Abstract: A bone anchoring device for securement to a bone. The device includes an anchor, a receiver, a retainer and an insert. The receiver includes a seating surface defining a cavity communicating with the exterior of the receiver through a first opening configured to receive the connection head of the anchor therethrough. The retainer includes at least two discrete retaining members configured to engage with the receiver seating surface when they are captured between the connection head and the seating surface. The insert is disposed within the receiver and configured to frictionally engage the connection head. The insert includes a main body and at least one pin protruding from the main body, for circumferential insertion between two adjacent retaining members of the retainer.

Abstract: An enclosure device connecting a pedicle fixation device with an elongated spinal fixation member. The enclosure device can include an enclosure member and an elongated guide member affixed to the enclosure member and defining a fracture region for breaking off the guide member from the enclosure member. The enclosure member can have a spherical outer surface rotatably received within a receiver portion of the pedicle fixation device. The enclosure member can include an internal bore capable of slidably receiving the fixation member.

Abstract: A screw, comprising a head, and a shaft, wherein the shaft comprises a first threaded shaft portion; a second threaded shaft portion disposed contiguous to said head; and a middle shaft portion disposed between said first threaded shaft portion and said second threaded shaft, wherein said middle shaft portion is an irregular form.

Abstract: The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of a spinal fixation procedure. A uniplanar bone anchor system for a fixation procedure is provided. The system can include a bone fastener including a head with a bearing surface and a shaft adapted to engage an anatomy. The system can also include a saddle, which can include a first bore formed about a longitudinal axis that receives the bone fastener and a coupling bore defined transverse to the longitudinal axis. The system can also include a coupling system, which can have a second bearing surface. The coupling system can be received through the coupling bore such that the second bearing surface of the coupling system can contact the bearing surface to permit the bone fastener to move in only one plane.

Abstract: This invention relates to a bony fixation system and method for use as a prosthetic implant. The system and method includes a plate dimensioned to be situated between adjacent bony structures, such as adjacent vertebrae. Screws are provided in one embodiment and are dimensioned or configured to be inserted into a bony structure and to lock against each other to retain the screws and consequently secure the plate in place against the bony structure.

Abstract: A polyaxial bone anchor including a housing and a bone screw. A bottom surface of the housing includes an aperture that defines an angulation limit of the bone screw for each azimuthal angle around a longitudinal axis of the housing. The aperture is V-shaped, with the V-shape having converging side walls that define a low-angulation direction near their intersection and a high-angulation direction opposite the low-angulation direction. In some cases, the angulation limit of the bone screw is generally constant over a range of azimuthal angles centered around the high-angulation direction. The housing may be modular, including tabs on one component that are plastically deformed to engage a lip on another component. During assembly, a mandrel advances longitudinally along a bore in the housing, and forces the tabs radially outward toward the lip to a radially outward plastically deformed state.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. The upper portion expands a retaining member in the receiver cavity to capture the shank upper portion in the receiver. In some embodiments either the retaining member or an insert provide for a friction fit of the shank upper portion in the receiver resulting in non-floppy placement of the shank with respect to the receiver.

Abstract: In an exemplary embodiment, the present invention provides a fastener assembly that can be used for the fixation or anchoring of orthopedic devices or instruments to bone tissue. In particular, the present invention preferably provides a low profile variable angle or fixed angle fastener assembly that is able to securely connect the orthopedic device to bone tissue. Furthermore, in an exemplary embodiment, the present invention provides a fastener assembly having a locking mechanism that will quickly and easily lock the fastener assembly with respect to the orthopedic device.

Abstract: In an exemplary embodiment, the present invention provides an orthopedic fastener blocking system that allows for a desirable number of fasteners to be used with an orthopedic device even when the orthopedic device is too small to accommodate a desired number of traditionally located and oriented fasteners or when the accessibility to the device is reduced so that addressing a desired number of traditionally located and oriented fasteners is not possible. The system includes an orthopedic implant and at least first and second fasteners where one of the first and second fasteners prevents the other of the first and second fasteners from uninstalling when the first and second fasteners are in the installed position.

Abstract: A polyaxial screw head remobilizer for remobilizing a screw body member relative to a head of a polyaxial bone screw includes a barrel body, a handle assembly, an inner shaft, a slide assembly, and a lever. The barrel body includes proximal and distal ends. The distal end includes a plurality of prongs for releasably engaging a plurality of yokes of the polyaxial screw body member to center the inner shaft over the head of the screw. The handle assembly couples to the proximal end of the barrel body. The inner shaft, disposed within the barrel body, includes proximal and distal ends. An engagement feature of the inner shaft mates with pockets of a bushing of the screw body member. The slide assembly is operably coupled to the barrel body and effect translations of the inner shaft. The lever extends from the slide assembly and rotates to actuate the slide assembly.

