A surgical repositioning instrument for lowering and fixing a fixing rod in the tulip head of a bone screw has a coupling sleeve with two distal latching arms. A locking sleeve is longitudinally displaceable on the coupling sleeve between a release and locking position. A rod presser contacts and lowers the fixing rod, which is arranged displaceably within the coupling sleeve. Arranged in a through bore in the handle part is the locking sleeve, coupling sleeve and rod presser. On a grip part, an actuating lever is pivotally mounted to advance the rod presser relative to the coupling sleeve. The actuating lever has a laterally projecting force arm and a load arm which is coupled to the rod presser. The locking sleeve protrudes in its release position and is independently slid into its locking position by the rod presser acting on its proximal end with an axially directed force.

An implantable body for a posterior stabilization system includes a lateral end, a medial end, an inwardly facing surface configured to abut against a lamina when the body is implanted along a vertebra. A lateral bone outrigger extends from the inwardly facing surface and may include a bone-abutting surface along a medial portion disposed to abut against a lateral mass of the vertebra when the body is implanted along a vertebra. The lateral bone outrigger may have a first height. A penetrating feature extends from the inwardly facing surface between the bone-engaging portion of the inwardly facing surface and the lateral bone outrigger. The penetrating feature may have a second height less than the first height. A fastener bore extends through the body at an angle toward the lateral bone outrigger.

A bone anchoring device includes a receiving part with a head receiving portion defining a seat for pivotably receiving a head of a bone anchor, and a rod receiving portion defining a recess for receiving a rod, the recess forming two legs each having an engagement surface for engaging a locking device to lock the rod in the recess, and an expansion limiting member having a surface configured to engage a portion of the receiving part spaced apart from the engagement surfaces of the legs. When the legs are urged radially outwardly, the head receiving portion is urged radially inwardly to compress and lock the head. The expansion limiting member is adjustable from a first configuration relative to the receiving part where the head receiving portion is expandable to permit the insertion of the head, to a second configuration where expansion of the head receiving portion is restricted.

A spinal implant, in the form of a multi-part connection device that couples a fastening element to a connection element, including a first part formed as a bracket, which has a receptacle for a part of the fastening element, and a second part in the form of a tulip, which has, in an axially upper region, a receptacle for the connection element and surrounds the bracket receptacle in an axially lower region. When the bracket is assembled in a predefined orientation in the tulip, the bracket can be axially moved in the tulip such that, when moved towards the upper region, in a receiving position the bracket can receive the part of the fastening element, and such that, when moved towards the lower region, in a holding position the bracket is no longer able to release the received part of the fastening element. An axial guide, for providing the axial movability, includes a projection region on the face of the bracket that is outside when viewed radially, which projection region engages in a cut-out region in the face of the tulip that is inside when viewed radially. The end regions, viewed azimuthally, of which projection region are spaced apart by at least 18°. An axial lock prevents the projection region from axially exiting the cut-out region towards the upper region, and a rotary lock prevents the projection region from rotationally entering the cut-out region and, when assembled, prevents the projection region from rotationally exiting the cut-out region.

A bone attachment assembly may include an attachment head, a set screw configured to attach to the attachment head, and a rod surface with a first raised portion and a second raised portion that define a lowered portion positioned between the first raised portion and the second raised portion. The first raised portion, the second raised portion, and the set screw may be configured to directly contact a rod in order to retain the rod within the attachment head.

A length adjustable modular screw includes a neck assembly and a shank. The neck assembly has proximal and distal ends and includes an expander component and a collet component that are slidably engagable by insertion of the expander component in a through channel of the collet component along a common axis. The length adjustable modular screw also includes a shank suitable for insertion and retention within a bone, the shank including a threaded portion between proximal and distal ends and a socket adapted to coaxially receive at least a portion of the distal end of the neck assembly. The length adjustable modular screw has a length that is selected by splaying at least a portion of the distal end of the engaged expander and collet components of the neck assembly within the socket of the shank.

A spinal-surgery system having a rod receiver and/or a cap having a generally cylindrical body, a set of opposing splay-resisting flanges, and a set of opposing rotation-preventing/rotation-resisting wings. Each wing has a lateral rotation-preventing portion and a lateral rotation-resisting portion. A receiver proximal end forms a wing-receiving cavity having a lateral rotation-preventing side and a lateral rotation-resisting side. Each flange has a proximal-facing splay-resist surface, and a distal-facing pop-on surface. Each receiver proximal protrusion has a proximal-facing sloped receiver pop-on surface, and a distal-facing sloped receiver splay-resist surface. Each rotation-preventing portion contacts a corresponding rotation-preventing side and each rotation-resisting portion contacts a corresponding rotation-resisting sides when the cap is popped on. The rotation-preventing portions contacting the rotation-preventing sides prevents cap rotation in a first direction. The rotation-resisting portion contacting the rotation-resisting side resists cap rotation in a second direction, but allows rotation in the second, forcing the arms to splay.

A pivotal bone anchor assembly includes a shank with a head, an anchor portion, and a neck extending between the head and the anchor portion, and a receiver with upright arms defining a channel for receiving a rod and a central bore extending downward to a lower portion of the receiver. The assembly also includes a retaining structure rotatably coupled with the receiver with an internal seating structure pivotally supporting the head while providing for independent rotation of the shank prior to locking the assembly with the rod and a closure. The retaining structure includes an external surface and a slot extending between the seating structure and the external surface with a concave cut-out configured to closely receive the neck so as to provide for increased articulation between the shank and the receiver along the slot, and with the shank and the retaining structure being rotatable together around a centerline axis to align the increased articulation in any radial direction around the circumference of the receiver.

A pivotal bone anchor assembly includes a receiver with a base defining an internal cavity with a seating surface adjacent a bottom opening and an upper portion defining a channel configured to receive an elongate rod. The assembly also includes an anchor member having a proximal end portion with a partial spherical or spheroid shaped head to establish pivotable motion between the anchor member and the receiver, and a planar top surface surrounding an internal drive socket. The assembly further includes an insert positionable within the channel to direct a downwardly-directed force onto the proximal end portion to lock a position of the anchor member relative to the receiver, with the planar top surface remaining spaced apart from the insert so as to not directly receive the downwardly-directed force therefrom. A method of use is disclosed.

A bone anchoring device includes an anchoring element having a shank for anchoring in a bone and a head, a receiving part configured to pivotably receive the head, and a pressure member for exerting pressure on the head to clamp the head in the receiving part, the pressure member defining a head receiving recess for pivotably holding at least a portion of the head therein and comprising a first surface configured to restrict removal of the head from the head receiving recess. The head includes a first position indication structure configured to engage a second position indication structure of the bone anchoring device when the shank assumes a first angular position relative to the receiving part. The first and second position indication structures disengage from one another when the shank is moved out of the first angular position to a different angular position.