Abstract: A spinal surgical system includes at least two extenders extending proximally from respective ones of first and second anchors engaged to the spinal column. A connecting member is positionable between the at least two extenders such that the connecting member extends between the at least two extenders. The connecting member is movable distally along the at least two extenders and engageable to the first and second anchors.

Abstract: Novel orthopaedic bone screws/spinal pedicle screws and implants that include coatings to help promote a structurally stable interface between the implant and the patient's bone/tissue, and methods of coating such screws and implants are provided. The implants and methodologies described involve at least a coating that facilitates osseous integration, and additionally at least one coating that either reduces the risk of infection in immunologically suppressed patients and/or for utilization in patients who have infection, but who require stabilization, or coatings that permit the use of dissimilar metals and prevent galvanic corrosive reactions.

Abstract: A multiple screw dispensing apparatus and method for surgical applications includes a body and a screw set loaded within the body. The screw set includes a plurality of releasably coupled screws. A block is slidably mounted with respect to the body and abuts a head portion of the screw. After driving a screw into a material, another screw may be positioned for use by engaging the block.

Abstract: A surgical tool for inserting a surgical implant in a body and a method of performing a surgical procedure, wherein the tool is composed of materials consisting essentially of radiolucent materials. In one embodiment the radiolucent materials comprise plastic. In another embodiment the radiolucent materials comprise carbon fibers. In still another embodiment the radiolucent materials comprise thin aluminum. The tool has a torque capacity of at least 6 Nm.

Abstract: A system is provided with a screwdriver and a bone screw (30), wherein the screwdriver has a tool (4), which is provided with at least two radially and axially extending tool blades (5, 6, 7, 8), which can be caused to engage groove-like blade slots (36, 38) of the bone screw (30) in a positive-locking manner. To improve the handling of a bone screw (30) even in case of the smallest possible dimensions, provisions are made according to the present invention for the tool blades (5, 6, 7, 8) to form at least one elastic clamping section (20, 21, 22, 23), with which the tool (4) can be caused to clampingly engage the bone screw (30) in the area of the blade slots (36, 38).

Abstract: A surgical screwdriver is disclosed and can include a motor, a microprocessor coupled to the motor, and a key sensor coupled to the microprocessor. The key sensor can be configured to sense a key tag.

Abstract: An instrument attachment mechanism is disclosed that is operable to be temporarily, but securely, connected with a surgical device. The attachment mechanism includes a body that has a drive member protruding outwardly from a portion of the body. The drive member includes a plurality of side walls and a passageway running from a bottom surface of the drive member to a predetermined depth in the drive member. At least one slot is located in a respective one of the plurality of side walls that extends through the side wall into the passageway. A biasing member is positioned within the passageway such that a select portion of the biasing member protrudes outwardly from the slot. A surgical device, such as a surgical instrument or implant, may be temporarily connected with the drive member such that the select portions of the biasing member apply force to an inner wall of a drive receiving member of the surgical device.

Abstract: A method is provided for detecting neural interference between a bone anchor and a neural element during or subsequent to the application of force on the bone anchor to adjust the orientation of one or more vertebral bodies relative to the spinal column. The method includes engaging at least one bone anchor to the vertebral body and applying force to the bone anchor to adjust the positioning or orientation of the vertebral body. A nerve monitoring system provides an electrical signal and is operable to detect a neural element and its proximity to the bone anchor as a function of a characteristic of the electrical signal.

Abstract: A screw holding device has a screw engaging part and a fixation sleeve. The screw for use with the screw holding device has a head and a shaft. The head of the bone screw has a recess and a notch. The screw engaging part has two halves with a hook formed on each half. The hook is shaped to fit in the notch. A fixation sleeve slides over the screw engaging part. When the fixation sleeve is pulled in proximal direction, the two halves of the screw engaging part are able to flex easily towards each other and thereby are insertable in the recess. When the fixation sleeve is moved towards the distal end of the screw engaging part, the two halves of the screw engaging part are prevented from flexing towards each other and thereby rigidly lock the screw and the screw engaging part together.

