Abstract: Orthopedic implant and methods of implantation for fixing adjacent bones. In one embodiment, the implant includes a locking mechanism that is adapted to be advanced by a locking instrument, wherein advancement of the locking mechanism in a first direction produces rotation of a first rigid abutment surface of the implant from a first orientation to a second orientation, and continued advancement of the locking mechanism produces advancement of the first rigid abutment surface towards a second rigid abutment surface of the implant. The continued advancement may also place a compressive load onto the implant sufficient to immobilize the implant relative to a first bony surface and a second bony surface.

Abstract: A bone fracture plate assembly including female and male plate portions. The female plate portion has a post, a female dovetail, and an extending arm with a group of ratchet teeth. The male plate portion has two upstanding posts, a male dovetail for coupling to the female dovetail so that the plate portions move linearly with respect to each other, a slot for the arm, and a pawl for engaging the ratchet teeth. A spring, coupled to the posts of the plate portions, dynamically connects the plate portions by applying a compressive load therebetween. The spring has a pair of elongated ears, each defining a slot to allow for relative movement of the plate portions. The ratchet teeth are engaged by the pawl to retain the plate portions together, and the spring mounts on the posts of the plate portions such that the spring biases the plate portions together.

Abstract: An articulated fixation device is provided having a high degree of adjustability for securing a plate member thereof to a skull and at least one spinal rod thereof to a vertebral bone. In one form, an adjustable bridge member is provided that is adjustably connected to both the plate member and the spinal rod. The adjustable connections can include an upper and rearward pivot connection between the plate member and the bridge member and a lower and forward pivot connection between the spinal rod and the bridge member.

Abstract: Rod delivery tools, methods for delivering a connecting rod of a pedicle screw system into seating slots of at least first and second long arm screw towers of a pedicle screw system, and a rod reduction tool and related methods for urging a distal leading end of a connecting rod and an opening of a long arm screw tower into alignment with one another, where the two are initially misaligned.

Abstract: In one embodiment, the present invention is a laminal implant including: a first body including a first flange adapted to engage a first lamina end, a tab and a receiving channel; and a second body including a second flange adapted to engage a second lamina end, and a plurality of teeth adapted to engage the tab, at least a portion of the second body adapted to be positioned within the receiving channel, the first and second bodies adapted to slideably engage one another.

Abstract: A spinal implant includes an implant body extending between an anterior surface and a posterior surface. The implant body includes a first vertebral engaging surface and a second vertebral engaging surface. The implant body defines a cavity. A plate is connectable with the implant body via a coupling member adjacent the cavity and is translatable relative thereto. The coupling member has a portion including a frangible torque limit. The plate defines at least one opening oriented to implant a fastener with tissue. Systems, spinal constructs, surgical instruments and methods are disclosed.

Abstract: An intervertebral spinal spacer that can include a substantially annular body that can include an upper surface, a lower surface, an outer surface, and an inner surface. The inner surface of the substantially annular body can define an internal cavity. The annular body can include a plurality of outer apertures and a plurality of inner apertures connected by a plurality of fluid passages that can draw fluid into the internal cavity.

Abstract: A percutaneous system in which tubular retractors are utilized as a means of access, visualization, and a controlled orientation for preparation of posterior spinal elements and delivery of graft material for posterior spinal fusion. The tubular retractors are affixed to screw extensions to rotate and articulate relative to multi-axial screws percutaneously inserted into respective pedicles of vertebral bodies. The procedure is done bilaterally, although it could be performed unilaterally in cases where the anatomy or surgeon preference dictates. A number of different deployable graft concepts are disclosed, the primary features being to allow for creation of a graft space volume and a means for delivery of the graft material preferred by the surgeon.

Abstract: An implant to be surgically positioned between two adjacent vertebrae made of a biocompatible material having two distinct areas of geometry—a front/anterior distracting portion and a second stabilizing back end/posterior portion. The device is inserted into the disc space on its side—in a first position—up until a point and then the device is rotated 90 degrees along a z-axis—into a second position—and then pushed the remainder of the way into the disc space. As viewed from the bottom of the device (in the second position—the position of the implant after rotation, the device is L-shaped, about L-shaped, or an angled dual leg configuration. A base member forms an angle anywhere between 30 to 150 degrees with a connected extended member.

Abstract: Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: A spinal fixation device is provided having first and second elongate members that are angularly adjustable relative to one another. Each elongate member can include a connecting feature formed on a terminal end thereof, and each connecting feature can be coupled to one another to allow angular movement of the first and second elongate members. The device can also include a locking mechanism that is adapted to couple to the connecting feature on each of the first and second elongate members to lock the elongate members in a fixed position relative to one another.

