Abstract: An instrument for manipulating a spinal fixation element relative to a bone anchor includes a bone anchor grasping mechanism, a first adjustment mechanism, and a second adjustment mechanism. The bone anchor grasping mechanism includes a first arm having a distal end configured to engage an opening provided in the bone anchor. The first adjustment mechanism includes a second arm pivotally connected to the first arm. The second arm has a distal end configured to engage an opening provided in the bone anchor and is operable to adjust a spinal fixation element in a first direction upon pivoting relative to the first arm. The second adjustment mechanism is removably and replaceably coupled to the bone anchor grasping mechanism and is movable relative to the bone anchor grasping mechanism to adjust the spinal fixation element in a second direction, perpendicular to the first direction, relative to the bone anchor.

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: An instrument for engaging a bone anchor may include a first implant engaging member having a proximal end and a distal end and a second implant engaging member having a proximal end and a distal end. The second implant engaging member may be integrally connected to the first implant engaging member by a pair of opposed integral spring members located proximal to the distal ends of the first and second implant engaging members. Manipulation of the proximal ends of the first and second implant engaging member can cause each of the distal ends to rotate about the pair of opposed spring members to engage at least a portion of a bone anchor. A rod adjusting tool may be connectable to the bone anchor engaging tool and may be axially adjustable relative to the bone anchor tool to adjust a spinal rod relative to the bone anchor.

Abstract: Methods and devices are provided for reducing a spinal fixation element into a spinal implant element. In one exemplary embodiment, a spinal rod reduction device is provided for reducing a spinal fixation element into a spinal implant element. The spinal rod reduction device can include a fastener engaging member for engaging at least a portion a spinal implant element, a reduction member for engaging at least a portion of a spinal fixation element, and a handle assembly mated to the reduction member. The handle assembly can be designed in such a way that actuation of the handle assembly causes movement of the reduction member relative to the fastener engaging member and the movement of the reduction member reduces the spinal fixation element into the spinal implant element. Two different styles of spinal rod reduction devices are discussed in detail. Various techniques are also provided for reducing a spinal fixation element into a spinal implant element.

Abstract: Methods and devices are provided for reducing a spinal fixation element into a spinal implant element. In one exemplary embodiment, a spinal rod reduction device is provided for reducing a spinal fixation element into a spinal implant element. The spinal rod reduction device can include a fastener engaging member for engaging at least a portion a spinal implant element, a reduction member for engaging at least a portion of a spinal fixation element, and a handle assembly mated to the reduction member. The handle assembly can be designed in such a way that actuation of the handle assembly causes movement of the reduction member relative to the fastener engaging member and the movement of the reduction member reduces the spinal fixation element into the spinal implant element. Two different styles of spinal rod reduction devices are discussed in detail. Various techniques are also provided for reducing a spinal fixation element into a spinal implant element.

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 instrument for engaging a bone anchor may include a first implant engaging member having a proximal end and a distal end and a second implant engaging member having a proximal end and a distal end. The second implant engaging member may be integrally connected to the first implant engaging member by a pair of opposed integral spring members located proximal to the distal ends of the first and second implant engaging members. Manipulation of the proximal ends of the first and second implant engaging member can cause each of the distal ends to rotate about the pair of opposed spring members to engage at least a portion of a bone anchor. A rod adjusting tool may be connectable to the bone anchor engaging tool and may be axially adjustable relative to the bone anchor tool to adjust a spinal rod relative to the bone anchor.

Abstract: An instrument for engaging a bone anchor may include a first implant engaging member having a proximal end and a distal end and a second implant engaging member having a proximal end and a distal end. The second implant engaging member may be pivotally connected to the first implant engaging member about a pivot point located proximate the distal ends of the first and second implant engaging members. Manipulation of the proximal ends of the first and second implant engaging member can cause each of the distal ends to rotate about the pivot point to engage at least a portion of a bone anchor. A rod adjusting tool may be connectable to the bone anchor engaging tool and may be axially adjustable relative to the bone anchor tool to adjust a spinal rod relative to the bone anchor.

Abstract: An implant inserter for use in ALIF spine surgery, wherein the inserter has a flexible bracket, biased closed, onto which two long blades can be removably attached.

Abstract: A fastener assembly for a spinal fixation system that is particularly useful in treatment of pediatric and small-statured patients includes a fastener, an attachment member, and a locking member. The fastener has a lower portion for contacting a bone and an upper portion integral with the lower portion. The upper portion has two open channels. Each channel is configured and dimensioned to receive a portion of a longitudinal or connecting member along its circumference. The attachment member is positionable on the fastener and at least partially covers the channel that receives the longitudinal or connecting member. The locking member is operatively associated with the upper portion of the fastener and secures the attachment member and the longitudinal or connecting member to the fastener.

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: An instrument for guiding a spinal rod into a rod-receiving portion of an implant comprises a linear portion comprising two relatively moveable shafts, an actuator portion coupled to the linear portion for moving the spinal rod relative to the implant and a handle portion for moving the shafts to actuate the actuator portion. The actuator portion holds the rod in place until the surgeon inserts a setscrew or other device for securing the rod to the anchor. The actuator portion further defines a path for inserting and securing a locking device, such as a setscrew, for securing the rod in the implant while also holding the rod in the implant. The path for the screw is aligned with the rod-holding portion of the implant. Using the instrument, a surgeon can guide a rod into a selected position in the implant, reposition the spine to match the contour of the rod, hold the rod in the selected position and secure the rod to the implant.

