A length adjustable modular screw includes a neck assembly and a shank. The neck assembly has proximal and distal ends and includes an expander component and a collet component that are slidably engagable by insertion of the expander component in a through channel of the collet component along a common axis. The length adjustable modular screw also includes a shank suitable for insertion and retention within a bone, the shank including a threaded portion between proximal and distal ends and a socket adapted to coaxially receive at least a portion of the distal end of the neck assembly. The length adjustable modular screw has a length that is selected by splaying at least a portion of the distal end of the engaged expander and collet components of the neck assembly within the socket of the shank.

An implant device (100d) for engagement with a bone of a subject, said the implant device (100d) comprising a distal end (102d), a proximal end (104d), a central shaft (106d), a longitudinal central axis (108d) and a helical thread portion (110d) having a leading edge (114d) and a trailing edge (116d). A portion of the leading edge (114d) extends in a direction towards the distal end (102d) of the implant further than the most distal portion of the root (112d) of the thread portion (110d); and wherein the trailing edge (116d) extends in a direction of from the most proximal portion of the root (112d) in a radial outward direction and towards the distal end (102d); and a crest portion (118d) disposed between the leading edge (114d) and the trailing edge (116d) and wherein said the crest portion (118d) forms a radially outward portion of the thread portion (110d). Hence, the implant device (100d) improved the axial pull-out strength and reduced stress concentration.

A pivotal bone anchor assembly includes a shank with a head, an anchor portion, and a neck extending between the head and the anchor portion, and a receiver with upright arms defining a channel for receiving a rod and a central bore extending downward to a lower portion of the receiver. The assembly also includes a retaining structure rotatably coupled with the receiver with an internal seating structure pivotally supporting the head while providing for independent rotation of the shank prior to locking the assembly with the rod and a closure. The retaining structure includes an external surface and a slot extending between the seating structure and the external surface with a concave cut-out configured to closely receive the neck so as to provide for increased articulation between the shank and the receiver along the slot, and with the shank and the retaining structure being rotatable together around a centerline axis to align the increased articulation in any radial direction around the circumference of the receiver.

A surgical screw for fixation into bone or soft tissue. The surgical screw includes a cannulated body having a proximal end and a distal end. The distal end of the cannulated body has a tapered tip and a plurality of threads extend around the exterior of the cannulated body. An introducer extends distally from the tapered tip and has a diameter (which can be variable or constant) which is less than a diameter of the tapered tip. The surgical screw is cannulated such that a channel extends through the body from the proximal end to (and sometimes through) the distal end.

A surgical fastener manipulation tool in accordance with embodiment of the present invention is useful by a surgeon to place fasteners such as threaded screws. The surgical fastener manipulation tool selectively engages a mating structure of fastener for securing the fastener thereto. Thus, advantageously, the surgical fastener manipulation tool can be used for placing such fasteners and/or can be used for extracting (i.e., removing) such fasteners. The ability to extract a fastener (e.g., a threaded bone screw) with the same tool used for placing it is highly beneficial due to time savings during a surgical procedure and is advantageous with respect to prior art fastener manipulation tool configurations that require placement and extraction tools to be differently configured.

Instruments and methods for delivering bone cement are disclosed herein. In one exemplary embodiment, the instrument includes a cannulated bone screw having a head that is configured to be received within a rod receiver and a shank extending distally from the head and configured to extend distally from the rod receiver, a cannulated shaft having a distal end configured to extend into the shank of the cannulated bone screw and a proximal end configured to couple to a bone cement delivery system, and a retaining sleeve disposed around at least a portion of the cannulated shaft. The head of the bone screw has proximal and distal recesses therein, and a distal end of the retaining sleeve is configured to couple to the proximal recess.

A method for instant lumbar spine fusion between two vertebrae in a patient includes establishing under X-ray fluoroscopy the location of the transpedicular notch of the next lower vertebra in caudal direction, making a percutaneous incision to the transpedicular notch, inserting a cannulated guide, drilling a transpedicular approach from the pedicle of the lower vertebra to the anterior part of the vertebral body of the vertebrae above the disc to be treated, inserting a working cannula through the previously drilled approach reaching the intervertebral disk, cleaning and scrapping the intervertebral disk space, inserting transpedicularly at least one intervertebral stabilizing screw, and acting on both intervertebral screws with screwdrivers in order to distract or contract both screws allowing to adjust or correct the intervertebral distance of the disk. The method can be performed on an outpatient basis.

A spinal joint distraction system for treating a facet joint including articular surfaces having a contour is disclosed and may include a delivery device including a generally tubular structure adapted to engage a facet joint, an implant adapted to be delivered through the delivery device and into the facet joint, the implant comprising two members arranged in opposed position, and an implant distractor comprising a generally elongate member adapted to advance between the two members of the implant causing separation of the members and distraction of the facet joint, wherein the implant is adapted to conform to the shape of the implant distractor and/or the articular surfaces of the facet upon being delivered to the facet joint. Several embodiments of a system, several embodiments of an implant, and several methods are disclosed including a method for interbody fusion.

Systems, devices and methods are provided for implanting medical devices into patients. The systems, devices and methods are particularly useful for orthopedic implants, such as spinal implants that facilitate fusion of bone segments. A fixation assembly for an implant comprises a screw having a head and a shaft, and a washer having at least one outer surface with one or more frictional elements for engaging a surface of the implant. The shaft includes one or more projections that cooperate with the washer to prevent the washer from sliding back down the screw, while allowing for easy application of the washer to ensure optimal placement and desired contact with the screw head. The washer and/or the screw head may also include interlocking cams that create a wedge effect that inhibits the screw from backing out or loosening from a hole in bone or other tissue.

A suture anchor comprises a tubular body having an axial bore therethrough and having one or more purchase enhancements on an exterior surface of the body adapted to enhance purchase of the body within a bone hole, such as threads. A lateral port passes through the body from the bore to the exterior surface and is formed of a slot entering the body from its proximal end. A length of suture for attaching soft tissue to bone passes down along the exterior surface over the one or more purchase enhancements, over a distal end of the body, up into the bore through and then back out of the bore and up along the exterior surface over the one or more purchase enhancements.