Abstract: A surgical instrument comprises a member being engageable to a spinal implant configured for connection to a bone fastener shaft. An actuator is connected to the member. A latch is connected to the actuator and the connection is configured to change between at least one non-locked orientation such that the actuator is movable relative to the member and a locked orientation such that the actuator is fixed relative to the member. Systems, spinal constructs, implants and methods are disclosed.

Abstract: An anchor assembly can be couplable to a bone and can include an anchor and a housing. The anchor can include a shank securable to bone and a head coupled to a proximal portion of the shank. The housing can include a proximal portion including an anchor bore and a distal portion including a secondary bore configured to engage the anchor to limit angulation of the anchor relative to the housing.

Abstract: A bone anchoring device includes a bone anchoring element with a spherical segment-shaped head, a receiving part configured to couple a rod to the bone anchoring element, and having a top end, a bottom end, a first passage at the bottom end with a first longitudinal axis, and a second passage at the top end with a second longitudinal axis that intersects the first longitudinal axis, a compression element, and a locking element. The receiving part also has a recess for the rod, the recess extending from the top end towards the bottom end and having a bottom that extends along an axis that is perpendicular to the second longitudinal axis. The receiving part or the compression element further has a seat. The compression element is configured to move along the first longitudinal axis while the locking element is configured to move along the second longitudinal axis.

Abstract: A polyaxial bone anchor with a receiver, a shank, a pressure insert, a retainer for holding the shank in the receiver, and a closure. The receiver includes at least one insert alignment surface formed in an axial bore of the receiver to prevent the insert from axially rotating relative to the receiver when the insert is engaged by the closure. In one aspect the retainer is uploadable through the bottom opening of the receiver, and in another aspect the insert and the retainer are both uploadable through the bottom opening.

Abstract: A spinal screw assembly is provided. The assembly may be provided with a screw and a movable head in which angulation of the screw relative to the movable head is constrained so that angulation within limits is allowed in one plane but lesser or no angulation is allowed in another plane. Methods to assemble the disclosed apparatus are also disclosed.

Abstract: A ball and socket joint assembly is disclosed that includes a body defining a cavity, a collet disposed in the cavity to receive a ball of a connector, and an actuator shaft coupled to the collet for rotating and translating the collet in the cavity. The cavity has a distal opening to accept the ball and an engagement feature extending into the cavity. The collet has an outer diameter larger than the opening in the body when the ball is disposed in the collet, and the collet has a corresponding engagement feature around at least a portion of the outer surface for receiving the engagement feature and converting rotation of the compression member into translation of the compression member along a proximal-distal axis of the body. The collet is compressed against the opening of the cavity when the collet is advanced distally against the opening.

Abstract: A coupling device for coupling a bone anchor to a rod includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for holding a head of a bone anchor, a pressure member having a first portion for holding and clamping the head and a deformable portion with a free end, and a locking member. The pressure member is expandable for inserting the head and adjustable to lock the head. When the deformable portion is at a first configuration, the free end of the deformable portion is supported by the receiving part, and at least part of the locking member is movable to exert a force on the deformable portion for adjusting the deformable portion to a second configuration where at least part of the deformable portion is farther away from the longitudinal axis compared to the first configuration.

Abstract: Systems for variable angle insertion of surgical fasteners relative to an orthopedic plate with locking of the surgical fastener relative to the plate upon insertion. The systems may include a pivot member secured relative to either the orthopedic plate or the fastener. In either regard, the pivot member may provide locking engagement with the plate to lockingly engage the fastener relative to the plate.

Abstract: The disclosure provides a spinal implant having spinal anchors comprising a bone anchor and a receiver configured to securely and polyaxially receive the bone anchor. Further, provided herein are methods for using the spinal implant.

Abstract: A wire harness including: a wire harness main body that includes an electric wire, an exterior tube that covers an outer circumferential surface of the electric wire, and a first path restrictor that is attached to an outer circumferential surface of the exterior tube and is configured to restrict a path of the exterior tube; and an attachment that is attached to an outer circumferential surface of a portion of the first path restrictor in a lengthwise direction thereof.

