Patent Description:
Spinal disorders such as degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis, kyphosis and other curvature abnormalities, tumor, and fracture may result from factors including trauma, disease and degenerative conditions caused by injury and aging. Spinal disorders typically result in symptoms including pain, nerve damage, and partial or complete loss of mobility.

Non-surgical treatments, such as medication, rehabilitation and exercise can be effective, however, may fail to relieve the symptoms associated with these disorders. Surgical treatment of these spinal disorders includes correction, ligamentotaxy, corpectomy, discectomy, laminectomy, fusion, fixation and implantable prosthetics. Correction treatments used for positioning and alignment of vertebrae may employ spinal implants including spinal constructs and interbody devices for stabilization of a treated section of a spine. In some cases, the spinal implants may be manipulated with surgical instruments for compression and distraction of vertebrae. This disclosure describes an improvement over these prior technologies.

According to <CIT>, a surgical instrument comprises a first member including a first body connected to at least one second body. The first body is configured for disposal of an implant support having an outer surface. The at least one second body includes a capture element configured to dispose an implant support having an outer surface with the at least one second body such that the outer surfaces are spaced apart and each of the implant supports are engageable with a first implant. A second member is connected with the first member and is engageable with a second implant. The members are relatively movable to dispose the second implant with the implant supports and to align the second implant with at least one of the first implants. Systems and methods are disclosed.

According to <CIT>, a spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

The invention provides a surgical compression instrument according to claim <NUM> and a surgical system according to claim <NUM>.

The embodiments of the system and related methods of use (the methods not claimed) disclosed are discussed in terms of medical devices for correction of a spine disorder. According to the invention, the present surgical system includes surgical instruments that allow vertebral manipulation to treat spinal disorders, as described herein, for managing lordosis and/or kyphosis restoration. The surgical instruments according to the invention allow for parallel distraction and/or compression of vertebral tissue.

In some embodiments, the present surgical system includes a trauma instrument. The present surgical system is utilized with a method to correct complex spinal deformities. The present surgical system is utilized with a method to treat degenerative spinal disorders and/or employed with transforaminal lumbar interbody fusion procedures. In some embodiments, the present surgical system is configured for utilization with a sagittal adjusting screw (SAS), a fixed axis screw (FAS) and/or a multi-axial screw (MAS). In some embodiments, the present surgical system comprises a single distractor to treat degenerative spinal disorders, for example, for disposal along a side of vertebrae oriented for decompression and/or interbody cage insertion.

The present surgical system includes a surgical instrument employed with a surgical method including degenerative lumbar spine fusion. The present surgical system includes a surgical instrument employed with a surgical method including the step of segmental posterior stabilization with MAS screws. The present surgical system includes a surgical method including an interbody fusion, posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF) utilizing a minimally invasive surgical approach or a percutaneous approach. In some embodiments, the present surgical system includes bone screw extenders, tissue retractors and a distractor/compressor system. The present surgical system includes segmental distraction to facilitate decompression, including final construct compression. In some examples, the present surgical system includes radio transparent tissue retractor blades.

The present surgical system includes a surgical instrument employed with a surgical method including the step of: connecting extenders, such as, for example, implant supports with MAS screws; connecting a sleeve with the implant support and the bone screw; and employing a universal screw driver for percutaneous implantation of the bone screw utilizing a PAK needle, guidewire or fluoroscopy. The present surgical system includes screw based segmental distraction.

According to the invention, the surgical system includes a compression instrument. In some embodiments, the compression instrument includes a member disposed longitudinally along a first implant support for pivotably connecting with a second implant support. The compression instrument includes a slider being movable relative to the member and engageable with the implant supports such that the second implant support moves relative to the first implant support to compress the vertebral tissue. In some embodiments, the compression instrument includes connection buttons configured to prevent backing up of the compression instrument relative to the implant support. In some examples, the compression instrument is configured for one step top loading.

