Systems and devices are disclosed comprising a neuromonitoring probe, a navigation array attached to the probe, a tracking system to detect and track elements of the navigation array, and a controller having at least one processor configured to receive neuromonitoring data from the probe, receive probe positional data from the tracking system to determine a three-dimensional position and orientation of the probe, correlate the neuromonitoring data to the positional data to determine neuromapping data indicating a nerve position in the patient, and overlay a representation of the neuromapping data over three-dimensional position and orientation of the patient to establish a boundary around the nerve. The boundary may be a visual boundary on a display or a physical boundary in a computer-assisted surgical system.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 90/50 - Supports for surgical instruments, e.g. articulated arms
2.
METHOD AND APPARATUS FOR GUIDING A SURGICAL ACCESS DEVICE
A system for facilitating a medical procedure includes an access device/trocar having a trocar body and first and second sensors supported by a trocar body. First and second sensors are configured to sense at least one of a position of the trocar, an orientation of the trocar, a property of tissue proximate to the trocar, and a distance from a tissue and the trocar. A processor is configured to overlay on a display graphical representations of data of the sensors as the trocar is advanced toward a target anatomical site.
A61B 90/30 - Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
Various exemplary devices, systems, and methods for knotless suture anchor fixation are provided. In general, a suture anchor system is configured for knotless suture anchor insertion in a soft tissue repair surgical procedure. The inserter tool is configured to insert an anchor and an implant into a bone of a patient to secure a soft tissue relative to the bone. A suture is releasably coupled to a distal eyelet of the inserter tool and is captured by an implant that is advanced along an inner shaft of the shaft and secured by the suture anchor into the bone hole. The distal eyelet and implant are aligned with one another to position, capture, and secure the suture in the bone hole.
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
Surgical instruments for interfacing with implants can include an inserter configured to dock to a unilateral portion of an implant. The inserter can include a control shaft that is configured to lock or unlock the inserter coupling with the implant. Actuation of the control shaft can occur by way of a knob that can control movement of the control shaft. The inserter can facilitate positioning of the implant relative to a surgical site and allow for application of counter-torque when imparting torque for tightening a set screw, etc. Additional instruments can also be used to manipulate the implant. For example, auxiliary instruments can be coupled to the inserter, such as a reducer instrument, to facilitate rod reduction, etc. Alternatively or in addition, a holder instrument can be used that has a threaded distal engagement feature for coupling to the implant to facilitate positioning thereof.
Modular connectors and methods are disclosed that provide two sides of a connector in modular and interchangeable fashion. The modular design can be enhanced to add various useful features to one or both sides of the connectors, including the use of rods, hooks, rod receivers of various configurations, etc. This modular approach can allow the assembly of various unique connectors from a pool of components that are interchangeable while minimizing manufacturing cost and complexity.
A suture construct includes a single filament of suture forming two cinchable loops from separate finger trap arrangements, with a fixed-length spanning portion extending between fixed portions of the two finger traps. A tail of the suture extends from each finger trap and is slidably disposed therein to cinch the respective loop. The construct can include an anchor slidably coupled to each of the first and second loops. An inserter for the construct includes first and second insertion devices, each having a proximal handle and distal insertion shaft. The two handles couple together to dispose the insertion shafts alongside each other, with a first shaft extending through the second handle shaft and beyond the second shaft. The first handle is coupled proximal to the second such that the first device can be decoupled from the second by removing it proximally, which withdraws the first shaft from the second handle.
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
A61B 17/06 - Needles; Holders or packages for needles or suture materials
The present disclosure relates to a robotic surgical system, comprising: - a robot (1A-1C) holding a surgical tool (3A-3C), the robot comprising a base (10), a flange (12) coupled to the surgical tool and an actuation unit (11) configured to move the flange (12) relative to the base (10); - a robotic carrier arm (2) comprising at least one joint (22A-22G), the carrier arm comprising a flange (23) removably connected to the base (10) of the robot (1A-1C), the carrier arm being configured to maintain position of the robot base (10) in a fixed joint configuration during operation of the robot (1A-1C); - a localization unit configured to determine in real time position of the surgical tool; - a control unit configured to: - determine the position of the surgical tool (3A-3C) based on data received from the localization unit; - carry out a control loop for dynamically compensating elastic deformation of the carrier arm, the control loop comprising, based on a target position of the surgical tool, on a current joint position of the actuation unit, and on the position of the surgical tool, determining at least one command of the actuation unit to achieve the target position.
A61B 34/00 - Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Plates are described for securement to an intervertebral implant, and for fixation to a vertebral body so as to stabilize the implant during the surgical procedure, and in particular as the patient is repositioned during the surgical procedure, for instance from a lateral decubitus position to a prone position. The plate includes a securement member that is movable between an unlocked configuration whereby the securement member is positioned for insertion into the implant, and a locked configuration that couples the securement member to the intervertebral implant. The securement member is further movable to a secured position that secures the plate to the intervertebral implant as to define a rigid construct.
An expandable intervertebral cage includes vertically opposed superior and inferior plates and longitudinally opposed distal and proximal wedges disposed between the plates. The wedges define ramps that engage complimentary ramps of the superior and inferior plates to increase a vertical distance between the plates. An actuator is located between the plates, defines a central, longitudinal axis, and is coupled to the wedges such that, as the actuator rotates about the axis, at least one of the wedges moves longitudinally relative to the other, thereby increasing the vertical separation distance. At least one locking component is insertable within a receptacle at least partially defined by the proximal wedge and is configured to transition from an unlocked configuration, where the actuator is rotatable relative to the proximal wedge, to a locked configuration, where the actuator is rotationally affixed relative to the proximal wedge.
Various exemplary devices, systems, and methods for knotless anchor temporary suture capture are provided. In general, an inserter tool is configured for knotless anchor insertion in a soft tissue repair surgical procedure. The inserter tool is configured to insert an anchor into a bone of a patient to secure a soft tissue relative to the bone. A suture coupled to the soft tissue is secured relative to the bone by being trapped between an exterior surface of the anchor and a bone surface defining a hole in the bone in which the anchor is positioned. The inserter tool and the anchor are configured to cooperate with one another to temporarily capture and lock the suture with respect to the anchor and the inserter tool before the anchor is secured in the bone hole.
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
Various exemplary devices, systems, and methods for knotless anchor inserter tool extraction are provided. In general, an inserter tool is configured for knotless anchor insertion in a soft tissue repair surgical procedure. The inserter tool is configured to insert an anchor into a bone of a patient to secure a soft tissue relative to the bone. The inserter tool includes a retraction mechanism configured to cause the inserter tool to be removed from within the anchor.
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
12.
