An instrument includes an outer sleeve and an inner sleeve positioned in the outer sleeve. The inner sleeve defines a cavity. The shaft extends through the inner sleeve and includes a drive. A latch is positioned in the cavity. An inner sheath extends through an outer sheath and has a proximal end positioned between the inner sleeve and the shaft and a distal end comprising a threaded surface. The proximal end of the inner sheath includes a groove. The inner sleeve is movable relative to the outer sleeve to move the instrument between a first orientation in which the latch is positioned in the groove and the sheaths are prevented from translating relative to the outer sleeve and a second orientation in which the latch is spaced apart from the groove and the sheaths are translatable relative to the outer sleeve. Systems, implants and methods are disclosed.

A pivotal bone anchor assembly includes a shank having an anchor portion and a head with a partially spherical outer surface, a drive socket, an annular planar top surface surrounding the drive socket, and a frusto-conical surface between the planar top surface and the partially spherical outer surface. The assembly further includes a receiver having a base defining an axial bore and an upper portion defining a channel configured to receive a rod, and an insert positionable within the axial bore having an upper surface engageable with the rod, a lower surface for transferring a downwardly-directed force toward the head, and a central aperture for accessing the drive socket, with the rod extending across the central aperture when the fixation rod is engaged by the upper surface. After the head, the insert, and the rod are positioned in the receiver, the frusto-conical surface remains spaced apart from the rod to provide for increased articulation of the shank relative to the receiver.

A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

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.

A medical robot system, including a robot coupled to an effectuator element with the robot configured for controlled movement and positioning. The system may include a transmitter configured to emit one or more signals, and the transmitter is coupled to an instrument coupled to the effectuator element. The system may further include a motor assembly coupled to the robot and a plurality of receivers configured to receive the one or more signals emitted by the transmitter. A control unit is coupled to the motor assembly and the plurality of receivers, and the control unit is configured to supply one or more instruction signals to the motor assembly. The instruction signals can be configured to cause the motor assembly to selectively move the effectuator element.

An apparatus for inserting implants in a bone comprising a frame having a cartridge receiving chamber and a barrel. A cartridge defining a plurality of chambers is positioned in the cartridge receiving chamber so the chambers are selectively alignable with a longitudinal passage of the barrel. At least one instrument is positioned in one of the chambers, and a plurality of implants is positioned in the other chambers. A drive assembly is engageable with the instrument and the implants. The drive assembly is slidably and rotatably disposed in the frame and is moveable between a retracted position, an engaging position wherein the distal end of the drive assembly is positioned to engage the selected one of the instrument and the implants, and an extended position wherein the drive assembly extends through the chamber to transport the selected one of the instrument or the implant from the chamber to the distal end of the barrel.

The present invention relates to a method, such as a surgical method for assisting a surgeon for placing screws in the spine using a robot attached to a passive structure. The present invention also related to a method, such as a surgical method for assisting a surgeon for removing volumes in the body of a patient using a robot attached to a passive structure and to a device to carry out said methods. The present invention further concerns a device suitable to carry out the methods according to the present invention.

A method comprises the steps of: imaging a patient anatomy; selecting an implant strategy for at least one bone fastener having a first member; registering the imaging of the patient anatomy with imaging of at least a portion of a robot; engaging the first member with tissue of the patient anatomy via robotic guidance according to the implant strategy; and subsequently, manipulating the patient anatomy. Systems, spinal constructs, implants and surgical instruments are disclosed.

Surgical instruments and methods for delivering bone anchor assemblies into bone are disclosed herein. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. In general, a surgical instrument can include a handle assembly having an elongate shaft extending distally therefrom. The handle assembly can be configured to axially translate a stylet extending therethrough relative to a bone anchor assembly coupled to the elongate shaft, and it can be configured to move the stylet proximally in response to distal advancement of a bone anchor assembly into bone. The surgical instruments can include various mechanisms for adjusting the position of the stylet.