Abstract: A polyaxial bone anchoring device includes an anchoring element having a shaft and a head, a receiving part having a first end and a second end, a bore extending from the first end towards the second end, a seat for receiving the head, and at least one threaded through hole transverse to the bore, a pressure element to exert pressure onto the head, such that the head is pivotable and can be locked at an angle relative to the receiving part, the pressure element having at least one hole configured to at least partially align with the through hole, and at least one set screw threadable into the through hole to engage the pressure element at the hole such that a force is exerted by the pressure element onto the head that maintains the head at an adjustable angular position relative to the receiving part by friction.

Abstract: The present invention provides a pedicle screw for spinal fixation having a bone fastener portion a permanent rod coupling, a breakaway portion connected to the permanent rod coupling and a temporary rod coupling. A permanent rod can be positioned in the permanent rod coupling and a temporary rod can be positioned in the temporary rod coupling and when the temporary rod is not needed the temporary rod coupling can be removed by separation at a breakaway portion.

Abstract: A bone fixation device adapted to be coupled to bone anchors that allows movement of rods to permit a screw-rod construct to lengthen in response to bone growth without necessitating post surgical installation adjustment of the device. The bone fixation device includes a locking mechanism that is operably associated with a housing to allow relative movement of a rod and a housing in a first direction and inhibiting relative movement of the rod and the housing in a second direction.

Abstract: A dynamic stabilizing device (1) for bones (3), in particular for vertebrae, includes two bone anchoring elements (2) spaced from one another, which are connectable via fastening elements (4) with at least one rod (5) that is at least partly elastic. The rod (5) has an adjustable device (7) for affecting its elasticity, which is adjustable before and/or after the implantation of the stabilizing device (1). The adjustable device (7) is formed, such that it changes the free length of an elastic section (11) of the rod (5). The adjustable device (7) includes a carriage that is displaceable over the rod (5), and the carriage (20) engages the rod (5) on a peripheral side at least partially.

Abstract: Devices and methods for facilitating insertion of a spinal rod into a rod-receiving channel formed in a bone fixation element are described herein. In some embodiments, a reduction sleeve can include a through-bore sized to receive the bone fixation element and a transverse channel sized to receive the spinal rod and substantially aligned with the rod-receiving channel formed in the bone fixation element. The reduction sleeve can also include at least one break-off point for breaking and removal of the reduction sleeve The reduction sleeve can also include a plurality of threads for engaging a reduction instrument, an alignment mechanism so that the bone fixation element can only be inserted into the reduction sleeve when the rod-receiving channels are aligned, and an inwardly projecting protrusion formed on the inner surface of the reduction sleeve so that, once inserted, the projection contacts a top surface formed on the bone fixation element.

Abstract: Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient's tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

Abstract: A retractor system for percutaneous surgery in a patient includes first and second retractor portions positionable opposite one another in an incision of the patient. The system also includes at least one actuating member operable to provide an oscillating motion to at least one of the first and second retractor portions. The actuating member is in communication with a controller and is responsive to the controller to move and adjust at least one of the first and second retractor portions between a first position and a second position. The system also includes at least one pressure sensor and display and at least one timing circuit with display. In another form, a method is directed to retracting tissue for percutaneous access to a surgical site in a patient using the pressure sensors and display as will as the timing circuit and display to assure that the amount of pressure applied and the duration does not exceed pre-determined values.

Abstract: Systems for interbody fusion of adjacent bone portions may include an expanding implant and related instruments. An expanding implant may be formed as a linkage which is movable between a compact configuration and an expanded configuration. A shaft of the implant may increase and decrease in length to move between the compact and expanded configurations, and an implant width perpendicular to the length may be increased in the expanded configuration. The implant width may increase more in a first direction than a second direction opposite the first direction. An inserter instrument may releasably grasp the spacer and transform the implant between the compact and expanded configurations.

Abstract: There is provided a posterior lumbar joint prosthesis which includes prosthetic elements reproducing the movements of the joint facets and vertebral anchors which adapt to the variations in the anatomy of vertebra. In use, the prosthesis has lower and upper connectors on each side of the lumbar vertebra. The lower connectors are coupled with, and pivotably mounted onto, respective lower pedicular screws, and a member defining a member axis links lower and upper connectors on each side of the lumbar vertebra. Upon lateral flexion of one of the upper and lower vertebrae relative to the other, each lower connector is capable of multiaxis pivotable movement relative to the respective lower pedicular screws such that each member is capable to pivot with respect to (i) the axis of the lower screw, (ii) a first axis intersecting the lower screw and the lower connector, and/or (iii) an axis intersecting the above first axis and the lower screw, while the member can also move along the member axis.

Abstract: A spinal implant for limiting flexion of the spine includes a tether structure for encircling adjacent spinal processes. Usually, a pair of compliance members will be provided as part of the tether structure for elastically limiting flexion while permitting an extension. A cross-member is provided between the compliance member or other portions of the tether structure to stabilize the tether structure and prevent misalignment after implantation.

