A surgical instrument comprises a first member extending between a proximal end and a distal end configured for fixation with tissue. A second member defines a longitudinal passageway and is 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 is positioned relative to a sensor to communicate a signal representative of an orientation of the first member. A third member extends between a proximal end and a distal end. The third member is mountable with the first member along the orientation such that the distal end of the third member is engageable with the tissue. Systems, spinal implants, constructs and methods are disclosed.

The present invention includes a novel procedure and corresponding medical devices for a Purcutaneous Spinal Interbody Fusion (PSIF). In PSIF, 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.

In one embodiment, a surgical rigid arm (100, 150, 200, 900) includes a first portion (102, 152, 202, 902), a second portion (103, 153, 203, 903) and a central portion (105, 154, 205, 906), where the central portion is extends between the first and second portions. A first end of the first portion and a second end of the second portion are each attached to a peripheral side (14) of a surgical bed (10, 30) such that the first portion and the second portion extend from the surgical bed in a first direction. The central portion extends substantially horizontally and is positioned over the surgical bed, the central portion being connected to the surgical instrument such that a load from the surgical instrument is distributed across the central portion to the first portion and second portion to provide rigid support for the surgical instrument.

A system includes a bone anchor including a shank having a first end, a second end, a channel extending through the shank with a channel axis, and an internal advancement structure having at least a portion being closer axially to the second end than to the first end, and an elongate instrument configured to extend through the channel, with a tip portion and an external advancement structure configured to cooperate with the internal advancement structure. Engagement between the advancement structures facilitates holding of the tip portion at a first axial position relative to the bone anchor and movement of the tip portion from the first axial position towards both the first and second ends of the shank. The tip portion and the external advancement structure of the elongate instrument are insertable into and removable from the channel via the first end of the shank.

A system includes a first spacer sized and configured to be received within a resected bone space of a first bone and a second spacer sized and configured to be coupled to a second bone. The first spacer and the second spacer each include a body extending between a bone contacting surface and a coupling surface. At least one shim is positioned between the first and second spacers. The shim includes a body extending between a first coupling surface and a second coupling surface. The first spacer, the second spacer, and the at least one shim position the first and second bones in a predetermined alignment. An adjustable guide including a guide adapter and a guide body is configured to couple to the first spacer and is adjustable on a first axis.

An implant system for use in orthopaedic surgery for fixation of bone includes an intramedullary nail and a coupling member. The intramedullary nail includes a proximal portion defining a longitudinal axis. The proximal portion includes an axial bore defining an axis substantially parallel to the longitudinal axis of the proximal portion and a transverse bore configured to receive a bone fastener. The coupling member includes a through hole and is movably arranged within the axial bore of the proximal portion. Further, the coupling member includes a drive portion and a bone fastener engagement portion. The drive portion is in one variant non-rotatably coupled to the bone fastener engagement portion. The bone fastener engagement portion is configured to engage the bone fastener penetrating the transverse bore. In one variant the engagement is realized via an extended contact region.

A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non-removably attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radio-opaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.

The invention is directed to a surgical device which is externally used as aiming device that permits accurate placement of surgical wire to mend a supracondylar fracture. The device of the invention decreases operative time, risks of the re-dislocation through continuous manipulation, radiology exposure for both the patient and operation room staff, and to decreases anesthesia duration. It is also directed to surgical use of the device for repair of a supracondylar fracture and to methods for making it.

Osteotomy systems, devices, and methods for using the osteotomy systems are disclosed. The osteotomy system including an alignment device, at least one k-wire for insertion into the alignment device, and a cut guide with at least one hole for receiving at least one k-wire and a slot for receiving a saw blade. An osteotomy kit including an alignment device, cut guide, and position rotation device. The alignment device, cut guide, position rotation device, and bone plate are also disclosed. Finally, a method for fusing bones using the osteotomy system is also disclosed.

An apparatus and a method are provided for performing cartilage allograft implant surgeries. The apparatus comprises an allograft plug kit comprising one or more grafts configured to treat osteochondral defects in various bone joint locations in a patient's body. Each of the grafts comprises a cartilage layer coupled with a bone portion. The cartilage layer comprises a thickness selected to closely match the thickness of existing cartilage at an implant location. The bone portion comprises surface features configured to encourage the patient's bone tissue to grow into the bone portion, thereby accelerating incorporation of the graft into the patient's bone. An instrument kit comprises a multiplicity of instruments configured for implantation of the grafts into the patient's body, including at least a graft inserter, a guidewire, a reamer, and a size gauge.