Abstract: Bone anchor assemblies and related instrumentation are disclosed herein. In some embodiments, a modular bone anchor assembly allows for a bone anchor to be driven into bone and a head or receiver member to be attached thereto at some later point in time. The bone anchor can have a smaller footprint than the complete assembly, which can improve visualization and anatomical spatial awareness during insertion of the bone anchor and during other surgical steps performed prior to attaching the head or receiver member to the bone anchor. A variety of modular head types are disclosed, as are various instruments for driving a bone anchor, attaching a head to a bone anchor, removing a head from a bone anchor, and making a unilateral attachment to a head of a bone anchor assembly. Drive interfaces for driving a bone anchor are disclosed, as are features that allow a bone anchor to act as a fixation point for soft tissue retraction, disc space distraction, derotation, and the like.

Abstract: Devices, systems, and methods are provided for driving an implant and applying counter torque. For example, a driver can include a handle, a driver shaft, and a counter torque shaft, the counter torque shaft being laterally offset from the driver shaft. A distal end of each shaft can mate with a specific type of implant and/or anatomy. The shafts can be removed and replaced from the device, allowing a user to select shafts having particular lengths and/or mating tips. In use, distal ends of the shafts can be fixed or constrained relative to one another and to an implant such that the counter torque shaft cannot orbit around the driver shaft. Rotating the handle can rotate the driver shaft, driving the implant. This can cause the counter torque shaft to try to orbit around the driver shaft, but the fixed/constrained ends restrict this motion, applying the counter torque.

Abstract: An apparatus for inserting implants in a bone comprising a frame having a cartridge receiving chamber and a barrel. A cartridge defining a plurality of chambers is positioned in the cartridge receiving chamber so the chambers are selectively alignable with a longitudinal passage of the barrel. At least one instrument is positioned in one of the chambers, and a plurality of implants is positioned in the other chambers. A drive assembly is engageable with the instrument and the implants. The drive assembly is slidably and rotatably disposed in the frame and is moveable between a retracted position, an engaging position wherein the distal end of the drive assembly is positioned to engage the selected one of the instrument and the implants, and an extended position wherein the drive assembly extends through the chamber to transport the selected one of the instrument or the implant from the chamber to the distal end of the barrel.

Abstract: In some embodiments, a connector can be configured to couple a first fixation element (e.g., a first rod) to a second fixation element (e.g., a second rod). One or both of the first and second fixation elements can be included with the connector, or one or both can be separately provided. In some instances, at least one of the fixation elements is previously implanted in a patient. The connector can provide one or more degrees of freedom between the first and second fixation elements. The connector can also include a locking element configured to (1) lock one or more of the fixation elements to the connector, and (2) lock one or more of the degrees of freedom between the fixation elements. The connector can be configured to snap onto or otherwise engage a fixation element in a manner that provides tactile and/or audible feedback to the surgeon.

Abstract: Devices and methods for tissue removal are disclosed herein, including those in which a powered rotary tool actuates a cutting blade to sever tissue and drives an auger to transport the severed tissue proximally through the device. The severed tissue can be collected in an on-board collection chamber for subsequent use as graft material or otherwise (e.g., assay, analysis, post-processing, etc.). Devices of the type disclosed herein can reduce or eliminate the need to move the device in and out of the surgical site, reduce user input force, and provide improved ergonomics and increased user focus.

Abstract: Devices, systems, and methods are provided for driving an implant and applying counter torque. For example, a driver can include a handle, a driver shaft, and a counter torque shaft, the counter torque shaft being laterally offset from the driver shaft. A distal end of each shaft can mate with a specific type of implant and/or anatomy. The shafts can be removed and replaced from the device, allowing a user to select shafts having particular lengths and/or mating tips. In use, distal ends of the shafts can be fixed or constrained relative to one another and to an implant such that the counter torque shaft cannot orbit around the driver shaft. Rotating the handle can rotate the driver shaft, driving the implant. This can cause the counter torque shaft to try to orbit around the driver shaft, but the fixed/constrained ends restrict this motion, applying the counter torque.

Abstract: In some embodiments, a connector can be configured to couple a first fixation element (e.g., a first rod) to a second fixation element (e.g., a second rod). One or both of the first and second fixation elements can be included with the connector, or one or both can be separately provided. In some instances, at least one of the fixation elements is previously implanted in a patient. The connector can provide one or more degrees of freedom between the first and second fixation elements. The connector can also include a locking element configured to (1) lock one or more of the fixation elements to the connector, and (2) lock one or more of the degrees of freedom between the fixation elements. The connector can be configured to snap onto or otherwise engage a fixation element in a manner that provides tactile and/or audible feedback to the surgeon.

Abstract: A dilation system and method for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a dilation assembly and an actuating mechanism. The dilation assembly comprises plurality of dilator segments. The actuating mechanism is operably associated with the dilator segments so as to cause the dilator segments to move from a collapsed state to an expanded state.

