Abstract: A torque-limiting fastener driver for driving a bone fastener into bone includes a handle supporting a driver shaft. The driver shaft includes limited components which are designed to provide feedback to a user regarding the applied torsional force. In addition, the driver shaft is designed to controllably fail before any potential uncontrolled failure of the distal driving tip. This prevents application of too much torque and controlled design of the shape and size of the failed components.

Abstract: Orthopedic implant insertion instruments for precision guiding of a fracture fixation implant into fractured bone to promote healing are disclosed. The implant insertion instruments comprise an insertion handle for implantation of a first fixation implant, an aiming arm for precise guiding of a second fixation implant into bone, a guide sleeve for protection of soft tissue and for translational and rotational control of the second fixation implant, and a drive shaft with coupling screw for attachment to the second fixation implant and for driving the second fixation element through the aiming arm and guide sleeve into the fractured bone. The implant insertion instruments also include a soft tissue clearance device to aid the surgeon in inserting the first fixation implant into the fractured bone. Also disclosed is a measuring device that reduces measuring errors made by a user and a measuring device that determines implant length, diameter, and angle of insertion.

Abstract: An implantation pin kit and a method for implanting an implantation pin includes a cannulated implantation pin having a channel and a heating device. The channel of the pin extends in a longitudinal direction of the pin and connects a proximal opening at a proximal end of the pin with a distal opening at a distal end of the pin. The channel of the pin and the heating device are adapted such that the heating device can be accommodated within at least a portion of the channel of the pin. The heating device is adapted to thermally heat material comprised in at least one of the pin and the heating device. Thereby, meltable material of the pin can be liquefied or additional liquefied meltable material can be inserted into the pin and the liquefied material can then be push towards and out of the distal opening in order to augment and fix the implantation pin in a target structure.

Abstract: A bone screw driver (12) for inserting a bone screw (14) into a bone region (218A) includes a driver shaft (12B) that selectively engages the bone screw (14). The bone screw (14) includes a screw threaded region (14A) and a screw engagement region (14B). The screw engagement region (14B) includes a screw shaft (14D) and an engager ring (14E). The driver shaft (12B) includes a shaft aperture (322), a first resilient member (324A), and a first shaft projection (326A). The shaft aperture (322) receives at least a portion of the screw shaft (14D), the first resilient member (324A) engages the screw shaft (14D) to inhibit movement of the screw shaft (14D), and the first shaft projection (326A) engages the engager ring (14E) so that rotation of the driver shaft (12B) results in rotation of the bone screw (14).

Abstract: The invention concerns a device for adjusting the position of a screw (13) that is able to move a part of a surgical instrument, said device (4) comprising: —a stem (41) comprising a tip (42) suited to the head (130) of the screw (13), —an actuated system (45) for driving said stem (41) in rotation, —communication means to communicate with a control unit (21), such that the control unit (21) transmits to the actuated system (45) the number of turns to apply to the stem (41) to reach the target position of the screw (13).

Abstract: A method and devices for facilitating fixating and joining of bone fractures utilizing expandable devices that are positioned within the bone and across the fracture site. The stress from the expanded may enhance and expedite bone healing.

Abstract: A system to allow registration of a patient to image space is disclosed. The registration can be performed without touching a plurality of fiducial points on the patient or in the image data. The registration process can eliminate manual steps of image to patient registration and image to image registration.

Abstract: A bone-fastening system includes an implant with a threaded screw, a distal nut with a threaded bore, and a proximal washer which may also be threaded. An instrument for implanting the implant includes a handle and a barrel terminating in a holder for the washer. A c-shaped bridge assembly has a first end connected to the barrel and a second end including a holder for the nut in axial alignment with the washer. A manually operated control on the instrument, coupled to an elongated element in the barrel, causes the washer to move toward the nut, thereby applying compressive pressure to bone portions to be fastened together. A drive mechanism disposed within the barrel has a distal end with a holder for the screw and a proximal end that is turned by a user, thereby advancing the screw through the washer to the nut to fasten the bone portions under compression. The manually operated control is preferably a trigger that is squeezed toward the handle by a user.

