The present invention relates to a method, such as a surgical method for assisting a surgeon for placing screws in the spine using a robot attached to a passive structure. The present invention also related to a method, such as a surgical method for assisting a surgeon for removing volumes in the body of a patient using a robot attached to a passive structure and to a device to carry out said methods. The present invention further concerns a device suitable to carry out the methods according to the present invention.

A method and apparatus for preparing a region between adjacent bones for fusion. A first aperture is formed that extends through one of the bones. An undercutting system is inserted into the first aperture. The undercutting system includes an insertion apparatus and a cutting assembly. A first path is cut between the adjacent bones by extending or retracting the cutting assembly with respect to the insertion apparatus.

A method comprises the steps of: imaging a patient anatomy; selecting an implant strategy for at least one bone fastener having a first member; registering the imaging of the patient anatomy with imaging of at least a portion of a robot; engaging the first member with tissue of the patient anatomy via robotic guidance according to the implant strategy; and subsequently, manipulating the patient anatomy. Systems, spinal constructs, implants and surgical instruments are disclosed.

A tool for cleaning a vertebral disc includes an elongated hollow shaft including a proximal end and a distal end; a first drum rotatably disposed in a housing secured to the proximal end of the shaft, the first drum having a first axis; a second drum rotatably disposed proximate the distal end of the shaft, the second drum having a second axis parallel to the first axis; and a belt extending through the hollow shaft and operatively coupled to the first drum and the second drum, the belt comprising a plurality of teeth configured to cut anatomical tissue, each tooth of the plurality of teeth remaining flush with an outer surface of the belt when a section of the belt comprising the tooth is substantially straight, and projecting beyond the outer surface when the section of the belt bends around the first drum or the second drum.

A joint replacement balancing system which provides real-time feedback to a surgeon during a joint replacement surgery to assist the surgeon to balance a joint replacement. The joint replacement balancing system includes a non-transitory processor-readable medium storing code representing instructions to cause a processor to receive a signal from a joint balancing apparatus, determine if the joint replacement is out of balance, determine a corrective course of action to bring the joint into balance and generate and display to the surgeon during the joint replacement surgery a recommended corrective course of action to complete the joint replacement surgery.

Devices and methods for placing an implant between two bone portions are disclosed. In some embodiments, a method comprises disposing a portion of a flexible member through a first bone portion, through an aperture in a trial implant, and through a second bone portion. The trial implant can be withdrawn to enable an implant to be coupled to the flexible member. The method includes applying tension to the flexible member to urge the implant into the space between two bone portions. In some embodiments, the two bone portions are facets.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

A method for inserting an interspinous spinal implant into an opened gap between first and second spinous processes of adjacent superior and inferior vertebras, respectively includes the following. First forming an opened gap between a first spinous processes of a superior vertebra and a second spinous processes of an adjacent inferior vertebra by first inserting a decompression knife into diseased areas of the adjacent superior and inferior vertebras, then cutting fascia tissue, then separating soft tissue from bone by rocking the decompression knife back and forth, and then inserting a broach cutter into the diseased areas of the adjacent superior and inferior vertebras and cutting interspinous ligament between the adjacent superior and inferior vertebras. Next, determining and selecting an appropriate sized and shaped interspinous spinal implant for the opened gap by inserting a sizing tool into the opened gap, and sizing the opened gap with the sizing tool. Next, inserting the selected interspinous spinal implant into the opened gap with an insertion tool, and then compressing first and second elongated components of the interspinous spinal implant onto first and second opposite sides of the first and second spinous processes with a compressor tool, respectively. Finally, locking the interspinous spinal implant onto the first and second spinous processes of the adjacent superior and inferior vertebras with a locking driver.

An anti-skive bone drill assembly is provided, and may be used for spinal surgical procedures. The anti-skive assembly can include a sheath, a drill bit disposed within the sheath, and a mechanism for maneuvering the drill bit within the sheath. The anti-skive assembly, and particularly the sheath, may be mounted in a surgical robot. The anti-skive assembly may be used to side cut a bone to create a flattened surface in an otherwise non-perpendicular bone surface.

Methods and systems are disclosed for accessing and treating the interior of the facet joint for vertebral distraction and immobilization. The systems include a number of tools that facilitate access to the facet joint, distraction of the articulating decortication of the articulating surfaces, and delivery of implants and agents into the facet joint for fusion.