Abstract: Spinal plates with additional features to improve the stability of the interface between the plate and the underlying bone. A bone plate may include one or more sharp ridges along the periphery of its underside. When attached to bone, the ridge digs into the bone and increases stability. A bone plate may alternatively or additionally include one or more holes for optional spikes, which may be inserted once the plate is attached to the bone. By separating the spikes and including them as an optional component, the plate may enhance stability while reducing or eliminating the chance of the spike injuring the patient. Furthermore, bone screws may incorporate alternating notches and ridges into the head of the screw. The notches and ridges may interface with a set screw, thereby preventing rotation and loosening of the screw.

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 having a sub-structure, 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: Polyaxial bone anchors include a retainer for holding a shank within a receiver, the retainer being in at least two discrete pieces and cooperating with a variety of inserts, some of which independently lock the polyaxial mechanism. Polyaxial and mono-axial bone anchor assemblies include pivot and/or pressure inserts or pads that cooperate with longitudinal connecting members to provide a desired degree of continued control of angulation of the longitudinal connecting member in the sagittal plane or to hold the connecting member in place. Pressure pads for deformable rods may also be made from a deformable plastic material.

Abstract: A screw for use in spinal surgery provided with a screw shaft and a screw head and at least one extension tab extending proximally from the screw head, the extension tab being defined relative to the screw head by a stress concentration feature. At a proximal end of the extension tab, the extension tab may be narrower in a circumferential direction than the extension tab at a distal portion thereof. A particular shape of stress concentration may be provided.

Abstract: A cannulated bone anchor assembly includes a bone anchor, a receiver member for receiving a spinal fixation element to be coupled to the bone anchor, and a closure mechanism to fix the spinal fixation element with respect to the receiver member. The bone anchor includes a distal shaft having a first threaded section proximal a proximal head, a second threaded section proximal to and adjacent the first threaded section, and a third threaded section proximal to and adjacent the second threaded section. The first threaded section having a constant major and minor diameter. The second threaded section having a tapering major and minor diameter. The third threaded section having a tapering major diameter and a constant minor diameter.

Abstract: Systems, devices, and methods for percutaneously implanting a spinal screw provide reduced trauma to soft tissues, less blood loss and postoperative pain, less scarring, and faster mobilization compared to open spinal procedures. The devices and methods provide techniques for percutaneous insertion of pedicle screws or other screws without the use of a guide wire. Screw extenders are paired and include extending branches with elongated portions for extending from a proximal end outside a patient to a distal end. The screw extenders include interlocking tabs and other locking mechanisms at the distal ends that connect at the undersurface of a screw head and include a graduated bilateral locking mechanism to ensure a positive connection between the paired extender branches. The screw extenders are used through a working channel firmly held in place by a table-mounted flexible arm. The screw extenders can be used on available pedicle screw systems to convert their insertion to a percutaneous technique.

Abstract: A pedicle screw assembly, including: a bone screw having a head portion and a thread portion, wherein the thread portion includes an axial shaft and a triple lead thread disposed about the axial shaft; and a rod retention member selectively coupled to the head portion of the bone screw. Optionally, the triple lead thread includes leads that originate at different points along the axial shaft. Optionally, the triple lead thread includes leads that terminate at different points along the axial shaft. Optionally, the axial shaft includes a first tapering portion proximate a tip of the axial shaft. Optionally, the axial shaft includes a second tapering portion proximate the tip of the axial shaft. Preferably, the second tapering portion tapers more steeply than the first tapering portion. Optionally, the axial shaft includes a reduced diameter portion proximate the head portion. Optionally, the axial shaft includes one or more tapering portions proximate the head portion.