Abstract: Disclosed embodiments relate to an orthopedic device including a plate and a single-step self-locking mechanism. The plate includes one or more tapered apertures and a slot defined in a top surface of the plate, the slot extending from each aperture. The locking mechanism is slidably seated in the slot and is operable to be positioned in a first position along the slot where a portion of the locking mechanism extends over the aperture or positioned in a second position along the slot where the portion of the locking mechanism is fully retracted from the aperture.

Abstract: A multi-planar axial spinal rod connector includes a first portion, a second portion, and a connector assembly. The first portion defines a longitudinal axis and defines a first passage. The first passage is sized and configured to slidably receive a first spinal rod. The second portion defines a second longitudinal axis and defines a second passage. The second longitudinal axis is different from the first longitudinal axis. The second passage is sized and configured to slidably receive a second spinal rod. The connector assembly is configured to fix the first and second portions relative to one another such that the first and second longitudinal axes define an angle relative to one another.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element, including a receiving part having first and second ends, a recess at the first end for the rod, and an accommodation space for a head of the bone anchoring element, the accommodation space having an opening at the second end to permit insertion of the head into the receiving part, a retainer element configured to be arranged at least partially in the accommodation space and to hold at least part of the head, and a spring element configured to be arranged at least partially in the accommodation space and to be compressed in an axial direction. The retainer element and the spring element are separate parts. When the retainer element and the spring element are in the accommodation space of the receiving part in a first position, the spring element extends into the recess of the receiving part.

Abstract: A polyaxial pedicle screw includes a housing, a bone screw member, and an anvil. The bone screw member includes a head and a threaded shaft extending from the head. The head is selectively securable within the housing. The anvil is positionable within the housing adjacent to the head of the bone screw member when the anvil and the head of the bone screw member are positioned within the housing. The anvil may define one or more grooves in an outer surface of the anvil. The groove defines a flap that is flexibly attached to the anvil to enable the anvil to flex an amount sufficient to maintain the head of the bone screw in constant contact with the anvil when the bone screw member is moved relative to the anvil. A rod reducer may be secured to the polyaxial pedicle screw to secure a spinal rod within the housing.

Abstract: A receiving part of a bone anchoring device is provided, where the receiving part includes a first end, a second end opposite to the first end, a central axis extending through the first end and the second end, and a substantially U-shaped-recess adjacent to the first end for receiving a spinal fixation element. The substantially U-shaped recess forms two free legs. The receiving part also includes a bore extending from the first end towards the second end and in communication with the substantially U-shaped recess. A groove is provided in an outer surface of each of the legs, where the groove has a first end and a second end and extends in a circumferential direction in an arcuate shape between the first end of the groove and the second end of the groove.

Abstract: Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spinal fixation element through at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in a lengthwise orientation that is substantially transverse to the longitudinal axis of each percutaneous access device. The spinal fixation element can then be advanced in the lengthwise orientation to seat the spinal fixation element in or adjacent to the receiver heads of at least two adjacent spinal anchors. A fastening element or other closure mechanism can then be applied to each spinal anchor to engage the spinal fixation element within the receiver heads of the adjacent anchors.

Abstract: A spinal stabilization system generally comprises first and second anchor members configured to be secured to first and second vertebrae within a patient's body, a flexible element secured to the first anchor member, and a rigid element secured to the second anchor member. An end portion of the rigid element is coupled to an end portion of the flexible so that the system is able to provide both rigid and dynamic stabilization. The coupling is maintained even if the flexible element relaxes after a period of time within the patient's body.

Abstract: Implant for stabilization of pelvic ring fractures, comprising a nail for intraosseous implantation, a fixing agent and at least one locking element for relative fixation of the pelvic bone to the nail.

Abstract: Placement apparatus and methods of use for impanation of spacers within an inter-vertebral disc space. In one embodiment, the load-bearing superstructure of the implant is subdivided and the bone forming material is positioned within an internal space of the placement instrument but external to the load bearing elements themselves. At least a portion of the bone graft material is freely contained within the disc space. A method of using the device is also described. In one embodiment, the placement device is used to place the implantable spacers at opposing ends of the disc space using a directly lateral surgical approach.

Abstract: Spinal fixation systems including a member, a first attachment portion, a second attachment portion, and an intermediate portion. The first attachment portion is attached at a superior end of the member and includes a first opening. The second attachment portion is attached at an inferior end of the member and includes a second opening. The intermediate portion connects the first and second attachment portions. The spinal fixation systems may also include a relief in at least one of the first opening and the second opening. The systems may also include a third attachment portion with a third opening and an intermediate portion with a first and a second elastic mechanism. The first elastic mechanism connects the first and third attachment portions and the second elastic mechanism connects the third and second attachment portions. Surgical methods for inserting the spinal fixation systems in a patient are also disclosed.

