Assemblies of one or more implant structures make possible the achievement of diverse interventions involving the fusion and/or stabilization of the SI-joint and/or lumbar and sacral vertebra in a non-invasive manner, with minimal incision, and without the necessitating the removing the intervertebral disc. The representative lumbar spine interventions, which can be performed on adults or children, include, but are not limited to, SI-joint fusion or fixation; lumbar interbody fusion; translaminar lumbar fusion; lumbar facet fusion; trans-iliac lumbar fusion; and the stabilization of a spondylolisthesis.

A pedicle fixation system (10) may include a first fastener (12) and a second fastener (14). The first fastener (12) may include a first shank (40) extending along a first fastener axis (41) and a channel (52) extending along a skew axis (51). The skew axis (51) may be transverse to the first fastener axis (41) and the channel (52) may have a channel diameter perpendicular to the skew axis (51). The second fastener (14) may extend through the channel (52) and include a second shank (60) extending along a second fastener axis (63). At least a distal part of the second shank (60) may have a second fastener diameter perpendicular to the second fastener axis (63). The second fastener diameter may be smaller than the channel diameter.

A surgical fastener manipulation tool in accordance with embodiment of the present invention is useful by a surgeon to place fasteners such as threaded screws. The surgical fastener manipulation tool selectively engages a mating structure of fastener for securing the fastener thereto. Thus, advantageously, the surgical fastener manipulation tool can be used for placing such fasteners and/or can be used for extracting (i.e., removing) such fasteners. The ability to extract a fastener (e.g., a threaded bone screw) with the same tool used for placing it is highly beneficial due to time savings during a surgical procedure and is advantageous with respect to prior art fastener manipulation tool configurations that require placement and extraction tools to be differently configured.

A bone coupling device is configured for joining a first bone piece to a second bone piece which includes a first component having an inner surface bounding a first cavity and a first stem portion for insertion into the first bone piece. A second component includes a second stem portion for insertion into the second bone piece and an axially extending connector extending from the second stem portion and configured to be inserted into the first cavity. The connector has an outer surface which is complementarily shaped relative to an inner surface to inhibit rotation relative to each other when the connector is received in the cavity to engage the first component and the second component.

A method for instant lumbar spine fusion between two vertebrae in a patient includes establishing under X-ray fluoroscopy the location of the transpedicular notch of the next lower vertebra in caudal direction, making a percutaneous incision to the transpedicular notch, inserting a cannulated guide, drilling a transpedicular approach from the pedicle of the lower vertebra to the anterior part of the vertebral body of the vertebrae above the disc to be treated, inserting a working cannula through the previously drilled approach reaching the intervertebral disk, cleaning and scrapping the intervertebral disk space, inserting transpedicularly at least one intervertebral stabilizing screw, and acting on both intervertebral screws with screwdrivers in order to distract or contract both screws allowing to adjust or correct the intervertebral distance of the disk. The method can be performed on an outpatient basis.

Methods and apparatus for immobilizing a synovial joint, such as a sacroiliac (SI) joint are disclosed. In one form, a multipiece fixation device, such as a dowel, includes multiple expandable fasteners that are configured to fix adjacent bones of a synovial joint with respect to one another. The expandable fasteners include expansion portions that are expanded radially via insertion of another expandable fastener or an expansion device to fix the expandable fasteners to the bone. The fixation device may be configured to provide for compression or distraction of the bones of the synovial joint while at the same time stabilizing the joint.

A tissue fixation implant that includes leading fixation and trailing fixation members, each fixation member having a proximal head and an elongate shank with a distal tip, and each fixation member adapted to at least partially contact the other fixation member at one or more points along their respective lengths. The tissue fixation implant includes a proximal inter-engagement feature for fixedly engaging each of the two fixation members relative to one another when engaged within tissue, including bone tissue, soft tissue, and combinations of these, and has an interior chamber suitable for receiving osteogenic material to enhance new bone growth and fusion of the fixation implant within bone.

Described herein is a pedicle screw for use in the thoracolumbar spine where the height can be adjusted intra-operatively before or after installation member of the longitudinal member. The pedicle screws with adjustable height may be made with a monoaxial or polyaxial configuration. The height of the pedicle screw can be lengthened or shortened.

A receiver assembly includes a receiver having a first channel, a through-space with internal recesses beneath a guide and advancement structure, and internal ridges projecting inwardly below the internal recesses. The assembly also includes an insert having a second channel, side structures protruding laterally outward below top surfaces, and opposed lower extensions extending downwardly below the second channel, with the insert being loadable into the through-space with the second channel in non-alignment with the first channel. The insert is the non-threadably rotatable within the through-space to align the second channel with the first channel and to move the side structures into the internal recesses above the internal ridges, with subsequent downward displacement of the insert within the through-space causing the opposed lower extensions to engage the capture head of a bone anchor with a frictional engagement that inhibits the bone anchor from moving upward within the through-space.

A woven retention device for interfacing with a bone surface is provided that includes a sleeve body that can surround a fastener, a proximal end for receiving the fastener, and a distal end. The sleeve body includes interwoven monofilaments of different diameters forming a substantially tubular lattice with protuberances distributed on interior and exterior surfaces of the lattice at a predetermined spatial relationship. In a first state, the sleeve body has a plurality of combinations of filament cross-section geometries at the intersection points, forming a plurality of protuberance thicknesses as measured in a radial direction of the sleeve body. In a second state when a fastener is inserted into the tubular lattice, pressure from the fastener is transmitted to the tubular lattice such that the spatial relationship of the protuberances changes according to a function of bone density and an interfacing surface shape of the fastener.