Abstract: A lock screw assembly for use with a pedicle screw assembly comprises a lock screw and an upper saddle. The lock screw includes a fastening tool engaging structure at a first end portion thereof and an upper saddle receiving structure at a second end portion thereof. The upper saddle is engaged with the upper saddle receiving structure of the lock screw in a manner allowing the upper saddle to rotate about a centerline axis of the lock screw. A plurality of intersecting spine rod receiving channels extend through a spine rod engaging portion of the upper saddle in a manner such that an outwardly-extending spine rod engaging structure is provided between adjacent ones of the spine rod receiving channels. Upper and lower surfaces of each spine rod engaging structure are acutely angled with respect to each other and wherein a channel edge defined between the surfaces is sharply pointed.

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 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. A rod reducer may be secured to the polyaxial pedicle screw to secure a spinal rod within the housing.

Abstract: A tool set for implanting a rod in a human spine in conjunction with bone screws. The tool set includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Intermediate guide tools having guiding pass through slots are utilized to guide intermediate locations along the rod toward associated bone screws. An attachment structure operably connects the guide tools to the bone screws. The guide tools each include a lower guide and advancement structure to allow a closure top with mating structure to be rotated and driven downward against the rod and to cooperate with similar structure in the bone screw to seat and lock the rod therein.

Abstract: An implantable assembly includes an anchor member and a spacer. The anchor member has a hub portion and a shank portion. The spacer includes a central opening to receive bone fusion material and at least one passage for receiving the anchor member. In one embodiment, the passage includes first and second means for locking the anchor member in the passage against backout. The second means for locking the anchor member in the passage against backout includes means for centering the anchor member in the passage and means for stabilizing the anchor member in the passage. In addition, the second means for locking the anchor member in the passage against backout provides a mechanical advantage to assist in driving the screw into bone and mechanical advantage to assist in reversing the screw out of the spacer.

Abstract: Various bone screws and methods for accommodating stiffness regions in bone are provided. The bone screw provided generally includes a receiver member configured to receive a fixation element and an elongate shank having different stiffness regions. In one embodiment, the elongate shank can include at least one slot for increasing the flexibility of the slotted portion of the elongate shank. In another embodiment, the elongate shank can be manufactured from materials selected to alter the stiffness of the shank. The different stiffness regions allow the bone screw to mimic the flexibility of bone, reducing the risk of fracture of the bone and/or loosening of the bone screw.

Abstract: A tool set for implanting a rod in a human spine in conjunction with bone screws. The tool set includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Intermediate guide tools having guiding pass through slots are utilized to guide intermediate locations along the rod toward associated bone screws. An attachment structure operably connects the guide tools to the bone screws. The guide tools each include a lower guide and advancement structure to allow a closure top with mating structure to be rotated and driven downward against the rod and to cooperate with similar structure in the bone screw to seat and lock the rod therein. A method utilizing the tool set allows a surgeon to percutaneously implant the rod in the patient.

Abstract: A surgical method is for at least one ilium having an iliac crest and inner and outer tables on opposing sides of the iliac crest. The method may include inserting at least one base into the ilium, where the at least one base has a channel therein. The method may further include inserting a support member through the ilium and through the channel of the at least one base so that the support member extends between the inner and outer tables, and securing the support member to the at least one base.

Abstract: Bone screws, such as polyaxial bone screws, with dilations located between the screw head and the threaded portion of the screw, for use in preserving polyaxial functionality of the screw head and/or to which crosslinks may be coupled.

Abstract: A bone anchor assembly is described having a large diameter for fixing a spinal connection element to bone. The assembly includes a receiver member for receiving the spinal connection element, a bone-engaging shank for engaging bone and a first and second insert for retaining the head of the shank within the receiver member.

Abstract: A spinal stabilization system for surgical implantation in the spine having a bone fastener. The bone fastener is provided with a head portion and a shaft portion. A housing is also provided with a recess defined by sidewalls and an opening for receiving the head portion of the bone fastener. A seating element is disposed within the housing and positioned over the head portion of the bone fastener. An elongate rod is positioned on the seating element within the recess of the housing. The system also includes a cap capable of engaging with a top portion of the housing and capturing the elongate rod within the recess of the housing when the cap is rotated. The bone fastener articulates in a single plane with respect to the housing and the seat element.

