An improved cortico-cancello-cortical screw (FIG. 8a-c) to hold properly in the cortical portion at the two ends of vertebral-body which has a threaded portion (L) provided with cortical thread for the cortical bone and cancellous thread for cancellous bone; a neck portion; a shoulder portion that connects the threaded portion to the screw head; a taper of approximately 2° along entire length of the screw to ensure smooth insertion and progress as the screw is fastened so that proximal portion of the screw would engage cortical bone the same way as the intermediate portion that would engage the cancellous bone. L is divided into L1 (proximal section) that engages the cortical bone of vertebra, L2 (intermediate section) that engages the cancellous bone and has flanges bent on itself and L3 (distal section) that engages distal cortical bone to provide increased surface area and better pull out strength.

The present invention provides for a joint fixation device and method utilizing a bone screw having a bi-directional drill point that is constructed and arranged to cut and form a hole in a bone when the screw is rotated or oscillated in both directions around the longitudinal axis of the screw. The screw can then be rotated into a final position by rotation in a single direction; and removed by rotating the screw in an opposite direction.

Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.

A bone anchor assembly includes a shank having a head and an anchor portion, and a receiver having a first channel to receive a rod and an axial bore with an upper internal thread, interference abutment surfaces below the upper internal thread, and a bottom opening. The assembly also includes an insert having a second channel to receive the rod and opposed lateral protrusions positioned above the interference abutment surfaces upon loading into a first position within the axial bore. The assembly further includes a resiliently expandable retainer positionable within the axial bore adjacent the bottom opening to capture and hold the head in the receiver. After the head is uploaded into the axial bore, the insert is downwardly deployable by tooling into a second position with the opposite lateral protrusions being forced below the interference abutment surfaces and with lower portions of the insert entering into compressive overlapping engagement with the retainer to hold down the retainer within the axial bore.

An improved method of fusing the sacroiliac joint and tools for accomplishing the same is disclosed. In one embodiment, the present invention is a method that uses an intra-articular joint fusion device for connecting the sacrum and ilium that includes creating a first incision in the patient's skin proximal to the patient's sacroiliac joint, inserting a surgical channel tool into the incision from the patient's posterior, creating a void in the sacroiliac joint, inserting a fusion implant into the void, the fusion implant having at least one fixation element for engagement with bone tissue in the articular surfaces of the sacrum and the ilium, and driving the fusion implant into the void such that the at least one fixation element engages with bone tissue in an articular surface of at least one of the sacrum and ilium, and the fusion implant fixes relative positions of the sacrum and ilium.

A bone anchoring screw comprises a head, a shaft and a threaded portion arranged successively along a common axis, the head having a recess comprising at least two stages arranged in succession along the common axis, the first stage having a diameter larger than the diameter of the second stage, in which one of the two stages comprises at least one socket of a first type and the other of the two stages comprises at least one socket of the first type and one other type.

An apparatus and methods are provided for a bone fusion plate for treating deformities of the hallux. The bone fusion plate includes a width and a length and screw hole position and trajectory suitable for fixating a 1.sup.st metatarsal bone and a metatarsal head during a straight distal osteotomy to correct a hallux valgus deformity of a patient. The bone fusion plate includes a plate portion comprising a lower, distal surface and a buttress comprising a proximal surface. The distal surface fastens onto the metatarsal head while the proximal surface fastens onto a proximal bone surface exposed by cutting the 1.sup.st metatarsal bone and laterally shifting the metatarsal head during the straight distal osteotomy. Threaded countersunk screw holes in the buttress and the plate portion receive bone screws for fastening onto the 1.sup.st metatarsal bone and the metatarsal head. The countersinks prevent the bone screws from irritating surrounding soft tissues.

A coupling assembly for coupling a rod to a bone anchoring element includes a receiving part having a first end, a second end, a recess having a bottom for receiving the rod, and an accommodation space having an opening at the second end of the receiving part for accommodating a head of the bone anchoring element, and a retainer element configured to be inserted into the receiving part from the first end and to hold at least part of the head, the retainer element having a first portion and a spring portion compressible in an axial direction attached to the first portion. When the retainer element is in the accommodation space in a first position, the spring portion extends in the axial direction from the first portion of the retainer element to an axial position between the first end of the receiving part and the bottom of the recess.

Innovative orthopedic implant assemblies and devices are provided. One example assembly includes two implant devices. An example implant device includes two ends oppositely located with a bulbous portion located at one end and a screw portion located at the opposite end. An example second implant device includes two ends oppositely located with a looped portion defining an aperture located at one end and a nail portion located at the opposite end. The nail portion can include a tip and a smooth or substantially smooth portion. The second implant device can be implanted into a bone by striking the looped portion to facilitate the tip and at least part of the nail portion penetrating the bone.

Provided is a nested screw assembly and a related method for fusing a joint between two bones using the nested screw assembly, where the nested screw assembly includes a cannulated outer screw and an inner screw.