According to the invention, the compression instrument includes an actuator including a threaded surface engageable with a body of the member for gradual activation of the slider. In some embodiments, the compression instrument includes a crossing point compatible with a pre-bent rod. The slider is configured to drive compression of the vertebrae. In some examples, the compression instrument is utilized with a method including the steps of: removing a sleeve from an implant support; reducing a spinal rod with a first bone screw receiver; fixing a set screw with the bone screw receiver to fix the spinal rod in position and breaking off of a break off portion of the set screw; and engaging a second set screw with the second end of the spinal rod and a second bone screw receiver. The bone screw receivers are compressed a selected distance apart. In some examples, the distance ranges from about <NUM> to about <NUM>. In some examples, the shafts of the bone screws are compressed at a relative angle. In some examples, the angle is in a range of about <NUM> degrees to about <NUM> degrees.

In some examples, the present surgical system includes a distractor configured for parallel distraction of selected vertebrae. In some examples, the distractor includes an adaptor engageable with the implant supports. In some examples, multi-axial bone screw receivers are utilized to facilitate connection of the implant supports with the adaptors.

In some examples, one or all of the components of the surgical system are disposable, peel-pack, pre-packed sterile devices used 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 with multiple sized and configured components.

In some examples, the present disclosure may be employed to treat spinal disorders such as, for example, degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis, kyphosis, and other curvature abnormalities, tumor and fractures. In some examples, the present disclosure may be employed with other osteal and bone related applications, including those associated with diagnostics and therapeutics. In some examples, the disclosed surgical system and methods may be alternatively employed in a surgical treatment with a patient in a prone or supine position, and/or employ various surgical approaches to the spine, including posterior and/or posterior mid-line and in other body regions. The present disclosure may also be alternatively employed with procedures for treating the lumbar, cervical, thoracic, sacral and pelvic regions of a spinal column. The system and methods of the present disclosure may also be used on animals, bone models and other non-living substrates, such as, for example, in training, testing and demonstration.

The present disclosure may be understood more readily by reference to the following detailed description of the embodiments taken in connection with the accompanying drawing figures, which form a part of this disclosure.

The following discussion includes a description of a surgical system and related methods of employing the surgical system (the methods not claimed) in accordance with the principles of the present invention.

Alternate embodiments are disclosed. Reference is made to the embodiments of the present invention which are illustrated in the accompanying figures. Turning to <FIG>, there are illustrated components of a surgical system <NUM>.

The components of surgical system <NUM> can be fabricated from biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and bone material and/or their composites. For example, the components of surgical system <NUM>, individually or collectively, can be fabricated from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, Grade <NUM> titanium, super-elastic titanium alloys, cobalt-chrome alloys, superelastic metallic alloys (e.g., Nitinol, super elasto-plastic metals), ceramics and composites thereof such as calcium phosphate (e.g., SKELITETM), thermoplastics such as polyaryletherketone (PAEK) including polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO4 polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers, elastomeric composites, rigid polymers including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy, bone material including autograft, allograft, xenograft or transgenic cortical and/or corticocancellous bone, and tissue growth or differentiation factors, partially resorbable materials, such as, for example, composites of metals and calcium-based ceramics, composites of PEEK and calcium based ceramics, composites of PEEK with resorbable polymers, totally resorbable materials, such as, for example, calcium based ceramics such as calcium phosphate, tri-calcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate, or other resorbable polymers such as polyaetide, polyglycolide, polytyrosine carbonate, polycaroplaetohe and their combinations.

Surgical system <NUM> is employed, for example, with a minimally invasive procedure, including percutaneous techniques, mini-open and open surgical techniques to deliver and introduce instrumentation and/or components of spinal constructs at a surgical site within a patient body of a patient, for example, a section of a spine. In some embodiments, one or more of the components of surgical system <NUM> are configured for engagement with spinal constructs attached with vertebrae to manipulate tissue and/or correct a spinal disorder, such as, for example, a sagittal deformity, as described herein. In some embodiments, surgical system <NUM> may be employed with surgical procedures, such as, for example, corpectomy, discectomy and/or fracture/trauma treatment and may include fusion and/or fixation that employ implants to restore the mechanical support function of vertebrae.

