Abstract: An adjustable apparatus for guiding medical instruments used in attaching bone plates. The apparatus has a handle assembly, guide member, a spacer, and an actuation member. The actuation member extends from the handle assembly and actuates the spacer between a position adjacent the guide member and a position spaced from the guide member. The spacer has a through hole that may axially align with a lumen extending through the guide member when in the first position and which is moved out of axial alignment with the lumen in the second position. The spacer may function as a depth stop to control the maximum depth a drill bit can extend from the guide member.

Abstract: A cannula (10) receives surgical instruments (120) for performing a surgical procedure on a body (130). The cannula (10) comprises a tube structure (12) defining a passage (16) through which the surgical instruments (120) are inserted into the body (130). The tube structure (12) has a proximal end (20) and a distal end (62). The tube structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16) at the distal end (62). The expandable portion (40) of the tube structure (12), when expanded, has a conical configuration.

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 driver instrument for engaging and transferring rotational torque to a bone anchor already screwed into a bony structure. The driver instrument may be advanced through an incision while disengaged from the bone anchor and thereafter engaged in a driver socket of the bone anchor. The driver instrument includes an elongate shaft extending distally from a handle, a tapered distal tip, and a driver engagement feature located proximally of the tapered distal tip. The tapered distal tip and the driver engagement feature are configured such that the longitudinal rotational axis of the driver instrument automatically moves into parallel alignment with the longitudinal rotational axis of the bone anchor as the driver engagement feature of the driver instrument is advanced into the driver socket of the bone anchor.

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: An intervertebral or spinal implant having a spacer, a cage, and a locking mechanism, where the locking mechanism may be configured to facilitate a connection between the spacer and the cage. In some cases, the spacer may include a distal end wall, a proximal end wall, a first lateral wall, and a second lateral wall, where the locking mechanism may be situated at the proximal end wall adjacent a receiving opening in the proximal end wall. The implant may have one or more spikes extending from a top and/or a bottom of the spacer to facilitate stabilizing the implant between vertebrae after insertion of the implant in the spinal column.

Abstract: Retractor for insertion in an incision of a patient includes a frame defining a central opening and a reference plane, and at least one blade disposed within the central opening. The blade operatively coupled to the frame by a support structure for movement in a first direction generally laterally with the reference plane between an unretracted position and a retracted position, a second direction at an angle extending through and relative to the reference plane for adjustment of the blade depth, and a third direction rotationally relative to the reference plane. Additionally, the frame includes a track in mating relationship with the support structure for sliding movement therebetween in a defined relationship relative to the reference plane. Retractor assembly includes the retractor as previously described, in combination with an adjustment tool or an insertion tool.

Abstract: A vertebral column correction system for correcting a spinal deformity without fusing the joint segments is disclosed. The vertebral column correction system may have first and second vertebral anchors secured to first and second vertebrae. The vertebral column correction system may further comprise one or more intermediate vertebral anchors secured to vertebrae between the first and second vertebrae. A connection member may be disposed within a head portion of the vertebral anchors. At least a portion of the connection member may be a flexible member, such as a flexible cord, configured for tensioning between at least two vertebral anchors for providing a desired amount of tension to apply a correctional force to the spinal column. A spring member, or other tensioning member, may maintain the tension of the connection member.

Abstract: The disclosure relates generally to embodiments of systems and methods of spinal stabilization. Embodiments include methods that use a dilator to displace tissue proximate to a sleeve. An embodiment of a surgical system can comprise a dilator that may define a working channel from a first opening to a second opening. The dilator can be positioned to displace tissue proximate to the sleeve. The dilator may be shaped to allow a first end of an elongated member to enter the working channel through the first opening and exit the dilator through the second opening to be percutaneously moved to another assembly.

Abstract: A spinal fixation assembly for connecting an elongate member along a region of a spinal column with a plurality of fasteners is disclosed. The spinal fixation assembly comprises a threaded fastener having a first threaded end region and a second end region configured to receive an elongate member, such as a rod. A locking member is included for securing the elongate member within the second end region. The second end region and the locking member include elastomeric members that contact the elongate member to allow for a degree of dynamic movement.

Abstract: A surgical access system for accessing a surgical target site within a spine includes a retractor and an elongated element. The retractor has a closed configuration defining a lumen with an internal circumference, and an open configuration in which the internal circumference, at least at the distal end of the retractor, is enlarged relative to said closed configuration. The open configuration creates and maintains an operative corridor to said target site. The elongated element is releasably coupled to an interior wall of the retractor and has an extension extending distal of the distal end of the retractor into the surgical target site. When coupled to the retractor, the elongated element covers a body structure at the target site without blocking access to the operative corridor.

Abstract: An apparatus for anchoring a rod to a bone fastener in a spine stabilization system. A first resilient insert may have two deflectable arms and a first channel formed therein. A second resilient insert may have two deflectable arms and a second channel formed therein. A cylindrical body may have a passage, wherein the first resilient insert and the second resilient insert have a width greater than the inner diameter of the cylindrical body when the first resilient insert is in a neutral state. Advancement of the first resilient insert or the second resilient insert into the passage deflects the two deflectable arms inward, causing the width of the first or second channel to decrease, and inhibiting the first resilient insert or the second resilient insert from moving relative to the cylindrical body.

Abstract: A composite interbody vertebral implant for facilitating fusion of adjacent vertebrae. The implant includes a first endplate of a porous metal material and a second endplate of a porous metal material which are configured to allow bone in-growth. The implant also includes a polymeric body positioned between and bonded to the first and second endplates such that polymeric material of the polymeric body is impregnated into pores of the first and second endplates to bond the components together. The implant may include a cavity extending through the composite implant configured to receive bone growth material to facilitate fusion between a first vertebra and a second vertebra.

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: Embodiments described herein provide tools and methods for spinal fusion procedures. One embodiment of a tool can be a pedicle access tool that performs the functions of targeting needle, cannula, tap and awl. The cannula of the tool can be used to guide various tools and bone graft or fusion promoting material to a surgical site for a spinal fusion procedure, such as a posterolateral procedure. In other embodiments, a k-wire can be used as the guide.

Abstract: A spinal implant for stabilizing first and second vertebrae. The spinal implant includes an intervertebral spacer and a bone stabilization member configured to be coupled to the intervertebral spacer. The bone stabilization member includes a plurality of bone screw openings and a plurality of bone screws extendable through the bone screw openings to secure the bone stabilization member to the vertebrae. A retention member, which is slidably coupled to the bone stabilization member, is linearly slidable between a first position and a second position while coupled to the bone stabilization member. In the first position, each of the bone screws is permitted to be inserted into the bone screw openings, and in the second position the retention member at least partially covers each of the bone screw openings to prevent a bone screw from backing out of the respective bone screw opening.

Abstract: A spinal plate system that maintains intervertebral spacing and spinal stability is provided. In an embodiment, a spinal compression plate may include two or more plates coupled together form an adjustable-length plate. Compression of a spinal compression plate movement may mimic natural settling of bones in a spine and/or distribute at least a portion of a vertebral load to an implant positioned between two vertebrae. Maintaining at least a portion of the vertebral load on an insert may increase bone growth and increase fusion between an implant and surrounding vertebrae.

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 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 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).