Abstract: Intramedullary nails, systems, and methods. The intramedullary nail may include a generally elongate body extending from a first, distal end to a second, proximal end. The distal end may include one or more openings configured to receive one or more bone anchors that extend transversely through the distal end intramedullary nail, and thereby configured to secure the distal end of the nail. The proximal end may also include one or more openings configured to receive one or more bone anchors that extend transversely through the proximal end of the intramedullary nail, and thereby configured to secure the proximal end of the nail.

Abstract: Orthopedic fixation devices including a pre-assembled double headed tulip assembly, having two tulip elements to receive rods, wherein the assembly may receive a bone fastener in at least one of the tulip elements. At least one of the tulip elements may include a saddle and a ring to attach the double headed tulip to a bone fastener.

Abstract: A polyaxial rod connector comprising a body having an external surface. The connector body is intersected by an imaginary first reference plane and an imaginary second reference plane perpendicular to the first plane. The first body portion is on one side of the first plane and defines a first spinal rod passage defining a first passage axis and a first set screw opening defining a first axis perpendicular to the first passage axis. A second body portion is adjoined to the first body portion, defining a second spinal rod passage defining a plurality of passage axes, and a second set screw opening defining a second axis perpendicular to the plurality of second passage axes. The first passage axis is non-parallel with one of second passage axes in the second plane. Either the first or second spinal rod passage have an hourglass shaped cross-section parallel to the second plane.

Abstract: A cutter for cutting an implant is provided. The cutter includes a gearbox; a primary milling bit, a secondary milling bit and a lead screw operatively coupled to the gearbox; an input coupling coupled rigidly to the primary milling bit; and an implant coupler coupled rigidly to the lead screw, wherein the gearbox is operable to translate with respect to the lead screw and to drive the secondary milling bit in response to a driving force applied to the input coupling.

Abstract: A receiver assembly for securing an elongate rod to a bone anchor including a receiver and a threaded plug. The receiver including an upper portion defining a channel to receive the elongate rod, an interior surface having helically wound receiver thread, and an exterior surface having in some embodiments first and second horizontal curvate extending instrument engaging grooves. The threaded plug including a longitudinal axis, a lower surface having a protrusion, and an external side surface having a continuous helically wound closure thread to rotatably mate with the helically wound receiver thread. The continuous helically wound closure thread including a lower leading surface and an upper trailing surface, both in some embodiments extending perpendicular to the longitudinal axis, and a cylindrical outer crest surface extending parallel to the longitudinal axis. When the protrusion on the threaded plug engages the elongate rod, the threaded plug does not extend overtop a top surface of the receiver.

Abstract: A pivotal bone anchor assembly includes a receiver having a base defining a cavity for receiving the capture portion of a shank and a first pair of upright arms defining a first channel for receiving an elongate rod, and a pressure insert with a second pair of upright arms defining a second channel.

Abstract: An “extension ready” spinal support system that enables the extension to be accomplished with minimal disturbance to an existing spinal support structure to which the extension system is coupled. In some embodiments, the existing spinal support rod and pedicle screws can remain intact while extension subassemblies are mounted directly to the existing base rod receptacles. The extension subassemblies include a skirt portion that surrounds and engages the existing base receptacle to prevent splaying of the base receptacle. Additional resistance to splaying may be provided by a canted thread arrangement between the skirt and the base receptacle. In some embodiments, the extension receptacle is provided with a low profile (i.e., shortened axial length from the base rod receptacle) by providing a monoaxial rotation structure that rotates about but does not pitch relative to the extension axis and is shorter relative to polyaxial rotation structures.

Abstract: A retractor for use in surgical operations comprises a pair of blade assemblies. In operation, the blade assemblies are initially in a closed position to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The retractor is adapted to rotate a first blade about a first axis and a second blade about a second axis. The retractor is adapted to move the pair of blade assemblies apart along a third axis. The retractor is adapted to pivot the first blade about a fourth axis and the second blade about a fifth axis. In some embodiments, a method of performing an operation, e.g. a spinal operation, on a patient using the disclosed retractor is provided.

Abstract: Adjustable rail apparatuses and external bone and/or tissue fixation system including an adjustable rail apparatus is disclosed. The rail apparatuses comprise first and second external fixation beam elements with alignment grooves, and a joint coupling the first and second beam elements and configured to selectively adjust the relative angular and rotational arrangement of the first and second beam elements. The joint also comprises a first and second beam end housings rotationally fixed to the first and second external fixation beam elements, respectively. The joint also comprises first and second clamp members axially and rotationally fixed to the first and beam end housings, respectively. The joint also comprises first and second rotation end housings coupled with the first and second clamp members, respectively, the first and second rotation end housings being selectively rotatably adjusted with respect to the first and second clamp members, respectively, within fixed ranges of rotation.

Abstract: A system and method for osseous fixation is a surgical hardware device that allows bone fixation for purposes of fracture repair, arthrodesis, or other types of orthopedic applications. A partially threaded wire or pin is inserted into the bone and external compression and rotational stability are achieved with a locking cap. The locking cap may include serrations or other anti-rotation features which engage bone to provide rotational stability. Upon adequate bone healing, the external cap may be used to facilitate removal of the wire/pin from the bone.

