The present disclosure illustrates an osteotome for treating hard tissue and methods of use. The osteotome embodiments described herein include a shaft with a working end configured to displace hard tissue and a lumen to deliver material through the shaft. The working end may create pathways by selectively transitioning from a linear to a non-linear configuration. The lumen may deliver material through the shaft while the working end is in a linear or a non-linear configuration allowing precise filling of the pathways.

Drivers and drive systems (e.g., off-axis drive systems, pneumatic motors, multi-gear drive systems, and/or the like), and kits comprising drivers with drive systems, such as those, for example, configured to move a drive shaft.

Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device (e.g., an energy delivery device).

Apparatus and methods are provided to penetrate a bone and associated bone marrow using a powered driver. The powered driver is operable to insert an intraosseous device into a bone and associated bone marrow. The powered driver may include a housing having a distal end and a proximal end; a drive shaft having a first end disposed within the housing; a motor disposed within the housing and rotatably engaged with the drive shaft; a power supply to supply power to the motor; and a trigger assembly to activate the motor to rotate the drive shaft. A light may be connected to the power supply and operable to illuminate an insertion site for the intraosseous device.

An automatic detection of surgical instruments with respect to a type and a location thereof is provided with a detection system, which includes at least two surgical instruments, which each include at least one cavity extending along a longitudinal axis of the instrument and a proximal entry region to the cavity. An angle of the proximal entry region in relation to the longitudinal extension of the cavity is different in the two instruments. A sensor unit includes two electromagnetic sensors and is insertable into the cavity. One of the sensors extends axially in the cavity, and the other sensor is arranged in the entry region. A field generator generates an electromagnetic field. An analysis unit analyzes signals transmitted by the sensors to the analysis unit in accordance with the location thereof in the field of the field generator.

An apparatus and method for penetrating bone marrow is provided. The apparatus may include a housing such as a handheld body, a penetrator assembly, a connector that releasably attaches the penetrator assembly to a drill shaft, a gear mechanism, a motor and a power supply and associated circuitry operable to power the motor. The penetrator assembly may include a removable inner trocar and an outer penetrator or needle. It may also include a grooved trocar that allows bone chips to be expelled as the apparatus is inserted into bone marrow. Various connectors are provided to attach the penetrator assembly to the drill shaft.

Disclosed in some forms is a process of limiting the impact of surgery on a nerve, the process comprising applying a therapeutic substance to the nerve during surgery. In some aspects, disclosed is a formulation for reducing nerve trauma comprising an active pharmacological ingredient adapted to intervene in the activation of pathways of cellular degradation within the nerve and a carrier adapted to reduce dissemination of the active pharmacological ingredient beyond the site at which its effect is intended.

A device for intraosseous injection is provided which can accurately, quickly, and safely introduce desired fluid into a patient's bone marrow. The intraosseous injector includes a housing, a container located within the housing, a hollow needle, and a valve. The intraosseous injector may further include a release mechanism comprising a bone probe needle and a movable release member. The intraosseous injector may include a depth limiter mechanism operable to limit a depth of penetration of the needle relative to a surface of a bone. A method for intraosseous injection is also provided.

In some embodiments, a bone implant for percutaneous use is provided. The bone implant comprises a head, a body adjacent to the head and a tip opposite the head. At least the head, body or tip is configured to contact bone. An expandable member contacts at least one of the head, tip or body and is movable from an unexpanded configuration to an expanded configuration when deployed at a bone implant site. In some embodiments, a system for percutaneous bone harvesting is provided.

Systems and methods for attaching a reference marker to a patient in a computer-assisted image-guided surgery system. An apparatus for attaching a reference marker to a patient includes an elongated member extending between a first end and a second end, a sharp tip located proximate to the first end of the elongated member that is configured to break through a cortical surface of a bone of the patient to enable the elongated member to be advanced into the bone, an anchoring device that is extendable from the elongated member in order to anchor the apparatus within the bone and inhibit relative movement of the apparatus and the bone, and a reference marker device comprising at least one optical marker configured to enable the apparatus to be tracked using a motion tracking system.