Abstract: A method for securing an elongate rod to a bone anchor with a receiver and a threaded plug. The receiver includes a channel configured to receive the elongate rod, and a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The threaded plug is configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the threaded plug having an outer surface with a mating continuous helically wound guide and advancement structure configured for rotatable engagement with the receiver guide and advancement structure.

Abstract: A receiver assembly for securing an elongate rod to a bone anchor including a receiver and a threaded plug. The receiver including an upper portion defining a channel to receive the elongate rod, an interior surface having helically wound receiver thread, and an exterior surface having first and second horizontal curvate extending instrument engaging grooves. The threaded plug including a longitudinal axis, a lower surface having a protrusion, and an external side surface having a continuous helically wound closure thread to rotatably mate with the helically wound receiver thread. The continuous helically wound closure thread including a lower leading surface and an upper trailing surface, both extending perpendicular to the longitudinal axis, and a cylindrical outer crest surface extending parallel to the longitudinal axis. When the protrusion on the threaded plug engages the elongate rod, the threaded plug does not extend overtop a top surface of the receiver.

Abstract: A spinal fixation system includes a plurality of bone anchors and an array of receiver sub-assemblies, with each bone anchor having a common universal capture portion configured for bottom loading into one of the receiver sub-assemblies that includes at least one of a multiplanar receiver sub-assembly, a monoplanar receiver sub-assembly, and a monoaxial receiver sub-assembly that further include, respectively, a multiplanar retainer sub-assembly for providing pivotal motion of the bone anchor relative to the receiver in multiple planes, a monoplanar retainer sub-assembly for limiting pivotal motion of the bone anchor relative to the receiver to a single plane, and a monoaxial retainer sub-assembly for inhibiting all pivotal motion of the bone anchor relative to the receiver while providing of rotation the monoaxial receiver sub-assembly about the longitudinal axis of the bone anchor.

Abstract: A medical implant assembly includes a shank having a head and an anchor portion, and a receiver having a base defining a central bore for receiving the shank head through a bottom opening and an upper portion defining a channel for receiving an elongate rod. The central bore extends upwardly to a closer mating structure adjacent the top of the receiver and an inwardly-protruding horizontal ridge below the closure mating structure. The assembly also includes an insert having a saddle surfacing for receiving the elongate rod, a lower surface for engaging the shank head, and outward-facing side surfaces adjacent upward-facing top edge surfaces. The insert is initially positionable into the central bore with the outward facing side surfaces in an overlapping arrangement with the horizontal ridge to maintain the position of the insert within the receiver prior to uploading the shank head.

Abstract: A pivotal bone anchor system includes a plurality of bone anchors with rounded capture portions having a circumferentially extending outer engagement surface without flat side faces. The system also includes multi-planar receiver sub-assemblies, each comprising a multi-planar receiver defining a cavity with a multi-planar seating surface, and a multi-planar pivoting retainer configured for multi-planar motion upon engagement with both the multi-planar seating surface and the outer engagement surface of a bone anchor. The system further includes uni-planar receiver sub-assemblies, each comprising a uni-planar receiver defining a cavity with a uni-planar seating surface, and a uni-planar pivoting retainer configured for uni-planar motion upon engagement with the uni-planar seating surface and the outer engagement surface of another bone anchor.

Abstract: A pivotal spinal screw assembly includes a shank with an upper capture portion having a tapered upper surface, a curvilinear lower surface extending upwardly and outwardly from a neck, and a side outer surface extending between the curvilinear lower surface and the tapered upper surface with a first guide and advancement structure formed therein. The assembly also includes a head member with a central bore having a reduced cross-section adjacent a lower opening configured to maintain the capture structure within the central bore, and with the lower opening having a second guide and advancement structure that is threadably mateable with the first guide and advancement structure. The curvilinear lower surface of the capture portion is configured for pivotal engagement with an internal surface on the reduced cross-section when the capture portion is disposed within the lower portion of the central bore so as to provide for pivotal angular movement of the shank relative to the head member.

