Surgical systems and methods

Abstract

The surgical compression instrument includes a member configured to be arranged longitudinally along a first implant support for pivotally connecting the first implant support to a second implant support. The first implant support can be engaged with a first receiver having a first fastener having a first axis fixed with vertebral tissue, and the second implant support can be engaged with a second receiver having a second fastener having a second axis fixed with vertebral tissue. A component can move relative to the member and can engage with the implant support so that the second implant support moves relative to the first implant support to compress the vertebral tissue. Surgical systems, constructs, implants and methods are disclosed.

Description

Technical Field

[0001] The present disclosure relates generally to medical devices for treating spinal disorders, and more particularly to surgical systems and methods for correcting spinal disorders. Background Art

[0002] Spinal disorders such as degenerative disc disease, herniated disc, osteoporosis, spondylolisthesis, stenosis, scoliosis, kyphosis and other curvature abnormalities, tumors, and fractures may result from factors including trauma, disease, and degenerative conditions caused by injury and aging. Spinal disorders often result in symptoms including pain, nerve damage, and partial or complete loss of mobility.

[0003] Non-surgical treatment (such as drug therapy, rehabilitation and exercise) can be effective, but can not alleviate the symptoms associated with these diseases. The surgical treatment of these spinal disorders includes correction, ligament repair, corpectomy, discectomy, laminectomy, fusion, fixation and implantable prosthesis. The corrective treatment for the positioning and alignment of the vertebrae can adopt spinal implants, which include spinal structures and intervertebral devices for stabilizing the treatment section of the spine. In some cases, spinal implants can be manipulated with surgical instruments to compress and traction vertebrae. The present disclosure describes improvements that are superior to these prior arts. Summary of the invention

[0004] In one embodiment, a surgical compression instrument is provided. The surgical compression instrument includes a member configured to be arranged longitudinally along a first implant support, for pivotally connecting the first implant support to a second implant support. The first implant support can engage with a first receiver having a first fastener having a first axis fixed with vertebral tissue, and the second implant support can engage with a second receiver having a second fastener having a second axis fixed with vertebral tissue. A component can move relative to the member and can engage with the implant support so that the second implant support moves relative to the first implant support to compress vertebral tissue. In some embodiments, a surgical system, a construct, an implant and a method are disclosed.

[0005] In one embodiment, the surgical compression instrument includes a pivot body attached to and extending longitudinally along a first implant support and including a receiver configured to arrange a second implant support. The first implant support can engage with a receiver having a fastener having an axis of vertebral tissue fixed thereto, and the second implant support can engage with a receiver having a fastener having an axis of vertebral tissue fixed thereto. The surgical compression instrument includes a slider and an actuator connected to the slider to translate the slider relative to the pivot body so that the slider can engage with the second implant support to move the second implant support relative to the first implant support to compress the vertebral tissue.

[0006] In one embodiment, a surgical system is provided. The surgical system includes a first fastener having an axis that can be fixed to vertebral tissue. A first implant support can engage with a receiver of the first fastener. A second fastener has an axis that can be fixed to vertebral tissue. A second implant support can engage with a receiver of the second fastener. A member is arranged longitudinally along the first implant support to pivotally connect the implant support. A portion can move relative to the member and can engage with the second implant support so that the second implant support moves relative to the first implant support to compress the vertebral tissue. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The present disclosure will become more readily apparent from the detailed description accompanying the following drawings, in which:

[0008] Figure 1 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0009] Figure 2 is an exploded perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0010] Figure 3 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0011] Figure 4 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0012] Figure 5 is an isolated perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0013] Figure 6 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0014] Figure 7 is a perspective view of components of one embodiment of a surgical system in accordance with the principles of the present invention as manipulated by a user;

[0015] Figure 8 is an isolated perspective view, partially in phantom, of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0016] Fig. 9 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0017] Fig.10 yes Fig. 9 Detailed drawings of the components shown in ;

[0018] Fig.11 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0019] Fig.12 yes Fig.11 Detailed drawings of the components shown in ;

[0020] Fig.13 is a perspective view, partially in phantom, of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0021] Fig.14 is a perspective view of components of one embodiment of a surgical system according to the principles of the present disclosure;

[0022] Fig.15 yes Fig.14 Detailed views of the components shown; and

[0023] Fig.16 is a side view of components of one embodiment of the system in accordance with principles of the present disclosure disposed with a vertebra. DETAILED DESCRIPTION

[0024] Exemplary embodiments of the disclosed systems and associated methods of use are discussed in the context of medical devices for treating musculoskeletal disorders, and more specifically, in the context of surgical systems and methods for correcting spinal disorders. In some embodiments, the present surgical systems include surgical instruments that allow vertebral manipulation to treat spinal disorders as described herein for managing lordotic and / or kyphotic restoration. In some embodiments, the surgical instruments allow parallel traction and / or compression of vertebral tissue.

