A percutaneous spinal cross link system for interconnecting a spinal fusion construct on one side of the longitudinal axis of the spine with a spinal fusion construct on the other side of the longitudinal axis may include a cross bar connected at each end by a respective connector to a respective spinal fusion rod of each of the spinal fusion constructs. The connector may include a rod receiving portion adapted to receive one of the spinal fusion rods and a cross bar receiving portion adapted receive the cross bar in an orientation generally perpendicular to the spinal fusion rod. A cannula defined by two spaced apart blades may be connected to the connector for defining a minimally invasive pathway through body tissue for introduction of the cross bar to the connector. Other tools for use with the system are also disclosed.

A battery pack for a use with a powered surgical tool. The battery pack may include a housing with an outer wall and opposing first and second ends. The housing may include an elongated shape that extends between the first and second ends. A first member may extend across the first end of the housing and include a first aperture, and a second end member may extend across the second end of the housing and may include a second aperture. A passage may extend through the housing with a first end that aligns with the first aperture and a second end that aligns with the second aperture. The housing may be sized for a plurality of storage locations positioned between the first and second members and around the passage, and each of the storage locations may be configured to store a power cell.

A pivotal bone anchor assembly for securing an elongate rod to patient bone includes a shank having a head and an anchor portion, a receiver having an axial bore and a channel for receiving the elongate rod, a collet insert top loaded into a first position within the axial bore and having a collet pocket for receiving the shank head, and a pressure ring uploadable into the collet pocket prior to the shank head and having an upper surface for engaging the rod. After receiving the shank head within the collet pocket, the collet insert and pressure ring are downwardly deployable with the shank head into a second position to capture the shank head in the assembly, the pressure ring being operable to transfer pressure from the elongate rod in the channel to the shank head to lock an angular position of the shank relative to the receiver.

A bone anchoring device includes a receiving part for coupling a rod to a bone anchoring element, the receiving part having a first end, a second end, a recess at the first end for receiving the rod, and a compressible head receiving portion at the second end for accommodating a head of the bone anchoring element, a pressure member positionable in the receiving part to exert pressure on the head, and a clamping ring positionable around the head receiving portion and movable towards the first end of the receiving part to a locking position where the clamping ring exerts force on and compresses the head receiving portion. In the locking position, at least part of the clamping ring that faces the first end of the receiving part is exposed to the outside to facilitate movement of the clamping ring away from the first end of the receiving part.

An anchoring system for the implantation of at least one anchoring device in at least one preferably bone tissue, the system is disclosed, with some embodiments comprising: at least one anchoring device comprising a curved body extending between an anterior end intended to penetrate without any deformation in the bone tissue and a posterior end intended to remain turned outward of the bone tissue, at least one guide extending along a longitudinal axis between a posterior end and an anterior end and comprising at least one guiding surface, substantially along the longitudinal axis, able to guide at least one anchoring device.

A surgical instrument comprises a fulcrum including a first surface that defines a cavity configured for disposal of a first implant support such that the fulcrum is movable relative to the support. The first surface is rotatable relative to the fulcrum to engage the support and fix the first surface with the support. A second surface is engageable with a second implant support. In some embodiments, spinal constructs, implants, systems and methods are disclosed.

A pivotal bone anchor assembly includes a receiver comprising a base defining a central opening and upright arms defining an open channel for receiving a rod and including tool engaging structures for releasable overlapping engagement with an insert compressing tool. The assembly further includes a bone anchor comprising a capture head pivotably positionable within the central opening of the base and an anchor portion for fixation to the bone, and a compression insert positionable within the central opening above the capture head and comprising an upper surface engageable with the rod, a center through-bore, and upward-facing tool engagement surfaces located radially outward from the center through-bore. The tool engaging structures of the upright arms and the upward-facing tool engagement surfaces of the insert are configured for simultaneous non-threadable engagement with the insert compressing tool to apply a downwardly-directed force to the capture head to temporarily independently lock an articulated position of the bone anchor with respect to the receiver.

A fluoro-navigation system for navigating a tool relative to a medical image. The system includes a motorized X-ray imaging system for acquiring a plurality of images of a region of interest of a patient, the position of each image being known. Also included is a localization system, a registration phantom with a plurality of radiopaque fiducials, a tracker for being tracked by the localization system, a processor for receiving the plurality of images and for reconstructing a 3D medical image from the images using radiopaque fiducials visible in the plurality of images. Also included is base made of a substantially radiotransparent material, to be rigidly secured to a patient's bone and having a reproducible fixation system for attaching the registration phantom and/or tracker.

A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver. Further alternative bone screws are hinged, polyaxial or fixed and include lordosing or kyphosing lateral surfaces.

A pedicle screw implant construct kit, comprising at least one pedicle screw, at least one collar comprising a recess for receiving a rod, the collar configured to be coupled to a head of the pedicle screw, an elongated rod for connecting the collar to one more additional collars to couple between the pedicle screw and one or more additional screws, and a locking ring sized to be positioned over at least a distal portion of the collar to restrain relative movement of the screw head and rod by exerting radial compression force onto the collar. In some embodiments, the components of the kit are comprised of carbon reinforced composite material, optionally with no radiation blocking material. In some exemplary embodiments of the invention, the kit includes two locking rings on a collar, optionally both below the rod.