Surgical system <NUM> includes an extender, such as, for example, an implant support <NUM> and an implant support 14a (<FIG>), similar to implant support <NUM>, as described herein, and a sleeve <NUM> (<FIG>), both engageable with separate and spaced apart bone screws <NUM> (<FIG> and <FIG>). Implant supports <NUM>, 14a are connectable to surgical instruments, such as, for example, a distractor <NUM> (<FIG>) and/or a compression instrument <NUM> to facilitate manipulation of tissue, as described herein.

Implant support <NUM> extends along an axis X1, as shown in <FIG>. Implant support <NUM> includes a first extension <NUM> and a second extension <NUM>, as shown in <FIG>. Extensions <NUM>, <NUM> are moveable relative to each other, via relative translation of a translation element, such as, for example, a slide <NUM> disposed with implant support <NUM>, as shown in <FIG>. Slide <NUM> is manipulated for translation within a channel <NUM> to move extensions <NUM>, <NUM> between an open orientation and a closed, capture orientation. Slide <NUM> is translated, in a direction shown by arrow A in <FIG>, to cause extensions <NUM>, <NUM> to rotate and expand, in a direction shown by arrows B, to the open orientation. In the open orientation, pins <NUM>, connected with extensions <NUM>, <NUM>, are disposed in a bottom of slots <NUM> of slide <NUM>. Slide <NUM> is translated, in a direction shown by arrow C in <FIG>, to cause extensions <NUM>, <NUM> to rotate and contract, in a direction shown by arrows D, to the closed orientation to capture a wall <NUM> of a receiver <NUM> of bone screw <NUM>, as shown in <FIG>. In the closed orientation, pins <NUM> are disposed at the top of slots <NUM>. In some embodiments, extensions <NUM>, <NUM> are flexible to facilitate contraction.

Implant support <NUM> is connected with wall <NUM>, as described herein in connection with <FIG> and <FIG>, so as to not block direct access to an implant cavity (between walls <NUM> and <NUM>) of receiver <NUM> to facilitate insertion of an implant, such as a spinal rod, and perhaps also a securing device, such as a set cap or setscrew.

In some embodiments, one or more implant supports <NUM> are manipulable, as described herein, to provide a counter-torque for small deformity maneuvers and manipulation of vertebrae during a surgical treatment, for example, to displace, pull, twist or align vertebrae.

Referring again to <FIG> and <FIG>, sleeve <NUM> is connectable with implant support <NUM> and wall <NUM>. Sleeve <NUM> includes a body <NUM> extending between a first end <NUM> and a second end <NUM>. Body <NUM> extends along implant support <NUM>. End <NUM> includes a first flange <NUM> and a second, opposing, flange <NUM> having corresponding mating surfaces defining a mating channel <NUM>. Each surface may include a mating groove <NUM> formed therein. Mating grooves <NUM>, or at least flanges <NUM>, <NUM>, are configured for disposal of a proximal portion of implant support <NUM>, as shown in <FIG>.

In various embodiments, flanges <NUM>, <NUM> are flexible such that flanges <NUM>, <NUM> snap fit around and into engagement with implant support <NUM>. Upon disposal of implant support <NUM> with flanges <NUM>, <NUM>, sleeve <NUM> is disposed in a configuration to capture a wall <NUM> of receiver <NUM>, as shown in <FIG>.

End <NUM> includes a surface <NUM> that defines a mating surface <NUM>. Surface <NUM> is configured for capture of wall <NUM>. In various embodiments, surface <NUM> includes a distal projection <NUM> configured for engagement with a cavity <NUM> (<FIG>) of wall <NUM> of receiver <NUM> to facilitate engagement.

