Abstract: Articulating expandable fusion devices, systems, instruments, and methods thereof. The articulating expandable fusion implant having a plurality of links is capable of being deployed and articulated inside an intervertebral disc space link by link. After the links are articulated into a polygonal shape, the links may be expanded outwardly into an expanded configuration. Instruments may be provided to articulate and expand the implant.

Abstract: A pivotal bone anchor assembly includes a receiver having a first channel configured to receive an elongate rod and an axial bore with a bottom opening, and a shank having a head portion positionable into the axial bore with the shank extending downward through the bottom opening. The assembly also includes an insert positionable into the axial bore above the head portion and having a second channel alignable with the first channel, opposite extensions extending outwardly in the direction of the channels to block rotation between the receiver and the insert, and upward-facing surfaces located radially outward from a central opening. The upward-facing surfaces are configured for releasable compressive engagement by a compressing tool after the elongate rod is received within the channels and prior to a final locking of the assembly with a closure top, so as to provisionally lock the shank from pivoting with respect to the receiver.

Abstract: A tissue guard for use with a surgical access device includes a proximal ring having proximal and distal ends, the distal end configured to operably couple to a ground ring that ultimately electrically connects to an electrical ground. One or more mechanical interfaces extend about the proximal ring and are configured to mechanically engage a rim of an access device to secure the tissue guard thereon. A retention body is configured to operably couple to a distal end of the ground ring, the retention body including a distal end configured to operably engage the access device to secure the tissue guard therein.

Abstract: A spinal implant comprises an implant body extending between an anterior surface and a posterior surface, and including a first vertebral engaging surface and a second vertebral engaging surface. The implant body includes an inner surface that defines at least one opening oriented to implant a fastener oblique relative to a lateral axis of a subject body and adjacent an intervertebral space of the subject body. The implant body defining a cavity such that a surgical instrument is connectable with the implant body adjacent the cavity and movable relative to the implant body. Systems, surgical instruments and methods are disclosed.

Abstract: This invention relates to a method of preoperative planning to correct spine misalignment of a patient, comprising a step of making a translation and a rotation, in a sagittal plane, of each vertebra of a set of several cervical and/or thoracic and/or lumbar imaged spine vertebrae, so that said set of imaged vertebrae presents afterwards, in the sagittal plane, the same cervical lordosis and/or the same thoracic kyphosis and/or the same lumbar lordosis as a model adapted for said patient, wherein it also comprises, before said step of making said translation and said rotation in a sagittal plane: a step of making a translation and a rotation, in a coronal plane, of each vertebra of said set of several cervical and/or thoracic and/or lumbar imaged spine vertebrae, so that said set of imaged vertebrae becomes straight in said coronal plane, and of making a rotation, in an axial plane, of each vertebra of said set of several cervical and/or thoracic and/or lumbar imaged spine vertebrae, so that said set of image

Abstract: A posterior cervical fixation system including an occipital plate member, a cross connector, a pair of elongated spinal rods and a plurality of polyaxial screws. The occipital plate member configured for fixing to an occipital bone comprises an aperture to receive a bone anchor member to secure the occipital plate member to the occipital bone and at least one rod clamping element dimensioned to receive at least one spinal rod. The cross connector secures the pair of elongated spinal rods to vertebral bodies. The cross connector includes a pair of collet connectors and a cross bar that is configured to secure the pair of elongated spinal rods in a desired distance. Each polyaxial screw has an anchor head associated with a fastening member. The pair of elongated spinal rods is configured to extend along the vertebral bodies between the occipital plate member and at least one of the polyaxial screws.

Abstract: A delicate tissue retraction system for use with a navigation probe having a probe shaft and a probe tip at a distal end of the probe shaft. The delicate tissue retraction system includes a retractor and an introducer that is removably installed within the retractor. The introducer has a wall forming a hollow channel extending from a proximal introducer end to a distal introducer end. A mount is integrally formed with the introducer and extends from the distal introducer end into the channel. The mount is positioned to surround the probe tip when the navigation probe is at a fully inserted position within the introducer with the probe tip at the distal introducer end.

Abstract: A total artificial spinous process (spino)-laminar prosthesis (TASP-LP) including a body having a portion forming a spinous process extending away from the body, a first lamina portion extending from a first side of the body, and a second lamina portion extending from a second side of the body, wherein the first lamina portion and the second lamina portion are disposed on opposite sides of the spinous process.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element includes a receiving part with an accommodation space defining an opening for inserting and accommodating a head of the bone anchoring element, and a pressure element having a cap portion configured to hold the head. In an inserting position, the cap portion of the pressure element is expandable in the accommodation space of the receiving part, and a first retaining element is configured to prevent the pressure element from moving towards a first end of the receiving part. In a pre-locking position, the head is held in the cap portion of the pressure element and is pivotable in the receiving part, while the cap portion is restricted from expanding to prevent removal of the head, and where a second retaining element is configured to prevent the pressure element from moving from the pre-locking position towards the inserting position.

