system, provides three points of fixation for a single vertebral level. A fastener may fixate a facet joint between adjacent vertebrae and couple a stabilization structural member to a vertebra. Connectors may couple the structural members to the spinous processes of the vertebrae. Use of a spinal stabilization system may improve the stability of a weakened or damaged portion of a spine. When used in conjunction with an implant or other device, the spinal stabilization system may immobilize vertebrae and allow for fusion of the implant or other device with vertebrae.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient Bone fastener assemblies may be coupled to vertebrae Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Abstract: A vertebral fixing system having a flexible elongated member, a connecting part, and an anchor, where the anchor may engage a bone structure (e.g., a vertebra) through an opening of the connecting part and the flexible elongated member may connect to the connecting part. In some cases, the vertebral fixing system may include a tightening part configured to apply a tension to the elongated member and/or secure the elongated member with respect to the connecting part. The vertebral fixing system may be configured to receive a rod and may be capable of connecting thereto. The connecting part may have a plurality of connecting members, where at least one of the connecting members includes an opening for receiving the anchor and at least one of the connecting members connects to the elongated member.

Abstract: Embodiments disclosed herein provide compression/distraction methods and tools useful for fitting a spinal stabilization system in a patient through minimally invasive surgery. The spinal stabilization system may comprise screws anchored in vertebrae. The vertebrae may need to be compressed or distracted. One embodiment of an instrument disclosed herein may comprise a shaft for engaging one of the screws through an extender sleeve. A driver may engage another screw through an opening of the instrument. Through this engagement, a surgeon may use the rack and pinion of the instrument to compress or distract one or more levels of the vertebrae in a parallel motion, which can be advantageous clinically in certain situations.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

Abstract: A uniplanar bone anchor including a housing and a bone screw is provided. The lower region of the housing defines mating elements that mate with engaging elements on the bone screw to limit movement of the housing relative to the bone screw to a single plane.

Abstract: A spinal stabilization system may include a pair of structural members coupled to at least a portion of a human vertebra with connectors. Connectors may couple structural members to spinous processes. Some embodiments of a spinal stabilization system may include fasteners that couple structural members to vertebrae. In some embodiments, a spinal stabilization system, provides three points of fixation for a single vertebral level. A fastener may fixate a facet joint between adjacent vertebrae and couple a stabilization structural member to a vertebra. Connectors may couple the structural members to the spinous processes of the vertebrae. Use of a spinal stabilization system may improve the stability of a weakened or damaged portion of a spine. When used in conjunction with an implant or other device, the spinal stabilization system may immobilize vertebrae and allow for fusion of the implant or other device with vertebrae.

Abstract: Embodiments disclosed herein provide compression/distraction methods and tools useful for fitting a spinal stabilization system in a patient through minimally invasive surgery. The spinal stabilization system may comprise screws anchored in vertebrae. The vertebrae may need to be compressed or distracted. One embodiment of an instrument disclosed herein may comprise a shaft for engaging one of the screws through an extender sleeve. A driver may engage another screw through an opening of the instrument. Through this engagement, a surgeon may use the rack and pinion of the instrument to compress or distract one or more levels of the vertebrae in a parallel motion, which can be advantageous clinically in certain situations.

Abstract: A method of fixing vertebrae of a patient together at a surgical site includes the following steps: inserting a first cannula (10) into the body (130) of the patient; moving a first fastener (624) through the cannula (10) and securing the first fastener (624) to a first vertebrae (601); moving a second fastener (624) through the cannula (10) and securing the second fastener (624) to a second vertebrae (602); moving a first fixation element (650) through the cannula (10); and fixing the first fixation element (650) to the first and second fasteners (624).

Abstract: A spinal plate system that maintains intervertebral spacing and spinal stability is provided. One embodiment includes a spacer for establishing an initial condition of an adjustable spinal device. The spacer includes a first coupling portion configured to couple selectively with a first segment of the adjustable spinal device, a second coupling portion configured to couple selectively with a second segment of the adjustable spinal device, and a spacer body extending between the first coupling portion and the second coupling portion. The spacer prevents movement of the first segment of the spinal device relative to the second segment when the first coupling portion is coupled selectively with the first segment and the second coupling portion is coupled selectively with the second segment.

Abstract: A driver instrument for engaging and transferring rotational torque to a bone screw assembly which includes a shaft and sleeve adapted to engage and couple the bone screw assembly into a single coaxial unit while the bone screw assembly is being driven into a bone and then to release the bone screw assembly from the driver instrument. The driver instrument includes an elongate shaft, a sleeve, and bone screw assembly engaging features on the elongate shaft and/or the sleeve.

Abstract: A system for reduction of vertebral bodies (or vertebrae) in various embodiments includes a reducer, and extender, and a hollow tube. The reducer couples to the extender, which in turn couples to an elongated member, such as a rod, and to a bone fastener assembly. The reducer allows reduction of the vertebral body incrementally, and by a desired amount. The reducer may include or may be used in conjunction with a holding device or holder in order to hold or keep the amount of reduction constant or steady once the desired amount of reduction has been obtained. The reducer may use one of several embodiments, including embodiments that use threaded assemblies or members, inclining members or wedges, offset cams, scissor jacks, and/or levers.

Abstract: Embodiments of a surgical instrument disclosed herein can include mechanisms for reduction and distraction as well as compression. Some embodiments of the surgical instrument may comprise a reducer knob having a first passage through which a first shaft of a driver is acceptable, a connecting element coupled to the reducer knob and having a second passage through which the first shaft of the driver is acceptable, a compressor handle coupled to the connecting element at a first end and having a through hole, and a common handle coupled to the compressor handle via the through hole and pivots between the reducer knob and the compressor handle. With embodiments of a surgical instrument disclosed herein, surgical personnel can distract and hold vertebrae in a distracted state and perform a reduction without having to switch or add instruments. Some embodiments disclosed herein can be particularly useful for reducing spondylolisthesis during posterior fixation.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

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: A spinal stabilization system generally comprises first and second anchor members configured to be secured to first and second vertebrae within a patient's body, a flexible element secured to the first anchor member, and a rigid element secured to the second anchor member. An end portion of the rigid element is coupled to an end portion of the flexible so that the system is able to provide both rigid and dynamic stabilization. The coupling is maintained even if the flexible element relaxes after a period of time within the patient's body.

Abstract: An intervertebral implant and associated insertion instrument. The intervertebral implant includes an instrument engagement interface including first and second channels extending along opposite sides of the implant forwardly from a trailing end wall of the implant and a positioning projection extending rearward from the trailing end wall of the implant. The insertion instrument includes a grasping mechanism for engagement with the instrument engagement interface. The grasping mechanism includes first and second jaws including grasping portions positionable in the first and second channels and an enlarged opening defined between the first and second jaws for receiving the positioning projection therein.