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 rod reducer can comprise a reducing mechanism, a hinge mechanism, a handle mechanism and a bearing mechanism. The reducing mechanism can comprise a first elongate member extending along an axis to engage a bone anchor, and a second elongate member configured to slide along the first elongate member to engage a rod. The hinge mechanism can slidably couple the first and second elongate members such that the elongate members can translate against each other. The handle mechanism can comprise handles coupled to the hinge mechanism and configured to cause the first and second elongate members to translate relative to each other. The bearing mechanism can be configured to permit the handles to rotate about the axis independent of the elongate members. Methods of using the rotating rod reducer can include rotating the handles out of the way of adjacent levels of a spinal column being simultaneously reduced.

Instruments and methods for selectively coupling to an object are provided, for example surgical instruments that can form a rigid connection with an object and also be disassembled for cleaning, sterilization, etc. One embodiment includes an elongate shaft with a longitudinal groove, a first partial circumferential groove that intersects with a distal end of the longitudinal groove, and a second at least partial circumferential groove formed distal to the first partial circumferential groove. The instrument also includes a sleeve disposed over the elongate shaft that includes a protrusion extending from an internal wall that is received within the longitudinal groove to constrain movement of the sleeve relative to the elongate shaft. The sleeve further includes a lock that interfaces with the second at least partial circumferential groove when the protrusion is disposed in the first partial circumferential groove to further selectively constrain axial and rotational movement of the sleeve.

A lateral reducer includes a translating reducer arm, an interface and handle bars. The arm includes a first longitudinal axis and laterally drives a rod. The interface has a fulcrum and a first side integrated with the arm. The interface pivots the arm between an open position and a closed position. A first handle bar connects to the fulcrum and has a second longitudinal axis. A second handle bar connects to a second side of the interface. The second handle bar has a first position, intermediate positions and a second position. In the first position, the arm is in the open position. In the second position, the arm is in the closed position so that the first longitudinal axis and the second longitudinal axis are parallel. In intermediate positions between the first and second positions, the arm moves laterally in a direction toward the first handle bar.

A dual-sided rod bender for contouring a rod is disclosed. The rod bender may include a first handle and a second handle pivotably coupled together and extending in a longitudinal direction, respectively, from a proximal end to a distal end. A first side of the rod bender may include a first roller adjacent the distal end, a second roller adjacent the distal end, and a third roller disposed between the first roller and the second roller. A second side of the rod bender may include a fourth roller adjacent the distal end, a fifth roller adjacent the distal end, and a sixth roller disposed between the fourth roller and the fifth roller. The first side may be configured apply a first mechanical advantage to bend a rod and the second side may be configured to apply a second mechanical advantage to bend a rod.

A system for robotic spinal manipulation includes a first robotic arm comprising an end effector; a second robotic arm configured to hold a spinal rod; at least one processor; and a memory storing instructions for execution by the at least one processor. The instructions, when executed, cause the at least one processor to control the first robotic arm to link the end effector with at least one vertebral screw implanted in a vertebra of a spine of a patient; control the second robotic arm to hold the spinal rod in a predetermined pose; and cause the first robotic arm to move the at least one implanted vertebral screw into engagement with the spinal rod.

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.

Bone anchor assemblies are disclosed herein that provide for a single bone anchor assembly that can be utilized across a range of spinal surgical procedures, reduce manufacturing burden and cost, and provide for greater flexibility during a surgical procedure. The bone anchor assemblies disclosed herein include an implantable shank and a receiver member having two spaced apart arms which form a U-shaped seat to receive a rod, among other components. The bone anchor assemblies disclosed herein also provide a number of features to enhance capability and usability. Examples include features to facilitate better implantation of the shank, better coupling of instrumentation to the anchor, better performance in reducing a spinal fixation element, such as a rod, into the receiver member seat, and others.

Bone anchor assemblies are disclosed herein that provide for a single bone anchor assembly that can be utilized across a range of spinal surgical procedures, reduce manufacturing burden and cost, and provide for greater flexibility during a surgical procedure. The bone anchor assemblies disclosed herein include an implantable shank and a receiver member having two spaced apart arms which form a U-shaped seat to receive a rod, among other components. The bone anchor assemblies disclosed herein also provide a number of features to enhance capability and usability. Examples include features to facilitate better implantation of the shank, better coupling of instrumentation to the anchor, better performance in reducing a spinal fixation element, such as a rod, into the receiver member seat, and others.

Surgical instruments that are configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure, such as spinal rod reduction and derotation, are provided. For example, in one embodiment a surgical instrument can include an outer sleeve terminating in a pair of extensions, an inner sleeve having a proximal threaded portion and a distal translating portion configured to pass through the outer sleeve, and a pair of pivoting arms received in the extensions of the outer sleeve. The pivoting arms can be configured to extend into a channel of the outer sleeve to couple a bone anchor to the outer sleeve, and a proximal end portion of the outer sleeve can include one or more flats configured to engage with another instrument.