Surgical Device Activation Detection Using Current Sensing
In general, devices, systems, and methods for surgical device activation detection using current sensing are provided. In an exemplary embodiment, a surgical system includes a surgical pump, a detector, and a surgical device. The detector is configured to sense changes in electrical power in an AC power line from an AC power source to the surgical device to detect activation of the surgical device. In response to the detection activation, the pump can properly provide suction pressure to the surgical device to allow the surgical device to provide aspiration at a surgical site during performance of a surgical procedure.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
Disclosed are reducer instrument locking mechanisms. They can be located near a center pivot joint of the reducer, thereby eliminating a ratchet at the reducer proximal end. The locking mechanisms can include a pawl or latch that travels with one handle from an open position to a closed position. The pawl can fall into a groove formed in an opposing handle such that handles of the reducer can be locked relative to one another, at least with regard to movement of the handles away from one another. When falling into the groove, the pawl can create an auditory and/or tactile indication that a sufficient amount of rod reduction has been achieved to allow for set screw insertion. After set screw insertion, the reducer locking mechanisms can be released to clear it of the groove and allow the reducer to return to its open position.
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.
A flexible surgical access port is provided that includes a flexible body. The flexible body is configured to elastically expand in response to passage of a surgical equipment therethrough, and thus retracts as the surgical equipment moves past. Thus, the flexible body can provide a surgical access path through Kambin's Triangle, and large surgical equipment passed through the flexible body does not compress the exiting nerve or the traversing nerve root for a prolonged period of time.
Anchors for anchoring soft tissue to bone are provided. In one exemplary embodiment, an anchor can include a non-threaded, asymmetric anchor body having a distal nose and a spine extending proximally from one side of the distal nose, and a deflectable clip extending proximally from a side of the nose opposite the spine. The spine defines a back surface of the anchor body. The spine has an outer bone engaging surface, an inner tissue seating surface opposite the outer bone engaging surface, and opposed lateral sides. The deflectable clip and a portion of the spine defines a guide region configured to accommodate and shield a leading end of a soft tissue to be attached to bone. Soft tissue anchoring systems and methods for inserting an anchor into bone are also provided.
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 90/90 - Identification means for patients or instruments, e.g. tags
17.
SURGICAL ARRAY STABILIZERS, AND RELATED SYSTEMS AND METHODS
An array stabilizer for a surgical system includes a pair of arms configured to extend alongside opposite sides of a portion of an array adapter, which is attachable to a rotational instrument in a manner such that the rotational instrument is rotatable about a central axis relative to the array adapter. The array adapter is configured to extend from another component of the surgical system, such that at least one of the arms of the array adapter is configured to resist rotation of the array adapter about the central axis relative to such component as the rotational instrument rotates. The array stabilizer is either rigidly integrated with such component or is coupled to such component via a coupling device.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A suture construct that is elongate along a longitudinal direction and configured to change in size from a first configuration to a second configuration includes an outer layer of material that extends along the longitudinal direction and has a plurality of intertwined fibers that comprise a first sub-set of fibers crossed by a second sub-set of fibers at respective intersections, such that the first subset of fibers and the second subset of fibers are configured to reorient relative to each other in a manner causing the outer layer of material to change in one or more of surface texture and visual appearance as the suture construct changes between the first and second configurations.
A61B 17/06 - Needles; Holders or packages for needles or suture materials
A61B 90/92 - Identification means for patients or instruments, e.g. tags coded with colour
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
A system may be configured to facilitate a medical procedure. Some embodiments may: acquire a scan corresponding to a region of interest (ROI); capture an image of a patient in real- time; identify, via a trained machine learning (ML) model using the acquired scan and the captured image, a Kambin's triangle; and overlay, on the captured image, a representation of the identified Kambin's triangle.
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
In general, devices, systems, and methods for arthroscopic pump saline management are provided. In an exemplary embodiment, a pump system including a pump is configured to manage fluid pumped by the pump to a surgical site during performance of a surgical procedure. The pump system being configured to manage fluid pumped to the surgical site can allow the pump system to manage fluid pressure at the surgical site by monitoring fluid loss at the surgical site. In other embodiments, the pump system being configured to manage fluid pumped to the surgical site can allow the pump system to manage fluid pressure at the surgical site according to a predetermined timing schedule.
A61M 1/00 - Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
A serial dilation system includes a plurality of serial dilators that can be advanced over each other so as to dilate anatomical soft tissue along a trajectory toward a target anatomical site. An access cannula can then be introduced over the serial dilators. The serial dilators can be coupled to each other, such that once the access cannula is in place, removal of one of the serial dilators from the access cannula causes all of the serial dilators to be removed from the access cannula.
Implant bending instruments disclosed herein can have a plurality of bending elements that can be symmetrically driven to bend or contour an implant, such as a spinal rod. A single actuator handle can be moved to drive a compound gear train and move the bending elements to intersect an implant-receiving channel and bend an implant received therein. Instruments of the present disclosure can have an increased mechanical advantage than conventional bending instruments thereby allowing for an increased amount of force to bend an implant. A locking pawl can selectively prevent counter rotation of the gear train such that the handle can be actuated a plurality of times to achieve a desired contour angle.
Bottom-loading bone anchor assemblies and components thereof are disclosed that have a reduced profile and can be utilized with bone screws of various size. A bone anchor assembly (200) of the present disclosure includes a receiver member (206), a drag retaining ring (204), and a shank (202). The retaining ring and shank can be inserted proximally into a bore of the receiver member. The drag ring can have a base and a walled portion extending proximally therefrom. The drag retaining ring can be disposed in a groove of the receiver member with the base forming a seat for the shank head that can hold the shank within the receiver. The walled portion of the drag retaining ring can impart a drag force on the shank head seated in the base to prevent unintended movement between the shank and the receiver member.
Systems, methods, and instruments for tracking localized movement of an anatomic structure at a surgical site are provided that can, for example, detect and i dentify movement of the anatomic structure not otherwise tracked by a global navigation system. One embodiment can include a cannula with a localized navigation sensor coupled to a distal end thereof. The cannula can be coupled to a robot arm and the localized navigation sensor can detect movement of an anatomic structure relative to the cannula. The localized navigation sensor can include one or more tines that selectively extend from the cannula to contact the anatomic structure. A controller can receive data from the localized navigation sensor and a global navigation system, and determine if movement detected by the localized navigation sensor is tracked by the global navigation system. Systems, methods, and instruments of the present disclosure can be used independently of a global navigation system.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
An intervertebral implant includes a first endplate member and a second endplate member, and a distal wedge member and a proximal wedge member that couple the first and second endplate members together. The distal wedge member is configured to move in an expansion direction that causes the fusion cage to move from a contracted position to an expanded position.
An intervertebral fusion cage includes first and second endplate members, first and second ramp members, and an actuator. The first and second ramp members and first and second endplate members have complementary ramp surfaces that engage to expand the height of the fusion cage and to impart a lordotic profile to the fusion cage.
