The present disclosure relates to an anchor. The anchor includes a suture bridge having a proximal end and distal end. The distal end of the suture bridge has a thickness greater than a thickness of the proximal end of the suture bridge. At least two ribs extend from the proximal end of the suture bridge to a proximal end of the anchor. At least one open helical coil wraps around the at least two ribs and extends, substantially, from the proximal end of the suture bridge to the proximal end of the anchor. The at least one open helical coil defines an internal volume communicating with a region exterior to the anchor through apertures between turns of the at least one open helical coil. The at least two ribs are engagable with a grooved shaft of a driver.

A bone screw comprises a main body including a shank portion, a head portion attached to the shank portion, and a cap moveably attached to the head portion. The head portion includes a tool interface structure therein having a closed end portion, an open end portion and sidewall extending therebetween. A tool lock recess is provided in at least one of the sidewalls of the tool interface structure. The tool interface structure is accessible through an opening within an exterior surface of the cap.

A locking element is configured to be used with a polyaxial bone anchor. The locking element including a central axis, a bottom side, a top side opposite to the bottom side, and a peripheral surface portion that extending completely around the locking element that has an external thread. The bottom side defines a first recess facing toward the bottom side for accommodating and applying a force in a direction toward the bottom side to at least the portion of the head of the polyaxial bone anchor. The top side defines a second recess having a non-circular cross-section in a plane perpendicular to the central axis for torqueable engagement with a driver.

An orthopedic screw extractor device including a shaft, an end portion about a first end of the shaft for securing to a handle, and a screw extracting tip about a second end of the shaft opposite the first end. The screw extracting tip further includes a generally frustoconical shape having a side at an angle of about 5 to 15 degrees relative to a longitudinal axis of the screw extracting tip. The screw extracting tip further includes first, second and third screw threads and first, second and third flutes circumferentially spaced about the screw extracting tip and extending across an entire length of the screw extracting tip. Each of the screw threads has a lead of about 0.07 to 0.12 inches, a pitch of about 0.02 to 0.04 inches, a thread angle of about 40 to 50 degrees, and a depth of about 0.01 to 0.02 inches.

Driver instruments and related methods are disclosed herein, e.g., for applying a fastener to a bone anchor. Various features are disclosed for retaining the fastener to the driver instrument, such as tapered drive tips, as are various features for impacting the driver instrument into the fastener, such as slidable slap-hammer type handles. Driver instruments with interchangeable handles or handle geometries that can be changed without separating the instrument from an attached fastener are also disclosed.

A fixation system for spinal instrumentation comprising a cap (1), which houses the head of a screw (2), the end of said screw (2) projecting through a lower opening of said cap (1). A coupling element (3) having two tabs (33) on both side ends rests on the upper part of the head of said screw (2). Said coupling element (3) houses therein an adjusting ring (4) secured to a series of tabs (7), by which means the movement of the head of said screw (2) can be limited.

A tool adapted for use with a bone plate assembly includes a driver with an engagement portion configured to engage a locking element, and a tubular holder. The driver may be configured to extend with the engagement portion through the tubular holder, and may be axially movable and rotatable within the holder. The holder may have a radial slot adapted for insertion of the locking element. The holder may include a portion with an internal thread for cooperation with an external thread of the locking element. The locking element may be used with a polyaxial bone anchor.

A locking element is configured to be used with a polyaxial bone anchor, and is substantially cylindrical with a bottom side facing a head of the bone anchor, a top side opposite to the bottom side, and a surface portion with an external thread. The locking element has a first recess at the bottom side for accommodating at least a portion of the head, and a second recess at the top side for engagement with a driver. The second recess is located outside the center of the top side. The head has a portion with a largest diameter, and a first level L1 is defined by the highest point of a circle with the largest diameter drawn around the head, and a second level L2 is defined by the bottom of the second recess, L2 being at a level not higher than L1.

A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an element engageable with a second mating surface of the bone fastener. An actuator is connected with the second member and includes visual indicia of engagement of the element with the second mating surface. Systems, spinal implants and methods are disclosed.

A screw driver system includes a screw driver and a guide clamp. The screw driver includes a driving bit. The driving bit includes a body having a first end and a second end and an outer surface comprising a cylindrical portion between the first and second ends. The screw driving bit includes a first circumferential groove and a second circumferential groove on the outer surface of the cylindrical portion each having a bottom surface. The bottom surface of the first circumferential groove defines a first outer diameter that is larger than a second outer diameter defined by the second circumferential groove. The guide clamp includes a jaw for holding the screw driving bit. When engaged with the first circumferential groove, the guide clamp prevents rotation of the screw driving bit. When engaged with the second circumferential groove, the guide clamp does not prevent rotation of the screw driving bit.