With continued reference to <FIG>, bone screw <NUM> includes a shaft <NUM> and receiver <NUM>. Receiver <NUM> is moveable relative to shaft in a multi axial configuration. Receiver <NUM> is configured for engagement with implant support <NUM> and sleeve <NUM>, as described herein. At least one of the walls <NUM>, <NUM> includes a surface that defines cavity <NUM> (<FIG>). Each cavity <NUM> can be used to facilitate connection with implant support <NUM> and/or sleeve <NUM>, as described herein. Walls <NUM>, <NUM> include an inner surface that defines a U-shaped passageway <NUM> for disposal of a spinal rod, as described herein. The inner surface of receiver <NUM> includes a thread form configured for engagement with a set screw.

In assembly, operation and use, surgical system <NUM>, similar to the systems and methods described herein, is employed with a surgical procedure, for treatment of a spine of a patient including vertebrae V, as shown in FIGS. <NUM>-<NUM>. Surgical system <NUM> may also be employed with surgical procedures, such as, for example, discectomy, laminectomy, fusion, laminotomy, laminectomy, nerve root retraction, foramenotomy, facetectomy, decompression, spinal nucleus or disc replacement and bone graft and implantable prosthetics including plates, rods, and bone engaging fasteners.

Surgical system <NUM> is employed with a procedure for treatment of an applicable condition or injury of an affected section of a spinal column and adjacent areas within a body. For example, vertebrae V includes a vertebral level V1, a vertebral level V2 and a vertebral level V3, as shown in FIG. Diseased and/or damaged vertebrae and intervertebral discs are disposed at vertebra V2 between vertebrae V1 and V3. In some examples, components of surgical system <NUM> are configured for insertion with a vertebral space to space apart articular joint surfaces, provide support and maximize stabilization of vertebrae V.

In use, to treat the affected section of vertebrae V, a medical practitioner obtains access to a surgical site including vertebrae V in any appropriate manner, such as through incision and retraction of tissues. In some examples, surgical system <NUM> may be used in any existing surgical method or technique including open surgery, mini-open surgery, minimally invasive surgery and percutaneous surgical implantation, whereby vertebrae V is accessed through a mini-incision, or sleeve that provides a protected passageway to the area.

An incision is made in the body of a patient and a cutting instrument (not shown) creates a surgical pathway for implantation of components of surgical system <NUM>. A preparation instrument (not shown) can be employed to prepare tissue surfaces of vertebrae V, as well as for aspiration and irrigation of a surgical region.

Pilot holes or the like are made in selected vertebrae V1 and V3 for receiving bone screws <NUM>. Implant supports <NUM>, 14a are engaged with wall <NUM> of receiver <NUM>, as described herein. Sleeves <NUM> are engaged with wall <NUM> of receiver <NUM>, as described herein. Mating grooves <NUM>, <NUM> are engaged with implant support <NUM>, as described herein. A driver <NUM> is disposed adjacent vertebrae V at a surgical site and is manipulated to drive, torque, insert or otherwise connect bone screw <NUM> with vertebrae.

A distractor <NUM>, as shown in <FIG>, is connected with implant supports <NUM>, 14a, to allow for distraction of vertebrae V connected with bone screws <NUM>. Distractor <NUM> includes a longitudinal element, such as, for example, a rack <NUM> extending between an end <NUM> and an end <NUM>. Rack <NUM> is configured to connect adjacent implant supports <NUM>, 14a. Rack <NUM> includes an outer surface <NUM> having a plurality of teeth, such as, for example, splines <NUM> engageable with an arm <NUM>, as described herein. Rack <NUM> includes an arm <NUM> extending from end <NUM>. In some embodiments, arm <NUM> is attached with rack <NUM> with, for example, with clips, hooks, adhesives and/or flanges.