Abstract: A spinal construct includes a first member. The first member includes a proximal portion defining a first cavity and a distal portion defining a second cavity disposed at an angle relative to the first cavity. The distal portion is configured for connecting with a second member. The second member is configured for fixation with vertebral tissue. A crown defines a first opening aligned with the first cavity and a second opening aligned with the second cavity. Implants, systems, instruments and methods are disclosed.

Abstract: The present disclosure includes a polyaxial bone fixation element for use in spinal fixation to interconnect a longitudinal spinal rod with a patient's vertebra. The polyaxial bone fixation element preferably includes a bone anchor, a collet, a body, and a locking cap. The polyaxial bone fixation element preferably enables in-situ assembly. That is, the polyaxial bone fixation element is preferably configured so that in use, the bone anchor may be secured to the patient's vertebra prior to being received within the body. Accordingly, the polyaxial bone fixation element enables a surgeon to implant the bone anchor without the body to maximize visibility and access around the anchoring site. Once the bone anchor has been secured to the patient's vertebra, the body can be snapped-onto the bone anchor. The bone anchor preferably also includes a second tool interface so that a surgical instrument can be directly coupled to the bone anchor.

Abstract: A receiving part for receiving a rod for coupling the rod to a bone anchoring element, the receiving part including: a receiving part body having a channel for receiving a rod and defining an accommodation space for accommodating a head of a bone anchoring element, the accommodation space having an opening for inserting the head; and a pressure element at least partially in the accommodation space, the pressure element including a first portion having a recess to receive the rod, and a second portion having a flexible portion to clamp the head, wherein the pressure element is moveable along a longitudinal axis of the receiving part body from an inserting position to insert the head, to a pre-locking position to clamp the head in the receiving part by a pre-stress exerted by the pressure element, to a locking position to lock the head in the receiving part.

Abstract: A screw tower that is a single-use instrument that attaches to existing screws but remains open along a rod slot to allow for screws to intermesh and prevent interference of adjacent screws during screw and rod insertion. The screw tower interfaces with existing features of the screws to facilitate screw insertion, rod insertion, rod reduction, and locking cap insertion in a percutaneous approach. The tower is broken in half and removed from patient to end with a completed construct.

Abstract: In one aspect, the present disclosure provides a monolithic percutaneous-screw system for use in spinal surgery. The system includes (i) a receiver having a distal base and a pair of opposing arms extending proximally from the base, a pair of opposing distal breakoff sections, each connected monolithically to a proximal end of a corresponding one of the arms, (ii) a pair of opposing proximal breakoff sections, (iii) a pair of opposing intermediate extenders, each extending from a distal end, connected monolithically to a corresponding one of the distal breakoff sections, to a proximal end connected monolithically to a corresponding one of the proximal breakoff section, and (iv) a guide cap connected monolithically to both of the proximal breakoff sections.

Abstract: Spinal fixation apparatus with a first end for selectively flexing to expand in diameter when receiving a head of an engagement member, the engagement member for coupling to a portion of a spine and a flexible sidewall between the first end and a second end, the flexible sidewall to selectively expand in length, between the first end and the second end, when the first end is not in receipt of the head of an engagement member and alternatively to contract in length when the first end is in receipt of the head of the engagement member.

Abstract: A ball and socket joint assembly is disclosed that includes a body defining a cavity, a collet disposed in the cavity to receive a ball of a connector, and an actuator shaft coupled to the collet for rotating and translating the collet in the cavity. The cavity has a distal opening to accept the ball and an engagement feature extending into the cavity. The collet has an outer diameter larger than the opening in the body when the ball is disposed in the collet, and the collet has a corresponding engagement feature around at least a portion of the outer surface for receiving the engagement feature and converting rotation of the compression member into translation of the compression member along a proximal-distal axis of the body. The collet is compressed against the opening of the cavity when the collet is advanced distally against the opening.

