A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an element engageable with a second mating surface of the bone fastener. The members are engageable with the bone fastener in a release configuration, an intermediate configuration and a locked configuration. Systems, surgical adaptors, spinal implants and methods are disclosed.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Disclosed is a surgical alignment and distraction frame and associated methods of use that facilitates correction of a sagittal imbalance. The alignment and distraction frame works in conjunction with pedicle screw installation guide assemblies to impart the desired correction. The alignment frame can be utilized to ensure the pedicle screw housings are aligned (to facilitate rod coupling) in concert with the completion of a correction maneuver.

This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. More specifically, the application describes instruments and methods for building a posterior fixation construct across one or more segments of the spinal column in a minimally invasive fashion.

An apparatus includes a reference array, a bone anchor, a receiver assembly coupled to the bone anchor, and an adapter axially locked with the receiver assembly. The adapter includes a proximal end coupled to the reference array and a distal end coupled to the receiver assembly.

Embodiments of the present invention are directed toward a system of apparatuses to correct spinal deformities along with associated surgical techniques. The apparatuses comprise passages or channels in which spinal rods of differing diameters may be secured to allow a surgeon to vary the diameter of rods used along the length of the spine. Additionally, embodiments of the present invention are directed toward instrumentation for reduction of spinal rods into spinal pedicle screws.

An instrument for provisionally tightening a screw body member to a head of a polyaxial bone screw includes a barrel body, an inner shaft, a handle and lever, and a load link assembly. The barrel body includes a distal end with a pair of rotatable tangs configured to engage the screw body member. The inner shaft includes a distal end configured to engage a bushing within the screw body member. The lever pivotally couples to one of the handle and the barrel body. The load link assembly couples to the inner shaft and the lever. Actuation of the lever towards causes the load link assembly to longitudinally displace the inner shaft toward the distal end to contact the bushing and advance the bushing into frictional fit between the screw body member and the head of the polyaxial bone screw.

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 surgical derotator instrument comprises a shaft, a handle and an articulating coupler. The shaft comprises a first end portion having a bone anchor coupling and a second end portion opposite the first end portion. The handle comprises a body portion and a slot extending in the body portion. The articulating coupler connects the shaft and the handle. A method for coupling a plurality of derotator instruments into a series of derotator instruments comprises: attaching a plurality of derotator instruments to a plurality of adjacent bone anchor housings, each derotator instrument comprising: a shaft for connecting to a bone anchor housing, a handle having a slot, and an adjustable coupler connecting the shaft and the handle; adjusting one or more of the adjustable couplers to align at least one of the slots of the series with other slots of the series; and inserting an elongate member through the at least one slots that are aligned.

A surgical instrument comprises a first portion defining a cavity configured for disposal of a first implant support member. A second portion defines at least one passageway aligned with the cavity and including a guide engageable with a second implant support member to orient the second implant support member with the at least one passageway such that the second implant support member is connectable with the first implant support member. Systems, spinal constructs, spinal implants and methods are disclosed.