Abstract: A dilation system for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a dilation assembly and an actuating mechanism. The dilation assembly comprises plurality of dilator segments. The actuating mechanism is operably associated with the dilator segments so as to cause the dilator segments to move from a collapsed state to an expanded state.

Abstract: An expandable implant is made via a central strut having a pivotable arm on each end. The implant can be inserted into a disc space either horizontally or vertically with the arms in a closed position and then (if inserted horizontally) optionally rotated up into place. The arms are then pivoted out, thereby increasing the foot print of a horizontally inserted implant. The expanded implant can be locked in place through the use of an additional insert or ratchet that fits between the arms and locks the arms in place.

Abstract: Devices, systems, and methods are provided for driving an implant and applying counter torque. For example, a driver can include a handle, a driver shaft, and a counter torque shaft, the counter torque shaft being laterally offset from the driver shaft. A distal end of each shaft can mate with a specific type of implant and/or anatomy. The shafts can be removed and replaced from the device, allowing a user to select shafts having particular lengths and/or mating tips. In use, distal ends of the shafts can be fixed or constrained relative to one another and to an implant such that the counter torque shaft cannot orbit around the driver shaft. Rotating the handle can rotate the driver shaft, driving the implant. This can cause the counter torque shaft to try to orbit around the driver shaft, but the fixed/constrained ends restrict this motion, applying the counter torque.

Abstract: An apparatus for dispensing a plurality of implants including a barrel, a magazine, and a driver. The barrel has a longitudinal passage and a lateral passage intersecting the longitudinal passage adjacent a distal end of the barrel. The magazine has a housing defining a chamber for holding a plurality of implants. The housing is slidably connected to the barrel and movable between a retracted position and an extended position wherein a slot of the housing is aligned with the lateral passage of the barrel. A pusher member connected to the housing is caused to push one of the implants through the slot and the lateral passage and into the longitudinal passage. The driver is disposed in the longitudinal passage to be axially and rotatably movable to apply a rotational force to the implant.

Abstract: An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Abstract: Devices and methods for bending or cutting implants are disclosed herein. In some embodiments, an instrument can include a rotatable drive shaft that urges first and second portions of a modular bending or cutting template toward one another to bend or cut an implant disposed between the template portions. A linkage assembly can be included to provide a mechanical advantage in urging the template portions toward one another. In some embodiments, an instrument can include a rotatable drive shaft that, depending on direction of rotation, pushes or pulls a first modular template portion with respect to a second modular template portion to bend an implant disposed between the template portions in one direction or another direction. In some embodiments, an instrument can include a worm drive that rotates a cutting wheel with respect to a cutting plate to cut an implant inserted through openings formed in the cutting wheel and the cutting plate.

Abstract: An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Abstract: A dilator system includes a series of sequential dilators. A first dilator has an elongated body having a major axis and a minor axis, the minor axis being substantially normal to the major axis. A second dilator has an elongated body having a major axis and a minor axis, the minor axis of the second dilator being substantially normal to the major axis of the second dilator. A bore of the second dilator is configured to matingly receive the first dilator in such a way that the major axis of the second dilator is aligned with the minor axis of the first dilator and the minor axis of the second dilator is aligned with the major axis of the first dilator.

Abstract: In some embodiments, a connector can be configured to couple a first fixation element (e.g., a first rod) to a second fixation element (e.g., a second rod). One or both of the first and second fixation elements can be included with the connector, or one or both can be separately provided. In some instances, at least one of the fixation elements is previously implanted in a patient. The connector can provide one or more degrees of freedom between the first and second fixation elements. The connector can also include a locking element configured to (1) lock one or more of the fixation elements to the connector, and (2) lock one or more of the degrees of freedom between the fixation elements. The connector can be configured to snap onto or otherwise engage a fixation element in a manner that provides tactile and/or audible feedback to the surgeon.

Abstract: A dilation system for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a dilation assembly and an actuating mechanism. The dilation assembly comprises plurality of dilator segments. The actuating mechanism is operably associated with the dilator segments so as to cause the dilator segments to move from a collapsed state to an expanded state.

Abstract: An expandable trial can include an inferior portion, a superior portion, and a middle expanding portion as well as load cells for monitoring the load on the trial. The trial may also include recesses on its lateral sides to provide spacing to accommodate a disc removal tool so tissue can be cleared monitoring load. In addition, neural foramen spacing can be monitoring to provide information about how much neural release has been achieved as the disc is cleaned and the spine is positioned and repositioned.

Abstract: A vertebral adjustment system configured to move individual vertebral bodies relative to the other vertebral bodies to thereby realign the spine. The system may include a frame, and a plurality of alignment devices coupled to the frame and to the individual vertebral bodies. By manipulated the alignment devices the vertebral bodies to which they are attached may be moved.