The present disclosure includes bone screws and assemblies thereof for surgical procedures of the spine including but not limited to posterior spinal fixation procedures.

For treating a fracture in a pars interarticularis, methods and apparatus provide for: (i) coupling a spinous process plate to a lateral side of a spinous process of a spine of a patient, the spinous process plate extending substantially parallel to a sagittal plane through the spine, the spinous process plate including a first fixation element configured to attach the spinous process plate to the lateral side; (ii) coupling a laminar plate to a laminar on the lateral side, the laminar plate extending transversely from the spinous process plate and transversely to both the sagittal plane and a coronal plane through the spine, the laminar plate including a second fixation element configured to attach the laminar plate to the laminar on the lateral side; (iii) engaging a sub-laminar hook to the laminar on the lateral side, the sub-laminar hook extending transversely from the laminar plate and substantially parallel to a transverse plane through the spine, the sub-laminar hook configured to extend and hook beneath the laminar on the lateral side; (iv) extending a rod toward a pedicle on the lateral side, the rod having proximal and distal ends and extending substantially perpendicular to a length of the fracture, from the laminar plate toward the pedicle; and (v) anchoring the rod in a configuration that prohibits movement of first and second parts of the fractured pars interarticularis relative to one another, by coupling the proximal end to the laminar plate, and the distal end to the pedicle on the lateral side.

Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a plate that is seated between the receiver member and the rod and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a hook that extends out from the receiver member to hook onto an anatomical structure or another implant to augment the fixation of the assembly's primary bone anchor. Surgical methods using the bone anchor assemblies described herein are also disclosed.

A surgical implant includes a first portion and a second portion. The first portion includes a body and connector assemblies. The body includes a posterior surface and defines a first bore defining an acute angle with respect to a first axis that is orthogonal to the posterior surface. The connector assemblies are disposed on opposing lateral sides of the body. Each connector assembly is selectively rotatable relative to the body. The second portion includes a base extending in a cephalad direction from the first portion, and an extension extending in the cephalad direction from the base. The base defines second bores configured to receive respective bone screws. The extension defines a third bore. The first bore of the body and the third bore of the extension define a second axis. The second bores are defined along a third axis orthogonal to the second axis.

An adjustable spinal stabilization system for maintaining preselected spacing and movement between adjacent vertebrae in a spinal column and for providing overall stability thereto. The system includes at least one interlaminar member positioned in the spaces intermediate a first vertebra and the vertebrae positioned immediately above or immediately below and adjacent to the first vertebra. The interlaminar member is operatively connected to an adjustable support structure and cooperates therewith to maintain the preselected spacing between adjacent vertebrae and to provide overall stability to the spinal column.

A surgical connection device for a spine is disclosed including a stabilization member, compression arms and traction arms, the device being used in conjunction with first anchor points fixed to vertebrae at a first lateral side of the spine and second anchor points fixed to vertebrae at a second lateral side of the spine. A first spinal rod may be attached to the first anchor points and a second spinal rod may be attached to the second anchor points. The compression arms connect the stabilization member to the first and second anchor points or rods and bear compressive forces. The traction arms connect the stabilization member to the first and o second anchor points or rods and bear tensile forces. Application of both tensile and compressive forces via the device may serve to straighten, change a direction of bending or increase a degree of bending of the rods and/or spine. The use of the traction arms may also provide for a more flexible construct.

Apparatus and devices for adding an additional spinal construct in a patient are disclosed. In one arrangement the additional spinal construct extends an existing spinal construct ipsilaterally with an inline rod connector in a minimally invasive or preferably, percutaneous procedure. In another arrangement, the ipsilateral extension of an existing spinal construct uses an offset rod connector for receiving an additional spinal rod that may be placed interiorly or exteriorly of the existing spinal construct.

A pivotal bone anchor assembly includes a shank having a head portion and an anchor portion for fixation to the bone of a patient, and a receiver comprising a base defining a lower portion of central bore and a pair of upright arms defining a channel for receiving an elongate rod. The assembly also includes a retaining structure with a central opening configured to capture and pivotally retain and support the head portion of the shank in the retaining structure, and which is slidably movable relative to the receiver so as to provide for increased articulated movement between the shank and the receiver prior to locking the assembly with the elongate rod and a closure. The assembly further includes an insert configured to engage the elongate rod and the head portion of the shank when in use, and to have an overlapping configuration with the retaining structure when the assembly is in the locked configuration.

Disclosed herein are an orthopedic rod-to-rod connector and rod-to-rod connector assemblies for spinal fusion surgery. The rod-to-rod connector may include a first connector portion and a second connector portion. The first connector portion may have a first aperture configured to receive at least a portion of a bone-engaging screw and a first spinal rod. The second connector portion may be rotatably connected with the first connector portion and may include a second aperture to receive a second spinal rod. The second connector portion may be L-shaped and may include a set screw to control rotation of the first connector portion with respect to the second connector portion.

The present invention provides a single surgical method, procedure and/or system that creates open direct visual and/or physical access to an identified spinal treatment site that comprises both targeted vertebral and spinal levels to be treated, wherein the spinal levels comprise at least one dorsal root ganglion. A spinal treatment procedure may be performed generally in combination with implantation of a neuromodulation system that may comprise placement of electrical lead(s) on the at least one dorsal root ganglion, wherein each lead is in operative connection with a pulse generator that may also be implanted during the surgical method. Electrical stimulation may be generated with the pulse generator through the electrical leads to the at least one dorsal root ganglion during and/or after the closure of the identified spinal treatment site.