Abstract: A medical instrument includes first and second support members movably coupled to one another to provide variable spacing between distal portions of the support members. A first engagement element is attached to the distal portion of the first support member and extends generally along a first axis, and a second engagement element is attached to the distal portion of the second support member and extends generally along a second axis. At least one of the engagement elements includes an articulating portion articularly engaged with a mounting portion to provide multi-axial movement therebetween to thereby vary an angular orientation of the first axis relative to the second axis. An indicator extends between proximal portions of the support members and includes multiple indicia corresponding to variable distances between the first and second axes adjacent the engagement elements to provide an indication corresponding to a select distance between the first and second axes adjacent the engagement elements.

Abstract: In one form, systems and methods for positioning a connecting member adjacent the spinal column include at least one anchor that is engageable to bony structure and has a receiver for receiving the connecting member. A pair of elongated members is engaged to the receiver and defines a pathway that extends proximally from the receiver. The connecting member is movable along the elongated members to the receiver of the bone anchor. The elongated members are removable from the receiver of the bone anchor after the connecting member is positioned in the receiver to provide a low profile anchor and connecting member assembly when finally implanted in the patient. However, other embodiments, forms and applications are also envisioned.

Abstract: Surgical constructs pre-assembled for insertion as a unit into a patient. The pre-assembled construct may include an elongated member with opposing first and second ends. The construct may also include a connector with a body, a first receptacle that extends through the body and receives the elongated member, a threaded aperture that extends from an exterior of the body into the first receptacle, a fastener threaded into the threaded aperture, and a second receptacle that receives a structural member in the patient. The first receptacle may be larger than the elongated member for the connector to be movable along the elongated member. The construct may also include retaining members permanently attached to each of the first and second ends of the elongated member. The retaining members may include a central opening with an inner radial surface that contacts the elongated member and an outer radial surface that extends outward beyond the elongated member.

Abstract: In one form, systems and methods for positioning a connecting member adjacent the spinal column include at least one anchor that is engageable to bony structure and has a receiver for receiving the connecting member. A pair of elongated members is engaged to the receiver and defines a pathway that extends proximally from the receiver. The connecting member is movable along the elongated members to the receiver of the bone anchor. The elongated members are removable from the receiver of the bone anchor after the connecting member is positioned in the receiver to provide a low profile anchor and connecting member assembly when finally implanted in the patient. However, other embodiments, forms and applications are also envisioned.

Abstract: Vertebral column manipulation systems include spinal derotation instrumentation to affect one or more derotation maneuvers on a scoliotic spine or on a spine having one or more displaced, misaligned or curved vertebral levels. Derotation instrumentation is attached to at least one vertebral body, with the instrumentation including at least two elongated extensions mounted to and extending proximally from the at least one vertebral body. A linking assembly extends between and links proximal ends of the extensions to one another. The linking assembly includes first and second mounting assemblies movably engaged to an elongate link member extending transversely to the extensions. Each of the mounting assemblies includes a movable joint for receiving the proximal end of a respective one of the extensions and a cam assembly for securing the mounting assembly in position relative to the link member and to fix the joint around the extension.

Abstract: An assembly for tissue retraction in surgery includes a pair of arm members removably positioned on and movable along an elongate support member. The arm members each include an external housing, a locking member positioned within the external housing and a passageway extending through the external housing and the locking member. The elongate support member extends through the passageways and the locking members are releasably biased into engagement with the elongate support member to allow the arm members to move in opposite directions along the elongate support member and prevent the arm members from moving toward one another. Each arm member further includes a rotatable engagement portion engageable with a respective retractor portion and a locking element releasably biased into engagement with the engagement portion to limit rotation of the engagement portion to a first direction relative to the arm member.

Abstract: A method for assembling a system for correcting alignment of a spinal column of a patient is provided. The method includes the steps of engaging first and second implants to a first vertebra; engaging a distal portion of respective first and second implant holders to respective ones of the first and second implants, the first and second implant holders each extending from said distal portion along a longitudinal axis to a proximal end outside the patient; engaging a transverse bridge between and to proximal ends of each of the first and second implant holders; and engaging a derotation handle to the transverse bridge at a location between the first and second implant holders and in a generally parallel orientation to a sagittal plane of the spinal column so that the transverse derotation handle extends transversely to the sagital plane.

Abstract: Systems and methods for positioning a connecting member adjacent the spinal column include at least one anchor assembly having an anchor engageable to bony structure and a receiver for receiving the connecting member. An elongated extension is removably engaged to the receiver and extends proximally from the receiver. The extension and at least a portion of the receiver is removable from the remaining portion of the receiver of the bone anchor after the connecting member is positioned in the receiver to provide a low profile anchor and connecting member assembly when finally implanted in the patient.

Abstract: Bone anchors are provided that include a distal shaft for engaging bony structure of a vertebral body and a proximal post pivotably mounted at or near the proximal end of the shaft during implantation of the bone anchor. The bone anchors include a locking member that is engageable to the post and to the shaft to lock the post in a selected angular orientation relative to the shaft.

Abstract: A medical instrument includes first and second support members movably coupled to one another to provide variable spacing between distal portions of the support members. A first engagement element is attached to the distal portion of the first support member and extends generally along a first axis, and a second engagement element is attached to the distal portion of the second support member and extends generally along a second axis. At least one of the engagement elements includes an articulating portion articularly engaged with a mounting portion to provide multi-axial movement therebetween to thereby vary an angular orientation of the first axis relative to the second axis. An indicator extends between proximal portions of the support members and includes multiple indicia corresponding to variable distances between the first and second axes adjacent the engagement elements to provide an indication corresponding to a select distance between the first and second axes adjacent the engagement elements.

