Abstract: An improved apparatus is provided to allow for an adjustable length tether for use in the spine and other parts of the body. The tether comprises an artificial strand with an eyelet formed in one end, the other end being looped through the eyelet. The other end is then secured with respect to the eyelet by a crimp, the excess length being cut off after the length of the tether has been given an appropriate tension. Alternatively, the eyelet end may be formed around a grommet. The crimp may be separate from the grommet or a part of the grommet. The mechanism by which the length is adjusted in some cases will take advantage of the shape memory properties of alloys such as nickel-titanium.

Abstract: One embodiment of a spinal fixation system 10 including a pair of longitudinal members 11, 12 positionable adjacent the spine, means for engaging longitudinal members to the spine 13, 14, a pair of wedge members 16 each having a bearing surface 38 configured to bear on a longitudinal member 11, 12, and a connector 20 configured to span a distance between the longitudinal members 11, 12. The connector 20 includes a pair of engaging members 25, 26 each having a fixation surface 33 and a connecting surface 30, and a bridge member 21 attached to the connecting surfaces 30. The engaging members 25, 26 each define a thru-hole 35 for receiving one of the wedge members 16. The thru-holes 35 are aligned so that wherein one of the wedge members 16 is advanced through the thru-hole 35, the bearing surface 38 will bear on a corresponding longitudinal member 11, 12 to force the longitudinal member 11, 12 into contact with the fixation surface 33 and engage the longitudinal member 11, 12 to the connector 20.

Abstract: A modular bone fastener system for use with a longitudinal member, such as a plate, having a fastener with a threaded lower potion for engaging a spinal element and an upper portion adapted to receive a headpiece. The headpiece is adapted to mate with the upper portion of the fastener and to engage a longitudinal member. A plurality of headpieces having angulated projections, lateral sections, and angulated lateral sections, all of which are adapted to engage a longitudinal member and overcome angular and translational misalignment of the fastener, may also be provided. The headpieces of some connectors are configured to permit angulation of a bore fastener relative to the connector.

Abstract: A method and an assembly for reducing a displaced vertebra and connecting the displaced vertebra to a spinal implant rod. The assembly has a reduction bolt with machine threads on one end and coarse threads on the other. A connection unit attaches the spinal rod to the reduction bolt, and until it is tightened, the connection unit allows the reduction bolt to slide within the connection unit. The connection unit includes a washer that rides against the side of the reduction bolt, and a nut is threaded onto the machine threads of the reduction bolt over a collar. The collar open is open at both ends and is of a size to readily slide over the reduction bolt. The posterior face of the collar has a notch to accept that portion of the lateral side of the washer as it presses against the reduction bolt. The notch is part of the open end of the collar into which is slide over the reduction bolt and down onto the connection unit.

Abstract: An instrument and method for guiding a spinal implant from a location outside of a patient's body to a location adjacent an exposed portion of a bone anchor engaged to the patient's spine. The instrument is a guide rod having a connecting portion and a guiding portion disposed along a longitudinal axis, with the connecting portion having a shaped end portion adapted to releasably engage a corresponding shaped end portion of the bone anchor. The guiding portion slideably engages a spinal implant and guides the implant along the longitudinal axis until the implant is positioned adjacent the exposed portion of the bone anchor for fixation thereto. The guide rod is then selectively separated or detached from the bone anchor and removed from the patient's body. In one aspect of the invention, the guiding portion is at least partially formed of a malleable material, such as aluminum or a shape-memory material, to allow the guiding portion to be bent or reshaped.

Abstract: A modular bone fastener system for use with a longitudinal member, such as a plate, having a fastener with a threaded lower potion for engaging a spinal element and an upper portion adapted to receive a headpiece. The headpiece is adapted to mate with the upper portion of the fastener and to engage a longitudinal member. A plurality of headpieces having angulated projections, lateral sections, and angulated lateral sections, all of which are adapted to engage a longitudinal member and overcome angular and translational misalignment of the fastener, may also be provided. The headpieces of some connectors are configured to permit angulation of a bore fastener relative to the connector.

Abstract: A cable operated bone anchor compressor and a method for thoracoscopically compressing bone anchors are disclosed. In procedures in which bone anchors, such as bone screws, are fixed to bone tissue and such bone tissue is to be readjusted or realigned, the device of the present invention is thoracoscopically inserted. The device includes a cable to be placed in contact with one bone anchor, and an elongated member with a mating head to be placed against another bone anchor. When the cable is retracted, the bone anchors are compressed or pulled toward each other to realign, in a desired fashion, the bone tissue to which they are attached.

