Abstract: A surgical access device includes a proximal frame of fixed construction and a plurality of tissue engaging blades connected to the frame. The plurality of tissue engaging blades may include a first blade that is rotatable, independent of other blades, about an axis that is oriented approximately parallel to a plane defined by the proximal frame.

Abstract: A bone plate secured by both a screw and a post. The head of the post may act as a cam that prevents screw backout. Preferably, the shaft of the first post passes partially through the first post through hole so that the distal unthreaded portion of its shaft substantially extends beyond the plate and the proximal threaded portion of its shaft substantially remains in the first post through hole.

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 surgical retractor includes a plurality of blade assemblies interconnected by a plurality of racks. One or more of the blade assemblies is movable along a rack to selectively expand the retractor. At least one of the blade assemblies includes a blade that is rotatably connected to the blade assembly and that is rotatable independent of other blades of the retractor.

Abstract: Methods and instruments are provided for connecting a rod extending along a patient's spinal column to a misaligned vertebra. The method comprises implanting a bone anchor in the misaligned vertebra, attaching an approximating device to the implanted bone anchor and rod, approximating the vertebra toward the rod using the approximating device, and connecting the rod to the bone anchor on the approximated vertebra. In certain embodiments the approximating device may include a winch mechanism. In other embodiments the approximating device is a cannula used in conjunction with a guide system.

Abstract: The present invention provides methods and devices for placing a spinal fixation rod into a rod receiving opening in a spinal anchor and installing a fastener to secure the rod to the spinal anchor. In one embodiment, the system can include a cap having a bore extending therethrough, an elongate drive rod that is adapted to extend through the bore, and a fastener that is disposed on a distal portion of the drive rod. The cap can include a driving element that is adapted to cooperate with a complementary driving element disposed on the rod to form a driving mechanism. Actuation of the driver mechanism can be effective to advance the drive rod through the cap to thereby reduce a spinal rod into a rod receiving opening of the spinal anchor and install the fastener to secure the rod to the spinal anchor.

Abstract: A spanning connector for connecting an offset bone anchor to a previously inserted spinal fixation element and method of use is provided. The spanning connector includes a first connecting mechanism for connecting the spanning connector to the bone anchor, and a second connecting mechanism for connector the spanning connector to the previously inserted spinal fixation element. The spanning connector also includes a connector body for coupling the first connecting mechanism and the second connecting mechanism. Embodiments of a spanning connector may also reduce a separation distance between the bone anchor and the spinal fixation element. Embodiments of a spanning connector are configured, sized and dimensioned for use in a minimally invasive surgical technique, such as a rod-first spinal surgical technique.

Abstract: A surgical access device includes a proximal frame of fixed construction and a plurality of tissue engaging blades connected to the frame. The plurality of tissue engaging blades may include a first blade that is rotatable, independent of other blades, about an axis that is oriented approximately parallel to a plane defined by the proximal frame.

Abstract: A surgical access device includes a proximal frame of fixed construction and a plurality of tissue engaging blades connected to the frame. The plurality of tissue engaging blades may include a first blade that is rotatable, independent of other blades, about an axis that is oriented approximately parallel to a plane defined by the proximal frame.

Abstract: A surgical retractor for use with a spinal stabilization system including a plurality of bone anchors and a plurality of anchor extensions. The surgical retractor includes a frame positionable between a first anchor extension connected to a first bone anchor implanted in a first vertebra and a second anchor extension connected to a second bone anchor implanted in a second vertebra and a first retractor blade connectable to the frame for retracting tissue between the first anchor extension and the second anchor extension.

Abstract: A surgical retractor includes a plurality of blade assemblies interconnected by a plurality of racks. One or more of the blade assemblies is movable along a rack to selectively expand the retractor. At least one of the blade assemblies includes a blade that is rotatably connected to the blade assembly and that is rotatable independent of other blades of the retractor.

Abstract: An expandable port for minimally invasive surgery includes a first section, a second section, and at least one intermediate section. The port is expandable from a closed configuration in which the first section is proximate the second section along at least a portion of a length of the first section to an expanded configuration in which the first section is spaced apart from the second section. The intermediate portion spans a gap between the first section and the second section when the port is in the expanded configuration.

