A pivotal bone anchor assembly includes a body member with upright arms defining a channel for receiving a fixation rod, an axial bore having a bottom opening, a lower interior surface disposed about the bottom opening, and a downwardly facing recessed surface above the lower interior surface. The assembly also includes a shank comprising a partial spherical head positionable into the axial bore and an anchor portion for attachment to the bone. The assembly further includes a bushing insertable into the axial bore having an outer surface configured to resiliently snap under the downwardly facing surface so as to inhibit the bushing from moving upward in the axial bore, and a lower surface configured for biased engagement with the partial spherical head of the bone anchor, with the biased engagement providing a pre-lock press fitment about the partial spherical head so that the bone anchor and body member do not move freely with respect to each other prior to insert and securement of the fixation rod.

A pivotal bone anchor assembly includes a body member with upright arms defining a channel for receiving a fixation rod, an axial bore having a bottom opening, a lower interior surface disposed about the bottom opening, and a downwardly facing recessed surface above the lower interior surface. The assembly also includes a shank comprising a partial spherical head positionable into the axial bore and an anchor portion for attachment to the bone. The assembly further includes a bushing insertable into the axial bore having an outer surface configured to resiliently snap under the downwardly facing surface so as to inhibit the bushing from moving upward in the axial bore, and a lower surface configured for biased engagement with the partial spherical head of the bone anchor, with the biased engagement providing a pre-lock press fitment about the partial spherical head so that the bone anchor and body member do not move freely with respect to each other prior to insert and securement of the fixation rod.

A method for manipulating a vertebra includes connecting a first bone anchor to a first vertebra, connecting a second bone anchor to a second bone anchor, positioning a spinal rod in a receiving member of the first bone anchor and in a receiving member of the second bone anchor, connecting a first instrument to the receiving member of the first bone anchor, and manipulating the first instrument to rotate first bone anchor and the first vertebra relative to the second vertebra.

A polyaxial bone anchor has a locking element shaped and configured to allow an anchoring member (e.g., a screw or hook) to polyaxially rotate at large angles about a central axis of the bone anchor before compression locking the anchoring member within an anchor head.

A bone plate for treating periprosthetic fractures includes a head portion to be positioned along a greater trochanter of a bone. The head portion includes pairs of bone fixation element receiving openings extending therethrough from a first surface of the plate which, when the plate is in an operative position, faces away from the bone, and a second surface which, when the plate is in the operative position, faces toward the bone. A pair of cable holes extend through the head portion from a first longitudinal side connecting the first and second surfaces to a second longitudinal side connecting the first and second surfaces. The head portion includes a pair of hooks for engaging a superior ridge of the greater trochanter. The plate also includes a shaft portion extending distally from the head portion to extend along a portion of the bone distal of the greater trochanter.

A bone fastener comprises a first member defining a plurality of grooves. A coupling member is disposed with the first member. A first band and a second band are disposable within the grooves. A second member is configured to penetrate tissue and includes a head engageable with the first band to provisionally connect the first member to the second member. The coupling member is engageable with a part to move the part relative to the first member into engagement with the second band to dispose the second band adjacent the first band to connect the first member to the second member. Systems, surgical instruments, implants and methods are disclosed.

A spinal screw assembly includes a bone screw having a head with a rounded outer surface and an anchor portion for fixation to the bone. The assembly also includes a body member defining an internal cavity communicating with a bottom surface of the body member through a lower opening, with an interior surface adjacent the lower opening configured to engage the rounded outer surface of the head of the screw, and an upper portion defining a channel for receiving a fixation rod. The screw head is configured for uploading into the cavity of the body member through the bottom opening until the rounded outer surface enters into pivotal engagement with the interior surface of the internal cavity, with the screw extending downwardly through the lower opening, so as to allow for variable angular movement of the bone screw relative to the body member prior to locking the spinal screw assembly with a closure.

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. A first part is engageable with a spinal rod disposed with the implant cavity. A second part is attached with the first part and engageable with the second band to dispose the second band adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

A spinal fixation device for securing two stabilizing rods to bone has a threaded shaft for fastening to bone, a primary rod coupling head and a secondary rod coupling head. The first rod coupling head is connected to the threaded shaft and has a side wall and a cavity for receiving a rod, the cavity being open toward a top of the first rod coupling head. In a neutral position of the first rod coupling head, the first rod coupling head extends symmetrically around the longitudinal axis of the threaded shaft. The second rod coupling head is rotatably connected to the first rod coupling head, around an axis of rotation that is disposed at an angle that is not perpendicular to the longitudinal axis of the threaded shaft when the first rod coupling head is in the neutral position.

A bone fastener comprises a first member defining a plurality of grooves. A coupling member is disposed with the first member. A first band and a second band are disposable within the grooves. A second member is configured to penetrate tissue and includes a head engageable with the first band to provisionally connect the first member to the second member. The coupling member is engageable with a part to move the part relative to the first member into engagement with the second band to dispose the second band adjacent the first band to connect the first member to the second member. Systems, surgical instruments, implants and methods are disclosed.