Abstract: A dynamic subsidence plate is described having a first plate member and a second plate member in sliding engagement that may infinitely subside between a first and second assembled position. The plate includes a lock assembly associated with the first and second plate members. The lock assembly includes a ramp portion, an interference portion, and a bearing member situated between the ramp portion and the interference portion. The lock assembly of the plate is configured to allow movement of the first member with respect to the second member in a first direction in an infinite number of positions between a first assembled position and a second assembled position. Further, the lock assembly alternatively prevents movement of the first member with respect to the second member in an opposite second direction between the first and second assembled positions.

Abstract: An expandable rod system includes a first rod portion having an internal cavity, a second rod portion sealingly positioned within the internal cavity of the first rod portion and moveable in a first axial direction relative to the first rod portion, and an osmotic chamber for receiving an osmotic agent to facilitate movement of the second rod portion to expand the rod system. The rod system includes a lock assembly engageable with the second rod portion to prevent the second rod portion from moving in a second axial direction. The lock assembly includes a tapered ramped portion and a bearing member that is moveable within the tapered ramped portion such that when compression forces are imparted on the second rod portion, the bearing member becomes wedged in the tapered ramped portion.

Abstract: A bone plate that includes an upper surface defined by at least two flat surfaces and a bone contacting surface defined by at least two flat surfaces.

Abstract: In one embodiment, the present disclosure relates to a retractor apparatus that includes a retractor frame, five arms attached to the retractor frame and five rods each attached to one of the five arms. Each rod includes a convex surface facing a center of the retractor frame. At least two of the five rods are movable independently from one another. A first rod of the five rods includes a longitudinal axis and is translatable along the longitudinal axis. Further, the first rod is attached to a first arm of the five arms and is pivotable relative to the first arm. The axis of pivot is offset from the longitudinal axis through which the first rod translates.

Abstract: Tool assemblies, system, and methods for manipulating tissue and methods for performing a surgical procedure on a vertebral body adjacent soft tissue. A manipulator moves an end effector, and a screw is coupled to the end effector. A sleeve is disposed coaxially around the screw, and the screw and the sleeve are releasably engaged to one another. A navigation system is configured to track the vertebral body, and one or more controllers control the end effector to advance the screw relative to the sleeve along an insertion trajectory defined with respect to a surgical plan. The screw disengages the sleeve during advancement, and the screw is secured to the vertebral body. A distal working portion of the screw may be freely slidable through a distal end of the sleeve when disengaged. The screw may be a tap marker removably couplable with a tracking device of the navigation system.

Abstract: The present invention relates to systems and methods for accessing the spine to place implants. In one embodiment, a system includes an adjustable rod structure having four rods radially surrounding a probe, a ring and a retractor. The adjustable rod structure is configured to have a closed and open profile controlled by the retractor such that the open profile creates a space between rods of the structure. The ring is configured to be placed within retracted rods to maintain the open profile after retraction. In a method embodiment, the adjustable rod structure is inserted through a percutaneous incision in the closed position until it reaches a target site. The retractor is then attached to the rods and used to retract the rods. The probe is then removed from within an opening created and a ring is advanced into the opening to hold the rods in place.

Abstract: Disclosed herein is a spinal implant with a solid frame and a porous inner layer. The implant may have a cavity defined by the porous inner layer. The solid frame may have one or more ribs extending from a medial wall to a lateral wall. The thickness of the porous layer may vary relative the thickness of the solid frame at various locations. An inserter to place a spinal implant and a method to perform same are also disclosed.

Abstract: In one embodiment, an expander set includes a first and second expander. The first expander includes an outer surface having a first engagement feature and a groove and the second expander includes an inside surface having a second engagement feature adapted to engage with the first engagement feature. The inside surface of the second expander is shaped to correspond to a portion of the outer surface of the first expander. Additionally, the groove on the outer surface of the first expander is sized and shaped to accommodate a rod of a retraction system such that when the first expander is advanced within the retraction system, the rod remains within the groove. When the first and second expanders are engaged with one another, they define an oblong cross-section.

Abstract: A spinal rod insertion instrument includes a hollow, monolithic body having a proximal end and a distal end. The body defines a passageway that extends along a first axis between the proximal and distal ends. The distal end includes first and second arms defining a slot therebetween. The first and second arms are configured to releasably retain a spinal rod therebetween. Also provided is a method of securing a spinal rod to a coupling element attached with a pedicle screw.

Abstract: A system includes tubular members removably positionable over a passageway device connected to a connecting element attached to a vertebra. The tubular members may each include a sidewall having an opening positionable adjacent a proximal end of the passageway device when the tubular member is positioned over the passageway device. The tubular members include channels therein to receive respective blades of the passageway devices. One of the tubular members may be a counter torque tube, and another two of the tubular members may be a hinge shaft and a ball shaft, respectively, of a compression and distraction system. The blades of each passageway device may be integrally formed with a cage of the connecting element to form a monolithic blade-screw. The blades of the monolithic blade-screw may be constructed by affixing distal ends of non-threaded blade extensions to proximal ends of threaded reduction portions integrally connected to the cage.

