Abstract: A spinal implant provides support for desired parts of the spine. The implant can provide support in fusion situations. The spinal implant includes a pair of elongated members and a variable length cross-link. A variable length cross-link apparatus may couple to the first and second elongated members. Each variable length cross-link device may include a fixed portion having a receiver portion for attachment to a first elongated member. Each variable length cross-link may include a transverse portion. Each variable length cross-link may include an adjustable portion having a receiver portion for attachment to a second elongated member and a transverse portion engaging member. Inserting the transverse portion of the fixed portion into the engaging portion of the adjustable portion may form a cross-link for stabilizing motion between two elongated members. Engaging the adjustable portion at a selected point on the transverse portion establishes a length selected by the surgeon.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Abstract: Minimally invasive methods and instruments for reducing spinal stabilization rods into pedicle screws. In some embodiments, a method comprises positioning an instrument over a pedicle screw where a rod remains proud. A distal end of a first extension of the instrument is engaged with a collar of the pedicle screw. A second extension of the instrument is moved in translation relative to the first extension until a distal end of the second extension contacts the rod. This translation is accomplished by manipulating a pair of handles of the instrument. The rod is urged into the collar of the pedicle screw by application of force on the rod through the distal end of the second extension. The rod can be locked in the collar of the pedicle screw using a set screw passed through a passage in the first extension of the instrument.

Abstract: The disclosure relates to systems and methods of spinal stabilization. Embodiments include minimally invasive methods of delivering a rod having a non-circular cross-sectional profile using a wire having an accommodating non-circular cross-sectional profile to inhibit movement of the rod relative to the wire. A rod or a segment of the rod having a non-circular cross-sectional profile may be aligned with the wire and advanced and coupled to bone fastener assemblies which are anchored in vertebrae. The rod is then securely seated in collars of the bone fastener assemblies to stabilize the spine.

Abstract: The disclosure relates to systems and methods of spinal stabilization. Embodiments include methods of delivering a rod having a non-circular cross-sectional profile using a wire having an accommodating non-circular cross-sectional profile to inhibit movement of a rod relative to the wire. A surgical system can comprise a first sleeve advanced via a first incision to a vertebra, a second sleeve advanced via a second incision to another vertebra, a wire having a non-circular cross-sectional profile advanced via a third incision to the vertebrae and passed through the collars of bone fastener assemblies to extend from a fourth incision. A rod or a segment of a rod having a corresponding non-circular cross-sectional profile may be aligned with the wire and advanced and coupled with the vertebrae to stabilize the spine. After the rod is securely seated in the collars, the wire may be withdrawn from the body.

Abstract: Embodiments disclosed herein provide a rod and a corresponding rod inserter. The rod has an elongated body with a removable end configured for an insertion tool engagement. The removable end of the rod has a part that can be securely attached to a rod holder of a rod inserter ex situ prior to minimally invasive rod insertion. A breakable portion is located between the part and the elongated body. The part can be broken off from the rod in situ to release the rod inserter. The broken off part of the rod is removed with the rod inserter and separated from the rod inserter ex situ.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Abstract: A system (10) and associated method are provided for mechanically fixating a region of a skull to a portion of a spine. A plate (20) is provided to contact a region of the skull and be secured thereto. A spinal rod (22) is configured to extend from a location adjacent the plate (20) to a location adjacent at least one vertebra (30). A variable connection (24) is provided to secure the rod (22) to the plate (20). The variable connection (24) has a first mode wherein the relative position of the rod (22) to the plate (20) can be adjusted and a second mode wherein the relative position of the rod (22) to the plate (20) is locked at a particular value selected to maintain a desired curvature of the spine.

Abstract: Embodiments described herein provide tools and methods for spinal fusion procedures. One embodiment of a tool can be a pedicle access tool that performs the functions of targeting needle, cannula, tap and awl. The cannula of the tool can be used to guide various tools and bone graft or fusion promoting material to a surgical site for a spinal fusion procedure, such as a posterolateral procedure. In other embodiments, a k-wire can be used as the guide.