Abstract: A patient support system includes independently adjustable end columns supporting a centrally hinged, jointed or breaking patient support structure. At least one column includes a powered rotation assembly. The patient support includes at least two sections. A coordinated drive system provides for both upwardly and downwardly breaking or jointed orientations of the two sections in various inclined and tilted positions. Cable, cantilevered and pull-rod systems are included.

Abstract: A pivotal bone anchor assembly includes a shank with a head and an anchor portion, and a receiver with a channel for receiving a rod and a lower portion of an axial bore for receiving the shank head, with the axial bore including a stop structure and a downwardly-facing surface beneath a helically wound thread. The assembly also includes an insert having an upwardly-facing seat, a lower surface for engaging the shank head, a side structure for engaging the stop structure, and an upwardly-facing surface positioned radially outward from the upwardly-facing seat, with the insert being installed into the axial bore in a first angular position. Subsequent rotation of the insert within the axial bore moves the upwardly-facing surface under the downwardly-facing surface to inhibit upward movement of the insert within the axial bore, with further rotation being inhibited by the side structure coming into engagement with the stop structure.

Abstract: A bone anchor implant assembly configured for surgical implantation into a bone of a patient. The bone anchor implant assembly includes an elongate rod, a separate shank and head, and a closure mechanism configured as a one-part closure or two-part closure. The one-part closure and two-part closure are configured to be interchangeable with each other for closing a channel of the head and locking the assembly and the elongate rod between arms of the head with the closure mechanism.

Abstract: A surgical frame and method for use thereof is provided. The surgical frame is capable of reconfiguration before, during, or after surgery. The surgical frame includes a main beam that can be rotated, raised/lowered, and tilted upwardly/downwardly to afford positioning and repositioning of a patient supported thereon. The surgical frame also includes a reconfigurable upper leg support for supporting portions of the upper legs, the hips, and the lower back of the patient to facilitate positioning and repositioning there during surgery. The upper leg support via reconfiguration thereof can accommodate patients of different sizes, can provide flexure of the patient's lumbar spine to facilitate surgical access thereto, and can prevent unwanted torsion of a patient's spine during such reconfiguration.

Abstract: A method of assembling a pivotal bone anchor assembly with tooling includes positioning a retainer and a pressure insert within a central bore of a receiver, uploading a capture portion of a bone anchor through a bottom opening and into the retainer to cause the retainer to first widen within an expansion portion of the central bore to receive the capture portion and then to close around and secure the capture portion while providing for pivotal motion of the bone anchor relative to the receiver, and downwardly deploying the retainer and the pressure insert within the central bore with the tooling until an outer surface of the retainer engages a narrower engagement portion below the wider expansion portion to impede repeat widening of the retainer, and the pressure insert comes into forced interference engagement with interference wedging surfaces of the central bore to inhibit the pressure insert from moving back up within the receiver.

Abstract: A tool set for implanting bone screws in a human spine, followed by the implantation of a rod into the bone screws includes end guide tools having flexible back wall flaps that receive opposite ends of the rod and intermediate guide tools that hold the rod in intermediate locations between the end guide tools. Both the end and intermediate guide tools include an attachment structure for operably connecting the guide tool to a bone screw. The attachment structure includes an undercut and/or recess so as to resist splaying and separation of the guide tool from an attached bone screw.

Abstract: A polyaxial bone screw assembly includes a receiver, a shank, an articulation structure for retaining the shank in the receiver and a compression insert for engagement with a longitudinal connecting member such as a rod. The articulation structure includes substantially spherical convex and concave surfaces that slidably engage both shank and receiver surfaces to provide compound articulation between the receiver and the shank. The receiver includes inwardly directed spring tabs engaging the insert and prohibiting rotation of the insert within the receiver.

