A method of providing access to an intervertebral disc has been developed that involves using the patient's bony pedicle as an anchoring spot for a pedicle screw that temporarily attaches to the access port. Because this new procedure eliminates the need for the surgical table as an anchor, it also eliminates the assembly components extending from the table to the port at the access site, thereby unencumbering the surgeon's view and workspace while providing minimally invasive access. One key element of the method is an assembly comprising: a) a screw extension comprising a shaft having a distal end portion comprising a receiver adapted for receiving a screw and a proximal end portion comprising a pivoting feature, b) a port comprising: j) a tubular wall defining a central passageway, ii) a longitudinal slot in the wall defining opposed ends of the wall, iii) opposed flanges extending radially from each end of the wall, and iv) a mating feature disposed in each opposed flanges adapted to pivotally mate with the pivoting feature of the screw extension, wherein the mating feature of the tube pivotally mates with the pivoting feature of the screw extension.

Surgical visualization systems and related methods are disclosed herein, e.g., for providing visualization during surgical procedures. Systems and methods herein can be used in a wide range of surgical procedures, including spinal surgeries such as minimally-invasive fusion or discectomy procedures. Systems and methods herein can include various features for enhancing end user experience, improving clinical outcomes, or reducing the invasiveness of a surgery. Exemplary features can include access port integration, hands-free operation, active and/or passive lens cleaning, adjustable camera depth, and many others.

The present teachings provide one or more surgical implements for repairing damaged tissue, such as through a fixation procedure. A system for a percutaneous procedure is provided. The system can include a bone fastener including a receiver. The system can include a device having a first end, a second end and a middle portion. The first end, middle portion and second end can be disposed along a longitudinal axis, and the second end can be connected to the receiver. The middle portion can have a pair of deformable leg members extending between the first and second ends. The leg members can define a channel having a width. The leg members can be selectively movable between a retracted state and an expanded state with the width of the channel greater in the expanded state than in the retracted state.

A system for implanting an inter-body device between adjacent vertebrae comprises an inter-body device having a plurality of cans secured to a flexible bridge and having a relief portion therebetween. An inserter tube and complementary bullnoses are advantageously secured to the vertebrae by an extension arm for securing the assembly precisely in place. A plurality of articulating trial implants are provided to test fit a disc space for the proper sized inter-body device.

A medical apparatus for parallel alignment of at least two medical instruments for holding and manipulating a surgical fastening element is described. The fastening element includes a fastening part and a holding part for a connection element, the holding part being movably mounted relative to the fastening part in a mounting position. The medical instruments have a distal end couplable to the fastening element. The apparatus includes at least two coupling devices, each defining a coupling longitudinal axis, for temporary coupling with proximal ends of the at least two medical instruments, wherein the apparatus comprises a frame, wherein the coupling longitudinal axes of the at least two coupling devices are alignable parallel to one another. Improved sets of medical instruments and improved spine stabilization systems are also described.

A minimally invasive system for retraction, compression and distraction includes a tap having a shaft with threads and a head, a blade having a proximal end and a distal end and a base removably mountable to the proximal end. The tap is configured to form screw threads in a bone. The distal end is mountable to the head. The blade is pivotable relative to the head in a mounted configuration. The blade is configured to facilitate soft tissue retraction in the mounted configuration. The base is configured to manipulate the blade to retract and compress segments of the bone. The base is configured to provide distraction and/or compression using the provisional taps either directly or through the use of blades, insertion devices or tubes. The blades may be used to retract tissue and provide a visual field either independent or in conjunction with the provisional taps, insertion devices or tubes.

Systems and methods for a guide assembly for introducing a bone anchor to an operative target site. The guide includes an outer sleeve and an inner sleeve. The outer sleeve has a distal anchor engaging end, a proximal end, and a central passage extending from the distal end to the proximal end. The inner sleeve may be situated in the central passage of the outer sleeve. The inner sleeve is movable being between a first position and a second position. The first position permits insertion of the bone anchor in the central passage. The second position releasably fixes the bone anchor to the guide assembly.

An instrument for locking and unlocking a head of a bone anchor relative to a receiving part of a polyaxial bone anchoring device includes a tube assembly with an inner tube and an outer tube at least partially around the inner tube, and an actuator assembly including an actuating mechanism movable from a first orientation to a second orientation to displace the inner tube and the outer tube relative to one another between a first axial position configured to unlock the bone anchoring device such that the head is pivotable relative to the receiving part, and a second axial position configured to lock the head. The actuator assembly is adjustable between a first configuration where the tube assembly assumes the first axial position when the actuating mechanism is moved, and a second configuration where the tube assembly assumes the second axial position when the actuating mechanism is moved.

An anchor can be coupleable to a bone, where the anchor includes a head, a shank, a first extension, and a second extension. The head can include a distal head portion and a proximal head portion, where the proximal head portion can be open at a proximal end of the head. The shank can extend distally from the distal head portion, where the shank including a threaded portion configured to engage the bone. The second extension can be opposing the first extension, and the second extension can include a second proximal support coupled to a second end of a first elongate portion, where a first proximal support can extend transverse to the longitudinal axis, and the first proximal support portion and the second proximal support portion can be separated in a first condition and can be engaged to transfer forces there between in a second.

A surgical instrument includes a first member including a first portion and a second portion. The second portion includes an arm and a part. The part is connectable with a first blade such that the first blade is rotatable about the longitudinal axis through a selected angular range and about the transverse axis through a selected angular range. A second member includes a first portion and a second portion that is connectable with a second blade. The first portions are pivotably connected such that the blades are movable between a first configuration and a second configuration to define an opening and space tissue adjacent a spine. Surgical systems, constructs, implants and methods are disclosed.