Abstract: The various embodiments disclosed herein relate to implantable devices for the treatment of structural bone and joint deformity, including hallux valgus. More specifically, the various embodiments include systems, devices, and methods for implantation of an implantable device having at least one bone anchor with deployable prongs for treating such deformity.

Abstract: A polyaxial screw assembly includes a pedicle screw, a coupling, an insert, and a housing. The pedicle screw includes a shank having a helical thread formed thereon and a head at one end. The coupling is positioned on top the pedicle screw and releasably engages portions of the head. The coupling and pedicle screw are positioned within a distal portion of the housing. The pedicle screw is slid through an opening in the insert and the insert is thread into the distal portion of the housing to retain the coupling and the pedicle screw within the housing. The pedicle screw is rotatable and pivotable relative to the housing. Compressing the coupling within the housing locks the pedicle screw in a desired orientation.

Abstract: A pedicle screw construct includes a pedicle screw, a coupling, a collet, and a set screw. The pedicle screw includes a shank having a helical thread formed thereon and a head at one end. The collet is positioned atop the head of the pedicle screw. The collet and pedicle screw are inserted into the coupling. The set screw is positioned in the collet such that the set screw contacts a portion of the rod and is releasably secured to the pedicle screw via a gripping tool. The pedicle screw is rotatable and pivotable relative to the collet and coupling assembly.

Abstract: An assembly for rigid bone fixation includes a plate and a screw. The screw can be rotated freely within the plate in a non-locking configuration to secure the plate against the bone. A locking mechanism is engaged to prevent the screw from moving relative the plate. In one embodiment, the plate includes a threaded portion and a non-threaded portion. The screw head rotates within the non-threaded portion to tighten the screw and pull the plate against the bone. The locking mechanism can include a moveable nut that rotates within the threaded portion of the plate to lock the screw and plate in a locking mode. The locking mechanism can include a second screw to actuate and expansion portion of screw inserted into the bone. The assembly can be used for rigid fixation of bones that experience cyclic loads, such as the sternum and mandible. Methods of rigid bone fixation are also described.

Abstract: A screw is configured to be inserted into an aperture of a plate. The screw comprises a head, a neck that extends distally from the head and having a diameter, a shoulder that extends distally from the neck and has a diameter, and a shaft that extends distally from the shoulder and has a thread, a major diameter and a minor diameter. The diameter of shoulder is larger than the diameter of the neck and larger than the minor diameter of the shaft.

Abstract: Cannulated anchors are provided that may be optimally forced in, press fit, screwed in or otherwise installed into tissue with minimal damage to the flexible members or sutures attached thereto. Systems for installing at least one flexible member into tissue include the cannulated anchor, the at least one flexible member capable of being received by the cannulated anchor; and an installer with a driver head insertable into the cannulation of the anchor proximate the trailing end and with an essentially longitudinal cannulation centrally disposed along the axis and sized to accept a guidewire therethrough. Movement of the installer about the longitudinal axis causes corresponding movement of the cannulated anchor such that the outer surface of the cannulated anchor is capable of effecting anchoring into the tissue.

Abstract: A system and method for facilitating the fixation of bone fractures is disclosed. The head component includes a tip, cutting threads and mating threads which are inserted into the far cortex of the bone. A wire extends from the head component and exits from the near cortex. A cap device includes a tension spring, wherein the tension spring is configured to assert friction against the wire when the cap is translated in one direction, but minimal friction against the wire when the cap is translated in the opposite direction. The cap is threaded over the wire such that the cap is restricted from backwards movement. Tension is then applied to the wire while the cap is tightened against or within the bone surface to apply an appropriate amount of pressure between the surfaces of the fracture. The excess wire beyond the cap can then be removed.

Abstract: Bone screw assemblies include longitudinal connecting members that provide for dynamic stabilization, some including non-uniform portions that are configured to flex, contract or expand. Composite longitudinal connecting members include longitudinal segments made from different materials having different flexibilities. Polyaxial bone screw assemblies include change-out receivers for cooperating with replacement longitudinal connecting members having a different flexibility. Bone screw shanks for cooperating with one or more open receivers include treatment or coating to provide biologically active interface with bone.

Abstract: A dynamic anchoring device is described. An element with a shank for anchoring in a bone or a vertebra and with a head connected to the shank is provided with a receiving part for the head and with an elastomeric pressure element acting on the head. The pressure element is formed and located in such a way that, upon a movement of the element from a first angular position of the shank relative to the receiving part into a second angular position, it exerts a return force on the head. Further, a dynamic stabilization device, in particular for vertebrae, is provided. In such a stabilization device, a rod is connected two anchoring devices. At least one of the anchoring devices is constructed as dynamic anchoring element.

