A persuader instrument for advancing a fixation rod into a vertebral implant includes a housing and at least one arm. The at least one arm can include detents for detachable connection to the vertebral implant. The persuader instrument can also include a shaft coupled to an anchor. The anchor can include a fixation rod engagement surface. The shaft can be axially displaceable through the housing to axially displace the anchor and a rod engaged by the anchor. The persuader instrument can further include an auto-locking ratchet assembly in releasable engagement with the shaft. The auto-locking ratchet assembly can control axial displacement of the shaft through the longitudinal passage of the housing.

A persuader instrument for advancing a fixation rod into a vertebral implant includes a housing and at least one arm. The at least one arm can include detents for detachable connection to the vertebral implant. The persuader instrument can also include a shaft coupled to an anchor. The anchor can include a fixation rod engagement surface. The shaft can be axially displaceable through the housing to axially displace the anchor and a rod engaged by the anchor. The persuader instrument can further include an auto-locking ratchet assembly in releasable engagement with the shaft. The auto-locking ratchet assembly can control axial displacement of the shaft through the longitudinal passage of the housing.

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blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element.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.

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.

Articulating implant connectors and related methods are disclosed herein. Exemplary connectors can include first and second bodies that are rotatable relative to one another about a rotation axis and selectively lockable to resist or prevent such rotation. Each of the bodies can be configured to couple to a rod or other fixation component, and the connector can be used to lock first and second rods together even when the rods are obliquely angled with respect to one another.

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.

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.

An implantable body for a posterior stabilization system includes a lateral end, a medial end, an inwardly facing surface configured to abut against a lamina when the body is implanted along a vertebra. A lateral bone outrigger extends from the inwardly facing surface and may include a bone-abutting surface along a medial portion disposed to abut against a lateral mass of the vertebra when the body is implanted along a vertebra. The lateral bone outrigger may have a first height. A penetrating feature extends from the inwardly facing surface between the bone-engaging portion of the inwardly facing surface and the lateral bone outrigger. The penetrating feature may have a second height less than the first height. A fastener bore extends through the body at an angle toward the lateral bone outrigger.

A system, a method, and instruments for manipulating a surgical cord into spinal implants to assist in correcting a spinal deformity are described. The system may include a tensioner, a tensioner extension, and a counter tensioner. One of the instruments can include an elongate body, a dual coupler, and a nose member. The elongate body has a flexible cylindrical member adapted to carry tension along a longitudinal axis, where the flexible cylindrical member is sized to receive a surgical cord through a lumen within the flexible cylindrical member. The dual coupler is disposed on a proximal end of the elongate body, and include a bore for receiving a nose portion of a tensioner and for guiding the surgical cord into the tensioner. The nose member is disposed on a distal end of the elongate body, and be adapted to discharge the surgical cord from the elongate body.

A retractor having a pair of blades is disclosed. A ring having an opening is attached to one end of the blades. The blades define a channel therebetween. The blades may be pivotally coupled to the ring. The retractor may have at least two conditions. In a first condition, the retractor is insertable through an incision in a patient's skin to an operative site. In a second condition, the retractor may be manipulated for retracting tissue surrounding the operative site. Instruments, prostheses, or tissue may be inserted or removed through the channel of the retractor.