Abstract: A method for securing a soft tissue replacement in a bone tunnel includes forming a first and second tunnel in the bone. The second tunnel intersects the first tunnel and defines a first and second access passage. A first flexible member is passed through the tunnel and includes a first end extending out of the first passage, an intermediate portion supporting the soft tissue replacement and a second end extending out of the second passage. The first end of the first flexible member is fastened to an insertion member. A crosspin is positioned between the first passage and the insertion member. The second end of the first flexible member is advanced until a distal portion of the crosspin advances into the first access passage. The insertion member is impacted thereby pushing the crosspin into an engaged position with the bone.

Abstract: A surgical instrument for holding and inserting a connection member of an osteosynthesis device into a retainer of a bone anchorage element comprises a distal end, a proximal end and a first connection portion at a distal end. The first connection portion comprises a connection member receptacle for receiving at least a portion of the connection member. The instrument further comprises a locking mechanism which is transferable from a release position, in which the instrument is releasable from the connection member, to a connection position, in which the instrument can be connected to the connection member. Moreover, an osteosynthesis device comprising at least two bone anchorage elements and at least a connection member is proposed, which further comprises a surgical instrument for holding and inserting the connection member into at least one retainer of the bone anchorage elements.

Abstract: A tensioning device for surgical elements is described. The tensioning device comprises a fixation device, a clamping device, a spring device, and a force deflecting device that interacts with the clamping device. The force deflecting device is designed to convert the spring force exerted by the spring device on the clamping device into a clamping force exerted by the clamping device on the surgical element.

Abstract: A method for securing soft tissue to bone which does not require the surgeon to tie suture knots to secure the tissue to the bone. Suture is passed through the graft at desired points. A cannulated plug or screw is pre-loaded onto the distal end of a driver provided with an eyelet implant at its distal end. Suture attached to the graft is passed through the eyelet of the implant located at the distal end of the driver. The distal end of the driver together with the eyelet implant is inserted into the bone. Tension is applied to the suture to position the graft at the desired location relative to the bone. The screw or plug is advanced into the pilot hole by turning the interference screw or tapping the plug until the cannulated screw or plug securely engages and locks in the eyelet implant, so that the cannulated plug or screw with the engaged eyelet implant is flush with the bone.

Abstract: The invention relates to a device for fixing screws in osteoporotic bones, formed by biocompatible fixing elements and an instrument for placing same. The instrument consists of two parts, a male part (A) and a female part (B), which can perform a relative linear sliding movement. The caudal end of each part has a pivoting jaw (Pa, Pb) forming an inverted U therebetween. The biocompatible element is placed in the jaw of the male part, which element will be traversed by a screw inserted through interchangeable guides (g) placed in the other jaw, acting as a locking and fixing nut for said screw. Both parts have a handle (m) to allow moving the jaws closer together. The opening of the device, restricted by a closure (C), is achieved by the action of a compression spring (R), upon releasing, by the action of the thumb, the catch inserted in the upper face, cut in a saw-toothed manner, of part A.

Abstract: A torque-limiting driver for orthopedic surgical use is described. The torque-limiting driver has a housing to which a torque force may be applied and transferred to a driver output shaft. The housing encloses a cam bearing assembly having a ball cage disposed so that balls of the ball cage move along a first vector path (Vr) radial to the axis of rotation. The bearing assembly also has an inner race abutting the ball. The inner race travels along a second vector path (F) parallel to the axis of rotation. The first vector path (Vr) and the second vector path (F) are not co-axial. A bearing load assembly applies a bias force (F) to the inner race of the cam bearing assembly to set the calibrated maximum amount of torque that can be transmitted via the housing through the cam bearing assembly to the output shaft of the torque-limiting driver.

Abstract: A screw placement guide tool for use in minimally invasive surgery has a proximal handle portion, an extension member extending distally from the handle portion, and an alignment element connected transversely to a distal portion of the extension member and having a screw placement guide located thereon. In this aspect of the invention, the tool is configured so that a surgeon may operate the tool using the handle portion external to a patient's body to align the alignment element with implanted screws so that the screw placement guide indicates a desired position for implantation of an additional screw. Systems and methods for placing a rod receiving screw are also provided.

Abstract: A surgical tool for inserting a surgical implant in a body and a method of performing a surgical procedure, wherein the tool is composed of materials consisting essentially of radiolucent materials. In one embodiment the radiolucent materials comprise plastic. In another embodiment the radiolucent materials comprise carbon fibers. In still another embodiment the radiolucent materials comprise thin aluminum. The tool has a torque capacity of at least 6 Nm.