Abstract: Instruments and methods are provided for delivering multiple implants to multiple implant locations in a patient without requiring a second implant to be loaded onto or engaged to the delivery instrument after delivery of a first implant. The implants can be sequentially engaged using the delivery instrument to the patient or to receptacles of one or more receiving members secured to the patient.

Abstract: An implant for resurfacing a joint and a driver for the implant. The inserter attaches to the head of the implant. The inserter is designed to facilitate the handling and insertion of an implant at a surgical site. The inserter is provided with a plurality of arms that securely engage a plurality of indents on the edge or periphery of the implant.

Abstract: A screwdriver for bone screws, especially for compression screws and locking screws, has a handle and shaft extending out centrally from the handle. The shaft has a screw-driving tool on its free end. The shaft, includes a flexible shaft portion, wherein the shaft has two rigid, solid portions on both sides of the flexible portion. The flexible shaft portion has a flexible element for the transmission of a torque, and at least the flexible shaft portion is surrounded by an elastic protection hose or a rubber or plastic elastomeric tubular cover.

Abstract: A tool for driving a workpiece during surgical procedures has a handle. A gear with teeth thereon is rotatably supported along an axis within the handle. Two pawls are pivotally supported by the handle adjacent the gear and are orbital about the axis upon rotation of the handle. Each pawl has teeth that engage the gear teeth to transmit torque from the handle to the workpiece. Two springs yieldingly urge the pawls into engagement the gear teeth. A cap, with an actuator thereon, is rotatable with respect to handle. The cap has a first position in which the actuator retracts the first pawl out of engagement with the gear teeth, a second position in which the actuator retracts the second pawl out of engagement with the gear teeth, and a third position in which neither the first pawl nor the second pawl is retracted by the actuator.

Abstract: Apparatus, methods, systems, and kits related to surgical procedures and instruments are disclosed. In one aspect, a method for securing a fixation device to a driver for use in a surgical procedure is disclosed. The method comprises engaging a first portion of the driver with the fixation device to limit rotational movement of the fixation device relative to the driver; and engaging a second portion of the driver with the fixation device to limit axial movement of the fixation device relative to the driver; wherein engaging the second portion of the driver with the fixation device comprises actuating an actuator of the driver to cause the second portion of the driver to move relative to the first portion of the driver. In other aspects, surgical drivers, surgical kits, and surgical procedures are disclosed.

Abstract: The invention may be characterized as a method, apparatus and bone-fixation system. The system includes a plurality of drivers, each of the drivers including a handle coupled to a shaft, the shaft including a distal tip opposite the handle that is configured to couple with a head of a surgical fixation element, each of the drivers including indicia of a particular length and a particular diameter; and a plurality of surgical fixation elements, each of the plurality of surgical fixation elements being detachably coupled to the distal tip of a corresponding one of the drivers that has indicia of the length and diameter of the fixation element coupled to the driver.

Abstract: A rod reduction instrument for position a rod relative to a seat of a bone anchor in a spinal implant system is provided. The instrument includes three concentric cannulas with circumferentially aligned rod receiving portions formed therein. One cannula is movable with respect to another to lock and unlock the seat of a bone anchor to the rod reduction instrument. The rod to be reduced is positioned inside at least one of the rod receiving portion. One cannula is moved with respect to another to lock the seat of the bone anchor to the rod reduction instrument. Once locked to the bone anchor, the remaining cannula is moved to reduce the distance between the rod and the seat within at least one of the rod receiving portions. The distance between the rod and the seat is reduced until the rod is position inside the seat. A secondary instrument is inserted through a central bore of the rod reduction instrument to introduce a cap and lock the cap to the seat securing the rod to the bone anchor.

Abstract: An orthopedic jig and pins therefore are disclosed that allow the pins to be pre-loaded into apertures through the jig before the jig is positioned at a desired location with respect to a bone during an orthopedic surgical procedure. At least one of the pin and/or jig includes a retention mechanism whereby the pin can be inserted into the bore and releasably restrained therein until the jig is place in the selected position and the pins driven into the bone.

