Abstract: The present invention provides a connection assembly that can be used to securely connect a spinal implant to a bone anchor. In particular, the present invention preferably provides a spinal implant connection assembly that is able to securely connect the spinal implant to the anchors even when there is a variance in the angle and position of the anchors with respect to the spinal implant. Furthermore, the present invention provides a connection assembly with structure to increase the locking strength of the connection assembly.

Abstract: In one form, systems and methods for positioning a connecting member adjacent the spinal column include at least one anchor that is engageable to bony structure and has a receiver for receiving the connecting member. A pair of elongated members is engaged to the receiver and defines a pathway that extends proximally from the receiver. The connecting member is movable along the elongated members to the receiver of the bone anchor. The elongated members are removable from the receiver of the bone anchor after the connecting member is positioned in the receiver to provide a low profile anchor and connecting member assembly when finally implanted in the patient. However, other embodiments, forms and applications are also envisioned.

Abstract: The bottom loading fastening system that consists of the polyaxial ball and socket joint used in conjunction with a bone screw having threads on one end for use in anchoring to the spine and a spherical connector on the other end operating as a pivot point about which a connecting assembly moves in a polyaxial fashion. A substantially U-shaped connecting assembly has a lower receptacle having a retainer ring within a retaining ring groove for use in securing the spherical connector to the connecting assembly.

Abstract: A coupling device for securing an elongate member to the spine is provided. The coupling device comprises a compressible inner member that secures an anchor member therein when the inner member is axially shifted within an outer member. Structures are provided to prevent disassembly of the anchor and coupling device prior to locking of the elongate member.

Abstract: A transverse fixation device is disclosed. The device includes one or more connecting bodies disposed substantially between two elongate rods. Each connecting body includes a receptacle that is capable of engaging with the two elongate rods. A c-ring comprising an outer surface having a spherical curvature is also included. A third rod may be inserted into the c-ring. A clamp included in the connecting bodies may then be disposed about the c-ring and third rod to allow the connecting bodies to slidingly engage with the third rod.

Abstract: A polyaxial bone anchoring device is provided comprising a bone anchoring element (1) having a shank (2) to be anchored in the bone and a head (3); a receiving part (5) coupled to the shank and configured to pivotably receive the head, and having a channel (56) for receiving a rod (6) and a central axis (C); a pressure member (7) arranged in the receiving part and configured to exert pressure onto the head to lock the head in the receiving part; a locking member (8) that is insertable into the channel, the locking member comprising a top end (81) and a bottom end (82) facing the pressure member; a deformable first portion (85) and a second portion (84) provided at the bottom end; wherein, when the locking member is advanced into the channel in the direction of the central axis (C), first the deformable first portion (85) comes into contact with the pressure member (7) and is deformed resulting in a load applied to the pressure member that clamps the head, and thereafter the second portion (84) comes into cont

Abstract: A spinal implant provides support for desired parts of the spine. The spinal implant includes a pair of elongated members and a variable length cross-link. A variable length cross-link device may include a fixed portion having a receiver portion for attachment to a first elongated member, a transverse portion ,and an adjustable portion having a receiver portion for attachment to a second elongated member and a transverse portion engaging member. Inserting the transverse portion of the fixed portion into the engaging portion of the adjustable portion may form a cross-link for stabilizing motion between two elongated members. Engaging the adjustable portion at a selected point on the transverse portion establishes a length selected by the surgeon. The surgical procedure may use minimally invasive surgery or non-minimally invasive surgery, as desired. Components may be inserted through sleeves attached to various coupling devices, or may be inserted and guided along wires.

Abstract: An implant device includes a pair of hook devices and an elongate guide device. The hook devices are configured to be disposed between and engage adjacent vertebral bodies. The elongate guide device is connected to the hook devices and allows for relative movement of at least one of the hook devices to adjust for the geometries of the vertebral surfaces to be engaged by the hook devices.

Abstract: A device for fixing a bony structure to a support member. The device includes a main body with first and second members, the second member being movable in rotation with respect to the first member, around a first axis. A flexible member passes between the members and forms a loop around a bony structure. A clamping mechanism moves the first and second members into a clamping position. A support member and the flexible member are secured between the members in the clamping position. The first axis is movable in translation along a first direction and the second member is movable in translation along the first direction. The clamping mechanism cooperates with the first and second members to move the second member in translation in the first direction.