Abstract: The present invention provides an implant that can be inserted on top of a previously placed spinal fixation element. The implant includes a bone anchor and a connector body. The bone anchor includes a proximal head and a distal shaft extending along a longitudinal axis configured to engage bone. The connector body is configured to engage the proximal head of bone anchor and engage a spinal fixation element offset from longitudinal axis of the bone anchor shaft. Because, the implant is inserted over the spinal fixation element, direct visualization of the surgical site is available during insertion. In addition, the implant may provide tactile or audible feedback indicating that the spinal fixation element has been engaged by the implant.

Abstract: An adaptable clamping mechanism for coupling an elongate spinal fixation element to a bone anchor is provided. A seat element and a clamp element of the adaptable clamping mechanism adapt to seat and clamp an elongate spinal fixation element whose longitudinal axis is non-perpendicular relative to the as central axis of the bone anchor. One or both of the seat element and the clamp element may adjust to an out-of-plane orientation of the elongate spinal fixation element by pivoting or rotating in one or more directions. One or both of the seat element and the clamp element may have a deformable portion configured to deform to the orientation of a surface of the elongate spinal fixation element.

Abstract: Methods and instruments are provided for connecting a rod extending along a patient's spinal column to a misaligned vertebra. The method comprises implanting a bone anchor in the misaligned vertebra, attaching an approximating device to the implanted bone anchor and rod, approximating the vertebra toward the rod using the approximating device, and connecting the rod to the bone anchor on the approximated vertebra. In certain embodiments the approximating device may include a winch mechanism. In other embodiments the approximating device is a cannula used in conjunction with a guide system.

Abstract: A bone anchor assembly for coupling an offset bone anchor with a previously inserted spinal fixation element and method of use is provided. Exemplary embodiments of a bone anchor assembly are particularly suited for use in a rod-first spinal surgical technique in which a bone anchor inserted into a patient vertebra may be separated from a previously inserted spinal fixation element by a separation distance.

Abstract: A spanning connector for connecting an offset bone anchor to a previously inserted spinal fixation element and method of use is provided. The spanning connector includes a first connecting mechanism for connecting the spanning connector to the bone anchor, and a second connecting mechanism for connector the spanning connector to the previously inserted spinal fixation element. The spanning connector also includes a connector body for coupling the first connecting mechanism and the second connecting mechanism. Embodiments of a spanning connector may also reduce a separation distance between the bone anchor and the spinal fixation element. Embodiments of a spanning connector are configured, sized and dimensioned for use in a minimally invasive surgical technique, such as a rod-first spinal surgical technique.

Abstract: The present invention provides methods and devices for placing a spinal fixation rod into a rod receiving opening in a spinal anchor and installing a fastener to secure the rod to the spinal anchor. In one embodiment, the system can include a cap having a bore extending therethrough, an elongate drive rod that is adapted to extend through the bore, and a fastener that is disposed on a distal portion of the drive rod. The cap can include a driving element that is adapted to cooperate with a complementary driving element disposed on the rod to form a driving mechanism. Actuation of the driver mechanism can be effective to advance the drive rod through the cap to thereby reduce a spinal rod into a rod receiving opening of the spinal anchor and install the fastener to secure the rod to the spinal anchor.

Abstract: An instrument for smoothing an end of a spinal rod includes a housing having an opening sized and shaped to receive a spinal rod and a smoothing surface positioned within the housing and in communication with the opening. The smoothing surface has one or more structures configured to engage a portion of the spinal rod and, upon relative rotation of the spinal rod to the smoothing surface, to smooth the portion of the spinal rod by removing material from the spinal rod.

Abstract: The present invention provides an inflatable retractor for providing access to a surgical site, such as a patient's spine, during a surgical process. When used in spinal surgery, the inflatable retractor allows a surgeon to operate on one or more spinal levels. The inflatable retractor includes an inflatable body defining a central cavity, wherein the body is flaccid in a non-inflated state and increasingly rigid in an inflated state. The inflatable retractor is inserted into an incision in a deflated, or partially inflated, state and then inflated once the retractor is in position. The inflation of the retractor retracts skin and muscle from the surgical site, allowing adequate visualization of the surgical site and forms a passage providing access for implants and surgical instruments to pass through the retractor and into the surgical site.