Abstract: The present invention relates to a vertebral fixation device (1) for holding a vertebra (V) on a rod (2), having a body (3) of U-shaped or substantially U-shaped cross section, a flexible band (4, 4?) for connecting said vertebra to the fixation body which is provided with slits (17) for passage of the band and of means (M) for adjustably blocking the flexible band against the rod in the fixation body. The flexible hand (4, 4?) comprises a loop (5, 5?) closed on itself and provided with a flexible lamella (6, 6?) which is able to form a guide for passage around the vertebra and into the fixation body.

Abstract: A device for the external fixation of a first bone element and a second bone element articulated to each other, comprises: a guide member equipped with a curvilinear guide; a first fastening member slidably associated with the guide and equipped with first means for releasable fastening to the first bone element; a second fastening member associated with the guide member and equipped with first means for releasable fastening to the second bone element; and relative movement means by which the first fastening member is moved relative to the second fastening member along the guide.

Abstract: An artificial intervertebral disc for implantation between two adjacent vertebrae includes superior and inferior shells connected in a ball and socket arrangement. The inferior shell preferably incorporating a convex portion that cooperates with a concave portion on the superior shell. A resilient nucleus is provided within an enclosure defined by the opposing inner surfaces of the shells and biases the shells against each other. The ball portion can be provided in either fixed or slidable arrangement. The artificial disc of the invention includes various resistance means for restricting and limiting the range of rotational and translational motion between the shells.

Abstract: A method of inserting a spinal stabilization system into a patient generally comprises inserting a first positioning tool through a first location on a patient's skin and along a path generally toward a first vertebral anchor, coupling an end of the first positioning tool to the first vertebral anchor, positioning at least a portion of a delivery device over a connecting element, and inserting the delivery device and the connecting element through the patient's skin at the first location and along at least a portion of the first positioning tool. The first positioning tool is configured to facilitate directing the delivery device and connecting element generally toward a second vertebral anchor within the patient's body.

Abstract: Embodiments herein are generally directed to rod reduction clips that can efficiently attach to orthopedic fixation devices and reduce rods therein. Other embodiments herein are generally directed to coupling elements having removable extended tabs for use in orthopedic fixation devices.

Abstract: A bone fastener includes a proximal member having an inner surface that defines an implant cavity and an outer surface including a first threaded portion configured for penetrating fixation with tissue and a second portion. The proximal member defines a longitudinal axis. An intermediate member includes an inner surface extending between a proximal portion connected with the second portion and a distal portion. A distal member includes an outer surface extending between a proximal portion disposed with the distal portion of the intermediate member and a distal portion configured for penetrating fixation with tissue. The distal member is configured for axial translation relative to the intermediate member. Methods of use are disclosed.

Abstract: A spinal implant having a series of sections or units hinged together and a balloon connected to at least some of the sections, the balloon having a curved configuration. The implant has a first delivery configuration and a second curved placement configuration, wherein it has a more linear configuration in the first delivery configuration than in the second curved configuration. The implant assumes the first delivery configuration during delivery to the disc space and maintains the curved configuration after placement within the disc space. The curved configuration can result from filling or expanding the balloon.

Abstract: Bone fixation methods and devices with an elongate body having a longitudinal axis and having a flexible state and a rigid state, a plurality of grippers, a rigid hub connected to the elongated body, and an actuator operably connected to the grippers to deploy the grippers from a first shape to an expanded second shape. One method can include inserting a bone fixation device into an intramedullary space of the bone to place at least a portion of an elongate body of the fixation device in a flexible state on one side of the fracture and at least a portion of a rigid hub on another side of the fracture, and operating an actuator to deploy a plurality of grippers of the fixation device to engage an inner surface of the intramedullary space to anchor the fixation device to the bone.

Abstract: A fixation clamp for use in an external fixation system for holding bone fragments adjacent to each other with the help of fixation elements has at least one clamping assembly having a pair of jaws with at least two different size grooves to accommodate a bone fixation element such as a pin or rod. An alternate clamping assembly has at least three grooves wherein at least two of the grooves have a different size adapted to accommodate a correspondingly sized bone fixation element such as a bone pin. The longitudinal axes of the grooves define a polygon. The jaw pairs can be rotated about a central longitudinal axis to present different size reception cavities towards the pins or rocks depending on their diameter.

Abstract: A bone anchoring device includes an anchoring element having a shaft and a head; a receiving part having a top end, a bottom end, a rod recess, a coaxial bore, and a seat; and a pressure element that is movable within the bore. The head is pivotable with respect to the receiving part and can be fixed at an angle by exerting pressure via the pressure element onto the head. The pressure element has an outer wall portion having a recess or a projection. The receiving part has an inner wall portion having a recess or a projection that cooperates with the recess or projection of the pressure element. The pressure element is configured to assume a first position within the receiving part in which the recess and the projection interact to allow the pressure element to exert a preload onto the head and the head is prevented from freely pivoting but is not locked.