Abstract: The invention relates to a device for stabilizing the spine, comprising a bone screw (1) having a screw shaft (2) and having a first threaded portion (5) for insertion into the bone, comprising a rod (3) and a connector (4) that may be fixed to the bone screw (1) for the releasable connection of the rod (3) to the bone screw (1). The connector (3) comprises a connector body (9) having a throughgoing hole (10) and a rod seat (11) that is open on one side, into which the rod (3) may be snap fitted.

Abstract: A tool set for implanting bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws includes a pair of independently mountable and manipulatable elongate guide tools that form a unitary tool guide when desired. Each guide tool includes attachment structure for independent operable connection of the guide tool to an arm of the bone screw. The bone screw/guide tool attachment includes an undercut and/or recess so as to resist separation of the guide tool member from an attached bone screw. Further tools include a removable stabilizer, a cooperating bone screw driver with an attached stabilizer, a closure starter/reduction tool, a closure driver and a counter torque tool.

Abstract: An inventive iliac connector comprises a connector head (1) and a connecting rod (2) for connecting a sacrum (S) or a spine (SP) to an ilium (I). The connector head (1) has a first hole (15) for holding a spinal rod (3) and a second hole (16) for holding the connecting rod (2), wherein the connecting rod (2) is made of a material being more flexible than titanium. This iliac connector enables a stabilization of ilium, sacrum and spine and enables at the same time movement between ilium and sacrum.

Abstract: Spinal anchoring methods and devices are provided that are effective to correct spinal deformities while allowing some flexibility to the spinal. In particular, the methods and devices allow a spinal fixation element to mate to several adjacent vertebrae to maintain the vertebrae at a fixed distance relative to one another, yet to allow the orientation of each vertebrae relative to the fixation element to adjust as the orientation of the patient's spine changes.

Abstract: A spinal fixation system includes a rod and anchor devices that include a bone engaging fastener having a head defining a spherical socket. A ball insert is placed within the socket and rotated so that the ball insert is juxtaposed with the socket. The anchor device further includes a yoke defining a yoke channel for receiving the rod and a stem engaged to the ball insert captured within the socket. A sleeve disposed between the yoke channel and the fastener head supports the rod. A set screw is operable to clamp the rod against the sleeve and draw the insert into engagement within the socket. A releasable detent defined between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener. Portions of the releasable detent may also exert a frictional retention force against the fastener head.

Abstract: A polyaxial bone screw assembly for capturing a rod includes a receiver, a threaded shank body having an upper capture portion mated with a retaining and articulating structure, a compression insert and a closure having a domed bottom. The closure captures and fixes the rod within the receiver between the domed bottom and the compression insert, the insert pressing on the retaining and articulating structure to fix such structure against the receiver.

Abstract: Orthopaedic devices including a connecting element suited for receiving at least part of a first rod, and a lock screw. The connecting element includes an anchor for securing the connecting element to a bone, in particular a vertebra, a first lateral opening, and a top opening with a first inner screw thread. The lock screw is received within the top opening and includes a proximal face presenting a screw drive, accessible from outside the connecting element, a distal end for locking the first rod within the connecting element, and wherein the lock screw is adapted to fit through the first lateral opening to be subsequently introduced into the top opening with the proximal face leading.

Abstract: A rod to rod connector includes at least one clamping assembly for receiving a first spinal rod. The clamping assembly may include a polyaxial articulation element. The articulation element may include a hollow body forming an opening. The clamping body may further include a pivot element configured to clamp the first spinal rod between the pivot element and a channel wall in the clamping assembly. The rod to rod connector may also include a connector member for connecting the clamping assembly to a second spinal rod. The connector member may include a socket configured to receive the polyaxial articulation element of the clamping assembly, with the articulation element polyaxially rotatable relative to the axis of the socket.

Abstract: An implant connector comprises a first surface defining a first cavity configured for disposal of a first implant. A second surface defines a second cavity configured for disposal of a coupling member. A third surface defines a third transverse cavity configured for disposal of a second implant. The third surface includes a projection configured to engage the second implant in a provisional locking orientation. Methods of use are disclosed.

Abstract: A rod holding device for binding a rod to an osseous structure. This rod holding device includes a holding body, an anchor member for anchoring the holding body to the osseous structure, a closure member for engagement with an engagement portion of the holding body, and a sleeve member with an opening for receiving the rod and a non-spherical outer contact surface for engagement with a complementary inner contact surface of the receiving portion and configured to be locked in a receiving portion of the holding body by engagement of the closure member with the engagement portion of the holding body, and to secure the rod within the opening. The rod holding device can thus be adapted to rods of various sizes by choosing a sleeve member with an opening of appropriate diameter.