Arm <NUM> includes a member, such as, for example, an adaptor <NUM> extending between an end <NUM> and an end <NUM>. Adaptor <NUM> includes a surface <NUM> and walls <NUM> that defines a receiver <NUM> extending between ends <NUM>, <NUM>. Receiver <NUM> is configured for disposal of implant support 14a. Adaptor <NUM> includes a rectangular cross section configuration, as shown in <FIG>. In some embodiments, all or only a portion of the cross section of adaptor <NUM> may have alternate cross section configurations, such as, for example, arcuate, closed, V-shaped, W-shaped, oval, oblong triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and/or tapered.

Rack <NUM> includes arm <NUM> that is axially translatable relative to arm <NUM>. Arm <NUM> includes a member, such as, for example, an adaptor <NUM> extending between an end <NUM> and an end <NUM>. Adaptor <NUM> includes a surface <NUM> and walls <NUM> that define a receiver <NUM> extending between ends <NUM>, <NUM>. Receiver <NUM> is configured for disposal of implant support <NUM>. Adaptor <NUM> includes a rectangular cross section configuration, as shown in <FIG>. In some embodiments, all or only a portion of the cross section of adaptor <NUM> may have alternate cross section configurations, such as, for example, arcuate, closed, V-shaped, W-shaped, oval, oblong triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and/or tapered.

For distraction, implant support <NUM> is disposed with adaptor <NUM> and implant support 14a is disposed with adaptor <NUM>, as shown in <FIG>. Bone screws <NUM> with multi-axial receivers <NUM> facilitate manipulation of implant supports <NUM>, 14a for engagement with adaptors <NUM>, <NUM>. Rack <NUM> includes a latch <NUM> that is pivotable relative to arm <NUM> for disposal in a distraction position, as shown in <FIG>. In the distraction position, latch <NUM> engages rack <NUM> to allow axial and/or incremental translation of arm <NUM> relative to arm <NUM>/rack <NUM> and prevents axial translation of arm <NUM> relative to arm <NUM>/rack <NUM>, in an opposing direction. For example, latch <NUM> is pivotable to the distraction position, as described herein, to allow translation of arm <NUM>, in the direction shown by arrow E in <FIG>, and prevent translation of arm <NUM>, in the direction shown by arrow F, relative to arm <NUM>/rack <NUM>. As such, distraction of vertebrae V1, V3, which are connected with implant supports <NUM>, 14a, can be performed.

In some embodiments, a dilator (not shown) is inserted between implant supports <NUM>, 14a into contact with bony anatomy and determine tissue depth. In some embodiments, a retractor blades (not shown) are translated along the dilator into engagement with the bony anatomy. The blades are disposed with tissue to form a surgical passageway to facilitate insertion of a spinal implant, such as, for example, an interbody spinal implant.

In some embodiments, a rod inserter (not shown) is engaged with a spinal rod <NUM> to direct and/or guide spinal rod <NUM> through implant supports <NUM>, 14a into receiver <NUM>. Sleeve <NUM> is disengaged from implant support <NUM>, as shown in <FIG>. A driver (not shown) is utilized to engage a set screw <NUM> with bone screw <NUM> to fix one end of spinal rod <NUM> disposed with bone screw <NUM> connected with implant support <NUM>, as shown in <FIG>.

Implant supports <NUM>, 14a are crossed and a compression instrument <NUM> is disposed with implant supports <NUM>, 14a, as shown in <FIG>. Instrument <NUM> is configured to facilitate compression of vertebrae V via connection with implant supports <NUM>, 14a. Instrument <NUM> includes a member, such as, for example, a pivot body <NUM> configured to facilitate rotation of implant support 14a relative to body <NUM>. Body <NUM> extends between an end <NUM> and an end <NUM> and defines an axis X10. Body <NUM> includes a surface <NUM> that defines a cavity, such as, for example, an opening <NUM>. Opening <NUM> extends between end <NUM> and end <NUM>. Opening <NUM> is configured for disposal with a proximal end of implant support <NUM>.

