Implants, instruments, and methods for performing surgical procedures on the spine, including one or more of creating an operative corridor to the spine, delivering implants to the spine, fusing one or more segments of the spine and fixing one or more segments of the spine.

An assembly for remotely manipulating a patient's spine. A compressor/distractor mechanism attaches to spinal anatomy or vertebral screws on adjacent vertebrae at a spinal surgical site on a patient's spine. A flexible cable is operatively connected to the compressor/distractor mechanism and to a control mechanism. The control mechanism manipulates the flexible cable, controlling the compressor/distractor mechanism to compress or distract the vertebrae. A rotatable surgical table with a remote control can be used in place of the compressor/distractor mechanism and the control mechanism. The rotatable surgical table can rotate the patient to place the spinal surgical site in a desired compressed or distracted position, and to place the patient in a desired orientation with respect to a horizontal reference plane. The assembly permits manipulation of the spine at the surgical site via a posterior approach, while the surgeon can also manipulate the spine at the surgical site via an anterior, lateral or oblique approach.

A method for treating a spine is provided. The method includes the steps of: disposing an interbody implant adjacent a posterior portion of an intervertebral disc space; connecting a surgical instrument with at least one fixation element fastened with tissue adjacent the posterior portion; and manipulating the surgical instrument such that tissue adjacent the posterior portion engages the interbody implant and one or more vertebra rotate about the interbody implant. Spinal implants; surgical instruments and systems are disclosed.

A surgical derotator instrument comprises a shaft, a handle and an articulating coupler. The shaft comprises a first end portion having a bone anchor coupling and a second end portion opposite the first end portion. The handle comprises a body portion and a slot extending in the body portion. The articulating coupler connects the shaft and the handle. A method for coupling a plurality of derotator instruments into a series of derotator instruments comprises: attaching a plurality of derotator instruments to a plurality of adjacent bone anchor housings, each derotator instrument comprising: a shaft for connecting to a bone anchor housing, a handle having a slot, and an adjustable coupler connecting the shaft and the handle; adjusting one or more of the adjustable couplers to align at least one of the slots of the series with other slots of the series; and inserting an elongate member through the at least one slots that are aligned.

A bone screw extension assembly for use in placing a connecting rod percutaneously into tissue of a patient comprises a multi-axial bone screw and a screw extension releasably coupled to yoke of the bone screw. The screw extension includes coaxially disposed outer sleeve and inner sleeves that are rotatable relative to each other. A screw engaging member projects radially from the distal end of the inner sleeve and is configured to engage an extension coupling surface on the outer sleeve upon relative rotation of the inner and outer sleeves. A securement member including cooperative surfaces is defined adjacent the distal end of the inner and outer sleeves that is operable upon relative rotation of the inner sleeve and outer sleeve to radially secure the sleeves together to thereby maintain the engagement of the screw engaging member and the bone screw.

An orthopedic device configured for use as a compressor or a distractor is provided. The device has two arm members and a locking sleeve for securely holding an elongated pin is attached to each of the two arm members. The locking sleeve are hingeably connected to the outer end of each of the two arm members by a biaxial hinge block, wherein the biaxial hinge block is configured to allow the locking sleeve to swivel in two different directions about two orthogonally oriented axes.

The present invention provides a compression and distraction shaft assembly used to apply compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. An hourglass-shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. Distraction pliers having cylindrical tips are used to apply distraction to vertebrae. Once handles are pressed to impart an appropriate amount of distraction to the vertebrae, they are locked in this position. Compression pliers having cylindrical tips are used to apply compression to vertebrae. Once handles are pressed to impart an appropriate amount of compression to the vertebrae, they are locked in this position.

Devices for retracting tissue during a minimally-invasive, posterior spinal fusion procedure include a blade positionable along a passageway device connected to a connecting element implanted in a vertebra of the spine, such that the blade covers at least a portion of a longitudinal opening of the passageway device. The blade may be coupled to the passageway device by receiving the passageway device with a receiving portion. Systems for displacing the vertebrae of the spine include first and second extenders, the distal ends of each of which are configured to engage the connecting elements. Each extender may include a shaft configured to be securely engaged within a cage of the respective connecting element. The devices and systems of the present invention may be used in connection with an interbody fusion technique performed through an opening extending between the passageway devices, and an intermediate retractor blade may provide additional tissue retraction.

Methods and apparatus for compressing and/or distracting bones are described herein. In one such method, a tap marker is engaged with a bone and a compressor/distractor device. The tap marker can be removed after moving the bone and a bone screw can be inserted into the space previously occupied by the tap marker. A rod or other fixation element can then be attached to the bone screw.

A system for correcting a position of bones, bone parts, or vertebrae includes a first bone anchor including a shank for anchoring in bone and a receiver for connecting a rod to the shank, a second bone anchor including a shank for anchoring in bone and a receiver for connecting the rod to the shank, and an instrument including a positioning member, a first coupling member for coupling the positioning member to the first bone anchor, and a second coupling member for coupling the positioning member to the second bone anchor. The first and second coupling members are movable relative to one another. The receiver is pivotable relative to the shank for at least one bone anchor. The at least one bone anchor can assume a locked configuration where an angular position of the receiver relative to the shank is locked while the rod remains movable relative to the receiver.