Abstract: A transverse coupling for connecting multiple implant extensions includes at least a first sleeve and a second sleeve. The first sleeve defines a first aperture adapted to axially receive a first implant extension through the first aperture. The second sleeve defines a second aperture adapted to axially receive a second implant extension through the second aperture. The transverse coupling also includes a central housing. A first shaft connects the first sleeve to the central housing, and a second shaft connects the second sleeve to the central housing. The central housing includes at least one joint for connecting the central housing to at least one of the first and second shafts in a movable arrangement that allows the shaft(s) to move through one or more degrees of freedom relative to the central housing.

Abstract: A persuader instrument for advancing a fixation rod into a vertebral implant includes a housing and at least one arm. The at least one arm can include detents for detachable connection to the vertebral implant. The persuader instrument can also include a shaft coupled to an anchor. The anchor can include a fixation rod engagement surface. The shaft can be axially displaceable through the housing to axially displace the anchor and a rod engaged by the anchor. The persuader instrument can further include an auto-locking ratchet assembly in releasable engagement with the shaft. The auto-locking ratchet assembly can control axial displacement of the shaft through the longitudinal passage of the housing.

Abstract: A transverse coupling for connecting multiple implant extensions includes at least a first sleeve and a second sleeve. The first sleeve defines a first aperture adapted to axially receive a first implant extension through the first aperture. The second sleeve defines a second aperture adapted to axially receive a second implant extension through the second aperture. The transverse coupling also includes a central housing. A first shaft connects the first sleeve to the central housing, and a second shaft connects the second sleeve to the central housing. The central housing includes at least one joint for connecting the central housing to at least one of the first and second shafts in a movable arrangement that allows the shaft(s) to move through one or more degrees of freedom relative to the central housing.

Abstract: A persuader instrument for advancing a fixation rod into a vertebral implant includes a housing and at least one arm. The at least one arm can include detents for detachable connection to the vertebral implant. The persuader instrument can also include a shaft coupled to an anchor. The anchor can include a fixation rod engagement surface. The shaft can be axially displaceable through the housing to axially displace the anchor and a rod engaged by the anchor. The persuader instrument can further include an auto-locking ratchet assembly in releasable engagement with the shaft. The auto-locking ratchet assembly can control axial displacement of the shaft through the longitudinal passage of the housing.

Abstract: A transverse coupling for connecting multiple implant extensions includes at least a first sleeve and a second sleeve. The first sleeve defines a first aperture adapted to axially receive a first implant extension through the first aperture. The second sleeve defines a second aperture adapted to axially receive a second implant extension through the second aperture. The transverse coupling also includes a central housing. A first shaft connects the first sleeve to the central housing, and a second shaft connects the second sleeve to the central housing. The central housing includes at least one joint for connecting the central housing to at least one of the first and second shafts in a movable arrangement that allows the shaft(s) to move through one or more degrees of freedom relative to the central housing.

Abstract: A transverse coupling for connecting multiple implant extensions includes at least a first sleeve and a second sleeve. The first sleeve defines a first aperture adapted to axially receive a first implant extension through the first aperture. The second sleeve defines a second aperture adapted to axially receive a second implant extension through the second aperture. The transverse coupling also includes a central housing. A first shaft connects the first sleeve to the central housing, and a second shaft connects the second sleeve to the central housing. The central housing includes at least one joint for connecting the central housing to at least one of the first and second shafts in a movable arrangement that allows the shaft(s) to move through one or more degrees of freedom relative to the central housing.

Abstract: An instrument assembly includes a downtube having a tubular body with a proximal end and a distal end. In one embodiment, the proximal end forms an opening for receiving a surgical tool, and the distal end forms at least two attachment members for attaching to a bone anchor. The tubular body forms a hollow passage extending from the proximal end to the distal end. The assembly includes a key for insertion into the proximal end of the downtube to attach the downtube to a bone anchor. The key includes an engagement end configured to engage the at least two attachment members when the key is inserted into the downtube. The key is rotatable within the tubular body between a clamping orientation and a releasing orientation.

Abstract: A rod inserter, system and method can include an inserter that has a handle and an extension structure extending from the handle. A knob and a lever can be located adjacent the handle. A rod connection structure can be located at the distal end of the extension structure, and configured to rotate with respect to the extension structure. The rod connection structure can include a first clamshell structure and a second clamshell structure configured to move towards and away from each other in order to connect and disconnect from a rod, such as a spinal rod. The knob can be configured such that when actuated the first clamshell structure and second clamshell structure move with respect to each other. The lever can be configured such that when actuated the first clamshell structure and second clamshell structure are prevented from rotating with respect to the extension structure.

Abstract: A surgical ratchet tool and system along with associated methods are disclosed. The surgical ratchet tool can include a relatively simple encompassing member that included a pawl extending into the opening for directly contacting a nut during surgery. The ratchet tool and system can be used for various types of surgery in which easy sterilization and a reduced profile for a ratchet tool is desired. For example, the ratchet tool can be used during surgery for adjustment of a spinal implant, where manipulation of a nut located on a downtube connected to a screw and/or spinal rod is desired. The encompassing member and pawl can be constructed/molded as a single piece unitary structure. A first handle and possibly a second handle can extend from an outer periphery of the encompassing member.