Abstract: Systems and methods for positioning a connecting member adjacent the spinal column include at least one anchor assembly having an anchor engageable to bony structure and a receiver for receiving the connecting member. An extension member is engaged to the receiver and defines a pathway that extends proximally from the receiver. The connecting member is movable along the extension member to the receiver of the bone anchor. The extension member is removable from the receiver of the bone anchor after the connecting member is positioned in the receiver to provide a low profile anchor and connecting member assembly when finally implanted in the patient.

Abstract: Devices and methods include an anchor assembly engageable to a vertebra and a connecting element positionable through a receiver of the anchor assembly. The assembly includes an engaging member for engaging the connecting element in the receiver. The engaging member includes a base with a cavity that receives a deformed portion the connecting element when the engaging member is securely engaged to the connecting element.

Abstract: Surgical constructs pre-assembled for insertion as a unit into a patient. The pre-assembled construct may include an elongated member with opposing first and second ends. The construct may also include a connector with a body, a first receptacle that extends through the body and receives the elongated member, a threaded aperture that extends from an exterior of the body into the first receptacle, a fastener threaded into the threaded aperture, and a second receptacle that receives a structural member in the patient. The first receptacle may be larger than the elongated member for the connector to be movable along the elongated member. The construct may also include retaining members permanently attached to each of the first and second ends of the elongated member. The retaining members may include a central opening with an inner radial surface that contacts the elongated member and an outer radial surface that extends outward beyond the elongated member.

Abstract: Vertebral column manipulation systems include spinal derotation instrumentation to affect one or more derotation maneuvers on a scoliotic spine or on a spine having one or more displaced, misaligned or curved vertebral levels. Derotation instrumentation is attached to at least one vertebral body, with the instrumentation including at least two elongated extensions mounted to and extending proximally from the at least one vertebral body. A linking assembly extends between and links proximal ends of the extensions to one another. The linking assembly includes first and second mounting assemblies movably engaged to an elongate link member extending transversely to the extensions. Each of the mounting assemblies includes a movable joint for receiving the proximal end of a respective one of the extensions and a cam assembly for securing the mounting assembly in position relative to the link member and to fix the joint around the extension.

Abstract: Derotation instrument assemblies and systems are provided to facilitate positioning one or more vertebrae of a spinal column into a desired alignment. The instrument assemblies and systems include implant holders engageable to respective implants engaged to vertebrae of the spinal column, transverse bridges to connect implant holders associated with a particular vertebra, and inter-level linking assemblies to connect instrument assemblies associated with different vertebrae. Derotation handles can be provided to facilitate application of the alignment forces, while the assemblies distribute the corrective forces to the connected implants and vertebrae.

Abstract: Derotation instrument assemblies and systems are provided to facilitate positioning one or more vertebrae of a spinal column into a desired alignment. The instrument assemblies and systems include implant holders engageable to respective implants engaged to vertebrae of the spinal column, transverse bridges to connect implant holders associated with a particular vertebra, and inter-level linking assemblies to connect instrument assemblies associated with different vertebrae. Derotation handles can be provided to facilitate application of the alignment forces, while the assemblies distribute the corrective forces to the connected implants and vertebrae.

Abstract: One embodiment of the present application includes a surgical instrument comprising a first member and a second member that are pivotally interconnected together. The first member and the second member each include a proximal end structured for manual manipulation by an operator and a distal end defining a gripping nose structured to engage a bone anchor. The instrument further includes a bearing surface to contact an implantable rod when the gripping nose is engaged with a bone anchor and to urge the rod toward the bone anchor when the gripping nose is pivoted thereabout. A thread guide is included that is engaged by threading of a rotatable member. The rotatable member can include a swivel-mounted head structured to bear against and further urge the rod toward a seat in the bone anchor when the rotatable member is turned through the guide.

Abstract: An assembly for tissue retraction in surgery includes a pair of arm members removably positioned on and movable along an elongate support member. The arm members each include an external housing, a locking member positioned within the external housing and a passageway extending through the external housing and the locking member. The elongate support member extends through the passageways and the locking members are releasably biased into engagement with the elongate support member to allow the arm members to move in opposite directions along the elongate support member and prevent the arm members from moving toward one another. Each arm member further includes a rotatable engagement portion engageable with a respective retractor portion and a locking element releasably biased into engagement with the engagement portion to limit rotation of the engagement portion to a first direction relative to the arm member.

Abstract: Derotation instrument assemblies and systems are provided to facilitate positioning one or more vertebrae of a spinal column into a desired alignment. The instrument assemblies and systems include implant holders engageable to respective implants engaged to vertebrae of the spinal column, transverse bridges to connect implant holders associated with a particular vertebra, and inter-level linking assemblies to connect instrument assemblies associated with different vertebrae. Derotation handles can be provided on the implant holders to facilitate application of the alignment forces, while the assemblies distribute the corrective forces to the connected implants and vertebrae.

Abstract: A spinal tool is disclosed and can include a first arm and a second arm. A rack can extend from the first arm. Further, a pinion gear can be coupled to the second arm. The pinion gear can engage the rack. The spinal tool can also include a worm gear engaged with the pinion gear.