Abstract: Provided are rod coupler devices, systems, kits and methods, which include at least one saddle having a concave configuration that either abuts a bone fastener and/or a locking cap and is shaped so as to contact the rod in two or more lines of contact, which reduces pressure on the rod, and therefore permits use of a rod having various materials, such as PEEK, without significant deformation of the rod. Also provided is the saddle itself and integrated locking caps that include a saddle, the locking cap and a set screw. Also provided are elongate rods having advantageous shapes, configurations, and/or compositions for rod coupler devices, systems and methods. Further provided are screw and cap devices and systems that themselves include a concave configuration so as to contact a rod in two or more lines of contact, which reduces pressure on the rod.

Abstract: An anchoring system for implanting in bone, the system comprising a first coupling assembly having a first clamp and a first coupling body that receives and holds a first stabilization element; a second coupling assembly that receives and holds a second stabilization element; and a plate that attaches to the first coupling assembly and the second coupling assembly, wherein the first coupling assembly attaches to a bone fastener, and wherein the first coupling body includes a cap retainer that receives a locking cap that applies a directional force to force the first coupling body toward the plate, and applies another directional force to force the first clamp toward the plate, thereby fixedly securing the first coupling body and the first clamp to the plate.

Abstract: A facet joint replacement system includes an inferior implant with an inferior articular surface, and a superior implant with a superior articular surface. The implants may be coupled together by a detachable coupler which can align and rigidly hold the inferior and superior articular surfaces in a preferred alignment relative to one another. In one method of implantation, the superior and inferior implants may be aligned and coupled together with the coupler, and then secured to fixation members anchored in adjacent vertebrae. Alternatively, a first implant may be secured to a fixation member anchored in a first vertebra, and a second implant coupled to the coupler, aligned with the first implant and then secured to a fixation member anchored in a second vertebra. A tool may grip, position and/or deliver the coupler and the implants.

Abstract: A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.

Abstract: A swellable, resilient self-retaining interspinous implant that includes two oppositely disposed retaining members connected by a centrally disposed cross body, the cross body defining a center axis, each retaining member extending in opposite directions relative to each other and perpendicular to the center axis, the implant being dimensioned and configured to fit between two spinous processes of two adjacent vertebrae. In embodiments, the implant has a first configuration of reduced size such that it can be inserted into the patient in a minimally invasive manner. Once inserted to an application point within the patient, the implant expands in size to dynamically maintain the adjacent spinous processes in beneficial alignment. Also provided is a method of making a swellable, resilient interspinous implant as described herein.

Abstract: A bi-directional fixating transvertebral (BDFT) screw/cage apparatus includes an intervertebral cage having a plurality of internal angled screw guides and screw members and a screw locking mechanism. The screw locking mechanism has leaf springs mechanically interacting with ratcheted screw heads of the screws and allowing the ratchet teeth of the screw heads to rotate only in a penetrating direction and preventing rotation of the screw head in an opposite direction. The intervertebral cage is adapted for posterior lumbar intervertebral placement, anterior lumbar intervertebral placement, anterio-lateral thoracic intervertebral placement, or anterior cervical intervertebral placement.

Abstract: In one embodiment, the present invention is a laminal implant including: a first body including a first flange adapted to engage a first lamina end, a tab and a receiving channel; and a second body including a second flange adapted to engage a second lamina end, and a plurality of teeth adapted to engage the tab, at least a portion of the second body adapted to be positioned within the receiving channel, the first and second bodies adapted to slideably engage one another.

Abstract: Aspects of the present disclosure involve a method of diagnosing and treating a sacroiliac joint of a patient comprising: a) delivering a first member into the ilium via a first posterior approach; b) delivering a second member into the sacrum via a second posterior approach; and c) diagnosing an ailment of the sacroiliac joint by: manipulating the first member relative to the second member; or identifying joint movement via a sensor positioned in or near the sacroiliac joint.

Abstract: A fixation assembly for securing parts of a sternum has a first section having a first attachment structure for securing the first section to a first sternum part. The fixation assembly includes a second section having a second attachment structure for securing the second section to a second sternum part. A mating arrangement is provided defining a mating direction and a predetermined relative position between the first and second sections in a plane perpendicular to the mating direction. At least one holding member is provided for detachably holding the first and second sections in an abutting relationship in the predetermined relative position. This may be achieved in one variant by simultaneous engagement of the first and second sections substantially along the mating direction.