Abstract: A polyaxial screwdriver for inserting a bone screw in a vertebra. A polyaxial bone screw assembly includes a coupling element. When a screw engaging end of the polyaxial screwdriver is lowered on the head of the bone screw, the complimentary surfaces of the screw engaging end of the screwdriver and the head of the screw self-align. A ratchet mechanism formed in the screwdriver provides progressive and automatic locking of the polyaxial screwdriver to the coupling element and prevents the accidental unthreading from the coupling element. In another embodiment of the polyaxial screwdriver, a collet slides over the outside surface of the upper end of the coupling element and locks on to the coupling element. In yet another embodiment of a polyaxial screwdriver, the outer sleeve of the polyaxial screwdriver has a split end that securely engages the coupling element.

Abstract: A method may include rotating a threaded fastener at a first rotational speed to provide a kinetic energy force component for the fastener based on the first rotational speed and driving the fastener into a structure based on the rotating. The structure may provide a torsional resistance during the driving greater than a torsional strength of the fastener. The driving may provide a torque force component applied to the fastener. The driving may cut threads into the structure with the fastener. The driving may apply a total force to the structure from the fastener including the kinetic energy force component and the torque force component. The total force applied by the fastener may be greater than or equal to a force required for the cutting. The torque force component may be less than a torsional strength of the fastener.

Abstract: In a screwdriver for bone screws, having a handle and rotationally fixedly held thereon a shaft, the free end of which has a non-circular cross section and is insertable in a positively locked manner in a non-circular receiving opening in the head of a bone screw, at least one expander element being mounted so as to be displaceable in the longitudinal direction in the shaft and so as to slide, when displaced in the longitudinal direction, along a slide surface in the area of the free end of the shaft in such a way that it projects laterally over the contour of the shaft, in order to simplify the actuation of the at least one expander element, it is proposed that the at least one expander element be pretensioned by an elastic spring element in the direction towards the free end of the shaft and be retractable against the action of the spring element in the shaft until it no longer projects laterally over the contour of the shaft.

Abstract: A surgical driver includes an elongated drive shaft engageable with a surgical bone anchor in torque transmitting relationship, a locking sleeve, and a sleeve locking member. The locking sleeve is mounted to the drive shaft and is engageable with the head of surgical bone anchor. The sleeve locking member is mounted for relative motion between a first position in which it is simultaneously engaged with both the drive shaft and the locking sleeve in rotationally fixed relationship and a second position in which it is disengaged from the rotationally fixed relationship with at least one of the drive shaft and locking sleeve.

Abstract: An instrument for manipulating a bone anchor and, in turn, a vertebral body to which the bone anchor is attached. The exemplary instrument includes an inner shaft, an anchor engagement mechanism, and an outer sleeve disposed about the inner shaft. The exemplary instrument may be employed to manipulate a bone anchor for implantation or adjustment. The exemplary instrument may also be use engage a bone anchor implanted in a vertebra and maneuver the bone anchor and the vertebra by manipulating the instrument. For example, the exemplary instrument may be employed to rotate the bone anchor and the vertebra relative to other vertebrae and thereby by correct the angular orientation of the vertebra. The instrument, when employed in the exemplary manner, thus may be used to effect segmental correction of the angular orientation of the vertebrae of the spine.

Abstract: An assembly and method for performing a bone shortening osteotomy are provided. The present invention provides an assembly for performing a shortening osteotomy on a bone comprising a main guide configured to be coupled to the bone and to guide at least one cut into the bone. The assembly also includes at least a first interchangeable bone resection guide configured to engage the main guide and guide at least one cut into the bone wherein the cuts formed using the main guide and the first interchangeable bone resection guide cooperate to define two bone segments. The two bone segments are compressed together and affixed to promote healing of the bone.

Abstract: A suture anchor and inserter arrangement, including a suture anchor configured for implanting in hard tissue, such as bone, and an inserter device for installing the anchor in hard tissue. The suture anchor includes at least one eyelet formed from suture material at a proximal end thereof, which eyelet cooperates with a working suture associated with the inserter device. The working suture is engaged with the eyelet of the implanted anchor, and can be utilized to anchor soft tissue to hard tissue.

