Various embodiments of bone ties, bone tie inserters, and methods for treating the spine are provided. The bone tie can include a proximal end and a distal end. The bone tie can include a head section comprising a rounded head. The bone tie can include a neck section extending proximally from the head section. A bone tie inserter for placing a bone tie can also be provided. The bone tie inserter can include a bone tie advancer with a curved surface configured to guide a rounded head of a bone tie. The bone tie inserter can include a bone tie retriever configured to receive the rounded head of a bone tie. The bone tie is configured to pivot and/or rotate within the retriever portion of the bone tie inserter. The method can include forming a lumen in a first bone portion and a second bone portion. The bone tie can be configured to pivot and/or rotate as the bone tie retriever is withdrawn.

A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an element engageable with a second mating surface of the bone fastener. The members are engageable with the bone fastener in a release configuration, an intermediate configuration and a locked configuration. Systems, surgical adaptors, spinal implants and methods are disclosed.

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.

The present invention is directed at minimally invasive systems in which the proximal end portion of the working channel has either zero or a limited range of movement in the lateral direction. A first embodiment has a slidable collar attached to a pair of flanges, wherein movement of the collar is bounded by an annular frame. A second embodiment has a substantially spherical element attached to the tube. A third embodiment has a plurality of caps. A fourth embodiment is adapted for a larger working channel.

Prostheses are described for stabilizing dysfunctional sacroiliac (SI) joints. The prostheses are sized and configured to be press-fit into surgically created pilot SI joint openings in dysfunctional SI joint structures. The prostheses have an integral structure with opposed elongated sections connected by a bridge section. The elongated sections, in some instances, have an unequal length.

Systems for and methods of fusing a sacroiliac joint are provided which may include an implant adapted to be inserted into the joint space defined by the bones of a sacrum and an ilium and a delivery tool for inserting the implant into the sacroiliac joint. The method may include delivering the implant into the SI joint in a first position and transitioning the implant from the first position to a second position in situ. The implant may be configured such that in the second position the implant generally mimics a shape of the joint space of the sacroiliac joint. The implant may further include an actuation mechanism configured to cause the implant to transition from the first position to the second position. The actuation mechanism may include a hydraulic, pneumatic, geared or screwed mechanical arrangement.

A method for fusing a spinal sacroiliac joint and a surgical kit. The kit includes a bone-void filler, stabilization device or implant, a guide pin, a joint locator, a set of dilation tubes, a reamer, a novel directional cannula, a novel tapping cap, a novel drill guide, a drill bit, and a novel implant positioner. The method includes the steps of locating the sacroiliac joint, retracting the soft tissue exposing the graft site, removing any bone obstructions and preparing a relatively smooth graft site horizontal to the immediate sacroiliac joint, creating a cavity in the ilium and sacrum to a predetermined depth that spans the sacroiliac joint, inserting a novel stabilization implant into the cavity, and seating the implant within the cavity at a predetermined depth.

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 disposable insertion instrument for inserting an implant includes a handle assembly, a drive assembly, and a plunger assembly. The drive assembly comprises an inner shaft and a spring received within an outer sleeve. A locking pin and drive lobes on the inner shaft cooperate to reversibly lock the drive assembly in a retracted position. A medical implant may be attached to the instrument via an adapter located at a distal end of the drive assembly. Following insertion of the medical implant into a patient, the disposable insertion instrument may be discarded.

A system, including various apparatus and methods, for surgical navigation is provided. The system is configured to track the spine of a patient by capturing images via one or more cameras. The cameras are configured to capture images of one or more arrays. The system transmits the images to a computer system. The one or more arrays are releasably secured with the spine of the patient, such as by a spine pin or a spine clamp. The system can determine the spatial position and orientation of relevant anatomical features, implants, and instruments using and processing the captured images.