Abstract: A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an element engageable with a second mating surface of the bone fastener. The members are engageable with the bone fastener in a release configuration, an intermediate configuration and a locked configuration. Systems, surgical adaptors, spinal implants and methods are disclosed.

Abstract: In order to improve the reliability of a dental restoration, a method of implanting the dental restoration is provided. The method includes virtually disposing a virtual implant selected from a digital library on the basis of a CT image to correspond to an implantation information, and a virtual implanting guide sleeve, which is virtually and concentrically disposed to be spaced upward from an upper end portion of the virtual implant by an offset distance, and a scanning image overlap and are integrally stored; and generating design information of a surgical guide, wherein a virtual coupling hole corresponding to an outer circumference of the virtual implanting guide sleeve is formed in the design information.

Abstract: Systems, methods, and devices for securing a spinal rod are provided. A clamp assembly comprises a tulip comprising an opening comprising an inner surface, wherein the inner surface is threaded; and a threaded locking cap disposed in the opening, wherein threads of the locking cap and the inner surface include various geometries.

Abstract: A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion.

Abstract: Orthopedic fixation devices and methods of installing the same. The orthopedic fixation device may include a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element and a retention member is configured to allow polyaxial rotation of the bone fastener and also to lock the bone fastener in place upon application of a force on a saddle and clamp in the coupling element.

Abstract: A pivotal bone anchor assembly for securing an elongate rod to patient bone includes a shank having a head and an anchor portion, a receiver having an axial bore and a channel for receiving the elongate rod, a collet insert top loaded into a first position within the axial bore and having a collet pocket for receiving the shank head, and a pressure ring uploadable into the collet pocket prior to the shank head and having an upper surface for engaging the rod. After receiving the shank head within the collet pocket, the collet insert and pressure ring are downwardly deployable with the shank head into a second position to capture the shank head in the assembly, the pressure ring being operable to transfer pressure from the elongate rod in the channel to the shank head to lock an angular position of the shank relative to the receiver.

Abstract: An anchor extender can be couplable to a bone anchor and can include an outer sleeve, an inner sleeve, and a lock. The lock can be operable to translate the inner sleeve relative to the outer sleeve between a locked position and an unlocked position to secure the inner sleeve and the outer sleeve to a head of the bone anchor in the locked position and to release the inner sleeve and the outer sleeve from the head of the bone anchor in the unlocked position.

Abstract: Disclosed spinal implants may include a rod extending in a horizontal direction and a first implant receiver having a first passageway extending in the horizontal direction and a first threaded passageway extending in a vertical direction, for example. Additionally, the implant may include a second implant receiver having a second passageway extending in the horizontal direction and a second threaded passageway extending in the vertical direction, for example. The implant may include a first set screw having a size and shape corresponding to a size and shape of the first threaded passageway and a second set screw having a size and shape corresponding to a size and shape of the second threaded passageway, for example. In some embodiments, the rod may extend in the horizontal direction through the first and second passageways and may be constrained from moving in the vertical direction by the first and second passageways, for example.

Abstract: A screw insertion system has a screw having a threaded shaft and a head. The head has a conically tapered outer surface, the taper increasing in distance from a central longitudinal axis of the screw from a free end of the head towards a larger diameter adjacent the connection between the head and the threaded shaft. The conically tapered head outer surface has preferably two helically extending partially rounded threads. The head has a drive element for engaging a driver. A tubular screw holder has an outer surface and internal bore extending between a leading end and a trailing end for receiving the screw. The leading end having a conically tapered inner threaded portion for engaging the conically tapered outer thread of the screw head. The tubular screw holder outer surface having a diameter less than or equal to the maximum diameter of the conically tapered head.