Abstract: A polyaxial bone anchoring device includes a receiving part with an upper member having a first end, a second end, and a recess at the first end for receiving a rod, and a lower member connectable around the second end of the upper member, and a pressure member positionable in the upper member to exert pressure on a head of a bone anchoring element. The lower member is movable from a first position where the head is pivotable, to a second position closer to the first end of the upper member where an angular position of the head is locked while the recess remains vacant or unobstructed. When the lower member is at the second position, at least part of the lower member is aligned axially with at least part of an end face at the second end of the upper member.

Abstract: Orthopedic fixation devices and methods of installing the same. The orthopedic fixation device may include a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element.

Abstract: An intervertebral implant may include an input for expanding at least two extendable support elements connected to a body at respective locations, such that the extendable support elements each apply a respective expansion force directed away from a surface of the body. Application of a single input force to the input may induce the extendable support elements to apply different amounts of expansion force. Alternatively or additionally, an intervertebral implant may include at least two portions connected together by a hinge for articulation about the hinge. In one aspect, the hinge may include at least two rigid links each pivotably connected to the two portions. In another aspect, a rigid link of the hinge may include a passageway for communicating a hydraulic fluid between the two portions. A locking system may be positionable into successive locked configurations by operation of a cam to prevent contraction of an extendable support element.

Abstract: Implants for the fusion or fixation of two bone segments are described. For example, the implants can be used for the fusion or fixation of the sacroiliac joint. The implants can have a matrix structure, have a rectilinear cross-sectional area, and have a curvature.

Abstract: A device for bone adjustment in a mammal. The device comprising two or more anchoring devices adapted to implanted intramedullary and attached to a bone in said mammal and an adjustment device for exerting force on said anchoring devices, said adjustment device being adapted to postoperatively adjust at least one of the distance between or orientation of, at least two of said anchoring devices. The operation device further comprises a motor and said operation device is adapted to operate said adjustment device. The operation device further comprises a gearbox connected to the motor, wherein an outgoing speed from the gear box is lower than the speed by the motor alone, accomplished by the gearbox, and wherein the outgoing speed of the gearbox is less than 10 turn per second during normal operation.

Abstract: A method comprises the steps of: imaging a patient anatomy; selecting an implant strategy for at least one bone fastener having a first member; registering the imaging of the patient anatomy with imaging of a surgical driver; engaging the first member with tissue of the patient anatomy via the surgical driver according to the implant strategy; manipulating the patient anatomy; acquiring data points representative of a position of the first member relative to tissue; and retrieving the data points from a computer database for attaching a second member with the first member. Systems, spinal constructs, implants and surgical instruments are disclosed.

Abstract: Expandable spinal interbody implants include a body and at least one extendable support element connected thereto. Such an implant may include a second extendable support element and a tool selectively positionable with respect to the implant so as to independently or simultaneously expand both extendable support elements. In another example, such an implant may include, at each of a first and second location, a respective movable member and a respective locking element. The at least one extendable support element may be actuatable to expand so as to induce movement of at least one of the movable members away from the body. The locking elements at each of the first and second locations may be selectively lockable such that, when locked, the locking element restrains movement of the associated movable member at that location away from the body without restraining movement of the other movable member away from the body.

Abstract: A device for straightening and stabilizing the vertebral column, particularly for stabilizing broken vertebrae, includes a supporting implant which is plastically expandable by internal pressure. The supporting implant can be placed into the interior of a vertebral body which has been fractured under compression or between adjacent vertebral bodies. A pressure balloon to which pressure fluid can be admitted may be arranged in the interior of the supporting implant for producing the internal pressure.

Abstract: Various embodiments comprise an expansible intervertebral implant intended to be implanted in a space between two adjacent vertebrae to at least partly supplant an intervertebral disc, said implant being able to expand along three substantially mutually orthogonal axes so as to comply with the lordosis of the patient while still having increased stability and reliability.

Abstract: A screw element includes a screw axis, a shank for inserting in a bone, and a drive portion for engaging a screw driver. The drive portion includes a first wall defining a first recess and a second wall defining a second recess. Drive grooves are formed in the first wall and extend parallel to the screw axis. The second wall extends axially from a free end portion of the screw element to the first wall and has an inner diameter that continuously increases from the first wall towards the free end portion. A plurality of guide grooves are formed in the second wall at circumferential positions corresponding respectively to circumferential positions of the drive grooves. The guide grooves extend further radially from the screw axis than the drive grooves and guide the screw driver from the free end portion of the screw element to the drive grooves.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element is provided, wherein the coupling assembly includes a receiving part having a first end, a second end, a central axis extending through the first end and second end, an accommodation space for accommodating a head of an anchoring element, a bore extending from the accommodation space to the first end, and a recess for receiving a rod. The accommodation space has an opening at the second end sized to permit insertion of a head of the bone anchoring element. The coupling assembly further includes a retainer element configured to be positioned at least partially in the accommodation space and being radially expandable and/or compressible to allow retaining a head inserted through the opening. The retainer element is held in position adjacent the opening by an engagement structure provided at or in the accommodation space.