Abstract: Implant removal tool (1) which allows removing an implant (5) from a patient's bone (6). The implant removal tool (1) comprises a head (2), to which a torque-providing system is attached, and a threaded body (4) preferably with a decreasing diameter. The threaded body (4) preferably has a thread to the left and is intended to be threaded into the hole (7) of the implant (5). The extraction of the implant (5) is relatively simple to carry out, removing the implant (5) in an almost clean manner and leaving a very small cavity (13) in the patient's bone (6). Therefore, the implant removal tool (1) according to the invention makes the removal of an implant (5) a far less traumatic procedure for the patient.

Abstract: A bone plate system including a bone plate and a bone screw with an integrated locking mechanism is disclosed. The bone screw includes an elongate member having a threaded shank and a bone screw head that is radially deformable. The integrated locking mechanism sits within the bone screw head and can rotate between a locked condition and an unlocked condition. When the bone screw head is seated within an aperture in the bone plate, rotating the integrated locking mechanism into the locked condition helps to prevent bone screw backout.

Abstract: Methods and instruments are provided to allow access to a surgical site through a small incision while optimizing visualization of the patient anatomy. The instrumentation provide for the retraction of soft tissue, creation of a working envelope below the skin, and access to intervertebral discs and/or the surrounding bony structures for the purpose of performing various operative procedures including discectomy, laminectomy, and other spinal fixations. One set of disclosed instrumentation provides for the targeting of placement and trajectory of spinal fixation devices while reducing the number of instruments necessary needed to pass through the surgical incision. Another instrument disclosed herein allows for the compression of the intervertebral space through a very small incision. The instrument profile is minimized by using the same instrument that is used for tightening of the pedicle screws as one of the active components of the compression instrument.

Abstract: Instruments and methods are provided for delivering multiple implants to multiple implant locations in a patient without requiring a second implant to be loaded onto or engaged to the delivery instrument after delivery of a first implant. The implants can be sequentially engaged, using the delivery instrument, to the patient or to receptacles of one or more receiving members secured to the patient.

Abstract: A system for installation of a graft ligament support block is provided. The system includes an installation tool having a holder including a shaft having a handle at a proximal end and a distal end configured for selectively engaging the graft ligament support block. The installation tool further includes a drill guide including an outrigger having a bore formed on its distal end for selectively receiving a drill sleeve and a proximal end configured to selectively engage the holder. Also provided is a kit for use in reconstructing a ligament. The kit includes an installation tool including a holder and a drill guide, a drill sleeve, a guidewire, one or more drills, one or more graft ligament support blocks and one or more transverse fixation pins.

Abstract: A pedicle screw tower having a guide chute, open at both ends, affixed to the exterior of the main body of the tower. The guide chute extends the length of the tower and is curved inwardly at its bottom such that the exit direction is at approximately 90 degrees to and facing the central axis of tower. A guide cable is passed into and through the guide chute such that it is directed across the tower to an adjacent tower.

Abstract: Disclosed is a medical fastener that can be mounted to a bone of a patient. The medical fastener can include a head portion comprising a recess having a first portion, a second tapered portion extending from the first portion, and a third cylindrical portion extending from the second tapered portion. A threaded body portion can extend from the head portion. The first portion and the second portion can have a Torx geometry or star-shaped configuration. Also disclosed is a driver usable to mount the medical fastener to the bone. The driver can include a tip that is complementary to the recess and an end that enables the driver to mount to a drill or other device that can rotate the driver.

Abstract: A screw delivery system is provided. Such a system may include a carrier including a carrier body, a driver, and a nose. The carrier may define a bore that extends at least partially through the carrier body. The driver may be configured to be at least partially disposed in the bore. The driver may include a head that is configured to mate with a head of a fastener. At least a first guide member may be carried by the carrier body. The nose may be operably aligned with the bore, and may include at least a second guide member that is configured to engage the first guide member. The system may be configured such that insertion of the driver from the bore into the nose causes the first and second guide members to engage so as to cause the nose to rotate relative to the carrier body.

Abstract: A screwdriver serves for handling a screw in the body of a person or an animal. The screwdriver has a handle, and a stem permanently connected to said handle. An outer tube surrounds the stem. A locking mechanism has a locking element engaging into a locking point in at least three different axial displacement positions of said outer tube. The locking element is prevented from moving further in an axial direction at a locking position by a barrier, which barrier can be overcome only by rotating said outer tube and said stem relative to one another about a longitudinal axis.

Abstract: In one embodiment, a spinal stabilization apparatus includes a vertebral anchor having a head portion and a bone attachment portion. An elongate, flexible guide is removably coupled to the head portion of the vertebral anchor and has a channel extending longitudinally thereof and communicating with a slot in the head portion of the anchor. An elongate cord may be received within the channel to facilitate inserting and securing a spacer between pairs of anchors installed into adjacent vertebrae of a person's spine.

Abstract: The invention provides a medical screwdriver having a sleeve that can be coupled to the medical screwdriver without the need to align the sleeve to the medical screwdriver. The medical screwdriver includes a body portion having a receiver, a drive shaft, a sleeve, and a coupling connecting the sleeve to the receiver. The sleeve surrounds at least a portion of the drive shaft when coupled to the receiver. The coupling comprises an end of the sleeve and the receiver of the body portion. The end of the sleeve and the receiver are designed so that the end of the sleeve can be coupled with the receiver of the body portion without rotationally aligning the end of the sleeve to the receiver of the body portion and so that the sleeve is prevented from rotating in a direction of rotation during use.

Abstract: A perforated sheath is anchored in a tissue opening with the aid of a tool, wherein the anchorage is achieved with the aid of mechanical vibration and a material which is liquefiable by the vibration. The tool includes a vibrating element and a counter element. Distal portions of both elements are introduced into the sheath to be in contact with each other at an interface. The vibrating element is connected to a vibration source and the vibrating element and the counter element are held against each other for effecting liquefaction of the liquefiable material at the interface. Under the effect of the force applied to the vibrating and counter element for holding them against each other, the liquefied material flows from the interface through the sheath perforation and penetrates the tissue.

Abstract: A plate system and method comprising a plate and a screw having an integral resilient lock. The screw comprises a head that has a portion that is adapted to be compressible as it is screwed into bone using a tool. After the screw head is received in the plate and the tool is removed therefrom, the screw head decompresses or expands into a locking or receiving area, thereby locking the screw in the plate. The plate is adapted to have at least one or a plurality of detents or lips for cooperating with at least a portion of the screw head to retain the screw in the plate and prevent it from withdrawing therefrom.

Abstract: A surgical tool includes a proximal end, a distal end and a longitudinal axis extending from the proximal end to the distal end. The surgical tool has a fastener engagement tip having a spring extension extending substantially parallel to the longitudinal axis of the surgical tool. The spring extension is resiliently flexible and deflectable between a first arrangement, in which the spring extension is in a relaxed state, and a second arrangement, in which the spring extension is deflected to facilitate insertion of the fastener engagement tip into a fastener slot.

Abstract: A humeral fracture fixation system is provided and includes a nail-plate fixation device having a plate-like head portion, an intramedullary nail portion, and a bent neck portion therebetween which creates an angle between the plate and nail portions. The upper surface of the nail portion is substantially straight for contact with the endosteum and the nail portion includes threaded holes for machine screws. The head portion includes locking holes for receiving fixed-angle bone support elements, and K-wire alignment holes. The front of the head portion includes suture holes while presenting a smooth profile. A specific implantation jigs and a screw guide cannula are also provided.

Abstract: A method for guiding symmetric implantation of bone screws is provided. The method includes the steps of: providing a spinal image of a spine, wherein the spine has a first bone screw implanted in one side of a spinous process of the spine; obtaining a first implanting information of the first bone screw; setting a reference line in the spinal image; generating a second implanting information by mirroring the first implanting information with respect to the reference line; and guiding a second bone screw to be implanted in the other side of the spinous process according to the second implanting information. The method generates a second implanting information that is based on and symmetric to the first implanting information, thus allowing the bone screws to be precisely implanted in both sides of the spinous process and aligned with each other in the same transverse section of the spinous process.

Abstract: An instrument is provided for use in orthopedic surgery, such as for reduction of spinal rods. In one embodiment, a shaft is pivotably connected to a plate with an aperture, and a sleeve is slidable over the shaft and plate. A base member can be provided for ease in handling the instrument, which may include a ratchet mechanism connected to the sleeve. The plate is moved so that its aperture is oriented to allow an orthopedic implant, such as a Schanz-type screw, to be inserted into the aperture. After insertion, the shaft is moved so as to pivot the plate so that the plate grips or holds the implant. The sleeve is then slid over the shaft, plate and implant in contact with an elongated member, such as a spinal rod, or other implanted device or tissue. Further sliding the sleeve forces the elongated member toward or past the implant.

Abstract: A surgical instrument for applying and fixing a fixation screw to a threaded section of a head of a bone anchorage element comprises a distal end and a proximal end, a first tool member and a second tool member. The first tool member is arranged at the distal end and adapted for engaging the threaded section of the bone anchorage element head. The second tool member is adapted for engaging a tool-engaging member of the fixation screw. The instrument is constructed such that in a working position of the instrument the second tool member is supported on the instrument in a torque proof manner relative to the first tool member about a longitudinal axis and is movable parallel to the longitudinal axis relative to the first tool member. Moreover, an osteosynthesis device comprising at least two bone anchorage elements and at least one connection member is suggested. Further, a method for fixing an osteosynthesis device on two vertebrae of a spinal column in a minimal invasive manner is proposed.

Abstract: In accordance with a particular embodiment of the present invention, an implantation tool includes an elongate inner shaft having first and second ends. The tool also includes a first post coupled to the elongate inner shaft proximate the first end of the elongate inner shaft. The first post is configured to engage with a component to couple the component with the elongate inner shaft. The tool further includes a hollow outer shaft defining a longitudinal axial bore within which the elongate inner shaft is disposed. The hollow outer shaft is able to slide along the elongate inner shaft from a first longitudinal position to a second longitudinal position. The hollow outer shaft includes a first locking arm. Moving the hollow outer shaft from the first longitudinal position to the second longitudinal position moves the locking arm closer to the first post.

Abstract: An implantable cervical plate assembly for stabilization of two adjacent spinal vertebras includes a cervical plate and one or more bone fasteners. The cervical plate comprises an elongated asymmetric body having a first straight side surface, a second contoured side surface opposite to the first side surface, front and back surfaces and top and bottom surfaces. The elongated asymmetric body comprises one or more through-openings extending from the front surface to the back surface of the elongated asymmetric body. The one or more bone fasteners are configured to be inserted through the one or more through-openings, respectively, and to be attached to locations in the spinal vertebras, thereby attaching the cervical plate to the spinal vertebras. The through-openings comprise a first diameter at the front surface of the elongated body, a second diameter at the back surface of the elongated body and a third diameter in the area between the front and back surfaces of the elongated body.

Abstract: A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver.

Abstract: A device for repairing a bone disorder using a polyaxial screw. The device has a pivoted lever mounted rotatably to an extension of a bone screw and which extends essentially at right angles to the longitudinal direction of the extension to which it is mounted and is in contact with a stop on the other extension associated with the vertebral body to be repositioned. The extension that acts on the polyaxial bone screw comprises a longitudinal sleeve, a rod, preferably threaded, extending from within the sleeve and moveable within the sleeve, and a contact surface disposed on the end of the threaded rod which is configured to transmit a force against the bone screw to prevent polyaxial movement of the polyaxial bone screw for as long as the force is transmitted.

Abstract: An inserter for inserting a suture anchor into bone. The inserter has external markings that uniquely identify the orientations and the relative longitudinal positions of at least two suture passages through a suture anchor releasably engaged with the inserter. The markings assist a surgeon in determining a preferred placement and orientation of the anchor at an operative site during a surgical procedure.

Abstract: A fixation device for securing tissue to a bone. The fixation device includes an anchor having a hollow body defining a longitudinal passage, and a plug configured to be received in at least a portion of the passage. The body comprises a cylindrical portion and a tapered tip portion. The cylindrical portion comprises a plurality of thin-walled window covers such that after implantation the window covers are resorbed first relative to other portions of the cylindrical portion for defining a plurality of apertures on the cylindrical portion.

Abstract: A surgical fastener system includes a plurality of fasteners having a throughbore with a non-circular cross section portion. The fasteners may engage with a splined mandrel that passes through the throughbore of the fasteners and rotates the fasteners relative to the mandrel to move at least one of the fasteners along the mandrel, e.g., along the mandrel's longitudinal axis. A distal end of the mandrel may be inserted into a material, such as a tissue, prosthetic or other, and a fastener may be deployed from the distal end of the mandrel while the distal end is positioned in the material.

Abstract: There are disclosed various embodiments of surgical tacks for use in surgical procedures. The tacks generally include a head and a barrel portion extending distally from the head. Preferably the head and the barrel portion define a throughbore for receipt of a drive instrument. A thread on the head is provided to engage threads in the installation tool. A tissue thread is provided on the barrel portion to engage tissue. Distal and proximal surfaces of the tissue thread may be oriented at various angles relative to the barrel portion. There is also disclosed an insertion instrument to insert one or more tacks as well as a method of use. There is further disclosed a model device for use in explaining the operation of the instrument.

Abstract: A self retaining screw inserter for inserting, positioning and removing a set screw of a spinal fixation system, includes an active reverse-collet retainer. The active reverse-collet retainer has fingers configured to move outward to engage and retain a set screw. When engaged, the fingers flare outward to engage the set screw.

Abstract: A method for performing spinal fixation and instrumentation. A first incision may be made through the skin and a passageway may be created to the spine. A screw may be inserted through the passageway and into a vertebrae. The screw may have a head portion including a channel. An insertion guide may be operable connected to the screw. The insertion guide may have first and second longitudinal slots. Additional screws may each be inserted through separate incisions or through the first incision. Insertion guides may be operably connected to a head portion of each screw. A sleeve may be positioned into one insertion guide in a first position to guide a rod through at least one other insertion guide. The sleeve may be rotated to a second position to allow the rod to move down the slots of the insertion guide(s) and into the head portion of the screw.

Abstract: An auxiliary instrument for fixing a rod places a detent pin on a head portion of the screw. The auxiliary instrument comprises an inner cylinder, an outer cylinder, a first lever and a second lever. The inner cylinder has a plurality of claw portions and an opening employed to introduce the detent pin into an interior thereof. The outer cylinder is arranged to surround the inner cylinder and has a claw pressing portion. The first lever is rotatably connected to the inner cylinder and arranged in substantially perpendicular to an axial direction of the inner cylinder. The second lever is rotatably connected to the fist lever and the outer cylinder and arranged in substantially perpendicular to an axial direction of the outer cylinder. When the first and second levers are operated, the claw portions are pressed inward by the claw pressing portion to hold the head portion of the screw.

Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: A surgical screw and driver arrangement whereby the end of the driver is vertically inserted and removed from the slotted end of the surgical screw and whereby the end of the driver is attached to and removed from the slotted end of the surgical screw by a quarter turn in the clockwise and counterclockwise directions. The driver includes an inner shaft connecting with a center locking cam at one end of the driver and an outer shaft that connects with a pair of blades, one on each side of the locking cam. The surgical screw includes a slotted head at one end and a tapered threaded rod attached to the head. A pair of dovetail slots extending perpendicular within the slotted head receives the locking cam when the driver inner shaft is rotated a quarter turn clockwise to fasten the surgical screw to the end of the driver.

Abstract: A bone anchoring device includes an anchoring element having a shaft for anchoring in the bone and a head, a receiving part formed in one piece, and a pressure element formed in one piece. The receiving part has a seat for receiving the head and an outer channel for receiving a rod to be connected to the anchoring element, which is pivotable with respect to the receiving part and can be fixed at an angle by exerting pressure via the pressure element onto the head. The pressure element is movable in the receiving part and includes an inner channel for receiving the rod and a spring element that engages a portion of the receiving part via a detent connection so that the pressure element can be held in a position that allows pivoting of the anchoring element. The spring element is formed by at least a first portion of one of two side walls forming the inner channel, the first portion being spaced apart from a second portion of the one side wall by a slot.

Abstract: A trajectory structure is configured for contact with a surface to dictate an insertion trajectory of a pin relative to the surface. A location structure is configured to allow longitudinal passage of at least a portion of the pin therethrough to dictate an insertion location of the pin relative to the surface. An elongate handling rod is connected to the trajectory structure and the location structure. The handling rod supports the trajectory structure and the location structure for manipulation by a user. The handling rod spaces the trajectory structure and the location structure longitudinally apart. The trajectory structure is connected to the handling rod for trajectory adjustment in at least two degrees of freedom relative to the handling rod. The insertion trajectory of the pin insertion is substantially dependent upon the trajectory adjustment. A method for inserting an elongate guide pin into a bone surface is also provided.

Abstract: An implant, particularly for the spinal column, comprises a plate having openings, bone-anchoring members capable of being accommodated in the openings and at least one split-ring capable of holding the members in the orifices. The split-ring can come into direct contact with the anchoring member or members to hold the member or members in the orifices.