The present invention includes a novel procedure and corresponding medical devices for a Purcutaneous Spinal Interbody Fusion (PSIF). In PSIF, the surgeon performs the entire operation percutaneously without the use of a microscope, endoscope, or magnifying loupes. An adjustable retractor system is disclosed that enables the surgeon to percutaneously perform the surgery through accessing the facet joint (and later disc space) that was created by said retractor system. This retractor system provides the surgeon a safe area to work and operate without fear of damaging nerves, blood vessels, or other tissue. An expanding trial may be inserted into and removed from the disc space through the interior of the retractor system to determine the proper size for the expandable cage. The retractor system also enables the expandable cage to be inserted into the disc space.

Biplanar forceps reducer instruments and methods are disclosed herein. The instruments disclosed herein can engage an implant, such as a bone anchor receiver head, and reduce or move a spinal fixation element, such as a rod, in two planes to move the rod into a channel formed in the receiver head. Further, the biplanar forceps reducer instruments disclosed herein can allow for introduction and tightening of a set screw using an inserter that can pass through a cannulated tube of the reducer. The low profile and biplanar reduction functionality can allow a single type of reducer instrument to couple with each bone anchor along a spinal fixation construct and remain in position until the construct is secured in position.

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 receiving part of a bone anchoring device includes a channel adjacent a first end for receiving a bone fixation element, the channel forming two free legs each having an engagement structure for engaging a locking element to lock the bone fixation element in the channel, an outer surface portion, and at least one projection for engaging an instrument to connect the instrument to the receiving part. The projection projects radially outwardly from the outer surface portion, is spaced apart axially from the first end of the receiving part, and has a circumferential width less than a circumferential width of the legs. The projection has a first side wall that faces the first end. At least part of the first side wall is inclined towards the first end as the first side wall extends circumferentially, to form a region of the projection that narrows towards the first end.

This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. Instruments are provided to aid in insertion and positioning or the rod.

A fixation assembly includes a pedicle screw having a screw head, an elongate tulip head inserted over the pedicle screw, and a swivel rocker inserted into the tulip head. The swivel rocker has an axial through passage extending therethrough, an arcuate concave distal face being contoured to match the screw head, and a saddle shaped proximal face. A rod assembly is seated on the saddle shaped proximal face. A retainer ring secures the tulip head around the screw head. A method of implanting the assembly is also provided.

A coupling device for coupling a rod to a bone anchor includes a receiving part configured to receive a head of the bone anchor, the receiving part having a first end and a second end, a central axis that extends between the first and second ends, and two legs at the first end that define a recess extending in a longitudinal direction transverse to the central axis for receiving the rod, and a monolithic pressure member positionable in the receiving part, the pressure member including a rod support surface and an engagement portion to adjust the pressure member to exert pressure on the head. The engagement portion is positioned farther radially from the central axis in the longitudinal direction than a first portion of the rod support surface, and extends closer axially to the first end of the receiving part than the entire first portion of the rod support surface.

The present invention concerns an orthopaedic rod bender including: a rod receiving zone configured to receive a first rod having a predefined curvature and a second rod to which a curvature is to be imparted; a first support and a second support for contacting the first rod, the first and the second 9B supports being located on a first side of the rod receiving zone opposite the first side; and a mobile head located on a second side of the rod receiving zone; the mobile head being configured to be displaced towards the first side and in the rod receiving zone to contact the second rod and to apply a force to the second rod to push the second rod towards the first rod to impart a curvature to the second rod.

Systems and methods for a guide assembly for introducing a bone anchor to an operative target site. The guide includes an outer sleeve and an inner sleeve. The outer sleeve has a distal anchor engaging end, a proximal end, and a central passage extending from the distal end to the proximal end. The inner sleeve may be situated in the central passage of the outer sleeve. The inner sleeve is movable being between a first position and a second position. The first position permits insertion of the bone anchor in the central passage. The second position releasably fixes the bone anchor to the guide assembly.

A coupling device for coupling a rod to a bone anchoring element includes a receiving part with a head receiving portion for receiving a head of the bone anchoring element, a rod receiving portion for receiving the rod, a downwardly facing surface, and an upwardly facing surface below and monolithically formed with the downwardly facing surface, and a locking member movable relative to the receiving part from a first position where the head is insertable into the head receiving portion to a second position where the head is prevented from being removed from the head receiving portion. At least part of the locking member is held to the receiving part between the downwardly and upwardly facing surfaces, and wherein the receiving part and the locking member are only separable from one another by permanently deforming or damaging at least one of the receiving part or the locking member.