Abstract: A closure assembly for securing an elongate stabilization element in a receiving part of a bone anchoring device includes a first closure member and a second closure member. The first closure member is receivable between legs of the receiving part, has an axis of rotation, and includes an outer surface with an engagement portion configured to engage the legs of the receiving part, and an inner surface having at least a portion that is threaded and that defines a central passage that passes axially through the first closure member. The second closure member has an axis of rotation and an outer surface having a threaded portion configured to cooperate with the threaded portion of the inner surface of the first closure member. The threaded portion of the outer surface of the second closure member includes a multi-start thread with at least two starts.

Abstract: A stabilization device for bones or vertebrae includes a rod having a rod axis and a plurality of distinct external surfaces that extend parallel to the rod axis, such that for a cross-section of the rod, the distinct external surfaces are arranged at respective angles relative to one another around the rod axis, a bone anchoring device including a receiving part having a channel for receiving the rod and a contact surface for supporting the rod, and a fixation member with a contact surface for fixing the rod in the channel. When the rod is fixed in the channel with the fixation member, the contact surfaces of the receiving part and the fixation member together form surface portions that are shaped to correspond to at least three of the distinct external surfaces, such that the rod is clamped along the at least three distinct external surfaces.

Abstract: A spinal-surgery system having a rod receiver and/or a cap for use insertion and removal from the receiver. The cap has a generally cylindrical body, a set of opposing splay-resisting flanges, and set of opposing rotation-preventing wings, the flanges extending radially from the body along a first radial line of the body, and the wings extending radially away from the body along a second radial line of the body generally orthogonal to the first radial line. Each cap flange has a proximal-facing cap splay-resisting surface, and a distal-facing cap pop-on surface. Each receiver proximal protrusion has a proximal-facing sloped receiver pop-on surface, and a distal-facing sloped receiver splay-resisting surface. The receiver pop-on surfaces are spaced such that each cap pop-on surface contacts a respective receiver pop-on surface when the cap is centered, with the cap wings aligned between receiver arms, and moved distally to contact the receiver.

Abstract: A bone anchoring device includes a receiving part with a rod receiving portion having a first end, a second end, a recess for the rod, an outer surface, and a first engagement structure on the outer surface that extends farther radially outwardly than other parts of the rod receiving portion, and a flexible head receiving portion for inserting and clamping the head. The bone anchoring device also includes a locking ring configured to be arranged around the head receiving portion for locking the head, the locking ring having an outer surface and a second engagement structure on the outer surface that extends farther radially outwardly than the outer surface of the rod receiving portion. The engagement structures are configured to be engaged by an instrument to move the locking ring from a locking position to a position where the inserted head is pivotable.

Abstract: A bone fastener comprises a head including a first receiver that defines an implant cavity and a second receiver that defines an implant cavity. The first receiver is connected to the second receiver. A shaft is aligned with the first receiver and configured to engage tissue. A part is disposed within the implant cavity of the second receiver and movable relative thereto in a selected plane of a body. Systems, surgical instruments, spinal constructs, implants and methods are disclosed.

Abstract: A tool set for implanting a rod in a human spine in conjunction with bone screws.

Abstract: A spinal screw assembly is provided. The assembly may be provided with a screw and a movable head in which angulation of the screw relative to the movable head is constrained so that angulation within limits is allowed in one plane but lesser or no angulation is allowed in another plane. Methods to assemble the disclosed apparatus are also disclosed.

Abstract: A bone attachment assembly may include an attachment head, a set screw configured to attach to the attachment head, and a rod surface with a first raised portion and a second raised portion that define a lowered portion positioned between the first raised portion and the second raised portion. The first raised portion, the second raised portion, and the set screw may be configured to directly contact a rod in order to retain the rod within the attachment head.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

Abstract: Systems and methods of treating spinal deformity, including one or more intervertebral implants to be introduced laterally into respective intervertebral spaces, a plurality of bone screws introduced generally laterally into vertebral bodies adjacent to the intervertebral implants and/or the intervertebral implants themselves, and a cable dimensioned to be coupled to the bone screws and manipulated to adjust and/or correct the spinal deformity.

Abstract: A uniplanar bone anchor including a housing and a bone screw is provided. The lower region of the housing defines mating elements that mate with engaging elements on the bone screw to limit movement of the housing relative to the bone screw to a single plane.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: A bone screw includes a screw head and a seating sleeve or tulip on the screw head. The bone screw includes two sleeve flanks having a thread. A seat for a rod for surgical connection of adjacent bone screws is formed between the sleeve flanks. On at least one of the sleeve flanks, a guide surface extending in the circumferential direction for a clamping screw to be screwed into the thread is configured on the run-in side, with the guide surface offset in the radial direction vis-à-vis the thread diameter of the female thread.