Abstract: The present invention is a minimally invasive surgical method for fusing adjacent vertebrae. A first K-wire is inserted into the spinous process of an upper vertebrae. A second K-wire is inserted into a transverse process of a lower vertebrae. A first fixation block is secured to the first K-wire and a second fixation block is secured to the second K-wire. A rod member extends across the K-wires. A swivel block assembly is secured to achieve a desired angle for a first axis along which a first screw will be implanted into a facet joint. The swivel block assembly is secured at a desired axial position on the rod member. Percutaneous access to the upper vertebrae along the first axis is then obtained via a cannula. A removable screw having a threaded section for implantation across the facet joint and an elongated shank section that is shearable subcutaneously is inserted through the cannula. The threaded section is implanted along the first axis across the facet joint to attach the upper and lower vertebrae.

Abstract: A clip for retaining a screw on a tip of a screwdriver shaft. The clip comprises a housing that has a first end and a second end and a longitudinal axis extending therebetween. The housing includes a longitudinal bore that is accessible from both the first and second ends of the housing. A pair of jaw members is provided on the housing proximate the first end thereof. The jaw members surround a first portion of the bore and are configured to capture and retain a length of the screwdriver shaft therebetween. A pair of clamping members is formed on the housing proximate the second end thereof. The clamping members surround a second portion of the bore and are configured to capture a head of the surgical screw therebetween. During use, the screwdriver shaft is pushed downwardly and twisted slightly within the bore to engage the head of the screw. The screw is threadably engaged in a pre-drilled hole in the patient's bone.

Abstract: A surgical instrument for applying and fixing a fixation screw to a threaded section of a head of a bone anchorage element comprises a distal end and a proximal end, a first tool member and a second tool member. The first tool member is arranged at the distal end and adapted for engaging the threaded section of the bone anchorage element head. The second tool member is adapted for engaging a tool-engaging member of the fixation screw. The instrument is constructed such that in a working position of the instrument the second tool member is supported on the instrument in a torque proof manner relative to the first tool member about a longitudinal axis and is movable parallel to the longitudinal axis relative to the first tool member. Moreover, an osteosynthesis device comprising at least two bone anchorage elements and at least one connection member is suggested. Further, a method for fixing an osteosynthesis device on two vertebrae of a spinal column in a minimal invasive manner is proposed.

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 cannulated driver including an elongate body having an internal wall defining a longitudinal bore extending substantially the entire length of the elongate body. A cannulated bone screw including a threaded shaft, a head, and a longitudinal bore extending entirely through the threaded shaft and the head of the cannulated bone screw. In one exemplary embodiment, the exterior surface of the head of the cannulated bone screw may include an indentation formed therein. The indentation may be any shape, such as a semi-circular shape. The indentation may be configured to mate with a corresponding projection on the internal wall of a cannulated driver to rotationally lock the cannulated bone screw relative to the cannulated driver.

Abstract: Instruments and methods are provided for delivering multiple implants to multiple implant locations in a patient without requiring a second implant to be loaded onto or engaged to the delivery instrument after delivery of a first implant. The implants can be sequentially engaged, using the delivery instrument, to the patient or to receptacles of one or more receiving members secured to the patient.

Abstract: A surgical device suitable for use in spinal fusion of the cervical vertebrae is provided. The surgical device includes an inner tubular body and an outer tubular body. The inner and outer tubular body each has a lengthwise region and a distal portion with a discontinuous wall forming a fenestration. The fenestrations are alignable to provide a passage through the wall of the surgical device. The surgical device may provide any of several benefits, including unobstructed access to a surgical site, greater stability, and improved tactile control.

Abstract: Disclosed herein are methods and devices for securing soft tissue to a rigid material such as bone. A non-metallic bone anchor is described that comprises a base and a top such that suture material may be compressed between surfaces on the base and top to secure the suture to the anchor by ultrasonically welding the surfaces. Also described is an inserter/welder that can be used to insert the bone anchor into bone and move the anchor top relative to the anchor base to clamp suture material there between and to weld the suture material within the clamping area.