[0025] In some embodiments, the surgical system includes a traumatic instrument. In some embodiments, the surgical system is used with a method for correcting complex spinal deformities. In some embodiments, the surgical system is used with a method for treating degenerative spinal disease and / or with transforaminal lumbar interbody fusion. In some embodiments, the surgical system is configured for use with a sagittal adjustment screw (SAS), a fixed axis screw (FAS) and / or a multi-axial screw (MAS). In some embodiments, the surgical system includes a single distractor for treating degenerative spinal disease, for example, for lateral treatment along a vertebra oriented for decompression and / or interbody cage insertion.

[0026] In some embodiments, the surgical system includes surgical instruments for use with surgical methods including degenerative lumbar fusion. In some embodiments, the surgical system includes surgical instruments for use with surgical methods including the step of segmental posterior stabilization with a MAS screw. In some embodiments, the surgical system includes surgical methods including interbody fusion, posterior lumbar interbody fusion (PLIF), transforaminal interbody fusion (TLIF) using a minimally invasive surgical approach or a percutaneous approach. In some embodiments, the surgical system includes a bone screw extender, a tissue retractor, and a retractor / compressor system. In some embodiments, the surgical system includes segmental traction to facilitate decompression, including final structure compression. In some embodiments, the surgical system includes a radiolucent tissue retractor blade.

[0027] In some embodiments, the surgical system includes a surgical instrument for use with a surgical method, the surgical method including the steps of: connecting an extender with a MAS screw, such as, for example, an implant support; connecting a cannula to the implant support and the bone screw; and using a universal screwdriver to perform percutaneous implantation of the bone screw using a PAK needle, a guide wire, or fluoroscopy. In some embodiments, the surgical system includes screw-based segmented traction.

[0028] In some embodiments, the surgical system includes a compression instrument. In some embodiments, the compression instrument includes a member longitudinally arranged along the first implant support, for being pivotally connected to the second implant support. In some embodiments, the compression instrument includes a slider that can move relative to the member and can engage with the implant support so that the second implant support moves relative to the first implant support to compress vertebral tissue. In some embodiments, the compression instrument includes a connection button that is configured to prevent the compression instrument from regressing relative to the implant support. In some embodiments, the compression instrument is configured for one-step top loading.

[0029] In some embodiments, the compression instrument includes an actuator, such as, for example, a threaded button for gradually activating the slider. In some embodiments, the compression instrument includes a cross point compatible with a pre-bent rod. In some embodiments, the slider is configured to drive compression of the vertebra. In some embodiments, the compression instrument is used with a method comprising the following steps: removing a sleeve from an implant support; lowering a spinal rod with a first bone screw receiver; fixing a set screw with a bone screw receiver to fix the spinal rod in place and breaking off a broken portion of the set screw; and engaging a second set screw with a second end of the spinal rod and a second bone screw receiver. In some embodiments, the bone screw receiver is compressed to separate a selected distance. In some embodiments, the distance ranges from about 50 mm to about 19 mm. In some embodiments, the shaft of the bone screw is compressed at a relative angle. In some embodiments, the angle is in the range of about 27 degrees to about 8 degrees.

[0030] In some embodiments, the surgical system includes a traction device configured to pull the selected vertebrae in parallel. In some embodiments, the traction device includes an adapter that can engage with the implant support. In some embodiments, a polyaxial bone screw receiver is used to facilitate the connection of the implant support with the adapter.

[0031] In some embodiments, one or all of the components of the surgical system are disposable, peel-and-strip, pre-packaged sterile devices for use with a spinal construct. One or all of the components of the surgical system may be reusable. The surgical system may be configured as a kit having multiple sized and configured components.

