Methods and devices for polyaxial screw alignment

1. A polyaxial screw alignment instrument, comprising:

an elongate frame having a longitudinal axis extending therethrough;

a plurality of connection caps slidably disposed along the elongate frame, each connection cap being configured to removably couple to a polyaxial screw extension tube and to selectively lock relative to the elongate frame such that a distance between the plurality of connection caps and an angular orientation of each connection cap relative to the elongate frame is maintained; and

a transverse angle indicator that is coupled to the elongate frame such that the transverse angle indicator can rotate about the longitudinal axis of the elongate frame to indicate an angular orientation of the elongate frame in a plane transverse to the longitudinal axis of the elongate frame;

wherein the transverse angle indicator comprises a bubble level coupled to the elongate frame.

2. The instrument of claim 1 , wherein the plane is perpendicular to the longitudinal axis of the elongate frame.

3. The instrument of claim 1 , wherein each of the plurality of connection caps includes a thumbscrew configured to selectively lock the connection cap relative to the elongate frame when tightened.

4. A polyaxial screw alignment system, comprising:

a plurality of polyaxial screws having a threaded shank and a receiving member coupled to the threaded shank that can move polyaxially with respect to the threaded shank;

a plurality of extension tubes, each extension tube configured to be coupled to the receiving member of one of the plurality of polyaxial screws such that a longitudinal axis of the extension tube and a longitudinal axis of the receiving member are maintained in a coaxial orientation;

a plurality of alignment shafts, each alignment shaft configured to be coupled to one of the plurality of polyaxial screws such that a longitudinal axis of the threaded shank and a longitudinal axis of the receiving member are maintained in a coaxial orientation; and

a polyaxial screw alignment instrument having an elongate frame and a plurality of connection caps slidably disposed thereon, each connection cap configured to be coupled to a proximal end of one of the plurality of extension tubes and selectively locked relative to the elongate frame to maintain a distance between the plurality of connection caps and an angular orientation of each of the connection caps relative to the elongate frame; and

a transverse angle indicator that is coupled to the elongate frame such that the transverse angle indicator can rotate about a longitudinal axis of the elongate frame to indicate an angular orientation of the elongate frame of the polyaxial screw alignment instrument in a plane transverse to the longitudinal axis of the elongate frame;

wherein the transverse angle indicator comprises a bubble level coupled to the elongate frame.

5. The system of claim 4 , wherein each of the plurality of alignment shafts threadably engages with the receiving member of one of the plurality of polyaxial screws.

6. The system of claim 5 , wherein each of the plurality of alignment shafts includes a protrusion formed on a distal end thereof that interfaces with a recess formed in the threaded shank of the polyaxial screw.

7. A method of aligning polyaxial screws, comprising:

coupling a plurality of extension tubes to receiving members of a plurality of polyaxial screws;

coupling a plurality of alignment shafts to the plurality of polyaxial screws such that each alignment shaft maintains a longitudinal axis of a receiving member and a longitudinal axis of a threaded shank of one of the plurality of polyaxial screws in a coaxial orientation;

coupling a polyaxial screw alignment instrument to proximal ends of the plurality of extension tubes and selectively locking the polyaxial screw alignment instrument to indicate a distance between and an angular orientation of each of the plurality of extension tubes relative to a longitudinal axis of the polyaxial screw alignment instrument; and

rotating a transverse angle indicator about the longitudinal axis of the polyaxial alignment instrument to indicate an angular orientation of the polyaxial screw alignment instrument in a plane transverse to the longitudinal axis of the polyaxial screw alignment instrument;

wherein the transverse angle indicator comprises a bubble level coupled to the polyaxial alignment instrument.

8. The method of claim 7 , further comprising:

removing the polyaxial screw alignment instrument from the proximal ends of the plurality of extension tubes;

removing the plurality of alignment shafts from the plurality of polyaxial screws;

passing a spinal fixation element through the receiving member of at least one of the plurality of polyaxial screws; and

re-coupling the polyaxial screw alignment instrument to the proximal ends of the plurality of extension tubes to return each of the plurality of polyaxial screws to an orientation wherein a longitudinal axis of the receiving member and a longitudinal axis of the threaded shank are coaxial.

9. The method of claim 8 , further comprising inserting a set screw into each of the plurality of polyaxial screws after re-coupling the polyaxial screw alignment instrument to maintain the coaxial orientation of the receiving member and the threaded shank.

10. The method of claim 7 , wherein the plurality of polyaxial screws comprise two polyaxial screws implanted bilaterally in a patient's vertebra.