Abstract: Disclosed are various instruments and implants used in minimally invasive spine surgery. Disclosed is a cannulated probe, a guide wire handle; a guide wire handle having a locking mechanism, an all-in-one guide wire tool; a retractor flex rod passage; or a tab break tool.

Abstract: A system and method for tool exchange during surgery for cooperatively controlled robots comprises a tool holder for receiving a surgical tool adapted to be held by a robot and a surgeon, a tool holding element for constraining downward motion of the tool while allowing low force removal of the surgical tool from the holder, a first sensor for detecting if the surgical tool is docked within the tool holder, and a selector for automatically selecting different movements or actions of the tool holder to be performed based upon information detected by the first sensor. The system and method of the present invention provides an advantage to an often slow moving cooperative robot, by increasing the speed by which the tool holder may move in the direction away from the patient.

Abstract: A surgical guide wire or K-wire and method of use are provided. The K-wire, or guide wire, has opposite end portions and a shank portion in between. One end portion has a deformable end portion that, once outside of a confining guide passage, can be deformed to present a projected forward facing area that is larger than the transverse cross section of the K-wire, or guide wire, while in the passage. The increased area will provide increased resistance to additional forward axial movement into the surgical site.

Abstract: Instruments and methods for inserting a spinal fixation rod include various components for inserting a rod with visual guidance. One kit includes a plurality of hollow elongated extension tubes and rod templates. The tube connectors connect the extension tubes in series. Another kit includes a rod guidance instrument having a sleeve. A guide member is attachable to the midsection of the sleeve, and a spinal fixation rod is attachable to the distal end of the sleeve. A method for inserting a spinal fixation rod into a plurality of rod receiving implants includes the steps of contouring a fixation rod to conform to a predetermined shape, contouring a guide member to match the shape of the contoured rod, and guiding the fixation rod into a rod receiving implant by maneuvering the guide member through a guide slot representing the location of the rod receiving implant.

Abstract: Alignment clamps, extension caps, and systems, with associated methods, for pedicle screw extension alignment in an orthopedic patient are described. An alignment clamp for alignment of pedicle screw extensions includes a clamp having a hollow interior. The clamp can receive a pedicle screw extension through the hollow interior. The clamp includes opposing open ends in communication with the hollow interior. A straightening rod receptacle is on a side of the clamp. The straightening rod receptacle is oriented to receive a straightening rod therethrough. The straightening rod receptacle can be substantially perpendicular to a direction of the clamp through which the pedicle screw extension is receivable.

Abstract: The present invention discloses a securing device that is used to secure a fixation device to two bone portions to promote healing between the two bone portions. The bone portions commonly include a skull bone portion and a skull bone flap or implant, and the fixation device is commonly a cranial clamp. The securing device provides for securing the fixation device in a uniform, single movement as opposed to currently available products. The securing device has two handles pivotably connected, and a gripping means moveably associated with one handle. As the handles are activated, the gripping means travels proximally along the one handle and grips an elongated section of the fixation device and exerts a tensioning force along the shaft of the elongated section prior to the cutting means cutting the elongated shaft to secure the fixation device in place.

Abstract: A spinal stabilization system, method, and a surgical kit having a surgical extender apparatus for implanting a surgical screw are disclosed. The extender includes a housing having a distal end and a proximal end, a hollow interior passageway disposed between the distal end and the proximal end, a channel disposed along an exterior surface of the housing at least partially between the distal end and the proximal end and configured to at least partially expose the hollow interior passageway, an interior locking mechanism disposed on an interior surface of the housing and substantially adjacent the proximal end, wherein the interior locking mechanism is configured to allow attachment of at least one surgical tool, and at least one flexible member disposed substantially adjacent the distal end. The housing is configured to accommodate placement of a surgical screw implant. The surgical screw implant is secured to the housing using a mating feature in the surgical screw implant.

Abstract: A cable tensioning system includes a reaction frame which contains a sliding platform arranged to move linearly within the frame, and a clam-type cleat attached to the sliding platform. The cleat features one or more grooves, each of which comprises two arrays of opposing ridges that converge to form a V-shape groove adapted to receive a length of cable. The ridges of each groove are tilted relative to an axis perpendicular to the groove's longitudinal axis, such that the cable is progressively captured between the ridges of the opposing arrays as it settles into the crotch of the groove when moved in a first direction, and can be disengaged from the cleat by relaxing the axial force on the cable and moving it in the opposite direction. A linear actuator mechanism may be coupled to the sliding platform to move the platform with respect to the reaction frame.

