The present invention relates to a system, method, device and kit which utilize a modular pedicle screw implant that does not require the use of a guide wire for implantation and can be assembled in situ. The system, method, device, and kit include a surgical instrument for implanting a modular pedicle screw comprising a cannula coaxially aligned with a modified trocar style instrument or surgical shaft. The surgical shaft contains a first member of a surgical shaft-inner pedicle bone screw member joint, illustrated herein as a locking taper, for securing an inner member of a pedicle screw thereto. The inner member of a pedicle screw is further adapted to couple to an outer pedicle sheath. In combination, the inner member of a pedicle screw and the outer pedicle sheath form a solid modular pedicle screw.

A device may include an outer sleeve with a hollow interior, and an inner sleeve with a hollow interior to couple axially and slidingly. The outer sleeve may include an outer central body, an outer proximal end part and an outer distal end part integrally connected to one another, and an outer channel extending along the entire outer proximal end part and along a substantial portion of the outer central body. The inner sleeve may include an inner central body, an inner proximal end part and an inner distal end part integrally connected to one another, and an inner channel extending along the entire inner proximal end part and along a substantial part of the inner central body. The inner sleeve may include, in the inner proximal end of the inner sleeve, a lateral engagement element, and an axial engagement element for releasably engaging a surgical screw.

An anchor for anchoring tensile members to bone includes: a housing extending along a central axis, with a hollow interior; a collet in the hollow interior having a central bore for accepting tensile members and an exterior surface, the collet being configured to swage around and against tensile members; a sleeve having a peripheral wall defining interior and exterior surfaces, the sleeve disposed in the housing's hollow interior axially adjacent to the collet, and movable parallel to the central axis between first and second positions; and wherein at least one of the collet exterior surface and the sleeve interior surface is tapered and the sleeve and the collet are arranged so movement of the sleeve from the first position to the second position causes the sleeve interior surface to bear against the collet exterior surface, causing the collet to swage radially inwards around and against one or more tensile members.

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.

The disclosure provides apparatus and methods of use pertaining to syndesmosis reinforcement. Embodiments include a clamp having two jaws that extend toward each other to clamp two bone portions therebetween. The clamp may include an angle gauge and an adjustment mechanism having a force gauge that combine to enable the compression of the two bone portions in an optimal direction or angle and at an optimal, measurable compression force. Embodiments also include a tension instrument configured to knotlessly lock a flexible strand construct between two anchors at the same optimal direction and tension applied by the clamp. Further embodiments include an exemplary syndesmosis reinforcement procedure that employs the clamp and the tension instrument to construct a ligament reinforcement construct that achieves optimal anatomic positioning in both directional alignment and the reduction force applied by the construct. Other embodiments are disclosed.

A disposable guide device for spinal surgery comprises two tubular guide bodies extending along respective main axes between a proximal end and a distal end to guide a surgical operation on a vertebra of a patient, a plurality of support feet projecting laterally relative to each guide body, near said proximal end, each defining a contact area configured to abut on a side of the spinous process or on a lamina or facet or transverse process of the vertebra of the patient, in a mating configuration, at least one junction element extending between the guide bodies, starting from the respective distal ends, in order to space them from each other, wherein the guide bodies are oriented so that the proximal ends are more distant from each other with respect to the distal ends.

An implant for insertion into a disc space between vertebrae, wherein the implant includes a spacer portion, a plate portion coupled to the spacer portion, two bone fixation elements for engaging the vertebrae and a retention mechanism for preventing the bone fixation elements from postoperatively backing-out of the plate portion. The retention mechanism may be in the form of a spring biased snapper element that is biased into communication with the bone fixation elements so that once the bone fixation element advances past the snapper element, the snapper element is biased back to its initial position in which the snapper element interfaces with the bone fixation elements. Alternatively, the retention mechanism may be in the form of a propeller rotatable between a first position in which the bone fixation elements are insertable to a second position where the bone fixation elements are prevented from backing-out.

An implant for insertion into a disc space between vertebrae, wherein the implant includes a spacer portion, a plate portion coupled to the spacer portion, two bone fixation elements for engaging the vertebrae and a retention mechanism for preventing the bone fixation elements from postoperatively backing-out of the plate portion. The retention mechanism may be in the form of a spring biased snapper element that is biased into communication with the bone fixation elements so that once the bone fixation element advances past the snapper element, the snapper element is biased back to its initial position in which the snapper element interfaces with the bone fixation elements. Alternatively, the retention mechanism may be in the form of a propeller rotatable between a first position in which the bone fixation elements are insertable to a second position where the bone fixation elements are prevented from backing-out.

Surgical instruments and methods for delivering bone anchor assemblies into bone are disclosed herein. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. In general, a surgical instrument can include a handle assembly having an elongate shaft extending distally therefrom. The handle assembly can be configured to axially translate a stylet extending therethrough relative to a bone anchor assembly coupled to the elongate shaft, and it can be configured to move the stylet proximally in response to distal advancement of a bone anchor assembly into bone. The surgical instruments can include various mechanisms for adjusting the position of the stylet.

A polyaxial screwdriver for inserting a bone screw in a vertebra. A polyaxial bone screw assembly includes a coupling element. When a screw engaging end of the polyaxial screwdriver is lowered on the head of the bone screw, the complimentary surfaces of the screw engaging end of the screwdriver and the head of the screw self-align. A ratchet mechanism formed in the screwdriver provides progressive and automatic locking of the polyaxial screwdriver to the coupling element and prevents the accidental unthreading from the coupling element. In another embodiment of the polyaxial screwdriver, a collet slides over the outside surface of the upper end of the coupling element and locks on to the coupling element. In yet another embodiment of a polyaxial screwdriver, the outer sleeve of the polyaxial screwdriver has a split end that securely engages the coupling element.