Camera position indication systems and methods are disclosed herein for conveying a camera's position to a user and/or adjusting a camera view display to match a user's perspective during a surgical procedure. In one embodiment, an example method can include receiving an output view from a camera placed within a channel of an access device to view a surgical site within a patient, receiving an input of camera position from a user, and showing on a display the output view from the camera and an indication of camera position based on the input of camera position.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Surgical instruments that are configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure, such as spinal rod reduction and derotation, are provided. For example, in one embodiment a surgical instrument can include an outer sleeve terminating in a pair of extensions, an inner sleeve having a proximal threaded portion and a distal translating portion configured to pass through the outer sleeve, and a pair of pivoting arms received in the extensions of the outer sleeve. The pivoting arms can be configured to extend into a channel of the outer sleeve to couple a bone anchor to the outer sleeve, and a proximal end portion of the outer sleeve can include one or more flats configured to engage with another instrument.
Bone anchor assemblies are disclosed herein that provide for a single bone anchor assembly that can be utilized across a range of spinal surgical procedures, reduce manufacturing burden and cost, and provide for greater flexibility during a surgical procedure. The bone anchor assemblies disclosed herein include an implantable shank and a receiver member having two spaced apart arms which form a U-shaped seat to receive a rod, among other components. The bone anchor assemblies disclosed herein also provide a number of features to enhance capability and usability. Examples include features to facilitate better implantation of the shank, better coupling of instrumentation to the anchor, better performance in reducing a spinal fixation element, such as a rod, into the receiver member seat, and others.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
The present disclosure generally relates to pedicle screws that can selectively lock polyaxial motion of a receiver head with a locking cap. The locking cap can allow locking of the polyaxial motion of the receiver member relative to the spherical head of the bone shank without having a rod placed in the rod slot of the receiver member. This can enable placement of the head of the pedicle screw in a desired position and orientation, locking the head in the desired position and orientation, and performing a maneuver, such as derotation, without a rod in place or any extra motion between the receiver member and the bone shank. In some embodiments, actuation of the locking cap can be achieved by rotating the locking cap relative to the receiver member, where rotation of the locking cap causes corresponding axial translation of the locking cap relative to the receiver member.
Bone anchor assemblies are disclosed herein that provide for a single bone anchor assembly that can be utilized across a range of spinal surgical procedures, reduce manufacturing burden and cost, and provide for greater flexibility during a surgical procedure. The bone anchor assemblies disclosed herein include an implantable shank and a receiver member having two spaced apart arms which form a U-shaped seat to receive a rod, among other components. The bone anchor assemblies disclosed herein also provide a number of features to enhance capability and usability. Examples include features to facilitate better implantation of the shank, better coupling of instrumentation to the anchor, better performance in reducing a spinal fixation element, such as a rod, into the receiver member seat, and others.
Instruments (100) and methods for selectively coupling to an object are provided, for example surgical instruments that can form a rigid connection with an object and also be disassembled for cleaning, sterilization, etc. One embodiment includes an elongate shaft (102) with a longitudinal groove (126), a first partial circumferential groove (128) that intersects with a distal end of the longitudinal groove, and a second at least partial circumferential groove (132) formed distal to the first partial circumferential groove. The instrument also includes a sleeve (104) disposed over the elongate shaft that includes a protrusion (156) extending from an internal wall that is received within the longitudinal groove to constrain movement of the sleeve relative to the elongate shaft. The sleeve further includes a lock that interfaces with the second at least partial circumferential groove when the protrusion is disposed in the first partial circumferential groove to further selectively constrain axial and rotational movement of the sleeve.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
33.
FLEXIBLE SLEEVE FOR BONE FIXATION, AND RELATED SYSTEMS AND METHODS
A flexible tubular member for guiding insertion of instrumentation to a bone screw affixed within bone includes a tubular body that is flexible, constructed of textile material, and defines a longitudinal axis. The tubular body also defines a proximal end and a distal end opposite each other along the longitudinal axis. The tubular body further defines a guide channel that extends from a proximal opening at the proximal end to a distal opening at the distal end. An attachment member is located at the distal end of the tubular body and is configured to couple the distal end to a proximal portion of the bone screw. The attachment member has an annular shape around the guide channel and is configured to expand responsive to a predetermined tensile force applied to the tubular body for decoupling from the bone screw.
Biplanar forceps reducer instruments and methods are disclosed herein. The instruments disclosed herein can engage an implant, such as a bone anchor receiver head, and reduce or move a spinal fixation element, such as a rod, in two planes to move the rod into a channel formed in the receiver head. Further, the biplanar forceps reducer instruments disclosed herein can allow for introduction and tightening of a set screw using an inserter that can pass through a cannulated tube of the reducer. The low profile and biplanar reduction functionality can allow a single type of reducer instrument to couple with each bone anchor along a spinal fixation construct and remain in position until the construct is secured in position.
This disclosure relates generally to surgical instruments used to deliver locking or set screws (110) to secure a rod or spinal fixation element relative to an implanted bone anchor or other spinal fixation construct during spine surgery. In one embodiment, the inserter instrument (100) includes an inner driver shaft (102), a ratcheted outer sleeve (104), and a handle (106) configured to receive the shaft and the sleeve therein. The inner driver shaft can receive a plurality of set screws on a distal end thereof. A side latch, pawl, or button (178) engages with the ratcheted outer sleeve to facilitate step-wise advancement of the sleeve relative to the driver shaft for set screw delivery. Step-wise advancement can be controlled using another button that causes movement of the side latch.
Various implant holding systems are provided herein that include an outer tube, an inner tube, and a holder. The implant holding systems can be designed to hold various implants, such as one or more set screws used in spinal operations. For example, one embodiment of an implant holding system can have an outer tube, an inner tube that can be disposed within the outer tube, and a surgical implant holder that can be disposed within the inner tube. One or more stackable surgical implants, such as set screws, of various configurations and sizes can be disposed within the holder, and the holder can engage the surgical implants to assist in maintaining an orientation of the surgical implants relative to the holder.
An adjustment tool configured to adjust an intervertebral implant comprises a housing, a traveler member, a tether member, and a drive member. The traveler member is coupled to the housing. A proximal end of the tether member is coupled to the traveler, and a distal end of the tether member is configured to couple to the implant. The tether member is substantially linearly fixed to the traveler and rotatable relative to the traveler. The drive member is configured to transition between 1.) a first position in which the drive member is coupled to the tether such that rotation of the drive member causes rotation of the tether relative to the traveler, and 2.) a second position in which the drive member is coupled to the traveler such that rotation of the drive member causes rotation of the traveler relative to the housing.
