Anchors extender assemblies and methods for using

One nonlimiting embodiment is directed to an anchor extender releasably engaged with an anchor configured for engagement with one or more bones or bony portions. The anchor extender generally includes a first member and a second member positioned about and movable relative to the first member. The anchor extender is positionable adjacent the anchor and movement of the second member relative to the first member toward the anchor as the anchor extender is engaged with the anchor results in lateral displacement of the anchor extender relative to the anchor while the first member engages with a first side of the anchor and the second member engages with an opposite second side of the anchor. However, in other embodiments, different forms and applications are envisioned.

BACKGROUND

The present application relates to surgical devices and methods, and more particularly, but not exclusively, to anchor extender assemblies for use during surgical procedures.

Several surgical procedures utilize anchors that can be secured to bone or bony structures. These anchors can be used to apply stabilizing or corrective forces to the bone or bony structures. A wide variety of anchors are provided that are specifically designed to connect to or engage various bones or bony structures. For example, such anchors can include bone posts or spikes that can be anchored into various bones or bony structures. Additionally, another anchor comprises a hook configured to engage the laminae of the vertebra. Other anchors include spinal screws or bolts having threaded sections configured to be anchored in vertebral bone. With reference to spinal surgery, the anchors are typically used in conjunction with other implant components used to stabilize the vertebra. These other implant components can include, for example, a stabilization device or connecting element such as a spinal rod or plate. Typically, the anchors include a receiver member adapted to engage the connecting element. More particularly, in one form, the receiver member has a channel or opening adapted to receive and engage the connecting element. The receiver member may also be configured to engage a securing member that connects the connecting element to the anchor.

Positioning the connecting element into the channel of the receiver member in-situ can be difficult due to interference with surrounding anatomical features such as skin and soft tissues. Moreover, if the channel of the receiver member is not properly aligned with the connecting element, forces may need to be applied to move the anchor and/or stress the connecting element to achieve proper alignment with the receiver member. Manipulation of the anchor and/or the connecting element can be awkward or cumbersome due to, amongst other things, the limited amount of space available to manipulate the implant components and the required surgical instruments. Thus, there remains a need for further improvements in this area.

SUMMARY

One nonlimiting embodiment of the present application is directed to an anchor extender releasably engaged with an anchor configured for engagement with one or more bones or bony tissues such as, for example, the spinal column. The anchor extender generally includes a first member and second member positioned about and movable relative to the first member. The anchor extender is positionable adjacent to the anchor and movement of the second member relative to the first member toward the anchor as the anchor extender engages the anchor results in lateral displacement of the anchor extender relative to the anchor while the first member engages with a first side of the anchor and the second member engages an opposite second side of the anchor. Amongst other things, the anchor extender can be used for guiding a connecting element, such as a spinal rod, into a receiving channel of the anchor. Moreover, in one non-limiting form, reduction instrumentation can be coupled with the anchor extender and used to reduce the connecting element into the receiving channel of the anchor. Additionally or alternatively, one or more instruments for manipulating the positioning of the anchor may also be coupled with the anchor extender. However, in other embodiments, different forms and applications are envisioned.

For example, another embodiment of the present application is directed to an apparatus that includes an anchor having a bone engaging portion and a receiver member. The receiver member includes a pair of oppositely positioned branches and a receiving channel positioned between the branches and extending between opposite first and second sides of the receiver member. The apparatus also includes an anchor extender engageable with the anchor. The anchor extender includes a first member having an elongate body extending between a proximal end and an opposite distal end and including oppositely positioned first and second arms each having an engaging portion structured to engage a respective one of the branches on the first side of the receiver member. The anchor extender also includes a second member positioned about the first member and movable relative to the first member between a first position and a second position. The second member further includes a distal portion structured to engage the branches on the second side of the receiver member. Distal movement of the second member relative to the first member from the first position to the second position moves the engaging portions of the first and second arms into engagement with the branches on the first side of the receiver member and the distal portion of the second member along the branches on the second side of the receiver member.