Abstract: Embodiments of a bony implant extension arm breakoff tool are described. The tool may enable a surgeon to break a section of a bony segment implant extension located in a transdermal location within a patient. Other embodiments may be described and claimed.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in an integral receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A down-loadable compression insert, a down-loadable friction fit split retaining ring having inner and outer tangs and an up-loadable shank upper portion cooperate to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra. The shank and receiver once assembled cannot be disassembled.

Abstract: An adjustable offset connector for connecting iliac screws to fixation rods. The connector includes an adjustable offset rod to facilitate mating the rod with the tulip of the iliac screws and an anti-torque mechanism designed to resist torque and securely lock the offset rod in position and provide a strong, stable connection.

Abstract: A uniplanar bone anchor including a housing and a bone screw is provided. The lower region of the housing defines mating elements that mate with engaging elements on the bone screw to limit movement of the housing relative to the bone screw to a single plane.

Abstract: Anchor assemblies useful for connecting structures to each other are described. An anchor assembly includes a head member and an anchor. In the fully assembled anchor assembly, the anchor is partially disposed within the head member. During assembly, the proximal end of the anchor can be inserted into an opening defined by a distal end of the head member. A retaining member maintains a portion of the anchor within a portion of the head member after assembly. In an embodiment, a compression member enables movement of the retaining member within the head member to allow insertion of a portion of the anchor and subsequent maintenance of the portion of the anchor within a portion of the head member.

Abstract: A polyaxial screw body includes a side wall defining a lumen having a first end and a second end. An opening disposed at the first end of the lumen, includes an interior surface disposed in the side wall thereabout. The interior surface is adapted to accommodate a head portion of a pedicle screw. A transverse channel extends from a first aperture through the side wall to a second aperture and is adapted to accommodate a portion of a fixation rod therebetween. A lateral connector extending integrally from the side wall.

Abstract: An anti-splay apparatus having a bridge and frangible connection points for use with mechanical fasteners having a shank portion and a receiving member with opposing arms is provided. The bridge may take a number of forms including a ring, a notched ring, a tube, or a notched tube and the connection points join the opposing arms of the receiving member with the bridge. Also provided is the anti-splay apparatus also having tabs connected between frangible connection points.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient Bone fastener assemblies may be coupled to vertebrae Each bone fastener assembly may include a bone fastener and a collar. The collar may be rotated and/or angulated relative to the bone fastener. Detachable members may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The detachable members may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars.

Abstract: A spinal stabilization system generally comprises first and second anchor members configured to be secured to first and second vertebrae within a patient's body, a flexible element secured to the first anchor member, and a rigid element secured to the second anchor member. An end portion of the rigid element is coupled to an end portion of the flexible so that the system is able to provide both rigid and dynamic stabilization. The coupling is maintained even if the flexible element relaxes after a period of time within the patient's body.

Abstract: A receiving part for coupling a rod to a bone anchoring element includes a receiving part body including a rod receiving portion having a channel for receiving a rod, and a head receiving portion for accommodating a head of a bone anchoring element, the head receiving portion having an open end and being flexible for inserting and clamping of the head; and a locking ring around the head receiving portion, wherein in a pre-locking position, a spring portion on one of the locking ring or the receiving part body engages a corresponding portion on the other one of the locking ring or the receiving part body, and the locking ring exerts a first force onto the head receiving portion, and wherein in a locking position, the locking ring exerts a second force greater than the first force onto the head receiving portion to lock the head therein.

Abstract: A pedicle screw and rod fixation assembly including a pair of opposing tabs having a proximal end and a distal end, the pair of opposing tabs being coupled to one another about the distal end thereof by a screw head member, a decoupling mechanism for decoupling the pair of opposing tabs from the screw head member, a rod receiving slot between the pair of opposing tabs, and a sliding member configured for coupling to the pair of opposing tabs. The sliding member and the pair of opposing tabs are configured for allowing movement of the sliding member distally along the pair of opposing tabs and preventing movement of the sliding member proximally along the pair of opposing tabs.

Abstract: A bone anchoring device includes a receiving part for receiving a rod, the receiving part having a first bore coaxial with a longitudinal axis and a second bore. The bone anchoring device also includes an anchoring element having a first end for insertion into the bone and a second end positionable within a second bore, the second end having a spherically shaped surface portion. The bone anchoring device further has a locking device provided to the second bore of the receiving part. The locking device protrudes from an inner wall of the second bore and engages with a recessed surface portion of the second end of the anchoring element, such that the anchoring element is pivotable relative to the receiving part around a single axis of rotation. The locking device may comprise pins inserted into through holes formed in the receiving part, which engage with the recessed surface portion of the second end.

