Abstract: A pivotal bone anchor assembly includes a receiver defining a central bore with a circumferentially-extending horizontal interference structure located above an upper expansion region and a lower locking region, and a shank having an upper end portion up-loadable into the central bore through a bottom opening. The assembly also includes a retainer having an upper portion and a lower expansion portion pre-positioned within the upper expansion region and being operable to capture the upper end portion of the shank, and a compression insert postionable within the central bore having an upwardly-facing surface for engaging a rod, an exterior side surface for engaging the horizontal interference structure, and a lower recess for receiving the upper portion of the retaining structure in a side-to-side overlapping engagement.

Abstract: An implant comprises a unitary body including an intramedullary portion connected to an extramedullary portion. The unitary body is configured to attach a first bone section to a second bone section. The intramedullary portion has a first longitudinal axis, and is configured for insertion into the first bone section. The intramedullary portion includes at least one first fastener aperture having an aperture axis oriented obliquely relative to the first longitudinal axis. The extramedullary portion is configured to abut a surface of the second bone section and includes at least one second fastener aperture disposed to transversely receive a bone fastener inserted in the second bone section. The extramedullary portion has a second longitudinal axis offset from, the first longitudinal axis.

Abstract: Systems and methods for reducing the risk of PJK, PJF, and other conditions are disclosed herein. In some embodiments, a longitudinal extension can be added to a primary fixation construct to extend the construct to one or more additional vertebral levels. The extension can be attached to a first attachment point, such as a spinous process of a vertebra that is superior to the primary construct. The extension can also be attached to a second attachment point, such as a component of the primary construct or an anatomical structure disposed inferior to the first attachment point. The extension can be more flexible than the primary construct and/or can limit motion to a lesser degree than the primary construct, thereby providing a more-gradual transition from the instrumented vertebrae to the natural patient anatomy adjacent thereto. The extension can be placed with little or no soft tissue disruption.

Abstract: An outer sheath used with a surgical access assembly is disclosed. The outer sheath includes a proximal end, a distal end and a body portion therebetween. The proximal end defines a first opening. The distal end is disposed opposite the proximal end and defines a second opening. The body portion includes at least one slot formed therein. At least one light source is retained within the slot, adjacent the proximal end.

Abstract: A robotic surgical system may include a cannula attachment device or cannula mount having a locking mechanism configured to pivot between an unlocked position and a locked over-center position. The locking mechanism may actuate a clamp or other feature that is configured to move between a closed position and an open position. The clamp may include a locating structure with one or more tapered surfaces that is configured to mate with a corresponding structure disposed on a portion of a cannula when the cannula is positioned in the cannula attachment device. The locating structure may guide the cannula into the attachment device, as well as assist with orientating the cannula relative to the attachment device.

Abstract: An intervertebral implant includes a body with a first face, a second face connected to the first face, and an axis of rotation. The body defines a hollow space for connecting to an insertion device, the hollow space being accessible through an opening formed between the first and second faces. The opening is elongate and extends around the axis of rotation to facilitate pivoting of the implant relative to the insertion device about the axis of rotation to a first angular position and a second angular position. The implant further includes a first abutment surface that engages the insertion device in a form-fit manner at the first angular position, and a second abutment surface that engages the insertion device in a form-fit manner at the second angular position. The opening can also engage the insertion device to hold the implant at at least one additional angular position.

Abstract: Systems and methods for reducing the risk of PJK, PJF, and other conditions are disclosed herein. In some embodiments, a longitudinal extension can be added to a primary fixation construct to extend the construct to one or more additional vertebral levels. The extension can be attached to a first attachment point, such as a bone anchor implanted in a vertebra that is superior to the primary construct. The extension can also be attached to a second attachment point, such as a component of the primary construct or an anatomical structure disposed inferior to the first attachment point. The extension can be more flexible than the primary construct and/or can limit motion to a lesser degree than the primary construct, thereby providing a more-gradual transition from the instrumented vertebrae to the natural patient anatomy adjacent thereto. The extension can be placed with little or no soft tissue disruption.

Abstract: Disclosed herein is a surgical cannula configured as an instrument retaining or centering apparatus, configured for providing insufflation gases to a surgical cavity of a patient (such as the pneumoperitoneum) and allowing insertion of medical instruments into the surgical cavity through the cannula. The cannula can include features to direct gas flow in particular directions to prevent or reduce smoke, fog/condensation, or other unwanted media from contacting a portion of a medical instrument.

Abstract: A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.

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: Pedicle-based intradiscal fixation devices, systems, instruments, and methods thereof. The implant or a portion thereof may be composed of a shape-memory material, which has a curved shape-memory orientation and a temporarily straight orientation. The implant may be configured to be inserted into a pedicle of an inferior vertebra, through the vertebral body of the inferior vertebra, and into the vertebral body of the superior vertebra to thereby stabilize the inferior and superior vertebrae.