Access port cutters and related systems and methods can be used to cut an access port (102) to a desired length based on particular patient and/or surgical procedure needs at a point of use. More particularly, an access port cutter (100) can include a base (120) with an opening (106) that can receive an access port therein such that a desired length of the access port can extend from the opening. An actuation mechanism (104) can translate a blade linearly along at least a portion of the base such that the blade can traverse the opening and cut across the access port. In some embodiments, the actuation mechanism can include a handle (110) that can pivot relative to the base to drive the blade. One or more safety features can reduce the risk of inadvertent actuation of the blade and/or prevent debris from contaminating a surgical site or falling onto a patient.
Sterile connectors for robotic or robot-assisted surgery and related systems and methods can be used to establish a sterile barrier between a non-sterile robot arm and a surgical site. More particularly, a sterile connector can include a first component connector to couple to a distal end of a robot arm, a second component connector to couple to an end effector, and a sterile drape extending from the sterile connector. The sterile drape can drape the robot arm and can maintain a sterile barrier around the robot arm throughout the course of a surgical procedure. In this manner, an end effector can be swapped out during the procedure without the need to re-drape or re-establish the sterile surgical field. In some embodiments, the sterile connector can facilitate the passage of electrical signals and/or light between the sterile connector and at least one of the robot arm and end effector.
Bone anchor assemblies and related methods are disclosed herein that can provide for improved fixation of a primary bone anchor. A bone anchor assembly (100) includes a base (104) rotatably received within a rod-receiving member (106). The base has a toroid body with a radially-extending portion (116) including at least one auxiliary bone anchor opening (124) that can receive an auxiliary bone anchor to augment fixation of a primary bone anchor of the bone anchor assembly. The base can be rotated relative to the rod-receiving member and the primary bone anchor such that the at least one auxiliary bone anchor opening can be placed in a desired position for supplemental fixation.
Navigated instrument guide systems and related methods can identify an absolute position of an instrument received within an instrument mount of a robotic arm. A navigation array unit of the guide system can include a main array and a mounted array. The main array can identify a position of the robotic arm and the instrument mount, while the mounted array can identify a depth position of a distal end of an instrument received within the instrument mount. The instrument can be passed through a lumen of the mounted array as the instrument is inserted into the instrument mount. The mounted array can be configured to translate relative to the instrument mount and the main array with distal translation of the instrument. In this manner, a position of the mounted array can identify a depth position of the instrument without a mechanical connection between the mounted array and the instrument.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
42.
RETRACTOR MEMBERS, AND RELATED SYSTEMS AND METHODS
A retractor member is configured for insertion through a channel of an access member and for moving soft tissue at a treatment site that is accessible through the channel. The retractor includes a body having a proximal end and a distal end and spaced from each other along a longitudinal direction. The distal end defines a retractor blade and the body defines a first surface and a second surface opposite each other along a transverse direction substantially perpendicular to the longitudinal direction. The retractor includes an attachment device configured to selectively attach the body to a portion of the access member such that the body is extendable through the working channel while the body is attached to the portion of the access member.
A driver-specific back-out prevention mechanism is disclosed that includes a screw and a body. A first driver can be used for coupling and decoupling the screw with the body, and a second driver can only be used for adjusting the position of the screw in the receiving body. The body includes a cavity for receiving a head of the screw, with the cavity having an inward flange. The screw includes upper and lower sockets, with a channel extending though the head from the lower socket and a lock body disposed in the channel. Engagement with the first driver allows the locking body to move such that the fastener can be inserted and removed from the body. Engagement with the second driver displaces the locking body such that the locking body interferes with the flange such that screw fastener cannot be removed from the body by the second driver.
A coupling and related methods are disclosed herein that can provide for coupling a first object and a second object with minimal play. A coupling can include a first coupling component having a cylindrical surface with a screw and a pin extending therefrom and a second coupling component having a prismatic surface with a first and a second through-hole. The first coupling component and the second coupling component can be configured such that relative motion between the first coupling component and the second coupling component can be restricted in all six degrees of freedom when the screw is engaged with the first through-hole to secure the cylindrical surface of the first component against the prismatic surface of the second component. The pin can be configured to maintain stability of the coupling and further limit relative movement, such that positioning and/or orientation errors between the first and second components is minimized.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
Various implant holding systems are provided herein that include an outer tube, an inner tube, and a holder. The implant holding systems can be designed to hold various implants, such as bone anchors used in spinal operations. For example, one embodiment of an implant holding system can have an outer tube, an inner tube that can be disposed within the outer tube, and an implant holder that can be disposed within the inner tube. An individual bone anchor that has various configurations and sizes can be disposed within the holder, and the holder can engage the bone anchor to assist in maintaining an orientation of the bone anchor relative to the holder.
An endoscope handpiece and system may include an angle of view selector, a depressible button, which may be connected to a lock disposed within a port of the endoscopic handpiece. The system may further provide an endoscope, which may be connected to the handpiece via the port and locked in place by the lock.
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
Implants with grip grooves are disclosed herein. In some embodiments, an implant includes a rod-receiving recess defining a rod axis where an inner surface of the rod-receiving recess defines two grip grooves extending parallel to each other and the rod axis. Each grip groove defines two edges where the grip groove intersects the inner surface, the four edges of the two grip grooves together defining a circular radius about the rod axis. The implant includes a retaining member configured to move with respect to the body to apply a force against a rod that is perpendicular to the rod axis, the force engaging the rod against the four edges of the grip grooves, where the engagement of the four edges of the grip grooves against the rod restrains rotational movement of the rod about the rod axis.
Bone anchor assemblies and related methods are disclosed herein that can provide for improved fixation of a primary bone anchor. A bone anchor assembly can include a wing with a distal portion that can define a plurality of auxiliary bone anchor openings. Each auxiliary bone anchor opening can receive an auxiliary bone anchor that can augment fixation of a primary bone anchor of the bone anchor assembly. The plurality of auxiliary bone anchor openings can be oriented such that, when the wing is coupled to a primary bone anchor assembly of a vertebral level in a first configuration, at least one auxiliary bone anchor can be driven to extend across a facet plane of the vertebral level and, when coupled in a second configuration, each auxiliary bone anchor received within the wing can be driven to conform to the vertebral level.
A system for delivering flowable biomaterial to an intervertebral disc space between adjacent vertebral bodies includes a delivery body defining a proximal end, a distal end spaced from the proximal end along a longitudinal direction, a cannulation extending from the proximal end to an opening adjacent the distal end, and a distal region including a tip that extends to the distal end. The distal region defines a maximum height at a location proximal of the distal end and measured along a second direction perpendicular to the longitudinal direction. The distal region is for indicating a distance between the adjacent vertebral bodies. The system includes a carrier having a longitudinaly elongate channel for carrying biomaterial and being insertable within the cannulation, as well as an advancement member configured for insertion within the cannulation to forcibly advance the biomaterial from the cannulation, through the opening, and into the disc space.
Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a driver shaft, a retaining sleeve disposed around the driver shaft, and a locking sleeve disposed around the retaining sleeve. The locking sleeve can have a first position in which rotation of the driver shaft causes corresponding rotation of the retaining sleeve while the locking sleeve is held stationary, and a second position in which rotation of the locking sleeve causes corresponding rotation of the retaining sleeve while the driver shaft is held stationary.
Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a screw drive assembly having a first handle and a driver shaft coupled to the first handle, and a stylet assembly having a second handle and a stylet extending through the driver shaft. The first handle can have a locked configuration, in which the first handle and the driver shaft are coupled such that the first handle can maintain the driver shaft in a fixed position while the second handle is rotated relative to the first handle, and an unlocked configuration, in which the first handle and the driver shaft can rotate simultaneously in a first direction and the first handle can rotate independent of the driver shaft in a second opposite direction.
Instruments and methods for delivering bone cement are disclosed herein. In one exemplary embodiment, the instrument includes a cannulated bone screw having a head that is configured to be received within a rod receiver and a shank extending distally from the head and configured to extend distally from the rod receiver, a cannulated shaft having a distal end configured to extend into the shank of the cannulated bone screw and a proximal end configured to couple to a bone cement delivery system, and a retaining sleeve disposed around at least a portion of the cannulated shaft. The head of the bone screw has proximal and distal recesses therein, and a distal end of the retaining sleeve is configured to couple to the proximal recess.
In an embodiment, a system attaches a patient reference array of a computer-assisted surgery system to a patient. The system includes a fixation post having a shaft having proximal and distal ends that are offset from. A threaded fastener is coupled to the shaft at the distal end that rotates relative to the shaft so as to engage internal threads of a pedicle screw, thereby causing the distal end of the shaft to translate in the anchor seat and urge the pedicle screw to transition from an unlocked configuration to a locked configuration. The attachment assembly has an arm that supports the patient reference array, and a coupler supported by the arm. The coupler has a fixation body that defines a recess that receives at least a portion of the fixation post, and an actuator that secures the attachment assembly to the fixation post.
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
Embodiments of bone and tissue resection devices are disclosed herein. In one embodiment, a device can include a blade (300) having a distal cutting edge configured to perform a cutting action that produces a plug or core from a media being cut by the cutting edge, a drive mechanism (20) arranged to transfer an oscillating force to the cutting edge for oscillating the cutting edge, a shield positioned (250) to block contact with a portion of the cutting edge, and a depth adjustment mechanism (730) configured to translate the cutting edge along a proximal-distal axis of the shield to adjust an axial position of the cutting edge relative to the shield.
Inflatable orthopedic implants and related methods are disclosed herein, e.g., for deploying such implants within an intervertebral space for use in spinal fusion surgery, other intervertebral surgical procedures, or other surgical procedures. The inflatable intervertebral implant can include a hollow inflatable body that can be configured in a compact state for insertion into a target intervertebral space between a pair of adjacent vertebral bodies. Once the vertebral bodies are separated or distracted, e.g., using one or more inflatable distractors, the hollow body of the inflatable implant can be inflated with bone cement or other curable material. When the curable material hardens, the inflated implant can form a rigid intervertebral support structure (e.g., a fusion cage) capable of maintaining the vertebral distraction and thereby enabling removal of the distractors.
Systems, devices, and methods are provided for trajectory guidance using instrument position data and planned trajectories into or through a patient's body or an object. Lasers are emitted from a laser system toward the patient's body or object at an area within or proximate to the instrument operator's line of sight. Information about the instrument, including the position of its proximal and distal ends, and the position of the patient's body or object, are used to direct the emission of the lasers in real-time during operation of the instrument. The emitted lasers function as visual cues indicating the manner in which to position the distal and proximal ends of the instrument to properly align with the planned trajectory. A guidance map on the instrument can be used to output visual cues about the position of the distal and proximal ends of the instrument relative to a planned trajectory.
A61B 90/13 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints guided by light, e.g. laser pointers
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Surgical access stabilization devices, systems, and methods are disclosed herein. For example, the devices, systems, and methods disclosed herein can be used during a surgical procedure to selectively establish, stabilize, and maintain a desired trajectory and/or positioning of a surgical access device. An exemplary surgical access stabilization device can include a pad with an adhesive distal facing surface to adhere to an anchor surface, a surgical access device coupled to the pad, and a locking mechanism to selectively lock a position of the surgical access device relative to the pad. In one embodiment, the anchor surface can be the skin of a patient. An exemplary surgical access device stabilization method can include making an incision in a patient at a surgical site, inserting a surgical access device through the incision, adhering a pad to an anchor surface, e.g., the skin of the patient, coupling the surgical access device to the pad, and selectively locking a position of the surgical access device relative to the pad. Other exemplary devices, systems, and methods are also provided.
Kerrison-style rod reducers, inline-style rod reducers, and related methods of using the disclosed rod reducers for holding a spinal implant and seating a fixation rod in a rod-receiving portion of the spinal implant are provided for herein. The disclosed rod reducers can also be configured for applying a set screw or other closure mechanism to secure the rod within the rod-receiving portion of the spinal implant. The disclosed embodiments can be easy to use, not require significant force to operate, and be efficient, thereby reducing the time and expense necessary to perform spinal surgery. The disclosed rod reducers can be readily dissembled, thereby making these surgical instruments easy to clean and sterilize.
Kerrison-style rod reducers, inline-style rod reducers, and related methods of using the disclosed rod reducers for holding a spinal implant and seating a fixation rod in a rod-receiving portion of the spinal implant are provided for herein. The disclosed rod reducers can also be configured for applying a set screw or other closure mechanism to secure the rod within the rod-receiving portion of the spinal implant. The disclosed embodiments can be easy to use, not require significant force to operate, and be efficient, thereby reducing the time and expense necessary to perform spinal surgery. The disclosed rod reducers can be readily dissembled, thereby making these surgical instruments easy to clean and sterilize.
Methods and devices are provided for bending spinal rods. A handheld tool (100) is provided having an elongate shaft (102) with a lumen (114) formed therein that is configured to accommodate a spinal rod (R). The tool includes an opening (116) in a proximal end (102p) that is configured to permit the loading of the spinal rod into the lumen, and a plurality of openings (124) spaced along a longitudinal axis thereof that intersect the lumen for allowing a user to view and/or grasp a rod extending through the rod-receiving lumen and positioned within one of the plurality of openings. The tool is further configured to permit a bent spinal rod to be received within the lumen. Therefore, the tool includes a channel (130) in a lower surface (106) thereof that allows a rod to exit the lumen and to extend laterally away from the tool.
