Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: Devices and methods are disclosed for less invasive surgery. More particularly, methods and devices described herein permit improved access within a body cavity when performing a minimally invasive procedure, typically through a small opening, a surgical port, or during an open surgical procedure.

Abstract: The present invention provides minimally invasive devices and methods for delivering a spinal connector to one or more spinal anchor sites in a patient's spinal column. In one embodiment, a spinal implant and access device is provided that includes a U-shaped receiver member, a bone-engaging member, and an extension member. The U-shaped receiver member can have a recess formed therein that is adapted to seat a spinal connector. The bone-engaging member can extend distally from the receiver member and it can be adapted to engage bone to thereby mate the receiver member to bone. The extension member can extend proximally from the receiver member and it can include a frangible portion formed thereon that is adapted to break when a predetermined force is applied thereto thereby allowing at least a portion of the extension member to be separated from the receiver member.

Abstract: Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In general, the method involves advancing a spinal fixation element in a first, lengthwise orientation along a pathway extending from a minimally invasive percutaneous incision to a spinal anchor site. As the spinal fixation element approaches the spinal anchor site, the fixation element can be manipulated to extend in a second orientation, which is preferably substantially transverse to the first orientation, to position the fixation element in relation to one or more spinal anchors.

Abstract: A method for introducing a spinal fixation element between two bone anchors includes engaging a spinal fixation element to a shaft of an instrument, positioning the shaft of the instrument through a sidewall opening of a first percutaneous access device connected to a first bone anchor and through a side wall opening of a second percutaneous access device connected to a second bone anchor, the spinal fixation element extending in an orientation substantially parallel to the longitudinal axis of at least one of the first percutaneous access device and the second percutaneous access device, and pivoting the instrument to change the orientation of the spinal fixation element and position the spinal fixation element in proximity to the first bone anchor and in proximity to the second bone anchor.

Abstract: The present invention provides minimally invasive devices and methods for delivering a spinal connector to one or more spinal anchor sites in a patient's spinal column. In one embodiment, a spinal implant and access device is provided that includes a U-shaped receiver member, a bone-engaging member, and an extension member. The U-shaped receiver member can have a recess formed therein that is adapted to seat a spinal connector. The bone-engaging member can extend distally from the receiver member and it can be adapted to engage bone to thereby mate the receiver member to bone. The extension member can extend proximally from the receiver member and it can include a frangible portion formed thereon that is adapted to break when a predetermined force is applied thereto thereby allowing at least a portion of the extension member to be separated from the receiver member.

Abstract: The present invention provides minimally invasive devices and methods for delivering a spinal connector to one or more spinal anchor sites in a patient's spinal column. In one embodiment, a spinal implant and access device is provided that includes a U-shaped receiver member, a bone-engaging member, and an extension member. The U-shaped receiver member can have a recess formed therein that is adapted to seat a spinal connector. The bone-engaging member can extend distally from the receiver member and it can be adapted to engage bone to thereby mate the receiver member to bone. The extension member can extend proximally from the receiver member and it can include a frangible portion formed thereon that is adapted to break when a predetermined force is applied thereto thereby allowing at least a portion of the extension member to be separated from the receiver member.

Abstract: The present invention provides minimally invasive devices and methods for delivering a spinal connector to one or more spinal anchor sites in a patient's spinal column. In one embodiment, a spinal implant and access device is provided that includes a U-shaped receiver member, a bone-engaging member, and an extension member. The U-shaped receiver member can have a recess formed therein that is adapted to seat a spinal connector. The bone-engaging member can extend distally from the receiver member and it can be adapted to engage bone to thereby mate the receiver member to bone. The extension member can extend proximally from the receiver member and it can include a frangible portion formed thereon that is adapted to break when a predetermined force is applied thereto thereby allowing at least a portion of the extension member to be separated from the receiver member.

Abstract: Methods and devices are provided for spinal fixation. In one exemplary embodiment, the methods and devices provide a spinal fixation system that can include a spinal connector which can be disposed within a recess in a head of a bone anchor. The spinal connector can have a variety of configurations. The methods and devices are particularly useful for unilateral fixation, in which one or more levels of the spine are stabilized along a single lateral side of the spine.

Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: A system for guiding an implant to an optimal placement within a patient includes a trajectory guide for guiding instruments along a selected trajectory and a trajectory fixation device for fixing the trajectory guide in a selected position. The trajectory guide defines a path configured to align with the selected trajectory. A movable support mounts the trajectory guide and selectively moves the trajectory guide to align the trajectory guide with the selected trajectory prior to fixing the trajectory guide in the selected position. The trajectory is aligned coarsely by hand, then the trajectory is aligned using a fine adjustment system. After fixing the trajectory guide, instruments can be inserted along the trajectory through the path defined by the trajectory guide.

Abstract: A spinal anchor assembly for securing a fixation element includes an anchor element and a twist-in cap. The anchor element is configured for attachment to a bone, typically by comprising a mono- or polyaxial screw or hook, and includes a proximal portion having an open slot for receiving the fixation element and having radially inwardly protruding flange segments. The twist-in cap is received in and closes the open slot. The proximal portion of the anchor and the cap are adapted to twist-lock together by a partial rotation of the cap from an open position to a closed position to cover the slot so as to capture the fixation element and to lock the cap in the closed position.

Abstract: An assembly such as an anchor screw, bone plate, offset hook, post, transverse connector or other spinal anchor for anchoring to bone and clamping a linkage such as a rod, wire cable or the like. The assembly has a top member with an open slot to receive the linkage, and a twist-lock closure cap to close the open end, capturing the linkage in the slot. One closure cap fits over and around the top member, with a set of segmented protrusions that extend through a corresponding set of protruding flange segments spaced about the circumference of the top member. The cap is configured to rotate and lock against the top member like a flange-locking bayonet mount when turned through a limited degree of rotation.

Abstract: A system for guiding an implant to an optimal placement within a patient includes a trajectory guide for guiding instruments along a selected trajectory and a trajectory fixation device for fixing the trajectory guide in a selected position. The trajectory guide defines a path configured to align with the selected trajectory. A movable support mounts the trajectory guide and selectively moves the trajectory guide to align the trajectory guide with the selected trajectory prior to fixing the trajectory guide in the selected position. After fixing the trajectory guide, instruments can be inserted along the trajectory through the path defined by the trajectory guide.

Abstract: A method for introducing a spinal fixation element between two bone anchors includes engaging a spinal fixation element to a shaft of an instrument, positioning the shaft of the instrument through a sidewall opening of a first percutaneous access device connected to a first bone anchor and through a side wall opening of a second percutaneous access device connected to a second bone anchor, the spinal fixation element extending in an orientation substantially parallel to the longitudinal axis of at least one of the first percutaneous access device and the second percutaneous access device, and pivoting the instrument to change the orientation of the spinal fixation element and position the spinal fixation element in proximity to the first bone anchor and in proximity to the second bone anchor.

Abstract: A spinal anchor assembly for securing a fixation element includes an anchor element and a twist-in cap. The anchor element is configured for attachment to a bone, typically by comprising a mono- or polyaxial screw or hook, and includes a proximal portion having an open slot for receiving the fixation element and having radially inwardly protruding flange segments. The twist-in cap is received in and closes the open slot. The proximal portion of the anchor and the cap are adapted to twist-lock together by a partial rotation of the cap from an open position to a closed position to cover the slot so as to capture the fixation element and to lock the cap in the closed position.

Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: A flexible spinal fixation element is provided that is movable between a first position, in which the spinal fixation element is adapted to be angularly manipulated, and a second, locked position, in which the spinal fixation element is aligned in a desired orientation and is immovable. The configuration of the flexible spinal fixation element can vary, but the fixation element is preferably formed from a bioimplantable member having segments or a bellows configuration that allows the fixation element to be selectively configurable between the first and second positions. In use, the flexibility of the spinal fixation element allows the fixation element to be introduced through a percutaneous access device, thereby advantageously allowing the fixation element to be implanted using minimally invasive techniques.