Tool assemblies, system, and methods for manipulating tissue and methods for performing a surgical procedure on a vertebral body adjacent soft tissue. A manipulator moves an end effector, and a screw is coupled to the end effector. A sleeve is disposed coaxially around the screw, and the screw and the sleeve are releasably engaged to one another. A navigation system is configured to track the vertebral body, and one or more controllers control the end effector to advance the screw relative to the sleeve along an insertion trajectory defined with respect to a surgical plan. The screw disengages the sleeve during advancement, and the screw is secured to the vertebral body. A distal working portion of the screw may be freely slidable through a distal end of the sleeve when disengaged. The screw may be a tap marker removably couplable with a tracking device of the navigation system.

A polyaxial bone anchoring device includes a receiving part with a rod receiving portion defining a recess for receiving a rod, and a head receiving portion with a wall that defines an accommodation space for accommodating a head of an anchoring element, and a locking member positionable at least partially around the head receiving portion and movable from a first position where the head can pivot in the accommodation space to a second position where an angular position of the head is locked. The wall of the head receiving portion further defines at least one cavity in communication with the accommodation space that reduces a radial thickness of at least part of the wall located between the accommodation space and the locking member, and at least part of the cavity is separated radially from the accommodation space by a portion of the wall.

The present invention provides for a joint fixation device and method utilizing a bone screw having a bi-directional drill point that is constructed and arranged to cut and form a hole in a bone when the screw is rotated or oscillated in both directions around the longitudinal axis of the screw. The screw can then be rotated into a final position by rotation in a single direction; and removed by rotating the screw in an opposite direction.

A system includes a screw tower, an instrument, and a housing. The instrument includes a driver shaft extendable longitudinally through the screw tower, and a threaded sleeve mounted on a proximal portion of the driver shaft. The housing includes one or more retention members coupleable to the screw tower, and a threaded button threadably coupleable to the threaded sleeve. The threaded sleeve is rotatable about a longitudinal axis to urge the driver shaft longitudinally relative to the screw tower.

A receiver of a bone anchor includes a base and a pair of upright arms extending upward from the base to define an open channel for receiving an elongate rod, with the upright arms having opposed interior surfaces with a discontinuous guide and advancement structure formed therein and side outer faces opposite the opposed interior surfaces extending downward across the base to a bottom of the receiver. A horizontally-elongated upper tool engaging groove is formed into the side outer face of each upright arm that extends to at least a front face or back face of the upright arm and that includes a downwardly-facing upper surface, an upwardly-facing lower surface, and an outwardly-facing inner surface. A vertical tool-engaging groove is also formed into the side outer face of each upright arm that extends downward from a top surface of the upright arm through to a level below the lower surface of the upper tool engaging groove.

A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having a channel configured to receive the elongate rod, a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The receiver assembly further includes a fastener configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the fastener 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.

An inserter for attaching a modular yoke to a bone screw and for providing an indication of attachment, comprises a tubular body having a central lumen, distal and proximal ends, and an attachment portion for releasable attachment to a yoke having a bottom opening for receipt of a head of said bone screw. The inserter includes an inner shaft having a distal end configured to be received into the yoke, the shaft being axially movable within the lumen from first to second axial positions in response to the introduction of the bone screw head into the yoke bottom opening. An indicator button supported by the body is movable in response to axial movement of the shaft from a first indicator position indicating the first axial position of the shaft relative to the body to a second indicator position indicating the second axial position of the shaft relative to the body.

A clamp device includes multiple claws for collectively gripping a vertebra, particularly over a pars interarticularis. At least one of the claws is movable relative to a body of the clamp device. The movable claw includes an elongate tab received within a track extending within the body. The body or the tab includes a threaded hole within which set screws may be received for immobilizing the movable claw relative to the body. The clamp device also includes an array of rod clamps. The rod clamps are supported by the body, and more directly by a bar supported by the body. The bar is releasably connectable to the body, and the rod clamps are pivotably connectable to the bar.

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.

An instrument for use in surgery includes a hollow shaft connectable to a drive shaft of a bone anchor insertion device in a rotationally fixed manner, a needle holder configured to hold a needle and movable axially relative to the hollow shaft, an actuator rotatable relative to the hollow shaft, and a transmission member connectable to the needle holder and movable axially relative to the actuator. The transmission member is positionable around at least part of the hollow shaft and includes a first advancement surface engageable with a second advancement surface of the hollow shaft to convert a rotational movement of the actuator into axial movement of the needle holder relative to the hollow shaft for axially advancing and retracting the needle held by the needle holder.