A tool set for implanting bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws includes a pair of independently mountable and manipulatable elongate guide tools that form a unitary tool guide when desired. Each guide tool includes attachment structure for independent operable connection of the guide tool to an arm of the bone screw. The bone screw/guide tool attachment includes an undercut and/or recess so as to resist separation of the guide tool member from an attached bone screw. Further tools include a removable stabilizer, a cooperating bone screw driver with an attached stabilizer, a closure starter/reduction tool, a closure driver and a counter torque tool.

A fusion rod includes mounting structures located at different places thereon, and a first flexible element attached to one of the mounting structures and a second flexible element attached to another of the mounting structures.

Various exemplary methods and devices are provided for the removal and retention of bone screw rod reduction tabs extending from one or more bone screws implanted in a spinal column during a surgical procedure. In one embodiment, a removal and retention tool is provided having an elongated shaft with a channel formed therein that is configured to receive a rod reduction tab. The elongate shaft can be advanced over a rod reduction tab on a screw, and moved laterally to detach the reduction tab from the screw. The tool can include features to engage and retain the detached tab within the channel. Moreover, the tool can be configured to receive and retain multiple tabs, thus eliminating the need to remove the tool from a surgical site. The tool can also include a release actuator for releasing any tabs stored within the elongate shaft as may be needed.

A kit for performing a spine stabilization procedure is provided. The kit can include a balloon-tipped cannula having an expandable balloon enclosed by an expandable metal mesh. The balloon-tipped cannula can be configured to pass through a working sleeve and to expand the expandable balloon and expandable metal mesh within a surgical site. The kit can also include a pedicle screw having at least one fenestration or cannulation. The pedicle screw can be configured to be inserted into the surgical site. Related apparatus, systems, kits, techniques and articles are also described.

Various bone screws configured to be implanted into bone and methods of use are provided. In an exemplary embodiment, a bone screw is provided with an elongate shank having at least two threads thereon, and having a distal facing surface with at least two cutting edges. The cutting edges can be configured to cut bone as the bone screw is rotated into bone, thereby forming a path for the threads.

A bone anchor includes a shank for anchoring to a bone and a receiving part for coupling a rod to the shank. The receiving part includes a base and two legs each including a first portion extending away from the base, and a second portion extending from the first portion further away from the base, and an elongate extension member extending from the second portion still further away from the base. An internal engagement structure is provided on the first and second portions for engaging a fixation device. A breakaway portion facilitates breaking away of the second portion. The extension members are at least as long as the second portions. The second portions are stiffer than a region of the extension members adjacent the second portions.

A screw extension assembly for use in minimally invasive spinal surgery, the assembly has an inner slotted shaft and an outer shaft, a rod reducer and a removable nut. The combination when assembled is configured to move a spinal fixation rod into a slotted rod receiving spinal implant where it is seated and affixed thereto. The screw extension assembly further has a locking knob rotationally coupled to a proximal end of the outer shaft, wherein the inner shaft has one or more cam grooves and the locking knob has a pin extending into and guided by said cam groove causing the outer shaft to translate longitudinally upon rotation of the locking knob relative to the inner shaft toward an engaged position locking the deflectable legs in the coupled position to the slotted rod receiving implant.

A delivery system includes a first instrument having an outer sleeve defining a passageway. The first instrument includes an inner sleeve having a first end disposed in the passageway and a second end including a first mating element. The inner sleeve defines a channel. A second instrument includes a hollow shaft disposed in the channel and a handle coupled to the shaft. The handle includes a body and a second mating element extending from the body. The second mating element is configured to engage the first mating element to secure the second instrument to the first instrument. Methods are disclosed.

Provided is a spinal surgery apparatus for inserting a rod, which allows a rod forming an implant structure to be easily inserted and fixed, thus facilitating spinal surgery and minimizing invasions during the spinal surgery, thus helping a patient's recovery.

The spinal surgery apparatus for inserting a rod includes a handle gripped by a user, a fixing shaft connected to the handle, having on a lower end thereof a fixing part to which the rod is fixed, and separating the fixing part from the rod while the fixing shaft is tilted forwards, an actuating part including a connecting shaft inserted into the handle, and an actuating member installed on an end of the connecting shaft to move the connecting shaft up and down by rotation, and a rod push shaft inserted into the fixing shaft, and simultaneously coming at an upper end thereof into contact with a lower end of the connecting shaft, so that the rod push shaft is moved down by an operation of the actuating part, thus pushing and fixing the rod.

A device for use as a portal in percutaneous minimally invasive surgery performed within a patient's body cavity includes a first elongated hollow tube having a length adjusted with a self-contained mechanism. The first elongated tube includes an inner hollow tube and an outer hollow tube and the inner tube is adapted to slide within the outer tube thereby providing the self-contained length adjusting mechanism. Two or more elongated tubes with adjustable lengths can be placed into two or more adjacent body cavities, respectively. Paths are opened within the tissue areas between the two or more body cavities, and are used to transfer devices and tools between the adjacent body cavities. This system of two or more elongated tubes with adjustable lengths is particularly advantageous in percutaneous minimally invasive spinal surgeries, and provides the benefits of minimizing long incisions, recovery time and post-operative complications.