Devices and methods for enhancing the effectiveness of spinal stabilization, and particularly that of cervical spinal stabilization, are provided herein. More specifically, methods and systems are disclosed for effectively positioning occipital plates and spinal fixation assemblies within target vertebrae, while also reducing any associated patient trauma (e.g., muscle stripping, tissue damage, etc.). The systems and methods can utilize trans-lamina delivery of the spinal fixation assemblies to allow for the positioning of the fixation elements along the midline of the patient's spine.

The present application is directed to various spinal stabilization systems. The systems can include one or more guiding elements attached to screw members to assist in guiding rod implants and tools to desired locations within a patient. The guiding elements can include a plurality of wires, blades, or tabs. The guiding elements can be capable of criss-crossing or intersecting at or near an incision, such that only a single incision may be needed to perform a surgery. The guiding elements can also include telescoping features that allow the height of the guiding elements to be adjusted in use, thereby allowing multiple telescoping guiding elements to be used with the same incision.

Methods and devices for treating spinal deformities are provided. In one exemplary embodiment, a low-profile spinal anchoring device is provided for receiving a spinal fixation element, such as a tether, therethrough. The device generally includes a staple body that is adapted to seat a spinal fixation element, a fastening element for fixing the staple body to bone, and a locking assembly for coupling a spinal fixation element to the staple body. In one embodiment, the locking assembly includes a washer that is adapted to couple to the staple body such that the spinal fixation is disposed therebetween, and a locking nut that is adapted to engage the staple body to mate the washer to the staple body.

A dynamic longitudinal connecting member assembly includes an anchor member having an integral or otherwise fixed elongate core of circular or non-circular cross-section. The core is pre-tensioned and extends through at least one elastic spacer and at least one outer sleeve. The anchor member and the outer sleeve each attach to at least one bone anchor. In operation, the core is held in tension by the spacer.

An artificial functional spinal unit including an expandable intervertebral implant that can be inserted via a posterior surgical approach and used with one or more facet replacement devices to provide an anatomically correct range of motion is described. Lordotic and non-lordotic expandable, articulating implants and cages are described, along with embodiments of facet replacement devices and instruments for insertion. Methods of insertion are also described.

The present invention discloses single level fusion systems and methods of use. The single level fusion systems include a first fastener, a second fastener, and a connector to secure the first fastener to the second fastener. The method of assembling a single level fusion system including obtaining a first fastener, a second fastener, and a connector, securing the first fastener to the connector, and securing the second fastener to the connector. Methods of using the single level fusion systems are also disclosed.

A spinal fixation construct for aligning vertebral bodies includes a bone screw, a spinal rod, a flexible member, and a fixation member. The spinal rod is disposed within a saddle portion of a housing of the bone screw, and includes an elongated body having a first end and a second end. The spinal rod is formed from a first material having a first modulus of elasticity. The flexible member is coupled to the spinal rod, and includes an elongated body having a first end portion and a second end portion. The flexible member is formed from a second material having a second modulus of elasticity that is different from the first modulus of elasticity. The fixation member includes a threaded body portion and a head portion defining a hole therethrough. A portion of the flexible member extends through the hole of the head portion.

A pivotal bone anchor assembly includes a shank having a head portion and an anchor portion for fixation to the bone of a patient, and a receiver comprising a base defining a lower portion of central bore and a pair of upright arms defining a channel for receiving an elongate rod. The assembly also includes a retaining structure with a central opening configured to capture and pivotally retain and support the head portion of the shank in the retaining structure, and which is slidably movable relative to the receiver so as to provide for increased articulated movement between the shank and the receiver prior to locking the assembly with the elongate rod and a closure. The assembly further includes an insert configured to engage the elongate rod and the head portion of the shank when in use, and to have an overlapping configuration with the retaining structure when the assembly is in the locked configuration.

A tool set for implanting bone screws in a human spine, followed by the implantation of a rod into the bone screws includes end guide tools having flexible back wall flaps that receive opposite ends of the rod and intermediate guide tools that hold the rod in intermediate locations between the end guide tools. Both the end and intermediate guide tools include an attachment structure for operably connecting the guide tool to a bone screw. The attachment structure includes an undercut and/or recess so as to resist splaying and separation of the guide tool from an attached bone screw.

Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.