Abstract: Disclosed is an implantable artificial intervertebral disc joint replacement device for implantation between adjacent vertebral bodies. The device allows selective positioning of a disc implant element and comprises translatable surfaces, a mechanism for translation, a means for bone attachment, and an integrated disc implant. The device can be used in the lumbar, thoracic, and cervical regions of the spine in single or multi-level configurations. When implanted in a patient, the device includes an upper (cranial) component and a lower (caudal) component attached to the vertebral body above and below the replaced intervertebral disc respectively, with the joint implant integrated into the translatable surfaces. Following implantation, precise positioning of the joint implant within the intervertebral space with respect to the spinal axis is then adjusted based upon the particular anatomical and functional needs of the individual patient to satisfy spinal range of motion and stability requirements.

Abstract: An anchoring member for a polyaxial bone anchoring device includes a bone anchoring section having a first end, a second end, and a bone engagement structure, a head having an outer surface portion that defines a segment of a sphere, wherein a central axis extends through the head and the first and second ends of the bone anchoring section, and a neck extending between the first end of the bone anchoring section and the head. The neck has a first portion and a second portion between the first portion and the bone anchoring section. In at least a first cross-sectional plane including the central axis, the first portion of the neck is concave with a first curvature, and the second portion of the neck is concave with a second curvature that is less curved than the first curvature.

Abstract: An anchoring assembly for anchoring a rod to a bone or vertebra includes a shank and a receiving part pivotably connected to one another, the receiving part defining a channel for the rod, a pressure element for locking the shank with the receiving part, first and second rods with different diameters configured to be interchangeably received in the channel, and first and second closure elements configured to interchangeably cooperate with the receiving part. The first closure element acts on the selected rod in the receiving part such that the rod exerts pressure on the pressure element to simultaneously lock the shank with the receiving part and fix the rod in the channel. The second closure element cooperates with the receiving part to act on the pressure element to lock the shank with the receiving part, and to act separately on the selected rod to fix the rod in the channel.

Abstract: Retractor holding frames and related methods are provided. The frame includes a support body including a first bore extending transversely from a first side of the support body to a second side of the support body opposite the first side, and a second bore extending transversely from the second side to the first side. The frame includes a left support frame arm including a first annular hub configured to be disposed within the first bore and a first plurality of posts disposed along an outer edge of the left support frame arm configured to retain a first retractor in a first orientation. The frame includes a right support frame arm including a second annular hub configured to be disposed within the second bore and a second plurality of posts disposed along an outer edge of the right support frame arm configured to retain a second retractor in a second orientation.

Abstract: Systems, methods, and devices for securing a spinal rod are provided. A clamp assembly may include a tulip comprising a first opening and a second opening, wherein an inner surface of the first opening comprises threads; a saddle movably disposed within the tulip between the first and second openings, the saddle comprising a first end and a second end, the first end comprising a portion configured to receive a spinal rod, the second end comprising a cavity configured to receive a pedicle screw, the saddle comprising slots configured to receive a rotating tool; and a threaded locking cap disposed in the first opening.

Abstract: The fusion systems include a first fastener, a second fastener, and an elongate member with a first end and a second end. The first end being secured to the first fastener and the second end being secure to the second fastener. The method of assembling a fusion system including obtaining towers, fasteners, and an elongate member; coupling the fasteners to the towers; inserting ends of the elongate member into the fasteners; coupling locking caps to a screwdriver; and screwing the locking caps into heads of the fasteners to secure the ends of the elongate member to the fasteners. The methods of using the fusion systems including exposing a patient's vertebrae and obtaining the fusion system, inserting first and second fasteners into first and second vertebra, and coupling the first fastener and second fastener.

Abstract: Apparatus for treating dermatological tissue including a user holdable device having an end defining a surface configured to receive and capable of being releasably coupled to a needle module that includes a movable needle assembly having a plurality of needles that is located past the end of the device when the module is releasably coupled to the device. The device includes a motor capable of moving the assembly to deploy the needles to penetrate dermatological tissue to a selectable desired depth. The apparatus includes a signal generator capable of being coupled to the needles to provide a radio frequency signal having a selectable intensity; at least one processor configured to provide a signal to cause the motor to deploy the needles to the desired depth and a signal to cause the signal generator to provide the intensity of the radio frequency signal to the needles; and at least one display.

Abstract: A protective device (10, 10?) provides a protective cover for a part (12, 12?, 12?) of a medical device and includes a flexible part (14, 14?) and a rigid part (16, 16?). The rigid part (16, 16?) has at least one locking element (28, 28?). The locking element (28, 28?) is lockingly connectable to a counterpiece of the corresponding part (12, 12?, 12?) of the medical device.

Abstract: A method of designing an orthopedic implant comprising: (a) iteratively evaluating possible shapes of a dynamic orthopedic implant using actual anatomical shape considerations and kinematic shape considerations; and, (b) selecting a dynamic orthopedic implant shape from one of the possible shapes, where the dynamic orthopedic implant shape selected satisfies predetermined kinematic and anatomical constraints.

Abstract: A bone anchoring device includes an anchoring element having a shank and a head, a receiving part configured to pivotably receive the head, and a pressure member defining a head receiving recess for pivotably holding the head and having a portion configured to extend to a side opposite a free end of the head and to exert pressure on the side opposite the free end to clamp the head in the receiving part. The head has a first position indication structure configured to engage a second position indication structure of the pressure member when the shank assumes a first angular position, and to disengage from the second position indication structure when the shank is at an angular position different from the first angular position. The second position indication structure is engageable with the first position indication structure without protruding into a profile defined by the head receiving recess.