Abstract: An instrument includes components configured to secure a locking device inside a rod fixation assembly. In one embodiment, an instrument includes an outer sleeve and a pusher member arranged telescopically within the outer sleeve. A drive assembly cooperatively engages the pusher member. In another embodiment, an instrument includes an outer sleeve, a pusher member arranged telescopically within the outer sleeve, and a pair of drive assemblies. A first drive assembly engages the pusher member to distally advance the pusher member under a first loading. A second drive assembly also engages the pusher member to distally advance the pusher member under a second loading, the second loading being substantially greater than the first loading. In another embodiment, a method for reducing and locking a spinal rod includes the step of advancing a locking element while the locking element is retained in a fixed orientation.

Abstract: A system for interfacing a first spinal support rod to a second spinal support rod may optionally comprise a rod interface device configured to receive a portion of the first rod and grip a portion of the second rod to secure the second rod to the first rod. The system may optionally comprise a screw interface device configured to receive a portion of the first rod and configured to mount on a head portion of a pedicle screw.

Abstract: The present disclosure relates, according to some embodiments, to a spinal fixation system comprising a bone screw, a body, and a pressure cap. The bone screw may comprise a head at a proximal end and a bone connection element at a distal end. The body may comprise a proximal end, a distal end, a mounting rod receiving channel at the proximal end and a bone screw head receiving channel at the distal end. A proximal end of the pressure cap may comprise two side walls disposed apart from each other and one biasing member on each side wall. A distal end of the pressure cap may comprise a surface operable to contact at least a portion of the head of the bone screw. The pressure cap may be operable to exert pressure on the bone screw when a mounting rod is biased against the proximal end of the pressure cap.

Abstract: A pedicle screw system that includes a pedicle screw and a collar. The pedicle screw includes an insertion portion, a shaft portion that extends from the insertion portion, and a head portion that is attached to the shaft portion. The head portion has a diameter that is larger than the shaft portion. The collar includes a first aperture and a second aperture. The first aperture and the second aperture are both adapted to receive the head portion. The first aperture includes a first aperture section and a second aperture section. The first aperture section is larger than the head portion. The second aperture section is smaller than the head portion.

Abstract: A spinal rod persuader, system and method can include an outer tube, an inner tube, and a locking element. A first actuation mechanism can be movable in a linear fashion along a longitudinal axis direction to cause the locking element to move in a linear fashion over the inner tube and to lock the inner tube onto a pedicle screw. A second actuation mechanism can be rotated to cause the outer tube to move in a longitudinal axis direction with respect to the inner tube to push the spinal rod into a final position with respect to the pedicle screw while the pedicle screw is locked to the inner tube. A slot and/or tab structure can be provided in the outer tube such that actuation of the slot/tab will allow disassembly of the inner tube, outer tube and locking element with respect to each other.

Abstract: A vertebral rod for stabilizing a patient's spine. The rod may include an elongated body with first and second ends and have an elongated cross-sectional shape with a major axis and a minor axis and a centroid positioned at an intersection of the axes. First and second longitudinal channels may extend through the body. The channels may be spaced apart and contained within the body. The body may have a first flexural rigidity along the major axis and a different second flexural rigidity along the minor axis.

Abstract: A system for anchoring a pedicle screw in a patient's vertebra uses a pedicle screw having a threaded portion sinkable in the vertebral arch. The space between the threaded portion and cortical edge layer of the pedicle is at least partially filled by a spacer that enables an all-round support of the threaded portion at the cortical edge layer. A kit includes a pedicle screw and a spacer which at least partially fills the space between the threaded portion and cortical edge layer of the pedicle. A spacer has an essentially oval cross-section for form-locking fit in a corresponding axial recess sunk in the pedicle and having an axial through-hole to accommodate the threaded portion of a pedicle screw, as well as a spacer in the form of an essentially cylindrical pedicle augmentation in the form of a bone screw or a bone bracket.

Abstract: In one embodiment, the present invention includes a bone fixation assembly comprising a coupling element and a bone anchor. The coupling element has an upper surface with a first diameter defining a first bore extending along a first axis, a lower surface with a second diameter defining a second bore extending along a second axis, and an internal surface area defining a seating portion adjacent to the lower surface. The bone anchor has an insertion end opposite of a head. The head may be curved for receipt within the seating portion. The second diameter of the second bore may be greater than the first diameter of the first bore or vice versa. Likewise, the first and second axes may intersect such that the first and second bores are in communication with one another. Related elements and systems of this assembly are also disclosed.

