Abstract: A method and tool for driving a bit. The tool includes a handle extending along a longitudinal axis between a first end and a second end. The handle can be in a first configuration to provide a first drive ration. In a second configuration, such as a T-shaped configuration, a gear assembly can be disengaged to provide a second drive ratio for the bit driving system.

Abstract: A fluid delivery and bone screw driver apparatus attaches to a bone screw. An inner sleeve joins a material delivery source connected to one end of the inner sleeve to the bone screw connected to the other end. A removable liner communicates the material through the inner sleeve and into the bone screw. An outer sleeve seals the outer sleeve to the head of the bone screw. Rotating the outer sleeve tightens the seal and rotates the bone screw.

Abstract: In one embodiment, a bone-fastening system includes a handle, a barrel assembly connected to the handle, and a bridge assembly connected to the barrel assembly. The bridge assembly may be configured to receive a first connector element and a second connector element in axial alignment with the first connector element so as to receive a fastening element between the first and second connector elements. The system may also include a control configured to, upon actuation, approximate the first connector element and the second connector element so as to apply compressive pressure to bone portions positioned between the first connector element and the second connector element. A drive mechanism configured to advance the fastening element through the bone portions and connect the first connector element with the second connector element to fasten the bone portions under compression may also be provided with the system.

Abstract: Systems and methods for bone anchor removal include a removal guide and a removal instrument. The removal guide includes grooves for guiding the removal instrument to the anchors, and for guiding removal of the anchor. The removal instrument includes a distal working end with a grasping feature designed to engage a portion of the bone anchor and an engagement feature designed to engage the grooves of the removal guide for anchor removal.

Abstract: A surgical instrument for applying a rotational force to a structural element during a surgical procedure. The instrument may be designed for increasing an input force to produce an enlarged output force adequate for fracturing an excess section of the elongated element from a remainder of the structural element. The instrument may include an input mechanism that receives an external rotational input force, a planetary gear system that multiples the input force, and an output mechanism that attaches to and delivers the multiplied rotational output force to the excess section of the structural element. The output mechanism may also be configured to capture the separated excess section. The instrument may include a housing and a handle for grasping and manipulating during the surgical procedure.

Abstract: The present invention is directed to a release mechanism for removing and/or releasing a locking cap from the head of a bone anchor in situ. The release mechanism includes a sleeve, an anchor coupling member and a knob. The anchor coupling member is located within the sleeve and the knob engages both the anchor coupling member and the sleeve. The distal end of the sleeve and anchor coupling member engage the bone anchor causing the bone anchor to splay from the locking cap. A driver may be inserted into the central bore of the release mechanism to release any further threaded engagement of the locking cap and the bone anchor.

Abstract: A variable angle locking screw assembly that includes a plate material, a screw, and a washer at least partially located within the plate material, the washer and screw cooperating to create a wedge locking the screw in one of a plurality of axial and rotational positions, where the locked position may be undone and adjusted by manipulation of at least one of the screw and washer.

Abstract: Apparatus, systems, and methods for spine surgery employ a guide wire temporarily anchored to a contralateral side of an intervertebral disc. The guide wire establishes a reliable pathway for passage and actuation of cannulated instruments or implants through a small working channel leading to an ipsilateral side of the disc. The guide wire may be disconnected and removed from the disc after use.

Abstract: In one aspect of the disclosure, an intramedullary (IM) apparatus for treating a fractured bone of an animal includes an IM nail elongated along a longitudinal axis and having at least three locking holes equally distantly defined thereon along the longitudinal axis, and a positional reference member having a longitudinal vernier scale thereon. The IM nail is configured to be inserted to a medullary cavity of a bone fragment, such that the IM nail is fixable to the bone fragment by a locking member correspondingly inserted into one of the locking holes through the bone fragment. The positional reference member is configured to be detachably mounted to the IM nail by two positioning members inserted into two of the locking holes such that the longitudinal vernier scale is parallel to the longitudinal axis of the IM nail, and each of the locking holes is locatable by the longitudinal vernier scale.