In yet another embodiment, an anchor extender includes a first member having a first elongate body extending along a first longitudinal axis between a proximal end and an opposite distal end. The first elongate body also includes a pair of oppositely positioned tabs laterally offset from and extending toward the first longitudinal axis. The anchor extender further includes a second member having a second elongate body extending along a second longitudinal axis between a proximal end and an opposite distal end. The second elongate body includes an elongate passage extending between the proximal and distal ends. The elongate passage includes a first portion positioned adjacent the distal end, a second portion positioned proximally of the first portion, and a transition portion extending obliquely toward the second longitudinal axis in a proximal direction from the first portion to the second portion of the elongate passage. The second member is positionable over the first member and slidably movable relative to the first member across a plurality of positions including an anchor engaging position in which the oppositely positioned tabs are positioned in the elongate passage opposite of and facing the transition portion of the elongate passage.

In another embodiment, a method includes providing an anchor having a bone engaging portion and a receiver member, with the receiver member extending along a central axis between a proximal end and an oppositely positioned distal end and further including a pair of oppositely positioned branches and a receiving channel positioned between the branches. The receiving channel extends between opposite first and second sides of the receiver member. The method also includes providing an anchor extender engageable with the anchor, with the anchor extender extending along a longitudinal axis between a proximal end and an opposite distal end. The anchor extender includes a first member having oppositely positioned first and second arms, each including an engaging portion structured to engage with a respective one of the branches on the first side of the receiver member. The anchor extender also includes a second member movably positioned about the first member and including a distal portion structured to engage the branches on the second side of the receiver member. The method further includes positioning the anchor extender adjacent the proximal end of the receiver member with the longitudinal axis of the anchor extender offset from the central axis of the receiver member, and distally moving the second member relative to the first member to releasably couple the anchor extender with the receiver member. Distally moving the second member relative to the first member includes aligning the longitudinal axis with the central axis.

Another embodiment of the present application is directed to a unique anchor extender for use in surgical procedures in a patient. Other embodiments include unique methods, techniques, systems, devices, kits, assemblies, equipment, and/or apparatus involving anchor extenders.

Further embodiments, forms, features, aspects, benefits, objects and advantages of the present application shall become apparent from the detailed description and figures provided herewith.

DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS

The subject application is generally directed to an anchor extender which can be releasably engaged with an anchor configured for engagement with one or more bones or bony tissues, such as the spinal column, although it should be understood that other skeletal locations are also possible. The anchor extender generally includes a first member and second member positioned about and movable relative to the first member. The anchor extender is positionable adjacent to the anchor and movement of the second member relative to the first member toward the anchor as the anchor extender is engaged with the anchor results in lateral displacement of the anchor extender relative to the anchor while the first member engages a first side of the anchor and the second member engages an opposite second side of the anchor. Amongst other things, the anchor extender can be used for guiding a connecting element, such as a spinal rod, into a receiving channel of the anchor. Moreover, in one non-limiting form, reduction instrumentation can be coupled with the anchor extender, or the anchor extender can be further configured as a reduction instrument, and used to reduce the connecting element into the receiving channel of the anchor. In one or more forms, the anchor extender may also be used to manually manipulate the positioning of the anchor or the bones or bony tissues to which it is engaged. Additionally or alternatively, one or more instruments for manipulating the positioning of the anchor or the bones or bony tissues to which it is engaged may also be coupled with the anchor extender.