Devices and methods are provided for optimized spinal fixation using additive manufacturing techniques to create implants with optimized structure for various surgical approaches, anatomies, etc. One exemplary embodiment includes a cage having an X-shaped connection that can bear a load during cage impaction. The cage can be additively manufactured to incorporate features such as variable wall thickness or material density to adjust properties of the cage, including load bearing capability, flexibility, radiolucency, etc. The cage can further include one or more of the connectors disposed between upper and lower endplates. In some embodiments, the cage can include a feature for coupling an insertion device thereto for introducing the cage into the body of a patient. In some embodiments, a plate can be appended to or integrally formed with a proximal end of the cage to assist with securing the cage to vertebral bodies.
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.
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Surface features for device retention are disclosed herein, e.g., for retaining an access port within a patient during a surgical procedure. The surface features can prevent ejection of the access port from a body of a patient. The surface features can be positioned along the access port and configured to glide along body tissues with minimal friction so as not to hinder travel of the access port in an insertion direction. After insertion of the access port, the surface features can engage with surrounding tissue to increase friction therebetween and to prevent ejection of the access port from the patient. Deployment of the surface features can occur due to friction with the surrounding tissue and/or via activation of the surface features to protrude from the access port. The surface features can include teeth, hooks, scales, fins, bristles, braids, and/or threads for engaging tissue. The surface features can be disengaged from the tissue to enable withdrawal of the access port without damaging the surrounding tissue.
Various exemplary methods and devices are provided for the delivery of spinal screws to a spinal implant site. A variety of exemplary configurations and implementations are provided, but, in general, a handheld tool is provided having a guide member with a lumen formed therein that is configured to deliver a spinal screw to a cervical spine implant. The tool can include various features that facilitate the delivery of the spinal screw to the implant. The tool can include a storage component, such as a magazine, that is configured to hold a plurality of spinal screws for delivery of multiple spinal screws during a surgical procedure.
Various exemplary methods and devices are provided for the removal and retention of bone screw rod reduction tabs extending from one or more bone screws implanted in a spinal column during a surgical procedure. In one embodiment, a removal and retention tool is provided having an elongated shaft with a channel formed therein that is configured to receive a rod reduction tab. The elongate shaft can be advanced over a rod reduction tab on a screw, and moved laterally to detach the reduction tab from the screw. The tool can include features to engage and retain the detached tab within the channel. Moreover, the tool can be configured to receive and retain multiple tabs, thus eliminating the need to remove the tool from a surgical site. The tool can also include a release actuator for releasing any tabs stored within the elongate shaft as may be needed.
An ultrasound probe for percutaneous insertion into an incision and related methods are disclosed herein, e.g., for imaging neural structures at a surgical site of a patient. An exemplary ultrasound probe can be a portable ultrasound probe configured to be passed percutaneously into an incision and can have an imaging region extending distally from a distal tip of the probe. In one embodiment the ultrasound probe can be a navigated portable ultrasound probe. The ultrasound probe can be connected to a computing station and configured to transmit images to the computing station for processing. In another embodiment, an ultrasound probe can be part of a network of sensors, including at least one external sensor, where the network of sensors is configured to transmit images to the computing station for processing. The computing station can process and display images to visualize and/or highlight neurological structures in an imaged region.
Surgical instruments, methods, and systems are provided for securing spinal fixation elements to bone. For example, a spinal fixation system is provided that has a receiver with proximal and distal ends. The proximal end of the receiver is configured to receive various fixation members, such as spinal rods and set screws, therein. The distal end of the receiver has a hook member that is operably coupled thereto and has an opening that is configured to receive bone therein. The hook member is configured to be secured to bone without penetrating the bone.
A system and method for providing enhanced information to a surgeon is described. A three-dimensional reconstruction of a patient's anatomical structure selected for surgery and a representation of a surgical treatment apparatus are rendered on a display device. At least one attachment metric for a proposed attachment between the surgical treatment apparatus and the patient's anatomical structure is calculated using the three-dimensional position of the surgical treatment apparatus relative to the patient's anatomical structure. And, an indication of the attachment metric is rendered on the display device.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A suture anchor for fixation within an anatomical structure includes an actuation member in contact with an anchor body at a first location thereof. The anchor body is elongate along a direction of elongation and defines a central axis. In a neutral configuration, the anchor body is flat and defines a thickness along a transverse direction and a width along a lateral direction, the width being greater than the thickness. The anchor body has first and second tails that are braided together along a portion of the actuation member from the first location to a second location of the anchor body. The actuation member is configured to apply a force to the braided anchor body so as to actuate the anchor body in a manner increasing its maximum thickness along a second direction that is angularly offset from the direction of elongation.
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
70.
EXPANDABLE INTERVERTEBRAL IMPLANT AND INSERTER INSTRUMENT
An expandable intervertebral implant includes a first endplate and a endplate, a first wedge member and a second wedge member spaced from the first wedge member that couple the first and second plates together. The first and second wedge members configured to move between a first collapsed position and a second expansion position. The implant includes an actuation member coupled to the first wedge member and the second wedge member. The first and second wedge members can be coupled to the upper and lower endplates at guide members that are asymmetric. An instrument can be coupled to the implant so as to provide a force to the actuation member that causes the wedge members to move between the collapsed position and the expansion position. The instrument can include a drive shaft and a toggle member that is configured to move the drive shaft between a first position whereby the drive shaft is configured to drive an attachment pin into the implant, and a second position whereby the drive shaft is aligned to drive the actuation member to rotate.
Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument (200, 300) can include a feedback mechanism (206) configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor (100). The feedback mechanism can be triggered by a movable shaft (204) of the instrument that is displaced by the shank portion (102) of the bone anchor as the surrounding bone is reamed.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
: Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member. The distal portion of the wing can define a bone anchor opening through which one or more auxiliary bone anchors can be disposed to augment the fixation of the assembly's primary bone anchor. A distal surface of the distal portion of the wing can be obliquely angled relative to a proximal-distal axis of the spanning portion to face one of a caudal direction or a cephalad direction. A distal surface of the distal portion of the wing can be obliquely angled relative to the proximal-distal axis of the spanning portion to face one of a medial direction or a lateral direction. Surgical methods using the bone anchor assemblies described herein are also disclosed.
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.
A61B 1/313 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
A61B 1/018 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
A61F 2/46 - Special tools for implanting artificial joints
Various bone screws configured to be implanted into bone and methods of use are provided. In an exemplary embodiment, a bone screw (100) is provided with an elongate shank (102) having at least two threads (130) thereon, and having a distal facing surface (115) with at least two cutting edges (122). The cutting edges can be configured to cut bone as the bone screw is rotated into bone, thereby forming a path for the threads.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Various embodiments of unilateral implant holders and related methods are disclosed herein. An exemplary unilateral implant holder can include a surgical instrument that includes a unilateral locking mechanism arranged at a distal end of the instrument for rigidly holding onto a unilateral portion of the implant. The locking mechanism can be configured to lock onto a unilateral portion of the implant such that access to the implant is not blocked. By engaging the instrument's locking mechanism with a counterpart locking interface defined in an implant, sufficient clamping force can be applied by the locking mechanism to resist multi-directional forces exerted on the implant during a surgical procedure. The surgical instrument can be a stand-alone unilateral implant holder. The surgical instrument can be configured to perform a surgical task while concurrently holding the implant in place using the unilateral locking mechanism.
