Abstract: A system and device for manipulating a spinal construct is provided. For example, the manipulation device can include a drive member to be disposed within a first surgical sleeve extending from a first vertebra, and a coupling member positioned adjacent a second surgical sleeve. In one embodiment, at least one of the drive member and the coupling member can be releasably engaged to an actuation mechanism. In one aspect, the actuation mechanism can include a floating and/or auto-locking pivot point thereby allowing a user to quickly and easily position the manipulation device relative to the adjacent surgical sleeves. Additionally, a method of manipulating spinal constructs is also provided.

Abstract: Instruments and methods are provided for manipulating a bone anchor and a spinal fixation element. The instruments and methods disclosed herein are particularly suited to facilitate rotation of a bone anchor relative to another bone to correct the angular rotation of the vertebrae attached to the bone anchor. The instrument does not require the spinal fixation element to be inserted into the bone anchor prior to manipulation. The instrument further may be used in the insertion of the spinal fixation element into the bone anchor.

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 system and method for manipulating intervertebral tissue in one embodiment includes a conduit, a segmented expansion media configured to pass through the conduit, and an expandable node comprising a plurality of abrading strands and operably connected to the intervertebral tissue removal system conduit so as to receive the segmented expansion media therein, the expandable node expandable from a first condition whereat the plurality of abrading strands define at least one opening having a first maximum diameter, to an expanded condition whereat the at least one opening has a second maximum diameter larger than the first maximum diameter, wherein the second maximum diameter is less than a minimum diameter of the segmented expansion media, such that insertion of the segmented expansion media through the intervertebral tissue removal system conduit and into the expandable node causes the expandable node to expand from the first condition to the expanded condition.

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: A spinal fixation element fixation reduction system is provided herein. In general, the system can include a cap element with a bore having a central axis extending therethrough wherein the cap element is configured to releasably engage any type of surgical device (e.g., an access sleeve, a vertebral body rotator, etc.). Further, the system can include a driver configured to be slidably and removably positioned through the cap element. The system can also include an actuator configured to apply a force to the driver substantially along the central axis of the cap element thereby moving the driver in a distal direction so as to effect reduction of a spinal fixation element into a bone anchor. Additionally, a method of reducing a spinal fixation element into a bone anchor is also provided wherein the method can be performed as a minimally invasive surgical procedure or as an open procedure.

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: 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: 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: Systems of manipulating (e.g., compressing or distracting) a spinal construct are provided herein. In general, the system can include a surgical sleeve extending from a vertebra and a fulcrum movably coupled to some component of the system thereby allowing the fulcrum to be positioned at various location along the length of the sleeve. As indicated, the fulcrum can be movably coupled to virtually any component of the system. For example, the fulcrum can be movably coupled to the surgical sleeve, to a manipulation device sized and configured to receive the surgical sleeve, to a driver configured to apply a manipulation force, etc. Additionally, methods for manipulating a spinal construct are also provided herein.

Abstract: Spinal implants and methods for spinal stabilization and/or fusion are provided. Exemplary implants described herein can be configured for delivery to a facet joint to stabilize and/or fuse the facet joint, and can optionally be anchored within the pedicle for added fixation. The implant can optionally include a fusion-promoting bioactive material thereby providing a single device capable of spinal stabilization and/or fusion. Furthermore, a method of placing such an implant within a facet joint is provided.

Abstract: Spinal implants and methods for spinal stabilization and/or fusion are provided. Exemplary implants described herein can be configured for delivery to a facet joint to stabilize and/or fuse the facet joint, and can optionally be anchored within the pedicle for added fixation. The implant can optionally include a fusion-promoting bioactive material thereby providing a single device capable of spinal stabilization and/or fusion. Furthermore, a method of placing such an implant within a facet joint is provided.

Abstract: Modular medical instruments and kits are provided, having, a tool body portion with a first mating element at one end. A removable and replaceable modular end effector having a second mating element is matable with the first mating element. The instrument further includes a selectively engageable locking mechanism having a lever arm with a first portion associated with the body portion and a claw portion matingly engageable with a portion of the second mating element of the end effector, the locking mechanism being effective to secure the end effector to the body portion of the modular medical instrument. The invention can be particularly useful for providing a secure connection between the modular end effector and the body portion, yet provide ease of interchangeability between modular end effectors.

Abstract: A system and method for manipulating intervertebral tissue in one embodiment includes a conduit, a segmented expansion media configured to pass through the conduit, and an expandable node comprising a plurality of abrading strands and operably connected to the intervertebral tissue removal system conduit so as to receive the segmented expansion media therein, the expandable node expandable from a first condition whereat the plurality of abrading strands define at least one opening having a first maximum diameter, to an expanded condition whereat the at least one opening has a second maximum diameter larger than the first maximum diameter, wherein the second maximum diameter is less than a minimum diameter of the segmented expansion media, such that insertion of the segmented expansion media through the intervertebral tissue removal system conduit and into the expandable node causes the expandable node to expand from the first condition to the expanded condition.

Abstract: Devices and methods for preventing the migration or expulsion of a nucleus disc replacement implant are provided. In one embodiment, an anti-expulsion device includes a body that is movable between a compressed configuration where it is adapted to fit through an opening in an annulus of a spinal disc, and an expanded configuration where it has a size that is larger than a size of the opening in the annulus of a spinal disc. The body can also include one or more mating features that allow the body to interact with a nucleus disc replacement implant and/or an annular wall of an annulus. As a result, since the body is larger than the opening of the annulus in the expanded configuration, the interlocking connection between the body and the nucleus disc replacement implant and/or annular wall will allow the body to prevent the nucleus disc replacement implant from being expulsed from the opening in the annulus.

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: A method for manipulating intervertebral tissue in one embodiment includes inserting at least one abrading member for abrading tissue into an area to be cleared, expanding at least one expandable member from a first condition to a second condition, wherein the volume defined by the at least one expandable member in the second condition is greater than the volume defined by the at least one expandable member in the first condition, moving the inserted at least one abrading member from a first position to a second position by the expansion of the at least one expandable member, manipulating the inserted at least one abrading member to loosen tissue, and removing the loosened tissue from the area to be cleared.

Abstract: A spinal fixation element fixation reduction system is provided herein. In general, the system can include a cap element with a bore having a central axis extending therethrough wherein the cap element is configured to releasably engage any type of surgical device (e.g., an access sleeve, a vertebral body rotator, etc.). Further, the system can include a driver configured to be slidably and removably positioned through the cap element. The system can also include an actuator configured to apply a force to the driver substantially along the central axis of the cap element thereby moving the driver in a distal direction so as to effect reduction of a spinal fixation element into a bone anchor. Additionally, a method of reducing a spinal fixation element into a bone anchor is also provided wherein the method can be performed as a minimally invasive surgical procedure or as an open procedure.

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.