Referring now toFIG. 1, there is shown an anchor extender10positioned adjacent to a bone anchor210and to which reduction instrumentation310is coupled, further details of which will be provided below. The bone anchor210includes a receiver member212configured to receive a connecting element240and a distal bone engaging portion214. While not shown, it should be appreciated that the connecting element can extend between and be coupled with one or more additional anchors configured to be engaged with bones or bony tissues adjacent to the anchor10. In the illustrated embodiment, the bone engaging portion214is a bone screw with a threaded shank structured to engage the bony structure of an underlying vertebra when the bone anchor210is engaged to the spinal column. With reference toFIGS. 8 and 9A, the receiver member212extends along a central axis216between a proximal end218and a distal end220and includes a pair of opposing branches222,224defining a channel226extending between and opening through opposite first and second sides228,230of the receiver member212. The branches222,224further define a proximal/distally extending opening that opens through the proximal end218of the receiver member212to receive a set screw (not shown) structured to engage with internal threading232on the branches222,224to secure the connecting element240in the channel226. As illustrated inFIG. 12A, the branch222includes a pair of oppositely positioned and laterally facing receptacles234,236, each of which is configured for individual engagement with a portion of the anchor extender10depending on the orientation of the anchor extender10relative to the anchor210, further details of which will be provided below. Additionally, while not illustrated, it should be appreciated that the branch224also includes a pair of oppositely positioned and laterally facing receptacles configured the same as the receptacles234,236of the branch222. In another non-illustrated form, the branches222,224may each include a single lateral facing receptacle positioned on the same side of the receiver member212.

In the illustrated form, the bone engaging portion214is pivotally received in the receiver member212through a distal opening thereof, and structured to interact therewith to provide the anchor210with multi-axial capabilities that permit either a selected number of positions or infinitely numbered of positions of the bone engaging portion212relative to the receiver member212. Other forms for the anchor210are contemplated, including uni-axial and uni-planar forms. The bone engaging portion214can also be in the form of a spike, staple, hook, fusion device, cannulated screw, fenestrated screw, interbody device, intrabody device, clamp, plate, suture anchor, bolt, pin or other bone engaging member. The receiver member214can also be in the form of a saddle, yoke, eye-bolt or through-hole, side opening member, bottom opening member, top-opening member, eyelet, or any other structure engageable to the connecting element240and the anchor extender10.

In one non-limiting form in which the receiver member214is in the form of a side opening member, it includes a proximal branch and an oppositely positioned distal branch which cooperate to define a laterally opening channel that also extends between and opens through opposite first and second sides of the receiver member. In a further aspect of this form, the distal branch can be provided with an opening configured to receive a bone engaging portion in a multi-axial or uni-axial configuration, although forms in which the receiver member and bone engaging portion are integrally formed are also possible. Additionally, the proximal branch can also be provided with a threaded aperture configured to receive and engage with a set screw to secure a connecting element in the laterally opening channel. One non-limiting example of a bone anchor including a laterally opening channel is used in the TSRH® SILO™ Spinal System commercially available from Medtronic Spinal and Biologics, 2600 Sofamor Danek Drive, Memphis, Tenn., 38132. However, it should be understood that other bone anchors including laterally opening channels are also possible. It should also be understood that use of the anchor extender10with a bone anchor including a laterally opening channel for receiving the connecting element240may be carried out in a manner substantially similar to that discussed below in connection with the use of the anchor extender10with the illustrated bone anchor210.

In the illustrated embodiment, the connecting element240is a rigid rod that has a substantially linear configuration between its ends. However, it is contemplated that the connecting element240can have a curvature that extends along a constant arc, a varying arc, and/or is compounded between its ends. Additionally, in other forms, the connecting element240can include any known configuration for a rod, implant, or fastener. It is further contemplated that the connecting element240can be non-rigid, elastic and/or super-elastic and in the form of a cable, band, wire, or artificial ligament that is used in tethering or guiding, and/or in other surgical procedures, It should also be appreciated that other forms in which the anchor extender10is used in the absence of the connecting element240are also contemplated.

Referring collectively toFIGS. 1 and 8, the anchor extender10generally extends along a longitudinal axis L between a proximal end12and an opposite distal end14which is configured for engagement with the anchor210, further details of which will be provided below. The anchor extender10also includes a first member16and a second member18positioned about and slidably movable relative to the first member16. Referring collectively toFIGS. 2-4A, further details of the first member16will be provided. The first member16includes an elongate body20that extends along longitudinal axis L between a proximal end22and an opposite distal end24. The elongate body20includes a proximal portion26from which first and second spaced apart arms28,30extend, and also including an outwardly flared or tapered portion38that defines a distal facing surface40. A groove41is formed in the elongate body20adjacent to the distal facing surface40and includes a proximal portion41aand a distal portion41b. The distal facing surface40and the groove41are generally configured to cooperate and engage with a collar member coupled with the second member18, further details of which will be provided below. In the illustrated form, the elongate body20generally has a substantially rigid or inflexible configuration such that movement or flexing of the arms28,30relative to one another and/or the proximal portion26will be substantially or entirely eliminated. However, it should be appreciated that forms in which the elongate body20has a flexible configuration that facilitates movement or flexing of the arms28,30relative to one another and/or the proximal portion26are also possible.