Body <NUM> includes a lock, such as, for example a pair of depressible buttons <NUM> configured connection with implant support <NUM>. Buttons <NUM> are disposable between a lock or locking orientation and a non-locking orientation. In the lock orientation, buttons <NUM> releasably fix body <NUM> with implant support <NUM>. In the non-locking orientation, body <NUM> is translatable and/or removable from implant support <NUM>. Button <NUM> may be spring biased to a locked position, such as by a projection <NUM> defined by button <NUM> being biased in the lock orientation into engagement with a groove <NUM>, shown in <FIG>, of implant support <NUM> to releasably fix implant support <NUM> with body <NUM>. Buttons <NUM> are configured to resist and/or prevent body <NUM> from disengaging from implant support <NUM>. In some embodiments, an outer surface of body <NUM> includes one or a plurality of buttons <NUM>. In some embodiments, body <NUM> may include ridges to facilitate gripping of body <NUM>, for example, to manipulate body <NUM> relative to implant support <NUM>, as described herein.

End <NUM> includes arms <NUM>. Arms <NUM> include a surface <NUM> that define a receiver <NUM>. Arms <NUM> extend transverse to axis X10. In some embodiments, arms <NUM> may be variously oriented relative to axis X10, such as, for example, perpendicular, angular and/or offset. Receiver <NUM> is configured for engagement with implant support 14a. In some embodiments, surface <NUM> defines a cavity having a concave configuration to facilitate engagement with a surface of implant support 14a to facilitate crossing of implant support 14a with implant support <NUM>. In some embodiments, receiver <NUM> may include alternate configurations, such as, for example, arcuate, offset, staggered and/or angled portions.

Body <NUM> includes a housing <NUM>. Housing <NUM> includes a surface <NUM> that defines an opening, such as, for example, a passageway <NUM>. Passageway <NUM> is configured for moveable disposal of an actuator <NUM> and a part, such as, for example, a slider <NUM>. Surface <NUM> includes a thread form (not shown) engageable with actuator <NUM> to facilitate translation of slider <NUM>, as described herein. Actuator <NUM> includes a shaft <NUM> that extends between an end <NUM> and an end <NUM>. Shaft <NUM> includes a threaded surface <NUM> engageable with surface <NUM> to facilitate translation. End <NUM> includes a knob <NUM> to facilitate rotation of actuator <NUM>. End <NUM> includes slider <NUM>.

Slider <NUM> includes arms <NUM>. Arms <NUM> include a surface <NUM> that define a receiver <NUM>. Arms <NUM> extend transverse to shaft <NUM>. In some embodiments, arms <NUM> may be variously oriented relative to shaft <NUM>, such as, for example, perpendicular, angular and/or offset. Receiver <NUM> is configured for engagement with implant support 14a. In some embodiments, surface <NUM> defines a cavity having a concave configuration to facilitate engagement with a surface of implant support 14a. Slider <NUM> is actuated to translate along implant support <NUM> causing rotation of implant support 14a within receiver <NUM> to facilitate compression of vertebrae. In some embodiments, receiver <NUM> may include alternate configurations, such as, for example, arcuate, offset, staggered and/or angled portions.

To compress vertebrae V, body <NUM> is translated over implant support <NUM>, as shown by arrow G in <FIG>, such that implant support <NUM> is disposed with opening <NUM>. Buttons <NUM> snap into the lock position to fix instrument <NUM> with implant support <NUM>. Slider <NUM> is disposed in an initial orientation such that receivers <NUM>, <NUM> are disposed adjacent each other. Implant support 14a is disposed with receivers <NUM>, <NUM>, as shown in <FIG>, such that implant supports <NUM>, 14a are captured by receivers <NUM>, <NUM>. In some embodiments, receivers <NUM> are disposed a relative distance D1. In some embodiments, distance D1 is about <NUM>. In some embodiments, shafts <NUM> are disposed at a relative angle α1. In some embodiments, angle α1 is about <NUM> degrees.

