Abstract: An instrument is configured for use with a receiving part defining a recess for receiving a rod to connect the rod to a bone anchoring element. The instrument includes a tube having a first end and a second end, and defining a coaxial internal channel that opens towards the first and second ends, and at least one protruding portion monolithically formed with the tube that is engageable with the recess of the receiving part to prevent rotational movement of the tube relative to the receiving part. The first end of the tube forms a closed ring. The at least one protruding portion has a first region that extends radially outwardly from an outer surface of the tube at the first end and a second region that extends axially away from the first end in a direction opposite the second end.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element includes a receiving part having a first end, a second end, a recess having a bottom for receiving the rod, and an accommodation space having an opening at the second end of the receiving part for accommodating a head of the bone anchoring element, and a retainer element configured to be inserted into the receiving part from the first end and to hold at least part of the head, the retainer element having a first portion and a spring portion compressible in an axial direction attached to the first portion. When the retainer element is in the accommodation space in a first position, the spring portion extends in the axial direction from the first portion of the retainer element to an axial position between the first end of the receiving part and the bottom of the recess.

Abstract: A bone anchoring device for anchoring a rod to a bone or vertebra includes a receiving part with two legs defining a channel for the rod and a variable configuration member with a first rod contact surface configured to extend axially above a bottom of the channel to contact the rod. When a rod is inserted in the channel, the variable configuration member is adjustable from a first configuration where the first rod contact surface is at a first axial position relative to the receiving part and blocks the rod from contacting a second rod contact surface below the first rod contact surface, and a second configuration where the first rod contact surface is at a second axial position below the first axial position relative to the receiving part to permit the rod to contact the second rod contact surface.

Abstract: An instrument for use in surgery includes a hollow shaft connectable to a drive shaft of a bone anchor insertion device in a rotationally fixed manner, a needle holder configured to hold a needle and movable axially relative to the hollow shaft, an actuator rotatable relative to the hollow shaft, and a transmission member connectable to the needle holder and movable axially relative to the actuator. The transmission member is positionable around at least part of the hollow shaft and includes a first advancement surface engageable with a second advancement surface of the hollow shaft to convert a rotational movement of the actuator into axial movement of the needle holder relative to the hollow shaft for axially advancing and retracting the needle held by the needle holder.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element, and including a receiving part having a first end, a second end, and an accommodation space having an opening at the second end for inserting a head of the bone anchoring element, a pressure element insertable from the first end, positionable in the accommodation space, and configured to hold the head, the pressure element having at least one spring portion extending circumferentially around the pressure element and being radially compressible, and a rod receiving element separable from the pressure element, wherein in a first position, the spring portion is configured to engage an engagement structure at an inner wall of the receiving part to prevent movement of the pressure element towards the first end, and wherein the rod receiving element is configured to move the pressure element from the first position towards the second end.

Abstract: An instrument is configured for use with a receiving part defining a recess for receiving a rod to connect the rod to a bone anchoring element. The instrument includes a tube having a first end and a second end, and defining a coaxial internal channel that opens towards the first and second ends, and at least one protruding portion monolithically formed with the tube that is engageable with the recess of the receiving part to prevent rotational movement of the tube relative to the receiving part. The first end of the tube forms a closed ring. The at least one protruding portion has a first region that extends radially outwardly from an outer surface of the tube at the first end and a second region that extends axially away from the first end in a direction opposite the second end.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element, and including a receiving part having a first end, a second end, and an accommodation space having an opening at the second end for inserting a head of the bone anchoring element, a pressure element insertable from the first end, positionable in the accommodation space, and configured to hold the head, the pressure element having at least one spring portion extending circumferentially around the pressure element and being radially compressible, and a rod receiving element separable from the pressure element, wherein in a first position, the spring portion is configured to engage an engagement structure at an inner wall of the receiving part to prevent movement of the pressure element towards the first end, and wherein the rod receiving element is configured to move the pressure element from the first position towards the second end.

Abstract: An instrument for use in surgery includes a hollow shaft connectable to a drive shaft of a bone anchor insertion device in a rotationally fixed manner, a needle holder configured to hold a needle and movable axially relative to the hollow shaft, an actuator rotatable relative to the hollow shaft, and a transmission member connectable to the needle holder and movable axially relative to the actuator. The transmission member is positionable around at least part of the hollow shaft and includes a first advancement surface engageable with a second advancement surface of the hollow shaft to convert a rotational movement of the actuator into axial movement of the needle holder relative to the hollow shaft for axially advancing and retracting the needle held by the needle holder.

Abstract: A system for spine surgery includes a rod with a longitudinal axis and a connection portion, and a rod insertion device including a rod holding member with a central axis and a rod engagement portion, wherein at least part of a shape of the rod engagement portion substantially matches at least part of a shape of the connection portion to engage the connection portion in a fixed manner at more than one distinct rotational orientation around the longitudinal axis. When the connection portion is engaged with the rod engagement portion, when viewed in a plane perpendicular to the longitudinal axis, a cross-section of the connection portion has a maximum height measured in a direction of the central axis of the rod holding member that is greater than a maximum width of the connection portion measured in a direction transverse to the longitudinal axis.