Abstract: A novel cross-pin for use in ACL reconstructive surgical procedures. The cross-pin has an elongated body having a distal tapered end. A guide wire opening in the distal end is in communication with a tunnel contained in the distal end. There is a trough extending into the outer surface of the trough for receiving a guide wire. The trough is in communication with the tunnel.

Abstract: Devices, systems, and methods are provided for applying a controlled amount of torque during a surgical procedure. In one exemplary embodiment, after the amount of torque applied reaches a threshold amount, a modular driver tip can be deformed, for instance by breaking into pieces. A containment shield disposed around at least a portion of the tip is configured to receive at least a portion of the tip after it is deformed. In one aspect, multiple modular driver tips can be disposed in a cartridge, with a distal-most tip being held by a driver tip holder that has a holding force that is greater than a threshold torque value of the tip. Exemplary methods for operating surgical drivers and systems that include tips that deform at a threshold torque value, and a multitude of embodiments of tools and systems, are also provided.

Abstract: Embodiments of the invention are directed to a distal interphalangeal (“DIP”) fusion device for connecting a first bone of a patient to a second, adjacent bone of the patient. The device may include an anchor assembly and a compressor assembly. In another embodiment, a separate compressor base assembly is included. In yet another embodiment an access port assembly is included. The anchor assembly is rotationally coupled to one end of the compressor assembly, such that the compressor assembly may rotate about the anchor assembly within a semi-spherical zone (three degrees of rotational freedom) and translate axially (one degree of translational freedom). In an operative position, the anchor assembly is anchored in an intermediate phalanx of a digit of a patient, the compressor assembly is contained in a distal phalanx of the digit, and the distal phalanx is flexed relative to the intermediate phalanx to create a joint angle.

Abstract: A cannulated medical instrument for insertion of a medical device over a guide wire generally includes a cannulated driver member configured to engage the medical device and insert the medical device at an insertion rate. A clasping device connects to the cannulated driver member. The clasping device moves the guide wire distally away from the cannulated driver member at an extraction rate upon rotation of the cannulated driver member.

Abstract: A bone anchoring device has an anchoring element, a receiving portion, and a pressure element. The anchoring element includes a shank to be anchored in a bone or a vertebra and a head, the head having an exterior surface with a spherical segment-shaped portion. The shank and the head are separate parts. The receiving portion includes a first end, a second end opposite to the first end, a longitudinal axis passing through the two ends, a bore coaxial with the longitudinal axis, and a first region adjacent to the second end for receiving a spherical segment-shaped section of the head. The pressure element exerts pressure on the head to lock the head in the receiving portion. The head has a hollow inner portion to receive a free end portion of the shank and wherein the head and the end portion are formed such that the end portion can be elastically clamped by the head.

Abstract: A screw for fixation of, for example, a fracture having a hollow shaft, a first outer thread and radial openings at its distal end, and a second outer thread and an inner engagement portion at its proximal end. The second outer thread is adapted to engage with a tissue protection sleeve. The inner engagement portion is adapted to fit to a driving end of a driving tool. By way of this, forces in axial or radial direction may be applied to the screw by the sleeve, and forces in rotational direction may be applied by the driving tool. Therefore, the screw can be installed accurately at the intended site in an object.

Abstract: A method and apparatus for percutaneous and/or minimally invasive implantation of a construct. The construct may be implanted using a navigation system for planning and execution of a procedure. A plurality of portions of the construct may be interconnected using locations and paths determined and navigated with the navigation system.

Abstract: An orthopaedic alignment guide component is provided for preparing a patient's bone socket, such as the glenoid of the patient's scapula, to receive a prosthetic glenoid component. The orthopaedic alignment guide component includes a guide body for inserting a guide pin into the patient's scapula and an inferior referencing arm for referencing an inferior surface of the patient's scapula.