Abstract: An expandable cage for placement between adjacent vertebrae having two or more upper and lower end plates having compound-angled slots, ramps or rails, and a drive means having corresponding compound-angled slots, ramps or rails configured to slidingly engage the compound-angled slots, ramps or rails of the two or more upper and lower end plates, wherein movement of the drive means in a first direction moves the two or more upper and lower end plates away from each other both vertically and horizontally to expand both a height and a width of the expandable cage from a collapsed state to an expanded state.

Abstract: A system for correcting a lateral curvature of a spine that can include a plurality of screws configured to be implanted in a plurality of vertebrae, and a plurality of extensions configured to be removably coupled with the plurality of screws. Some embodiments of the plurality of extensions can be curved, bent, angled, and/or offset along at least a portion thereof and can be removably coupled with a screw head of each of the plurality of screws. The system can include a connecting element or rod that is configured to be coupled with the plurality of screw heads. Some embodiments of the system can be configured such that the rod can be guided along the plurality of extensions from the proximal toward the distal end portions of the extensions and into engagement with the plurality of screws to cause the plurality of vertebrae to move laterally.

Abstract: A spinal fixation device includes a modular head assembly and a bone screw having a head and a shank. The modular head assembly includes a housing defining proximal and distal surfaces and a throughhole therethrough; an anvil slidable within the throughhole; a biasing member circumferentially surrounding the anvil; an assembly cap secured to the housing and defining an inner surface having a first portion with a first diameter and a second portion with a second diameter smaller than the first diameter; a retaining ring movable from the first portion of the assembly cap to the second portion of the assembly cap to transition the retaining ring between a first configuration in which the retaining ring is sized to receive the head of the bone screw and a second configuration in which the retaining ring is compressed about the bone screw to fix the bone screw relative to the modular head assembly.

Abstract: Disclosed herein are power modules and methods for insertion of a cannulated bone anchor and a stylet. Power modules disclosed herein are configured to adjustably control insertion of a bone anchor and a stylet under power from a motor. In certain embodiments, the motor may be included in a power hand piece. The power modules disclosed herein may be further configured to releasably couple a power hand piece to a driver for insertion of the bone anchor and stylet into the bone of a subject.

Abstract: Embodiments of the disclosure provide systems and methods of removing a core from an intervertebral prosthetic disc. The method may include: securing a multipart prosthetic disc to a distal end of a removal instrument by grasping at least a portion of the multipart prosthetic disc between a pair of core removal arms on the placement instrument; inserting the pair of core removal arms between two prosthetic disc plates of the intervertebral prosthetic disc to distract the plates away from one another; and removing the core from the intervertebral prosthetic disc with the removal instrument. The removal instrument may include: an inner shaft connected to the pair of core removal arms; and an outer shaft movable with respect to the inner shaft and including an activation mechanism for causing the arms to grasp the core for removal.

Abstract: A polyaxial bone device includes a screw, a screw housing, and a spring. The screw includes a screw head and a shaft that extends from the screw head. The screw housing defines a longitudinal axis and a bore that extends along the longitudinal axis. The screw housing includes a basewall and opposed sidewalls that extend from the basewall. The basewall defines a notch that receives the shaft to increase pivotal movement between the screw and the screw housing relative to the longitudinal axis of the screw housing. The opposed sidewalls define a rod-receiving channel. The screw housing defines a transverse hole in communication with the bore. The spring is supported in the transverse hole and extends therethrough. The spring extends into the bore to frictionally engage the screw head while the screw head is seated in the bore.

Abstract: A screw driving instrument is provided with a stylet holder able to retain a head of a stylet at one of multiple discrete locations. A user may vary a distance that a point of the stylet extends from a distal end of the instrument by choosing which of the discrete locations to insert the stylet head into before coupling the stylet holder to the instrument. The instrument may include a ratcheting handle capable of rotation in one direction about a central axis of the instrument relative to other components of the instrument. The stylet holder may be engageable with the handle.

Abstract: An adjustable implant includes a telescopic body with first and second portions in sliding engagement, and a deflectable linkage formed from a first linking segment, an intermediate segment and a second linking segment pivotally interconnected so that adjustment of a length of the telescopic body causes a corresponding deflection of the deflectable linkage. The first linking segment and the second linking segment are formed with projecting features that provide a partial gear engagement between the first and second linking segments such that, during adjustment of a length of the telescopic body and corresponding deflection of the deflectable linkage, pivotal motion of the first and second linking segments relative to the intermediate segment about the first and second pivot axes occurs in a fixed ratio defined by the partial gear engagement.

Abstract: A vaginal speculum apparatus includes a portable illumination assembly that is releasably attached to one of the upper blade and lower blade of a disposable vaginal speculum. The portable illumination assembly is defined by a housing that retains at least one LED and a portable power supply. The portable illumination assembly can be energized by an externally accessible member after the illuminator has been attached to the speculum.