Robotic systems and methods are provided for trajectory guidance during surgical procedures, for example, robotically monitoring and identifying a desired trajectory of surgical access devices and implants for the purpose of preventing unintended injury to surrounding tissues, such as nerves, blood vessels, cartilage, or bone. The robotic systems and methods provided herein allow medical professionals to practice with little to no exposure of the medical professional to radiation.

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.

A surgical system includes a first surgical instrument having a selected configuration and an image guide disposed relative to a sensor to communicate a signal representative of a position of the image guide. A passive image guide is fixed with vertebral tissue and is disposed relative to the sensor to communicate a signal representative of a position of the passive image guide. The passive image guide includes a first surface. A second surgical instrument is connectable with the first surgical instrument and includes a second surface engageable with the first surface in a mating configuration to provide verification of the selected configuration. Surgical instruments, implants, spinal constructs and methods are disclosed.

A method may be provided to operate a medical system. First data may be provided for a first 3-dimensional (3D) image scan of an anatomical volume, with the first data identifying a blood vessel node in a first coordinate system for the first 3D image scan. Second data may be provided for a second 3D image scan of the anatomical volume, with the second data identifying the blood vessel node in a second coordinate system for the second 3D image scan. The first and second coordinate systems for the first and second 3D image scans of the anatomical volume may be co-registered using the blood vessel node identified in the first data and in the second data as a fiducial.

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 retractor includes retractor blades and one or more shims coupled to one or more of the retractor blades. The shims can include features configured to fasten the shim to vertebral anatomy. Such features can facilitate the use a K-wire or barbed features. Example disclosed shim designs include those featuring a K-wire feature, a barbed feature, and a K-wire with barb design.

A bone screw fixation system includes a bone screw body having a screw head at one end of the screw and a screw tip at an opposite end of the screw, the screw head having an internal complex geometric shaped drive and internal threads within the screw head; and a screw inserter compatible with the screw head and having a complex geometric shaped drive configured to matingly engage the internal complex geometric shaped drive of the screw head and a threaded tip configured to thread into the internal threads of the screw head.

A method comprises the steps of: fixing a distal end of a first member of a surgical instrument with tissue, the surgical instrument including a second member having a longitudinal passageway configured for disposal of the first member and being connected with a navigation component such that the distal end is disposable with the passageway at a selected distance from the navigation component, the navigation component being positioned relative to a sensor to communicate a signal representative of an orientation of the first member; removing the second member from the first member; and connecting a third member with the first member along the orientation such that a distal end of the third member is fixed with the tissue. Systems, spinal implants, constructs and instruments are disclosed.

In one embodiment, an access instrument for creating a surgical working portal includes a body having a first end and a body length, a first slot having a first slot length running along the length of the body from the first end, and a second slot having a second slot length running along the length of the body from the first end, wherein the first slot length and the second slot length are less than the body length.

Devices, systems, and methods for a robot-assisted surgery. Navigable instrumentation, which are capable of being navigated by a surgeon using the surgical robot system, and navigation software allow for the navigated placement of interbody fusion devices or other surgical devices. The interbody implant navigation may involve navigation of access instruments (e.g., dilators, retractors, ports), disc preparation instruments, trials, and inserters.