A flexible surgical access port is provided that includes a flexible body. The flexible body is configured to elastically expand in response to passage of a surgical equipment therethrough, and thus retracts as the surgical equipment moves past. Thus, the flexible body can provide a surgical access path through Kambin's Triangle, and large surgical equipment passed through the flexible body does not compress the exiting nerve or the traversing nerve root for a prolonged period of time.

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 an energy delivery device).

Articulated instruments that include tools for disrupting and/or distracting tissue, and methods of using the same.

A lateral disc cutter for morcellating and decorticating tissue of an intervertebral disc from between adjacent vertebrae. The device can be arranged in a retracted configuration for insertion via an access tube, and in an extended configuration for cutting of tissue in the target region. The blades may be extended to contact the concave endplate in an orientation that is substantially parallel to a mid-plane of the intervertebral disc. Blades of the device may be configured with a convex profile that substantially conforms to the concave shape of the endplate for enhanced contact length between the blade and the endplate. In some embodiments, the blades are configured for removal and replacement without need for tools, with the blades selectively determining a maximum displacement width of the morecellator assembly.

A method for performing percutaneous spinal interbody fusion on a spine of a patient can include inserting without direct visualization a neuro-monitoring dilating probe into the patient, performing neuro-monitoring via the neuro-monitoring dilating probe, advancing the neuro-monitoring dilating probe into a disc space, passing a second dilator over the neuro-monitoring dilating probe, and advancing the second dilator into the disc space. A kit for performing percutaneous spinal interbody fusion can include a neuro-monitoring dilating probe, a second dilator, a tissue removal tool, an access portal comprising an adjustable depth stop, and a discectomy verification device.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

Systems and methods are provided for determining acceptable ranges of pressures for use by a robotic arm on a surgical instrument, robotic systems and methods that are limited to using the acceptable ranges of pressures, and the medical devices for use in the robotic surgery. Learning software is included in the methods and systems for correlating manually-performed procedures with pressure sensors as a tactile gauge for qualifying the acceptable ranges of pressures for use by a robotic system. Robotic systems and methods are provided for (i) locating tissue borders of a surgical site, (ii) identifying a preferred pressure, and (iii) transmitting the data to the computer to avoid violating the integrity of tissue surrounding the surgical site.

A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin’s triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

A surgical instrument includes a first member defining an axis and including a cutting surface. A second member includes a cutting surface that is rotatable relative to the first member. A third member includes an outer surface. The cutting surface of the second member is rotatable relative to the outer surface to transfer the cut tissue along the axis. Systems and methods are disclosed.

A discectomy tool comprising: a) a cannula having an outer surface having a longitudinal bore therein, a proximal end and a distal end; b) a steering wire disposed in the longitudinal bore; c) a flexible, hollow transmission shaft disposed in the cannula, the shaft having a throughbore, a proximal end portion, a distal end portion and an outer surface having a thread extending therefrom; d) an irrigation source fluidly connected to the throughbore; e) a cutting tip attached to the distal end portion of the transmission shaft.