A spinal fixation device is provided having first and second elongate members that are angularly adjustable relative to one another. Each elongate member can include a connecting feature formed on a terminal end thereof, and each connecting feature can be coupled to one another to allow angular movement of the first and second elongate members. The device can also include a locking mechanism that is adapted to couple to the connecting feature on each of the first and second elongate members to lock the elongate members in a fixed position relative to one another.

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).

Methods of correcting a spinal deformity, including securing a first rod on a first side of a spine, securing an anchor on a second side of a spine, securing a lateral coupling between the rod and the anchor, translating and derotating the spine to correct the spinal deformity by adjusting an effective length of the lateral coupling, and securing a second rod on a second side of the spine to provide secondary stabilization to the spine.

Open implant closure structures include a helically wound guide and advancement flange form having splay control surfaces. Multi-start closures and closures with inner set screws have splay control contours for interlocking with cooperating flange forms of bone anchor receivers. Flange form heights, thicknesses and other geometry, such as splay control ramp angle may be varied.

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 pedicle screw implant construct kit, comprising at least one pedicle screw, at least one collar comprising a recess for receiving a rod, the collar configured to be coupled to a head of the pedicle screw, an elongated rod for connecting the collar to one more additional collars to couple between the pedicle screw and one or more additional screws, and a locking ring sized to be positioned over at least a distal portion of the collar to restrain relative movement of the screw head and rod by exerting radial compression force onto the collar. In some embodiments, the components of the kit are comprised of carbon reinforced composite material, optionally with no radiation blocking material. In some exemplary embodiments of the invention, the kit includes two locking rings on a collar, optionally both below the rod.

A coupling device includes a first coupling body configured to be coupled to a first bone anchor, a second coupling body configured to be coupled a second bone anchor, and a connection device comprising a first connection member connectable to the first coupling body, a second connection member connectable to the second coupling body, and a length adjustment member positionable between and insertable at least partially into each of the first and second connection members. The first and second connection members are movable relative to the length adjustment member. The length adjustment member can be actuated in a first direction to increase a distance between the first connection member and the second connection member, and in a second direction different from the first direction to decrease the distance between the first connection member and the second connection member.

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.

Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

A bone anchoring system having a flexible member with a first end and a second end opposite the first end. A fastener provided at a first end of the flexible member for retaining the flexible member within a bone. A rigid member is provided to ensure movement or pull-through of the flexible member does not occur.