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 The bone tie can be configured to pivot and/or rotate as the bone tie retriever is withdrawn.

Disclosed is a system for delivering a facet screw assembly to a facet joint. The system includes a facet screw assembly and a delivery device. The distal end of the delivery device includes a facet screw engagement feature, which is keyed to a corresponding delivery device engagement feature. In other embodiments, the system may include a facet screw assembly, a facet access guide, a washer sizer tool removably engaged with the facet access guide, a lateral mass decorticator guide slidably and removably engaged with the washer size tool, a washer implant delivery tool removably engaged with the facet access guide and detachably coupled to the facet screw assembly, and optionally an impact handle detachably coupled to the facet access guide, washer sizer tool, and washer implant delivery tool.

A distally expanding facet joint implant and delivery device for distally distracting a facet joint. The facet joint implant generally includes an outer part and an inner part. The outer part includes a pair of opposed distally expandable facet plates connected by a hinge. The inner part includes a wedge that is selectively movable against the facet plates to distally expand and contract the facet joint implant into open and closed states. Teeth on the outer part engage indents on the inner part to maintain the facet joint implant in the distally expanded state. The outer and inner parts include outer and inner connectors, and the delivery device includes corresponding outer and inner connectors adapted to be in locked engagement with the outer and inner connectors to hold the implant and selectively cause it to distally expand and contract.

A device for accessing and guiding at least one fixation device to a spine may include a distal portion configured to fit in a facet of the spine and a proximal portion extending from the distal portion. The proximal portion may be detachable from the distal portion and may be hollow or solid. A system for accessing and guiding at least one fixation device to a spine may include a distal portion configured to fit in a facet of the spine, a proximal portion extending from the distal portion, and a slidable guide device for sliding over the facet guide device to guide at least one instrument to the spine.

A tool assembly includes a universal, intervertebral bone fusion spacer for insertion into a disc space between a first vertebral body and a second vertebral body and fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, and a tool for manipulating and inserting the universal, intervertebral bone fusion spacer into the disc space between the first vertebral body and the second vertebral body to provide fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion.

A unique, universal Zero-Profile Expandable Intervertebral Spacer (ZP-EIS) device for fusion and distraction throughout the entire spine is provided which can be inserted via anterior, anterolateral, lateral, far lateral or posterior surgical approaches dependent on the need and preference. Multiple ZP-EIS embodiments each with unique mechanisms of calibrated expansion are provided. Two of these embodiments incorporate bi-directional fixating transvertebral (BDFT) screws and five other embodiments do not incorporate BDFT screws. A tool for implantation into the intervertebral device and calibrated device expansion is also disclosed.

A crosslink is provided for securing orthopedic implants, such as facet joint replacement implants, together. The crosslink has a pair of implant coupling components, a pair of rod coupling components, a rod, and a pair of fasteners. Each facet joint implant may include a semicylindrical interface received in a resilient member of the corresponding implant coupling component to permit relative cephalad/caudal adjustment between the crosslink and the implants. The resilient members grip the semicylindrical interface of the implant to enable at least temporary attachment of the implant coupling components to the implants independently of the rod. Clocking features on the semicylindrical interfaces and on the interfacing areas of the implant coupling components and rod coupling components may limit assembly of the crosslink to discrete relative orientations and prevent play after assembly. The fasteners secure the rod coupling components to the rod at the desired positions along the rod.

Described herein is an orthopedic fixation device for use in spinal surgery. The orthopedic device is a pivoting device that comprises one or more hinges. Fixation of multiple vertebrae is accomplished by fixation at the vertebral facet joints. Multiple devices may be further fixed at multiple vertebral levels with the use of a multi-level rod.

In some embodiments, a device for reinforcement of a facet joint is provided. The device comprises a lumen configured to receive a fastener member. In some embodiments, a second segment comprises a second lumen configured to receive a fastener member or fastener. In some embodiments, kits are provided with a fastener member and a facet reinforcement device. Methods are also provided for treating a spine. In some embodiments, the fastener member is placed through both articular processes of a facet joint and a facet reinforcement device.

Disclosed is a system for delivering a facet screw assembly to a facet joint. The system includes a facet screw assembly and a delivery device. The distal end of the delivery device includes a facet screw engagement feature, which is keyed to a corresponding delivery device engagement feature. In other embodiments, the system may include a facet screw assembly, a facet access guide, a washer sizer tool removably engaged with the facet access guide, a lateral mass decorticator guide slidably and removably engaged with the washer size tool, a washer implant delivery tool removably engaged with the facet access guide and detachably coupled to the facet screw assembly, and optionally an impact handle detachably coupled to the facet access guide, washer sizer tool, and washer implant delivery tool.