Abstract: A trajectory structure is configured for contact with a surface to dictate an insertion trajectory of a pin relative to the surface. A location structure is configured to allow longitudinal passage of at least a portion of the pin therethrough to dictate an insertion location of the pin relative to the surface. An elongate handling rod is connected to the trajectory structure and the location structure. The handling rod supports the trajectory structure and the location structure for manipulation by a user. The handling rod spaces the trajectory structure and the location structure longitudinally apart. The trajectory structure is connected to the handling rod for trajectory adjustment in at least two degrees of freedom relative to the handling rod. The insertion trajectory of the pin insertion is substantially dependent upon the trajectory adjustment. A method for inserting an elongate guide pin into a bone surface is also provided.

Abstract: The various embodiments disclosed herein relate to implantable devices for the treatment of structural bone and joint deformity, including hallux valgus. More specifically, the various embodiments include systems, devices, and methods for implantation of an implantable device having at least one bone anchor with deployable prongs for treating such deformity.

Abstract: A surgical instrument includes a first member extending between a proximal end and a distal end. The distal end includes a plurality of fingers extending radially outward in a tapered configuration. A second member extends between a proximal end and a distal end. The proximal end of the second member is configured for mating with the distal end of the first member. A third member has an inner surface defining a cavity configured for disposal of the first member and engagement with the first member to fix the first member with the second member. Systems and methods are disclosed.

Abstract: A surgical fastener system includes a plurality of fasteners having a throughbore with a non-circular cross section portion. The fasteners may engage with a splined mandrel that passes through the throughbore of the fasteners and rotates the fasteners relative to the mandrel to move at least one of the fasteners along the mandrel, e.g., along the mandrel's longitudinal axis. A distal end of the mandrel may be inserted into a material, such as a tissue, prosthetic or other, and a fastener may be deployed from the distal end of the mandrel while the distal end is positioned in the material.

Abstract: An apparatus for locating a central axis of a spinal column and method of using the same is disclosed. The apparatus and method includes one or more members capable of spanning a center line which may then be identified by at least one additional member positioned therebetween. Furthermore, the device may contain or be capable of accommodating various additional tools for marking the location of the central axis of a spinal column.

Abstract: A surgical instrument includes a first member that defines a longitudinal axis. The first member extends between a proximal end and a distal end. The distal end is configured to engage an outer surface of a first implant. A second member includes an inner surface that defines a cavity. The cavity is configured for disposal of the first member. The second member is engageable with a second implant connected to the first implant. An actuator is connected to the first member in a configuration for moving the second member into engagement with the second implant such that the second implant axially translates along the outer surface of the first implant. Systems and methods of use are disclosed.

Abstract: A working tower for gripping a correction screw during minimally invasive surgery and playing a role of a working surface for other external devices is provided, which includes an exterior pipe, an interior pipe slidably provided within the exterior pipe, a driving sleeve rotatably connected to the exterior pipe and screw-coupled to the interior pipe to move the interior pipe upward and downward along a lengthwise direction thereof during rotation, and a screw holder provided on a lower end of the interior pipe, and is elastically split apart to receive a head portion of the correction screw when withdrawn from the exterior pipe, and contracted to securely hold the head portion when inserted into the exterior pipe.

Abstract: A surgical implant driver includes a member defining a longitudinal axis and including an engagement portion. The engagement portion includes a first surface and a second surface disposed in a serial configuration along the longitudinal axis. The first surface includes a drive interface engageable with a first surface of an implant fastener and the second surface includes at least a retention interface engageable with a second surface of the implant fastener. Systems and methods are disclosed.

Abstract: A boring instrument guiding device which is used to guide a boring instrument that forms a pilot hole for embedding a pedicle screw in a vertebral pedicle includes a reference pin which is used as a reference by being inserted into the vertebral arch from the rear to the front of a spine, and an arm which extends sideward from the proximal end side of the reference pin, and is characterized in that a plurality of guide holes, each of which is opened toward the tip position of the reference pin to guide the boring instrument, are formed in the arm in a radial pattern centered at the tip position of the reference pin. It is possible to provide a boring instrument guiding device which is capable of more easily and precisely guiding the boring instrument.