Abstract: Systems, methods, and apparatuses for tensioning an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure. At least one device in accordance with various embodiments of the invention includes a handheld body handheld body capable of receiving a portion of the orthopedic surgical cable. The handheld body includes a clamping body adapted to restrain a first portion of the orthopedic surgical cable with an adjustable gripping force, wherein a tension is placed on the orthopedic surgical cable. The handheld body also includes an adjusting mechanism adapted to cooperate with the clamping body to change the gripping force on the orthopedic surgical cable. In addition, the handheld body includes a slide adapted to change the position of the clamping body relative to the handheld body.

Abstract: A surgical tool for tensioning a flexible member of a vertebral device, the flexible member having at least one end portion to which tension is applied. The surgical tool includes a longitudinal member having a longitudinal axis, a first end provided with an element for securing in rotation at least one end portion of the flexible member with the first end of the longitudinal member, and a second end provided with a handling element. The surgical tool also includes a guiding structure comprising a first end adapted to be applied against the body of the vertebral device, and at least one guiding element for guiding in rotation the longitudinal member about the longitudinal axis. The guiding structure maintains the longitudinal axis of the longitudinal member with respect to the body, whereby the rotation of the longitudinal member with the handling element produces the tensioning of the flexible member.

Abstract: Various exemplary methods and devices are provided for tensioning suture. The methods and devices are particularly useful in surgical suturing applications in which it is desirable to maintain tension on suture being delivered, yet to allow the tension to be released as desired without retracting the suture. Thus, when tension is released, a length of suture extended from the device can remain extended without any tension being applied thereto. Tension is only applied to any additional length of suture that is extended from the device. The tension applied to the suture is proportional to the length of the suture extended from the device until the tension is released and reset.

Abstract: A surgical guide wire or K-wire and method of use are provided. The K-wire, or guide wire, has opposite end portions and a shank portion in between. One end portion has a deformable end portion that, once outside of a confining guide passage, can be deformed to present a projected forward facing area that is larger than the transverse cross section of the K-wire, or guide wire, while in the passage. The increased area will provide increased resistance to additional forward axial movement into the surgical site.

Abstract: The invention relates to a surgery assistance system for guiding a surgical instrument. The surgical instrument (3) is fastened lo an arm system (10, 12, 14), the tip (S) of the surgical instrument (3) can be moved in a controlled manner by means of the arm system (10, 12, 14) in a Cartesian patient coordinate system (PKS), one of the three spatial axes (x, y, z) of the Cartesian patient coordinate system (PKS) extends through the surgical opening or the trocar point (T) receiving the surgical instrument (3). Advantageously, the angle of inclination (w) of the surgical instrument (3) is determined with respect to the spatial axis (z) of the Cartesian patent coordinate system (PKS) extending through the trocar point (T), the angle of inclination (w) so determined is compared with a predetermined set angle of inclination (ws) for the purpose of guiding the tip (S).

Abstract: An implantable intramedullary fixation structure adapted to be received in the intramedullary canal of a long bone is disclosed comprising a plurality of elongated segments. Each segment has a first end and a complementarily-shaped second end such that the first end of a segment cooperatively engages the second end of an adjacent segment. The segments define a guide aperture so as to be receivable over a guide for positioning in the intramedullary canal.

Abstract: An electronically guided spinal rod system for the placement of a spinal rod into the heads of pedicle screws and other types of bone fixation systems includes a bone screw inserter having rod access slots extending longitudinally for a length along the screw inserter, a rod detection system coupled to the rod access slots and a rod pusher for inserting a spinal rod through the rod access slots. The electronically guided spinal rod system insures that the spinal rod will be accurately positioned while allowing the operator complete freedom to choose its specific path into the screw inserter rod access slots.

Abstract: A cable tensioning apparatus and method are provided for positioning and tensioning a surgical cable to skeletal tissue or to implants. The invention is most applicable for securing surgical cable and/or orthopedic implants to bone in orthopedic surgery. A linearly translated drive rod attached to cable is driven by a friction drive to create tension on the surgical cable.

