Spinal instrument and method

Abstract

A surgical instrument comprises a first member defining a cavity and including a locking surface disposed with the cavity. The locking surface is engageable with a longitudinal member to fix a tether with the first member. A second member includes an inner surface that defines a longitudinal passageway configured for disposal of a surgical driver engageable with a spinal construct. The second member further includes at least one mating element being engageable with the spinal construct. An actuator is connected with the members and is configured to incrementally tension the tether. Systems, implants and methods are disclosed.

1 - 20 . (canceled) 
     
     
         21 . A surgical instrument comprising:
 a first member comprising a cavity and a locking surface disposed with the cavity, the locking surface being engageable with a tether to fix the tether with the first member;   a second member comprising a longitudinal passageway; and   an actuator comprising a channel, the second member being positioned in the channel, the actuator being coaxial with the passageway and configured to incrementally tension the tether.   
     
     
         22 . The surgical instrument recited in  claim 21 , further comprising the tether, wherein the first member comprises a lever, the lever including the locking surface, the locking surface being movable between a non-locked orientation in which the tether is movable relative to the locking surface and a locked orientation in which teeth of the locking surface engage the tether to fix the tether with the first member. 
     
     
         23 . The surgical instrument recited in  claim 21 , wherein the first member comprises a lever, the lever including a first end and a second end, the second end including the locking surface, the locking surface being a rotatable cam. 
     
     
         24 . The surgical instrument recited in  claim 21 , wherein the actuator comprises opposite proximal and distal end surfaces, the second member comprising a circumferential flange, the distal end surface engaging the circumferential flange such that the circumferential flange movably supports the actuator. 
     
     
         25 . The surgical instrument recited in  claim 21 , further comprising the tether, wherein the second member comprises a threaded outer surface, the actuator comprising a threaded inner surface that engages the threaded outer surface such that rotation of the actuator relative to the second member translates the second member relative to the first member to increase and decrease tension in the tether. 
     
     
         26 . The surgical instrument recited in  claim 21 , further comprising a coupling member positioned within the passageway and a surgical driver disposed within the passageway such that the surgical driver engages the coupling member. 
     
     
         27 . The surgical instrument recited in  claim 26 , wherein the surgical driver is rotatable relative to the second member. 
     
     
         28 . The surgical instrument recited in  claim 26 , wherein the coupling member has a break off portion. 
     
     
         29 . The surgical instrument recited in  claim 21 , wherein the second member includes an outer sleeve and an inner sleeve. 
     
     
         30 . A surgical system comprising:
 a tether;   a surgical instrument comprising:
 a first member comprising a cavity and a locking surface disposed with the cavity, the locking surface being engageable with a tether to fix the tether with the first member, 
 a second member comprising a longitudinal passageway, and 
 an actuator comprising a channel, the second member being positioned in the channel, the actuator being coaxial with the passageway and configured to incrementally tension the tether; 
   a coupling member positioned within the passageway; and   a surgical driver disposable with the passageway and engageable with the coupling member.   
     
     
         31 . The surgical system recited in  claim 30 , wherein the first member comprises a lever, the lever including the locking surface, the locking surface being movable between a non-locked orientation in which the tether is movable relative to the locking surface and a locked orientation in which teeth of the locking surface engage the tether to fix the tether with the first member. 
     
     
         32 . The surgical system recited in  claim 30 , wherein the actuator comprises opposite proximal and distal end surfaces, the second member comprising a circumferential flange, the distal end surface engaging the circumferential flange such that the circumferential flange movably supports the actuator. 
     
     
         33 . The surgical system recited in  claim 30 , wherein the second member comprises a threaded outer surface, the actuator comprising a threaded inner surface that engages the threaded outer surface such that rotation of the actuator relative to the second member translates the second member relative to the first member to increase and decrease tension in the tether. 
     
     
         34 . The surgical system recited in  claim 30 , further comprising a connector, the coupling member being connected to the connector. 
     
     
         35 . A method for treating a spine, the method comprising the steps of:
 connecting a tether with vertebrae;   connecting the tether to a surgical instrument, the surgical instrument including a first member having a locking surface, the locking surface being engageable with the tether, the surgical instrument including a second member that defines a longitudinal passageway and an actuator, the second member being positioned in a cavity of the actuator, the cavity of the actuator being coaxial with the passageway, the second member having a coupling member disposed in the passageway;   rotating the actuator relative to the second member to move the second member axially relative to the first member and tension the tether with the surgical instrument; and   guiding a surgical driver through the passageway for connection with the coupling member.   
     
     
         36 . The method recited in  claim 35 , further comprising the step of engaging the surgical instrument with a counter torque handle. 
     
     
         37 . The method recited in  claim 35 , wherein the coupling member includes a break off portion and further comprising the step of engaging the coupling member with the surgical driver. 
     
     
         38 . The method recited in  claim 35 , wherein the first member comprises a lever, the lever including the locking surface, and further comprising moving the locking surface from a non-locked orientation in which the tether is movable relative to the locking surface to a locked orientation in which teeth of the locking surface engage the tether to fix the tether with the first member. 
     
     
         39 . The method recited in  claim 35 , wherein the second member comprises a circumferential flange that movably supports the actuator and further comprising rotating the actuator relative to the flange to move the second member axially relative to the first member and tension the tether with the surgical instrument. 
     
     
         40 . The method recited in  claim 35 , wherein the coupling member is axially aligned with the longitudinal passageway.