Abstract: A rod inserter, system and method can include an inserter that has a handle and an extension structure extending from the handle. A knob and a lever can be located adjacent the handle. A rod connection structure can be located at the distal end of the extension structure, and configured to rotate with respect to the extension structure. The rod connection structure can include a first clamshell structure and a second clamshell structure configured to move towards and away from each other in order to connect and disconnect from a rod, such as a spinal rod. The knob can be configured such that when actuated the first clamshell structure and second clamshell structure move with respect to each other. The lever can be configured such that when actuated the first clamshell structure and second clamshell structure are prevented from rotating with respect to the extension structure.

Abstract: An implant driver assembly includes an assembly for advancing a threaded implant over a wire. The assembly may include a driver tool with a proximal end, a distal end and a first engagement surface that has a first thread. The driver tool may also include a first wire passage. The assembly may further include a wire locking mechanism with a second engagement surface having a second thread. The second thread is engaged with the first thread to rotatably couple the wire locking mechanism with the driver tool. The wire locking mechanism may further include a second wire passage. The second wire passage may be substantially coaxially aligned with the first wire passage.

Abstract: Apparatuses and methods for inserting elongated fixation elements into screw implants include one or components for visualizing the insertion process from a unique vantage point. One apparatus features a steering apparatus for adjusting the position of a receiver element on a screw implant, so that an elongated fixation element, such as a rod, can be inserted through a transverse passage in the receiver element. The steering apparatus may include an extension tube and a steering control member coupled to the extension tube. The extension tube may be configured for coupling to the receiver element, and the steering control member may be configured for coupling to the extension tube. The steering control member may include an opening for receiving an endoscope. The endoscope may be used to visually monitor the elongated fixation element as it is inserted into the transverse passage of the receiver element.

Abstract: A receiver body for an elongated spinal fixation element includes a housing portion with one or more flanges extending outwardly. In one embodiment, the receiver body includes first and second flanges extending outwardly from the housing portion. The housing portion includes first and second slots that form a passage through the housing portion. Each flange has a circular perimeter edge and a chamfered section, the chamfered section having a notched undercut for engagement with an instrument. In another embodiment, the receiver body includes a housing portion having a circular flange with a first chamfered section and a second chamfered section diametrically opposite the first chamfered section. The first chamfered section has a first aperture that opens out beneath the flange, and the second chamfered section has a second aperture that opens out beneath the flange. The first and second apertures form diametrically opposed pivot-attachment points for an instrument.

Abstract: An instrument includes components configured to secure a locking device inside a rod fixation assembly. In one embodiment, an instrument includes an outer sleeve and a pusher member arranged telescopically within the outer sleeve. A drive assembly cooperatively engages the pusher member. In another embodiment, an instrument includes an outer sleeve, a pusher member arranged telescopically within the outer sleeve, and a pair of drive assemblies. A first drive assembly engages the pusher member to distally advance the pusher member under a first loading. A second drive assembly also engages the pusher member to distally advance the pusher member under a second loading, the second loading being substantially greater than the first loading. In another embodiment, a method for reducing and locking a spinal rod includes the step of advancing a locking element while the locking element is retained in a fixed orientation.

Abstract: A surgical ratchet tool and system along with associated methods are disclosed. The surgical ratchet tool can include a relatively simple encompassing member that included a pawl extending into the opening for directly contacting a nut during surgery. The ratchet tool and system can be used for various types of surgery in which easy sterilization and a reduced profile for a ratchet tool is desired. For example, the ratchet tool can be used during surgery for adjustment of a spinal implant, where manipulation of a nut located on a downtube connected to a screw and/or spinal rod is desired. The encompassing member and pawl can be constructed/molded as a single piece unitary structure. A first handle and possibly a second handle can extend from an outer periphery of the encompassing member.

Abstract: An implant driver assembly includes an assembly for advancing a threaded implant over a wire. The assembly may include a driver tool with a proximal end, a distal end and a first engagement surface that has a first thread. The driver tool may also include a first wire passage. The assembly may further include a wire locking mechanism with a second engagement surface having a second thread. The second thread is engaged with the first thread to rotatably couple the wire locking mechanism with the driver tool. The wire locking mechanism may further include a second wire passage. The second wire passage may be substantially coaxially aligned with the first wire passage.

Abstract: A rod persuader assembly includes a tubular body, an inner shaft and an outer shaft. The inner shaft is axially displaceable relative to the tubular body, and has a gripping end and a handle end. The outer shaft is axially displaceable relative to the tubular body, and has a rod reducing end. In one embodiment, the handle end is rotatable relative to the gripping end. In another embodiment, the gripping end includes a cylindrical socket. In yet another embodiment, the rod persuader assembly is operable in two separate and independent stages to secure the instrument to an implant, and advance a rod into the implant.