Abstract: One embodiment of a spinal fixation system 10 including a pair of longitudinal members 11, 12 positionable adjacent the spine, means for engaging longitudinal members to the spine 13, 14, a pair of wedge members 16 each having a bearing surface 38 configured to bear on a longitudinal member 11, 12, and a connector 20 configured to span a distance between the longitudinal members 11, 12. The connector 20 includes a pair of engaging members 25, 26 each having a fixation surface 33 and a connecting surface 30, and a bridge member 21 attached to the connecting surfaces 30. The engaging members 25, 26 each define a thru-hole 35 for receiving one of the wedge members 16. The thru-holes 35 are aligned so that when one of the wedge members 16 is advanced through the thru-hole 35, the bearing surface 38 will bear on a corresponding longitudinal member 11, 12 to force the longitudinal member 11, 12 into contact with the fixation surface 33 and engage the longitudinal member 11, 12 to the connector 20.

Abstract: The embodiment of a spinal fixation system 10 including a pair of longitudinal members 11, 12 positionable adjacent the spine, engaging member for engaging longitudinal members to the spine 13, 14, a pair of wedge members 16 each having a bearing surface 38 configured to bear on a longitudinal member 11, 12, and a connector 20 configured to span a distance between the longitudinal members 11, 12. The connector 20 includes a pair of engaging members 25, 26 each having a fixation surface 33 and a connecting surface 30, and a bridge member 21 attached to the connecting surfaces 30. The engaging members 25, 26 each define a thru-hole 35 for receiving one of the wedge members 16. The thru-holes 35 are aligned so that when one of the wedge members 16 is advanced through the thru-hole 35, the bearing surface 38 will bear on a corresponding longitudinal member 11, 12 to force the longitudinal member 11, 12 into contact with the fixation surface 33 and engage the longitudinal member 11, 12 to the connector 20.

Abstract: Forceps are provided with a bifurcated gripping nose on one end adapted to pivotally engage an implant while a rod passes between the branches of the bifurcated gripping nose. The forceps further define a fulcrum adjacent the gripping nose. The pivotally engaging gripping nose and included fulcrum permit a surgeon to urge the rod into an opening in the implant with a single instrument while securely gripping the implant. With the implant pivotally engaged by the gripping nose, movement of the forceps towards the rod brings the fulcrum into contact with the rod and further movement urges the rod into an opening in the implant. In an alternative form, the gripping nose is laterally offset to urge a laterally offset rod into alignment with the implant upon rotation of the forceps.

Abstract: One embodiment of a spinal fixation system including a pair of longitudinal members 11, 12 positionable adjacent the spine, means for engaging longitudinal members to the spine 13, 14, a pair of wedge members 241 each having a bearing surface 242 configured to bear on a longitudinal member 11, 12, and a connector 200 configured to span a distance between the longitudinal members 11, 12. The connector 200 includes a pair of engaging members 205, 212 each having a fixation portion 207, 214 and a connecting portion 209, 216, and a bridge members 202 attachable to the connecting portions 209, 216. The engaging members 205, 212 each define a thru-hole 225 for receiving one of the wedge members 241.

Abstract: An introduction apparatus for approximating a longitudinal member and an implant to permit fixation therebetween. The introduction apparatus having a gripping nose for securely engaging an implant, a lateral approximation mechanism for laterally aligning an implant and an offset longitudinal member, and a reduction mechanism for reducing the vertical distance between the implant and the longitudinal member. The introduction apparatus is provide with a gripping nose actuated by axial movement of a clamping shaft in an outer sleeve. The clamping shaft further includes an axial cannula for passage of a fastener to the implant.

Abstract: Forceps are provided with a bifurcated gripping nose on one end adapted to pivotally engage an implant while a rod passes between the branches of the bifurcated gripping nose. The forceps further define a fulcrum adjacent the gripping nose. The pivotally engaging gripping nose and included fulcrum permit a surgeon to urge the rod into an opening in the implant with a single instrument while securely gripping the implant. With the implant pivotally engaged by the gripping nose, movement of the forceps towards the rod brings the fulcrum into contact with the rod and further movement urges the rod into an opening in the implant. In an alternative form, the gripping nose is laterally offset to urge a laterally offset rod into alignment with the implant upon rotation of the forceps.

Abstract: A spinal implant system for correcting spinal deformities and abnormalities includes an elongated spinal rod configured to be implanted adjacent the spinal column and spanning across several vertebral levels. A number of fixation elements, such as spinal hooks, are provided for engaging vertebrae at a number of vertebral levels. At least some of the fixation elements includes an elongated stem projecting from a vertebra engaging portion. The stems of each of the fixation elements are connected to the spinal rod by way of a rod connector having a one-piece body defining a rod channel adapted to receive the spinal rod therethrough, a stem bore adapted to receive a stem therethrough, and a threaded bore. The stem bore and rod channel intersect to permit contact between the rod and the stem of a fixation element. The threaded bore intersects either the rod channel or the stem bore so that a set screw threaded into the threaded bore bears against the spinal rod or fixation element stem.

