The combination of: a) an implant having a body with a leading end and a trailing end and external threads extending around a lengthwise axis, the body having an axial through passage and configured to be directed into a bone passage whereby upon turning the body in a first direction around the lengthwise axis, the external threads engage a surface bounding the bone passage and cause the implant to be advanced in an assembly direction into an operative position; and b) a removal tool with a first component that is configured to be engaged with the body with the implant in the operative position in such a manner that the body will follow movement of the first component as the first component is: a) turned in a direction opposite to the first direction; and b) drawn in a direction oppositely to the assembly direction to thereby allow the implant to be separated from the bone.

Telescopic nail (2) for the treatment of fractures or deformations of long bones, as for example in the case of osteogenesis imperfecta or pseudo-arthrosis. comprising: a hollow stem (2); a rod (10) telescopically inserted into said hollow stem (2); a first fastening element (20) coupled to an end of said hollow stem (2) for fixing to a first long bone end; a second fastening element (30) coupled to an end of said rod (10) for fixing to a second long bone end.

Advantageously, one end of said hollow stem (2) is provided with coupling means (40) for coupling to an end of a tool which can be inserted into a cavity formed in the bone for insertion of the nail.

A surgical technique can be performed utilizing a detachable driver-implant system and comparatively small surgical incision. The clinician can make an incision through the skin of the patient and retract the skin along the incision to expose a first bone region. The clinician can insert an implant into one or more bone portions using a detachable driver-implant system and then detach the driver, leaving the implant in the one or more bone portions. The clinician can reposition the skin of the patient at least partially over the end of the implant to expose a second bone region not exposed while the first bone region was exposed. After optionally performing one or more surgical steps on second bone region, the clinician can reposition the skin to again expose the first bone region. The clinician can then reattach the driver to the implant and remove the implant from the bone portions.

An apparatus for use in placing an implant into a patient is disclosed. The apparatus features an outer assembly having an outer shaft with an expandable driving member at its distal end and an inner canulated shaft that fits within and cooperates with the outer shaft to affect the driving member. The inner shaft includes an actuation knob attached to the proximal end of the inner shaft. A locking or driving thread is included on the outer surface of the inner shaft, proximal to the adjustment knob. The outer shaft includes a housing with the threaded interior such that when the inner shaft is mounted within the outer shaft, the driving thread operates with the threaded interior of the housing to allow for the inner shaft to be advanced along the inside of the outer shaft as the knob is turned. The tip of the inner shaft interacts with the interior of the driving member to expand the driving member.

A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an element engageable with a second mating surface of the bone fastener. An actuator is connected with the second member and includes visual indicia of engagement of the element with the second mating surface. Systems, spinal implants and methods are disclosed.

Methods and systems are provided for securing tissue to bone. A surgical system can include a driver having a proximal handle and a driver shaft extending therefrom, a distal awl shaft, a proximal awl shaft separate from the distal awl shaft and movable with respect to the distal awl shaft, a suture anchor, and a dilator feature distal to the suture anchor. The distal and proximal awl shafts are receivable in at least part of a lumen of the driver. In a bone forming configuration of the system, in which the distal awl shaft is driven into bone, a distal end of the proximal awl shaft abuts a proximal end of the distal awl shaft. The proximal awl shaft can be moved proximally, such as by activating an awl handle coupled thereto, with respect to the distal awl shaft to move the system in a suture anchor insertion configuration.

A screwdriver for driving a screw in bone includes a first body configured to engage a tulip of the screw, a first central bore extending through the first body, a second body having a second central bore extending through the second body and an external surface having a spline member positioned at least partially within the cavity, an inner shaft configured to drive a screw into bone and being rotatably coupled with the second body, a spring-biased pawl engageable with the spline member of the second body, a collar rotatable relative to the first body and the second body and having a cammed inner surface, when the collar is rotated in a first direction about the first body, the cammed inner surface pushes the spring-biased pawl into engagement with the spline member to rotatably couple the first body and the second body.

A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an element engageable with a second mating surface of the bone fastener. An actuator is connected with the second member and includes visual indicia of engagement of the element with the second mating surface. Systems, spinal implants and methods are disclosed.

The invention relates to a system and method for driving orthopedic bone screws. In one aspect the driver includes a powered driving rod that is configured to releasably couple with a recess in a bone screw via a threaded system for coupling and uncoupling the screw from the driving rod.

A bone fixation apparatus includes an insert and a bone anchor. The insert has open ends defining a lumen. A first thread is disposed on an outer surface of the insert and a second thread is disposed in the lumen. The insert is configured for threadably engaging bone. A driving tool is releasably attachable to the insert. The bone fixation apparatus also includes a bone anchor with a bone screw member and a housing. The bone screw member extends from the housing and has a third thread along a shank of the bone screw member. The third thread of the shank is engageable with the second thread of the lumen such that the bone anchor is coupled to the insert.