Abstract: The present invention generally provides a polyaxial fixation device having a shank with a spherical head formed on a proximal end thereof, and a receiver member having an axial passage formed therein that is adapted to polyaxially seat the spherical head of the shank. The polyaxial bone screw further includes an engagement member that is adapted to provide sufficient friction between the spherical head and the receiver member to enable the shank to be maintained in a desired angular orientation before locking the spherical head within the receiver member.

Abstract: The fastening system consists of the polyaxial ball and socket joint used in conjunction with a bone screw having threads on one end for use in anchoring to the spine and a spherical connector on the other end operating as a pivot point about which a connecting assembly moves in a polyaxial fashion. A substantially U-shaped connecting assembly has a lower receptacle that operates as a socket for housing a retainer ring within a retaining ring groove.

Abstract: The present invention is directed a polyaxial bone fixation element for use in spinal fixation to interconnect a longitudinal spinal rod with a patient's vertebra. The polyaxial bone fixation element preferably includes a bone anchor, a collet, a body, and a locking cap. The polyaxial bone fixation element preferably enables in-situ assembly. That is, the polyaxial bone fixation element is preferably configured so that in use, the bone anchor may be secured to the patient's vertebra prior to being received within the body. Accordingly, the polyaxial bone fixation element enables a surgeon to implant the bone anchor without the body to maximize visibility and access around the anchoring site. Once the bone anchor has been secured to the patient's vertebra, the body can be snapped-onto the bone anchor. The bone anchor preferably also includes a second tool interface so that a surgical instrument can be directly coupled to the bone anchor.

Abstract: The fastening system consists of the polyaxial ball and socket joint used in conjunction with a bone screw having threads on one end for use in anchoring to the spine and a spherical connector on the other end operating as a pivot point about which a connecting assembly moves in a polyaxial fashion. A substantially U-shaped connecting assembly has a lower receptacle that operates as a socket for housing a retainer ring within a retaining ring groove. The retaining ring cooperates with the connector assembly and a saddle that is positioned atop the spherical connector.

Abstract: An anchor-in-anchor fixation system is provided for securing underlying structure, such as bone. The fixation system includes a linkage that defines first and second bores, a first bone anchor having a shaft for fixation to underlying bone, and a head that is configured to attach to the linkage in the first bore, and a second bone anchor having a shaft for fixation to underlying bone and a head that is configured to attach to the linkage in the second bore.

Abstract: A pedicle screw fixation system and method for use of the same are disclosed. In one embodiment, a tulip is provided for holding a head of a pedicle screw substantially along a longitudinal axis. The tulip includes opposing first and second U-shaped receiving slots aligned along a transverse axis. A rod is received by the opposing first and second U-shaped receiving slots. A coupling collar includes a plurality of resilient fingers circumferentially disposed therearound such that a snap fit engagement with the head of the pedicle screw formed. The coupling collar includes a first deformable face operable for contact with the rod. A set screw is for adapted for driving engagement through the tulip along the longitudinal axis such that a second deformable face is positioned for contact with the rod. The first and second deformable faces conform to the shape of the rod in response to forceful engagement therewith.

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: The disclosed fasteners have a substantially cylindrical expansion head to secure the fastener in a support structure. The expansion fastener has a removable locking ring, a head, and a shaft extending from the distal end of the head. The exterior of the head has at least one slot extending from the edge toward the distal end. The slots can extend partially or fully to the base of the head. In one embodiment the locking ring has at least one tab that extends beyond the periphery and a tool receiving area. In one embodiment a channel having wall periphery reduction area receives a locking ring with tabs which, when rotated to contact the reduction areas expand the head. In another embodiment the locking ring has a threaded periphery that interacts with a reduced diameter threaded periphery within the head to expand the exterior of the head.

Abstract: The specification describes one-piece dental implants comprising a threaded shaft, optionally a non-circular abutment and a head having a shape which is capable of accepting a keeper cap or an O-ring, or which is capable of accepting and retaining a dental wire. The implants have dimensions that permit their use in a non-surgical method of insertion into bone, and are useful in both prosthodontic and orthodontic applications. It is emphasized that this abstract is provided to comply with the rules requiring an abstract which will allow a searcher or other reader to quickly ascertain the subject matter of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims.

