Abstract: A method is disclosed for introducing a spinal disc implant into an intervertebral space of a subject. The subject is placed in a lateral position, and the anterior face of the spinal disc intervertebral space is accessed, between the L5 and S1 vertebrae, from an anterior and lateral retroperitoneal approach. An operative corridor to the anterior face of the spinal disc space is established by introducing a retractor instrument anterolaterally to the spinal disc space between the anterior superior iliac spine and the anterior inferior iliac spine. The damaged spinal disc contents are removed from the intervertebral space through the operative corridor, and the implant is advanced into the intervertebral space at an oblique angle and pivoted to position the implant substantially laterally within the intervertebral space. Elongated retractor and insertion instruments, as well as a modified disc implant, are also disclosed for carrying out the method.

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: The present disclosure relates to an external fixation apparatus comprising a strut having a longitudinal axis defined therein, the strut comprising a strut housing having a housing adjustment aperture, an adjustment sleeve slidably disposed within the strut housing, and a fastener that releasably couples the strut housing with the adjustment sleeve. An embodiment of the adjustment sleeve comprises a first and a second bore extending from a top towards a bottom surface of the adjustment sleeve, a first sleeve member with a proximal end, a distal end, and an axial bore, and a second sleeve member adjoining the first sleeve member. In an embodiment, the second sleeve member comprises a body and a beveled end that is slidably disposed within the axial bore of the first sleeve member. The adjustment sleeve further comprises a biasing mechanism between the first sleeve member and the second sleeve member.

Abstract: A method facilitates the treatment of the spine of a patient by providing simultaneous access through at least a first opening and a second opening formed in the patient. For example, the method can include the acts of positioning the patient on a surgical table, providing the first opening into a posterior portion of the patient, providing the second opening into a lateral portion of the patient, inserting a first device through the first opening into the patient to contact the spine in a first direction that is transverse to the coronal plane of the patient, and inserting a second device through the second opening into the patient to contact the spine in a second direction that is transverse to the sagittal plane of the patient, where the first and second openings are accessible simultaneously, and, when the first and second devises are inserted into the patient, the position of the patient is stationary with respect to a portion of the table.

Abstract: An intramedullary implant has opposite ends inserted into bores in abutting phalanges for correcting hammer toe and for similar arthrodesis procedures. A rear end of the implant may be threaded and is received in a bore in the proximal phalanx. A front end has an asymmetric pointed shape with longitudinally and/or angularly spaced rear-facing gripping flukes. The pointed front end is received in the middle phalanx. The asymmetric pointed shape is self-aligning, enabling entry to begin without first longitudinally aligning the bones. The rear end when screwed into place can be rotated to select the orientation of the asymmetric pointed shape. The pointed front end is inserted and pushed to bring the phalanges into abutment where the implant holds them against retraction or rotational displacement.

Abstract: A clip-on reducer tool assembly for seating a spinal fixation rod in a rod receiving implant, the tool assembly has an outer sleeve. The outer sleeve has a proximal end with a cylindrical portion having a threaded opening, a first leg extension extending therefrom to a distal end, and a second leg extension joined to the first leg extension at an intermediate location between the distal end and proximal end. The second leg extension extends from the distal end toward the proximal end to a lever end spaced from the cylindrical portion. The leg extensions at the distal end have grasping members to engage an outer surface of a rod receiving implant and a fulcrum proximally located near the intermediate location configured to enlarge the space between the leg extension at the distal end as the lever end is depressed inwardly relative to a longitudinal axis of the outer sleeve.

Abstract: A polyaxial bone anchoring device is provided including a bone anchoring element (1) comprising a head (3) and a shank (2); a receiving part (4, 4?) for receiving a rod (100) for coupling the rod to the bone anchoring element, the receiving part comprising a first end (4a), an opposite second end (4b) and a central axis (C) extending through the first end and the second end, and a channel (9) for receiving the rod and an accommodation space (11) for receiving the head; a pressure element (6, 6?) arranged in the receiving part and configured to exert pressure onto the head; wherein the pressure element (6) comprises flexible sections (66a, 66b) facing away from the head (3), characterized in that the flexible sections (66a, 66b) comprise a free end portion (69a, 69b) with respect to the central axis (C) that cooperates with an inclined surface portion (15a, 15b) of the receiving part (4) such as to hold the pressure element (6) in a position in which it exerts a pre-load onto the head before the head is lo

Abstract: An implantable device includes a barrel. The barrel has a first portion and a second portion. The implantable device includes a first plate having multiple projections extending from one side of the first plate, where the first plate is configured to movably couple to the first portion of the barrel. The implantable device includes a second plate having multiple projections extending from one side of the second plate, where the second plate is configured to movably couple to the second portion of the barrel. The barrel is configured to transition from a collapsed form having a first height to an expanded form having a second height, where the second height is greater than the first height.

Abstract: An apparatus and method for fusing cervical vertebrae is provided. The apparatus may include a plate configured to be affixed to at least two vertebrae, and at least two screws configured to affix the plate to an anterior surface of the at least two vertebrae, wherein when the plate is affixed to the at least two vertebrae, the plate is configured to be partially disposed in a disc space between the at least two vertebrae, and extend in an anterior direction beyond an anterior surface of the at least two vertebrae.