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 has a lower friction fit collet and an outer receiver press fit surface. A down-loadable retaining ring has at least one inner edge and outer tiered surfaces. The ring cooperates with the shank 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. A uni-planar assembly is included.

Abstract: The present invention is generally directed to orthopedic fixation devices that comprise a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element.

Abstract: A bone screw assembly includes a screw, an outer housing, and an inner housing. The screw includes a shank and a head. The outer housing has a proximal end, a distal end, and a passageway extending longitudinally therethrough. The outer housing defines a saddle at the proximal end thereof for receiving at least a portion of a rod therein. The inner housing is positionable within the passageway of the outer housing. The inner housing has a recessed distal portion for receiving the head of the screw therein. The inner housing also includes a proximal surface defining a substantially V-shaped configuration for receiving rods of different diameters therein.

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 surgical bone screw includes an elongate body having a proximal end, a distal end, a threaded portion on the circumference of the body, and a passage extending between the proximal and the distal ends of the body. An electrical conductor is disposed in the passage between the proximal and the distal ends of the screw body. The conductor has a first terminal at the proximal end and a second terminal at the distal end. The conductor and both of the terminals are electrically insulated from surrounding portions of the screw body. When the screw is driven into bone tissue and a stimulating current is applied to the first terminal, the current is directed substantially through the conductor to flow into tissue adjacent to the second terminal at the distal end, without shunting by other tissue that surrounds the screw body.

Abstract: A bone anchoring device includes an anchoring element having a shank to be anchored in a bone or a vertebra, a receiving part connected to the shank the receiving part having a first end opposite to the shank and a second end facing the shank, a longitudinal axis passing through the two ends, a bore coaxial with the longitudinal axis extending from the first end through at least a portion of the receiving part and a substantially U-shaped recess for receiving a rod The U-shaped recess forms two free legs extending in the direction of the first end, the legs are provided with an internal thread. A locking device for securing the rod in the receiving part is provided which includes an external thread cooperating with the internal thread.

Abstract: A dynamic bone anchor for anchoring a spine stabilization assembly which supports the spine while providing for the preservation of spinal motion. The dynamic bone anchor provides load sharing while preserving range of motion and reducing stress exerted upon the bone anchors and spinal anatomy. The dynamic bone anchor includes a deflectable post connected by a ball-joint to a threaded anchor. Deflection of the deflectable post is controlled by a compliant ring. The force/deflection properties of the dynamic bone anchor may be adapted to the anatomy and functional requirements of the patient. The dynamic bone anchor may be used as a component of a dynamic stabilization system which supports the spine while providing for the preservation of spinal motion.

Abstract: A spinal fixation assembly includes a pedicle rod and pedicle screws which secure the pedicle rod to the spine. Each pedicle screw includes a head configured to receive a portion of the pedicle rod, and a threaded portion extending from a first end of the head and configured to engage a vertebra. The pedicle rod is secured to the head by a fastener. The head includes a breakaway region that defines a location in which at least a first portion of the head can be easily separated from the remainder of the head upon application of sufficient force to the first portion. A minimally invasive method of implanting the spinal fixation assembly is disclosed.

Abstract: A bone screw including a main body portion having a proximal end and a distal end. An external threaded surface and an internal threaded surface are formed on the main body portion. The external threaded surface intersects the internal threaded surface proximate a lower surface of the external threaded surface and a lower surface of the internal threaded surface. A plurality of bone growth apertures is defined on the surface of the main body portion where the external threaded surface and the internal threaded surface are not located. The bone growth apertures comprise between about 10 percent and about 60 percent of the surface of the main body portion.