Abstract: The insertion tool and pusher system of the present invention includes a bone screw having a head and a shaft. An annular washer is adapted to be mounted on the bone screw shaft. An insertion tool having a longitudinally extending shaft with an axial bore therethrough is provided for receiving the bone screw. The shaft has a first end with a washer retention surface surrounding the insertion tool cannulated shaft bore. The washer is held on the retention surface which positions the washer to receive the bone screw shaft. Pin-like spring elements are used to hold the washer in position. A plate is mounted on an outer surface at the first end of the inserter shaft, the plate having a bone contacting surface.

Abstract: A surgical instrument is configured to introduce a spinal fixation rod into a vertebral implant such that once the spinal fixation rod is engaged with the surgical instrument and the surgical instrument is put into a retention configuration, the spinal fixation rod cannot be removed from the surgical instrument until the spinal fixation rod is properly located and oriented with respect to the surgical construct and the surgical instrument is released from the retention configuration. The surgical instrument for introducing a spinal fixation rod includes a surgical instrument body with an actuator, and an engagement assembly at opposing ends and a transfer assembly extending between the actuator and the engagement assembly. The surgical instrument can also be used as part of a method for introducing a spinal fixation rod. Additionally, the surgical instrument can be part of a kit for introducing a spinal fixation rod, the kit including a plurality of spinal fixation rods of varying shapes and sizes.

Abstract: A surgical tool system for fitting an implant to a patient. The system includes a handpiece that is used to fit the implant. The handpiece is capable of reading data from a memory integral with the implant. The system includes a surgical navigation system capable of monitoring the position of the handpiece relative to the patient. Based on the data read by the handpiece from the memory of the implantable device and the data regarding the position of the implant the navigation system presents information regarding the procedure. This information includes data regarding the position of the implant relative to the patient or textual information based on the type of implantable device. If the implant is being improperly position, the surgical navigation system presents a warning or inhibits actuation of the handpiece.

Abstract: A bone fastener assembly instrument that can assemble a two-component bone fastener during surgery is provided. The bone fastener may be of a type that comprises a threaded bolt and nut for securing an implantable device to bone, such as a spinous process. A method for using the bone fastener assembly instrument is also provided.

Abstract: Devices and methods are provided for surgical retraction with a minimally invasive, maximum access surgical system. The surgical system can include anchor extensions that can be attached to bone screws. The bone screws can be inserted into a pedicle of a vertebral body. A retractor can be attached to anchor extensions connected to adjacent vertebrae on an operational side, and the retractor can be attached to anchor extensions connected to adjacent vertebrae on a contralateral side. The retractor can be used to distract the vertebral disc space between the adjacent vertebrae.

Abstract: A spinal stabilization system includes an implant and instrumentation for stabilizing the spine. In one embodiment, the system includes a plate having a side rail and a channel extending adjacent the side rail. A pedicle screw assembly is positioned in the channel in releasable engagement with the side rail. The pedicle screw assembly includes a polyaxial screw seated in a lower housing having a lower locking flange. An upper housing having an upper locking flange secures the plate to the lower housing. The side rail of the plate is releasably engaged between the upper locking flange and the lower locking flange. The upper and lower housings include on-board locking mechanisms for fixing components in the screw assembly. The screw assembly and plate are inserted and oriented by remote manipulation. Minimally invasive techniques for inserting the implant are performed with the instrumentation, and cause minimal disturbance to surrounding tissue.

Abstract: An orthopedic drill guide and surgical pin positioning device includes a primary surgical pin for insertion into a fractured bone and a longitudinal drum supported on said primary surgical pin. A set screw is also provided in said longitudinal drum for preventing the longitudinal drum from rotation about the primary surgical pin. A transverse drum is also provided and is rotatably disposed in the longitudinal drum as is a set screw for fixing the position of the transverse drum with respect to the longitudinal drum. A secondary pin extends through the transverse drum and is fixed in a second position on the hard tissue of the fractured bone. Finally, a pair of aligned openings extends through the transverse drum for guiding a drill bit and locating a surgical pin within the broken bone.