As best seen inFIG. 4, an elongate passage32extends through the elongate body20from the proximal end22to the distal end24. Additionally, a distally opening elongated slot34is positioned between the arms28,30and communicates with the elongate passage32. The first member16also includes an opening36that communicates with the elongate passage32and is configured to cooperate with the reduction instrumentation310when coupled with the anchor extender10, further details of which will be provided below. The arm28also includes a longitudinal tongue42positioned adjacent a longitudinal recess42a(FIG. 10), and the arm30includes a longitudinal tongue44positioned adjacent a longitudinal recess44a(FIG. 10). As illustrated inFIG. 10, the longitudinal tongues42,44and recesses42a,44aare generally configured to engage with corresponding structure(s) on the second member18.

The arms28,30each include an engaging portion adjacent the distal end24of the elongate body20configured to engage the receiver member212of the anchor210. More particularly, with reference toFIG. 3A, the arm28includes an engaging portion having an elongate tab46positioned in a recess48defined by a distal facing surface50, a side surface52, and an intermediate surface54from which the elongate tab46extends. As illustrated inFIGS. 3A and 4A, the arm30includes an engaging portion having an elongate tab56positioned in a recess58defined by a distal facing surface60, a side surface62, and an intermediate surface64from which the elongate tab56extends. The elongate tabs46,56are generally configured to be received in and engage with a respective one of the laterally facing receptacles on the branches222,224on a single side of the receiver member212. As illustrated inFIGS. 3 and 4, the elongate tabs46,56are positioned on opposite sides of and laterally offset from the longitudinal axis L, and extend substantially parallel with one another away from the arms28,30toward the longitudinal axis L. While not previously discussed, it should be appreciated that the recesses48,58cooperate to define a socket66(FIG. 3A) configured to receive a portion of the branches222,224of the receiver member212, further details of which will be provided below in connection withFIGS. 8-9Aand11-12A.

As illustrated inFIG. 5, the second member18includes an elongate body70that extends along longitudinal axis L between a proximal end72and an opposite distal end74. The elongate body70further includes a proximal portion76from which first and second arms78,80spaced apart from one another and positioned on opposite sides of the longitudinal axis L extend. As illustrated inFIG. 6, an elongate passage82extends through the elongate body70from the proximal end72to the distal end74and is configured to receive a portion of the first member16therein. Additionally, a distally opening elongated slot86is positioned between the arms78,80and communicates with the elongate passage82. The elongate body70also includes a pair of oppositely positioned guide surfaces88,90positioned adjacent opposite sides of the elongated slot86and extending obliquely to the longitudinal axis L. The guide surfaces88,90can assist in guiding the connecting element240into the elongated slot86. As illustrated inFIG. 10, the elongate body70also includes a pair of internally positioned longitudinal recesses92,94positioned opposite one another and configured to engage the longitudinal tongues42,44, respectively, of the arms28,30. The elongate body70also includes a pair of longitudinal tongues92a,94apositioned adjacent the longitudinal recesses92,94and configured to engage with the longitudinal recesses42a,44a, respectively, of the arms28,30. In this arrangement, the first and second members16,18cooperate with one another to prevent splaying of the arms28,30. However, in other non-illustrated forms, the first and second members16,18may alternatively be arranged and provided without any anti-splay arrangement.

