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.

Disclosed is a surgical alignment and distraction frame and associated methods of use that facilitates correction of a sagittal imbalance. The alignment and distraction frame works in conjunction with pedicle screw installation guide assemblies to impart the desired correction. The alignment frame can be utilized to ensure the pedicle screw housings are aligned (to facilitate rod coupling) in concert with the completion of a correction maneuver.

This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. More specifically, the application describes instruments and methods for building a posterior fixation construct across one or more segments of the spinal column in a minimally invasive fashion.

A pivotal bone anchor system includes a plurality of bone anchors with rounded capture portions having a circumferentially extending outer engagement surface without flat side faces. The system also includes multi-planar receiver sub-assemblies, each comprising a multi-planar receiver defining a cavity with a multi-planar seating surface, and a multi-planar pivoting retainer configured for multi-planar motion upon engagement with both the multi-planar seating surface and the outer engagement surface of a bone anchor. The system further includes uni-planar receiver sub-assemblies, each comprising a uni-planar receiver defining a cavity with a uni-planar seating surface, and a uni-planar pivoting retainer configured for uni-planar motion upon engagement with the uni-planar seating surface and the outer engagement surface of another bone anchor. The capture portions of the bone anchors are configured for capture by either a multi-planar or uni-planar receiver sub-assembly without further modification or adjustment.

An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60). A clamping mechanism (90) clamps the longitudinal member (12), the spacer (60), and the housing (40) to the fastener (16) to prevent movement of the fastener relative to the housing.

A medical implant assembly includes a shank having a head and an anchor portion, and a receiver having a base defining a central bore for receiving the shank head through a bottom opening and an upper portion defining a channel for receiving an elongate rod. The central bore extends upwardly to a closer mating structure adjacent the top of the receiver and an inwardly-protruding horizontal ridge below the closure mating structure. The assembly also includes an insert having a saddle surfacing for receiving the elongate rod, a lower surface for engaging the shank head, and outward-facing side surfaces adjacent upward-facing top edge surfaces. The insert is initially positionable into the central bore with the outward facing side surfaces in an overlapping arrangement with the horizontal ridge to maintain the position of the insert within the receiver prior to uploading the shank head.

The present disclosure provides an adjustable double-slot internal spinal fixation apparatus, including a first base, a second base and a connecting rod. The first base and the second base each contains a U-shaped slot from top to bottom. An inner wall of each U-shaped slot contains inner threads. The connecting rod is disposed along a horizontal direction. The second base contains a long slot along the horizontal direction. One end of the connecting rod is inserted in the first base, and the other end of the connecting rod is inserted in the long slot of the second base. The connecting rod can swing in the long slot. The first base and the second base are capable of relatively rotating on the connecting rod.

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 pivotal bone anchor assembly includes a shank with a head and an anchor portion, and a receiver with a channel for receiving a rod and a lower portion of an axial bore for receiving the shank head, with the axial bore including a stop structure and a downwardly-facing surface beneath a helically wound thread. The assembly also includes an insert having an upwardly-facing seat, a lower surface for engaging the shank head, a side structure for engaging the stop structure, and an upwardly-facing surface positioned radially outward from the upwardly-facing seat, with the insert being installed into the axial bore in a first angular position. Subsequent rotation of the insert within the axial bore moves the upwardly-facing surface under the downwardly-facing surface to inhibit upward movement of the insert within the axial bore, with further rotation being inhibited by the side structure coming into engagement with the stop structure.