Adjustable drill guides and related methods are disclosed herein. An exemplary drill guide can include an adjustment mechanism that allows for precise incremental adjustment of the drill guide's depth setting while securely maintaining the device at a fixed setting between adjustments. The adjustment mechanism can improve the safety and security of the drill guide, for example by limiting adjustment only to those situations where it is specifically intended by the user, thereby reducing or eliminating the risk of inadvertent depth adjustment. In some embodiments, a drill guide can include high visibility, easy-to-read depth indications while maintaining a slender profile and without shifting the user's eye gaze, for example by employing a multi-surface moving scale having a text height that is at least twice the adjustment increment. Handles, protection sleeves, navigation adapters, and various other accessories that can be used with or without a drill guide are also disclosed herein.
Various rod-to-rod connectors having robust rod closure mechanisms and related methods are disclosed herein, e.g., for enhancing the locking or clamping force on a rod. An exemplary connector can provide a robust closure mechanism for rod-to-rod connections in which the run on length of a rod slot is minimal. The connector can include a moveable jaw that is partially disposed within a connector body and configured to pivot or translate relative to the connector body to form a fully or substantially closed rod slot around a first rod. The closed rod slot can be formed between a first rod-receiving recess defined in the connector body and a counterpart first rod-receiving recess defined in the moveable jaw. The locking or clamping force of the moveable jaw can be amplified by a mechanical advantage caused by the force exerted to lock a second rod in a second rod-receiving slot of the connector body.
Instrument coupling interfaces and related methods are disclosed herein, e.g., for coupling a surgical instrument to a navigation array or other component. An exemplary coupling can include a first coupling interface associated with a first object, such as a surgical instrument, and a second coupling interface associated with a second object, such as a navigation array. The coupling interfaces can be configured to ensure that, when mated, the first and second objects are disposed in a known position and orientation relative to one another and blocked from relative movement in all six degrees of freedom. The interfaces can have a geometry that is not overdetermined, minimizing or eliminating navigation inaccuracy associated with system tolerances. An exemplary coupling can include counterpart centering features for blocking X- axis translation and Y-axis translation, counterpart rotation stops for blocking Z-axis rotation, counterpart reference planes for blocking X-axis rotation, Y-axis rotation, and Z-axis translation in a first direction, and a locking element for blocking Z-axis translation in a second, opposite direction.
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
F16B 17/00 - Fastening means without screw-thread for connecting constructional elements or machine parts by a part of or on one member entering a hole in the other
Surgical instruments and methods for implanted bone anchor assemblies into bone are disclosed herein. In one exemplary embodiment, an instrument is provided having an anchor drive assembly and a stylet assembly. The anchor drive assembly can have a first handle and an elongate shaft having a distal tip configured to couple to a bone anchor assembly. The stylet assembly can have a second handle and a stylet extending through the elongate shaft. The instrument can have a disengaged position and an engaged position such that rotation of the first handle is effective to drive the bone anchor assembly into bone only when the instrument is in the engaged position, and rotation of the second handle is effective to cause axial translation of the stylet relative to the elongate shaft.
Surgical tissue retraction systems and methods are described herein. Such systems and methods can be employed in some embodiments to provide medial-lateral tissue retraction to increase access to a surgical site. In one embodiment, a surgical instrument can include a body configured to couple to an implantable anchor, a first tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto, and a second tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto. Further, the first and second tissue manipulating implements can be opposed to one another such that they can move any of toward and away from one another.
A61B 17/02 - Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
A61B 17/60 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like for external osteosynthesis, e.g. distractors or contractors
Surgical support instruments are described herein that can couple to, e.g., an implanted anchor and provide a platform for coupling other surgical implements thereto. In one embodiment, an instrument can include an elongate body having opposed projections extending laterally from a distal portion thereof that can at least partially surround a shank of an implantable anchor such that a longitudinal axis of the elongate body is laterally offset from a longitudinal axis of the anchor. The instrument can further include a lock configured to exert a drag force on a head of the anchor to control polyaxial movement of the instrument relative to the anchor. Further, a proximal portion of the elongate body can be configured to receive a retractor assembly including a plurality of tissue manipulating implements and selectively lock the retractor assembly at any of a plurality of positions along a length of the elongate body.
A61B 17/88 - Methods or means for implanting or extracting internal fixation devices
A61F 2/00 - Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough. A set screw or closure mechanism, and a driver instrument for applying the set screw or closure mechanism to the bone anchor assembly, can be inserted through the working channel.
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.
The present invention is directed at minimally invasive systems in which the proximal end portion of the working channel has either zero or a limited range of movement in the lateral direction. A first embodiment has a slidable collar attached to a pair of flanges, wherein movement of the collar is bounded by an annular frame. A second embodiment has a substantially spherical element attached to the tube. A third embodiment has a plurality of caps. A fourth embodiment is adapted for a larger working channel.
Systems and methods for reducing the risk of PJK, PJF, and other conditions are disclosed herein. In some embodiments, a longitudinal extension can be added to a primary fixation construct to extend the construct to one or more additional vertebral levels. The extension can be attached to a first attachment point, such as a bone anchor implanted in a vertebra that is superior to the primary construct. The extension can also be attached to a second attachment point, such as a component of the primary construct or an anatomical structure disposed inferior to the first attachment point. The extension can be more flexible than the primary construct and/or can limit motion to a lesser degree than the primary construct, thereby providing a more-gradual transition from the instrumented vertebrae to the natural patient anatomy adjacent thereto. The extension can be placed with little or no soft tissue disruption.
A61B 17/56 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
A61B 17/58 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like
Systems and methods for reducing the risk of PJK, PJF, and other conditions are disclosed herein. In some embodiments, a longitudinal extension can be added to a primary fixation construct to extend the construct to one or more additional vertebral levels. The extension can be attached to a first attachment point, such as a spinous process of a vertebra that is superior to the primary construct. The extension can also be attached to a second attachment point, such as a component of the primary construct or an anatomical structure disposed inferior to the first attachment point. The extension can be more flexible than the primary construct and/or can limit motion to a lesser degree than the primary construct, thereby providing a more-gradual transition from the instrumented vertebrae to the natural patient anatomy adjacent thereto. The extension can be placed with little or no soft tissue disruption.
A61B 17/56 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
A61B 17/58 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like
Various bone screws configured to be implanted into bone and methods of use are provided. In an exemplary embodiment, a bone screw is provided with an elongate shank and a head with a drive feature configured to couple with a driver tool for being advanced into bone and a threaded shank. The screw can have a distal end or tip that has one or more cutting edges thereon configured to cut bone as the bone screw is inserted into bone.
