Abstract: A method of inserting a fastener includes positioning a portion of a stylet within a cannulated shaft of the fastener, advancing a tip of the stylet through a first bone and into a second bone, advancing a leading end of the fastener along the stylet through the first bone and into the second bone, and removing the stylet from the cannulated shaft of the fastener and the bone. In another embodiment, a method of inserting a fastener includes positioning a portion of a stylet within a cannulated shaft of the fastener, advancing a tip of the stylet into a bone to a first depth without advancing the fastener into the bone, advancing a leading end of the fastener along the stylet into the bone to a second depth without further advancing the stylet into the bone, and removing the stylet from the cannulated shaft of the fastener and the bone.

Abstract: A stylet control system for selectively advancing and retracting a stylet includes a stylet having a first end and a second end, the second end being threaded, a screwdriver defining a bore for receiving a portion of the stylet and having a screw-engaging end for engaging a screw, the stylet being rotationally fixed relative to the screwdriver. The system includes a control device having a passage for receiving the screwdriver and having an inner portion defining a lumen for receiving the portion of the stylet, the inner portion being threaded for engaging the threaded second end of the stylet, when the screwdriver is rotated in the first rotation direction and the control device is prevented from rotating, the screwdriver advances the screw in the first axial direction and the stylet retracts in a second axial direction, opposite the first axial direction.

Abstract: Tool assemblies, system, and methods for manipulating tissue and methods for performing a surgical procedure on a vertebral body adjacent soft tissue. A manipulator moves an end effector, and a screw is coupled to the end effector. A sleeve is disposed coaxially around the screw, and the screw and the sleeve are releasably engaged to one another. A navigation system is configured to track the vertebral body, and one or more controllers control the end effector to advance the screw relative to the sleeve along an insertion trajectory defined with respect to a surgical plan. The screw disengages the sleeve during advancement, and the screw is secured to the vertebral body. A distal working portion of the screw may be freely slidable through a distal end of the sleeve when disengaged. The screw may be a tap marker removably couplable with a tracking device of the navigation system.

Abstract: A fastener configured for spinal applications includes a head having a channel adapted to receive a spinal rod and a shaft extending from the head to a distal tip and having a thread, at least a portion of the thread being serrated. The serrated portion of the thread includes peaks and troughs and can extend along about 35 percent of a length of the thread.

Abstract: Tool assemblies, system, and methods for manipulating tissue and methods for performing a surgical procedure on a vertebral body adjacent soft tissue. A manipulator moves an end effector, and a screw is coupled to the end effector. A sleeve is disposed coaxially around the screw, and the screw and the sleeve are releasably engaged to one another. A navigation system is configured to track the vertebral body, and one or more controllers control the end effector to advance the screw relative to the sleeve along an insertion trajectory defined with respect to a surgical plan. The screw disengages the sleeve during advancement, and the screw is secured to the vertebral body. A distal working portion of the screw may be freely slidable through a distal end of the sleeve when disengaged. The screw may be a tap marker removably couplable with a tracking device of the navigation system.

Abstract: A fastener configured for spinal applications includes a head having a channel adapted to receive a spinal rod and a shaft extending from the head to a distal tip and having a thread, at least a portion of the thread being serrated. The serrated portion of the thread includes peaks and troughs and can extend along about 35 percent of a length of the thread.

Abstract: An access system is provided for establishing an access path to a surgical site within a patient. The access system comprises an access portal defining a working channel with a central axis, and an adaptor with a mating section mountable to the access portal. The adaptor is selectively rotatable about the central axis. The access portal includes a plurality of openings and the adaptor includes a plurality of projections, each of the projections and openings being arranged so that, in a first orientation, the openings and projections align to allow mounting of the adaptor to the access portal and, in a second orientation, the openings and projections do not align to prevent disassociation between the adaptor and the access portal. The adaptor also includes a holder for a viewing device, the viewing device being movable with the adaptor about the access portal and vertically translatable relative to the access portal.

Abstract: A percutaneous spinal cross link system for interconnecting a spinal fusion construct on one side of the longitudinal axis of the spine with a spinal fusion construct on the other side of the longitudinal axis may include a cross bar connected at each end by a respective connector to a respective spinal fusion rod of each of the spinal fusion constructs. The connector may include a rod receiving portion adapted to receive one of the spinal fusion rods and a cross bar receiving portion adapted to receive the cross bar in an orientation generally perpendicular to the spinal fusion rod. A cannula defined by two spaced apart blades may be connected to the connector for defining a minimally invasive pathway through body tissue for introduction of the cross bar to the connector. Other tools for use with the system are also disclosed.

Abstract: A percutaneous spinal cross link system for interconnecting a spinal fusion construct on one side of the longitudinal axis of the spine with a spinal fusion construct on the other side of the longitudinal axis may include a cross bar connected at each end by a respective connector to a respective spinal fusion rod of each of the spinal fusion constructs. The connector may include a rod receiving portion adapted to receive one of the spinal fusion rods and a cross bar receiving portion adapted to receive the cross bar in an orientation generally perpendicular to the spinal fusion rod. A cannula defined by two spaced apart blades may be connected to the connector for defining a minimally invasive pathway through body tissue for introduction of the cross bar to the connector. Other tools for use with the system are also disclosed.