Abstract: Methods and devices are provided for reducing a spinal fixation element into a spinal implant element. In one exemplary embodiment, a spinal rod reduction device is provided for reducing a spinal fixation element into a spinal implant element. The spinal rod reduction device can include a fastener engaging member for engaging at least a portion a spinal implant element, a reduction member for engaging at least a portion of a spinal fixation element, and a handle assembly mated to the reduction member. The handle assembly can be designed in such a way that actuation of the handle assembly causes movement of the reduction member relative to the fastener engaging member and the movement of the reduction member reduces the spinal fixation element into the spinal implant element. Two different styles of spinal rod reduction devices are discussed in detail. Various techniques are also provided for reducing a spinal fixation element into a spinal implant element.

Abstract: Methods and devices are provided for reducing a spinal fixation element into a spinal implant element. In one exemplary embodiment, a spinal rod reduction device is provided for reducing a spinal fixation element into a spinal implant element. The spinal rod reduction device can include a fastener engaging member for engaging at least a portion a spinal implant element, a reduction member for engaging at least a portion of a spinal fixation element, and a handle assembly mated to the reduction member. The handle assembly can be designed in such a way that actuation of the handle assembly causes movement of the reduction member relative to the fastener engaging member and the movement of the reduction member reduces the spinal fixation element into the spinal implant element. Two different styles of spinal rod reduction devices are discussed in detail. Various techniques are also provided for reducing a spinal fixation element into a spinal implant element.

Abstract: An instrument and method for bending a surgical implant, such as a spinal rod, includes a lever pivotally connected to a handle through a movable linkage system. The movable linkage system includes one or more bearing surfaces for applying a force to a first portion of the surgical implant while a rod seat connected to the handle holds an adjacent second portion of the surgical implant in a fixed position, thereby causing the surgical implant to bend between the first and second portion. The instrument can be easily operated using a single hand, is easy to control and requires a relatively small amount of force to bend a surgical implant. The instrument can include an automatic advancement means for advancing the surgical implant after bending to bend another portion of the surgical implant by a selected amount. The instrument can also be used for bending spinal rods having a non-circular cross-section in multiple planes.

Abstract: The present invention provides methods and devices for reducing a rod disposed within or adjacent to a rod-receiving head of a spinal implant. In general, a rod reduction device is provided that can removably mate to the rod-receiving head of a spinal implant and be effective to reduce a rod disposed within or adjacent to the rod-receiving head. In an exemplary embodiment, the rod reduction device can include a clamping member that is adapted to removably mate to a rod-receiving head of a spinal implant and a rod-reducing arm that is rotatably matable to the clamping member. The rod-reducing arm can be configured such that rotation of the arm with respect to the clamping member is effective to reduce a rod into the rod-receiving head of the spinal implant that is mated to the clamping member.

Abstract: The present invention is directed to a transconnector for coupling first and second spinal fixation rods or other elongate fixation elements. The transconnector includes a male member, a female member, and a locking member. The male member has a body with a linking element (such as a hook) associated with the lateral end for receiving one of the fixation elements, and a projection on the medial end. The projection includes a recess defined by lateral and medial walls. The female member has a body with a linking element associated with the lateral end for receiving the other fixation element, and a cavity with an opening on the medial end for receiving a portion of the male member projection. The locking member secures the position and orientation of the male member projection portion in the cavity in order to accommodate different separation distances and orientations between the first and second fixation elements.

Abstract: The present invention relates to a fastener assembly for a spinal fixation system and is particularly useful in treatment of pediatric and small-statured patients. The fastener assembly includes a fastener, an attachment member, and a locking member. The fastener has a lower portion for contacting a bone and a upper portion integral with the lower portion and having two open channels. Each channel is configured and dimensioned for receiving a portion of the longitudinal member along its circumference. The attachment member is positionable on the fastener and at least partially covers the channel that receives the longitudinal member. The attachment member is configured and dimensioned for receiving another portion of the longitudinal member along its circumference. The locking member is operatively associated with the upper portion of the fastener and secures the attachment member and longitudinal member to the fastener.

Abstract: The present invention is directed to a transconnector for coupling first and second spinal fixation rods or other elongate fixation elements. The transconnector includes a male member, a female member, and a locking member. The male member has a body with a linking element (such as a hook) associated with the lateral end for receiving one of the fixation elements, and a projection on the medial end. The projection includes a recess defined by lateral and medial walls. The female member has a body with a linking element associated with the lateral end for receiving the other fixation element, and a cavity with an opening on the medial end for receiving a portion of the male member projection. The locking member secures the position and orientation of the male member projection portion in the cavity in order to accommodate different separation distances and orientations between the first and second fixation elements.

Abstract: A transconnector for coupling first and second spinal fixation rods or other elongate fixation elements includes a male member, a female member, and a locking member. The male member has a body with a linking element (such as a hook) associated with the lateral end for receiving one of the fixation elements, and a projection on the medial end. The projection includes a recess defined by lateral and medial walls. The female member has a body with a linking element associated with the lateral end for receiving the other fixation element, and a cavity with an opening on the medial end for receiving a portion of the male member projection. The locking member secures the position and orientation of the male member projection portion in the cavity in order to accommodate different separation distances and orientations between the first and second fixation elements. The locking member cooperates with the medial wall of the recess of the projection to prevent uncoupling of the male and female members.