Abstract: A spinal implant includes a first member having an inner surface defining an implant cavity and at least one mating element. A second member includes a head and a shaft configured to penetrate tissue. The head includes at least one mating element engageable with the at least one mating element of the first member and a part. A third member includes an inner surface engageable with the part such that the members comprise a bone fastener having a selected movement. Systems, instruments and methods are disclosed.

Abstract: An embodiment includes a system comprising: a tulip including a slot to receive a linkage, first and second side walls that define a portion of the slot, and a ring that couples the first side wall to the second side wall; wherein the ring couples to the first side wall at a thinned first proximal fulcrum and to the second side wall at a thinned second proximal fulcrum and the ring pivots about the first and second proximal fulcrums when the ring is forced proximally; wherein the first side wall includes a first sidewall projection that projects past the first proximal fulcrum and the second side wall includes a second sidewall projection that projects past the second proximal fulcrum. Other embodiments are described herein.

Abstract: The present invention is a fastener (30). The current fastener (30) is particularly useful in surgical procedures. Among other things, the surgical fastener (30) is provided with a conduit (50, 210) to dispense or carry biocompatible substances.

Abstract: Modular devices, assemblies, and methods for coupling one or more fixation elements, such as bone fasteners and/or elongate rods. The device includes at least one coupling element having a body portion for receiving a bone fastener and an extension portion extending transversely from the body portion. A locking assembly is received in the coupling element and includes a locking member, a clamp portion, and a ring portion, wherein the locking member is configured to contact an upper portion of the clamp portion and the ring portion is configured to at least partially surround a lower portion of the clamp portion. When unlocked, the bone fastener is moveable within the clamp portion to allow for polyaxial movement of bone fastener relative to the coupling element, and when locked, the bone fastener is fixed relative to the coupling element.

Abstract: Devices for fixing interbody fusion devices to bone by helically or corkscrew-shaped elements are provided. Methods for surgically implanting an interbody fusion device using helically-shaped fixation wire are provided.

Abstract: The overdenture holder device includes a holder abutment in which a through insertion portion is formed to be opened in both directions of a body portion having a bottom end portion inserted into a top end of the fixture and protruding upward and a fastening hole penetrates along a longitudinal direction and has an inner circumferential side on which a holding step protruding radially inward is formed, a fastening screw having a bottom end portion inserted into the fastening hole to be screw-coupled with the inside of the top end of the fixture and a head portion formed at a top end portion and to be held by the holding step, and a pressurizing device coupled with a top end of the body portion and configured to provide a pressurizing force such that an outer surface of the fixing bar is fixed to an inside of the through insertion portion.

Abstract: An anchor assembly can be couplable to a bone and can include an anchor and a housing. The anchor can include a shank securable to bone and a head coupled to a proximal portion of the shank. The housing can include a proximal portion including an anchor bore and a distal portion including a secondary bore configured to engage the anchor to limit angulation of the anchor relative to the housing.

Abstract: A modular tensioned spinal screw comprises a bone fastener having a threaded elongate shaft and a spherical head at an upper end of said shaft. A modular yoke for polyaxial attachment to the head of said bone fastener has an inner bore, an upper end configured to receive a connecting rod and a lower end configured to receive the head of the bone fastener. An axially movable radially expandable socket collar, and a saddle having a rod receiving cradle are supported within the yoke bore. A retention pin fixed to the yoke movably supports the saddle and a tension member within the bore. The tension member comprises a resilient biasing element oriented such that upward axial movement of the saddle produces a downward bias force on said saddle to compress the head of the bone fastener between said saddle and said socket collar in a provisional holding position.

Abstract: A receiver subassembly adapted to couple with the capture portion of a bone anchor or shank to form a pivotal bone anchor assembly. The receiver subassembly includes a receiver having cavity above a distal opening sized and shaped for bottom loading the capture portion there-through, with the cavity configured to support both a split ring retainer and second split ring above of the spit ring retainer within the receiver. The receiver subassembly further includes an insert positionable in the receiver above the split rings and configured for downward deployment by tooling to engage the capture portion of the bone anchor. The split ring retainer is configured to expand around and close below the capture portion of the bone anchor upon an uploading of the capture portion into the cavity, so as to capture the capture portion within the cavity with the bone anchor extending downward through the distal opening.

