Abstract: Bone anchor assemblies are disclosed herein that provide for a single bone anchor assembly that can be utilized across a range of spinal surgical procedures, reduce manufacturing burden and cost, and provide for greater flexibility during a surgical procedure. The bone anchor assemblies disclosed herein include an implantable shank and a receiver member having two spaced apart arms which form a U-shaped seat to receive a rod, among other components. The bone anchor assemblies disclosed herein also provide a number of features to enhance capability and usability. Examples include features to facilitate better implantation of the shank, better coupling of instrumentation to the anchor, better performance in reducing a spinal fixation element, such as a rod, into the receiver member seat, and others.

Abstract: Surgical instruments that are configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure, such as spinal rod reduction and derotation, are provided. For example, in one embodiment a surgical instrument can include an outer sleeve terminating in a pair of extensions, an inner sleeve having a proximal threaded portion and a distal translating portion configured to pass through the outer sleeve, and a pair of pivoting arms received in the extensions of the outer sleeve. The pivoting arms can be configured to extend into a channel of the outer sleeve to couple a bone anchor to the outer sleeve, and a proximal end portion of the outer sleeve can include one or more flats configured to engage with another instrument.

Abstract: Instruments and methods for selectively coupling to an object are provided, for example surgical instruments that can form a rigid connection with an object and also be disassembled for cleaning, sterilization, etc. One embodiment includes an elongate shaft with a longitudinal groove, a first partial circumferential groove that intersects with a distal end of the longitudinal groove, and a second at least partial circumferential groove formed distal to the first partial circumferential groove. The instrument also includes a sleeve disposed over the elongate shaft that includes a protrusion extending from an internal wall that is received within the longitudinal groove to constrain movement of the sleeve relative to the elongate shaft. The sleeve further includes a lock that interfaces with the second at least partial circumferential groove when the protrusion is disposed in the first partial circumferential groove to further selectively constrain axial and rotational movement of the sleeve.

Abstract: Various bone screws configured to be implanted into bone and methods of use are provided. In an exemplary embodiment, a bone screw is provided with an elongate shank and a head with a drive feature configured to couple with a driver tool for being advanced into bone and a threaded shank. The screw can have a distal end or tip that has one or more cutting edges thereon configured to cut bone as the bone screw is inserted into bone.

Abstract: Biplanar forceps reducer instruments and methods are disclosed herein. The instruments disclosed herein can engage an implant, such as a bone anchor receiver head, and reduce or move a spinal fixation element, such as a rod, in two planes to move the rod into a channel formed in the receiver head. Further, the biplanar forceps reducer instruments disclosed herein can allow for introduction and tightening of a set screw using an inserter that can pass through a cannulated tube of the reducer. The low profile and biplanar reduction functionality can allow a single type of reducer instrument to couple with each bone anchor along a spinal fixation construct and remain in position until the construct is secured in position.

Abstract: This disclosure relates generally to surgical instruments used to deliver locking or set screws to secure a rod or spinal fixation element relative to an implanted bone anchor or other spinal fixation construct during spine surgery. In one embodiment, the inserter instrument can include an inner driver shaft, a ratcheted outer sleeve, and a handle configured to receive the shafts therein. The inner driver shaft can receive a plurality of set screws on a distal end thereof. A side latch, pawl, or button can engage with the ratcheted outer sleeve to facilitate step-wise advancement of the sleeve relative to the driver shaft for set screw delivery.

Abstract: Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a screw drive assembly having a first handle and a driver shaft coupled to the first handle, and a stylet assembly having a second handle and a stylet extending through the driver shaft. The first handle can have a locked configuration, in which the first handle and the driver shaft are coupled such that the first handle can maintain the driver shaft in a fixed position while the second handle is rotated relative to the first handle, and an unlocked configuration, in which the first handle and the driver shaft can rotate simultaneously in a first direction and the first handle can rotate independent of the driver shaft in a second opposite direction.

Abstract: Various implant holding systems are provided herein that include an outer tube, an inner tube, and a holder. The implant holding systems can be designed to hold various implants, such as bone anchors used in spinal operations. For example, one embodiment of an implant holding system can have an outer tube, an inner tube that can be disposed within the outer tube, and an implant holder that can be disposed within the inner tube. An individual bone anchor that has various configurations and sizes can be disposed within the holder, and the holder can engage the bone anchor to assist in maintaining an orientation of the bone anchor relative to the holder.

Abstract: Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a screw drive assembly having a first handle and a driver shaft coupled to the first handle, and a stylet assembly having a second handle and a stylet extending through the driver shaft. The first handle can have a locked configuration, in which the first handle and the driver shaft are coupled such that the first handle can maintain the driver shaft in a fixed position while the second handle is rotated relative to the first handle, and an unlocked configuration, in which the first handle and the driver shaft can rotate simultaneously in a first direction and the first handle can rotate independent of the driver shaft in a second opposite direction.

Abstract: Various implant holding systems are provided herein that include an outer tube, an inner tube, and a holder. The implant holding systems can be designed to hold various implants, such as bone anchors used in spinal operations. For example, one embodiment of an implant holding system can have an outer tube, an inner tube that can be disposed within the outer tube, and an implant holder that can be disposed within the inner tube. An individual bone anchor that has various configurations and sizes can be disposed within the holder, and the holder can engage the bone anchor to assist in maintaining an orientation of the bone anchor relative to the holder.

