Abstract: Bone anchor assemblies and related instrumentation are disclosed herein. In some embodiments, a modular bone anchor assembly allows for a bone anchor to be driven into bone and a head or receiver member to be attached thereto at some later point in time. The bone anchor can have a smaller footprint than the complete assembly, which can improve visualization and anatomical spatial awareness during insertion of the bone anchor and during other surgical steps performed prior to attaching the head or receiver member to the bone anchor. A variety of modular head types are disclosed, as are various instruments for driving a bone anchor, attaching a head to a bone anchor, removing a head from a bone anchor, and making a unilateral attachment to a head of a bone anchor assembly. Drive interfaces for driving a bone anchor are disclosed, as are features that allow a bone anchor to act as a fixation point for soft tissue retraction, disc space distraction, derotation, and the like.

Abstract: A surgical guide is provided comprising a body defining a first cavity that is configured for disposal of a surgical instrument and an opening. A connector is disposable with the opening and is engageable with a surgical robot. At least one insert is disposable in the first cavity. The at least one insert defines a second cavity configured for disposal of an alternate surgical instrument. Systems, methods, spinal constructs, implants and surgical instruments are disclosed.

Abstract: A receiver assembly includes a receiver with upright arms extending upward from a base to define an open channel for receiving a rod, and a central bore communicating with a bottom of the base through a bottom opening and having a discontinuous guide and advancement structure proximate the tops of the upright arms. Each upright arm further includes one or more tool engagement grooves extending horizontally and circumferentially below the top of the upright arm to a front or back outer face the receiver.

Abstract: A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having pair of upright arms that define an open channel configured to receive the elongate rod, a discontinuous helically wound receiver guide and advancement structure formed into the interior surfaces of the upright arms, and horizontally-elongated tool engaging grooves formed into upper portions of the outer surface of the upright arms. The receiver assembly further includes a closure configured for positioning within the open channel to secure the elongate rod to the receiver in a locked configuration, with the closure having an outer surface with a mating continuous helically wound closure guide and advancement structure configured to resist a tendency toward splaying between the upright arms upon a screwing in of the closure within the open channel by rotatable engagement with the receiver guide and advancement structure.

Abstract: A retractor assembly that includes a base portion in slidable engagement with two or more retractor arms with at least one of the retractor arms releasably securing a retractor blade configured to be anchored to a bone anchor. The retractor blade includes an elongate blade portion with a retractor engagement portion positioned at the proximal end of the elongate blade portion and an anchor mechanism positioned at the distal end of the elongate blade portion. The anchor mechanism includes a first jaw and second jaw configured to engage the bone implant. When closed around or anchored to the bone implant—which may be a shank of a modular screw system—the components of the modular screw are able to be assembled to the shank without adjusting, loosening, or opening the anchor mechanism.

Abstract: Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.

Abstract: The present disclosure includes a polyaxial bone fixation element for use in spinal fixation to interconnect a longitudinal spinal rod with a patient's vertebra. The polyaxial bone fixation element preferably includes a bone anchor, a collet, a body, and a locking cap. The polyaxial bone fixation element preferably enables in-situ assembly. That is, the polyaxial bone fixation element is preferably configured so that in use, the bone anchor may be secured to the patient's vertebra prior to being received within the body. Accordingly, the polyaxial bone fixation element enables a surgeon to implant the bone anchor without the body to maximize visibility and access around the anchoring site. Once the bone anchor has been secured to the patient's vertebra, the body can be snapped-onto the bone anchor. The bone anchor preferably also includes a second tool interface so that a surgical instrument can be directly coupled to the bone anchor.

Abstract: Methods and apparatus provide for coupling a spinous process plate to one lateral side of a spinous process of a spine of a patient; coupling a laminar plate to a laminar on the one lateral side of the spinous process of the spine; engaging a sub-laminar hook to the laminar on the one lateral side of the spinous process; and (iv) extending a rod toward a pedicle on the one lateral side of the spinous process of the spine of the patient, where the rod prohibits movement of bone associated with a fracture in a pars interarticularis of a vertebral arch on the one lateral side of the spinous process of the spine.

Abstract: A tissue retractor having a spring loaded retractor blade that provides constant downward pressure on the spine to eliminate/reduce tissue from creeping underneath the tips of the blades during use, which decreases operation time and reduces patient risk.

Abstract: A monoblock implant for fusing a cervical motion segment includes (a) an interbody portion configured to be positioned between superior and inferior vertebral bodies, of the cervical motion segment, with a first side of the interbody portion facing a first uncinate joint of the cervical motion segment and a second side of the interbody portion facing a second uncinate joint of the cervical motion segment, (b) a first wing extending away from the first side to extend into the first uncinate joint, and (c) a second wing extending away from the second side to extend into the second uncinate joint.