[0032] In some embodiments, the present disclosure can be used to treat spinal disorders, such as degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis, kyphosis and other curvature abnormalities, tumors and fractures. In some embodiments, the present disclosure can be used together with other skeleton and bone-related applications, including those applications associated with diagnosis and therapy. In some embodiments, the disclosed surgical system and method can be used alternatively for surgical treatments in which the patient is in a prone or supine position, and / or various surgical methods are used to reach the spine, including the posterior and / or posterior midline and other body regions. The present disclosure can also be used alternatively together with surgery for treating the lumbar, cervical, thoracic, sacral and pelvic regions of the spine. The systems and methods of the present disclosure can also be used in animals, bone models and other non-biological substrates, such as in training, testing and demonstrations.

[0033] The present disclosure can be more easily understood by referring to the following specific implementation of the embodiment in conjunction with the accompanying drawings, which form a part of the present disclosure. It should be understood that the present application is not limited to the specific devices, methods, conditions or parameters described and / or shown herein, and the terms used herein are only for the purpose of describing specific embodiments by example, rather than for limitation. In some embodiments, as used in the specification and including the appended claims, the singular forms "a (a)", "an (an)" and "the" include plural numbers, and unless the context clearly stipulates, the reference to a specific numerical value includes at least the specific value. The range can be expressed as from "about" or "approximately" a specific value and / or to "about" or "approximately" another specific value in this article. When expressing this range, another embodiment includes from a specific value and / or to another specific value. Similarly, when the value is expressed as an approximate value by using the antecedent "about", it should be understood that the specific value forms another embodiment. It should also be understood that all spatial references (such as horizontal, vertical, top, upper, lower, bottom, left and right) are only for illustrative purposes and can be changed within the scope of the present disclosure. For example, references to "upper" and "lower" are relative and are used only in context of one another, and are not necessarily "superior" and "inferior".

[0034] As used in the specification and including the appended claims, "treating" or "treatment" of a disease or condition refers to performing a procedure, which may include administering one or more drugs to a patient (normal or abnormal human or other mammal), using an implantable device, and / or using an instrument for treating the disease (e.g., a microdiscectomy instrument for removing bulging or herniated discs and / or bone spurs) in an effort to alleviate the signs or symptoms of the disease or condition. Relief may occur before and after the onset of signs or symptoms of the disease or condition. Thus, treatment includes preventing the disease or undesirable condition (e.g., preventing the disease from occurring in a patient who may be susceptible to the disease but has not yet been diagnosed with the disease). In addition, treatment does not require complete relief of signs or symptoms, does not require a cure, and specifically includes procedures that have only a marginal effect on the patient. Treatment may include inhibiting the disease, such as curbing its development, or alleviating the disease, such as causing regression of the disease. For example, treatment may include reducing acute or chronic inflammation; relieving pain, easing and inducing regrowth of new ligaments, bones, and other tissues; as an adjunct to surgery; and / or any reconstructive surgery. Furthermore, as used in this specification and including the appended claims, the term "tissue" includes soft tissue, ligament, tendon, cartilage and / or bone, unless specifically stated otherwise.

[0035] The following discussion includes descriptions of surgical systems and related methods employing surgical systems according to the principles of the present disclosure. Disclosure of Alternative Embodiments. Reference is made to exemplary embodiments of the present disclosure illustrated in the accompanying drawings. Go to Figure 1-4 , components of the surgical system 10 are depicted.

[0036] The components of the surgical system 10 can be made of bio-acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and bone materials and / or composites thereof. For example, the components of the surgical system 10 (individually or collectively) can be made of materials such as stainless steel alloys, commercially pure titanium, titanium alloys, grade 5 titanium, superelastic titanium alloys, cobalt-chromium alloys, superelastic metal alloys (e.g., nitinol, superelastic plastic metals), ceramics and their composites (e.g., calcium phosphates (e.g., SKELITE™)), ​​thermoplastics (e.g., polyaryletherketones (PAEK) including polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and polyetherketone (PEK)), carbon PEEK composites, PEEK-BaSO4 polymer rubber, polyethylene terephthalate (PET), fabrics, silicone, polyurethane, silicone-polyurethane copolymers, polymer rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, Thermoplastic elastomers, thermosetting elastomers, elastomeric composites, rigid polymers including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy resins, bone materials including autologous grafts, allografts, xenografts or transgenic cortical bone and / or cortical cancellous bone and tissue growth or differentiation factors, partially resorbable materials (such as composites of metal and calcium-based ceramics, composites of polyetheretherketone and calcium-based ceramics, composites of polyetheretherketone and resorbable polymers), fully resorbable materials (such as calcium-based ceramics, such as calcium phosphate, tricalcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate) or other resorbable polymers (such as polyadenylic acid, polyglycolide, polytyrosine carbonate, polylactide and combinations thereof).

