Systems, methods and a sensor alignment mechanism are disclosed for medical navigational guidance systems. In one example, a system to make sterile a non-sterile optical sensor for use in navigational guidance during surgery includes a sterile drape having an optically transparent window to drape the optical sensor in a sterile barrier and a sensor alignment mechanism. The alignment mechanism secures the sensor through the drape in alignment with the window without breaching the sterile barrier and facilitates adjustment of the orientation of the optical sensor. The optical sensor may be aligned to view a surgical site when the alignment mechanism, assembled with the sterile drape and optical sensor, is attached to a bone. The alignment mechanism may be a lockable ball joint and facilitate orientation of the sensor in at least two degrees of freedom. A quick connect mechanism may couple the alignment mechanism to the bone.

A support apparatus for supporting an end of a distraction marrow nail includes a base plate attachable to the pelvis, and a mounting device on the base plate for mounting of the support end of the distraction marrow nail. The mounting device includes a ball seat having a cavity forming a ball seat surface for mounting a ball on the support end of the distraction marrow nail, wherein the inside radius of the ball seat surface corresponds to the outside radius of the ball, and wherein the ball seat is arranged so that the ball of the distraction marrow nail can be movably mounted such that the distraction marrow nail can perform a movement sufficient for an extensively normal movement pattern of a femur and cannot luxate out of the ball seat when implanted in the femur.

A pivotal bone screw assembly includes a threaded shank body having an integral upper portion receivable in a receiver, with the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. The assembly also includes a downloadable compression insert with a side arm extension for engagement and compression by a vertically-translating insert side compressing member so as to lock the assembly independent of the closure top.

Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.

A coupling device is provided for coupling a rod to a bone anchoring element. The coupling device includes a receiving part having a first end, a second end, a central axis extending through the first end and the second end, and a channel for receiving a rod. The receiving part defines an accommodation space for accommodating a head of a bone anchoring element, the accommodation space having an opening for inserting the head. The coupling device further includes a pressure element arranged at least partially in the accommodation space, the pressure element having a flexible portion to clamp an inserted head, and a clamping element extending at least partially around the flexible portion of the pressure element. The clamping element is configured to move from a first position to a second position in which the clamping element exerts a clamping force onto the pressure element, where the movement includes rotating the clamping element around the central axis.

Implant connectors and related methods are disclosed herein. In some embodiments, a connector can include a low-profile portion to facilitate use of the connector in surgical applications where space is limited. In some embodiments, a connector can include a biased rod-pusher to allow the connector to snap onto a rod and/or to drag against the rod, e.g., for provisional positioning of the connector prior to locking.

A system and method for sharing and absorbing energy between body parts. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Devices, methods and systems for stabilizing at least a portion of the spinal column are provided. Devices include anchors and coupling members for engaging an elongate member. Systems include an elongate member sized to span a distance between at least two vertebral bodies and being at least partially formed of a flexible material. A number of anchors and coupling members are used to secure the elongate member to each of the vertebral bodies. The anchors can be compressed towards one another and the elongate member secured thereto and/or the elongate member can be tensioned to provide corrective forces to the spine.

A method of mounting a spinal rod extension includes accessing at least a portion of an existing spinal rod. The method also includes removing a locking cap from an existing pedicle screw that secures the existing spinal rod. The method also includes placing a connector portion of the spinal rod extension through a screw head of the existing pedicle screw. The method further includes using a connector to secure the connector portion to the existing spinal rod.

Interspinous process implants are disclosed. Also disclosed are systems and kits including such implants, methods of inserting such implants, and methods of alleviating pain or discomfort associated with the spinal column.