Abstract: A locking pedicle screw assembly has been designed which avoids misalignment and locks into place once the cap is fully threaded into the tulip, avoiding over tightening or stripping of the threads. The locking cap includes a retaining or locking ring, positioned either at the bottom of the cap so that it locks into a groove at the bottom of the threads in the tulip or at the top of the threads in the cap, locking into a groove at the top of the tulip when the cap is fully seated. In one embodiment, an audible signal is generated when the cap locks. In another embodiment, the cap is secured to a swiveling saddle that locks the rod into place as the screw cap is tightening, but does not interfere with the locking mechanism.

Abstract: A system for reducing curvature of a spine is provided, the system comprising a spinal construct having an elongated longitudinal element affixed to and extending between a first fixation element and a second fixation element, the first fixation element having a first end configured to engage at least a portion of a first anchor member, and the second fixation element having a second end configured to engage at least a portion of a second anchor member, the first and second anchor members configured to pierce the spine, wherein the elongated longitudinal element is configured to generate a corrective force sufficient to reduce curvature of the spine. The systems and methods provided allows a surgeon to select a tether, determine its length, and pre-assemble the spinal construct, which then can be coupled onto the head of a bone anchor.

Abstract: An implant system comprises a fastener including a proximal portion and a distal portion configured for penetrating tissue. The proximal portion defines a first cavity that defines a first longitudinal axis. A connector extends between a first end and a second end configured for disposal in the first cavity and movement within a first plane. The connector is moveable along the first longitudinal axis relative to the distal portion. A receiver is attached to the connector and includes an implant cavity defining a second longitudinal axis and configured for disposal of an implant. The implant cavity is rotatable about the first longitudinal axis such that the implant is rotatable in a second plane relative to the distal portion of the fastener. Methods of use are disclosed.

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

Abstract: In a preferred embodiment, the present invention provides a connection assembly that can be used to securely connect a spinal implant to a bone anchor. In particular, the present invention preferably provides a variable angle connection assembly that is able to securely connect the spinal implant to the anchors even when there is a variance in the angle and position of the anchors with respect to the spinal implant. Furthermore, in a preferred embodiment, the present invention provides a connection assembly that will not inadvertently lock the components of the connection assembly preventing the relative movement of the components.

Abstract: A determination oxygen storage amount used to determine whether a catalyst is degraded is a value obtained by applying a correction amount for removing error caused by response delay time of an output signal of an oxygen sensor to an oxygen storage amount calculated every short time. The correction amount is a value that is calculated using slopes stored in memory, i.e., the slopes for the number of storage cycles (>the short time) corresponding to the response delay time, or the like, and becomes more accurate as a value corresponding to the error as the storage cycle becomes relatively shorter with respect to the response delay time and the number of the slopes stored in the memory increases. The necessary storage capacity of the memory is inhibited from increasing excessively even if the number of the slopes stored in the memory is large.

Abstract: Systems, devices, and associated methods for correcting spinal column deformities that help minimize a number of attachment anchors utilized for correction, facilitate use of straight or contoured rods, limit rod roll, and/or help promote a more natural, physiologic motion of the spinal column.

Abstract: A device for dynamically attaching an elongated member to a vertebral member. The device may include a receiver with a channel configured to receive an elongated member. A fastener may secure the elongated member to the receiver. The receiver may further include a reservoir sized to receive a head of an anchor. The reservoir may be shaped for movement of the receiver relative to the anchor within one plane. This movement may accommodate spinal motion during flexion and extension of the patient. One or more dampeners may be positioned in the reservoir and contact against the anchor during the movement. The dampeners may provide resistance to the movement of the patient.

Abstract: In one embodiment, an implantable spinal fusion attachment element includes a rod attachment head having a passage that is adapted to receive a spinal alignment rod and means for securely attaching the attachment element to a vertebra without penetrating the pedicle of the vertebra.

Abstract: A posterior fixation system includes a saddle member, an anchoring member, an occipital plate, an occipital rod, and a cross-link connector. The anchoring member anchors the saddle member to bone. The saddle member includes a pair of upright portions that define a channel. The channel is adapted to receive an orthopedic rod, and the saddle member can include a hole to receive the anchoring member. The saddle member and the anchoring member can be coupled so as to allow multi-axial movement of the members. The anchoring member in one embodiment is a screw coupled to the hole of the saddle, and in another embodiment, the anchoring member is a hook. The offset member may be coupled to the saddle member to allow for offset connection of rods. Connection of individual rods can be accomplished by connecting the rods with the cross-link connector. The cross-link connector has an integrally formed cylindrical member that couples a pair of coupling portions together.