Abstract: Embodiments described herein provide systems and methods for vertebral reduction using sleeves detachably coupled to collars of bone fasteners. The reduction can be performed during a minimally invasive procedure for implanting spinal stabilization systems. A sleeve can include internal threads that match threads on the respective collar to form a continuous set of threads. Threads on a closure member can be engaged with the threads on the sleeve and the closure member turned to translate the closure member along the sleeve. The closure member can be used to push a rod relative to the collar to which the sleeve is attached to cause a vertebral body to move.

Abstract: Embodiments described herein provide systems and methods for inserting a spinal stabilization rod. A rod insertion tool can include a body defining a passage, a pivot rod disposed in the passage and a rod retaining member. Movement of the pivot rod can cause the rod retaining member to rotate and consequently the spinal stabilization rod to rotate. The rod insertion tool can be sized to fit through channels in sleeves used during implantation of a spinal stabilization system.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

Abstract: A poly-axial bone fastener assembly having a collar and a bone fastener can be coaxially locked to prevent poly-axial movements of the collar relative to the bone fastener while permitting the collar to rotate about an axis of the bone fastener, thereby combining the functions and advantages of a poly-axial bone screw and a fixed angle bone screw. Some embodiments of a coaxial locking mechanism may include a c-clip with a locking pin, a c-clip with hooks, a split ring with square corners, a pin that spins inside the collar, pins that travel about a neck of the bone fastener, a coaxially locking top that screws into the collar over a head of the bone fastener, and a top nut that threads onto the head of the bone fastener inside the collar to trap a flange of the collar between a shoulder of the bone fastener and the top nut.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

Abstract: Embodiments disclosed herein provide a combination compressor/distractor useful for fitting a spinal stabilization system in a patient through minimally invasive surgery. The spinal stabilization system may comprise screws anchored in vertebrae. The vertebrae may need to be compressed or distracted. One embodiment of an instrument disclosed herein may comprise a shaft for engaging one of the screws through an extender sleeve. A driver may engage another screw through an opening of the instrument. Through this engagement, a surgeon may use the rack and pinion of the instrument to compress or distract one or more levels of the vertebrae in a parallel motion, which can be advantageous clinically in certain situations.

Abstract: Instruments for reducing spinal stabilization rods into position in pedicle screws or other bone anchors placed on a spine. In some embodiments, instruments are provided which include inner and outer extensions adapted for engaging, respectively, pedicle screws and rods. Handles of the instrument can engage a parallel action compressor which actuate the extensions. The handles may be offset from the extensions by a distance in a direction along a longitudinal axis of the extensions, in a direction perpendicular thereto, or a combination thereof. Instruments of some embodiments can include locking, or ratchet, mechanisms extending between the handles. A biasing member may bias the handles apart from each other and assist in engaging the locking or ratchet mechanism. Surgical instrument kits including rod reduction instruments are provided by some embodiments. According to some embodiments, methods for reducing spinal stabilization rods into their desired positions are also provided.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Abstract: The disclosure relates to systems and methods of spinal stabilization. Embodiments include methods of delivering a rod having a non-circular cross-sectional profile using a wire having an accommodating non-circular cross-sectional profile to inhibit movement of a rod relative to the wire. A surgical system can comprise a first sleeve advanced via a first incision to a vertebra, a second sleeve advanced via a second incision to another vertebra, a wire having a non-circular cross-sectional profile advanced via a third incision to the vertebrae and passed through the collars of bone fastener assemblies to extend from a fourth incision. A rod or a segment of a rod having a corresponding non-circular cross-sectional profile may be aligned with the wire and advanced and coupled with the vertebrae to stabilize the spine. After the rod is securely seated in the collars, the wire may be withdrawn from the body.

Abstract: A spinal implant provides support for desired parts of the spine. The implant can provide support in fusion situations. The spinal implant includes a pair of elongated members and a variable length cross-link. A variable length cross-link apparatus may couple to the first and second elongated members. Each variable length cross-link device may include a fixed portion having a receiver portion for attachment to a first elongated member. Each variable length cross-link may include a transverse portion. Each variable length cross-link may include an adjustable portion having a receiver portion for attachment to a second elongated member and a transverse portion engaging member. Inserting the transverse portion of the fixed portion into the engaging portion of the adjustable portion may form a cross-link for stabilizing motion between two elongated members. Engaging the adjustable portion at a selected point on the transverse portion establishes a length selected by the surgeon.