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
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 carrier assembly that secures a stylet extending therethrough. Translation of the stylet can be made relative to a distal end of the elongate shaft. The surgical instruments can include various carrier assemblies for positioning the distal end of the stylet relative to the distal end of the elongate shaft based on a length of bone anchor to be installed by the surgical instrument.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
89.
EXPANDABLE INTERVERTEBRAL IMPLANT AND RELATED METHODS
An expandable implant with first and second plates spaced from each other along a first direction. The plates define opposed bone-contacting surfaces, along a first direction, configured to contact superior and inferior vertebral bodies respectively. An actuation member, disposed between the plates, defines a first axis, a first and second end spaced from the first end along a second direction of the axis. The second direction is perpendicular to the first. The implant includes first and second wedges on the actuation member in engagement with the plates and a drive member along a second axis spaced along a third direction, perpendicular to the first direction, along the second and offset from the second direction. The drive member communicates a force to the actuation member causing it to rotate and one of the wedges members to translate along the second direction, in response to rotation, to move one of the plates.
User interface systems for sterile fields and other working environments are disclosed herein. In some embodiments, a user interface system can include a projector that projects a graphical user interface onto a data board or other substrate disposed within a working environment. The system can also include a camera or other sensor that detects user interaction with the data board or substrate. Detected user interactions can be processed or interpreted by a controller that interfaces with equipment disposed outside of the working environment, thereby allowing user interaction with such equipment from within the working environment. The data board can be an inexpensive, disposable, single-use component of the system that can be easily sterilized or another component suitably prepared for use in a sterile field.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 34/20 - Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
A61B 34/00 - Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
91.
COUPLING DEVICES FOR SURGICAL INSTRUMENTS AND RELATED METHODS
Coupling devices and related methods are disclosed herein, e.g., for coupling a surgical instrument to a navigation array or other component. The coupling device can reduce or eliminate movement between the instrument and the navigation array, improving navigation precision. The coupling device can be quick and easy to use, reducing or eliminating the need for extra steps or additional tools to attach or detach the instrument from the coupling device. In some embodiments, the single step of inserting an instrument into the coupling device can automatically lock the instrument within the coupling device in a toggle-free manner. The coupling device can include features for consistently attaching instruments thereto at a known or predetermined location and/or orientation.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Instrument couplings and related methods are disclosed herein, e.g., for coupling a surgical instrument to a navigation array or other component. The coupling can reduce or eliminate movement between the instrument and the navigation array, improving navigation precision. The coupling can be quick and easy to use, reducing or eliminating the need for extra steps or additional tools to attach or detach the instrument from the coupling. In some embodiments, the single step of inserting an instrument into the coupling can automatically lock the instrument within the coupling in a toggle-free manner.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
An intervertebral implant that iterates between collapsed and expanded configurations includes first and second plates spaced from one another along a first direction and defining bone-contacting surfaces facing away from each other along the first direction. An expansion assembly is positioned between the plates with respect to the first direction and includes a first support wedge that supports the first plate and defines a first ramp and a second support wedge that supports the second plate and defines second and third ramps. The expansion assembly includes an expansion wedge defining a fourth ramp. The first, second, third, and fourth ramps are each inclined with respect to a second direction that is substantially perpendicular to the first direction. At least one of the first and second support wedges is slidable along the respective supported first or second plate. The implant includes an actuator configured to apply a drive force to the expansion wedge so as to cause 1) the fourth ramp to ride along the third ramp so as to increase a distance between the bone-contacting surfaces along the first direction, and 2) the second ramp to ride along the first ramp, thereby further increasing the distance, thereby iterating the implant from the collapsed to the expanded configuration.
Bone anchors are disclosed herein. In some embodiments, a bone anchor can include a drag interface. Exemplary drag interfaces include (i) friction between a shank and a bushing, (ii) friction between a bushing and a drag ring, (iii) friction generated by a biased saddle, and (iv) combinations of the above. The drag interface can help maintain the relative position between a receiver member and a shank of the bone anchor prior to locking the bone anchor, preventing unintended movement while still allowing free movement when intended by the user. In some embodiments, a bone anchor can include over-rotation blocking features, such as a groove, lip, or protrusion formed on a bushing of the bone anchor. Various other bone anchor features are also disclosed, including high aspect ratio drag rings and compressible drag posts.
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.
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.
A61B 1/05 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
Devices and methods for surgical retraction are described herein, e.g., for retracting nerve tissue, blood vessels, or other obstacles to create an unobstructed, safe surgical area. In some embodiments, a surgical access device can include an outer tube that defines a working channel through which a surgical procedure can be performed. A shield, blade, arm, or other structure can be manipulated with respect to the outer tube to retract an obstacle. For example, an inner blade can protrude from a distal end of the outer tube to retract obstacles disposed distal to the outer tube. The inner blade can be movable between a radially-inward position and a radially-outward position. The radially-inward position can allow insertion of the blade to the depth of the obstacle to position the obstacle adjacent to and radially-outward from the blade. Subsequent movement of the blade to the radially-outward position can retract the obstacle in a radially-outward direction. The blade can be manipulated remotely, e.g., from a proximal end of the access device or a location disposed outside of the patient. The blade can be manipulated in various ways, such as by rotating the blade relative to the outer tube, translating the blade longitudinally relative to the outer tube, sliding an expander along the blade, driving a wedge between the blade and the outer tube, actuating a cam mechanism of the access device, and/or pivoting the blade relative to the outer tube.
Connectors for connecting or linking one instrument or object to one or more other instruments or objects are disclosed herein. In some embodiments, a connector can include a first arm with a first attachment feature for attaching to a first object, such as a surgical access device, and a second arm with a second attachment feature for attaching to a second object, such as a support. The connector can have an unlocked state, in which the position and orientation of the access device can be adjusted relative to the support, and a locked state in which movement of the access device relative to the support is prevented or limited. Locking the connector can also be effective to clamp or otherwise attach the connector to the access device and the support, or said attachment can be independent of the locking of the connector.
A61B 17/56 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
A61B 17/58 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like
A61B 90/11 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
A61B 90/50 - Supports for surgical instruments, e.g. articulated arms
Surgical access port stabilization systems and methods are described herein. Such systems and methods can be employed to provide ipsilateral stabilization of a surgical access port, e.g., during spinal surgeries. In one embodiment, a surgical system can include an access port configured for percutaneous insertion into a patient to define a channel to a surgical site and an anchor configured for insertion into the patient's bone. Further, the access port can be coupled to the anchor such that a longitudinal axis of the access port and a longitudinal axis of the anchor are non-coaxial. With such a system, a surgeon or other user can access a surgical site through the access port without the need for external or other stabilization of the access port, but can instead position the access port relative to an anchor already placed in the patient's body.
Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.
A61B 1/313 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
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