A screw insertion instrument includes a handle, a driving assembly, and a stylet. The driving assembly extends distally from the handle and includes a knob, a tubular body extending distally from the knob, and a driver including an elongated body extending through the knob and the tubular body. The elongated body has a proximal region operably coupled to the handle and a distal region extending distally beyond the tubular body and engageable with a pedicle screw. The stylet includes an elongated body positionable through first and second longitudinal bores defined through the handle and the driver, respectively. A proximal portion of the stylet is positionable adjacent the handle and a distal portion of the stylet extends distally beyond the driver and is positionable through a third longitudinal bore defined through the pedicle screw such that the distal portion of the stylet extends distally beyond the pedicle screw.

Enzymatic and non-enzymatic detectors and associated membrane apparatus, and methods of use, such as within a fully implantable sensor apparatus. In one embodiment, detector performance is controlled through selective use of membrane configurations and enzyme region shapes, which enable accurate detection of blood glucose level within the solid tissue of the living host for extended periods of time. Isolation between the host's tissue and the underlying enzymes and reaction byproducts used in the detectors is also advantageously maintained in one embodiment via use of a non-enzyme containing permeable membrane formed of e.g., a biocompatible crosslinked protein-based material. Control of response range and/or rate in some embodiments also permits customization of sensor elements. In one variant, heterogeneous detector elements are used to, e.g., accommodate a wider range of blood glucose concentration within the host. Methods of manufacturing the membranes and detectors, including methods to increase reliability, are also disclosed.

A percutaneous revision implant for percutaneously revising an existing implant located in the spine of a patient may include, for example, extending the existing implant construct to span additional portions of the spine of the patient. The percutaneous revision implant comprises a proximal end portion and a distal end portion. The proximal end portion comprises a connector having two opposable walls joined at one end to define a cavity having a first longitudinal axis. The cavity is suitable to receive and engage a rod of the existing implant. The percutaneous revision implant of the invention permits a medical practitioner to extend an existing implant construct without significantly disrupting or removing the existing implant or its component parts. A method of using same is also provided.

Instruments, apparatus and procedures for performing surgical operations are provided. A sleeve for performing surgical procedures may include an elongate main body; a channel extending within a length of the elongate main body; and a retainer configured and dimensioned to releasably retain a fixation member in the sleeve at a predetermined orientation and predetermined distance from a distal end of the sleeve. An assembly for performing surgical procedures may include a sleeve comprising: an elongate main body, a channel extending within a length of the elongate main body; a fixation member having been preloaded in the sleeve; and a bone fastener comprising: a shaft configured to engage bone, a tulip configured to receive a rod, a retention feature and extended tabs extending from the tulip.

Certain systems, methods, and devices described herein are configured to dynamically model a patient area for surgery and/or other treatment, dynamically identify one or more features and/or characteristics thereon such as the length and/or elasticity of the posterior longitudinal ligament (PLL), dynamically allow modification of the model, dynamically limit and/or assist in modification of the model, and/or dynamically generate guidelines for generation of patient-specific implants and/or treatment kits for a specific patient.

An apparatus and method are provided for a syndesmosis treatment construct configured to be placed into a cinched configuration that presses a first bone against a second bone. The syndesmosis treatment construct comprises a proximal fixator to contact the first bone and a distal fixator to contact the second bone. A first suture and a second suture are parallelly looped through the proximal fixator and oppositely looped through the distal fixator. Distal ends of the first and second sutures are fixated within a washer disposed between the proximal fixator and the first bone. Proximal ends of the first and second sutures are passed through openings in the washer and through the proximal fixator. Pulling of the proximal ends by a practitioner places the syndesmosis treatment construct into a cinched configuration. Any of various suitable suture knots may be formed so as to fixate the cinched configuration.

Systems and methods for tibial plateau leveling osteotomy (TPLO) are disclosed. According to some embodiments, an osteotomy method may include cutting a tibia with an arcuate cut to separate a tibial plateau of the tibia from a tibial base of the tibia, rotating the tibial plateau relative to the tibial base from a first orientation to a second orientation, and, with the tibial plateau in the second orientation relative to the tibial base, securing an implant to the tibia to secure the tibial plateau to the tibial base. Securing the implant to the tibia may include embedding a first leg of the implant into the tibial base, and embedding a second leg of the implant into the tibial plateau such that the first and second legs apply compression urging the tibial plateau toward the tibial base.

Stabilization device embodiments for use in orthopedic procedures to couple to target areas of tissue. Stabilization devices described can be used to fuse, fix, provide a preselected spacing, and/or provide a preselected compression to target areas during use. Stabilization devices can be coupled to target areas using alignment elements such as pins, k-wires, and/or screws.

Various systems and methods for treating the spine are provided. A portal system can be provided for treating the spine. The portal system can include a portal comprising a proximal end and a distal end, a first passageway extending between the proximal end and the distal end, a second passageway extending between the proximal end and the distal end, and a latch. The bone tie can include a head, a body section comprising one or more gears, and a fastener section comprising a ratchet.

A method for fusing a spinal sacroiliac joint and a surgical kit. The kit includes a bone-void filler, stabilization device or implant, a guide pin, a joint locator, a set of dilation tubes, a reamer, a novel directional cannula, a novel tapping cap, a novel drill guide, a drill bit, and a novel implant positioner. The method includes the steps of locating the sacroiliac joint, retracting the soft tissue exposing the graft site, removing any bone obstructions and preparing a relatively smooth graft site horizontal to the immediate sacroiliac joint, creating a cavity in the ilium and sacrum to a predetermined depth that spans the sacroiliac joint, inserting a novel stabilization implant into the cavity, and seating the implant within the cavity at a predetermined depth.