The elongate passage82opens through the distal end74and generally provides a receptacle configured to receive a portion of the receiver member212therein. More particularly, as illustrated inFIG. 6A, the elongate passage82includes a first portion96positioned adjacent to distal end74and a second portion98positioned proximal the first portion96. A transition portion100extends between the first and second portions96,98and obliquely toward the longitudinal axis L in a proximal direction. In this arrangement, the first portion96of the elongate passage82includes a first cross-sectional dimension102that is greater than a second cross-sectional dimension104of the second portion98of the elongate passage82. The elongate passage82also includes a generally linear surface106positioned opposite the transition portion100. While the details of the elongate passage82adjacent to the distal end74of the elongate body70have been described in connection with the illustration of the arm80inFIGS. 6 and 6A, it should also be appreciated that the foregoing features of the elongate passage82are also present in connection with the arm78, which is configured similar to the arm80.

The elongate body70also includes a pair of oppositely positioned spring tabs84,85configured to engage with or bear against the first member16when positioned in the elongate passage82. Additionally, in the illustrated form, the arm80includes an arcuate notch108extending proximally from the distal end74. Moreover, while not illustrated, it should be appreciated that the arm78also includes an arcuate notch extending proximally from the distal end74and positioned opposite the arcuate notch108. As indicated above, the second member18is positionable over the first member16. In this arrangement, the first and second arms28,30of the first member16are positioned in the elongate passage82between the transition portion100and the linear surface106such that the elongated tabs46,56are generally positioned opposite of and extend toward the transition portion100.

While not illustrated inFIGS. 5-6A, it should be appreciated that a collar member110may be coupled with the proximal end72of the elongate body70of the second member18, as illustrated inFIGS. 1 and 7. It should also be appreciated that forms in which the collar member110is absent from the anchor extender10are contemplated. The collar member110is rotatably coupled with the elongate body70such that it can be rotated relative to the second member18. Moreover, the collar member110includes an inwardly extending pin112engageable within the groove41on the first member16when the second member18is positioned over the first member16. In this arrangement, the second member18can be moved distally from a first position relative to the first member16where the pin112is positioned in the proximal portion41aof the groove41and the collar member110abuts the distal facing surface40by rotating the collar member110relative to the second member18. As the collar member110is rotated, the pin112is distally guided into the distal portion41bof the groove41, which in turn results in distal displacement of the second member18to a second position relative to the first member16. Once the second member18is in the second position relative to the first member16, the collar member110can be rotated in an opposite direction such that the pin112is proximally guided into the proximal portion41aof the groove41, and the second member18is proximally returned to its first position relative to the first member16. In another non-illustrated form, the collar member110includes internal threads configured to engage with external threads on the first member16such that the interaction between the internal and external threads results in proximal and distal displacement of the second member18relative to the first member16as the collar member110is rotated in opposite directions relative to the first member16.

Referring collectively toFIGS. 8-9Aand11-12A, further details regarding engagement of the anchor extender10with the anchor210will be provided. More specifically, when the second member18is positioned in its first or proximal position relative to the first member16, the distal end14of the anchor extender10may be positioned adjacent to the receiver member212such that the anchor extender10is initially engaged therewith. More particularly, the anchor extender10is positionable relative to the anchor210such that a portion of the receiver member212is positioned in the elongate passage82. As illustrated inFIG. 9A, in this arrangement, a proximal portion of the branch222is positioned in the first portion96of the elongate passage82such that the proximal end218of the receiver member212is positioned in abutment against the transition portion100and the second member18engages the branch222on the second side230of the receiver member212. The branch222is further positioned between the first arm28and the second member18. Additionally, the arm28is positioned adjacent to the first side228of the receiver member212such that the elongate tab46faces the lateral receptacle234of the branch222. However, as illustrated inFIG. 9A, a gap G is positioned between the elongate tab46and the first side228of the receiver member212along the branch222. A portion of the branch222is also received in the recess48such that a portion of the side surface52extends along an external surface of the branch222between the opposite first and second sides228,230of the receiver member212.

