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, including a rod reduction instrument, 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. The rod reducer may be passed through the interior of the guide assemblies with a distal end arranged in a first position allowing the distal end to pass through the guide. Once through the guide the distal end may be expanded to provide dual contact on the rod at each end of the bone anchor rod channel.

An intervertebral spacer inserter includes a sleeve having a longitudinal axis, a hollow sleeve bore extending through the sleeve along the longitudinal axis, a sleeve tip end and an opening of a passage disposed in the sleeve tip end. The passage extends into the sleeve to the sleeve shaft along a passage axis that intersects the longitudinal axis at an angle less than about 90°. A sliding tip with an elongated slot is in contact with the sleeve tip end and is moveable with respect to the sleeve tip end between a first position with the opening accessible through the elongated slot and disposed adjacent a first end of the elongated slot and a second position with the opening accessible through the elongated slot and disposed adjacent a second end of the elongated slot opposite the first end.

An adjustable spinal stabilization system for maintaining preselected spacing and movement between adjacent vertebrae in a spinal column and for providing overall stability thereto. The system includes at least one interlaminar member positioned in the spaces intermediate a first vertebra and the vertebrae positioned immediately above or immediately below and adjacent to the first vertebra. The interlaminar member is operatively connected to an adjustable support structure and cooperates therewith to maintain the preselected spacing between adjacent vertebrae and to provide overall stability to the spinal column.

A bone anchoring device includes a receiving part with a rod receiving portion having a first end, a second end, a recess for the rod, an outer surface, and a first engagement structure on the outer surface that extends farther radially outwardly than other parts of the rod receiving portion, and a flexible head receiving portion for inserting and clamping the head. The bone anchoring device also includes a locking ring configured to be arranged around the head receiving portion for locking the head, the locking ring having an outer surface and a second engagement structure on the outer surface that extends farther radially outwardly than the outer surface of the rod receiving portion. The engagement structures are configured to be engaged by an instrument to move the locking ring from a locking position to a position where the inserted head is pivotable.

A bone anchoring device includes a receiving part for coupling a rod to a bone anchoring element, the receiving part having a first end, a second end, a recess at the first end for receiving the rod, and a compressible head receiving portion at the second end for accommodating a head of the bone anchoring element, a pressure member positionable in the receiving part to exert pressure on the head, and a clamping ring positionable around the head receiving portion and movable towards the first end of the receiving part to a locking position where the clamping ring exerts force on and compresses the head receiving portion. In the locking position, at least part of the clamping ring that faces the first end of the receiving part is exposed to the outside to facilitate movement of the clamping ring away from the first end of the receiving part.

Methods and systems for monitoring a rod reduction process is provided. The methods and systems include determining, based on at least one parameter, a threshold for forces exerted by a tool on a rod or a pedicle screw and receiving data corresponding to a magnitude of the forces exerted by the tool on the pedicle screw or the rod during reduction of the rod into a head of the pedicle screw. A surgical plan may be updated when the monitored magnitude meets the threshold.

Devices, systems, and methods for inserting a vertebral stabilization member, such as a rod. The insertion device includes an outer guide tube, a pin assembly including a pin and a pusher member extending therethrough. The insertion device is configured to actuate a rod between a first orientation and a second orientation angled with respect to the first orientation in order to position the rod in an appropriate location for attachment to bone.

A modular surgical instrument is provided that includes a tower having a first end, a second end and a ratchet segment between the first end and the second end. The instrument includes a ratchet reduction mechanism. The ratchet reduction mechanism includes a ratchet lever, a linear ratchet rack integrated into a ratchet segment of the tower at a location between the first end and the second end, and a ratchet collar coupled to the ratchet lever. The ratchet collar is configured to slide along the ratchet segment by application of an applied force. The instrument includes a reducer that may be affixed to the ratchet reduction mechanism. The reducer is configured to move in unison with the slide of the ratchet collar.

A rod reducer including a housing defining an opening, a body member defining an opening and a slot, a shaft disposed through the opening of the housing and coupled to the opening of the body member, an anvil including a linkage extending therefrom, the linkage coupled to the body member and the anvil, a plurality of arm members, and a biasing element disposed between the body member and the anvil. A pin of the linkage is slidably disposed within the slot, and the biasing element is configured to bias the anvil distally with respect to the body member. Rotation of the shaft translates into linear movement, relative to the housing, of the shaft, the body member, and the anvil. The arm members are coupled to the housing and movable towards a parallel configuration as the anvil is advanced away from the housing to engage a bone screw.