A clamp device includes multiple claws for collectively gripping a vertebra, particularly over a pars interarticularis. At least one of the claws is movable relative to a body of the clamp device. The movable claw includes an elongate tab received within a track extending within the body. The body or the tab includes a threaded hole within which set screws may be received for immobilizing the movable claw relative to the body. The clamp device also includes an array of rod clamps. The rod clamps are supported by the body, and more directly by a bar supported by the body. The bar is releasably connectable to the body, and the rod clamps are pivotably connectable to the bar.

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.

The present invention relates to stable fixation of spine segments, allowing for fusion in, e.g., skeletally mature patients. More particularly, the invention relates to a bone fixation device that can be affixed to vertebrae of a spine to provide reduction (or enlargement) capabilities and allow for fixation in the treatment of various conditions, including, e.g., spondyloslisthesis, degenerative disc disease, fracture, dislocation, spinal tumor, failed previous fusion, and the like, in the spine. The invention also relates to a method for delivering and implanting the bone fixation device.

A pivotal bone anchor assembly includes a bone anchor having a capture portion with a frusto-conical outer surface and a horizontal capture recess extending circumferentially around a mid-portion thereof, a receiver having a central bore with a seating surface proximate a bottom opening, and a ring retainer having a retainer aperture with an inner surface that is slidably engageable with the frusto-conical outer surface of the capture structure and a retainer aperture recess extending circumferentially into the inner surface. The assembly further includes a snap ring positionable within the retainer aperture recess with a snap ring aperture smaller than the retainer aperture. Upon securing the ring retainer within the central bore with the retainer aperture centered above the bottom opening, the capture portion is uploadable into the retainer aperture with the frusto-conical outer surface engaging and continuously expanding the snap ring until the horizontal capture recess reaches the retainer aperture recess and the snap ring snaps into the horizontal capture recess to couple the bone anchor to the ring retainer.

Various methods and apparatus for dynamic stabilization of bones, and especially of vertebra. Disclosed herein are bushings that permit axial movement of a rod, tether, or similar interconnection device relative to an anchoring head that is coupled to a bone. Some bushings further allow lateral relative movement or rotational relative movement, such additional relative movement being limited by the size and shape of the bushing, the size and shape of the interconnection device, the size and shape of the bushing container, the manner of attaching the anchoring head to the bone, or other considerations.

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 carrier assembly that secures a stylet extending therethrough. Translation of the stylet can be made relative to a distal end of the elongate shaft. The surgical instruments can include various carrier assemblies for positioning the distal end of the stylet relative to the distal end of the elongate shaft based on a length of bone anchor to be installed by the surgical instrument.

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.

A bone anchoring device for anchoring and fixing vertebrae and for insertion into a pedicle canal is disclosed. A fork head having a U-shaped cut-out in a side view for a correction element, a connecting rod with two legs which terminate proximally and form a threaded section which engages with an adjusting means, wherein the legs have a radially outer circumferential area in which at least one retaining groove or other instrument attachment point is formed for gripping the fork head by a handling instrument, and a bone anchoring element with a proximal end facing away therefrom in the axial direction such that a distal direction and a proximal direction are also defined. The bone anchoring element has a spherical head at the proximal area, and the bone anchoring element is polyaxially pivotable with respect to the fork head, and has a pressure piece distally partially surrounds the bone anchoring element at the ball head, and proximally forms a seat for the connecting rod.

Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument can include a feedback mechanism configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor. The feedback mechanism can be triggered by a movable shaft of the instrument that is displaced by the shank portion of the bone anchor as the surrounding bone is reamed.

A system is utilized, which comprises a cross connector for use in spinal fixation, further comprising multiple connection features configured to accommodate for direct attachment to multiple rods. Teachings are directed to a device that not only provides increased construct stiffness in flexion, extension and lateral bending, but also in torsion. The system adds stiffness in standard constructs. Joining multiple adjacent constructs with varying rod sizes for load distribution are also benefits of the system.