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: Disclosed herein are devices and methods for removing tissue. In one aspect, a device for removing tissue includes a hollow elongate member having an outer wall and a lumen, a selectively deployable tissue-cutting element extending from the hollow elongate member, and an actuation member extending through the lumen and coupled to the hollow elongate member at a location that is distal to the tissue-cutting element. Movement of the actuation member can cause the tissue-cutting element to move from the insertion configuration where the tissue-cutting element is not deployed to a tissue-cutting configuration where the tissue-cutting element is deployed such that it is radially extended relative to the insertion configuration.

Abstract: Tool assemblies and methods are disclosed, such as for robotic-assisted surgery with a robot. The tool assembly includes a working tool (44) sized to be coaxially movable within the dilator (60). A locking mechanism (70) releasably couples the working tool (44) and the dilator (60) to one another such that, in a locked configuration, the robot supports the tool assembly. An actuator (86) is configured to receive an input to move the locking mechanism to an unlocked configuration and permit axial movement of the working tool within the dilator. The dilator (60) may include at least one spike (104) disposed within the grooves (128) to penetrate bone. The dilator (60) may include an inner sleeve and outer sleeve coaxially movable relative to one another to move the tool assembly from an initial configuration to a deployed configuration in which the spikes are exposed beyond the sleeve(s). Methods of preparing a pedicle of the spine with the tool assembly with robotic assistance are also disclosed.

Abstract: Driver instruments are disclosed herein with various features for improving usability, easing the task of cleaning or sterilizing the instrument, reducing patient trauma associated with use of the instrument, and/or reducing the cost and assembly burden of the instrument. For example, a driver instrument can include a guide sleeve to protect patient tissue from damage caused by rotating components of the instrument or a bone anchor assembly coupled thereto, and to protect extension tabs of the bone anchor assembly from inadvertent separation. By way of further example, an instrument can include a preload assembly for maintaining engagement of a driver shaft of the instrument with a bone anchor assembly. As yet another example, an instrument can consist of a small number of components which are configured for simple, tool-free assembly and disassembly. An instrument can also be configured for use with bone anchor assemblies with and without extension tabs.

Abstract: A spinal marking system includes a marker having a threaded member and a flexible member connected to the threaded member. The flexible member has a length longer than that of the threaded member. The system also includes a navigation tool having a shaft configured to connect to the threaded member. The navigation tool also includes a navigation array connected to the shaft. The navigation array having a plurality of fiducials that are configured to communicate with a robotic system.

Abstract: A tool for creating an incision at a surgical site includes a body for use with a robotic end effector having a proximal end and a distal end, and a blade positioned at the distal end of the body, the blade having a proximal end and a distal end, the blade having a cutting edge defining a first portion extending outwardly from or adjacent to the proximal end to a maximum width and a second portion extending inwardly from the maximum width to a sharp distal tip.

Abstract: Devices and methods for aligning the components of polyaxial screws are described herein. In one embodiment, an alignment instrument includes an elongate frame having a longitudinal axis and a plurality of connection caps slidably disposed along the elongate frame. Each connection cap can removably couple to a polyaxial screw extension tube and selectively lock relative to the elongate frame such that a distance between the plurality of connection caps and an angular orientation of each connection cap relative to the elongate frame is maintained. The instrument can also include a transverse angle indicator to indicate an angular orientation of the elongate frame in a plane transverse to the longitudinal axis of the elongate frame. The device can, for example, capture the orientation of a plurality of polyaxial screws during spinal surgery such that the screws can be returned to the same orientation after manipulation to correct a spinal deformity, etc.

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: A spinal marking system includes a marker having a threaded member and a flexible member connected to the threaded member. The flexible member has a length longer than that of the threaded member. The system also includes a navigation tool having a shaft configured to connect to the threaded member. The navigation tool also includes a navigation array connected to the shaft. The navigation array having a plurality of fiducials that are configured to communicate with a robotic system.

Abstract: Devices and methods for selectively converting polyaxial bone screws into monoaxial screws are described herein. In one embodiment, a spinal screw extension instrument is provided having an outer component configured to engage a receiving member of a polyaxial screw. The instrument further includes an inner component disposed within an inner lumen of the outer component and configured to translate longitudinally relative to the outer component such that the inner component can apply a distal force to a compression member of the polyaxial screw disposed within a distal portion of the receiving member to thereby convert the polyaxial screw to a monoaxial screw.