Abstract: Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a driver shaft, a retaining sleeve disposed around the driver shaft, and a locking sleeve disposed around the retaining sleeve. The locking sleeve can have a first position in which rotation of the driver shaft causes corresponding rotation of the retaining sleeve while the locking sleeve is held stationary, and a second position in which rotation of the locking sleeve causes corresponding rotation of the retaining sleeve while the driver shaft is held stationary.

Abstract: A method of providing access to an intervertebral disc has been developed that involves using the patient's bony pedicle as an anchoring spot for a pedicle screw that temporarily attaches to the access port. Because this new procedure eliminates the need for the surgical table as an anchor, it also eliminates the assembly components extending from the table to the port at the access site, thereby unencumbering the surgeon's view and workspace while providing minimally invasive access.

Abstract: Methods and devices for providing access to an intervertebral disc using the patient's bony pedicle as an anchoring spot for a pedicle screw that temporarily attaches to an access port are disclosed herein. The disclosed methods and devices can eliminate the need for a surgical table as an anchor, as well as the need for components extending from the table to the port at the access site, thereby unencumbering the surgeon's view and workspace while providing minimally invasive access.

Abstract: Various implant holding systems are provided herein that include an outer tube, an inner tube, and a holder. The implant holding systems can be designed to hold various implants, such as bone anchors used in spinal operations. For example, one embodiment of an implant holding system can have an outer tube, an inner tube that can be disposed within the outer tube, and an implant holder that can be disposed within the inner tube. An individual bone anchor that has various configurations and sizes can be disposed within the holder, and the holder can engage the bone anchor to assist in maintaining an orientation of the bone anchor relative to the holder.

Abstract: Bone anchor assemblies and related instrumentation are disclosed herein. In some embodiments, a modular bone anchor assembly allows for a bone anchor to be driven into bone and a head or receiver member to be attached thereto at some later point in time. The bone anchor can have a smaller footprint than the complete assembly, which can improve visualization and anatomical spatial awareness during insertion of the bone anchor and during other surgical steps performed prior to attaching the head or receiver member to the bone anchor. A variety of modular head types are disclosed, as are various instruments for driving a bone anchor, attaching a head to a bone anchor, removing a head from a bone anchor, and making a unilateral attachment to a head of a bone anchor assembly. Drive interfaces for driving a bone anchor are disclosed, as are features that allow a bone anchor to act as a fixation point for soft tissue retraction, disc space distraction, derotation, and the like.

Abstract: Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument can include a feedback mechanism configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor. The feedback mechanism can be triggered by a movable shaft of the instrument that is displaced by the shank portion of the bone anchor as the surrounding bone is reamed.

Abstract: Bone anchor assemblies and related instrumentation are disclosed herein. In some embodiments, a modular bone anchor assembly allows for a bone anchor to be driven into bone and a head or receiver member to be attached thereto at some later point in time. The bone anchor can have a smaller footprint than the complete assembly, which can improve visualization and anatomical spatial awareness during insertion of the bone anchor and during other surgical steps performed prior to attaching the head or receiver member to the bone anchor. A variety of modular head types are disclosed, as are various instruments for driving a bone anchor, attaching a head to a bone anchor, removing a head from a bone anchor, and making a unilateral attachment to a head of a bone anchor assembly. Drive interfaces for driving a bone anchor are disclosed, as are features that allow a bone anchor to act as a fixation point for soft tissue retraction, disc space distraction, derotation, and the like.

Abstract: Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a driver shaft, a retaining sleeve disposed around the driver shaft, and a locking sleeve disposed around the retaining sleeve. The locking sleeve can have a first position in which rotation of the driver shaft causes corresponding rotation of the retaining sleeve while the locking sleeve is held stationary, and a second position in which rotation of the locking sleeve causes corresponding rotation of the retaining sleeve while the driver shaft is held stationary.

Abstract: Instruments and methods for delivering bone cement are disclosed herein. In one exemplary embodiment, the instrument includes a cannulated bone screw having a head that is configured to be received within a rod receiver and a shank extending distally from the head and configured to extend distally from the rod receiver, a cannulated shaft having a distal end configured to extend into the shank of the cannulated bone screw and a proximal end configured to couple to a bone cement delivery system, and a retaining sleeve disposed around at least a portion of the cannulated shaft. The head of the bone screw has proximal and distal recesses therein, and a distal end of the retaining sleeve is configured to couple to the proximal recess.

Abstract: Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a screw drive assembly having a first handle and a driver shaft coupled to the first handle, and a stylet assembly having a second handle and a stylet extending through the driver shaft. The first handle can have a locked configuration, in which the first handle and the driver shaft are coupled such that the first handle can maintain the driver shaft in a fixed position while the second handle is rotated relative to the first handle, and an unlocked configuration, in which the first handle and the driver shaft can rotate simultaneously in a first direction and the first handle can rotate independent of the driver shaft in a second opposite direction.