Abstract: A surgical screw assembly is provided that includes a fastener including an elongate shaft having a proximal end and a distal end and a head at the proximal end. A tulip having an internal bearing surface and a distal end having a bore therethrough is provided to allow the distal end of the elongate shaft to pass therethrough. A first step feature located at a distal end portion of the bore and extending inwardly therefrom reduces the diameter of the bore to allow the distal end of the elongate shaft to pass therethrough, but prevents passage of the head therethrough. A second step feature located at a distal end portion of the bore, distally of the first step feature, further reduces the diameter of the bore to a dimension less than a dimension established by the first step feature, the further reduced dimension allowing the distal end of the elongate shaft to pass therethrough, but preventing passage of the head therethrough.

Abstract: A surgical screw assembly including: a fastener including an elongate shaft having a proximal end and a distal end and a head at the proximal end. A tulip having a an internal bearing surface is provided. A distal end of the tulip has a bore therethrough defining the internal bearing surface. Locking enhancement features are configured to cooperate with the head, such that, in an unlocked configuration, the head is movable relative to the tulip; in a provisionally locked configuration, the locking enhancement features engage the head with a first polyaxial grip strength; and in a finally locked configuration, the locking enhancement features engage the head with a second polyaxial grip strength greater than the first polyaxial grip strength.

Abstract: The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of a spinal fixation procedure. A uniplanar bone anchor system for a fixation procedure is provided. The system can include a bone fastener including a head with a bearing surface and an engagement surface, and a shaft adapted to engage an anatomy. The system can include a saddle, which can include a first bore that receives the bone fastener and a coupling bore defined transverse to the longitudinal axis. The system can include a pressure cap received within the first bore having an engagement surface in contact with the engagement surface of the bone fastener. The system can further include a coupling system that can be received through the at least one coupling bore and can cooperate with the pressure cap to permit the bone fastener to move in only one plane.

Abstract: A polyaxial bone anchoring device includes a receiving part to receive a rod for coupling the rod to a bone anchoring element, the receiving part having a top end and a bottom end, a first passage at the bottom end with a first longitudinal axis, and a second passage at the top end with a second longitudinal axis that intersects the first longitudinal axis, and a compression element, wherein at least one of the receiving part or the compression element has a seat with an opening facing the bottom end, and wherein the compression element is movable relative to the receiving part along the first longitudinal axis between a first position wherein the seat is expandable and configured for insertion of a head of a bone anchoring element and pivoting of the head, and a second position wherein the seat is compressed to lock an inserted head therein.

Abstract: A receiving part for receiving a rod for coupling the rod to a bone anchoring element includes a receiving part body including a rod receiving portion with 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 so as to allow introduction and clamping of the head, the head receiving portion having an exterior surface with a tapered portion; and a locking ring around the head receiving portion and including an interior surface with a curved portion configured to engage the tapered portion of the exterior surface of the head receiving portion to clamp the head.

Abstract: A receiving part for receiving a rod for coupling the rod to a bone anchoring element includes a receiving part body including: a rod receiving portion with 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 an exterior surface with a curved portion; and a locking ring around the head receiving portion, wherein the locking ring has an interior surface with a curved portion for engagement with the curved portion of the exterior surface of the head receiving portion for locking a position of the head relative to the head receiving portion.

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: 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: 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: 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: The present invention is directed to a pedicle screw fixation system which can be made for either posterior cervical, thoracic, lumbar spine, or elsewhere. With this type of system a surgeon can implant a pedicle screw system utilizing the same instrument set for an open or closed procedure. The system is designed to avoid cross threading and splitting of tulip heard by use of an outer threaded tulip and reducing donut. The system also provides the ability for superior angulation for hard to reach areas that are common in spinal procedures. The system allows for a bio-absorbable part (the reduction donut) that enhances fusion in the coming months after the procedure. With the elongate tulip portion of the system the user is able to avoid the need for other cannula type instruments; the need of additional parts; the need of additional instruments which could introduce bacteria into the patient and the need for fluoroscopy. The system is completely cannulated so as to permit a HOLDING wire driven procedure.

Abstract: A threaded bone anchor includes a plurality of recesses formed lengthwise along an exterior cylindrical surface for engagement with a driver instrument through which a user applies clockwise or counterclockwise torque for the insertion or removal of the bone anchor into and from bone. The bone anchor includes a cross-sectional geometry that minimizes the anchor's outer diameter, survives high insertion/removal torque without compromising the anchor's bending/shear strength, and allows a mating clamp to be attached to the entire non-threaded surface, including the recessed portion.