Abstract: Systems for improved methods of performing a spinal fusion procedure that include an implant having an alignment guide system. The alignment guide system may include one or more guide lines configured to provide a visual indication when the implant is properly aligned within the disc space. In some embodiments, the system includes one or more tamp levelers that also aid with the proper alignment of the implant within the disc space.

Abstract: A bone access instrument comprising a shaft having a first shaft portion and a second shaft portion. The first shaft portion has a first diameter, a proximal end, a tapered distal end including at least three straight cutting edges being equally spaced circumferentially about the tapered distal end, and at least three flutes extending from the tapered distal end toward the proximal end in a parallel relationship to one another. The second shaft portion has a second diameter and a tapered distal end. The second diameter is less than the first diameter, and the second shaft portion extends axially from the distal end of the first shaft portion.

Abstract: Accordingly, a broad object of the invention can be to provide an inventive implant to facilitate stabilization while allowing an amount of motion of a sacroiliac joint. Embodiments of the sacroiliac joint implant can provide an elongate body, which can further include at least one fixation member, or a pair of fixation members which extend a distance outward from the longitudinal axis of the implant body adapted for non-transverse placement between the articular surfaces of the sacroiliac joint, and as to certain embodiments can further provide a third fixation member and additionally a fourth fixation member each adapted to extend a distance outward from the elongate body into the bone of the sacrum or the ilium.

Abstract: A biologically implantable device including a spacer body and fasteners for fixing the spacer body in place between vertebrae, and a method for use of the device to improve intervertebral spacing and correct foraminal stenosis, and to immobilize facet joints and promote fusion of adjacent vertebrae to each other. A drill guide may be used in providing bores in the facet joints to receive the fasteners.

Abstract: The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of a spinal fixation procedure. A bone anchor is provided. The anchor can include a bone fastener. The bone fastener can include a head and a second end adapted to engage an anatomy. The bone fastener can extend along a longitudinal axis. The anchor can also include a coupling arrangement coupled to the head of the bone fastener so that the bone fastener is rotatable about the longitudinal axis to define a first plane of motion. The anchor can further include a saddle, which can be coupled to the coupling arrangement. The saddle can be movable relative to at least one of the bone fastener and the coupling arrangement to define a second plane of motion.

Abstract: Disclosed is an orthopedic implant that includes an anchor, a bore, and a compressible and expandable mesh. The anchor is configured to secure the implant at an implantation site and defines a longitudinal axis. The bore is defined by the anchor and extends along the longitudinal axis. The compressible and expandable mesh is aligned along the longitudinal axis and defines a plurality of openings. The mesh is configured to compress along the longitudinal axis and expand from the longitudinal axis to engage surrounding bone or tissue at the implantation site to secure the implant at the implantation site.

Abstract: Apparatus and methods include an elongate connecting element including a body extending along a longitudinal axis between a first end and an opposite second end. The connecting element includes a first end portion at its first end and a second end portion at its second end. The connecting element includes a length between the first and second ends sized to extend between and be engaged to first and second anchors engageable to bony portions of the spinal column. The first and second end portions are positioned on opposite sides of the first and second anchors and project outwardly from the body of the connecting element to capture the first and second anchors between the first and second end portions.

Abstract: The present invention provides spinous process implant and associated methods. In one aspect of the invention the implant limits the maximum spacing between the spinous processes. In another aspect of the invention, a spacer has at least one transverse opening to facilitate tissue in-growth. In another aspect of the invention, an implant includes a spacer and separate extensions engageable with the spacer. In another aspect of the invention, instrumentation for inserting the implant is provided. In other aspects of the invention, methods for treating spine disease are provided.

Abstract: A method for treating a spine comprises the steps of: fastening a plurality of fasteners with a lateral portion of vertebrae, each of the fasteners including a first element that defines an implant cavity and a second element configured for penetrating the vertebrae; providing a longitudinal element including a portion having a selected curvature; disposing the longitudinal element with the implant cavities such that the portion is disposed in a selected orientation relative to the vertebrae; and moving a first element of at least one of the fasteners relative to the portion such that a second element of the at least one of the fasteners derotates the vertebrae while maintaining the portion in the selected orientation. Systems and implants are disclosed.