Abstract: A receiver assembly includes a receiver having a first channel, a through-space with internal recesses beneath a guide and advancement structure, and internal ridges projecting inwardly below the internal recesses. The assembly also includes an insert having a second channel, side structures protruding laterally outward below top surfaces, and opposed lower extensions extending downwardly below the second channel, with the insert being loadable into the through-space with the second channel in non-alignment with the first channel. The insert is the non-threadably rotatable within the through-space to align the second channel with the first channel and to move the side structures into the internal recesses above the internal ridges, with subsequent downward displacement of the insert within the through-space causing the opposed lower extensions to engage the capture head of a bone anchor with a frictional engagement that inhibits the bone anchor from moving upward within the through-space.

Abstract: A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having a channel configured to receive the elongate rod, a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The receiver assembly further includes a fastener configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the fastener having an outer surface with a mating continuous helically wound guide and advancement structure configured for rotatable engagement with the receiver guide and advancement structure.

Abstract: A pivotal bone anchor assembly includes a shank having a shank head with a partial spherical shape at a proximal end and an anchor portion opposite the shank head for fixation to the bone of a patient. The assembly also includes a receiver having an upper portion defining a channel for receiving an elongate rod and a base defining a cavity in communication with the channel and with a bottom surface of the receiver through a distal opening. The assembly further includes a retainer positionable into non-rotatable and non-pivotal engagement with an inner surface of the cavity prior to the shank head being received within the cavity, with the retainer having a central opening configured to receive and capture the shank head within the cavity while allowing for pivotal motion between the shank and the receiver in at least one plane, and with a lower portion of the retainer extending below the bottom surface of the receiver.

Abstract: A bone anchor assembly includes a shank having a head and an anchor portion, and a receiver having a first channel to receive a rod and an axial bore with an upper internal thread, interference abutment surfaces below the upper internal thread, and a bottom opening. The assembly also includes an insert having a second channel to receive the rod and opposed lateral protrusions positioned above the interference abutment surfaces upon loading into a first position within the axial bore. The assembly further includes a resiliently expandable retainer positionable within the axial bore adjacent the bottom opening to capture and hold the head in the receiver.

Abstract: A pivotal bone anchor system includes a plurality of bone anchors having rounded capture portions with circumferentially extending capture recesses. The system also includes multi-planar receiver sub-assemblies, each comprising a multi-planar receiver defining a cavity with a multi-planar seating surface, and a multi-planar pivoting retainer configured for multi-planar motion upon engagement with the multi-planar seating surface and to snap into a capture recess to capture a bone anchor within the multi-planar receiver. The system further includes uni-planar receiver sub-assemblies, each comprising a uni-planar receiver defining a cavity with a uni-planar seating surface, and a uni-planar pivoting retainer configured for uni-planar motion upon engagement with the uni-planar seating surface and to snap into a capture recess to capture a bone anchor within the uni-planar receiver.

Abstract: A pivotal bone anchor assembly includes a receiver with a base defining an internal cavity with a seating surface adjacent a bottom opening and an upper portion defining a channel configured to receive an elongate rod. The assembly also includes an anchor member having a proximal end portion with a partial spherical or spheroid shaped head to establish pivotable motion between the anchor member and the receiver, and a planar top surface surrounding an internal drive socket. The assembly further includes an insert positionable within the channel to direct a downwardly-directed force onto the proximal end portion to lock a position of the anchor member relative to the receiver, with the planar top surface remaining spaced apart from the insert so as to not directly receive the downwardly-directed force therefrom. A method of use is disclosed.

Abstract: A pivotal bone anchor assembly includes a receiver defining a cavity with an upper expansion region and a lower locking region, and a shank having a partial spherical head that is up-loadable into the cavity through a bottom opening. The assembly also includes a resiliently expandable retainer that is positionable within the upper expansion region with a discontinuous partial spherical internal surface and an inwardly facing surface above the discontinuous partial spherical internal surface, and a compression insert having a lower outwardly facing surface configured for side-to-side engagement with the inwardly facing surface and a downwardly facing partial spherical surface for frictionally engaging the head of the shank. The compression insert is positionable in overlapping engagement with the retainer within the receiver with the discontinuous partial spherical internal surface extending above and below a hemisphere of the head of the shank to capture the head within the retainer.