Innovative orthopedic implant assemblies and devices are provided. One example assembly includes two implant devices. An example implant device includes two ends oppositely located with a bulbous portion located at one end and a screw portion located at the opposite end. An example second implant device includes two ends oppositely located with a looped portion defining an aperture located at one end and a nail portion located at the opposite end. The nail portion can include a tip and a smooth or substantially smooth portion. The second implant device can be implanted into a bone by striking the looped portion to facilitate the tip and at least part of the nail portion penetrating the bone.

Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument can include a feedback mechanism configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor. The feedback mechanism can be triggered by a movable shaft of the instrument that is displaced by the shank portion of the bone anchor as the surrounding bone is reamed.

A woven retention device that is configured to receive a fastener in a bone hole can be configured to promote bone ingrowth and impede biofilm formation. The woven retention device can be made of woven filaments that outline apertures of varying sizes and shapes and can serve as an interface between the fastener and the bone material. In a first relaxed state, the interwoven filaments can outline apertures of varying sizes and shapes within a predetermined range and in a second constricted state inside the bone hole with the fastener the interwoven filaments can outline apertures of decreased area that still fall within the predetermined range. The woven retention device can be configured to allow for optimal bone growth while at the same time minimizing the likelihood that biofilm forms thereon.

A screw anchor assembly used in pedicle screw fixation is provided. The screw anchor assembly includes a screw having screw threads defined on a circumferential surface, and a screw anchor having a first end and a second end, an accommodating part defined by anchor screw threads on an inner surface of the screw anchor and having one end to receive the screw, and a locking step extended in a circumferential direction from the first end of the screw anchor. The accommodating part flexibly extends when the screw is screw-coupled to the screw anchor.

Bone implants, including methods of use and assembly. The bone implants, which are optionally composite implants, generally include a distal anchoring region and a growth region that is proximal to the distal anchoring region. The distal anchoring region can have one or more distal surface features that adapt the distal anchoring region for anchoring into iliac bone. The growth region can have one or more growth features that adapt the growth region to facilitate at least one of bony on-growth, in-growth, or through-growth. The implants may be positioned along a posterior sacral alar-iliac (“SAI”) trajectory. The implants may be coupled to one or more bone stabilizing constructs, such as rod elements thereof.

A dynamic bone fixation element can include a sleeve elongate along a first direction and a fixation member. The sleeve can define a channel that extends from a proximal end through to a distal end along the first direction. The channel has a first cross-sectional dimension. The fixation member has a head, a shaft extending from the head and elongate along a second direction, and an abutment member extending from the shaft and integral with the shaft, wherein the shaft extends through the channel such that the sleeve is captured between the abutment member and the head. At least a portion of the shaft that is within the channel has a second cross-sectional dimension that is less than the first cross-sectional dimension such that the fixation member is moveable with respect to the sleeve along a direction that has a directional component transverse to the first direction.

Bone implants, including methods of use and assembly. The bone implants, which are optionally composite implants, generally include a distal anchoring region and a growth region that is proximal to the distal anchoring region. The distal anchoring region can have one or more distal surface features that adapt the distal anchoring region for anchoring into iliac bone. The growth region can have one or more growth features that adapt the growth region to facilitate at least one of bony on-growth, in-growth, or through-growth. The implants may be positioned along a posterior sacral alar-iliac (“SAI”) trajectory. The implants may be coupled to one or more bone stabilizing constructs, such as rod elements thereof.

An osseous anchoring implant with cortical stabilization, including an expandable sleeve having a first threading inside and a second threading outside, a screw having an external profile complementary to the internal profile of said expandable sleeve and an external threading with a reverse screw pitch of the second threading. The implant switching from a folded rest position to a deployed position by the actuation of said reversed threadings, causing the penetration of the screw into the expandable sleeve and generating the radial expansion of said expandable sleeve by deformation on a distal portion. In the deployed position, the expandable sleeve has a frustoconical shape. The proximal portion of the screw includes an outer osseous anchoring threading and a frustoconical portion whose flaring is reversed relative to that of the expandable sleeve in the deployed position.

A bone fixation apparatus includes an insert and a bone anchor. The insert has open ends defining a lumen. A first thread is disposed on an outer surface of the insert and a second thread is disposed in the lumen. The insert is configured for threadably engaging bone. A driving tool is releasably attachable to the insert. The bone fixation apparatus also includes a bone anchor with a bone screw member and a housing. The bone screw member extends from the housing and has a third thread along a shank of the bone screw member. The third thread of the shank is engageable with the second thread of the lumen such that the bone anchor is coupled to the insert.

The present invention includes a novel procedure and corresponding medical devices for a Percutaneous Posterior Lumbar Interbody Fusion (PePLIF). In PePLIF, the surgeon performs the entire operation percutaneously without the use of a microscope, endoscope, or magnifying loupes. An adjustable retractor system is disclosed that enables the surgeon to percutaneously perform the surgery through accessing the facet joint (and later disc space) that was created by said retractor system. This retractor system provides the surgeon a safe area to work and operate without fear of damaging nerves, blood vessels, or other tissue. An expanding trial may be inserted into and removed from the disc space through the interior of the retractor system to determine the proper size for the expandable cage. The retractor system also enables the expandable cage to be inserted into the disc space.