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 implant that is implantable between vertebrae includes a monolithic body with a first end and a second end opposite the first end, an outer surface extending axially from the first end to the second end, a plurality of teeth at the first end, each of the teeth extending axially away from the second end to a free end, and an abutment surface facing away from the second end that is positioned radially inwardly relative to at least one of the teeth. The abutment surface is recessed axially relative to the free ends of the teeth to an extent such that the abutment surface is configured to contact a vertebra when the implant is implanted. The monolithic body is configured to extend axially over a majority of an entire axial length of the implant.

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 device for coupling a bone anchor to a rod includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for holding a head of a bone anchor, a pressure member having a first portion for holding and clamping the head and a deformable portion with a free end, and a locking member. The pressure member is expandable for inserting the head and adjustable to lock the head. When the deformable portion is at a first configuration, the free end of the deformable portion is supported by the receiving part, and at least part of the locking member is movable to exert a force on the deformable portion for adjusting the deformable portion to a second configuration where at least part of the deformable portion is farther away from the longitudinal axis compared to the first configuration.

Abstract: A coupling device for coupling a rod to a bone anchor includes a receiving part having first and second ends, a central axis, and two legs defining a recess at the first end for receiving the rod, a pressure member configured to exert pressure on an inserted head, and an actuating member with an engagement surface configured to engage the pressure member. When a first portion of the actuating member moves axially in a first direction, the engagement surface is configured to move from a first axial position to a second axial position to adjust the pressure member from a non-locking position where the head is pivotable to a locking position where the head is locked. When a second portion of the actuating member moves in the first direction, the pressure member is adjusted from the locking position back to the non-locking position.

Abstract: A bone anchoring device includes a receiving part for coupling a rod to a bone anchoring element, the receiving part having a first end, a second end, a recess at the first end for receiving the rod, and a compressible head receiving portion at the second end for accommodating a head of the bone anchoring element, a pressure member positionable in the receiving part to exert pressure on the head, and a clamping ring positionable around the head receiving portion and movable towards the first end of the receiving part to a locking position where the clamping ring exerts force on and compresses the head receiving portion. In the locking position, at least part of the clamping ring that faces the first end of the receiving part is exposed to the outside to facilitate movement of the clamping ring away from the first end of the receiving part.

Abstract: An adapter device for connecting an instrument to a bone anchor includes an elongate main portion having a longitudinal axis, a first end with a surface that is directly engageable with a head of the bone anchor, an opposite second end, and a channel that extends longitudinally through the main portion, and a holding member having an inner surface forming a seat for the head. The holding member is movable over a majority of the main portion, and is configured to be held at a position where a first portion of the seat is directed towards the second end of the main portion to hold the head in the seat against the first end of the main portion, while the holding member engages another part of the adapter device to keep the first portion of the seat spaced apart axially from the first end of the main portion.

Abstract: A bone anchoring device includes a receiving part having a first end with an end surface, a second end, a recess at the first end for receiving a rod, and a flexible head receiving portion at the second end for pivotably holding a head of a bone anchoring element, and a clamping ring positionable around the head receiving portion and movable from a first position where the head is pivotable relative to the receiving part, to a second position where the clamping ring exerts a radial force onto the head receiving portion to lock the head. The receiving part further includes a first engagement structure at or adjacent the end surface extending radially outwardly from an outer surface of the receiving part, such that a width of the receiving part including the first engagement structure is at least as wide as a maximum width of the clamping ring.

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 system for coupling a rod to bone includes first and second bone anchors that are different from one another and a coupling device including a receiving part with a central axis and a head receiving portion for interchangeably receiving a head of either the first or second bone anchors, and a pressure member configured to exert pressure on the head of either the first or second bone anchors when the head is in the receiving part to clamp the inserted head at a particular position relative to the receiving part. The coupling device includes a restraining surface configured to cooperate with the first bone anchor to restrict pivoting of the first bone anchor to a single plane. The coupling device is configured to cooperate with the second bone anchor to restrict pivoting of the second bone anchor differently than the restricted pivoting of the first bone anchor.

Abstract: A bone anchor includes a shank having a longitudinal axis, a core, a tip at one end of the core, and a thread forming a helix that extends around the core with a lower flank directed towards the tip and an upper flank directed away from the tip. A recess in a first turn of the thread forms a cutting structure, the recess being defined by first and second surfaces directly connected to one another at an angle. The first and second surfaces are spaced apart from every other turn of the thread above or below the first turn. A majority of the first surface is positioned higher axially than and circumferentially aligned with part of the second surface. At least one of the first or second surfaces extends circumferentially around the shank by a greater distance than an axial height of the at least one surface.