Abstract: An implant system comprises a fastener including a proximal portion including an inner surface that defines a first cavity that defines a first axis and a distal portion configured for penetrating tissue and defining a longitudinal axis disposed transverse to the first axis. A connector extends between a first end and a second end configured for disposal in the first cavity. A receiver is attachable to the first end and includes an implant cavity defining a second axis. The implant cavity is rotatable about a third axis disposed transverse to the second axis such that an implant disposed in the implant cavity and lateral to the first end is rotatable in a first plane relative to the first end in a configuration for selective fixation with the first end. Methods of use are disclosed.

Abstract: Some embodiments relate to systems, devices, and associated methods for correcting spinal column deformities that help minimize a number of attachment anchors utilized for correction, facilitate use of straight or contoured rods, and/or help promote a more natural, physiologic motion of the spinal column.

Abstract: A spinal correction system comprises an elongate member extending between a first end including a first inner surface defining a first cavity and a second end including a collar having a second inner surface defining a second cavity. The second cavity is movable relative to the elongate member in at least one orientation. The second end defining an elongated cavity. A first extender defines a first outer surface and a second extender defines a second outer surface. The elongate member is disposable between a first configuration and a second configuration such that the second cavity is movable in the at least one orientation to a position such that the first inner surface is forcibly disposable in a fixed engagement with the first outer surface and the interior surface is forcibly disposed in a fixed engagement with at least a portion of the collar. Methods of use are disclosed.

Abstract: A polyaxial bone anchoring device includes a bone anchoring element having a head and a shaft, a receiving part having a head receiving portion, a rod receiving portion, and a bore having a bore axis, and a pressure member movable in the bore and having a first surface for engaging the head, wherein the pressure member is movable to a first position where friction between the first surface and the head generates a preload on the head to maintain the shaft at a temporary angular position relative to the receiving part, and wherein the pressure member is configured to engage the receiving part to generate a holding force for holding the pressure member at the first position without a positive lock, and wherein the pressure member is movable in and out of the first position by applying an axial force on the pressure member greater than the holding force.

Abstract: An open implant closure structure includes a helically wound guide and advancement structure having at least two helically wound forms thereon providing a multi-start closing mechanism for use between spaced arms of a cooperating open medical implant having mating helically wound structure thereon. Illustrated structures include interlocking flange forms, v-threads, square threads, reverse angle threads and buttress threads and receivers with break-off extensions and cooperating tooling.

Abstract: A fusionless correction system comprises a longitudinal element extending between a first end and second end. At least one fixation element is disposed with the longitudinal element and is configured for disposal in bone. A lock is disposed with the at least one fixation element and includes at least one bone penetrating projection. The lock is movable relative to the at least one fixation element between a first non-engaging configuration and a second engaging configuration such that the at least one bone penetrating projection extends beyond an outer surface of the at least one fixation element. Methods of use are disclosed.

Abstract: A spinal correction system comprises a flexible longitudinal element extending between a first end and a second end. At least one fixation element includes a first portion and a second portion. The first portion includes an inner surface that defines a cavity such that the longitudinal element is disposable therein. The second portion is configured for penetrating tissue. A coupling member is engageable with the first portion of the at least one fixation element and the longitudinal element to connect the longitudinal element with the at least one fixation element. The coupling member includes a penetrating element configured to extend through the longitudinal element. A flexible member is disposed between the longitudinal element and the inner surface of the first portion of the at least one fixation element. Methods of use are disclosed.

Abstract: Disclosed is a spinal transconnector device for coupling longitudinal spinal rods on either side of the mid-sagittal plane. The device includes two interconnected rod engagement elements, a first rod engagement elements having a vaulted surface adapted to secure to a first longitudinal spinal rod via an interference fit comprising compression of the first longitudinal spinal rod against the generally vaulted surface; and an interference pin that advances into a bore of the first rod engagement element forming an interference fit between the interference pin and the rod engagement element. The interference fit can be associated with elastic deformation of the first rod engagement element occurring as a consequence of the interference pin being advanced through the bore in the engagement element and contacting a surface of the first longitudinal spinal rod.