Actuator <NUM> is rotated, as shown by arrow H in <FIG>, causing threaded shaft <NUM> to engage the threaded surface of housing <NUM>. Rotation of shaft <NUM> causes slider <NUM> to translate, in a direction shown by arrow I in <FIG>. Slider <NUM> translates along implant support 14a causing further selective compression of vertebrae V. Receiver <NUM> translates causing rotation of implant support 14a relative to instrument <NUM>. For example, receivers <NUM> are disposed a relative distance D2. In some embodiments, distance D2 is about <NUM>. In some embodiments, shafts <NUM> are disposed at a relative angle α2. In some embodiments, angle α2 is about <NUM> degrees.

Actuator <NUM> is further rotated, as shown by arrow J in <FIG>, causing threaded shaft <NUM> to engage the threaded surface of housing <NUM>. Rotation of shaft <NUM> causes slider <NUM> to translate, in a direction shown by arrow K in <FIG>. Slider <NUM> translates along implant support 14a causing selective compression of vertebrae V. Receiver <NUM> translates away from receiver <NUM> causing rotation of implant support 14a relative to instrument <NUM>. For example, receivers <NUM> are disposed a relative distance D3. In some embodiments, distance D3 is about <NUM>. In some embodiments, shafts <NUM> are disposed at a relative angle α3. In some embodiments, angle α3 is about <NUM> degrees. Compression instrument <NUM> and implant supports <NUM> are removed, as shown in <FIG>. Spinal rod is fixed with bone screws <NUM>.

Upon completion of a procedure, as described herein, the surgical instruments, assemblies and non-implanted components of surgical system <NUM> are removed and the incision(s) are closed. One or more of the components of surgical system <NUM> can be made of radiolucent materials such as polymers. Radiomarkers may be included for identification under x-ray, fluoroscopy, CT or other imaging techniques. In some embodiments, the use of surgical navigation, microsurgical and image guided technologies may be employed to access, view and repair spinal deterioration or damage, with the aid of surgical system <NUM>. In some embodiments, surgical system <NUM> may include one or a plurality of plates, connectors and/or bone fasteners for use with a single vertebral level or a plurality of vertebral levels.

In some embodiments, surgical system <NUM> includes one or a plurality of alternate surgical instruments, each configured for mating engagement in a quick release configuration with spinal constructs, as described herein. This configuration facilitates the interchangeability of the spinal constructs with the alternate surgical instruments. In some embodiments, surgical system <NUM> includes one or a plurality of alternate surgical instruments, such as, for example, inserters, extenders, reducers, spreaders, distractors, blades, retractors, clamps, forceps, elevators and drills, which may be alternately sized and dimensioned, and arranged as a kit.

Claim 1:
A surgical compression instrument (<NUM>) configured to facilitate compression of vertebrae (V) via connection with first and second implant supports (<NUM>, 14a) and comprising:
a member (<NUM>) configured for disposal longitudinally along the first implant support (<NUM>) for pivotably connecting the first implant support (<NUM>) to the second implant
support (14a), the first implant support (<NUM>) being engageable with a first receiver (<NUM>) of a first fastener (<NUM>) having a first shaft (<NUM>) fixed with vertebral tissue and the second implant support (14a) being engageable with a second receiver (<NUM>) of a second fastener (<NUM>) having a second shaft (<NUM>) fixed with vertebral tissue; and
a slider (<NUM>) being axially translatable relative to the member (<NUM>) and engageable with the implant supports (<NUM>, 14a) such that the second implant support (14a) moves relative to the first implant support (<NUM>) to compress the vertebral tissue,
wherein the member (<NUM>) includes an actuator (<NUM>) that translates the slider (<NUM>), wherein the actuator (<NUM>) includes a threaded surface engageable with a body of the member (<NUM>) to translate the slider (<NUM>).