Abstract: The invention relates to a surgical bone screw comprising a shaft which has a bone thread and comprising a blocking means for interacting with a bone plate or for directly anchoring in the bone, in particular in the cortical bone. The surgical bone screw also comprises a screw head which has a rotationally symmetrical enveloping contour. The blocking means has a rib structure with at least one flank structure portion extending in the circumferential direction. According to the invention, the lateral surface of the enveloping contour has a constant or stepped concave progression, and the rib structure flank portion which extends in the circumferential direction is interrupted at least once in the circumferential direction, in particular multiple times, such that at least one elevation, in particular a plurality of elevations which are spaced in the circumferential direction, is produced in order to interact with the bone plate or with the bone in a blocking manner.

Abstract: Spinal fixation system connectors comprising spring cage elements. In some embodiments, an engagement member, such as a bone screw, may be configured to be coupled with and received within a connector body. A spring cage structure may also be configured to be coupled with the connector body. The spring cage structure may comprise a spring configured to be positioned in a relaxed configuration and a flexed configuration, such that the spring defines an opening having a first size in the relaxed configuration and a second, larger size in the flexed configuration to allow the opening to receive and engage a head of the engagement member within the connector body.

Abstract: A coupling device for coupling a bone anchor to a rod includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for holding a head of a bone anchor, a pressure member having a first portion for holding and clamping the head and a deformable portion with a free end, and a locking member. The pressure member is expandable for inserting the head and adjustable to lock the head. When the deformable portion is at a first configuration, the free end of the deformable portion is supported by the receiving part, and at least part of the locking member is movable to exert a force on the deformable portion for adjusting the deformable portion to a second configuration where at least part of the deformable portion is farther away from the longitudinal axis compared to the first configuration.

Abstract: A bone fusing implant device includes an elongated body extending along a longitudinal direction. The elongated body includes a first segment having an outer surface with cortical threads, a second segment having an outer surface with cancellous threads, a top segment and a bottom segment. The first segment is adjacent to the second segment along the longitudinal direction and is configured to engage a cortical bone with the cortical threads and the second segment is configured to engage a cancellous bone with the cancellous threads. The elongated body has one or more elongated fusing gutters extending along the longitudinal direction on an outer surface of the elongated body covering the first and second segments, a central opening extending along the longitudinal direction through the elongated body's center and one or more through-openings that extend horizontally and intersect with the one or more fusing gutters.

Abstract: A bone anchoring device includes an anchoring element having a shaft and a head, a receiving part having a coaxial bore and a seat for receiving the head, a pressure element configured to be movable within the bore, and a preload element being positionable between the head and the pressure element. When the head is inserted in the receiving part, the head is pivotable with respect to the receiving part, and can be locked at an angle relative to the receiving part by the pressure element. The pressure element can assume a position relative to the receiving part where the pressure element and the preload element are in direct contact, and where the pressure element exerts a force onto the head via the preload element to maintain one of a plurality of releasable angular positions between the head and the receiving part by friction before locking the head.

Abstract: A surgical device is provided and includes a handle housing, an endoscopic assembly, and a follower assembly. The endoscopic assembly extends distally from the handle housing and includes an inner tube defining a longitudinal axis. The inner tube includes a distal portion defining a pair of opposed tines. The endoscopic assembly is configured to support a plurality of anchors at least partially therein. The follower assembly is disposed at least partially within the inner tube at a location proximal of the plurality of anchors, and includes a head and a shaft. A portion of the head is disposed between the pair of opposed tines. Actuation of the endoscopic surgical device causes rotation of the inner tube about the longitudinal axis relative to the handle housing, and causes distal advancement of the follower assembly relative to the inner tube.