Abstract: A dynamic bone anchor for anchoring a spine stabilization assembly which supports the spine while providing for the preservation of spinal motion. The dynamic bone anchor provides load sharing while preserving range of motion and reducing stress exerted upon the bone anchors and spinal anatomy. The dynamic bone anchor includes a deflectable post connected by a ball-joint to a threaded anchor. Deflection of the deflectable post is controlled by a compliant sleeve. The force/deflection properties of the dynamic bone anchor may be adapted to the anatomy and functional requirements of the patient. The dynamic bone anchor may be used as a component of a dynamic stabilization system which supports the spine while providing for the preservation of spinal motion.

Abstract: A collet for a spinal rod bone screw assembly is configured to provide an interference fit with the top or head of a polyaxial bone screw in order to aid in locking orientation of a polyaxial bone screw head relative to the polyaxial bone screw. An increase in spherical coverage created by the configuration of the collet increases the amount of surface contact with the polyaxial bone screw head. This allows for more controlled, uniform and secure orientation of the polyaxial head with respect to the bone screw during lock-up. A resilient, tapered base of the collet has a plurality of slots that allow the end of the collet to splay outwardly over and upon the head of the bone screw to create a snap or frictional interference fit between the collet and the polyaxial bone screw head when a spinal rod is fixed in the polyaxial bone screw head.

Abstract: The invention relates to a device that provides enhanced mechanical stabilization, as well as methods for its use. In various embodiments, the device is configured in a manner similar to a conventional screw, but with mechanical elements that afford greater fixation and stability and that lessen the likelihood that the device loosens after insertion into a substrate and/or falls out of the substrate entirely or releases its interaction with the substrate. Moreover, the device may have better pullout strength as compared with conventional screws and screw-type devices used in a range of applications.

Abstract: A spinal stabilization assembly is provided and includes a cup, fastener and keeper portions surrounding the head of the fastener. Further, methods of use of a spinal stabilization assembly are also provided. The keeper portions are located within the cup and at least partially surround the head of the fastener.

Abstract: A polyaxial bone screw includes a head member and a shank member. The shank has a capture end and an opposite threaded end for threaded insertion into a vertebra. The head has a U-shaped cradle for receiving a spinal fixation rod and a central bore for receiving the capture end of the shank. An expandible retainer ring with a radial split is snapped onto the capture end of the shank to retain it within the head. The retainer ring has a spherical outer surface which forms a ball joint with a spherical socket cavity within the head to enable the head to be angled relative to the shank. A threaded closure plug is tightened within the cradle to clamp the rod into engagement with a knurled dome on the capture end of the shank to secure the rod relative to the vertebra.

Abstract: A polyaxial bone screw assembly includes a receiver, a shank, an articulation structure for retaining the shank in the receiver and a compression insert for engagement with a longitudinal connecting member such as a rod. The articulation structure includes substantially spherical convex and concave surfaces that slidably engage both shank and receiver surfaces to provide compound articulation between the receiver and the shank. The receiver includes inwardly directed spring tabs engaging the insert and prohibiting rotation of the insert within the receiver.

Abstract: One nonlimiting embodiment of the present application is directed to a system for positioning a connecting element adjacent one or more bones or bony portions, such as the spinal column, through a minimally invasive surgical approach. The system generally includes a number of bone anchors engageable to the one or more bones or bony portions and a number of anchor extenders removably engaged to the bone anchors. A connecting element inserter instrument is engageable with one of the anchor extenders and is movable along a longitudinal axis of the anchor extender. As the inserter instrument is moved along the longitudinal axis toward the bone anchors, a leading end of the connecting element is rotated away from the longitudinal axis and the connecting element is positioned at a location adjacent the number of bone anchors in a minimally invasive surgical procedure. However, in other embodiments, different forms and applications are envisioned.

Abstract: The invention relates to a fixation device for bones, consisting of all implant (1; 11), having at least one through hole (2; 12), to be fastened to the bone, and of at least one bone screw (3; 13) to be fastened in said through hole (2; 12), fastening elements (5; 15) being arranged in the through hole (2; 12) and at the top end of the bone screw (3; 13) and engaging with each other. In order to allow various angular positions of the bone screw (3; 13) relative to the implant (1; 11) without cold welding, interlocking earns (6, 7; 16, 17) are arranged on the associated surfaces of the through hole (2; 12) and the bone screw (3; 13) as the fastening elements (5; 15).