Abstract: Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes a tensioning mechanism adapted to couple to a tether extending along a path between at least two bone anchors implanted in adjacent vertebrae. The tensioning mechanism can be adapted to apply a tensioning force to the tether along the path of the tether to thereby move the tether along the path. The device further includes an actuation mechanism movably coupled to the tensioning mechanism such that the actuation mechanism is adapted to effect movement of the tensioning mechanism to control the tensioning force applied to the tether.

Abstract: A line lock includes a body at least partially bounding two passageways that cooperate to receive a locking portion of a line such as a suture in such a manner that the locking portion can only be drawn through the passageways along one direction. A second suture locking portion may also received by the passageways, or by one of the two passageways in combination with a third passageway. The body may have an elongated, compact shape that is easily implantable in the body.

Abstract: An expandable interbody fusion device includes superior and inferior plates that are configured to receive a sequentially inserted stack of expansion members or wafers. The superior and inferior plates include features that at least initially interlock the two plates until the superior plate is dislodged by pressure from the growing wafer stack. The wafers include features on their top and bottom surfaces that interlock the wafers in multiple degrees of freedom so that the wafer stack is not disrupted when the fusion device is fully expanded. Each wafer also includes features that interlock with the inferior plate until the wafer id dislodged by sequential introduction of another wafer.

Abstract: A cerclage device includes a base member, a cerclage member, and a drive member. The base member has a length sufficient to allow for manual holding by a user, an interior space extending from a distal end toward a proximal end, and a slot extending from the distal end toward the proximal end. The cerclage member has a long side with a proximal end and a distal end and a curvature in one direction about its long side at least at the distal end. The cerclage member allows for attaching a suture and fits within and is straightened by the base member within the interior space when in a retracted position. When the drive member is attached to the cerclage member movement of the engagement portion in the slot pushes and pulls the cerclage member to/from the straightened position from/to the extended curved position.

Abstract: Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes a tensioning mechanism adapted to couple to a tether extending along a path between at least two bone anchors implanted in adjacent vertebrae. The tensioning mechanism can be adapted to apply a tensioning force to the tether along the path of the tether to thereby move the tether along the path. The device further includes an actuation mechanism movably coupled to the tensioning mechanism such that the actuation mechanism is adapted to effect movement of the tensioning mechanism to control the tensioning force applied to the tether.

Abstract: A device for tensioning suture which includes a cannulated tube that allows a suture to be fed through at least a portion of the tube. An adjustment device (for example, a wheel or a knob) is actuated to turn a threaded post on the end of the tube. A length of suture passes through at least a portion of the cannulated tube and is secured into a forked pin attached to the adjustment device. Turning the adjustment device draws against the suture, increasing therefore the tension on the suture. The suture tensioning device may be employed in conjunction with a tensiometer.

Abstract: A wire or pin fixation and tensioning device has a wire post having a head portion with an opening having a predetermined longitudinal axis for reception of a wire or pin. The wire post has a neck portion for engaging an opening of the medical device. A locking element is adapted to be introduced into opening having an opening with inclined sections inclined to the longitudinal axis. A clamping cone abuts an abutment element and has a clamping opening to accommodate a wire and has outer surfaces inclined to the longitudinal axis and encompassed within the conical section of the locking element. Upon an axial displacement of the locking element relative to the cone a radial force is exerted onto the cone leading to a reduction of the diameter of the clamping opening to apply a radial force onto a wire or pin therein.

Abstract: A method for placing a fixation member around a bone for internal fixation of the bone includes (a) inserting a first member of a cerclage tool through an incision and into a vicinity of the bone, the first member extending from a first proximal end comprising a first handle portion and along a first central portion to a first distal end comprising a first bent tube portion; (b) inserting a second member of the cerclage tool through the incision and into the vicinity of the bone, the second member extending from a second proximal end comprising a second handle portion and along a second central portion to a second distal end comprising a second bent tube portion; (c) joining the first and second members together to form a continuous tube with the first bent tube portion and the second bent tube portion that encircles the bone, wherein the first bent tube portion and the second bent tube portion cross over one another to form a non-zero angle at a location that is proximal of the bone when viewed from a direct

Abstract: A tensioning tool and method for tensioning a conformable ligature of a bone fixing system are disclosed. The ends of a conformable ligature can be passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop. Another portion of the conformable ligature can be coupled to a tensioning tool. The tensioning tool can include a first portion and a second portion in threaded engagement with each other. Rotation of one portion relative to the other can cause tensioning of the conformable ligature through translation of a tensioning member.