Abstract: An anchoring member is provided suitable for use in a polyaxial bone anchoring device, the anchoring member (1) comprising a bone anchoring section (2) with a bone engagement structure in at least a portion of an outer surface thereof; a head (3); a central axis (C) extending through a center of the head (3) and the bone anchoring section (2), and a neck portion (24; 24?; 24?; 24??) between the bone anchoring section and the head, wherein the neck portion is asymmetric with respect to the central axis (C); and wherein the bone anchoring section (2) has a contour in a circumferential direction adjacent to the neck portion and wherein the neck portion is at least partially recessed with respect to the contour of the bone anchoring section at one side and extends beyond the contour of the bone anchoring section at an opposite side from the central axis.

Abstract: A screw extension assembly for use in minimally invasive spinal surgery, the assembly has an inner slotted shaft and an outer shaft, a rod reducer and a removable nut. The combination when assembled is configured to move a spinal fixation rod into a slotted rod receiving spinal implant where it is seated and affixed thereto. The screw extension assembly further has a locking knob rotationally coupled to a proximal end of the outer shaft, wherein the inner shaft has one or more cam grooves and the locking knob has a pin extending into and guided by said cam groove causing the outer shaft to translate longitudinally upon rotation of the locking knob relative to the inner shaft toward an engaged position locking the deflectable legs in the coupled position to the slotted rod receiving implant.

Abstract: A surgical access assembly for a surgical instrument and/or a surgeon's hand, the assembly including a housing, such as a wound retractor, and a seal body mounted to the housing. The seal body may have a pleated configuration when viewed in cross-section. The seal body may have a first surface and a second surface, the first surface having a plurality of radially-extending first channels and the second surface having a plurality of radially-extending second channels, the plurality of first channels being offset from the plurality of second channels. The seal body may define a substantially centrally disposed opening for reception of a hand/arm or instrument. In addition, the seal body may define one or more additional openings for simultaneous reception of an instrument and a hand.

Abstract: A sacroiliac joint fusion screw and associated delivery tools and method. Embodiments of the sacroiliac joint fusion screw comprise a shaft having proximal and distal end portions and a head on the proximal end of the shaft. A threaded portion on a distal portion of the shaft is configured to engage a sacrum. A glide zone portion on the shaft between the threaded portion and the proximal end portion is configured to extend through an ilium. The screw can provide stability and compression to the joint.

Abstract: An elongate inserter has a distal end releasably connected to an expandable device for expanding body tissue and a proximal end including a trigger actuator. The expandable device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other between opposing tissue surfaces of a body. The inserter includes a lifting platform comprising ramp surfaces that upon operation of the trigger actuator cooperatively engage complementary surfaces of expansion structure within the device to cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert between the superior and inferior endplates after expansion of the device.

Abstract: The present invention provides spinous process implants and associated methods. In one aspect of the invention, the implant includes a first extension and a second extension. The first extension has a spacer extending from a medial lacing side along a longitudinal axis. The second extension has an aperture that slidingly receives the spacer. Accordingly, the second extension is moveable relative to the spacer along the longitudinal axis. The second extension includes a threaded bore in communication with the aperture. A set screw is threadably received in the threaded bore of the second extension. The set screw can be tightened against an outer surface of the spacer to lock the second extension in place relative to the longitudinal axis.

Abstract: A dilation system for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a wedge assembly and an actuating mechanism. The wedge assembly comprises includes a base and a plurality of blades extending from the base so that the distal end of the blades extend away from the base. The mechanism is operably associated with the blades so as to cause the distal end of the blades to move from a closed condition to an expanded condition.

Abstract: A polyaxial bone anchor assembly, comprising: a threaded screw portion comprising a head end; a head body disposed concentrically about the head end of the threaded screw portion; and a saddle assembly disposed within the head body and selectively engaging the head end of the threaded screw portion; wherein, when the saddle assembly is translated within the head body into a first locked position, the head body is coupled to the threaded screw portion such that disengagement of the head body from the threaded screw portion is allowed; and wherein, when the saddle assembly is translated within the head body into a second locked position, the head body is coupled to the threaded screw portion such that disengagement of the head body from the threaded screw portion is prevented.

Abstract: An implant system for use in orthopedic surgery for fixation of bone includes an intramedullary nail and a coupling unit. The intramedullary nail has a medial side, a lateral side and a proximal portion defining a longitudinal axis. The proximal portion includes a bore defining a first axis substantially parallel to the longitudinal axis of the proximal portion and a transverse bore configured to receive a bone fastener. The coupling unit is movably arranged within the bore of the proximal portion and includes one or more bone fastener engagement members at one or both of the lateral side and the medial side of the intramedullary nail.

Abstract: An osteotomy instrument includes a handle, a first arm assembly, a second arm assembly, a displacement mechanism, and a tuning mechanism. The first arm assembly is pivotably mounted to the handle. The first arm assembly includes a first fastener support configured to hold a fastener. The second arm assembly is pivotably mounted to the handle. The second arm assembly includes a second fastener support configured to hold a fastener. The displacing mechanism includes a dial disposed on the handle. The displacing mechanism is configured to laterally displace a distal end of the first arm assembly and second arm assembly away and towards each other. The dial actuates the displacing mechanism. The tuning mechanism is configured to change an angular position of the first fastener support with respect to the second fastener support.

Abstract: Devices, systems, and methods for inserting a vertebral stabilization member, such as a rod. The insertion device includes an outer guide tube, a pin assembly including a pin and a pusher member extending therethrough. The insertion device is configured to actuate a rod between a first orientation and a second orientation angled with respect to the first orientation in order to position the rod in an appropriate location for attachment to bone.