Abstract: A bone screw system includes a bone screw and a connecting device for coupling the bone screw to an elongate rod-shaped member. The bone screw has proximal and bone-engaging portions disposed at opposing ends relative to a long axis of the screw. The proximal portion includes a proximal locking feature that extends away from the long axis in a radial direction that is perpendicular to the long axis. The connecting device includes first and second coupling portions at opposing ends relative to the long axis when the coupling device is assembled to the bone screw. The first coupling portion defines an opening for receiving the proximal portion of the bone screw. The second coupling portion is configured to receive the rod-shaped member. The connecting device also includes a restraining feature that frictionally resists rotational motion of the connecting device relative to the bone screw.

Abstract: A fastener, for example a bone screw, is sized to pass into an aperture of an implant, for example a bone plate, the fastener having an anchor portion engageable with body tissue, and a head portion formed by an assembly of an insert and an anchor extension. The implant has an aperture with a reduced entry dimension. The insert and anchor extension cooperate to form a reduced dimension passable into the aperture, and an expanded dimension not passable out of the aperture. The size of the assembly is configurable by bending resilient tabs of the anchor extension or the implant, using ramped surfaces, or an expanding diameter of a threadable insert.

Abstract: A dynamic stabilization, motion preservation spinal implant system includes an anchor system, a horizontal rod system and a vertical rod system. The systems are modular so that various constructs and configurations can be created and customized to a patient.

Abstract: A fracture fixation device is described for fixing a bone having a near cortex and a far cortex, comprising a shaft portion configured to span a distance between the near cortex and the far cortex of the bone; a head portion adjoining the shaft portion and providing for engagement of the device with a bone plate, wherein the head portion is integral with the shaft portion; and a threaded front section for engagement of the device with the far cortex of the bone, wherein the device permits motion of the shaft portion relative to the near cortex.

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: Polyaxial bone anchors include a retainer for holding a shank within a receiver, the retainer being in at least two discrete pieces and cooperating with a variety of inserts, some of which independently lock the polyaxial mechanism. Polyaxial and mono-axial bone anchor assemblies include pivot and/or pressure inserts or pads that cooperate with longitudinal connecting members to provide a desired degree of continued control of angulation of the longitudinal connecting member in the sagittal plane or to hold the connecting member in place. Pressure pads for deformable rods may also be made from a deformable plastic material.

Abstract: One nonlimiting embodiment is directed to an anchor extender releasably engaged with an anchor configured for engagement with one or more bones or bony portions. The anchor extender generally includes a first member and a second member positioned about and movable relative to the first member. The anchor extender is positionable adjacent the anchor and movement of the second member relative to the first member toward the anchor as the anchor extender is engaged with the anchor results in lateral displacement of the anchor extender relative to the anchor while the first member engages with a first side of the anchor and the second member engages with an opposite second side of the anchor. However, in other embodiments, different forms and applications are envisioned.

Abstract: A pedicle screw configured to secure a rod is disclosed. In some embodiments, the pedicle screw is provided with a shaft, a yoke, a cap, a saddle and at least one separating device. The shaft has a forward end, a rear end and a longitudinal axis, the forward end being configured for insertion into a bone. The yoke is attached to the rear end of the shaft and has an interior wall nearest the shaft configured to bear against a rod inserted into the yoke. The cap is configured to engage an end of the yoke opposite the shaft. The saddle has a first side configured to mate with the cap within the yoke, and has an opposite second side configured to bear against the rod. The at least one separating device is coupled between the cap and the saddle, and is configured to urge the cap and the saddle apart from one another.

