An instrument for guiding a rod into a holder of an implant, in particular a pedicle screw, includes a coupling unit for coupling the instrument to the implant, in particular a head of the pedicle screw, a threaded rod that can be positioned in the axial direction relative to the coupling unit, and at least one internally threaded segment that is arranged in an axially fixed manner relative to the coupling unit, and can be positioned in a radial direction relative to the threaded rod, and prestressed toward the threaded rod by a prestressing element applying a radial force. The internally threaded segment can be brought into engagement with, and disengaged from, the male thread of the threaded rod by radial positioning. Thread flanks of the threaded rod and thread flanks of the internally threaded segment face each other and are each formed with an undercut.

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.

An instrument is configured for use with a receiving part defining a recess for receiving a rod to connect the rod to a bone anchoring element. The instrument includes a tube having a first end and a second end, and defining a coaxial internal channel that opens towards the first and second ends, and at least one protruding portion monolithically formed with the tube that is engageable with the recess of the receiving part to prevent rotational movement of the tube relative to the receiving part. The first end of the tube forms a closed ring. The at least one protruding portion has a first region that extends radially outwardly from an outer surface of the tube at the first end and a second region that extends axially away from the first end in a direction opposite the second end.

A coupling device includes a receiving part having a head receiving portion for pivotably receiving a head of a bone anchor and a rod receiving portion defining a recess for receiving the rod, the rod receiving portion having an engagement structure for engaging a locking member to lock the rod in the recess and a first engagement surface different from the engagement structure for engaging an instrument, wherein the first engagement surface is formed away from radially outwardly facing regions of the rod receiving portion, and a locking ring positionable around the head receiving portion and having a second engagement surface for engaging the instrument. The locking ring can assume an insertion position where the head of the bone anchor is insertable into the head receiving portion, and a pre-locking position where the head is prevented from removal from the head receiving portion.

A guide assembly includes a spinal screw assembly having a bone screw and a spinal rod holder; and a spinal rod guide having first and second elongated arc portions defining a pair of longitudinal slots extending along the first and second arc portions, each of the first and second arc portions further defining at least one recess extending transversely from each of the longitudinal slots, the at least one recess configured to receive at least a portion of a reduction tool to enable reduction of a spinal rod received within the spinal rod holder.

Spinal stabilization implant assemblies, as well as systems, instruments and methods are provided for implanting and stabilizing adjacent vertebra in connection with a surgical procedure, particularly a spinal surgery. The implant assemblies and instruments enable controlled spinal rod insertion and reduction, and controlled rotation or de-rotation of adjacent spinal bones for optimized compression to achieve enhanced sagittal balance in a treated spine.

A rod reducer includes a shaft, a sleeve assembly defining a bore dimensioned to receive the shaft therethrough, a housing defining a bore dimensioned to receive the shaft, arm members operatively associated with the housing, and an anvil operatively coupled with the shaft. The sleeve assembly includes a locking tab. The housing includes a groove configured to selectively receive the locking tab of the sleeve assembly. The housing includes a locking ledge portion in registration with the groove. The anvil is transitionable between a proximal position, in which, the arm members are spaced apart, and a distal position, in which, the arm members are in an approximated position. The sleeve assembly is rotatable between an engaged state in which, the locking ledge portion inhibits relative axial displacement of the sleeve assembly with the housing, and a disengaged state in which, the sleeve assembly is axially movable relative to the housing.

Spinal surgical procedures can benefit from a rod reduction instrument with a ratchet lock-out mechanism. The instrument can include an inner shaft, an outer housing and a ratchet mechanism. The inner shaft can include a threaded proximal portion and a distal end that includes a plurality of engagement members adapted to receive a pedicle screw. The outer housing can be slidably received over the inner shaft, and include a top sleeve and a bottom sleeve. The top sleeve can include the ratchet mechanism to selectively engage the threaded proximal portion of the inner shaft and the bottom sleeve can engage a connecting rod. The ratchet mechanism can include an engagement feature to selectively engage the threaded proximal portion of the inner shaft, and a locking mechanism to selectively lock the engagement feature of the ratchet mechanism against the threaded proximal portion of the inner shaft.

A clamp assembly for orthopedic use having a housing that includes a top surface, a recess, a distal base and a bottom surface, the recess defining a longitudinal axis and extending through the housing from the top surface through the distal base and toward the bottom surface, and at least two through slots, each one of being disposed at a bottom or a side a surface of the housing. The assembly including a securement assembly positionable within the recess in a co-axial relationship to a mating surface on the recess, and a band sized for travel along a predetermined path defined in part by the through slots in the housing, wherein at least one of the through slots is a starting point for travel of the band along the predetermined path.

A bone fixation system with variable z-axis translation is provided. The bone fixation system includes an outer tulip coupled to a bone fastener. An inner tulip, which provides a seat for an elongate fixation rod, is located inside the outer tulip. The inner tulip together with a seated rod is permitted to translate along the z-axis in an unlocked position. Also in the unlocked position, the bone fastener is free to angulate relative to the outer tulip. The bone fixation system includes a locked position in which the z-axis position of the inner tulip and rod relative to the outer tulip is fixed. Also in the locked position, the bone fastener is locked with respect to the outer tulip. The system may be adjusted between the locked and unlocked positions by way of a set screw or independently by rotation of the inner tulip relative to the outer tulip.