Abstract: The present disclosure relates to methods and devices for surgically manipulating tissue. In general, the methods and devices can include an elongate retractor shaft having a distal retractor tip that is configured to manipulate tissue, for example the tip can be configured to separate muscle and nerve fibers surrounding a vertebra. The elongate retractor shaft can include an illumination source such that at least a portion of the surgical field is illuminated by the device when the device is used in the body. A sensor can also or alternatively be included on the elongate retractor shaft, for example on the blunt retraction tip, such that the sensor can monitor physiological parameters of the tissue in or adjacent to the surgical field.

Abstract: Non-load-bearing, drug-eluting components, such as a rod cover, that can be added to load bearing spinal implants.

Abstract: A system for delivering flowable biomaterial to an intervertebral disc space between adjacent vertebral bodies includes a delivery body defining a proximal end, a distal end spaced from the proximal end along a longitudinal direction, a cannulation extending from the proximal end to an opening adjacent the distal end, and a distal region including a tip that extends to the distal end. The distal region defines a maximum height at a location proximal of the distal end and measured along a second direction perpendicular to the longitudinal direction. The distal region is for indicating a distance between the adjacent vertebral bodies. The system includes a carrier having a longitudinally elongate channel for carrying biomaterial and being insertable within the cannulation, as well as an advancement member configured for insertion within the cannulation to forcibly advance the biomaterial from the cannulation, through the opening, and into the disc space.

Abstract: A system for delivering flowable biomaterial to an intervertebral disc space between adjacent vertebral bodies includes a delivery body defining a proximal end, a distal end spaced from the proximal end along a longitudinal direction, a cannulation extending from the proximal end to an opening adjacent the distal end, and a distal region including a tip that extends to the distal end. The distal region defines a maximum height at a location proximal of the distal end and measured along a second direction perpendicular to the longitudinal direction. The distal region is for indicating a distance between the adjacent vertebral bodies. The system includes a carrier having a longitudinaly elongate channel for carrying biomaterial and being insertable within the cannulation, as well as an advancement member configured for insertion within the cannulation to forcibly advance the biomaterial from the cannulation, through the opening, and into the disc space.

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: Electronic devices that detect their position and/or orientation with respect to earth's frame of reference are described. A coupler can removeably maintain the electronic devices in physical proximity of one another. Each electronic device can have a housing and the coupler can be included on the housing and arranged to physically connect the housing of the electronic device to the housing of at least one other electronic device. Alternatively, the coupler can be a packaging that maintains the electronic devices in physical proximity of one another. Each electronic device can be calibrated using the orientation or position information obtained by other electronic devices maintained by the coupler. Further, each electronic device can include a power source that remains inactive until the device is ready for use.

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: An intervertebral fusion device comprising inferior and superior fusion cage devices that provide an ability to correct spondylolisthesis via in-situ adjustment.

Abstract: Electronic devices that detect their position and/or orientation with respect to earth's frame of reference are described. A coupler can removeably maintain the electronic devices in physical proximity of one another. Each electronic device can have a housing and the coupler can be included on the housing and arranged to physically connect the housing of the electronic device to the housing of at least one other electronic device. Alternatively, the coupler can be a packaging that maintains the electronic devices in physical proximity of one another. Each electronic device can be calibrated using the orientation or position information obtained by other electronic devices maintained by the coupler. Further, each electronic device can include a power source that remains inactive until the device is ready for use.

Abstract: A separate nub component between the plate and an intervertebral fusion cage, wherein the nub is attached to the plate. The nub lessens the undesired pivotal movement of the plate. It is believed that when the nub fits snugly between the endplates of the adjacent vertebral bodies, it acts as a stop against the undesired pivotal movement of the plate.

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 separate nub component between the plate and an intervertebral fusion cage, wherein the nub is attached to the plate. The nub lessens the undesired pivotal movement of the plate. It is believed that when the nub fits snugly between the endplates of the adjacent vertebral bodies, it acts as a stop against the undesired pivotal movement of the plate.

Abstract: A fusion cage has a first component that defines an outside surface that is configured to engage a vertebral endplate, and an interior surface. The fusion cage has a second component that defines first and second opposed surfaces. One of the first and second opposed surfaces can mate with the interior surface of the first component. The fusion cage can include vertical and lateral throughholes adapted to enhance fusion.

Abstract: An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Abstract: Adjustable drill guides and related methods are disclosed herein. An exemplary drill guide can include an adjustment mechanism that allows for precise incremental adjustment of the drill guide's depth setting while securely maintaining the device at a fixed setting between adjustments. The adjustment mechanism can improve the safety and security of the drill guide, for example by limiting adjustment only to those situations where it is specifically intended by the user, thereby reducing or eliminating the risk of inadvertent depth adjustment. In some embodiments, a drill guide can include high visibility, easy-to-read depth indications while maintaining a slender profile and without shifting the user's eye gaze, for example by employing a multi-surface moving scale having a text height that is at least twice the adjustment increment. Handles, protection sleeves, navigation adapters, and various other accessories that can be used with or without a drill guide are also disclosed herein.

Abstract: A fusion cage has a first component that defines an outside surface that is configured to engage a vertebral endplate, and an interior surface. The fusion cage has a second component that defines first and second opposed surfaces. One of the first and second opposed surfaces can mate with the interior surface of the first component. The fusion cage can include vertical and lateral throughholes adapted to enhance fusion.

Abstract: Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member. The distal portion of the wing can define a bone anchor opening through which one or more auxiliary bone anchors can be disposed to augment the fixation of the assembly's primary bone anchor. A distal surface of the distal portion of the wing can be obliquely angled relative to a proximal-distal axis of the spanning portion to face one of a caudal direction or a cephalad direction. A distal surface of the distal portion of the wing can be obliquely angled relative to the proximal-distal axis of the spanning portion to face one of a medial direction or a lateral direction. Surgical methods using the bone anchor assemblies described herein are also disclosed.

Abstract: An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Abstract: Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.