Abstract: A system includes a tensioner, a tension indicator, a tensioner extension, and a counter tensioner. The tensioner may include a nose, a reel with cord retention notches and cord alignment grooves configured to hold and tension a cord. The tension indicator may include a spring in a housing having a window with cord tension indications and an aperture for receiving the cord. The counter tensioner may be releasably couplable to a head of an implant at a proximal end thereof via an internal sleeve with a live spring with a pin to engage a mating feature on the head of the implant. The counter tensioner may guide the cord to a port proximate the distal end thereof, the port for receiving nose of the tensioner. The counter tensioner may enable translation of the implant relative to another implant implanted in an adjacent or nearby vertebrae.

Abstract: Various implants and surgical techniques for dynamic spinal tethering systems are discussed. In an example, a spinal tethering system can comprise a flexible elongate spinal tethering cord and a plurality of vertebral implants connecting the cord across at least four spinal levels. In this example, each vertebral implant of the plurality of vertebral implants can include a dynamic head coupling each vertebral implant to the cord. The dynamic head of each vertebral implant can be configured to share cord tension across multiple spinal levels by releasing a first tension generated at a first level between two vertebral implants of the plurality of vertebral implants to generate a second tension across two spinal levels between three vertebral implants of the plurality of vertebral implants, wherein the second tension is lower than the first tension.

Abstract: A bone anchor and system for applying tension via a tether or cord between bone anchors is provided. An illustrative bone anchor includes a screw having a head and a shank, where the shank defines a screw axis. The bone anchor further includes a connector attachable to the head of the screw, where the connector is configured to receive and secure a cord to the bone anchor.

Abstract: Various implants and surgical techniques for dynamic spinal tethering systems are discussed. In an example, a spinal tethering system can comprise a flexible elongate spinal tethering cord and a plurality of vertebral implants connecting the cord across at least four spinal levels. In this example, each vertebral implant of the plurality of vertebral implants can include a dynamic head coupling each vertebral implant to the cord. The dynamic head of each vertebral implant can be configured to share cord tension across multiple spinal levels by releasing a first tension generated at a first level between two vertebral implants of the plurality of vertebral implants to generate a second tension across two spinal levels between three vertebral implants of the plurality of vertebral implants, wherein the second tension is lower than the first tension.

Abstract: Various implants and surgical techniques for dynamic spinal tethering systems are discussed. In an example, a spinal tethering system can comprise a flexible elongate spinal tethering cord and a plurality of vertebral implants connecting the cord across at least four spinal levels. In this example, each vertebral implant of the plurality of vertebral implants can include a dynamic head coupling each vertebral implant to the cord. The dynamic head of each vertebral implant can be configured to share cord tension across multiple spinal levels by releasing a first tension generated at a first level between two vertebral implants of the plurality of vertebral implants to generate a second tension across two spinal levels between three vertebral implants of the plurality of vertebral implants, wherein the second tension is lower than the first tension.

Abstract: Various implants and surgical techniques for dynamic spinal tethering systems are discussed. In an example, a spinal tethering system can comprise a flexible elongate spinal tethering cord and a plurality of vertebral implants connecting the cord across at least four spinal levels. In this example, each vertebral implant of the plurality of vertebral implants can include a dynamic head coupling each vertebral implant to the cord. The dynamic head of each vertebral implant can be configured to share cord tension across multiple spinal levels by releasing a first tension generated at a first level between two vertebral implants of the plurality of vertebral implants to generate a second tension across two spinal levels between three vertebral implants of the plurality of vertebral implants, wherein the second tension is lower than the first tension.