Abstract: A robotic system for performing spine surgery. The robotic system comprises a robotic manipulator and a navigation system to track a surgical tool relative to a patient's spine. The robotic system may be controlled manually and/or autonomously to place implants in the patient's spine.

Abstract: In one embodiment, the present invention is a laminal implant including: a first body including a first flange adapted to engage a first lamina end, a tab and a receiving channel; and a second body including a second flange adapted to engage a second lamina end, and a plurality of teeth adapted to engage the tab, at least a portion of the second body adapted to be positioned within the receiving channel, the first and second bodies adapted to slideably engage one another.

Abstract: A bone plate having at least one screw hole adapted to receive a bone screw, a blocker having a blocking end for blocking a bone screw from further backout of bone the blocker being predisposed in a blocking position wherein the blocking end at least partially overlaps a portion of the screw hole, the blocker being moveable from the blocking position by contact with the bone screw during insertion of the bone screw into the screw hole, and a blocker fixation element having an open orientation at which the blocker can move from the blocking position and a closed orientation preventing substantial movement of the blocker from the blocking position. The blocker fixation element cannot be moved to the closed orientation unless the screw head passes the blocker, thereby revealing that the blocker fixation element is in position to prevent substantial movement of the blocker.

Abstract: A fastener configured for spinal applications includes a head having a channel adapted to receive a spinal rod and a shaft extending from the head to a distal tip and having a thread, at least a portion of the thread being serrated. The serrated portion of the thread includes peaks and troughs and can extend along about 35 percent of a length of the thread.

Abstract: Several different embodiment pedicle screws are disclosed. The designs allow for increased angulation between the screw portions and coupling elements, which may be particuarly useful for cervical vertebrae fusion procedures. Methods of utilizing the pedicle screws are disclosed herein.

Abstract: In one embodiment, the present invention is a laminal implant including: a first body including a first flange adapted to engage a first lamina end, a tab and a receiving channel; and a second body including a second flange adapted to engage a second lamina end, and a plurality of teeth adapted to engage the tab, at least a portion of the second body adapted to be positioned within the receiving channel, the first and second bodies adapted to slideably engage one another.

Abstract: A bone plate having at least one screw hole adapted to receive a bone screw, a blocker having a blocking end for blocking a bone screw from further backout of bone the blocker being predisposed in a blocking position wherein the blocking end at least partially overlaps a portion of the screw hole, the blocker being moveable from the blocking position by contact with the bone screw during insertion of the bone screw into the screw hole, and a blocker fixation element having an open orientation at which the blocker can move from the blocking position and a closed orientation preventing substantial movement of the blocker from the blocking position. The blocker fixation element cannot be moved to the closed orientation unless the screw head passes the blocker, thereby revealing that the blocker fixation element is in position to prevent substantial movement of the blocker.

Abstract: A percutaneous spinal cross link system for interconnecting a spinal fusion construct on one side of the longitudinal axis of the spine with a spinal fusion construct on the other side of the longitudinal axis may include a cross bar connected at each end by a respective connector to a respective spinal fusion rod of each of the spinal fusion constructs. The connector may include a rod receiving portion adapted to receive one of the spinal fusion rods and a cross bar receiving portion adapted to receive the cross bar in an orientation generally perpendicular to the spinal fusion rod. A cannula defined by two spaced apart blades may be connected to the connector for defining a minimally invasive pathway through body tissue for introduction of the cross bar to the connector. Other tools for use with the system are also disclosed.

Abstract: Disclosed herein are a spinal fixation assembly and method to provide adequate rigidity and support for a vertebral column without requiring additional pedicle screws and spinal rods. The spinal fixation assembly includes a spinal rod loop with multiple sides configured to be attached to a vertebral body with two or more pedicle screws. Each pedicle screw is adapted to fit at various locations along the spinal rod loop.

Abstract: A percutaneous spinal cross link system for interconnecting a spinal fusion construct on one side of the longitudinal axis of the spine with a spinal fusion construct on the other side of the longitudinal axis may include a cross bar connected at each end by a respective connector to a respective spinal fusion rod of each of the spinal fusion constructs. The connector may include a rod receiving portion adapted to receive one of the spinal fusion rods and a cross bar receiving portion adapted receive the cross bar in an orientation generally perpendicular to the spinal fusion rod. A cannula defined by two spaced apart blades may be connected to the connector for defining a minimally invasive pathway through body tissue for introduction of the cross bar to the connector. Other tools for use with the system are also disclosed.