[0037] The various components of the surgical system 10 may have composite materials including the above materials to achieve various desired properties, such as strength, rigidity, elasticity, compliance, biomechanical properties, durability, and radiolucency or imaging preference. The components of the surgical system 10 may also be made of heterogeneous materials (such as a combination of two or more of the above materials), either individually or collectively. As described herein, the components of the surgical system 10 may be integrally formed, integrally connected, or include fastening elements and / or instruments.

[0038] For example, the surgical system 10 is used with minimally invasive procedures, including percutaneous techniques, micro-open and open surgical techniques, to deliver and introduce instruments and / or components of a spinal construct, such as a portion of a spine, at a surgical site within a patient. In some embodiments, one or more of the components of the surgical system 10 are configured to engage a spinal construct attached to a vertebra to manipulate tissue and / or correct spinal disorders (e.g., sagittal deformity), as described herein. In some embodiments, the surgical system 10 may be used with surgery (e.g., corpectomy, discectomy, and / or fracture / trauma treatment) and may include fusion and / or fixation using an implant to restore the mechanical support function of the vertebrae.

[0039] Surgical system 10 includes extenders such as implant support 14 and implant support 14a ( Figure 6 ), similar to the implant support 14 described herein, and a sleeve 80 ( Figure 3 ), both of which may engage separate and spaced-apart bone screws 600 ( Figure 4 and 6 The implant support 14, 14a may be connected to a surgical instrument, such as, for example, a retractor 250 ( Figure 5 and 6 ) and / or compression device 1000 to facilitate manipulation of tissue as described herein.

[0040] The implant support 14 extends along the axis X1. Figure 1 As shown. Figure 2 As shown, the implant support 14 comprises a first extension 20 and a second extension 22. The extensions 20, 22 can be moved relative to each other by relative translation of a translation element, such as a slide 26 provided with the implant support 14, as shown in FIG. Figure 2 The slide 26 is manipulated to translate within the channel 28, thereby moving the extensions 20, 22 between the open orientation and the closed, captured orientation. Figure 2 The slide 26 is translated in the direction indicated by arrow A to rotate and expand the extensions 20, 22 to the open orientation in the direction indicated by arrow B. In the open orientation, the pin 30 connected to the extensions 20, 22 is arranged in the bottom of the slot 32 of the slide 26. The slide 26 is moved along the Figure 2 The extensions 20, 22 are rotated and retracted in the direction indicated by the arrows D to a closed orientation to capture the wall 604 of the receiver 602 of the bone screw 600, as shown in FIG. Figure 2 In the closed orientation, the pin 30 is disposed in the top of the slot 32. In some embodiments, the extensions 20, 22 are flexible to facilitate retraction.

[0041] The implant support 14 is connected to the wall 604, as described herein. Figure 3 and 4 As described, direct access to the implant cavity (between walls 604 and 606) of receiver 602 is not blocked to facilitate insertion of an implant such as a spinal rod and perhaps a fixation device such as a fixation cap or a fixation screw.

[0042] In some embodiments, as described herein, one or more implant supports 14 are steerable to provide counter-torque for micromalformation manipulation and vertebral manipulation during surgical treatment, such as to displace, pull, twist, or align vertebrae.

[0043] Reference again Figure 3 and Figure 4 , sleeve 80 can be connected to implant support 14 and wall 606. Sleeve 80 includes a body 82 extending between a first end 84 and a second end 86. Body 82 extends along implant support 14. End 84 includes a first flange 88 and an opposing second flange 90, which have corresponding mating surfaces defining a mating channel 91. Each surface may include a mating groove 92 formed therein. Mating groove 92, or at least flanges 88, 90, are configured to be arranged in a proximal portion of implant support 14, such as Figure 4 shown.

[0044] In various embodiments, the flanges 88, 90 are flexible so that the flanges 88, 90 snap fit around and engage the implant support 14. After the implant support 14 is arranged with the flanges 88, 90, the sleeve 80 is arranged to capture the configuration of the wall 606 of the receiver 602, such as Figure 4 shown.

[0045] The end 86 includes a surface 100 defining a mating surface 102. The surface 102 is configured to capture the wall 606. In various embodiments, the surface 102 includes a distal protrusion 104 that is configured to engage with the cavity 608 ( Figure 2 ) to facilitate bonding.