Abstract: A deployment device for a prosthesis includes a driving assembly, including a driving tube and a driving pin. The deployment device also includes a driven assembly, including a driven tube and a driven pin. The driven pin and the driven tube may be further associated with the prosthesis. The driving tube, the driving pin, the driven tube and the driven pin may all be located coaxially, with the driving pin configured to translate through a cavity in the driving tube and the driven pin configured to translate through a cavity in the driven tube. This configuration allows for a two-stage implantation process for the prosthesis, as the driving tube and driving pin may move together in one stage and may move relative to one another in a second stage.

Abstract: Apparatus and methods for spinal surgery include a retractor with an elongated body extending along a longitudinal axis between a distal end and an opposite proximal end. The retractor defines a passage between the distal and proximal ends and a window opening into the passage adjacent to the distal end. The apparatus also includes a guide member extending laterally from the proximal end of the retractor and the guide member includes a body extending along an arc. The body defines a number of trajectories each intersecting the window of the retractor. The apparatus further includes an instrument removably mounted to the guide member and the instrument is movable along the guide member and securable to the guide member in any one of the number of trajectories so that the instrument can be moved along the selected trajectory through the window.

Abstract: An articulating driver having a ball-in-socket joint. The driver may include a driver tip having a spherical head, a retention cap having a domed surface to mate with the spherical head, an input shaft, a spring disposed in an end of the input shaft and in a recess of the retention cap opposite that of the domed surface, and a housing that receives the input shaft, the spring, the retention cap and the spherical head. The housing may have a tapered end to positionally retain the spherical head therein. In another aspect, the driver may include a driver tip coupled to the input shaft that includes an interface to engage a screw. A bushing may engage the driver tip at one end and receive the screw at the other end to retain the screw within the driver.

Abstract: A screw delivery system is provided. Such a system may include a carrier including a carrier body, a driver, and a nose. The carrier may define a bore that extends at least partially through the carrier body. The driver may be configured to be at least partially disposed in the bore. The driver may include a head that is configured to mate with a head of a fastener. At least a first guide member may be carried by the carrier body. The nose may be operably aligned with the bore, and may include at least a second guide member that is configured to engage the first guide member. The system may be configured such that insertion of the driver from the bore into the nose causes the first and second guide members to engage so as to cause the nose to rotate relative to the carrier body.

Abstract: Method for positioning a viewing axis in relation to a distal fixation hole (2) for an intramedullary nail (1). A rigid support (3) is fixed to the proximal end of the nail (1). An adjustable viewing device (9) is mounted on the rigid support (3). A coarse adjustment is done of the length of the rigid support according to the length of the nail (1). A coarse adjustment is done in order to move the viewing device (9) closer to the nail, taking account of the patient's build. A precise adjustment is done of the position of the viewing device in relation to the nail, involving the translational and/or rotational movement of the viewing device in a plane perpendicular to the longitudinal axis of the viewing device (Z).

Abstract: A tool is disclosed for use in forming holes in bone and for driving a cannulated fastener into the formed hole. The tool may having a cutting tip for drilling a hole into bone, and may have a shaft and sleeve for accepting the cannulated fastener and for driving it into the drilled hole. The tool may be adjustable to allow fasteners of different lengths to be accepted, while ensuring that a portion of the cutting tip protrudes beyond the end of the fastener. A multiple-screw tool is also disclosed that allows more than one cannulated fastener at a time to be stacked on the tool, thus speeding the installation process.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

Abstract: An apparatus for anchoring in soft tissue generally includes an elongate tensile member adapted to extend within the interior of soft tissue and a first helical anchor configured for insertion within the interior of the soft tissue. The first helical anchor extends along a lengthwise axis of rotation and includes a proximal coil extending around the axis and a distal coil portion ending in a distal tip. The proximal coil defines an outer diameter adjacent to the distal coil portion, and the distal tip is positioned radially outward of the outer diameter. A drive member is coupled with the first helical anchor such that the drive member may be used to rotate the first helical anchor into the soft tissue.

