Abstract: Device for fixing a bony structure to a support member, the device comprising a first connecting member which comprises: a main body provided with a first passage configured for receiving the support member, and with a first opening configured for passing a flexible member therethrough; and a rod fixed to and/or monobloc with the main body and protruding therefrom. The device further comprises a first flexible member passing through the first opening of the main body and extending beyond the main body for attachment to the bony structure.

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 method and instrument for tensioning a flexible tie used for fastening an implant on a bony element by forming a first loop around it. In some embodiments, the instrument comprises a shaft having a distal end configured for contact with a rod, a moving part slidably engaged with the shaft, a holder connected to the moving part and configured to hold an end of the flexible tie, and a tension control member comprising a trigger that pivots relative to the moving part. In some embodiments, the method comprises coupling the end of the flexible tie to the instrument and squeezing the trigger to shorten the first loop of the flexible tie around the bony element, causing the moving part and the holder holding the end of the flexible tie to move in translation away from the distal end of the shaft, thereby exerting tension on the flexible tie.

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: An instrument for use in a procedure for inserting a spinal implant between human vertebrae may include a shaft and an end member. The end member may rotate with respect to the shaft. An angle of the end member with respect to the shaft may be varied when the end member is in a disc space between the human vertebrae. The instrument may include a slide for securing the end member at selected angles relative to the shaft. The end member may be separable from the shalt when the end member is in a selected orientation with the shaft. An instrument kit may include a shaft assembly and modular end members for various steps in a surgical procedure, such as disc space preparation, disc space evaluation, and spinal implant insertion.

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: A device for fixing a rod to an osseous structure. The device is configured to receive the rod with the main axis oriented in a first direction. The device includes a main body, a first fastening member directly connected to the main body and accessible from an outer surface of the main body for fastening the rod to the main body, and a second fastening member, also directly connected to the main body, offset with respect to the first fastening member in said first direction, and separately accessible from an outer surface of the main body for fastening to the main body. A flexible elongate member is provided to attach the main body to the osseous structure. The first and second fastening members are arranged so that the flexible elongate member can be fastened adjacent to the rod.

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 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: This disclosure relates to a spinal implant that can provisionally retain a rod in an assembly head without having to first lock the rod relative to the assembly head. The spinal implant has a clip insert structured to retain the rod in the assembly head. The clip insert has a top portion with a cylindrical opening and extending over the cylindrical opening to cover the connection rod in part when the connection rod is engaged in the clip insert. The top portion is deformable by application of force on the connection rod to engage the connection rod with the clip insert. The clip insert and the assembly head are mechanically decoupled and can be fully received within the assembly head. The mechanical forces to which the assembly head is subjected are not transmitted to the clip insert.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which the head portion is passable through the lower opening of the retainer.

Abstract: Embodiments described herein provide systems and methods for vertebral reduction using sleeves detachably coupled to collars of bone fasteners. The reduction can be performed during a minimally invasive procedure for implanting spinal stabilization systems. A sleeve can include internal threads that match threads on the respective collar to form a continuous set of threads. Threads on a closure member can be engaged with the threads on the sleeve and the closure member turned to translate the closure member along the sleeve. The closure member can be used to push a rod relative to the collar to which the sleeve is attached to cause a vertebral body to move.

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 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: Orthopedic devices including a connecting element suited for receiving at least part of a first rod, and a lock screw. The connecting element includes an anchor for securing the connecting element to a bone, in particular a vertebra, a first lateral opening, and a top opening with a first inner screw thread. The lock screw is received within the top opening and includes a proximal face presenting a screw drive, accessible from outside the connecting element, a distal end for locking the first rod within the connecting element, and wherein the lock screw is adapted to fit through the first lateral opening to be subsequently introduced into the top opening with the proximal face leading.

Abstract: A spinal stabilization system including an insert positionable in the channel of the housing of a vertebral anchor, and an associated support construct including a spacer and at least one cord extending through the insert. In some instances the construct includes first and second cords extending through first and second bores of the insert. A clamping member clamps the cord(s) in the insert. In some instances the clamping member includes first and second tabs movable in channels in first and second flanges of the insert.

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: Embodiments disclosed herein provide a device for securing a ligature to an osseous structure, the device comprising a first part, a second part, a flexible elongate member for engaging the osseous structure, a closure element, and a deformable element between the first and second parts for holding open a gap G between them. The flexible elongate member is threaded through an orifice in the first part and the gap G. The closure element is configured for clamping the first and second parts against each other, overcoming the resilience of the deformable element, so as to frictionally lock the flexible elongate member threaded through the gap G. Embodiments disclosed herein also provide a method for using the device.

Abstract: In one embodiment, a spinal stabilization apparatus includes a vertebral anchor having a head portion and a bone attachment portion. An elongate, flexible guide is removably coupled to the head portion of the vertebral anchor and has a channel extending longitudinally thereof and communicating with a slot in the head portion of the anchor. An elongate cord may be received within the channel to facilitate inserting and securing a spacer between pairs of anchors installed into adjacent vertebrae of a person's spine.

Abstract: In one embodiment, a spinal stabilization apparatus includes a vertebral anchor having a head portion and a bone attachment portion. An elongate, flexible guide is removably coupled to the head portion of the vertebral anchor and has a channel extending longitudinally thereof and communicating with a slot in the head portion of the anchor. An elongate cord may be received within the channel to facilitate inserting and securing a spacer between pairs of anchors installed into adjacent vertebrae of a person's spine.