Abstract: A percutaneous tower for the orthopedic procedures. The tower can include an outer elongated member, an inner elongated member received within the outer elongated member, a release actuator operable to move the inner elongated member relative to the outer elongated member between first and second positions, and a fastener engagement member coupled to a distal portion of the tower and operable to engage a bone fastener when the inner elongated member is in the first position, and to disengage the bone fastener when the inner elongated member is in the second position.

Abstract: An apparatus and method for use in aspirating bone marrow is provided. The apparatus comprises a tube which has a body with a distal end portion. The tube has a central opening at one end of a central passage extending through the tube and through which bone marrow is aspirated. The tube is also tapered. A thread convolution on the body of the tube at the distal end portion of the tube is also provided as an alternate design. At least one aspiration opening between the central opening and the thread convolution is used to further aspirate bone marrow.

Abstract: An implantation device for implantation in a target structure such as a bone includes a base region. The base region includes a connecting portion, wherein the connecting portion is adapted to interact with a coupling region of a handling device. In particular, the connecting portion and the coupling region may be engageable with each other. The device may be polymeric and is capable of being softened by mechanical energy such as sound energy.

Abstract: An implantation device and method for applying the same has an implantation device for implantation in a target structure such as a bone. The implantation device comprises a shaft region, wherein the shaft region has at least one protrusion. The protrusion comprises a material which is modifiable by using mechanical energy. In particular, the modifiable material may be liquefiable and/or shearable by the mechanical energy. Preferably, the material may be adapted in such a way that the modifications may be achievable by a mechanical energy input which does not destroy human tissue.

Abstract: A scissor-action screwdriver and screwdriver attachment comprises a plurality of arms pivotally attached to one another; a bias element mounted in at least one of the plurality of arms; and a sleeve slidably mounted around at least one of the plurality of arms, wherein the plurality of arms comprise a first arm and a second arm, and wherein each of the plurality of arms preferably comprise a prong end. The screwdriver attachment further comprises a stop component adapted to limit a distance of separation between the first arm and the second arm. Additionally, the bias element may comprise a spring. Moreover, each of the plurality of arms preferably comprises a tapered section, wherein the sleeve comprises an inner tapered wall adapted to engage the tapered section of each of the plurality of arms. The screwdriver further includes a handle connected to the second arm.

Abstract: A drive tool for accepting and rotationally locking the head portion of an orthopedic screw, such as a dental implant, to impart driving torque to the screw. In one exemplary embodiment, the drive tool includes an elongate body having an opening at its proximal end which is sized to receive the head portions of at least two different dental implants, the head portions of the dental implants being oriented at different angles with respect to the implant body portions. When the head portion of an implant is received within the opening, the drive tool is rotationally locked with respect to the implant. In this position, the body of the drive tool remains oriented so that same is substantially colinear with the body portion of the implant. Although the invention is described in the context of a drive tool used with a dental implant having a body portion and a head portion or abutment portion, the invention is more broadly applicable to drive tools which may be used with other types of orthopedic screws.

Abstract: An internal pedicle insulator apparatus, comprises an inner insertion rod having a top end and an opposing bottom end; and an outer insertion rod having an upper end and a lower end. The outer insertion rod being arranged and configured to substantially correspond to the inner insertion rod. The inner insertion rod is arranged and configured to slidably engaged inside the outer insertion rod and the inner insertion rod and the outer insertion rod are arranged and configured to position an internal pedicle insulator implant. A method of use is also provided.

Abstract: The tightening instrument is made up of two parts (2,4) joined to each other by means which are designed to automatically uncouple the said two parts (2,4) by shearing rupture of a pin (8) when a predetermined tightening torque is reached, a first (2) of the two parts being provided with a means (3) permitting driving, characterized in that the second (4) of the two parts is a rod whose end (5) opposite its tightening end (6) is adapted to be introduced into a complementary recess (7) formed in the first part (2), and in that the said end (5) includes an axial reservoir (15) for receiving the broken end section (18) of the pin (8).

Abstract: The present application is directed to screwdrivers and methods of use for applying a controlled amount of torque to a fastener. In one embodiment, the screwdriver includes a shaft constructed of a material that is deformable upon the application of an excessive amount of torque. The deformation may cause the screwdriver to disengage from the fastener. In one embodiment, the tip of the shaft that engages the fastener is constructed of a material that deforms when an excessive amount of torque is applied to the fastener. The deformation causes the tip to disengage from the fastener. The deformation prevents the screwdriver from applying an amount of torque above a predetermined limit.

