Sacral fixation implants can include first and second implant segments. One of the first and second implant segments is received in the other of the first and second implant segments, and the first and segments can be fixed with respect to movement toward and away from each other, thereby stabilizing a sacral fracture.

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.

Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spinal fixation element through at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in a lengthwise orientation that is substantially transverse to the longitudinal axis of each percutaneous access device. The spinal fixation element can then be advanced in the lengthwise orientation to seat the spinal fixation element in or adjacent to the receiver heads of at least two adjacent spinal anchors. A fastening element or other closure mechanism can then be applied to each spinal anchor to engage the spinal fixation element within the receiver heads of the adjacent anchors.

Devices, systems, and methods are provided for driving an implant and applying counter torque. For example, a driver can include a handle, a driver shaft, and a counter torque shaft, the counter torque shaft being laterally offset from the driver shaft. A distal end of each shaft can mate with a specific type of implant and/or anatomy. The shafts can be removed and replaced from the device, allowing a user to select shafts having particular lengths and/or mating tips. In use, distal ends of the shafts can be fixed or constrained relative to one another and to an implant such that the counter torque shaft cannot orbit around the driver shaft. Rotating the handle can rotate the driver shaft, driving the implant. This can cause the counter torque shaft to try to orbit around the driver shaft, but the fixed/constrained ends restrict this motion, applying the counter torque.

A system includes tubular members removably positionable over a passageway device connected to a connecting element attached to a vertebra. The tubular members may each include a sidewall having an opening positionable adjacent a proximal end of the passageway device when the tubular member is positioned over the passageway device. The tubular members include channels therein to receive respective blades of the passageway devices. One of the tubular members may be a counter torque tube, and another two of the tubular members may be a hinge shaft and a ball shaft, respectively, of a compression and distraction system. The blades of each passageway device may be integrally formed with a cage of the connecting element to form a monolithic blade-screw. The blades of the monolithic blade-screw may be constructed by affixing distal ends of non-threaded blade extensions to proximal ends of threaded reduction portions integrally connected to the cage.

This application describes a spinal fixation system. The spinal fixation system includes at least a rod member having shaped ends, at least two pedicle screws capable of receiving the shaped ends of the rod member, and a system for introducing the rod member and pedicle screws in a minimally invasive fashion.

A reduction sleeve for facilitating insertion of a spinal rod into a rod-receiving channel formed in a bone fixation element. The reduction sleeve may include a through-bore sized and configured to receive the bone fixation element and a substantially transverse channel sized and configured to receive the spinal rod. The channel being substantially aligned with the rod-receiving channel formed in the bone fixation element so that, once the bone fixation element has been inserted into the reduction sleeve, the spinal rod can pass through the aligned channels. The reduction sleeve may also include at least one break-off point or region for facilitating breaking and removal of the reduction sleeve once the spinal rod has been clamped into the rod-receiving channel of the bone fixation element. The reduction sleeve may also include a plurality of threads formed thereon for engaging a reduction instrument, an alignment mechanism so that the bone fixation element can only be inserted into the reduction sleeve when the rod-receiving channels are aligned, and an inwardly projecting protrusion formed on the inner surface of the reduction sleeve so that, once inserted, the projection contacts a top surface formed on the bone fixation element.

A bone fixation system with variable z-axis translation is provided. The system includes an outer tulip coupled to a bone fastener via a screw retainer. An inner tulip is coupled to the outer tulip such that the inner tulip is longitudinally movably relative to the outer tulip. The inner tulip includes a lock that provides a seat for a connecting rod. The inner tulip together with a seated rod is permitted to translate along the z-axis inside the outer tulip when in an unlocked position. Also in the unlocked position, the bone fastener is free to angulate relative to the outer tulip. The z-axis position of the inner tulip and rod relative to the outer tulip is fixed in a locked position. Also, in the locked position, the bone fastener is locked with respect to the outer tulip. The system may be adjusted between the locked and unlocked positions by way of a set screw.

A combination of an implant (100) like a bone screw together with an augmentation sleeve (200) is suggested. The bone screw may comprise a trailing end portion with a plurality of lateral bores (120). The augmentation sleeve may comprise a leading end portion which is adapted to be coupled to the trailing end portion of the bone screw, and a lateral opening (220) at the leading end. The augmentation sleeve may be adapted to guide an augmentation tool to the trailing end portion of the bone screw and to the leading end portion of the augmentation sleeve so that the trailing end portion of the bone screw may be augmented by pressing augmentation material through the plurality of lateral bores at the trailing end portion of the bone screw and further through the lateral opening of the augmentation sleeve into the bone at the trailing end of the bone screw, or other implant. After the augmentation of the trailing end portion of the bone screw, the augmentation sleeve may be removed.

A bone screw tightening device including a screw driver, the screw driver having along its axis a device for providing for radial bendability and at a same time preserving torsional stiffness along an axis of longitudinal extension of the screw.