Abstract: This disclosure describes spinal implants with anchoring elements including an aperture for delivery of injectable materials. In one aspect, a spinal implant includes a body defining one or more injection ports and one or more channels, the one or more injection ports configured to receive flowable material and to provide the flowable material to the one or more channels; and one or more anchoring elements protruding from a surface of the body, the one or more anchoring elements each defining an aperture coupled to the one or more channels and configured to receive the flowable material from the one or more channels and to provide/output the flowable material from the aperture.

Abstract: A surgical screw system and device with a screw head having multiple insertion engagement features. The screw preferably a tubular body having a first end and a closed second end, wherein the head configured to engage with a diiver to advance the screw into the bone. The head of the screw has at least two different insertion features, such as a cross shaped insertion feature and a hexalobe shaped insertion. The screw can be advanced or removed via a driver that mates with the cross shaped or the hexalobe shaped insertion features.

Abstract: A matrix for tissue growth includes: (a) a first layer including a first assembly of collagen fibers; (b) a plurality of projections on a top surface of the first layer; and (c) a second layer bonded to a bottom portion of the first layer and including a second assembly of collagen fibers, wherein the second layer has a lower density than the first layer, and the matrix includes pores effective to support cell growth into the matrix. A method for providing the matrix is also described.