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 system is suggested comprising an optical sensing means and a processing unit. The optical sensing means may include an optical guide with a distal end, wherein the optical guide may be configured to be arranged in a device to be inserted into tissue in a region of interest. The processing unit may be configured to receive information of a region of interest including different tissue types as well as of a path through the tissues, to determine a sequence of tissue types along the path, to determine a tissue type at the distal end of the optical guide based on information received from the optical sensing means, to compare the determined tissue type with the tissue types on the path, to determine possible positions of the distal end of the optical guide on the path based on the comparison of tissue types, and to generate a signal indicative for the possible positions.

Systems, methods, and devices for securing a spinal rod are provided. A clamp assembly may include a tulip comprising a first opening and a second opening, wherein an inner surface of the first opening comprises threads; a saddle movably disposed within the tulip between the first and second openings, the saddle comprising a first end and a second end, the first end comprising a portion configured to receive a spinal rod, the second end comprising a cavity configured to receive a pedicle screw, the saddle comprising slots configured to receive a rotating tool; and a threaded locking cap disposed in the first opening.

A stylet control system for selectively advancing and retracting a stylet includes a stylet having a first end and a second end, the second end being threaded, a screwdriver defining a bore for receiving a portion of the stylet and having a screw-engaging end for engaging a screw, the stylet being rotationally fixed relative to the screwdriver. The system includes a control device having a passage for receiving the screwdriver and having an inner portion defining a lumen for receiving the portion of the stylet, the inner portion being threaded for engaging the threaded second end of the stylet, when the screwdriver is rotated in the first rotation direction and the control device is prevented from rotating, the screwdriver advances the screw in the first axial direction and the stylet retracts in a second axial direction, opposite the first axial direction.

A method for securing an elongate rod to a bone anchor with a receiver and a threaded plug. The receiver includes a channel configured to receive the elongate rod, and a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The threaded plug is configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the threaded plug having an outer surface with a mating continuous helically wound guide and advancement structure configured for rotatable engagement with the receiver guide and advancement structure.

A receiver assembly for securing an elongate rod to a bone anchor including a receiver and a threaded plug. The receiver including an upper portion defining a channel to receive the elongate rod, an interior surface having helically wound receiver thread, and an exterior surface having first and second horizontal curvate extending instrument engaging grooves. The threaded plug including a longitudinal axis, a lower surface having a protrusion, and an external side surface having a continuous helically wound closure thread to rotatably mate with the helically wound receiver thread. The continuous helically wound closure thread including a lower leading surface and an upper trailing surface, both extending perpendicular to the longitudinal axis, and a cylindrical outer crest surface extending parallel to the longitudinal axis. When the protrusion on the threaded plug engages the elongate rod, the threaded plug does not extend overtop a top surface of the receiver.

Surgical tissue retraction systems and methods are described herein. Such systems and methods can be employed in some embodiments to provide medial-lateral tissue retraction to increase access to a surgical site. In one embodiment, a surgical instrument can include a body configured to couple to an implantable anchor, a first tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto, and a second tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto. Further, the first and second tissue manipulating implements can be opposed to one another such that they can move any of toward and away from one another.

A bone fastener comprises a first member defining an implant cavity and a plurality of adjacent grooves. A first band is configured for disposal within the grooves. A second band is configured for disposal within the grooves. A second member is configured to penetrate tissue and includes a head engageable with the first band to provisionally connect the members. The second band is moveable for disposal adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

An anchor assembly can be couplable to a bone and can include an anchor and a housing. The anchor can include a shank securable to bone and a head coupled to a proximal portion of the shank.

An orthopedic screw extension for use in spinal implant applications.