Abstract: Implant fixation systems, kits and methods for interbody fusions are described herein. Preferably, the implant has a cage containing two deployable blades and one or more strike plates that are able to deploy the blades. The blades are positioned inside the cage such that one blade faces upward and the other blade faces downward. Protrusions on the ends of the blades fit into correspondingly shaped tracks on the interior surface of the cage, allowing movement of the blades inside the cage. The implant also has two wedge-shaped strike plates that fit into attachment regions located on the blades, which allow the strike plates to slide. Impaction of the strike plate(s) causes them to push the blades superiorly or inferiorly. In the impaction position, a portion of the blades protrudes beyond the superior and the inferior surfaces of the cage and fixes the cage in the adjacent vertebral bodies.

Abstract: A horizontal and vertical expandable tissue spacer implants, insertion tools, assembly methods and surgical methods are disclosed. The horizontal expandable tissue spacer implant includes a first lateral member with a first side, a second lateral member with a first side, and an intermediate spacer member. The intermediate spacer member is adapted to cooperatively engage and hold the first side of the first lateral member and the first side of the second lateral member. A vertical expandable tissue spacer implant includes a top member with a bottom surface, a bottom member with a top surface, and an intermediate spacer member with a coupling mechanism. The coupling mechanism cooperatively engages the bottom surface of the top member to the intermediate spacer member and the top surface of the bottom member to the intermediate spacer member.

Abstract: An expandable interbody device for implantation within an intervertebral space is provided, together with methods and tools for use therewith. The interbody devices include a leading first and trailing second bearing member configured to expand laterally via connecting portions disposed at the trailing end of the first being member and at least the leading end of the second bearing member. In some forms, the connecting portions have an arcuate configuration. The insertion tool is configured expand the interbody device by holding the first bearing member while shifting the second bearing member.

Abstract: A system for applying a manipulative force to a target region of a spinal column during a surgical procedure is provided with at least four pedicle screws, at least four elongated levers configured to temporarily engage with the pedicle screws, a linking member configured to link at least two of the elongated levers in a axial direction such that they move in unison, and a cross-linking member configured to link at least two of the elongated levers in a transverse direction such that they move in unison. When the system is assembled, it permits an operator to move the at least four elongated levers in unison to simultaneously rotate the at least four pedicle screws about a spinal column roll axis. Related methods are also provided.

Abstract: A system for applying a manipulative force to a target region of a spinal column during a surgical procedure is provided with at least four pedicle screws, at least four elongated levers configured to temporarily engage with the pedicle screws, a linking member configured to link at least two of the elongated levers in a axial direction such that they move in unison, and a cross-linking member configured to link at least two of the elongated levers in a transverse direction such that they move in unison. When the system is assembled, it permits an operator to move the at least four elongated levers in unison to simultaneously rotate the at least four pedicle screws about a spinal column roll axis. Related methods are also provided.

Abstract: A spinal fixation system includes a low profile dynamic anterior vertebral body plate and bone screws for the fixation and stabilization of the cervical spine. The system has a locking element through which the bone screw passes and the locking element is capable of movement relative to the plate when the bone screws are fully inserted and in a locked position.

Abstract: A spinal implant is provided that comprises a first vertebral engaging surface and a second vertebral engaging surface. A wall extends between the surfaces. A lattice is disposed adjacent the wall and extending between the surfaces. Systems and methods of use are disclosed.

Abstract: A method of securing a fixation rod to a screw assembly that includes a screw, a bushing, and a receiver includes the steps of inserting the fixation rod within a receiver portion of the bushing and the receiver, advancing a locking member into contact with an engagement surface on a proximal portion of the bushing, applying a force with the locking member to increase an amount of friction between a distal engagement surface of the bushing and a head portion of the screw, and increasing the force to deform a deformable portion of the bushing and increase an amount of friction between the fixation rod and the bushing.

Abstract: Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: A three-dimensional correction of the curvatures of the spine, for reducing spinal deformities, such as scoliosis, uses a pair of pedicle screws placed on each of the spinal vertebrae of the spine to be corrected, in combination with alignment elongated members or extenders temporally fixed by a proximate portion and associated with corrective rods engaged with the extenders, running along a transverse plane. Each of the corrective rods provides implant rods.

Abstract: A spinal fusion surgery instrument for implanting and an intervertebral cage thereof are provided. The spinal fusion surgery instrument includes a body, a gripper subassembly, a first control subassembly, and a second control subassembly. The first control subassembly is provided to generate a displacement between a first connecting member and a second connecting member of the gripper subassembly to change the angle of gripper of the intervertebral cage. The second control subassembly is provided to enable a first gripper member and a second gripper member of the gripper subassembly separating smoothly from the dowel pins of the intervertebral cage. By means of the operation model, the spinal fusion surgery instrument may be controlled easily, and the orientation of the intervertebral cage may be promoted in the process of the surgery.