Abstract: There is provided a pedicle screw assembly for dynamic and static fixation, which is able to be assembled during the operation and allows a doctor to make an emergency choice between fusion fixation and non-fusion fixation. The pedicle screw assembly is used for inner fixation in spine surgery. During the operation, a pedicle screw is firstly implanted in a pedicle, and then a spherical head of the pedicle screw is enclosed by a connecting claw. After a screw seat is connected to the connecting claw by means of threads, a connecting rod is inserted in a groove and finally a locking screw is tightened to complete the fixation.

Abstract: A system for the amelioration of a recess (56) in a porous material, said system comprising an element (2) for coupling in mechanical energy, and a cylindrical collar (4, 40) having a central recess (44,45) for a guide pin (8), wherein the pin (8), having a cannulation (35), is provided to be inserted as far as the bottom of the recess (56) using a wire (52), wherein the pin (8) is surrounded by an amelioration sleeve (7), wherein the external cylindrical jacket surface of the sleeve (7) has substantially the same external diameter as the collar (4, 40), and wherein the pin (8) is received movably in the central recess (44,45) such that, when mechanical energy is applied, the collar (4,40) can be moved relative to the guide pin (8) in the direction toward the bottom of the recess (8) while liquefying and displacing the material of the sleeve (7).

Abstract: A coupling assembly for coupling a rod to a bone anchoring element includes a receiving part with an accommodation space defining an opening for inserting and accommodating a head of the bone anchoring element, and a pressure element having a cap portion configured to hold the head. In an inserting position, the cap portion of the pressure element is expandable in the accommodation space of the receiving part, and a first retaining element is configured to prevent the pressure element from moving towards a first end of the receiving part. In a pre-locking position, the head is held in the cap portion of the pressure element and is pivotable in the receiving part, while the cap portion is restricted from expanding to prevent removal of the head, and where a second retaining element is configured to prevent the pressure element from moving from the pre-locking position towards the inserting position.

Abstract: Orthopedic fixation devices and methods of installing the same. The orthopedic fixation device may include a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element. A retaining clip disposed below the fastener in an annular channel of the coupling element has an inner diameter which is less than a maximum diameter of the head of the bone fastener.

Abstract: The disclosure provides a spinal implant having spinal anchors comprising a bone anchor and a receiver configured to securely and polyaxially receive the bone anchor. Further, provided herein are methods for using the spinal implant.

Abstract: Methods of joint repair employing sutures and attached fixation devices are discussed. For example, a bone block graft procedure (e.g., Latarjet) is discussed which employs fixation devices to secure contact between graft surfaces of two bones. A suture construct, including a continuous suture loop routed through a first fastener, is secured to a first bone. Looped ends of the suture loop are passed through passageways formed in the two bones. The looped suture ends are further routed through a second fastener. The second fastener is mounted to the second bone and a sliding knot, formed in the looped suture ends, is advanced into contact with the second fastener. The suture is further tensioned using a tensioner device to secure the two bones together.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element is provided, wherein the coupling assembly includes a receiving part having a first end, a second end, a central axis extending through the first end and second end, an accommodation space for accommodating a head of an anchoring element, a bore extending from the accommodation space to the first end, and a recess for receiving a rod. The accommodation space has an opening at the second end sized to permit insertion of a head of the bone anchoring element. The coupling assembly further includes a retainer element configured to be positioned at least partially in the accommodation space and being radially expandable and/or compressible to allow retaining a head inserted through the opening. The retainer element is held in position adjacent the opening by an engagement structure provided at or in the accommodation space.

Abstract: The present invention generally provides a polyaxial fixation device having a shank with a spherical head formed on a proximal end thereof, and a receiver member having an axial passage formed therein that is adapted to polyaxially seat the spherical head of the shank. The polyaxial bone screw further includes an engagement member that is adapted to provide sufficient friction between the spherical head and the receiver member to enable the shank to be maintained in a desired angular orientation before locking the spherical head within the receiver member.

Abstract: A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion.