Abstract: A surgical instrument system comprising a housing, a shaft assembly, and an end effector is disclosed. The housing comprises a plurality of electric motors. The shaft assembly comprises a plurality of rotatable shafts. The electric motors are simultaneously coupled to the rotatable shafts as the shaft assembly is connected to the housing. The shaft assembly further comprises an articulation joint including an electrically conductive articulation joint conductor that traverses the articulation joint, an electrically conductive shaft conductor in communication with the articulation joint conductor, and a distal coupler. The end effector is releasably connectable to the distal coupler and comprises an electrically conductive end effector conductor. The distal coupler comprises an electrically conductive coupler pathway from the end effector conductor to the articulation joint conductor.

Abstract: A medical instrument having a tool assembly attachable to a distal end of the medical instrument is disclosed. The tool assembly includes a pair of opposing tissue engaging surfaces for clamping tissue therebetween. The medical instrument also includes a housing having a fixed handle and a movable handle mounted to the housing and selectively movable relative to the fixed handle from a first position in spaced relation relative to the fixed handle to a second position closer to the fixed handle to actuate the clamping of tissue. The instrument further includes a selectively activatable drive assembly including a power source and a motor which is operatively coupled to the movable handle, wherein upon actuation the motor actuates the pair of opposing tissue engaging surfaces. The drive assembly also includes a controller configured to variably control the rate at which the motor actuates the pair of opposing tissue engaging surfaces in response to the force exerted on the movable handle.

Abstract: A surgical fastener deployment system may include a plurality of coil fasteners having a head and coil body. In one embodiment, the head may be larger in diameter than the coil body. The fasteners may also be mounted on a guide rod or mandrel that passes through a through-hole of the head and the coil body. The shaft may also include a guiding element that contacts and stabilizes the coil body as the fastener is deployed from a distal end of the shaft. When the head approaches and contacts the guiding element, the guiding element may deflect to permit the head to pass.

Abstract: A surgical apparatus including a tool assembly is provided. The tool assembly includes a chip assembly, a staple cartridge body, a support plate, and a jaw member. The chip assembly includes a first projection facilitating alignment and connection with a connector assembly of the jaw. The chip assembly further includes a second projection received in a recess in the staple cartridge body. The connector assembly and chip assembly include an electrical connection therebetween.

Abstract: A compressible adjunct has a first portion, a second portion, and a middle portion. The middle portion is disposed between the first portion and the second portion. The middle portion comprises a first pillar, a second pillar, and an interconnecting member. The first pillar and the second pillar extend substantially between the first portion and the second portion. The interconnecting member is configured to engage at least the first pillar and the second pillar. When the compressible adjunct is compressed by a force, the first pillar is configured to deflect a first deflection and the second pillar is configured to deflect a second deflection. The first deflection differs from the second deflection.

Abstract: A surgical instrument includes a body assembly, a shaft assembly, and an end effector. The end effector has first and second jaws that are configured to receive a tissue therebetween. The end effector also includes a staple cartridge including a plurality of staples and a hydraulic expandable member that is configured to receive a fluid and thereby expand from a contracted state to an expanded state. The hydraulic expandable member is further configured to direct at least one of the plurality of staples toward an anvil of the first jaw for forcing the at least one of the staples against the anvil and forming the at least one of the staples within the tissue.

Abstract: A surgical stapling device including a handle assembly, a body portion extending distally from the handle assembly, a head portion including an anvil retainer and a shell assembly, the anvil retainer being movable in relation to the shell assembly between unapproximated and approximated positions, a tube surrounding a portion of the anvil retainer, wherein the anvil retainer includes a distal annular protrusion for releasably engaging an anvil assembly and wherein the anvil assembly includes a center rod.

Abstract: A bioresorbable drug-eluting biopolymer suture-free blood vessel anastomosis devices can be deployed to join two blood vessels and resorbed by the body over a predetermined time period after the blood vessel has become joined. The anastomosis device can include a hollow tube that is inserted interconnect the two vessels to be jointed. A non-piercing suture is wrapped around the vessel to secure the anastomosis. The anastomosis device can include hollow tube that extends along an axis from a first end to a second end. The ends can be fitted with elements that facilitate mechanical attachment of the vessel to the anastomosis device and provide for a secure seal.

Abstract: An apparatus for joining organ wall portions of first and second hollow organs, including first and second connectors, wherein the first and second connectors are magnetically attracted to one another. A device for delivering and deploying the first and second connectors to portions of the first and second hollow organs can be provided, wherein the device is configured and dimensioned to axially align the first and second connectors for performing circular anastomosis of the first and second hollow organs.

Abstract: A stapling apparatus includes a body portion, a staple cartridge disposed within the body portion, and a buttress removably attached to the staple cartridge. The staple cartridge includes a plurality of staple receiving slots defined in a tissue contacting surface of the staple cartridge, with each staple receiving slot of the plurality of staple receiving slots including a staple disposed therein. The buttress includes a plurality of tabs at an outer edge of the buttress. The buttress is releasably retained on the staple cartridge by at least one tab of the plurality of tabs extending into a staple receiving slot of the plurality of staple receiving slots defined in the staple cartridge.

Abstract: An end effector for use with a surgical fastening instrument is disclosed which comprises a staple cartridge and an anvil. The staple cartridge comprises a cartridge body including a deck and, in addition, fasteners removably stored in the cartridge body, wherein each fastener comprises a base and a leg extending from the base. The anvil comprises a tissue compression surface and forming pockets defined in the tissue compression surface. Each forming pocket comprises a first end configured to receive a staple leg, a second end, a central axis extending between the first end and the second end, a concave turning surface extending between the first end and the second end, and a channel defined in the concave turning surface, wherein the channel is laterally offset from the central axis.

Abstract: A surgical string applicator and method of use for anastomosis surgery are provided. The surgical string applicator includes an elongate shaft, a string applying assembly including a pair of opposing jaws connected to a distal end of the shaft, one or more jaws including one or more grooves along an inner surface of the jaw, each of the grooves configured to receive therein at least a portion of a surgical string, such as a zip-tie, and a string fastening mechanism adapted to engage and fasten the surgical string; and a handle portion connected to the proximal end of the shaft; the handle portion including control mechanisms adapted to open and close at least one of the jaws and to actuate the string fastening mechanism. Further provided is an intra-lumenal position guide to be used together with the surgical string applicator.

Abstract: A lung volume reduction system is disclosed comprising an implantable device adapted to be delivered to a lung airway of a patient in a delivery configuration and to change to a deployed configuration to bend the lung airway. The invention also discloses a method of bending a lung airway of a patient comprising inserting a device into the airway in a delivery configuration and bending the device into a deployed configuration, thereby bending the airway.

Abstract: Various systems and methods are provided for reducing pressure at an outflow of a duct such as the thoracic duct or the lymphatic duct. In one embodiment, an indwelling catheter can be configured to be at least partially implanted within a vein of a patient in the vicinity of an outflow port of a duct of the lymphatic system. The catheter can include first and second restrictors each configured to at least partially occlude the vein within which the catheter is implanted and thus to restrict fluid flow within the vein when the restrictors are activated. The restrictors can each be configured to move between an activated configuration, in which the restrictor occludes the vein, and a relaxed configuration, in which the restrictor does not occlude the vein. The catheter can include a pump, such as an axial motor pump, configured to pump fluid through the catheter.

Abstract: Implantable devices for placement at a cavity or opening such as an aneurysm are disclosed. The implantable devices, in a deployed condition, have a generally inverted U-shaped profile with a curved or angled framework support structure sized and configured for placement in proximity to tissue surrounding the opening and anchoring legs extending proximally from the framework structure sized and configured to contact the wall of a neighboring lumen at opposed locations. Occlusive and semi-occlusive membranes may be associated with the framework support structure and deployed over the opening to provide exclusion of the opening and flow diversion. Proximal anchoring segments providing additional lumen wall surface area contact for the implantable device following deployment may be incorporated.

Abstract: An endovascular surgical tool includes a flexible, electrically-conductive corewire, a return conductor, a resistive heating element attached to the distal end of the corewire, and a therapeutic payload attached to the loop of the resistive heating element by a coil connecting member. The corewire includes at least one segment at its distal end which transitions from the substantially uniform cross-section of its proximal end to a smaller distal cross-section. The return conductor is electrically insulated from and bonded to the corewire. The resistive heating element includes a first terminal electrically connected to the corewire, a second terminal electrically connected to the return conductor, a helical coil, and a loop. The helical coil and the loop are electrically in series between the first terminal and the second terminal. The coil connecting member has a release temperature lower than a loop melting temperature of the loop of the resistive heating element.

Abstract: Provided herein is an occlusion device for implantation into a body lumen or aneurysm comprising, a continuous compressible mesh structure comprising axial mesh carriages configured end to end, wherein each end of each carriage is a pinch point in the continuous mesh structure. Also provided herein is a kit comprising the occlusion device disclosed herein and a means for delivery thereof. Methods of manufacture and use of the occlusion device are also disclosed.

Abstract: A method of occluding an appendage of the heart with a clamp including at least first and second elongate clamping portions, the first and second elongate clamping portions including tissue engaging surfaces that promote tissue ingrowth. The method includes implanting the clamp by positioning the first and second elongate clamping portions on opposite sides of the appendage. At least one of the first or second elongate clamping portions is biased toward the other of the first and second elongate clamping portions to place the clamp into a clamping position on the appendage. Tissue ingrowth into the tissue engaging surfaces retains the clamp in place on the appendage.

Abstract: A guide device for knee replacement is configured such that during knee replacement surgery and/or knee replacement revision surgery for implanting a prosthetic knee implant, a degree of external rotation of a femur is identified and aligned through a cut surface of a proximal tibia, then a distance of a gap between the cut surface of the proximal tibia and a cut surface of a distal femur is identified during the surgery, so the degree of external rotation and the distance of the gap are identified simultaneously with one guide device, and thereby it is possible to facilitate the surgery, thereby reducing operation time and minimizing occurrence of a sequela of operation.

Abstract: Systems and apparatuses including a system that can be used in a knee replacement procedure are disclosed. According to one example, the system can include a tibial cut guide and an alignment guide. The tibial cut guide can have a first guide portion coupled to and adjustable relative to a second guide portion. The first guide portion can be configured to define a sagittal cut slot and the second guide portion can be configured to define a proximal cut slot. The alignment guide can be configured for extramedullary mounting to the patient and can be configured to couple with the second guide portion of the tibial cut guide. The alignment guide can have a first mechanism and a second mechanism of differing construction.

Abstract: A surgical instrument comprises a member configured for connection to an image guide defining an axis and being oriented relative to a sensor to communicate a signal representative of a position of the member. A stabilizer is aligned with the axis and configured to resist and/or prevent movement of the image guide from the orientation. Systems and methods are disclosed.

Abstract: A sizing caliper for facilitating the selection of a femoral component of a knee prosthesis includes a caliper body, two drill guide bodies, a stylus tower configured to be slidably linked to each other wherein as the caliper body and the stylus tower are linearly displaced at an equal rate relative to the drill guide body portions and the drill guide holes remain located at the midpoint of an anterior/posterior dimension defined by the distance between the tip of the stylus and the base portion. The caliper body comprises a base portion configured to couple and decouple from the caliper body using a sliding mechanism.

Abstract: A fecal matter removing tool for safely removing impacted fecal matter from children and adults. The removing tool includes a hollow, cone shaped barrel having a first end and an open second end, wherein the first end is tapered and can be inserted into a user's rectum and rotated in order to remove impacted fecal matter therefrom. A plurality of apertures are disposed along the barrel, wherein a side of each aperture is raised in order to cut and collect the fecal matter within the hollow interior of the barrel. A lip extends perpendicularly outward from the second end of the barrel in order to prevent the barrel from being positioned too far within a user's rectum. A cap is removably secured to the second end of the barrel so the removing tool can be grasped by a user in order to rotate the barrel within the user's rectum.

Abstract: A catheter system includes a shaft main body having a rotation axis lumen including a rotation central axis, a revolving lumen that revolves around the rotation axis lumen when the shaft main body is rotated about the rotation central axis, a side-by-side portion in which at least a portion of the rotation axis lumen and at least a portion of revolving lumen exist in side-by-side relationship, and a branch part at which the revolving lumen branches off from the side-by-side portion on a distal side relative to the branch part. The revolving lumen on the distal side relative to the branch part is formed of a distal shaft which has a proximal-side bending portion that bends in such a direction as to become farther away from the rotation axis lumen in radial direction and an opening that communicates with the revolving lumen.

Abstract: A vibrational catheter for disrupting obstructions in lumens such as blood vessels includes an elongate flexible catheter body having a proximal end, a distal end and at least one lumen extending longitudinally therethrough, a vibrational transmission member extending longitudinally through the lumen of the catheter body and having a proximal end and a distal end, and a transition connector attached to the proximal end of the vibrational transmission member for coupling the transmission member with a vibrational energy source. The transition connector includes a bore into which the proximal end of the vibrational transmission member extends. The proximal end of the vibrational transmission member is attached within the bore of the transition connector with variable attachment forces such that the transition connector exerts a lowest amount of attachment force on an attached distal-most portion of the vibrational transmission member housed within the bore.

Abstract: A clot retrieval device comprising an elongate shaft having a proximal end and a distal end and a clot retrieval element at the distal end of the elongate shaft. A proximal end of the elongate shaft of the clot retrieval device is adapted for retraction of a first catheter over the clot retrieval device elongate shaft. A second catheter is advanced to or adjacent to the distal end of the clot retrieval device shaft to enable enhanced aspiration adjacent to the clot retrieval element.

Abstract: A medical manipulator wherein a first section provided with a driven coupling is detachably attached to a second section provided with a driving coupling that includes a drive source and is driven by the drive source. The driving coupling and the driven coupling are fitted to each other to transmit the drive force from the drive source to a tip-end operation part. In at least one coupling among the driving coupling and the driven coupling, tooth ends on the side where the fitting of the driving coupling and the driven coupling begins when the first section and the second section are connected become thinner towards the axial-direction end surface.

Abstract: A microdermabrasion device (1) includes: a detachable tip (11) including at least one abrasive element (112), the abrasive element (112) being provided such as to be applied onto the surface of the skin; a body having a vibrating element, the vibrating element being capable of making the detachable tip (11) vibrate; and a tip holder (12) that is securely attached to the body. The device is characterized in that the detachable tip (11) includes a deformable element (113) that is positioned between the abrasive element (112) and the tip holder (12).

Abstract: An ultrasonic surgical blade with an improved heel portion is disclosed. The blade includes a solid body, a longitudinal portion having a proximal end configured to couple to an ultrasonic transmission waveguide and a transverse portion extending crosswise from the distal end of the longitudinal portion. At least one dissection edge and at least one hemostasis surface is provided on the blade. The transverse portion defines a hook having a free end configured to pull and dissect tissue. The blade further comprises a tissue plow comprising a plow edge and a distal-most vertex to increase the efficiency of heel dissection and tissue diversion.

Abstract: An ultrasonic surgical instrument includes an inner tube, an outer tube, an ultrasonic blade, and a clamp member pivotably moveable relative to the ultrasonic blade. The ultrasonic blade is acoustically coupled to an ultrasonic transducer. The clamp member pivotably movable relative to the ultrasonic blade between an open configuration and an approximated configuration with respect to the ultrasonic blade, wherein the clamp member is pivotably coupled to the inner tube, wherein the clamp member is pivotably coupled to the outer tube, and wherein movement of the outer tube relative to the inner tube between the first position and the second position transitions the clamp member between the open configuration and the approximate configuration.

Abstract: A snare may a loop at a distal end of the elongate member and defining an inner area. The loop may have an inner surface facing and exposed in the inner area, wherein a first section of the inner surface has an edge sharper than a second section of the inner surface.

Abstract: A resection device for resecting tissue from a body. The device includes an elongate member having a proximal end, a distal end, and a lumen extending from the proximal end to the distal end. The device further includes a cap assembly configured to be coupled to the distal end of the elongate member. The cap assembly may include a first cap defining a resection loop channel and a distal end having a first opening. The assembly may further include a second cap configured to receive a portion of the first cap. The second cap includes a distal end having a second opening. A distal portion of the first cap and a distal portion of the second cap may cooperate to define a resection loop track for receiving a resection loop.

Abstract: Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Ultrasound catheter devices generally include an elongate flexible catheter body with one or more lumens, an ultrasound transmission member extending longitudinally through the catheter body lumen and a distal head coupled with the transmission member and positioned adjacent the distal end of the catheter body for disrupting occlusions. Improved features of ultrasound catheters include catheter bodies and ultrasound transmission members with increasing distal flexibility, guidewire tubes allowing contact between a guidewire and an ultrasound transmission member, distal heads with improved guidewire lumens, and torquable proximal housings for enhancing disruption of blood vessel occlusions.

Abstract: A trocar has an insertion tube. A tube outlet of the insertion tube communicates with a collar of the insertion tube. An incision blade is provided to the tube outlet. The tube outlet opens toward the incision blade. The incision blade can thereby be inserted into an eyeball to form an incision, and the insertion tube can be inserted in the eyeball through the incision while the incision blade remains in the eyeball. Two lateral blade edges extend from a distal blade edge in the incision blade. The blade edges have outermost blade edges located in an outer region, which is a boundary surface, which includes the inner circumferential surface of the tube outlet. Therefore, the width dimension of the incision blade can be set greater than the inner diameter of the insertion tube.

Abstract: A finger-held instrument (25) having a handle (10) supporting a working tip (11, 31) on a mount (15) located at an end of the handle that is held proximate a working surface (43) during use, said handle being characterized by a projection (20) supported by or on said portion proximate the working tip and being dimensioned and shaped for supporting or shielding a user's finger (26a, 27a, 29a) and for exerting a contact force on the working surface so as to allow fine control of the working tip during use.

Abstract: The invention relates to a dermatome, comprising: a blade holder for holding a blade, said blade holder comprising at least one guiding element for guiding an oscillating movement of a said blade, and at least one spacer spaced apart from said blade holder for defining a cutting gap between a said blade held by said blade holder and said spacer, wherein said at least one guiding element and said at least one spacer define a curved path. The invention further relates to a blade, suitable to be used in such a dermatome, as well as an assembly of such a dermatome and such a blade.

Abstract: A polyp removal device includes an outer tubular body; an inner tubular body; a tubular cutter coupled to or formed as part of the distal end of the inner tubular body; a spring positioned to bias the inner tubular body in an extended direction with respect to the outer tubular body; a handle coupled to the proximal end of the outer tubular body; an actuation member movably coupled to the handle; and a disconnect mechanism for selectively coupling the actuation member to the inner tubular body and decoupling the actuation member from the inner tubular body, the disconnect mechanism is configured to automatically decouple the inner tubular body from the actuation member when the actuation member is moved in a first direction for a distance greater than a predetermined distance.

Abstract: A skull clamp for patient stabilization comprises a pair of arms where the arms include upright portions and lateral portions. The upright portions and lateral portions define longitudinal axes, where the intersection of these axes defines an arm angle that is greater than about 90 degrees. In some instances the arm angle is between about 100 and about 120 degrees. In some instances the arm angle is about 110 degrees. The skull clamp can have rails integrated in the arms for attaching various accessories to the skull clamp.

Abstract: A device for external orthopedic fixations, which has one or more frames which have a substantially and/or partially annular shape and are suitable for being arranged around a limb to surround it at least partially, wherein one or more rods are fixed to a frame by means of a locking mechanism is provided. The device has two jaws which, when closed, tighten the locking mechanism to a portion of the frame by exerting a prevalently axial force, wherein the jaws are closed by means of a cam mechanism suitable for being actuated by rotating a lever pivoted to a first jaw and provided with one or more cam surfaces cooperating with a surface of the second jaw.

Abstract: Disclosed herein are external fixation frames for correcting bone deformities. The external fixation frames include a top fixation ring and a bottom fixation ring coupled to one another by at least two struts. A half ring is coupled to bottom fixation ring. The bottom fixation ring is u-shaped. One or more rocker members may be coupled to the bottom fixation ring. The half ring may be hingedly coupled to the bottom fixation ring such that it can rotate with respect to the bottom fixation ring from a first position to a second position.

Abstract: Provided is a novel rod reducing device including a screw jack mechanism that is moveably engaged with an elongated grasping fork assembly, the screw jack mechanism having an elongated threaded portion, the elongated threaded portion being connected at its most distal end to a rod contact member, which is positioned in sliding circumferential contact with each of the two opposing elongated grasping members and the most proximal end of the elongated threaded portion terminating in a controlling member, which can be activated in a measured and controlled manner. A method of using the device is also provided.

Abstract: The present invention relates to a connection element for a spine stabilization system which comprises a first end for fixing to a first bone fixation device, a second end for fixing to a second bone fixation device and an intermediate portion arranged or formed between the two ends and defining a longitudinal axis. At least one of the two ends takes the form of a coupling element for fixing the connection element to a bone fixation device in at least one defined orientation relative to the longitudinal axis. The coupling element has a shape other than a circular cylinder.

Abstract: A polyaxial bone anchoring device includes a bone anchoring element having a head, a receiving part having a channel for receiving a rod and an accommodation space for pivotably holding the head, and a pressure member having a pressure exerting surface and a deformable portion with a free end. The deformable portion is adjustable from a first configuration where a first part of the deformable portion is supported at a first axial position relative to the receiving part while a second part of the deformable portion protrudes further radially into the channel than parts of the deformable portion positioned axially above the second part, to a second configuration where the second part of the deformable portion is deformed radially outwardly and the pressure exerting surface is shifted lower axially to exert pressure on the head while the first part of the deformable portion remains supported at the first axial position.

Abstract: The bottom loading fastening system that consists of the polyaxial ball and socket joint used in conjunction with a bone screw. The system allows attachment to a bone screw using a retaining ring spot welded to a blocker ring to assure proper ring positioning. Upon installation the retainer wall is expanded causing a break from the blocker ring producing an audible and tactile indication that the sufficient force has been applied to set the retainer and blocker rings locking the bone screw to a U-shaped connecting assembly.

Abstract: An insertion device for deploying an implant includes an elongated main body having a distal locking portion for coupling to the implant and a proximal handle portion. The main body defines a central passage and the distal locking portion has outer ridges and slots to allow the outer ridges to flex radially inward when mounting to the implant. A plunger slides in the central passage for movement between an unlocked position for mounting the implant on the distal locking portion, a locked position for locking the implant on the distal locking portion, and an insertion instrument deployed position for deploying the actuation plunger to move the blades from the stowed position to the deployed position. A spike cap drive rotatably mounts on the main body having a socket end for engaging a drive nut on the implant to, in turn, move the spike cap.

Abstract: A surgical instrument having a first member engageable with a first end of a fastener having a second end configured to penetrate tissue. A second member includes an expandable member configured for engaging the first end. Systems and methods are disclosed.

Abstract: Methods and apparatus for treating bones, including, in one or more embodiments, methods and apparatus for treatment of vertebral fractures that include a containment assembly for cement containment and/or a balloon assembly for maintaining vertebral height. A containment assembly comprising a containment jacket adapted to be deployed inside bone; and a dividing wall that separates the interior of the containment jacket into a proximal region and a distal region, the dividing wall having an opening for providing access to the distal region from the proximal region.

Abstract: A bone manipulator system incorporates a bone manipulator and bone plate that enables two degrees of motion to position a fractured bone, including axial and lateral translation of a bone portion. The bone manipulator system incorporates a bone plate having a plurality of apertures and a bone manipulator having a fastener-arm and a foot-arm for engagement with the bone plate. The fastener coupler of the fastener-arm is configured for rotational engagement with a fastener inserted through one of the apertures of the bone plate and secured into the bone thereunder. The foot-arm has a flared foot end for engagement with a separate aperture of the bone plate. The fractured bone is manipulated by movement of the bone plate by the flared foot end while the bone plate slides and/or rotates about the fastener in the slotted aperture.

Abstract: A surgical implant for fixing a soft tissue to a bone comprising a staple and a plate. The staple and the plate are positionable on an instrument in such a way that the plate may be manipulated with the instrument to hold the soft tissue against the bone and in such a way that the staple is fixable to the bone with the plate positioned between a bridge of the staple and the soft tissue when legs of the staple are driven through the plate and into the bone.

Abstract: A bone anchoring element (1) for anchoring an external device in a bone is described. A head (2) capable of connection to the external device is provided with a shaft (3) that can be anchored in a bone. A predetermined section of the shaft (3) has a bone thread (5). Moreover, the shaft (3) also has at least one bone thread-free surface (6,7; 11,12; 16,17; 21,22,23) that extends from a first end to a second end of the predetermined section essentially along the direction of the shaft axis. The bone anchoring element (1), thus provided, is pressed or soft-hammered into a hole (8, 28) previously generated in the bone and fixed in the bone by rotation by a predetermined angle. If the bone anchoring element has to be removed this can be achieved by unscrewing it in the standard fashion. The disclosure also describes methods for using the bone anchoring element.