[0046] Continue to refer Figure 4 , the bone screw 600 includes a shaft 610 and a receiver 602. The receiver 602 is movable relative to the shaft in a multi-axial configuration. As described herein, the receiver 602 is configured to engage with the implant support 14 and the sleeve 80. At least one of the walls 604, 606 includes a defined cavity 608 ( Figure 2 ) surface. As described herein, each cavity 608 can be used to facilitate connection with the implant support 14 and / or sleeve 80. Walls 604, 606 include an inner surface that defines a U-shaped passage 612 for accommodating a spinal rod, as described herein. The inner surface of receiver 602 includes a threaded form configured to engage with a set screw.

[0047] In assembly, operation, and use, a surgical system 10 similar to the systems and methods described herein is used in conjunction with a surgical procedure to treat a patient's spine (including vertebra V), such as Figure 8-1 9. The surgical system 10 may also be used with surgical procedures such as discectomy, laminectomy, fusion, laminotomy, laminectomy, nerve root retraction, foraminotomy, facectomy, decompression, spinal nucleus or disc replacement, and bone grafting and implantable prostheses including plates, rods, and bone engaging fasteners.

[0048] The surgical system 10 is used with a procedure for treating an affected portion of the spine and associated conditions or injuries in adjacent areas of the body. For example, vertebra V includes vertebral level V1, vertebral level V2, and vertebral level V3, as shown in FIG19. The diseased and / or damaged vertebrae and intervertebral discs are disposed at vertebra V2 between vertebrae V1 and V3. In some embodiments, components of the surgical system 10 are configured to be inserted into the vertebral space to isolate the joint surface, provide support, and maximize the stability of vertebrae V.

[0049] In use, to treat the affected portion of vertebra V, a medical practitioner accesses a surgical site including vertebra V in any appropriate manner (e.g., by incision and retraction of tissue). In some embodiments, surgical system 10 may be used with any existing surgical approach or technique, including open surgery, mini-open surgery, minimally invasive surgery, and percutaneous surgical implantation, whereby vertebra V is accessed through a small incision or sleeve that provides protected access to the area.

[0050] An incision is made in the patient, and a cutting instrument (not shown) forms a surgical path for implanting the components of surgical system 10. Preparation instruments (not shown) may be used to prepare the tissue surface of vertebra V, as well as for aspiration and irrigation of the surgical area.

[0051] Pilot holes or the like are formed in the selected vertebrae V1 and V3 for receiving the bone fastener 600. The implant support 14, 14a engages with the wall 604 of the receiver 602 as described herein. The sleeve 80 engages with the wall 606 of the receiver 602 as described herein. The mating grooves 88, 90 engage with the implant support 14 as described herein. The driver 650 is disposed adjacent to the vertebrae V at the surgical site and is manipulated to drive, torque, insert, or otherwise connect the bone screw 600 to the vertebrae.

[0052] Tractor 250, such as Figure 5As shown, the tractor 250 is connected to the implant support 14, 14a to allow traction of the vertebra V connected to the bone screw 600. The tractor 250 includes a longitudinal element, such as a rack 252 extending between an end 254 and an end 256. The rack 252 is configured to connect adjacent implant supports 14, 14a. The rack 252 includes an outer surface 258 having a plurality of teeth (e.g., a spline 260 that can engage with an arm 282), as described herein. The rack 252 includes an arm 262 extending from the end 254. In some embodiments, the arm 262 is attached to the rack 252, such as with a clamp, a hook, an adhesive and / or a flange.

[0053] The arm 262 includes a member, such as an adapter 270, extending between an end 272 and an end 274. The adapter 270 includes a surface 276 and a wall 278 that defines a receiver 280 extending between the ends 272, 274. The receiver 280 is configured to receive the implant support 14a. The adapter 270 includes a rectangular cross-sectional configuration, such as Figure 5 In some embodiments, all or only a portion of the cross-section of adapter 270 may have alternative cross-sectional configurations, such as arcuate, closed, V-shaped, W-shaped, elliptical, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and / or tapered.

