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: Methods and devices are provided for facilitating delivery and implanting of a bone anchor into bone. In one exemplary embodiment, a bone anchor extension is provided for coupling to a bone anchor to facilitate delivery and implanting of the bone anchor in bone. The bone anchor extension can have a generally elongate configuration that allows it to extend from a skin incision in a patient to a site proximate a patient's spine, and it can include a lumen extending therethrough between proximal and distal ends thereof. A distal end of the bone anchor extension can be adapted to engage a bone anchor, such as a bone screw. Various techniques are provided for locking the distal end of the bone anchor extension into engagement with a bone anchor.

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: 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: Methods for delivering a spinal fixation element to a surgical site are provided herein. More specifically, the method includes delivering a plurality of percutaneous access devices to a corresponding number of spinal locations, inserting a spinal fixation element through tissue, and manipulating the element through opposed sidewall openings formed in each access device. In an exemplary embodiment, the method can be optimized for position of large-scale fixation elements (e.g., greater than about 95 mm in length). In addition, a manipulation instrument configured to position such spinal fixation elements is also provided herein.

Abstract: An instrument for adjusting a spinal rod relative to a bone anchor includes a handle connecting a set screw driver with a reduction collar. The handle includes an inner shaft engageable with the set screw driver, an outer shaft engageable with the reduction collar, and a clutch connecting the inner shaft to the outer shaft and permitting selective rotation of the inner shaft relative to the outer shaft, and thus, selective rotation of the set screw driver relative to the reduction collar, upon application of a torque to the reduction collar and the outer shaft greater than a preselected torque value.

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: A method of contouring spinal rods, and systems therefor. The surgeon uses image guided surgery instruments to identify the locations of the screw heads through which the rod will pass. These locations allow a computer to form a best fit line that corresponds to the shape of a rod that can pass through the screw heads. This best fit line is then displayed on a projection table from both its coronal and sagittal views. The surgeon then shapes the rod using these 2-D images as a template.

Abstract: An intervertebral implant having an endplate that can be slidably expanded following its placement in the intervertebral space.

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: 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: 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: An instrument for adjusting a spinal rod relative to a bone anchor includes a handle connecting a set screw driver with a reduction collar. The handle includes an inner shaft engageable with the set screw driver, an outer shaft engageable with the reduction collar, and a clutch connecting the inner shaft to the outer shaft and permitting selective rotation of the inner shaft relative to the outer shaft, and thus, selective rotation of the set screw driver relative to the reduction collar, upon application of a torque to the reduction collar and the outer shaft greater than a preselected torque value.

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: 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: An instrument for adjusting a spinal rod relative to a bone anchor includes a handle connecting a set screw driver with a reduction collar. The handle includes an inner shaft engageable with the set screw driver, an outer shaft engageable with the reduction collar, and a clutch connecting the inner shaft to the outer shaft and permitting selective rotation of the inner shaft relative to the outer shaft, and thus, selective rotation of the set screw driver relative to the reduction collar. The handle clutch may include a spring and a plurality of disc clutch members positioned about the outer shaft. The spring biases the disc clutch members into contact with one another and at least one disc clutch member may rotate relative to an adjacent disc clutch member upon application of a torque to the reduction collar and the outer shaft greater than a preselected torque value.

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: The invention includes a system and method for loosening of tissue. In one embodiment, an intervertebral tissue removal system includes at least one abrading member for abrading tissue in an area to be cleared and at least one expandable member operable to be expanded 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, the at least one expandable member operably connected to the at least one abrading member such that as the at least one expandable member expands from the first condition to the second condition, the at least one abrading member is moved from a first position to a second position.

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.