Abstract: This invention relates to an apparatus for incrementally advancing functional probes through tissue.

Abstract: Instruments and methods are provided for positioning one or more implants into a spinal disc space. The instruments and methods have application in an anterior lateral approach to the disc space between the L4 and L5 vertebrae. The instruments include a distractor, a housing, a guide member to facilitate positioning of the housing, and a partition member engageable to the housing to facilitate positioning of one or more implants into the disc space.

Abstract: A bone plating system invention is shown comprising a bone plate and bone fasteners. The bone plate has a top portion, a bottom portion, and an interior middle portion. The fastener-retaining passageway extends through the plate. The fastener-retaining passageway comprises an upper portion having an inwardly projecting capture lip. The capture lip has a first diameter. The fastener-retaining passageway also has a middle undercut portion that has a second diameter. The second diameter is larger than the first diameter. The plate also has at least one access channel extending through the capture lip so as to communicate with the interior middle portion of the plate. The fastener comprises a shaft, a fastener engager means extending from, disposed on or coupled with the shaft for engaging bone and a head mounted on the shaft having a radially elastic member.

Abstract: A surgical instrument holder has a shank having a coupling end, a handle attached to an opposite end of the shank, a coupling device, and a locking mechanism. The coupling end has an interface thereon for receiving an instrument. The locking mechanism has an annular locking component, a spring, a ring which slides on the shank, and a locking device. The annular locking component is mounted so as to slide along the shank. The locking device cooperates with the locking component so as to lock the instrument onto the interface. The spring biases the locking component in a locking direction and bears on the ring. The ring is disengageably lockable to the shank via a connection device so as to enable quick disassembly for cleaning and component sterilization.

Abstract: An instrument guide and implant holding device is provided which releasably secures an implant to the instrument guide. The device provides a convenient guide for surgeons to perform various operative techniques on the subject bone without the need for separate devices, and allows all these operative techniques to be performed without removing the instrument guide from the dissected area until all operative techniques have been completed. The releasable mechanism allows the surgeon to easily hold the instrument to an implant using a simple press-fit approach, and easily releases from the implant with a minimal amount of force. An embodiment also allows the surgeon to releasably lock the cannula in a given orientation about the centroidal axis of the implant fastener hole.

Abstract: A surgical driver for use with an implant, having a shaft with proximal and distal ends and an attachment piece with proximal and distal ends. The surgical driver including a coupling arrangement that couples the shaft and the attachment piece relative to one another. The coupling arrangement includes a recess formed at the proximal end of the attachment piece and has at least one retaining member for reversibly engaging the shaft. The coupling arrangement is adapted to accommodate interaction between the surgical driver and an implant so that variable-axis torque on the implant is minimized.

Abstract: The method of making a tool for removal of broken screws from a base material, including the material of the bone of a medical patient. One end of the tool has an open bore with interior, left-hand tapered screw threads formed thereon by compressing the tool to form the taper after the threads are formed and presented in a cylindrical shape. The other end of the tool is solid for accommodating a driving tool which rotates the tool in the removal of the broken screw.

Abstract: An instrument for inserting, adjusting and engaging an implant, such as a polyaxial screw of a spinal fixation system, includes at least one retratractable tab for engaging a corresponding recess on the implant and a shaft that moves relative to the retractable tab. The movable shaft selectively moves the tab between an expanded position for engaging the recess and a retracted position out of engagement with the recess. The shaft selectively engages a portion of the implant to rigidify the implant after the retractable tab engages the recess. The axially extending shaft may be disposed within an axially extending passageway of a body assembly. A rotatable collar surrounding the body assembly is coupled to the shaft for moving the shaft relative to the retractable tab.

Abstract: A warming device includes a clinical garment having an inside surface supporting a convective apparatus with separately-inflatable sections, each adapted to enable a particular mode of warming. Each section has a surface or region with a permeability that varies from the permeability of a surface or region in another section.