Modular devices, assemblies, and methods for coupling one or more fixation elements, such as bone fasteners and/or elongate rods. The device includes at least one coupling element having a body portion for receiving a bone fastener and an extension portion extending transversely from the body portion. A locking assembly is received in the coupling element and includes a locking member, a clamp portion, and a ring portion, wherein the locking member is configured to contact an upper portion of the clamp portion and the ring portion is configured to at least partially surround a lower portion of the clamp portion. When unlocked, the bone fastener is moveable within the clamp portion to allow for polyaxial movement of bone fastener relative to the coupling element, and when locked, the bone fastener is fixed relative to the coupling element.

Articulating implant connectors and related methods are disclosed herein. Exemplary connectors can include first and second bodies that are rotatable relative to one another about a rotation axis and selectively lockable to resist or prevent such rotation. Each of the bodies can be configured to couple to a rod or other fixation component, and the connector can be used to lock first and second rods together even when the rods are obliquely angled with respect to one another.

A connector includes a first receiver that defines an implant cavity and includes a mating surface. A second receiver attachable with the first receiver via a flexible element, the second receiver defines an implant cavity and includes a mating surface engageable with the mating surface of the first receiver to fix relative orientation of the receivers. A biasing element is disposed adjacent the mating surfaces to space the mating surfaces such that the first receiver is movable relative to the second receiver in operation of the connector. Systems, surgical instruments, implants, spinal constructs and methods are disclosed.

A spinal fixation device for securing two stabilizing rods to bone has a threaded shaft for fastening to bone, a primary rod coupling head and a secondary rod coupling head. The first rod coupling head is connected to the threaded shaft and has a side wall and a cavity for receiving a rod, the cavity being open toward a top of the first rod coupling head. In a neutral position of the first rod coupling head, the first rod coupling head extends symmetrically around the longitudinal axis of the threaded shaft. The second rod coupling head is rotatably connected to the first rod coupling head, around an axis of rotation that is disposed at an angle that is not perpendicular to the longitudinal axis of the threaded shaft when the first rod coupling head is in the neutral position.

A bone fixation system is provided for use in the spine between vertebrae. The system comprises a first fastener configured to anchor into a first vertebrae, a second fastener configured to anchor into a second vertebrae, and a set screw to retain the second fastener to the first fastener. The first fastener includes a shaft extending along a longitudinal axis and a head. The shaft includes a first cylindrical body. The head of the first fastener includes a second cylindrical body defining a passageway having an interior surface. The passageway defines a longitudinal axis that is different than the longitudinal axis of the shaft. The first cylindrical body of the shaft and the second cylindrical body of the head are angled relative to each other. The second fastener includes a shaft and a head. The head of the second fastener is configured to engage the interior surface of the passageway of the head of the first fastener. The set screw also engages the interior surface of the passageway and retains the head of the second fastener in the passageway.

A low profile rod-to-rod cross-connector formed from an outer bar member having a first end forming a receptacle and a second end available for coupling to a first spinal rod. An inner bar having a unidirectional insertion end is slidably insertable into the receptacle, and a second end is available for coupling to a second spinal rod; the insertion end having a centrally disposed slot bifurcating the insertion end. A locking member is positioned in the centrally disposed slot, wherein placement of the locking member in the first position permits movement of the insertion end within the receptacle, and placement of the locking member in the second position results in splaying the left arm and right arm to frictionally engage an inner sidewall of the receptacle.

Implants, systems, and methods for securing a flexible band, thereby providing a desired correction to the spine. The implant may secure the flexible band to a spinal rod and/or a pedicle screw. The implant has a locking mechanism to secure the band. The band may be looped around bony anatomy and tensioned to achieve correction and provide fixation as an alternative or supplement to pedicle screws and spinal rods during spinal deformity surgery.

A system for spinal fixation with a non-rigid portion at least one of the caudal or cephalad terminus. Various devices and techniques are described for transition from a rigid fixation construct to a less rigid support structure applied to a “soft zone” that helps share the stress created on the spinal levels caused by the fixed levels below. In some embodiments, the soft zone is provided by terminating the construct with one of a flexible tether or a dampening rod.

A spine fixation assembly has a polyaxial spine screw rod holder for a first spine rod and a second rod holder for a second spine rod, the second rod holder is linked to the polyaxial spine screw rod holder via a connector, the connector extending radially outward from the polyaxial spine screw rod holder such that the second rod holder is spatially separated from and offset relative to the polyaxial spine screw rod holder. The polyaxial spine screw rod holder defines a first rod seat that holds the first spine rod. The first spine rod has a first longitudinal axis. The second rod holder defines a second rod seat that holds a second spine rod. The second rod has a second longitudinal axis. The second rod holder is oriented relative to the polyaxial spine screw rod holder by the connector at an offset (angle).

Implants, systems, and methods for securing a flexible band, thereby providing a desired correction to the spine. The implant may secure the flexible band to patient anatomy without the use of pedicle screws or spinal rods. The implant may include a locking member configured to secure the band. The band may be looped around bony anatomy and tensioned to achieve correction and provide fixation as an alternative to pedicle screws and spinal rods during spinal deformity surgery.