Abstract: A bone anchoring nail is provided having a threadless shaft with a free end, a head opposite to the free end, the head having a substantially U-shaped recess for accommodation of a rod or a rod-shaped element, a longitudinal bore extending through the shaft and opening towards any one of the head and the free end and a plurality of openings extending through the wall of the shaft and being in communication with the bore. The bone anchoring nail allows quick insertion and reliable fixation enhanced by the in-growth of blood vessels.

Abstract: A spinal stabilization apparatus and method according to which a fastener is engaged with a bone structure of a spinal system. The fastener is connected to a rod by moving the rod sideways toward the fastener in a coronal plane, and the direction of extension of at least a portion of the rod in the coronal plane may be selectively adjusted in predetermined angular increments through 360 degrees.

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: A bone anchoring device includes an anchoring element having a shank to be anchored in a bone or a vertebra, a receiving part connected to the shank the receiving part having a first end opposite to the shank and a second end facing the shank, a longitudinal axis passing through the two ends, a bore coaxial with the longitudinal axis extending from the first end through at least a portion of the receiving part and a substantially U-shaped recess for receiving a rod The U-shaped recess forms two free legs extending in the direction of the first end, the legs are provided with an internal thread. A locking device for securing the rod in the receiving part is provided which includes an external thread cooperating with the internal thread.

Abstract: A bone screw system is presented. The bone screw system has a fixation element, a receiving element, coupling element, and a compression element. In one aspect, the system also has a pair of leg extensions extending upwardly therefrom the receiving element.

Abstract: A polyaxial bone anchoring device includes an anchoring element having a shank and a head having an outer surface portion shaped as a segment of a sphere, a receiving part having a seat portion for receiving the head, and a pressure element having a head contacting surface portion having at least two circumferentially distinct projections and defining a recess for holding the head, the recess having a first region configured to receive the head and a second region defined by at least part of one of the projections and having an undersize compared to the shape of the head, such that when the head is held in the recess, the projections extend over a portion of the head with the largest outer diameter, and the head contacting surface portion corresponding to the second region is expanded from a neutral position to clamp the head by friction.

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: Apparatus and instruments 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 bone anchor assembly includes a bone anchor having a proximal head and a distal shaft configured to engage bone, a receiver member for receiving a spinal fixation element to be coupled to the bone anchor, an insert positioned in the proximal end of the receiver member having a pair of spaced apart insert arms defining a recess therebetween, and a closure mechanism positionable between and engaging the insert arms to capture a spinal fixation element within the recess of the insert and fix the spinal fixation element with respect to the receiver member.

Abstract: An open polyaxial bone anchor includes a pre-assembled receiver, retaining member and compression insert that may be popped-on or snapped-on to the shank upper portion prior to or after implantation of the shank into a vertebra. Cooperating closures have at least two helically wound forms thereon providing a multi-start closing mechanism for use between spaced arms of the bone anchor having mating helically wound structure thereon.

Abstract: An insert (70) for a clamping element with two jaws to clamp a rod-shaped element comprises an inner cavity (144) to accommodate a rod-shaped element and at least one flange element (153) at one longitudinal end of the insert intended to abut against the clamping element. The flange element (153) comprises clamping members (161) to reduce the available room within the inner cavity (144) for the rod-shaped element to be clamped and to clamp the flange element (153) between the rod-shaped element and an outer clamping surface of the clamping element to prohibit any longitudinal movement of the clamped insert.

Abstract: A locking assembly for securing a rod in a polyaxial bone anchoring device includes a first locking element having a first end, a second end, an outer surface with an external advancement structure, an inner wall, an internal advancement structure on the inner wall, and an engagement portion for a tool, and a second locking element having a first end configured to be oriented towards the first end of the first locking element, an opposite second end, an outer surface with an external advancement structure configured to cooperate with the internal advancement structure of the first locking element, and a portion at the second end having a width greater than a greatest width of the external advancement structure of the second locking element, wherein the second locking element is configured to move axially relative to the bone anchoring device at a speed different than the first locking element.

Abstract: A spinal rod connector is adapted to connect two spinal rods. The spinal rod connector includes first and second channels which are defined in a housing. The first and second channels can be urged together in order to capture first and second spinal rods when a fastener is actuated. The spinal rod connector allows the first and second rods to be positioned relative to each other in one of a parallel and a non-parallel manner prior to the fastener locking the first and second spinal rods in position.