Abstract: A tensioning tool and method for tensioning a conformable ligature of a bone fixing system are disclosed. The ends of a conformable ligature can be passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop. Another portion of the conformable ligature can be coupled to a tensioning tool. The tensioning tool can include a first portion and a second portion in threaded engagement with each other. Rotation of one portion relative to the other can cause tensioning of the conformable ligature through translation of a tensioning member.

Abstract: A method for attaching an elongated object to bone, the method comprising: forming a hole in the bone; positioning a loop of the elongated object in the hole; advancing a surgical wire into the bone so that the surgical wire is directed toward a location within the interior of the loop; and severing the surgical wire intermediate its length so as to create a distal portion and a remainder portion and, if the distal portion of the surgical wire does not extend through the loop, further advancing the distal portion of the surgical wire so that it extends through the loop.

Abstract: Apparatus for applying sustained tension on tether in treatment site includes a positioning mechanism, gripping mechanism and pressurized fluid actuated mechanism. The positioning mechanism is operable to position the pressurized fluid actuated mechanism at a fixed distance relative to treatment site, and to engage a target at treatment site and secure the tether proximate to the target. The gripping mechanism is operable to selectively grip the tether and maintain tether when tether is held in tension. The pressurized fluid actuated mechanism is selectively operable to apply desired pulling force on gripping mechanism directed away from treatment site so as to transmit and apply in a sustained manner the desired pulling force on the tether independently from the tether displacement and place it under desired level of tension while the tether is being secured.

Abstract: A tensioning tool and method for tensioning a conformable ligature of a bone fixing system are disclosed. The ends of a conformable ligature can be passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop. Another portion of the conformable ligature can be coupled to a tensioning tool. The tensioning tool can include a first portion and a second portion in threaded engagement with each other. Rotation of one portion relative to the other can cause tensioning of the conformable ligature through translation of a tensioning member.

Abstract: Described herein are devices and methods for positioning a wire around a target tissue. In some embodiments, a probe device includes a rigid outer cannula having a curved distal region and a flexible inner cannula slideably disposed within the rigid outer cannula, wherein the inner cannula is configured to assume a curved shape when extended distally from the outer cannula. In some embodiments, the probe device further includes a distal tip at the distal end of the inner cannula and a safety retainer cable coupled to the distal tip and secured to the probe proximally from the distal end of the safety retainer; wherein the safety retainer cable extends proximally from the distal tip and is slack. In some embodiments, the inner cannula comprises an elongate body with a longitudinally extending support member and a longitudinally extending tubular body, configured to pass a wire, disposed inside the elongate body.

Abstract: A method includes loading a longitudinal member comprising holes located at distal ends of the longitudinal member into a holder, the holder comprising a tip end comprising a first portion and a second portion, wherein any of the first portion and the second portion comprise a prong tip; a handle end located distally away from the tip end, wherein the handle end comprises a first gripping arm and a second gripping arm; and an engaging member operatively connecting the first gripping arm to the second gripping arm, wherein the engaging member comprises tooth-like features. The method further comprises engaging the tooth-like features of the engaging member with the second gripping arm; and fitting the prong tip of any of the first and second portions of the tip end of the holder into a hole of the longitudinal member.

Abstract: An orthopedic tool having a one-way lock bearing and a one-way actuator bearing for tensioning surgical cables around a bone and a method for using the same.

Abstract: An orthopedic tool having a one-way lock bearing and a one-way actuator bearing for tensioning surgical cables around a bone and a method for using the same.

Abstract: A tensioning tool and method for tensioning a conformable ligature of a bone fixing system are disclosed. The ends of a conformable ligature can be passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop. Another portion of the conformable ligature can be coupled to a tensioning tool. The tensioning tool can include a first portion and a second portion in threaded engagement with each other. Rotation of one portion relative to the other can cause tensioning of the conformable ligature through translation of a tensioning member.

