A receiver of a bone anchor includes a base and a pair of upright arms extending upward from the base to define an open channel for receiving an elongate rod, with the upright arms having opposed interior surfaces with a discontinuous guide and advancement structure formed therein and side outer faces opposite the opposed interior surfaces extending downward across the base to a bottom of the receiver. A horizontally-elongated upper tool engaging groove is formed into the side outer face of each upright arm that extends to at least a front face or back face of the upright arm and that includes a downwardly-facing upper surface, an upwardly-facing lower surface, and an outwardly-facing inner surface. A vertical tool-engaging groove is also formed into the side outer face of each upright arm that extends downward from a top surface of the upright arm through to a level below the lower surface of the upper tool engaging groove.

A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having a channel configured to receive the elongate rod, a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The receiver assembly further includes a fastener configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the fastener having an outer surface with a mating continuous helically wound guide and advancement structure configured for rotatable engagement with the receiver guide and advancement structure.

Surgical instruments and methods for delivering bone anchor assemblies into bone are disclosed herein. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. In general, a surgical instrument can include a handle assembly having an elongate shaft extending distally therefrom. The handle assembly can be configured to axially translate a stylet extending therethrough relative to a bone anchor assembly coupled to the elongate shaft, and it can be configured to move the stylet proximally in response to distal advancement of a bone anchor assembly into bone. The surgical instruments can include various mechanisms for adjusting the position of the stylet.

A surgical instrument includes a first member and an actuator disposed with the first member. An assembly is provided that includes a second member engageable with a bone fastener receiver. A third member is rotatable relative to the second member and threadably engageable with the bone fastener receiver to capture the bone fastener receiver. Systems, spinal constructs, implants and methods are disclosed.

This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. More specifically, the application describes instruments and methods for building a posterior fixation construct across one or more segments of the spinal column in a minimally invasive fashion.

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 bone anchoring device includes a receiving part with a rod receiving portion having a first end, a second end, a recess for the rod, an outer surface, and a first engagement structure on the outer surface that extends farther radially outwardly than other parts of the rod receiving portion, and a flexible head receiving portion for inserting and clamping the head. The bone anchoring device also includes a locking ring configured to be arranged around the head receiving portion for locking the head, the locking ring having an outer surface and a second engagement structure on the outer surface that extends farther radially outwardly than the outer surface of the rod receiving portion. The engagement structures are configured to be engaged by an instrument to move the locking ring from a locking position to a position where the inserted head is pivotable.

This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. Instruments are provided to aid in insertion and positioning or the rod.

A surgical derotator instrument comprises a shaft, a handle and an articulating coupler. The shaft comprises a first end portion having a bone anchor coupling and a second end portion opposite the first end portion. The handle comprises a body portion and a slot extending in the body portion. The articulating coupler connects the shaft and the handle. A method for coupling a plurality of derotator instruments into a series of derotator instruments comprises: attaching a plurality of derotator instruments to a plurality of adjacent bone anchor housings, each derotator instrument comprising: a shaft for connecting to a bone anchor housing, a handle having a slot, and an adjustable coupler connecting the shaft and the handle; adjusting one or more of the adjustable couplers to align at least one of the slots of the series with other slots of the series; and inserting an elongate member through the at least one slots that are aligned.

A screw insertion instrument includes a handle, a driving assembly, and a stylet. The driving assembly extends distally from the handle and includes a knob, a tubular body extending distally from the knob, and a driver including an elongated body extending through the knob and the tubular body. The elongated body has a proximal region operably coupled to the handle and a distal region extending distally beyond the tubular body and engageable with a pedicle screw. The stylet includes an elongated body positionable through first and second longitudinal bores defined through the handle and the driver, respectively. A proximal portion of the stylet is positionable adjacent the handle and a distal portion of the stylet extends distally beyond the driver and is positionable through a third longitudinal bore defined through the pedicle screw such that the distal portion of the stylet extends distally beyond the pedicle screw.