Abstract: A receiving part for receiving a rod for coupling the rod to a bone anchoring element includes a receiving part body with a top end, a bottom end, a central axis, a channel for receiving a rod, and an accommodation space for accommodating a head of a bone anchoring element, the accommodation space having an opening at the bottom end for introduction of the head, and a single piece pressure element having a top end, a bottom end, and a flexible portion to clamp the head, wherein the flexible portion has a first slit extending partially around the central axis when the pressure element is in the receiving part body, and a second slit extending from the bottom end of the pressure element to the first slit.

Abstract: An intervertebral stabilization system for at least three vertebrae comprising pedicle screws attachable to the vertebrae; at least one rod for the connection of at least two pedicle screws to form a rigid stiffening system; and at least one band which is capable of being pre-stressed in tension and which is surrounded in the implanted state of the stabilization system by at least one compressible pressure member arranged between two adjacent pedicle screws for the connection of the pedicle screws to form an elastic support system, wherein a common pedicle screw is associated both with the stiffening system and with the support system and the band is can be connected or is connected to the rod by means of a band attachment.

Abstract: An implant for fusing adjacent bones is disclosed. The implant includes an elongate threaded member and a flexible portion extending from the elongate threaded member. The flexible portion includes a plurality of prongs configured to be reversibly compressed toward an axis defined by the elongate threaded member.

Abstract: A bone fastener for use in orthopaedic surgery for anchoring an intramedullary nail to bone has a shaft with a front region and a rear region adjacent to the front region. The rear region has one or more explantation grooves helically arranged for facilitating the explantation of the bone fastener. Two axially spaced apart grooves or groove sections are separated by a flat shaft portion defining an outside diameter of the rear region, wherein the rear region has a core diameter greater than a core diameter of the front region.

Abstract: Disclosed embodiments relate to a fastener operable to be received into an opening defined in a plate. The fastener may include a modular sleeve having an actuatable mechanism operable to prevent the rotation of the fastener relative to the plate. The modular sleeve may be moved from a non-actuated first position and an actuated second position to actuate the actuatable mechanism. A portion of the modular sleeve may be accessible from a top side of the head of the fastener through a plurality of channels in the head, and the modular sleeve may be accessible through the plurality of channels in the head in order to actuate the modular sleeve.

Abstract: A self-drilling, self-tapping bone screw includes a body having a head at one end and a cutting end at an opposite end, the cutting end having a generally flat cutting surface supporting two symmetrical cutting edges which extend from the longitudinal centerline to diametrically opposed thread start points. A recess is formed in the head for receiving an end of an insertion tool. A dual lead thread extends outwardly from the body in a spiral path from the cutting end towards the head. The dual lead thread pitch is tapered towards the cutting end, and transitions to a straight or slightly tapered thread towards the head.

Abstract: The invention relates to a screw, particularly for attaching a superstructure to an intra-osseous implant. The extends along a longitudinal axis and comprises a head and a thread. The head comprises a bearing surface configured to cooperate with a bearing surface of the superstructure to hold the superstructure in position. The thread is configured to engage with a tapping to tighten the bearing surfaces of the superstructure and the screw. Between the bearing surface and the thread, the screw comprises a safety portion. The safety portion comprises a driving shape and a frangible section at the connection between the safety portion and the head of the screw, so that the driving shape remains attached to the thread if the frangible section breaks.

Abstract: A multi-axial screw assembly comprises a receiver, a base member, a crown and a bone screw. The base member includes an aperture extending through the base member and an opening on a bottom portion of the base member. The base member is rotatable relative to the receiver and has an inner wall extending partially around the aperture. The crown is received in the receiver and configured to mate to the base member. The crown has a projection configured to extend into the opening of the base member. The projection is configured to have an abutting surface. The bone screw is located between the base member and the crown, the bone screw is configured to be provisionally fixed within the receiver by a force between the abutting surface of the projection and the inner wall of the base member.

Abstract: Present invention depicts a poly-porous (micropore) hollow screws as diffusion chamber filled with core matrix for targeted delivery of growth factors and bone marrow stem cells. The screws comprise at least two parts: the distal part of the screw consists of the tip of the screw made of poly porous material and hollow inside proximally. It has threaded navel attached to the threaded nipple of the distal part of the proximal screw which has the screw head and is made of the solid material of the same kind. The screw head had hexagonal recess targeted for screw driver insertion. Assembly of screw created a chamber in the middle of the screw. The chamber is filled with core matrix consisting of gelatin nano-particles pre-impregnated with BMPs (BMP2/BMP7 for bone or BMP12 for tendon, ligament) and fibrin sealants or Chitosan dispersed with bone marrow stem cells and/or other growth factors. Bioactive protein core material is prepared during the surgery and filled the chamber of the screw by the surgeon.

Abstract: 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 a groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.