Methods of joint repair employing sutures and attached fixation devices are discussed. For example, a bone block graft procedure (e.g., Latarjet) is discussed which employs fixation devices to secure contact between graft surfaces of two bones. A suture construct, including a continuous suture loop routed through a first fastener, is secured to a first bone. Looped ends of the suture loop are passed through passageways formed in the two bones. The looped suture ends are further routed through a second fastener. The second fastener is mounted to the second bone and a sliding knot, formed in the looped suture ends, is advanced into contact with the second fastener. The suture is further tensioned using a tensioner device to secure the two bones together.

A locking element is configured to be used with a polyaxial bone anchor. The locking element including a central axis, a bottom side, a top side opposite to the bottom side, and a peripheral surface portion that extending completely around the locking element that has an external thread. The bottom side defines a first recess facing toward the bottom side for accommodating and applying a force in a direction toward the bottom side to at least the portion of the head of the polyaxial bone anchor. The top side defines a second recess having a non-circular cross-section in a plane perpendicular to the central axis for torqueable engagement with a driver.

Disclosed is a universal pedicle screw removal tool comprising a tapered shaft having an “L” shaped tip on one end and a generally square head on an opposite end. A lower section leads to a tapered section which is connected to a handle. The handle may include a set of serrations to provide increased grip. The handle is connected to the head. The tip is sized to engage the channel of a tuliped pedicle screw while the head is sized to engage a ratchet or other torque producing tool. In an alternate embodiment, the tip is “T” shaped. In another alternate embodiment, the handle section includes opposing members extending from the shaft to form a “T” shaped handle. In use, the tip is inserted into the channel of a tuliped pedicle screw while the shaft is rotated to unscrew the pedicle screw from a patient's bone.

Implants and instruments for providing an ideal trajectory for the insertion of instruments and screws during implantation of an interbody implant in a spinal surgery are disclosed.

Implants and instruments for providing an ideal trajectory for the insertion of instruments and screws during implantation of an interbody implant in a spinal surgery are disclosed.

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. An actuator is connected with the second member and includes visual indicia of engagement of the element with the second mating surface. Systems, spinal implants and methods are disclosed.

A compression nut for treating a bone includes a head and a body extending longitudinally from the head to a free end. The body includes an exterior threading along an exterior surface of a threaded portion of the body separated from the head via an unthreaded portion. The nut also includes a channel extending longitudinally through the body. The channel includes an interior threaded extending along an interior surface of the channel configured to threadedly engage an end of a locking screw received therein.

A helicoil interference fixation system comprising: a helicoil comprising a helical body comprising a plurality of turns separated by spaces therebetween, the helical body terminating in a proximal end and a distal end, and at least one internal strut extending between at least two turns of the helical body; and an inserter for turning the helicoil, the inserter comprising at least one groove for receiving the at least one strut; the helicoil being mounted on the inserter such that the at least one strut of the helicoil is mounted in the at least one groove of the inserter, such that rotation of the inserter causes rotation of the helicoil.

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.

Bone screw drivers are disclosed that apply torque to a threaded shank of a bone screw assembly and receive a cement delivery device to introduce bone cement through the threaded shank. Also disclosed are driver adapters that couple to a driver in order to facilitate application of torque thereto. The driver adapter can decouple from the driver after implanting a bone screw shank to allow the subsequent use of a cement delivery device in combination with the driver. The devices can be reusable and can employ a number of additional components, including retaining and counter-torque sleeves, driving handles, etc. Further, the devices can allow setup of a bone screw inserter assembly outside a surgical field, such that a completed assembly can be passed to a surgeon or other user for immediate use.