Abstract: An apparatus for automated implantation of an implant or for an automated augmentation process of hard tissue and/or hard tissue replacement material using a sheath element is provided. The apparatus comprises a casing, a converter operable to generate mechanical vibrations the converter inside the casing and displaceable in a longitudinal direction relative to the casing, and a sonotrode coupled to an output location of the converter. A shaft portion with a retention structure is rotationally coupled to the casing and is equipped for cooperating with a rotationally asymmetric element of the sheath element to rotationally couple the casing to the sheath element. An axial coupling is equipped for locking the casing to the sheath element. The shaft portion, the axial coupling and the sonotrode are mutually arranged so that the a distal end of the sonotrode may be introduced into a longitudinal opening of the sheath element.

Abstract: A multi-axial screw assembly comprises a receiver member, a base member, a crown and a bone anchoring member. The receiver member has an aperture configured to receive the base member and an internal groove. The base has a deflectable ring configured to mate with the internal groove of the receiver member and a slot configured to allow the deflectable ring to compress to a diameter less than the diameter of the aperture such that the base member may be compressed and axially received within the receiver member. The base member is axially restrained within the base member relative to the receiver member while allowed to rotate relative to the receiver member. The crown is received within the receiver member along the central axis of the receiver member. The crown maintains the diameter of the deflectable ring greater than the diameter of the aperture.

Abstract: An external fixator implant screw with an intercalated head, of which one embodiment for lag screw mode has a spherical head, and a partial thread. The spherical head in countersunk bone exerts concentric wide contact on insertion at various angles to surface. Optional canalization of central rod allows guide wire technique and optional mobility of head allows variable shaft length between head and thread. Another embodiment for use in basic implant mode, in a single bone fragment, at right angles to bone surface, has a conical head with limited basal contact on bone, the head being integrated to a solid rod and is fully threaded from head to leading tip. In both embodiments, the load transmission is renewable from outside in case of loosening, without reopening any wound. The implant is made of biocompatible material.

Abstract: A bone anchor assembly is provided, which may be used in cervical, thoracic, lumbar or sacral areas of the spine or other orthopedic locations. The anchor assembly includes a bone anchor, a receiver mounted to the bone anchor, a saddle within the receiver, a spacer within the receiver, and an engaging member. The receiver extends along a central longitudinal axis proximally away from the bone anchor. A rod or other elongated connecting element is received in a passage of the receiver in contact with the saddle, and the engaging member engages the connecting element against the saddle, which engages the saddle against the spacer, which in turn engages the proximal head of the bone anchor in the receiver. The orientation of the saddle in the receiver is adjustable to correspond to the orientation of the connecting element relative to the central longitudinal axis of the receiver.

Abstract: A polyaxial screwdriver for inserting a bone screw in a vertebra. A polyaxial bone screw assembly includes a coupling element. When a screw engaging end of the polyaxial screwdriver is lowered on the head of the bone screw, the complimentary surfaces of the screw engaging end of the screwdriver and the head of the screw self-align. A ratchet mechanism formed in the screwdriver provides progressive and automatic locking of the polyaxial screwdriver to the coupling element and prevents the accidental unthreading from the coupling element. In another embodiment of the polyaxial screwdriver, a collet slides over the outside surface of the upper end of the coupling element and locks on to the coupling element. In yet another embodiment of a polyaxial screwdriver, the outer sleeve of the polyaxial screwdriver has a split end that securely engages the coupling element.

Abstract: Devices and methods include a multi-axial anchor assembly engageable to a vertebra and a connecting element positionable through a receiver of the anchor assembly. The anchor assembly includes a flexible member between the receiver and an anchor member of the anchor assembly, thereby providing a flexible joint in the anchor assembly for allowing limited movement after primary multi-axial capability between the receiver and the anchor member has been arrested.

Abstract: An absorbable screw fastener and a method of firing with an applicator capable of applying a surgical fastener to tissue in order to form tissue connection to secure objects to tissue, the fastener including a body portion having a helical thread, a head portion disposed at the proximal end of the body portion. The head portion includes a driver receiving configuration on its outer surface. The screw fastener further includes a cannulated center lumen with an opening extending from the head portion through the longitudinal length of the body portion.