Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: A spinal implant with at least one flexible elongated extension element is provided. The spinal implant has a profile that is lower than standard spinal implants. The spinal implant includes a bone anchor with a head portion and a shaft extending along a longitudinal axis of the bone anchor. A head plate is coupled to the bone anchor. The head plate includes a first elongated extension element and a second elongated extension element. The first elongated extension element and the second elongated extension element may be formed as a single monolithic element that is attached to the head plate by passing through a pair of openings provided on the head plate. At least one of the first elongated extension element and the second elongated extension element is flexible.

Abstract: A spinal fixation element rotation instrument with two lever arms is provided. The lever arms are connected to each other at distal ends thereof. The second lever arm rotates relative to the first lever arm. The distal ends of the first and second lever arms are adapted to couple to a spinal fixation element. The distal ends of the lever arms may have a dual ratchet feature that prevents rotation in a set direction. When one arm rotates back and forth, the other arm is held stationary. As a result, the spinal fixation element rotates in a predetermined direction and is prevented from rotating back toward its initial position. The direction of the rotation of the spinal fixation element may be set using knobs or switches provided at a proximal end of one or both of the lever arms.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: Embodiments of the present invention provide an implant having a protrusion. The protrusion aids in the insertion and placement of the implant as well as the spinal fixation element. In certain embodiments the protrusion may be configured as a guide for the insertion of the spinal fixation element as well as closure mechanisms for connecting the spinal fixation element to the implant.

Abstract: A spinal implant with at least one flexible elongated extension element is provided. The spinal implant has a profile that is lower than standard spinal implants. The spinal implant includes a bone anchor with a head portion and a shaft extending along a longitudinal axis of the bone anchor. A head plate is coupled to the bone anchor. The head plate includes a first elongated extension element and a second elongated extension element. The first elongated extension element and the second elongated extension element may be formed as a single monolithic element that is attached to the head plate by passing through a pair of openings provided on the head plate. At least one of the first elongated extension element and the second elongated extension element is flexible.

Abstract: A minimally invasive fixation system and installation method is provided. The system includes a rod having an anchor fixation head, an anchor system for anchoring the rod using the anchor fixation head, and a guide system configured to attach to the anchor fixation head of the rod for the insertion of the additional anchor systems. In one embodiment, a method for placing a spinal fixation element relative to a vertebra is provided.

Abstract: An intervertebral implant having an endplate that can be slidably expanded following its placement in the intervertebral space.

Abstract: Methods and instruments are provided for connecting a rod extending along a patient's spinal column to a misaligned vertebra. The method comprises implanting a bone anchor in the misaligned vertebra, attaching an approximating device to the implanted bone anchor and rod, approximating the vertebra toward the rod using the approximating device, and connecting the rod to the bone anchor on the approximated vertebra. In certain embodiments the approximating device may include a winch mechanism. In other embodiments the approximating device is a cannula used in conjunction with a guide system.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: A spinal implant with at least one flexible elongated extension element is provided. The spinal implant has a profile that is lower than standard spinal implants. The spinal implant includes a bone anchor with a head portion and a shaft extending along a longitudinal axis of the bone anchor. A head plate is coupled to the bone anchor. The head plate includes a first elongated extension element and a second elongated extension element. The first elongated extension element and the second elongated extension element may be formed as a single monolithic element that is attached to the head plate by passing through a pair of openings provided on the head plate. At least one of the first elongated extension element and the second elongated extension element is flexible.

Abstract: A spanning connector for connecting an offset bone anchor to a previously inserted spinal fixation element and method of use is provided. The spanning connector includes a first connecting mechanism for connecting the spanning connector to the bone anchor, and a second connecting mechanism for connector the spanning connector to the previously inserted spinal fixation element. The spanning connector also includes a connector body for coupling the first connecting mechanism and the second connecting mechanism. Embodiments of a spanning connector may also reduce a separation distance between the bone anchor and the spinal fixation element. Embodiments of a spanning connector are configured, sized and dimensioned for use in a minimally invasive surgical technique, such as a rod-first spinal surgical technique.

Abstract: A rod anchoring system including a bone anchor and a connector is provided. The connector of the rod anchoring system is configured to be inserted in one orientation and then transitioned to a second orientation to connect the rod to the anchor. The bone anchor includes a detachable extension shaft that acts as a guide for inserting the connector. In use, once the bone anchor has been implanted at a target site on a vertebra, the connector is placed onto the extension shaft and slid along its length in a first orientation to insert the connector. Once the connector is at the implant site, it is transitioned from the first orientation to the second orientation to connect the rod to the anchor.

Abstract: The present invention provides methods for inserting a spinal fixation element using minimally invasive surgical techniques. The methods use implants having guide tabs. The guide tabs are used to locate the spinal fixation element along a patient's spine. The guide tabs may be orientated in different ways to accommodate different insertion techniques for the spinal fixation element.

Abstract: Methods and instruments are provided for connecting a rod extending along a patient's spinal column to a misaligned vertebra. The method comprises implanting a bone anchor in the misaligned vertebra, attaching an approximating device to the implanted bone anchor and rod, approximating the vertebra toward the rod using the approximating device, and connecting the rod to the bone anchor on the approximated vertebra. In certain embodiments the approximating device may include a winch mechanism. In other embodiments the approximating device is a cannula used in conjunction with a guide system.

Abstract: An adaptable clamping mechanism for coupling an elongate spinal fixation element to a bone anchor is provided. A seat element and a clamp element of the adaptable clamping mechanism adapt to seat and clamp an elongate spinal fixation element whose longitudinal axis is non-perpendicular relative to the as central axis of the bone anchor. One or both of the seat element and the clamp element may adjust to an out-of-plane orientation of the elongate spinal fixation element by pivoting or rotating in one or more directions. One or both of the seat element and the clamp element may have a deformable portion configured to deform to the orientation of a surface of the elongate spinal fixation element.

Abstract: A spanning connector for connecting an offset bone anchor to a previously inserted spinal fixation element and method of use is provided. The spanning connector includes a first connecting mechanism for connecting the spanning connector to the bone anchor, and a second connecting mechanism for connector the spanning connector to the previously inserted spinal fixation element. The spanning connector also includes a connector body for coupling the first connecting mechanism and the second connecting mechanism. Embodiments of a spanning connector may also reduce a separation distance between the bone anchor and the spinal fixation element. Embodiments of a spanning connector are configured, sized and dimensioned for use in a minimally invasive surgical technique, such as a rod-first spinal surgical technique.

Abstract: A rod anchoring system including a bone anchor and a connector is provided. The connector of the rod anchoring system is configured to be inserted in one orientation and then transitioned to a second orientation to connect the rod to the anchor. The bone anchor includes a detachable extension shaft that acts a guide for inserting the connector. In use, once the bone anchor has been implanted at a target site on a vertebra, the connector is placed onto the extension shaft and slid along its length in a first orientation to insert the connector. Once the connector is at the implant site, it is transitioned from the first orientation to the second orientation to connect the rod to the anchor.