Abstract: The invention relates to a resetting tool (1a), for the axial displacement of a Kirschner wire (2a), in particular, for application with bone plates, which may be implanted for the fixing of fractures. The above comprises a Kirschner wire (2a), comprising a thread in at least a part region and at least one guide tube (4a, 4b), by means of which the Kirschner wire may be positioned. A nut (3a) is provided, which is slotted and contains an internal drilling, such that the nut may be placed over the Kirschner wire and may be supported on the guide tube, whereby the Kirschner wire may be displaced in the axial direction by means of rotation of the nut.

Abstract: Apparatus and methods for repairing damaged tendons or ligaments. Various repair apparatus include an elongate tensile member and a pair of anchor assemblies connected for movement along the tensile member on either side of a repair site, such as a tear or laceration. The anchor assemblies or structures may take many forms, and may include barbed, helical, and crimp-type anchors. In the preferred embodiments, at least one anchor structure is movable along the elongate tensile member to assist with adjusting a tendon segment to an appropriate repair position and the anchor structure or structures are then lockable onto the elongate tensile member to assist with affixing the tendon at the repair position. Tendon and/or ligament-to-bone repair apparatus and methods employ similar concepts.

Abstract: The invention facilitates the fixation of bone fractures. In particular, the invention relates to a cap that has an inside surface comprising an interface component that is operable to engage a flexible wire. The flexible wire is connected to a head component that engages a first bone fragment. The outside surface of the cap may include cutting threads to facilitate attachment to a second bone fragment. A tensioner may be used to exert tension on the wire, the cap and the head component, thereby drawing the first bone fragment to the second bone fragment. In various embodiments, the cap is a planar disk that has a central hole that restricts backward translation and expands when the cap is translating down a wire.

Abstract: A tensioner for tensioning a wire/cable coupled to an external orthopedic device. The tensioner can include a housing, an outer sleeve movable relative to the housing, a movable tension actuator handle operable to move the outer sleeve relative to the housing, and a plurality of movable jaws supported in the outer sleeve. The jaws can move between an open position for receiving the wire/cable and a closed position for gripping the wire/cable when the tension actuator handle is operated.

Abstract: A wire retainer (10) for securing wire under tension comprising a body (11) having an exterior surface and a far end (11a) and a near end (11b) and a bore (12) extending therebetween in the general direction of a first axis (X) in a first plane (XY), the bore receiving an end of the wire (3) in use, a first slot (13) substantially in said first plane and having a far end which coincides with the far end of the body and a near end intermediate the far and near ends of the body, the first slot extending between said bore and said exterior surface and a second slot (14) intersecting said first slot at the near end thereof and at said bore.

Abstract: A suture tensioning apparatus for tightening the suture used to tie a tissue of a patient to the bone of the patient so that the tissue will cinch to the bone. A lever is mounted on a stub shaft that is supported to a base member and is movable in a lateral position. A pair of spaced spools are mounted on the lever and the reach of the suture is wrapped around each of the spools. Means, including a coil spring wrapped around the stub shaft is connected to the lever and a rotatable dome. The movement of the lever causes the lower portion of the coils to unwrap around the stub shaft, and rotation of the dome causes the upper portion of the coils to unwrap whereby the movement of the coil spring forces the lever to return to its original position. The tensioning apparatus can be incorporated into an existing suture gun or can be made integral therewith.

Abstract: Soft, flexible highly lubricious coatings for polymeric IOL insertion cartridges that allow IOLs to be easily inserted through small bore cartridges suitable for use with small (less than 3 mm) incisions are provided. These lubricious coatings allow IOLs to be inserted into the eye of a patient without the risk of lens damage or transfer of lubricants to the lens surface during implantation. Specifically, polymeric coatings comprising a matrix polymer having an equivalent weight greater than 5000 g/eq are used to form interpenetrating networks (IPN) on the surface of hydrophobic structural polymers. The IPNs thus formed entrap highly lubricious hydrophilic compounds within the IPN using multi-functional cross linkers.

Abstract: A device (1) for aligning a guide wire with a bone, comprising: an attachment means (2) reversibly attachable to a bone; an alignment means (31) connected to the attachment means, the alignment means being moveable so as to locate a portion of the bone for insertion of the guide wire. A method for aligning a guide wire with a bone.