Abstract: An instrument for locking and unlocking a head of a bone anchor relative to a receiving part of a polyaxial bone anchoring device includes a tube assembly with an inner tube and an outer tube at least partially around the inner tube, and an actuator assembly including an actuating mechanism movable from a first orientation to a second orientation to displace the inner tube and the outer tube relative to one another between a first axial position configured to unlock the bone anchoring device such that the head is pivotable relative to the receiving part, and a second axial position configured to lock the head. The actuator assembly is adjustable between a first configuration where the tube assembly assumes the first axial position when the actuating mechanism is moved, and a second configuration where the tube assembly assumes the second axial position when the actuating mechanism is moved.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element includes a receiving part having a first end, a second end, a recess having a bottom for receiving the rod, and an accommodation space having an opening at the second end of the receiving part for accommodating a head of the bone anchoring element, and a retainer element configured to be inserted into the receiving part from the first end and to hold at least part of the head, the retainer element having a first portion and a spring portion compressible in an axial direction attached to the first portion. When the retainer element is in the accommodation space in a first position, the spring portion extends in the axial direction from the first portion of the retainer element to an axial position between the first end of the receiving part and the bottom of the recess.

Abstract: A system for correcting a position of bones, bone parts, or vertebrae includes a first bone anchor including a shank for anchoring in bone and a receiver for connecting a rod to the shank, a second bone anchor including a shank for anchoring in bone and a receiver for connecting the rod to the shank, and an instrument including a positioning member, a first coupling member for coupling the positioning member to the first bone anchor, and a second coupling member for coupling the positioning member to the second bone anchor. The first and second coupling members are movable relative to one another. The receiver is pivotable relative to the shank for at least one bone anchor. The at least one bone anchor can assume a locked configuration where an angular position of the receiver relative to the shank is locked while the rod remains movable relative to the receiver.

Abstract: A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion.

Abstract: An instrument for use in surgery includes a hollow shaft connectable to a drive shaft of a bone anchor insertion device in a rotationally fixed manner, a needle holder configured to hold a needle and movable axially relative to the hollow shaft, an actuator rotatable relative to the hollow shaft, and a transmission member connectable to the needle holder and movable axially relative to the actuator. The transmission member is positionable around at least part of the hollow shaft and includes a first advancement surface engageable with a second advancement surface of the hollow shaft to convert a rotational movement of the actuator into axial movement of the needle holder relative to the hollow shaft for axially advancing and retracting the needle held by the needle holder.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element includes a receiving part having a first end, a second end, a recess having a bottom for receiving the rod, and an accommodation space having an opening at the second end of the receiving part for accommodating a head of the bone anchoring element, and a retainer element configured to be inserted into the receiving part from the first end and to hold at least part of the head, the retainer element having a first portion and a spring portion compressible in an axial direction attached to the first portion. When the retainer element is in the accommodation space in a first position, the spring portion extends in the axial direction from the first portion of the retainer element to an axial position between the first end of the receiving part and the bottom of the recess.

Abstract: A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion.

Abstract: A bone anchoring device for anchoring a rod to a bone or vertebra includes a receiving part with two legs defining a channel for the rod and a variable configuration member with a first rod contact surface configured to extend axially above a bottom of the channel to contact the rod. When a rod is inserted in the channel, the variable configuration member is adjustable from a first configuration where the first rod contact surface is at a first axial position relative to the receiving part and blocks the rod from contacting a second rod contact surface below the first rod contact surface, and a second configuration where the first rod contact surface is at a second axial position below the first axial position relative to the receiving part to permit the rod to contact the second rod contact surface.

Abstract: A surgical instrument is connectable to a bone anchor insertion device having a drive shaft that defines a coaxial channel for receiving a needle therethrough. The instrument includes a handle portion configured to be coupled to the drive shaft in a rotationally fixed manner to transmit torque to the drive shaft, a needle holder configured to hold a needle and movable axially relative to the handle portion, an actuator rotatable relative to the handle portion, and a transmission member connectable to the needle holder and movable axially relative to the actuator and comprising a first advancement surface engageable with a second advancement surface of the handle portion to convert rotational movement of the actuator into axial movement of the needle holder relative to the handle portion for axially advancing and retracting a needle held by the needle holder relative to the handle portion.

Abstract: An anchoring member for a polyaxial bone anchoring device includes a bone anchoring section having a first end, a second end, and a bone engagement structure, a head having an outer surface portion that defines a segment of a sphere, wherein a central axis extends through the head and the first and second ends of the bone anchoring section, and a neck extending between the first end of the bone anchoring section and the head. The neck has a first portion and a second portion between the first portion and the bone anchoring section. In at least a first cross-sectional plane including the central axis, the first portion of the neck is concave with a first curvature, and the second portion of the neck is concave with a second curvature that is less curved than the first curvature.

Abstract: A system for spine surgery includes a rod with a longitudinal axis and a connection portion, and a rod insertion device including a rod holding member with a central axis and a rod engagement portion, wherein at least part of a shape of the rod engagement portion substantially matches at least part of a shape of the connection portion to engage the connection portion in a fixed manner at more than one distinct rotational orientation around the longitudinal axis. When the connection portion is engaged with the rod engagement portion, when viewed in a plane perpendicular to the longitudinal axis, a cross-section of the connection portion has a maximum height measured in a direction of the central axis of the rod holding member that is greater than a maximum width of the connection portion measured in a direction transverse to the longitudinal axis.