[0054] The rack 252 includes an arm 282 that is axially translatable relative to the arm 162. The arm 262 includes a member, such as an adapter 290, extending between an end 292 and an end 294. The adapter 290 includes a surface 296 and a wall 298 that defines a receiver 300 extending between the ends 292, 294. The receiver 300 is configured to receive the implant support 14. The adapter 290 includes a rectangular cross-sectional configuration, such as Figure 5 In some embodiments, all or only a portion of the cross-section of adapter 290 may have alternative cross-sectional configurations, such as arcuate, closed, V-shaped, W-shaped, elliptical, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and / or tapered.

[0055] For distraction, the implant support 14 is provided with an adapter 290 and the implant support 14a is provided with an adapter 270, such as Figure 6 The bone screw 600 with the multi-axial receiver 602 facilitates manipulation of the implant support 14, 14a to engage with the adapter 270, 290. The rack 252 includes a latch 302 that can be pivoted relative to the arm 282 to be placed in a distraction position, such as Figure 6In the pull position, the latch 302 engages the rack 252 to allow axial and / or incremental translation of the arm 282 relative to the arm 262 / rack 252 and prevents axial translation of the arm 282 relative to the arm 262 / rack 252 in the opposite direction. For example, as described herein, the latch 300 can be pivoted to the pull position to allow the arm 282 to move along the Figure 6 The arm 282 is prevented from translating in the direction indicated by the arrow E and from translating in the direction indicated by the arrow F relative to the arm 262 / the rack 252. Thus, distraction of the vertebrae V1, V3 connected to the implant supports 14, 14a can be performed.

[0056] In some embodiments, an expander (not shown) is inserted between the implant supports 14, 14a to contact the bone anatomy and determine the tissue depth. In some embodiments, a retractor blade (not shown) is translated along the expander to engage the bone anatomy. The blade is arranged with the tissue to form a surgical channel to facilitate the insertion of a spinal implant, such as an intervertebral implant.

[0057] In some embodiments, a rod inserter (not shown) is engaged with the spinal rod 450 to guide and / or direct the spinal rod 450 through the implant support 14, 14a into the receiver 602. The sleeve 80 is disengaged from the implant support 14, such as Fig.14 A driver (not shown) is used to engage the fixing screw 601 with the bone screw 600 to fix one end of the spinal rod 450 provided with the bone screw 600, which is connected to the implant support 14, as shown in FIG. Figure 8 shown.

[0058] The implant supports 14, 14a are crossed and the compression instrument 1000 is arranged together with the implant supports 14, 14a, such as Figure 8-11 As shown. The instrument 1000 is configured to promote compression of vertebra V by connecting with implant supports 14, 14a. The instrument 1000 includes a member, such as a pivot body 1002, which is configured to promote rotation of the implant support 14a relative to the body 1002. The body 1002 extends between an end 1004 and an end 1006 and defines an axis X10. The body 1002 includes a surface 1010 that defines a cavity, such as an opening 1012. The opening 1012 extends between the end 1004 and the end 1006. The opening 1012 is configured to be placed together with the proximal end of the implant support 14.

[0059] The body 1002 includes a lock, such as a pair of depressible buttons 1020 configured to connect to the implant support 14. The buttons 1020 can be positioned between a locked or locked orientation and an unlocked orientation. In the locked orientation, the buttons 1020 releasably secure the body 1002 to the implant support 14. In the unlocked orientation, the body 1002 can be translated and / or removed from the implant support 14. The buttons 1020 can be spring-biased to the locked position, such as by a protrusion 1022 defined by the buttons 1020 being biased in the locked orientation to engage with a recess 1024 of the implant support 14, such as Fig.13 As shown, the body 1002 can be releasably fixed to the implant support 14 with the body 1002. The button 1020 is configured to resist and / or prevent the body 1002 from being disengaged from the implant support 14. In some embodiments, the outer surface of the body 1002 includes one or more buttons 1020. In some embodiments, the body 1002 can include ridges to facilitate gripping of the body 1002, for example, to manipulate the body 1002 relative to the implant support 14, as described herein.

[0060] End 1006 includes arm 1030. Arm 1030 includes surface 1032 defining receiver 1034. Arm 1030 extends transversely to axis X10. In some embodiments, arm 1030 may be oriented differently relative to axis X10, such as vertical, angled and / or offset. Receiver 1034 is configured to engage with implant support 14a. In some embodiments, surface 1032 defines a cavity with a concave configuration to facilitate engagement with the surface of implant support 14a, thereby facilitating intersection of implant support 14a with implant support 14. In some embodiments, receiver 1034 may include alternative configurations, such as arched, offset, staggered and / or angled portions.