Abstract: Devices and methods for aligning the components of polyaxial screws are described herein. In one embodiment, an alignment instrument includes an elongate frame having a longitudinal axis and a plurality of connection caps slidably disposed along the elongate frame. Each connection cap can removably couple to a polyaxial screw extension tube and selectively lock relative to the elongate frame such that a distance between the plurality of connection caps and an angular orientation of each connection cap relative to the elongate frame is maintained. The instrument can also include a transverse angle indicator to indicate an angular orientation of the elongate frame in a plane transverse to the longitudinal axis of the elongate frame. The device can, for example, capture the orientation of a plurality of polyaxial screws during spinal surgery such that the screws can be returned to the same orientation after manipulation to correct a spinal deformity, etc.

Abstract: Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a ball having a spherical exterior surface and a central lumen sized to receive the head portion of the shank, and a clip configured to be engaged between the head portion and the ball such that the clip is effective to lock the ball in engagement with the shank.

Abstract: Driver instruments are disclosed herein with various features for improving usability, easing the task of cleaning or sterilizing the instrument, reducing patient trauma associated with use of the instrument, and/or reducing the cost and assembly burden of the instrument. For example, a driver instrument can include a guide sleeve to protect patient tissue from damage caused by rotating components of the instrument or a bone anchor assembly coupled thereto, and to protect extension tabs of the bone anchor assembly from inadvertent separation. By way of further example, an instrument can include a preload assembly for maintaining engagement of a driver shaft of the instrument with a bone anchor assembly. As yet another example, an instrument can consist of a small number of components which are configured for simple, tool-free assembly and disassembly. An instrument can also be configured for use with bone anchor assemblies with and without extension tabs.

Abstract: Disclosed herein are devices and methods for removing tissue. In one aspect, a device for removing tissue includes a hollow elongate member having an outer wall and a lumen, a selectively deployable tissue-cutting element extending from the hollow elongate member, and an actuation member extending through the lumen and coupled to the hollow elongate member at a location that is distal to the tissue-cutting element. Movement of the actuation member can cause the tissue-cutting element to move from the insertion configuration where the tissue-cutting element is not deployed to a tissue-cutting configuration where the tissue-cutting element is deployed such that it is radially extended relative to the insertion configuration.

Abstract: Disclosed herein are devices and methods for removing tissue. In one aspect, a device for removing tissue includes a hollow elongate member having an outer wall and a lumen, a selectively deployable tissue-cutting element extending from the hollow elongate member, and an actuation member extending through the lumen and coupled to the hollow elongate member at a location that is distal to the tissue-cutting element. Movement of the actuation member can cause the tissue-cutting element to move from the insertion configuration where the tissue-cutting element is not deployed to a tissue-cutting configuration where the tissue-cutting element is deployed such that it is radially extended relative to the insertion configuration.

Abstract: Devices and methods for aligning the components of polyaxial screws are described herein. In one embodiment, an alignment instrument includes an elongate frame having a longitudinal axis and a plurality of connection caps slidably disposed along the elongate frame. Each connection cap can removably couple to a polyaxial screw extension tube and selectively lock relative to the elongate frame such that a distance between the plurality of connection caps and an angular orientation of each connection cap relative to the elongate frame is maintained. The instrument can also include a transverse angle indicator to indicate an angular orientation of the elongate frame in a plane transverse to the longitudinal axis of the elongate frame. The device can, for example, capture the orientation of a plurality of polyaxial screws during spinal surgery such that the screws can be returned to the same orientation after manipulation to correct a spinal deformity, etc.

Abstract: Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a ball having a spherical exterior surface and a central lumen sized to receive the head portion of the shank, and a clip configured to be engaged between the head portion and the ball such that the clip is effective to lock the ball in engagement with the shank.

Abstract: A spinal fixation element rotation instrument with two lever arms is provided. The lever arms are connected to each other at distal ends thereof. The second lever arm rotates relative to the first lever arm. The distal ends of the first and second lever arms are adapted to couple to a spinal fixation element. The distal ends of the lever arms may have a dual ratchet feature that prevents rotation in a set direction. When one arm rotates back and forth, the other arm is held stationary. As a result, the spinal fixation element rotates in a predetermined direction and is prevented from rotating back toward its initial position. The direction of the rotation of the spinal fixation element may be set using knobs or switches provided at a proximal end of one or both of the lever arms.

Abstract: Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a ball having a spherical exterior surface and a central lumen sized to receive the head portion of the shank, and a clip configured to be engaged between the head portion and the ball such that the clip is effective to lock the ball in engagement with the shank.