Abstract: A stylet control system for selectively advancing and retracting a stylet includes a stylet having a first end and a second end, the second end being threaded, a screwdriver defining a bore for receiving a portion of the stylet and having a screw-engaging end for engaging a screw, the stylet being rotationally fixed relative to the screwdriver. The system includes a control device having a passage for receiving the screwdriver and having an inner portion defining a lumen for receiving the portion of the stylet, the inner portion being threaded for engaging the threaded second end of the stylet, when the screwdriver is rotated in the first rotation direction and the control device is prevented from rotating, the screwdriver advances the screw in the first axial direction and the stylet retracts in a second axial direction, opposite the first axial direction.

Abstract: Tool assemblies, system, and methods for manipulating tissue and methods for performing a surgical procedure on a vertebral body adjacent soft tissue. A manipulator moves an end effector, and a screw is coupled to the end effector. A sleeve is disposed coaxially around the screw, and the screw and the sleeve are releasably engaged to one another. A navigation system is configured to track the vertebral body, and one or more controllers control the end effector to advance the screw relative to the sleeve along an insertion trajectory defined with respect to a surgical plan. The screw disengages the sleeve during advancement, and the screw is secured to the vertebral body. A distal working portion of the screw may be freely slidable through a distal end of the sleeve when disengaged. The screw may be a tap marker removably couplable with a tracking device of the navigation system.

Abstract: An access system is provided for establishing an access path to a surgical site within a patient. The access system comprises an access portal defining a working channel with a central axis, and an adaptor with a mating section mountable to the access portal. The adaptor is selectively rotatable about the central axis. The access portal includes a plurality of openings and the adaptor includes a plurality of projections, each of the projections and openings being arranged so that, in a first orientation, the openings and projections align to allow mounting of the adaptor to the access portal and, in a second orientation, the openings and projections do not align to prevent disassociation between the adaptor and the access portal. The adaptor also includes a holder for a viewing device, the viewing device being movable with the adaptor about the access portal and vertically translatable relative to the access portal.

Abstract: An access system is provided for establishing an access path to a surgical site within a patient. The access system comprises an access portal defining a working channel with a central axis, and an adaptor with a mating section mountable to the access portal. The adaptor is selectively rotatable about the central axis. The access portal includes a plurality of openings and the adaptor includes a plurality of projections, each of the projections and openings being arranged so that, in a first orientation, the openings and projections align to allow mounting of the adaptor to the access portal and, in a second orientation, the openings and projections do not align to prevent disassociation between the adaptor and the access portal. The adaptor also includes a holder for a viewing device, the viewing device being movable with the adaptor about the access portal and vertically translatable relative to the access portal.

Abstract: A system includes tubular members removably positionable over a passageway device connected to a connecting element attached to a vertebra. The tubular members may each include a sidewall having an opening positionable adjacent a proximal end of the passageway device when the tubular member is positioned over the passageway device. The tubular members include channels therein to receive respective blades of the passageway devices. One of the tubular members may be a counter torque tube, and another two of the tubular members may be a hinge shaft and a ball shaft, respectively, of a compression and distraction system. The blades of each passageway device may be integrally formed with a cage of the connecting element to form a monolithic blade-screw. The blades of the monolithic blade-screw may be constructed by affixing distal ends of non-threaded blade extensions to proximal ends of threaded reduction portions integrally connected to the cage.

Abstract: An access system is provided for establishing an access path to a surgical site within a patient. The access system comprises an access portal defining a working channel with a central axis, and an adaptor with a mating section mountable to the access portal. The adaptor is selectively rotatable about the central axis. The access portal includes a plurality of openings and the adaptor includes a plurality of projections, each of the projections and openings being arranged so that, in a first orientation, the openings and projections align to allow mounting of the adaptor to the access portal and, in a second orientation, the openings and projections do not align to prevent disassociation between the adaptor and the access portal. The adaptor also includes a holder for a viewing device, the viewing device being movable with the adaptor about the access portal and vertically translatable relative to the access portal.

Abstract: A fastener configured for spinal applications includes a head having a channel adapted to receive a spinal rod and a shaft extending from the head to a distal tip and having a thread, at least a portion of the thread being serrated. The serrated portion of the thread includes peaks and troughs and can extend along about 35 percent of a length of the thread.

Abstract: An access system is provided for establishing an access path to a surgical site within a patient. The access system comprises an access portal defining a working channel with a central axis, and an adaptor with a mating section mountable to the access portal. The adaptor is selectively rotatable about the central axis. The access portal includes a plurality of openings and the adaptor includes a plurality of projections, each of the projections and openings being arranged so that, in a first orientation, the openings and projections align to allow mounting of the adaptor to the access portal and, in a second orientation, the openings and projections do not align to prevent disassociation between the adaptor and the access portal. The adaptor also includes a holder for a viewing device, the viewing device being movable with the adaptor about the access portal and vertically translatable relative to the access portal.