A pedicle fixation system (10) may include a first fastener (12) and a second fastener (14). The first fastener (12) may include a first shank (40) extending along a first fastener axis (41) and a channel (52) extending along a skew axis (51). The skew axis (51) may be transverse to the first fastener axis (41) and the channel (52) may have a channel diameter perpendicular to the skew axis (51). The second fastener (14) may extend through the channel (52) and include a second shank (60) extending along a second fastener axis (63). At least a distal part of the second shank (60) may have a second fastener diameter perpendicular to the second fastener axis (63). The second fastener diameter may be smaller than the channel diameter.

A polyaxial bone screw assembly includes a receiver, a shank, an articulation structure for retaining the shank in the receiver and a compression insert for engagement with a longitudinal connecting member such as a rod. The articulation structure includes substantially spherical convex and concave surfaces that slidably engage both shank and receiver surfaces to provide compound articulation between the receiver and the shank. The receiver includes inwardly directed spring tabs engaging the insert and prohibiting rotation of the insert within the receiver.

A locking-cap module may include a locking-cap having a first connecting flange and a second connecting flange opposite the first connecting flange extending from a side surface of the locking-cap. The locking-cap may further include a first retaining rail and a second retaining rail opposite the first retaining rail. The locking-cap module may further include a set screw configured to engage with corresponding threads of the locking-cap. In some embodiments, the first connecting flange and second connecting flange are configured to engage with a connector such that the top surface of the locking-cap is flush with a top surface of the connector in an engaged position. In some embodiments, the set screw is initially coupled to the locking-cap by a pre-loaded connection. In some embodiments, a surgical tool is provided for rotating the locking-cap module into the engaged position.

A coupling device for coupling a rod to a bone anchor includes a receiving part configured to receive a head of the bone anchor, the receiving part having a first end and a second end, a central axis that extends between the first and second ends, and two legs at the first end that define a recess extending in a longitudinal direction transverse to the central axis for receiving the rod, and a monolithic pressure member positionable in the receiving part, the pressure member including a rod support surface and an engagement portion to adjust the pressure member to exert pressure on the head. The engagement portion is positioned farther radially from the central axis in the longitudinal direction than a first portion of the rod support surface, and extends closer axially to the first end of the receiving part than the entire first portion of the rod support surface.

An anchoring system for a spinal support rod. The anchoring system includes a self-tapping orthopedic fastener that is bored through the ilium via a lateral incision and a mounting receiver that is positioned to receive the orthopedic fastener via a posterior incision. The orthopedic fastener may be implanted from a lateral approach or a posterolateral approach. The mounting receiver may be implanted from a posterior or superior posterior approach.

An anchor assembly can be couplable to a bone and can include an anchor and a housing. The anchor can include a shank securable to bone and a head coupled to a proximal portion of the shank.

Systems, methods, and devices for securing a spinal rod are provided. A clamp assembly comprises a tulip comprising an opening comprising an inner surface, wherein the inner surface is threaded; and a threaded locking cap disposed in the opening, wherein threads of the locking cap and the inner surface include various geometries.

A method of assembling a pivotal bone anchor assembly with tooling includes positioning a retainer and a pressure insert within a central bore of a receiver, uploading a capture portion of a bone anchor through a bottom opening and into the retainer to cause the retainer to first widen within an expansion portion of the central bore to receive the capture portion and then to close around and secure the capture portion while providing for pivotal motion of the bone anchor relative to the receiver, and downwardly deploying the retainer and the pressure insert within the central bore with the tooling until an outer surface of the retainer engages a narrower engagement portion below the wider expansion portion to impede repeat widening of the retainer, and the pressure insert comes into forced interference engagement with interference wedging surfaces of the central bore to inhibit the pressure insert from moving back up within the receiver.

A device for spinal correction includes a stabilizer assembly including a hinge including a first rod-bearing leaf; a second rod-bearing leaf rotatably coupled to the first rod-bearing leaf to provide coronal or sagittal freedom of movement, or both, of the stabilizer assembly; a locking mechanism to lock the first and second rod-bearing leaves at a desired angle; a first stabilizing rod coupled to the first rod-bearing leaf; a second stabilizing rod coupled to the second rod-bearing leaf; and a plurality of monoaxial or polyaxial links, wherein each monoaxial or polyaxial link is movably coupled to the first or second stabilizing rod and is movably couplable to a first spinal rod or a second spinal rod fixed to the spine; wherein the stabilizer assembly is couplable to the first or second spinal rod to stabilize the spine to prevent compression, distraction, or translation of the spinal cord during a spinal correction.

A surgical kit includes a shield for covering a portion of the spine of a subject. The shield can include an attachment portion adapted to engage a bone fixation assembly which is adapted to be fixed on multiple vertebra bones of the subject. The bone fixation assembly can include a vertebra joining member secured between two bone anchors. Each bone anchor can include a fastener portion adapted to be implanted into a vertebra bone and a head coupling portion adapted to secure the vertebra joining member. The shield can be coupled to the bone fixation assembly via separate coupling elements, such as a clip or an adjustable link secured between two vertebra joining members of the bone fixation assembly. Alternatively, the shield can include an integral attachment portion configured to engage the bone fixation assembly directly.