[0061] The body 1002 includes a housing 1040. The housing 1040 includes a surface 1042 defining an opening, such as a channel 1044. The channel 1044 is configured to movably arrange an actuator 1046 and a component, such as a slider 1048. The surface 1042 includes a threaded form (not shown) that can engage with the actuator 1046 to facilitate translation of the slider 1048, as described herein. The actuator 1046 includes a shaft 1050 extending between an end 1052 and an end 1054. The shaft 1050 includes a threaded surface 1056 that can engage with the surface 1042 to facilitate translation. The end 1052 includes a knob 1058 to facilitate rotation of the actuator 1046. The end 1054 includes the slider 1048.

[0062] Slider 1048 includes arm 1060. Arm 1060 includes surface 1062 defining receiver 1064. Arm 1060 extends transversely to axis 1050. In some embodiments, arm 1060 may be oriented differently relative to axis 1050, such as vertically, angled and / or offset. Receiver 1064 is configured to engage with implant support 14a. In some embodiments, surface 1062 defines a cavity with a concave configuration to facilitate engagement with the surface of implant support 14a. Slider 1048 is actuated to translate along implant support 14, causing implant support 14a to rotate within receiver 1034 to facilitate compression of the vertebra. In some embodiments, receiver 1064 may include alternative configurations, such as arched, offset, staggered and / or angled portions.

[0063] To compress vertebra V, body 1002 is translated on implant support 14, as shown in FIG. Fig. 9 As shown by arrow G in the figure, the implant support 14 is provided with an opening 1012. The button 1020 is snapped into a locked position to fix the instrument 1000 with the implant support 14. The slider 1048 is arranged in an initial position so that the receivers 1034 and 1064 are arranged adjacent to each other. The implant support 14a is provided with receivers 1034 and 1064, as shown in FIG. Fig. 9 and 10 As shown, the implant support 14, 14a is captured by the receiver 1034, 1064. In some embodiments, the receiver 602 is arranged at a relative distance D1. In some embodiments, the distance D1 is about 50mm. In some embodiments, the axis 610 is arranged at a relative angle α1. In some embodiments, the angle α1 is about 27 degrees.

[0064] Actuator 1046 is rotated, as Fig. 9 As shown by arrow H in FIG. 1 , threaded shaft 1050 engages the threaded surface of housing 1040. Rotation of shaft 1050 causes slider 1048 to rotate. Fig.11 and 12 The slide 1048 translates along the implant support 14a, resulting in further selective compression of the vertebra V. The receiver 1062 translates, resulting in rotation of the implant support 14a relative to the instrument 1000. For example, the receiver 602 is arranged at a relative distance D2. In some embodiments, the distance D2 is about 35 mm. In some embodiments, the axis 610 is arranged at a relative angle α2. In some embodiments, the angle α2 is about 16 degrees.

[0065] Actuator 1046 is further rotated, as Fig.11 As shown by arrow J in the middle, the threaded shaft 1050 engages the threaded surface of the housing 1040. The rotation of the shaft 1050 causes the slider 1048 to rotate. Fig.14 and15 The slide 1048 translates along the implant support 14a, resulting in selective compression of the vertebra V. The receiver 1062 translates away from the receiver 1034, resulting in rotation of the implant support 14a relative to the instrument 1000. For example, the receivers 602 are arranged at a relative distance D3. In some embodiments, the distance D3 is about 19 mm. In some embodiments, the shaft 610 is arranged at a relative angle α3. In some embodiments, the angle α3 is about 8 degrees. The compression instrument 1000 and the implant support 14 are removed, as shown. Fig.16 The spinal rod is fixed with bone screws 600.

[0066] After the procedure is completed, as described herein, the surgical instruments, components, and non-implanted components of the surgical system 10 are removed and the incision(s) are closed. One or more of the components of the surgical system 10 may be made of a radiolucent material (e.g., a polymer). Radioactive markers may be included for identification under x-ray, fluoroscopy, CT, or other imaging techniques. In some embodiments, the use of surgical navigation, microsurgery, and image-guided techniques can be used to approach, view, and repair spinal degeneration or injury with the aid of the surgical system 10. In some embodiments, the surgical system 10 may include one or more plates, connectors, and / or bone fasteners for a single vertebral level or multiple vertebral levels.