While not illustrated inFIG. 9A, it should be appreciated that a portion of the branch224of the receiver member212is positioned in the elongate passage82and relative to the arm30and the second member18in the same manner as discussed above in connection with the branch222. More specifically, a proximal portion of the branch224is positioned in the first portion96of the elongate passage82such that the proximal end218of the receiver member212is positioned in abutment against the transition portion100, and the second member18engages the branch224on the second side230of the receiver member212. The branch224is further positioned between the second arm30and the second member18. Additionally, the arm30is positioned adjacent the first side228of the receiver member212such that the elongate tab56faces the lateral receptacle (not shown) of the branch224. However, a gap will also extend between the elongate tab56and the first side228of the receiver member212along the branch224. A portion of the branch224is also received in the recess58such that a portion of the side surface62extends along an external surface of the branch224between the opposite first and second sides228,230of the receiver member212.

In view of the foregoing, it should be appreciated that the anchor extender10can be initially or provisionally engaged with the anchor210such that a portion of the branches222,224on the first side228of the receiver member212are positioned in the socket66defined by the arms28,30, and a portion of the branches222,224on the second side230of the receiver member212are positioned in the elongate passage82. Additionally, as illustrated inFIG. 9A, the longitudinal axis L of the anchor extender10is laterally offset from the central axis216of the receiver member212when the anchor extender10is initially engaged with the anchor210in this manner. It should be appreciated that in this arrangement, the anchor extender10is readily disengageable from the anchor210as it is axially moved in a proximal direction relative to the anchor210. However, the axial positioning of the anchor extender10relative to the anchor210may also be fixed upon further engagement of the anchor extender10with the anchor210, further details of which will be provided below in connection withFIGS. 11-12A.

The anchor extender10can be further engaged with the anchor210by distally displacing the second member18relative to the first member16. As the second member18is distally displaced, the transition portion100of the elongate passage82engages with the proximal end218of the receiver member212on the branches222,224and guides the proximal end218into the second portion98of the elongate passage82. The second member218is laterally displaced relative to the anchor210as the proximal end218is guided into the second portion98of the elongate passage82, which in turn displaces the arms28,30toward the first side228of the receiver member212such that the elongate tabs46,56are moved into engagement with the lateral receptacles on the branches222,224on the first side228of the receiver member212. Once the elongated tabs are engaged with the branches222,224, the longitudinal axis L of the anchor extender10and the central axis216of the receiver member212are aligned with one another, as illustrated inFIG. 12A. In this arrangement, the anchor extender10is engaged with the anchor210such that it is not readily disengageable from the anchor210upon proximal movement of the anchor extender10. Rather, in order to disengage the anchor extender10from the anchor210in this arrangement, the second member18is proximally displaced relative to the first member16to facilitate disengagement of the elongated tabs46,56from the lateral receptacles of the branches222,224. While not previously discussed, it should be appreciated that whileFIG. 12Aillustrates engagement of the anchor extender210with the branch222, engagement of the anchor extender10with the branch224will occur in the same manner.

In the arrangement illustrated inFIG. 12A, the distal ends24,74of the first and second members16,18are generally aligned with one another in a proximal/distal direction, and the elongate tabs46,56are positioned in the elongate passage82opposite of and facing toward the transition portion100of the elongate passage82. Moreover, the branch222is engaged on the first side228by the arm28of the first member16and on the second side230by the arm78of the second member18, and the branch224is engaged on the first side228by the arm30of the first member16and on the second side230by the arm80of the second member18. As illustrated inFIGS. 1,8, and11, the channel226is unobstructed by the first and second members16,18, and the slots34,86of the first and second members16,18, respectively, align with one another and provide access to the channel226. Similarly, the connecting element240may be guided along the slots34,86into the channel226. Further, as illustrated inFIG. 12, the elongate passages32,82cooperate with one another to provide access through the anchor extender10to the channel226to facilitate engagement of a set screw with the internal threading232to lock the connecting element240in the channel226.