Abstract: Embodiments include a system for manipulating a portion of the spine. A support body provides support for extender sleeves that are coupled to bone screws implanted in bone. The extender sleeves are coupled to the support body in a manner that allows translation and rotation of the extender sleeves relative to the support body. Movement and rotation of the extender sleeves in selected directions can be allowed while movement and rotation in other directions can be inhibited. The extender sleeves can be manipulated to move the bone.

Abstract: An insertion instrument for inserting an orthopedic implant into a bone and guiding an implant attachment element into the bone comprising: a body having a first end and a second end and a bore extending along a central axis; a fixed arm and a deflectable arm coupled to the body second end, the fixed arm spaced from the deflectable arm forming an attachment element receiving passageway therebetween extending along the central axis, the fixed arm having an implant engaging free end spaced a fixed distance from the central axis; and an actuator mounted on the first end of the body for moving the deflectable arm away from the fixed arm while allowing the attachment element to traverse the passageway.

Abstract: Provided herein are patient-specific surgical device that allow for a stable fitted position for use in shoulder surgery. The patient-specific surgical devices may have different functions such as a function as a guide.

Abstract: An implant for fusing adjacent bones is disclosed. The implant includes an elongate threaded member and a flexible portion extending from the elongate threaded member. The flexible portion includes a plurality of prongs configured to be reversibly compressed toward an axis defined by the elongate threaded member.

Abstract: A bone screw is provided having first and second threaded portions of different diameter separated by a middle portion that is unthreaded so that the bone screw may be inserted into a pair of adjacent bone fragments and used to compress the fragments together by driving the screw into a hole drilled in the fragments. An installation tool is also disclosed for threadably engaging one end of the bone screw and is used to initially drive the screw into the bone hole. Thereafter, a screwdriver may be inserted through the tool and into engagement with a recess in the bone screw and may be used to drive the screw fully into the bone and to separate the bone screw from the installation tool. A method of installation is further provided.

Abstract: A surgical device of a drill/driver with bit recognition to set a desired application mode and a method of utilization thereof is provided. Various operating modes of the drill/driver are automatically set by a sensor which recognizes the bit applied to the drill/driver. A method of utilizing the drill/driver allows the drill driver to apply surgical screws at very high speeds while automatically preventing excessive torque levels that would strip out the surgical screw from the patient's bone.

Abstract: A tool and a method are provided for driving a bone pin into a fractured bone to stabilize the fractured bone by maintaining the fractured bone in a reduced state. The tool may be a handheld device including a cartridge having at least one passageway that receives the bone pin. The tool may also include a pneumatically-powered piston having a needle that is sized for receipt within the passageway of the cartridge, the needle applying sufficient force to the bone pin to drive the bone pin out of the cartridge and into the fractured bone.

Abstract: A fusion implant and fusion members for fusing target fusion bones of a lower extremity. The fusion implant including internally threaded apertures of a first thread lead, and fusion members including threading of the first thread lead and threading of a second thread lead that is less than the first thread lead. The fusion implant and a targeting instrument being configured to couple to one another in a predefined orientation. The predetermined orientation resulting in alignment of aspects of the fusion implant with aspects of the targeting instrument. The targeting instrument providing both distraction and compression to the joint between the target fusion bones. A guide instrument for preparing one of the target fusion bones for fusion thereof. A surgical method for applying compression to the joint between the target fusion bones to facilitate fusion thereof utilizing a fusion implant, fusion members, a targeting instrument and a guide instrument.

Abstract: Rod reducers for use in orthopedic surgery are disclosed that include a fastener engaging member and a reducing member coupled together by an actuator assembly. The fastener engaging member can be secured to a fastener engaged to bone or tissue of the patient. The actuator assembly moves the reducing member such that its distal end contacts a rod and moves it toward the fastener.