[0067] In some embodiments, the surgical system 10 includes one or more alternative surgical instruments, each of which is configured to engage with a quick release configuration of a spinal construct, as described herein. This configuration facilitates interchangeability of the spinal construct with the alternative surgical instruments. In some embodiments, the surgical system 10 includes one or more alternative surgical instruments, such as inserters, extenders, reducers, dilators, retractors, blades, retractors, clamps, forceps, elevators, and drills, which can be alternately sized and dimensioned and arranged in a kit.

[0068] In some embodiments, the surgical system 10 includes an agent that may be disposed, packaged, coated, or layered in, on, or around a component and / or surface of the surgical system 10. In some embodiments, the agent may include a bone growth promoting material, such as a bone graft, to enhance fixation of the component and / or surface of the surgical system 10 to the vertebrae. In some embodiments, the agent may include one or more therapeutic and / or pharmacological agents for release (including sustained release) to treat, for example, pain, inflammation, and degeneration.

[0069] It should be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be interpreted as limiting, but only as an illustration of various embodiments. Other modifications within the scope and spirit of the appended claims may be envisioned by those skilled in the art.

Claims

1. A surgical compression instrument comprising: a member configured to be disposed longitudinally along the first implant support and for pivotally connecting the first implant support to a second implant support, the first implant support being engageable with a first receiver of a first fastener having a first shaft to which vertebral tissue is secured, and the second implant support being engageable with a second receiver of a second fastener having a second shaft to which vertebral tissue is secured; and a member movable relative to the member and engageable with the implant support to move the second implant support relative to the first implant support to compress vertebral tissue, wherein the member includes a pivot body fixed to the first implant support so that the second implant support rotates relative to the pivot body, wherein the component comprises a slider, the slider being axially translatable relative to the member, and The member includes an actuator for translating the component, the actuator including a threaded surface engageable with a body of the member to translate the component.

2. The surgical compression instrument of claim 1, wherein the member comprises a receiver defining a cavity configured for seating the second implant support.

3. The surgical compression instrument of claim 2, wherein the member includes a body mounted to the proximal end of the first implant support, and the receiver of the member extends transversely to the body.

4. The surgical compression instrument of claim 1, wherein the member includes a lock to releasably secure the member with the first implant support.

5. The surgical compression instrument of claim 4, wherein the lock is movable between a locked orientation and an unlocked orientation and the lock is biased toward the locked orientation.

6. The surgical compression instrument of claim 4, wherein the lock comprises a pair of depressible buttons configured to couple with the first implant support.

7. A surgical compression instrument comprising: a pivot body coupled to and extending longitudinally along the first implant support and including a receiver configured to receive a second implant support, the first implant support being engageable with a receiver of a fastener having a shaft to which vertebral tissue is secured, and the second implant support being engageable with a receiver of a fastener having a shaft to which vertebral tissue is secured; a slider, the slider being axially translatable relative to the pivot body; and an actuator coupled to the slider for translating the slider relative to the pivot body such that the slider is engageable with the second implant support to move the second implant support relative to the first implant support to compress vertebral tissue, and the actuator includes a threaded surface engageable with the pivot body to translate the slider, Wherein, the pivot body enables the second implant support to rotate relative to the pivot body.

8. A surgical system comprising: a first fastener having a shaft fixable to vertebral tissue; a first implant support engageable with the receiver of the first fastener; a second fastener having a shaft fixable to vertebral tissue; a second implant support engageable with the receiver of the second fastener; a member disposed longitudinally along the first implant support to pivotally connect the implant support; and a member movable relative to the member and engageable with the second implant support so as to move the second implant support relative to the first implant support to compress vertebral tissue, wherein the member comprises a pivot body fixed to the proximal end of the first implant support, such that the distal end of the second implant support rotates relative to the pivot body, wherein the component comprises a slider, the slider being axially translatable relative to the member, and The member includes an actuator for translating the component, the actuator including a threaded surface engageable with a body of the member to translate the component.

9. The surgical system of claim 8, wherein the member comprises a receiver defining a cavity configured for seating the second implant support.

10. The surgical system of claim 9, wherein the member includes a body mounted to the proximal end of the first implant support, and the receiver of the member extends transversely to the body.

11. The surgical system of claim 8, wherein the member comprises a lock movable between a locked orientation and an unlocked orientation, and the lock is biased to the locked orientation.

12. The surgical system of claim 11, wherein the lock comprises a pair of depressible buttons configured to couple with the first implant support.

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