Abstract: A bone-tying cable tightening device with improved easiness of handling of is disclosed. The device comprises a grip portion, a rod-like member extending forward, a knot supporter at the tip, a cable holder to grip and hold the tow arms together, and a sliding block mounted around the rod-like member and connected to a puller and an operation lever to drive the puller. The knot supporter supports two arms that can be hooked away from each other and laterally above the rod-like member, the cable holder is made up of a longitudinal through groove a locking recess which extends, at the end of the through groove, and a backward biased locking member which is provided movably back and forth behind the locking recess on the upper side of the sliding block made so that its forward movement is blocked when it fits in the locking recess.

Abstract: An apparatus for securing a cerclage member about a bone within a living body comprises a crimp including a first space extending longitudinally therethrough from a first space proximal opening to a first space distal opening, the first space sized and shaped to slidably receive a cerclage member therein and a second space extending parallel to the first space from a second space proximal opening to a second space distal opening, the second space including a proximal portion to receive the cerclage member and a distal portion decreasing in cross-sectional area and an insert that, when inserted into the second space distal opening adjacent to a cerclage member, a decreasing cross-sectional area of the second space distal portion forces the insert laterally relative to a longitudinal axis of the second space, pinching and locking the cerclage member against movement relative to the crimp.

Abstract: A method and devices for facilitating fixating and joining of bone fractures utilizing expandable devices that are positioned within the bone and across the fracture site. The stress from the expanded may enhance and expedite bone healing.

Abstract: A surgical instrument for holding and inserting a connection member of an osteosynthesis device into a retainer of a bone anchorage element comprises a distal end, a proximal end and a first connection portion at a distal end. The first connection portion comprises a connection member receptacle for receiving at least a portion of the connection member. The instrument further comprises a locking mechanism which is transferable from a release position, in which the instrument is releasable from the connection member, to a connection position, in which the instrument can be connected to the connection member. Moreover, an osteosynthesis device comprising at least two bone anchorage elements and at least a connection member is proposed, which further comprises a surgical instrument for holding and inserting the connection member into at least one retainer of the bone anchorage elements.

Abstract: A device for installation of a guide wire for a drilling tool in a correct positional arrangement in a bone. The device includes a tissue protection sleeve, which has at one end a laterally projecting grip or handle. A trocar is provided, which trocar can be introduced into the tissue protection sleeve from the handle end and whose other end is closed. The trocar is rotatable in the tissue protection sleeve and has a central bore hole and a plurality of eccentric axially parallel bore holes, through which a guide wire can be passed. A second handle is provided which extends approximately in the same direction of the first handle and whose one end engages the end of the trocar situated the outside of the tissue protection sleeve, so that the normally freely rotatable trocar is fixed in the direction of rotation relative to the tissue protection sleeve, when both handles are manually clamped against each other.

Abstract: The present invention relates to a vertebral fixing system adapted to be mounted on a vertebra of the spine to connect it to a rod. Said fixing system comprises: a connecting part adapted to face the rib and/or said transverse process and to be connected to said rod; an elongate flexible ligature adapted to connect together said connecting part and at least one rib and/or one transverse process; and adjustable locking means fastened to said connecting part and adapted to fix simultaneously in position said connecting part relative to said rod and at least one portion of said ligature relative to said connecting part, so as to prevent relative displacement of said rod and said vertebra in opposite directions.

Abstract: The disclosure relates to systems and methods of spinal stabilization. Embodiments include methods of delivering a rod having a non-circular cross-sectional profile using a wire having an accommodating non-circular cross-sectional profile to inhibit movement of a rod relative to the wire. A surgical system can comprise a first sleeve advanced via a first incision to a vertebra, a second sleeve advanced via a second incision to another vertebra, a wire having a non-circular cross-sectional profile advanced via a third incision to the vertebrae and passed through the collars of bone fastener assemblies to extend from a fourth incision. A rod or a segment of a rod having a corresponding non-circular cross-sectional profile may be aligned with the wire and advanced and coupled with the vertebrae to stabilize the spine. After the rod is securely seated in the collars, the wire may be withdrawn from the body.

Abstract: A cerclage tool for placement of a wire around a bone for internal fixation of the bone comprising a first member having a handle portion, a central portion and a first bent tube portion and a second member having a handle portion, a central portion and a second bent tube portion. The first member and the second member are configured and adapted to be inserted separately through an incision into soft tissue surrounding the bone and subsequently joined together after insertion such that the first bent tube portion and the second bent tube portion form a continuous tube that encircles the bone.