Surgical cord tensioning devices, systems, and methods

A method for positioning and tensioning a surgical cord in spinal implants, the method comprising:

• receiving a proximal end of the surgical cord through an auxiliary surgical port disposed through an incision, wherein a distal end of the surgical cord is secured within a first spinal implant;
• threading the surgical cord into a tensioning system including a tensioner and a tensioner extension, the tensioner extension including a flexible elongate body and a distal nose member;
• maneuvering the flexible elongate body along a first length of the surgical cord until the distal nose member is adjacent a second spinal implant, while a proximal end of the tensioner extension and the tensioner remain outside the auxiliary surgical port;
• positioning the surgical cord into the second spinal implant;
• and
• tensioning the surgical cord between the first spinal implant and the second spinal implant using the tensioning system.

A spinal tethering procedure comprising:

• securing a tether in a first spinal implant;
• inserting an auxiliary surgical access device through an incision;
• maneuvering a proximal end of the tether out of a body cavity through the auxiliary surgical access device;
• threading the proximal end of the tether into a tensioning system, the tensioning system including a flexible elongate member;
• positioning a distal end of the flexible elongate member adjacent a second spinal implant to insert a portion of the tether into the second spinal implant, wherein positioning the distal end of the flexible elongate member adjacent the second spinal implant includes using a counter tensioner to assist in positioning the portion of the tether into the second spinal implant;
• and
• tensioning the tether between the first spinal implant and the second spinal implant using the tensioning system.

A spinal tethering procedure comprising:

• securing a tether in a first spinal implant;
• inserting an auxiliary surgical access device through an incision;
• maneuvering a proximal end of the tether out of a body cavity through the auxiliary surgical access device;
• axially threading the proximal end of the tether into a tensioning system along a length of a flexible elongate member from a first surgical access device;
• positioning a distal end of the flexible elongate member adjacent a second spinal implant to insert a portion of the tether into the second spinal implant;
• and
• tensioning the tether between the first spinal implant and the second spinal implant using the tensioning system.