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.

A minimally invasive precision cutting guide, targeting guide, implant, and other instruments comprise a system that permits a physician to surgically correct a bunion or similar deformity with a minimum disruption of surrounding soft tissue. The precision cutting guide ensures that the physician cuts bone in the proper location and orientation. Each of the instruments is designed to minimize disruption to surrounding soft tissue. The system also precisely locates an orthopedic implant such that it can fixate two bone fragments after an osteotomy, or two bones after surgery. The precision cutting guide, targeting guide, implant, and other instruments are provided in a sterile kit for the convenience of the surgeon and safety of the patient.

An embodiment includes a bone fixation system comprising: a bone anchor with a tapered head, the head being threaded; and a plate that includes a void, the void including one of a counterbore or a countersink; wherein: (a) no portion of the void is threaded; (b) the void includes an inner wall; (c) the inner wall includes reliefs along its perimeter. Other embodiments are described herein.

A bone fastener comprises a first member defining an implant cavity and a plurality of adjacent grooves. A first band is configured for disposal within the grooves. A second band is configured for disposal within the grooves. A second member is configured to penetrate tissue and includes a head engageable with the first band to provisionally connect the members. The second band is moveable for disposal adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

The invention relates to a bone anchor for triangular iliosacral osteosynthesis. The bone anchor includes an ilium screw having a first longitudinal direction and an iliosacral screw having a second longitudinal direction. The ilium screw, in a thread-free portion, has a preferably elongated-hole-like through-opening transversely to the first longitudinal direction, and the iliosacral screw has such a smaller outer diameter in relation to the ilium screw that the iliosacral screw can be guided through the through-opening and can be screwed proceeding from the ilium into the sacrum, through the ilium screw.

A bone screw for sacroiliac joint fusion is characterized by a longitudinal bone screw and a cylindrical sleeve received on a proximal end of the bone screw. The sleeve has axially extending fins or flutes on its outer surface that extend generally from one end of the sleeve to the other end of the sleeve. This feature allows the sleeve to resist reverse rotation which, in turn, aids in preventing back-out of the bone screw once installed. The bone screw has a self-tapping tip that allows the bone screw to be installed without need for a pilot hole, and self-harvesting geometry that gathers and retains bone shavings in and along the bone screw that are produced by bone screw installation for use as graft for bone fusion.

A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion. When the head and the pressure member and the locking member are in the receiving part, the free end of the deformable portion is supported in the receiving part, and the locking member is movable in the channel along the longitudinal direction in such a manner that the locking member first contacts the deformable portion and exerts a force onto the deformable portion to bring the deformable portion from the first configuration into the second configuration thereby locking the head. Thereafter the locking member comes into contact with the rod and locks the rod.

A modular spinal fixation system for securing an elongate rod to a bone of a patient includes a plurality of bone anchors, each having a universal shank head and an anchor portion opposite the universal shank head configured for fixation to the bone. The system further includes a plurality of pivoting and non-pivoting receiver sub-assemblies, with each receiver sub-assembly including a receiver having an upper portion defining a channel configured to receive the elongate rod and a base defining a lower portion of a central bore communicating with a bottom surface of the receiver through a bottom opening, and one of a shank head-engaging retainer or a rod-engaging insert positioned within the central bore. Each of the universal shank heads is configured for uploading into both the pivoting and non-pivoting receiver sub-assemblies through the bottom opening of the receiver and for axial rotation about a longitudinal axis of the shank relative to the receiver prior to locking the receiver sub-assembly to the head of the shank with the elongate rod and a closure.

A threaded implant can be provided with an elongated main body having external threads configured to thread into bone, and an internal support structure located within the external threads. The internal support structure has a helical arrangement that extends in an opposite direction to the external threads. Other threaded implants and methods are also disclosed.

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.