Without limitation to any particular application, it is contemplated that the anchor extender10can be engaged with the anchor210to provide assistance in performing a variety of aspects associated with a surgical procedure, non-limiting examples of which include guiding and/or reducing the connecting element240into the channel226and/or facilitating rotation or manipulation of the anchor210to facilitate alignment of the channel226with the connecting element240. Referring more particularly toFIG. 1, in the illustrated form, the reduction instrumentation310is coupled to the anchor extender10and configured to facilitate reduction of the connecting element240into the channel226. While not illustrated inFIG. 1, it should be appreciated that the anchor extender10can be engaged with the anchor210in the manner discussed above in connection withFIG. 12Awhile the connecting element240is reduced into the channel226.

The reduction instrumentation310generally includes a collar portion312positioned about the first member16and to which a release member314is pivotably coupled. The release member314generally includes an engaging portion (not shown) positioned in the elongate passage32of the first member16through the opening36and configured to engage with external threading of a reduction member316. The reduction member316is rotatably coupled with a connecting element engaging portion318and, when engaged with the release member314, distally advances or proximally withdraws the engaging portion318upon rotation in opposite directions relative to the anchor extender10. The release member314is also generally configured to facilitate distal movement of the reduction member316relative to the anchor extender10without rotation of the reduction member316when it is engaged with the release member314, and to prevent proximal movement of the reduction member316relative to the anchor extender10without rotation of the reduction member316when it is engaged with the release member314. However, the release member314may also be displaced from engagement with the reduction member316, in which case the reduction member316may be readily displaced relative to the anchor inserter10in both proximal and distal directions without rotation.

In operation, the reduction member316can be distally advanced, either by rotation, pushing without rotation, or a combination of the two, in order to seat the connecting element240in the channel226. Once the connecting element240is seated in the channel226, a set screw and related driver can be advanced through a hollow interior320of the reduction member316and engaged with the anchor210in order to secure the connecting element240in the channel226. Once the connecting element240has been properly secured in the channel226, the anchor extender10can be disengaged from the anchor210and removed, along with the reduction instrumentation310, from the surgical site adjacent the anchor210.

In addition to or in lieu of the foregoing, one or more instruments configured for adjusting, rotating or manipulating the position of the anchor210or the bone or bony tissue to which it is engaged may also be coupled with the anchor extender10. Non-limiting examples of such instruments include those useful in derotating, compressing, distracting or otherwise adjusting the relative positioning of bones or bony tissues. Further, while not previously discussed, it should be appreciated that the anchor extender10can be engaged with the anchor210either before or after it has been engaged in bone or bony tissue. Similarly, in one form, the anchor extender10can be used during placement and engagement of the anchor210in the respective bone or bony tissue.

As indicated above, in one form, the anchor extender10can be used in connection with surgical procedures for stabilizing one or more segments of the spinal column. However, it should be appreciated that the use of the anchor extender10in other surgical procedures is also contemplated, including those performed in anatomical locations other than the spinal column. Additionally, the methods, techniques, assemblies, devices, apparatuses, systems and instrumentation described herein may also be used in surgical procedures involving animals, or in demonstrations for training, education, marketing, sales and/or advertising purposes. The methods, techniques, assemblies, devices, apparatuses, systems and instrumentation described herein may also be used on or in connection with a non-living subject such as a cadaver, training aid or model, or in connection with testing of surgical systems, surgical procedures, orthopedic devices and/or apparatus.

Any theory, mechanism of operation, proof, or finding stated herein is meant to further enhance understanding of the present application and is not intended to make the present application in any way dependent upon such theory, mechanism of operation, proof, or finding. It should be understood that while the use of the word preferable, preferably or preferred in the description above indicates that the feature so described may be more desirable, it nonetheless may not be necessary and embodiments lacking the same may be contemplated as within the scope of the application, that scope being defined by the claims that follow. In reading the claims it is intended that when words such as “a,” “an,” “at least one,” “at least a portion” are used there is no intention to limit the claim to only one item unless specifically stated to the contrary in the claim. Further, when the language “at least a portion” and/or “a portion” is used the item may include a portion and/or the entire item unless specifically stated to the contrary.

While the application has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the selected embodiments have been shown and described and that all changes, modifications and equivalents that come within the spirit of the application as defined herein or by any of the following claims are desired to be protected.