Abstract: An intervertebral implant includes a body formed as an open lattice structure by a plurality of struts. Some of the struts of the plurality of struts intersect at nodes. The nodes can include an enlarged contact member that extends over the node and at least a portion of the width of some of the struts. Enlarged contact members may have an asymmetrical shape with respect to the intersection of struts. The enlarged contact members can provide improved bone contact for the implant. The plurality of struts can have a cross-sectional shape that includes a flattened portion. The flattened portion of the plurality of struts can provide improved bone contact for the implant. An additive manufacturing process can be used to build the implant in a substantially vertical direction.

Abstract: A band tensioner includes a shank, a head, and a tensioning mechanism disposed within the head. The shank is configured to secure the band tensioner to a first bony element and the head is secured to an end of the shank. The tensioning mechanism is configured to lengthen and shorten a flexible implant relative to the head of the band tensioner.

Abstract: An expandable interbody spacer that is delivered in the anterior approach with adjustable height and end plate angulation (lordosis). The expandable interbody spacer is configured to have an initial collapsed state having a first height suitable for being inserted into an intervertebral space defined by a pair of adjacent vertebrae, and an expanded state having a second height that is greater than the first height. The expandable interbody spacer may be expanded from the initial collapsed state to the expanded state in-situ. The expanded state increases the distance between the adjacent vertebrae and provides support to the adjacent vertebrae while bone fusion occurs and also provides rigid support between the adjacent vertebrae that withstands compressive forces.

Abstract: The invention relates to the intramedullar nail fixation (13) of the femoral bone that is used in the field of orthopedics and traumatology, in particular, in the pediatric orthopedics field; Its features include the follows; Removal of many negativities in the treatments of femoral proximal area fractures seen in the child age group, young and old bone rotation surgeries, malunion, nonunion and deformities, and in order to make positive contribution to the healing processes of patients, the proximal femoral de-rotation nail (13), by which location can be fixed by turning in an angular way, and by which the operator can perform rotation as much as necessary by fixing rotation angle, and which is formed with the proximal component (1) and the distal component (2), which can perform rotational movement on each other and can fix its location, was developed.

Abstract: The apparatus, systems and methods disclosed herein generally relate to the surgical repair or alteration of bone. More particularly, certain of the disclosed apparatus, systems and methods of the present disclosure relate to the use of a directionally-reinforced composite material to emulate anisotropic structural characteristics of an original anatomic trabecular structure. The directionally-reinforced composite material may generally include a scaffold set in a composite matrix, wherein the scaffold determines the anisotropic structural characteristics of the materials. In some of the embodiments, a scaffold may include at least a first plurality of struts which are generally aligned in a first direction and a second plurality of struts aligned in a second direction.

Abstract: A femoral nail includes a proximal section, a distal section remote from the proximal section, and an intermediate section disposed between the proximal section and distal section and having first and second curved portions. The first curved portion is positioned closer to the proximal section than the second curved portion. The second curved portion is curved in a first plane, and the first curved portion is curved in the first plane and a second and third plane.

Abstract: Surgical support instruments are described herein that can couple to, e.g., an implanted anchor and provide a platform for coupling other surgical implements thereto. In one embodiment, an instrument can include an elongate body having opposed projections extending laterally from a distal portion thereof that can at least partially surround a shank of an implantable anchor such that a longitudinal axis of the elongate body is laterally offset from a longitudinal axis of the anchor. The instrument can further include a lock configured to exert a drag force on a head of the anchor to control polyaxial movement of the instrument relative to the anchor. Further, a proximal portion of the elongate body can be configured to receive a retractor assembly including a plurality of tissue manipulating implements and selectively lock the retractor assembly at any of a plurality of positions along a length of the elongate body.

Abstract: An adjustable spinous process implant configured with one or more flexible members that extend from the implant and are further attachable to anchors implanted in adjacent vertebrae. The adjustable spinous process implant comprises a spacer that is shaped to fit between two adjacent spinal processes. The flexible members extend from one or more points on the adjustable spinous process implant and attach the anchors to provide tension and stability to the overall implant construct. The anchors are configured with a tensioning mechanism that enables the flexible members to be tensioned within the anchor.

Abstract: A bone fracture fixation system including reference pins inserted into bone fragments of a patient in a first configuration and an image capture device configured to capture an image of the reference pins, and the bone fragments. The system includes a processor configured to receive and pre-process the captured image data. The processor pre-processes the image data by virtually re-positioning the reference pins in the first configuration into a second configuration, wherein the re-positioning virtually re-positions the bone fragments into normal alignment; and virtually generating a support device. The system includes a point-of-care production apparatus that produces a three-dimensional model of the virtually generated support device in a form that can be applied to the patient.

Abstract: An implantable tissue retractor for treatment of a breathing disorder and related methods. The implantable tissue retractor comprises a shaft sized for insertion into a soft tissue located in a patient's oral cavity or pharynx. The implantable tissue retractor also comprises a retractor member at or near a first end of the shaft. The implantable tissue retractor also comprises a removable coupler connected at or near a second end of the shaft. At least one of a portion of the shaft or the retractor member is positionable on a surface of the soft tissue. At least one of the shaft, retractor member, or removable coupler is adjustable to vary a force to prevent a deformation of at least a portion of the soft tissue to prevent obstruction of the patient's airway.