Abstract: A bone anchoring device includes a receiving part including a rod receiving portion with a first end, a second end, and a U-shaped recess for receiving a rod, the recess defining two free legs, and a head receiving portion at the second end for introducing and clamping the head, and a locking ring configured to be arranged around the head receiving portion, the locking ring including an engagement structure for engagement with a tool, the engagement structure defining a width of the locking ring that is greater than a greatest width of the rod receiving portion, wherein the locking ring can assume a locking position exerting a greatest compressive force on the head receiving portion of the receiving part to lock an inserted head, and wherein the locking ring is movable out of the locking position towards the first end of the rod receiving portion.

Abstract: A surgical staple insertion system for compressing bone fragments includes a staple and an insertion tool. The staple has first and second legs and an elastically deformable bridge monolithically formed with the first and second legs. In a relaxed configuration, the free ends of the first and second legs are positioned closer to one another than are portions of the first and second legs connected to the bridge. The insertion tool retains the bridge in an elastically deformed configuration with the legs positioned relatively farther apart from one another during at least portion of the step of implantation of the staple. Then, the insertion tool is released from the staple so that the bone fragments between the legs are subject to compression.

Abstract: A system includes a bone anchor including a shank having a first end, a second end, a channel extending through the shank with a channel axis, and an internal advancement structure having at least a portion being closer axially to the second end than to the first end, and an elongate instrument configured to extend through the channel, with a tip portion and an external advancement structure configured to cooperate with the internal advancement structure. Engagement between the advancement structures facilitates holding of the tip portion at a first axial position relative to the bone anchor and movement of the tip portion from the first axial position towards both the first and second ends of the shank. The tip portion and the external advancement structure of the elongate instrument are insertable into and removable from the channel via the first end of the shank.

Abstract: A connection device includes a sleeve having a first end, a second end above the first end, a longitudinal axis, and a wall that extends at least partially around the longitudinal axis. An extension member of a bone anchoring device is insertable through the first end into the sleeve to position the sleeve around at least part of the extension member. The wall has an outer surface and defines a laterally extending opening. A surface at a lower end of the opening extends inwardly from the outer surface by a first distance to facilitate insertion of a free end of the extension member from the first end into the opening, while a surface at an upper end of the opening extends inwardly from the outer surface by a distance greater than the first distance to restrict the free end from extending past the upper end of the opening.

Abstract: A polyaxial bone anchoring device includes a receiving part with an upper member having a first end, a second end, and a recess at the first end for receiving a rod, and a lower member connectable around the second end of the upper member, and a pressure member positionable in the upper member to exert pressure on a head of a bone anchoring element. The lower member is movable from a first position where the head is pivotable, to a second position closer to the first end of the upper member where an angular position of the head is locked while the recess remains vacant or unobstructed. When the lower member is at the second position, at least part of the lower member is aligned axially with at least part of an end face at the second end of the upper member.

Abstract: An intervertebral implant has a hollow space formed within the implant and accessible through an elongate opening extending through a recessed portion of the side wall, and the hollow space is shaped to receive an engagement portion of a drive shaft of an insertion tool; and the intervertebral implant includes at least two guiding surfaces facing each other and being configured for sliding engagement by a portion of a sleeve of the insertion tool movably holding the drive shaft.

Abstract: A bone anchoring device includes a receiving part having a central axis, two legs defining a recess for receiving a rod, and a head receiving portion that is at least partially expandable and having an opening for inserting and pivotably holding a head of a bone anchoring element therein, and a locking ring mountable around the head receiving portion in an axial direction while a rotational orientation of the locking ring relative to the receiving part remains constant. When the locking ring is around the head receiving portion, the locking ring is rotatable around the central axis from a first rotational orientation to a second rotational orientation where a compressive force exerted by the locking ring on the head receiving portion is greater than at the first rotational orientation.

Abstract: A polyaxial bone anchoring device includes a receiving part with two legs defining a recess for receiving a rod and a pressure member for exerting pressure on a head of a bone anchoring element in the receiving part, the pressure member having an engagement portion. The engagement portion can extend at least partially into a leg and is directly engageable from outside the bone anchoring device to move the engagement portion axially for adjusting the pressure member from a non-locking position where the head is pivotable to a locking position where the head is clamped. When the pressure member is in the locking position and the engagement portion is free from any outside axial forces, a first contact surface of the receiving part cooperates with a second contact surface of the pressure member to hold the pressure member in the locking position.

Abstract: A coupling device includes a receiving part with an accommodation space for accommodating a head of a bone anchoring element, an opening, and a recess forming two legs for receiving a rod, and a pressure member arranged at least partially in the accommodation space. The pressure member is adjustable from a first configuration where a topmost end of the pressure member is at a first axial position and the head is pivotable in the accommodation space to a second configuration where the topmost end of the pressure member is at a second axial position below the first axial position and the pressure member provisionally lock the heads. At the second configuration, a latching connection is formed to prevent the pressure member from being adjusted back towards the first configuration. The latching connection is releasable to adjust the pressure member from the second configuration back towards the first configuration.