Abstract: An adjustable occipital plate includes a fixation plate, at least one lateral rod configured to be coupled to said fixation plate, at least one laterally sliding link configured to be coupled to and configured to be compressed around said at least one lateral rod to create a friction fit, and at least one rod connector coupled to said at least one laterally sliding link that is configured to receive at least one posterior cervical rod.

Abstract: There is provided a modular polyaxial pedicle screw assembly that includes various components which may be configured in various manners so as to provide different functionalities to the pedicle screw assembly. This advantageously decreases surgery time, reduces repetitive and tedious surgical steps, and allows for streamlining inventory of expensive medical equipment. In one embodiment, a pedicle screw assembly includes a pedicle screw, a rod holding element, a polyaxial insert, a rod, and a set screw. The pedicle screw includes a threaded shaft and a cap. The rod holding element includes a screw hole, an insert bearing area, a chamber, chamber walls, a saddle area, and a threading area. The insert is disposed within the chamber, and the insert defines a bearing surface, an upper surface, side walls and a receiving area.

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 system includes a first pedicle screw, a second pedicle screw, and an adjustable rod having an outer housing coupled to one of the first pedicle screw and the second pedicle screw, the outer housing having a threaded shaft secured to one end thereof extending along an interior portion thereof. The system further includes a hollow magnetic assembly disposed within the outer housing and having a magnetic element disposed therein, the hollow magnetic assembly having an internal threaded surface engaged with the threaded shaft, the magnetic assembly being coupled to the other of the first pedicle screw and the second pedicle screw, wherein the hollow magnetic assembly rotates in response to an externally applied magnetic field to thereby lengthen or shorten the distance between the first pedicle screw and the second pedicle screw.

Abstract: A spinal fixation device may include a bone anchoring member, a rod receiver, and an connection member. The rod receiver may include a channel for receiving a rod projection from a first adjacent fixation assembly. The rod receiver may have a central axis such that the channel is generally perpendicular to the central axis. The connection member may have a rod projection configured to extend to a second adjacent fixation assembly. The rod receiver may be coupled to the connection member and rotatable about the central axis of the rod receiver. The interior fixation assembly may be axially fixed such that the bone anchoring member, the rod receiver and the connection member are not translatably movable relative to each other.

Abstract: A fixation system is designed to lock an elongated member within a housing member, permitting positional and/or orientational adjustment of the elongated member prior to locking. The system includes a housing member, a slotted spherical collet, an elongated member, and may include a tapered wedge, which may be a discrete component or formed as part of the elongated member. The housing member and/or elongated member may be implantable. The elongated member may be positioned in the wedge, the wedge in the collet, and the collet in the housing such that when compression force is applied to the wedge and the collet, the wedge contracts about the elongated member and the collet expands to engage the housing, thus locking the elongated member relative to the housing. The collet may have a tapered channel with a degree of taper equal to the tapered wedge. The collet may have multiple slots to allow uniform radial expansion and compression.

Abstract: A polyaxial screw body includes a side wall defining a lumen having a first end and a second end. An opening disposed at the first end of the lumen, includes an interior surface disposed in the side wall thereabout. The interior surface is adapted to accommodate a head portion of a pedicle screw. A transverse channel extends from a first aperture through the side wall to a second aperture and is adapted to accommodate a portion of a fixation rod therebetween. A lateral connector extending integrally from the side wall.

Abstract: A polyaxial pedicle screw includes a housing, a bone screw member, and an anvil. The bone screw member includes a head and a threaded shaft extending from the head. The head is selectively securable within the housing. The anvil is positionable within the housing adjacent to the head of the bone screw member when the anvil and the head of the bone screw member are positioned within the housing. The anvil may define one or more grooves in an outer surface of the anvil. The groove defines a flap that is flexibly attached to the anvil to enable the anvil to flex an amount sufficient to maintain the head of the bone screw in constant contact with the anvil when the bone screw member is moved relative to the anvil.

Abstract: A vertebral column correction system for correcting a spinal deformity without fusing the joint segments is disclosed. The vertebral column correction system may have first and second vertebral anchors secured to first and second vertebrae. The vertebral column correction system may further comprise one or more intermediate vertebral anchors secured to vertebrae between the first and second vertebrae. A connection member may be disposed within a head portion of the vertebral anchors. At least a portion of the connection member may be a flexible member, such as a flexible cord, configured for tensioning between at least two vertebral anchors for providing a desired amount of tension to apply a correctional force to the spinal column. A spring member, or other tensioning member, may maintain the tension of the connection member.

