A polyaxial screwdriver for inserting a bone screw in a vertebra. A polyaxial bone screw assembly includes a coupling element. When a screw engaging end of the polyaxial screwdriver is lowered on the head of the bone screw, the complimentary surfaces of the screw engaging end of the screwdriver and the head of the screw self-align. A ratchet mechanism formed in the screwdriver provides progressive and automatic locking of the polyaxial screwdriver to the coupling element and prevents the accidental unthreading from the coupling element. In another embodiment of the polyaxial screwdriver, a collet slides over the outside surface of the upper end of the coupling element and locks on to the coupling element. In yet another embodiment of a polyaxial screwdriver, the outer sleeve of the polyaxial screwdriver has a split end that securely engages the coupling element.

A spinal manipulation instrument, system, and method may use a driving rod to move instrument arms toward or away from one another to compress or distract between selected vertebrae to which the arms are connected. Two arms may be coupled to the driving rod. A threaded collar may axially engage one of the arms, to translate that arm along the driving rod with respect to the other arm. The other arm may be at a fixed axial location or driven by another, oppositely-oriented thread. The arms may be highly adjustable to accommodate a wide range of anatomical variation between patients. Attachment members may be modular to interchangeably couple the arms across multiple platforms.

A surgical instrument having a first member being engageable with a fastener. A second member includes an expandable portion configured for capturing the fastener. A third member is engageable with the expandable portion to releasably capture the fastener. An actuator connected with the second member and the third member. The actuator includes a threaded inner surface and a threaded coupling member engageable with the threaded inner surface to facilitate axial translation of the second member relative to the third member. Systems, spinal constructs, implants and methods are disclosed.

Systems and method of using a surgical driver instrument are provided. The driver instrument includes a driver shank having a proximal end including a head connector for a bone construct. The instrument includes an inner sleeve having a length and configured to receive the driver shank therein and a handle member having a first end and a second end. The inner sleeve and the driver shank have a non-threaded connection. The instrument includes an outer sleeve connected to the second end and concentric with the inner sleeve and a sleeve actuator assembly coupled to the handle member. The sleeve actuator assembly includes a first position where a portion of the length of the inner sleeve extends out from the handle member and a second position where the portion of the length of the inner sleeve that is extended from the handle member is retracted into the handle member.

A stylet control system for selectively advancing and retracting a stylet includes a stylet having a first end and a second end, the second end being threaded, a screwdriver defining a bore for receiving a portion of the stylet and having a screw-engaging end for engaging a screw, the stylet being rotationally fixed relative to the screwdriver. The system includes a control device having a passage for receiving the screwdriver and having an inner portion defining a lumen for receiving the portion of the stylet, the inner portion being threaded for engaging the threaded second end of the stylet, when the screwdriver is rotated in the first rotation direction and the control device is prevented from rotating, the screwdriver advances the screw in the first axial direction and the stylet retracts in a second axial direction, opposite the first axial direction.

A method for securing an elongate rod to a bone anchor with a receiver and a threaded plug. The receiver includes a channel configured to receive the elongate rod, and a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The threaded plug is configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the threaded plug having an outer surface with a mating continuous helically wound guide and advancement structure configured for rotatable engagement with the receiver guide and advancement structure.

A sleeve can be adapted to reinforce a bone anchor, and can include a body, a lock, and an actuator. The body can include a first sleeve arm and a second sleeve arm, where each can extend longitudinally along opposing sides of a longitudinal bore open at a distal end of the sleeve. The lock can be coupled to the body and releasably securable to a channel of a head of the bone anchor to secure the sleeve to the anchor.

Robotic systems and methods include a robotic manipulator and a skin incision tool to be coupled to the robotic manipulator and being configured to create an incision in skin of a patient. A skin tracker is attached to the skin of the patient to track the skin of the patient. A robotic controller controls the robotic manipulator to move the skin incision tool relative to a determined location on the skin of the patient. The robotic controller controls the robotic manipulator to constrain movement of the skin incision tool with a haptic object defined relative to the determined location to guide the skin incision tool to the determined location for making the incision in the skin.

The invention relates to a bone anchor for triangular iliosacral osteosynthesis. The bone anchor includes an ilium screw having a first longitudinal direction and an iliosacral screw having a second longitudinal direction. The ilium screw, in a thread-free portion, has a preferably elongated-hole-like through-opening transversely to the first longitudinal direction, and the iliosacral screw has such a smaller outer diameter in relation to the ilium screw that the iliosacral screw can be guided through the through-opening and can be screwed proceeding from the ilium into the sacrum, through the ilium screw.

An instrument includes an outer sleeve defining a passageway and extending along an axis between proximal and distal ends. A knob sleeve is positioned in the passageway and defines a bore and a sleeve cavity. A latch is positioned in the sleeve cavity. A shaft is positioned in the bore. An inner sleeve is positioned between the knob sleeve and the shaft. A proximal end of the inner sleeve defines a notch. The knob sleeve is movable relative to the outer sleeve to move the instrument between a first orientation in which the latch is positioned in the notch and the inner sleeve is prevented from translating along the axis and a second orientation in which the latch is spaced apart from the notch and the inner sleeve is translatable along the axis. Systems, implants and methods are disclosed.