The present disclosure provides a fastener that has a body that has an axis. The body comprises a head portion and at least one body portion projecting from the head portion. The at least one body portion has an actuating surface portion and is arranged such that at least a part of the at least one body portion is urged away from the axis when an actuating member is received along the axis and urges against the actuating surface portion. The at least one body portion has a substantially flat surface portion facing away from the axis.

A spinal fixation construct for aligning vertebral bodies includes a bone screw, a spinal rod, a flexible member, and a fixation member. The spinal rod is disposed within a saddle portion of a housing of the bone screw, and includes an elongated body having a first end and a second end. The spinal rod is formed from a first material having a first modulus of elasticity. The flexible member is coupled to the spinal rod, and includes an elongated body having a first end portion and a second end portion. The flexible member is formed from a second material having a second modulus of elasticity that is different from the first modulus of elasticity. The fixation member includes a threaded body portion and a head portion defining a hole therethrough. A portion of the flexible member extends through the hole of the head portion.

A spinal implant including a body having an insert received within a bottom portion of the body, the insert receiving a bone screw at a bottom portion for attachment to a spine, a rod assembly received within a rod slot on a side portion of the body wherein the rod slot does not extend through a top surface of the body, and a locking nut received within a top portion of the body and interlocking with a top portion of the insert. Spinal implant assembly, including multiple spinal implants interconnected through rod assemblies. Method of using a spinal implant by inserting spinal implant at bone structure of a spine, tightening the locking nut, drawing the body upwards, compressing the insert against the bone screw head, and contacting a lower surface of locking nut and rod assembly and compressing rod assembly against the insert, thus locking rod assembly and bone screw.

A tool set for implanting bone screws in a human spine, followed by the implantation of a rod into the bone screws includes end guide tools having flexible back wall flaps that receive opposite ends of the rod and intermediate guide tools that hold the rod in intermediate locations between the end guide tools. Both the end and intermediate guide tools include an attachment structure for operably connecting the guide tool to a bone screw. The attachment structure includes an undercut and/or recess so as to resist splaying and separation of the guide tool from an attached bone screw.

A pivotal bone anchor assembly includes a shank, a receiver with an open channel in communication with an axial bore, and a pressure insert with an upwardly-facing seating surface for receiving an elongate rod. The axial bore includes a downwardly-facing surface below a closure top mating feature and one or more integral structures protruding inwardly toward a central longitudinal axis. The insert includes one or more notches formed into an outer side surface and an upwardly-facing surface positioned radially outward from the seating surface. Upon installation into the axial bore, the insert is rotatable about the longitudinal axis until the insert upwardly-facing surface is rotated under the receiver downwardly-facing surface to inhibit upward movement of the insert within the axial bore along the longitudinal axis and the receiver inwardly-protruding structures become positioned within the insert outer notches to prevent further rotation of the insert within the axial bore.

A tethering screw system includes a bone screw, a fastening member, and a securing member. The bone screw includes a threaded shank and a head portion. The head portion includes inner walls defining a slot and a recess distal of the slot. The fastening member is received in the recess of the head portion of the bone screw. The securing member has an engaging portion and a set screw rotatably coupled with the engaging portion. The engaging portion is configured to secure the fastening member in the recess of the head portion. The set screw is configured to threadably engage the inner walls of the head portion of bone screw, wherein when the set screw threadably engages the inner walls of the head portion of the bone screw, the engaging portion advances relative to the fastening member to secure the fastening member in the recess of the head portion.

A pedicle screw for spinal fixation having a bone fastener portion a permanent rod coupling, a breakaway portion connected to the permanent rod coupling and a temporary rod coupling. A permanent rod can be positioned in the permanent rod coupling and a temporary rod can be positioned in the temporary rod coupling and when the temporary rod is not needed the temporary rod coupling can be removed by separation at a breakaway portion.

The present invention discloses single level fusion systems and methods of use. The single level fusion systems include a first fastener, a second fastener, and a connector to secure the first fastener to the second fastener. The method of assembling a single level fusion system including obtaining a first fastener, a second fastener, and a connector, securing the first fastener to the connector, and securing the second fastener to the connector. Methods of using the single level fusion systems are also disclosed.

A receiver assembly for capturing an elongate rod in a receiver of a bone anchor includes the receiver, a first threaded closure, and a second threaded closure. The receiver includes an upper portion that defines a first channel, interior surfaces that have helically wound thread, and a lower pressure insert that can be positioned within the first channel and has upright arms. Each of the first threaded closure and the second threaded closure have a cylindrical body with an external surface having continuous helically wound thread that can rotatably mate with the helically wound receiver thread. The first threaded closure and the second threaded closure are interchangeable for different locking configurations in the receiver assembly. The first threaded closure has a downward protrusion that can compressively engage the elongate rod. The second threaded closure has a bottom surface that can compressively engage the upright arms of the lower pressure insert.

Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.