Abstract: A bone screw assembly includes a screw body, including anchor portion and rod-receiving portion, and a rod seat movably mounted in the screw body to allow for controlled angulation between a spinal connection element disposed in the rod seat and the screw body. The rod seat is pivotable in one or more selected directions about one or more axes relative to the screw body. The rod seat may include a first lower rod seat element disposed in a recess of the screw body having a cylindrical bottom surface to facilitate pivoting in a first direction. A second lower rod seat element is stacked on the first lower rod seat element and has a conical bottom surface abutting a top surface of the first lower rod seat element to facilitate pivoting in a second direction.

Abstract: Systems and methods for manipulating a spinal construct are provided herein. In general, the system includes first and second sleeves extending from vertebrae and a fulcrum that can be releasably coupled to the sleeves. In certain aspects, the fulcrum can receive a portion of the sleeves therein and can allow the sleeves to pivot about the fulcrum in response to an applied force. The fulcrum can releasably couple to the sleeves in a variety of ways, and a position of the fulcrum relative to the sleeves can vary depending on whether there is an applied distracting, compressing, and/or derotating force. In some embodiments, user can manipulate the first and second sleeves relative to the fulcrum, using one hand, to distract, compress, and/or derotate the vertebrae.

Abstract: Disclosed herein are a hook with rotating saddle and a rotatable mono axial pedicle screw. In an embodiment, the disclosed hook may include at least one body comprising a hook member and a saddle member. The hook member and saddle member may be rotatably mounted to one another so as to rotate with respect to each other only about a common axis, and the saddle member may be configured for connection to an end of a connecting member. A surgical screw system may include receiver and screw members engagable with one another such that when engaged, only rotation of the receiving member about the longitudinal axis of the screw member and restrain against substantially all other translational or rotational movement.

Abstract: A method of providing spinal stabilization is provided herein. More specifically, the method includes positioning a plurality of fixation assemblies within a plurality of vertebrae in a trans-lamina orientation wherein each fixation assembly includes a proximal portion configured to securely receive a stabilization element (e.g., a stabilization rod). The proximal portions of the various fixation assemblies can be aligned so as to secure at least one stabilization element in a desired position (e.g., along and above a midline of the patient's spine, adjacent and parallel to the midline). A system for providing spinal stabilization is also provided which utilizes trans-lamina delivery and positioning of fixation assemblies within target vertebrae thereby providing stronger fixation and a significant reduction in associated tissue damage.

Abstract: A polyaxial screw body includes a side wall defining a lumen having a first end and a second end. An opening disposed at the first end of the lumen, includes an interior surface disposed in the side wall thereabout. The interior surface is adapted to accommodate a head portion of a pedicle screw. A transverse channel extends from a first aperture through the side wall to a second aperture and is adapted to accommodate a portion of a fixation rod therebetween. A lateral connector extending integrally from the side wall.

Abstract: A bone fixation assembly comprises a tulip-shaped assembly and a bone fixation device such as a surgical or pedicle screw, comprising a head and a bone fixation portion. The tulip assembly comprises an upper portion to receive a rod and a lower portion that has a cavity in which the head of the bone fixation device rests. The cavity has an aperture below. The aperture has a length through which the tulip assembly may slide with respect to the bone fixation device, for movement of the tulip assembly when the bone fixation device is in place, while also maintaining the angular movement of the tulip assembly. The bone fixation device may comprise an aperture engaging part, which locks the bone fixation device position on the aperture length. A tulip assembly translation mechanism comprises a head, a cavity, an aperture to the cavity.

Abstract: Apparatus and methods include an elongate connecting element including a body extending along a longitudinal axis between a first end and an opposite second end. The connecting element includes a first end portion at its first end and a second end portion at its second end. The connecting element includes a length between the first and second ends sized to extend between and be engaged to first and second anchors engageable to bony portions of the spinal column. The first and second end portions are positioned on opposite sides of the first and second anchors and project outwardly from the body of the connecting element to capture the first and second anchors between the first and second end portions.

Abstract: In a fixation system for controlling the alignment of adjacent vertebra after spinal surgery, aligned fixation rods are held in a mount on each of such vertebra, with their juxtaposed ends received in a sleeve between the mounts. At least one of the rods is movable in the sleeve relative to the other to allow controlled movement of adjacent vertebra. In some embodiments, the sleeve can itself be held in a mount installed on one of such vertebra with the aligned fixation rods being capable of relative movement therein. The system allows the spine to grow without the need for further surgery.