Abstract: An apparatus for treating fractures of the femur including a screw and an intramedullary rod. The screw has a threaded portion and a smooth portion. The rod has a head and a stem. There is at least one opening through the head of the rod in an angled direction toward the femoral head relative to the longitudinal axis of the rod. The opening is adapted to slidingly receive the screw to permit the threaded portion of the screw, in use, to engage the femoral head and to allow sliding compression of a femoral neck or intertrochanteric fracture. An optional second opening and second screw which will also allow sliding compression may be provided to prevent rotation and to adapt the fracture device to a variety of applications.

Abstract: A spinal implant system for correcting spinal deformities and abnormalities includes an elongated spinal rod configured to be implanted adjacent the spinal column and spanning across several vertebral levels. A number of fixation elements, such as spinal hooks, are provided for engaging vertebrae at a number of vertebral levels. At least some of the fixation elements includes an elongated stem projecting from a vertebra engaging portion. The stems of each of the fixation elements are connected to the spinal rod by way of a rod connector having a one-piece body defining a rod channel adapted to receive the spinal rod therethrough, a stem bore adapted to receive a stem therethrough, and a threaded bore. The stem bore and rod channel intersect to permit contact between the rod and the stem of a fixation element. The threaded bore intersects either the rod channel or the stem bore so that a set screw threaded into the threaded bore bears against the spinal rod or fixation element stem.

Abstract: A spinal implant system for correcting spinal deformities and abnormalities includes an elongated spinal rod configured to be implanted adjacent the spinal column and spanning across several vertebral levels. A number of fixation elements, such as spinal hooks, are provided for engaging vertebrae at a number of vertebral levels. At least some of the fixation elements includes an elongated stem projecting from a vertebra engaging portion. The stems of each of the fixation elements are connected to the spinal rod by way of a rod connector having a one-piece body defining a rod channel adapted to receive the spinal rod therethrough, a stem bore adapted to receive a stem therethrough, and a threaded bore. The stem bore and rod channel intersect to permit contact between the rod and the stem of a fixation element. The threaded bore intersects either the rod channel or the stem bore so that a set screw threaded into the threaded bore bears against the spinal rod or fixation element stem.

Abstract: A spinal implant system for correcting spinal deformities and abnormalities includes an elongated spinal rod configured to be implanted adjacent the spinal column and spanning across several vertebral levels. A number of fixation elements, such as spinal hooks, are provided for engaging vertebrae at a number of vertebral levels. At least some of the fixation elements includes an elongated stem projecting from a vertebra engaging portion. The stems of each of the fixation elements are connected to the spinal rod by way of a rod connector having a one-piece body defining a rod channel adapted to receive the spinal rod therethrough, a stem bore adapted to receive a stem therethrough, and a threaded bore. The stem bore and rod channel intersect to permit contact between the rod and the stem of a fixation element. The threaded bore intersects either the rod channel or the stem bore so that a set screw threaded into the threaded bore bears against the spinal rod or fixation element stem.

Abstract: A system for direct visualization of the spine and the epidural and/or intra-discal space to facilitate diagnosis and treatment of spinal conditions and that is adapted for percutaneous introduction into the spinal space. The system includes a disposable flexible catheter, a fiber-optic bundle disposed within the catheter which is connected to a light source and camera. The bundle is removably and adjustably connected to the proximal end of the catheter to permit rotation of the bundle relative to the catheter. A mechanism for controllably deflecting the tip of the catheter is provided to vary the viewing angle of the fiber-optic bundle within and to assist in steering the catheter through the spinal space. The mechanism includes a deflection wire extending through the catheter and affixed at the distal end thereof. The proximal end of the deflection wire is affixed to a sleeve which is slidably disposed around the catheter and within a housing.

Abstract: A tool assembly has a shaft with a sleeve slidable along it. A hexagonal drive post at the lower end of tile shaft is received in a hex socket at the upper end of a bone bolt secured in a patient's spine. A nut to secure a connector on the bolt, is temporarily stored on a short thread on the shaft near the lower end. The sleeve is slid down the shaft and a hex socket at tile lower end of tile sleeve is received on the nut. The sleeve is manually turned while a handle on a drive post at the top of the shaft prevents the shaft, and thereby the bolt, from turning. As the sleeve turns, the nut is turned off the short thread and down onto the bolt thread. A torque wrench coupled to a tool receiving surface at the top of the sleeve tightens the nut on the bolt to the specified torque while the handle on the top of the shaft prevents the bolt from turning.