Disclosed spinal implants may include a rod extending in a horizontal direction and a first implant receiver having a first passageway extending in the horizontal direction and a first threaded passageway extending in a vertical direction, for example. Additionally, the implant may include a second implant receiver having a second passageway extending in the horizontal direction and a second threaded passageway extending in the vertical direction, for example. The implant may include a first set screw having a size and shape corresponding to a size and shape of the first threaded passageway and a second set screw having a size and shape corresponding to a size and shape of the second threaded passageway, for example. In some embodiments, the rod may extend in the horizontal direction through the first and second passageways and may be constrained from moving in the vertical direction by the first and second passageways, for example.

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 bone anchoring device includes a bone anchoring element with a spherical segment-shaped head, a receiving part configured to couple a rod to the bone anchoring element, and having a top end, a bottom end, a first passage at the bottom end with a first longitudinal axis, and a second passage at the top end with a second longitudinal axis that intersects the first longitudinal axis, a compression element, and a locking element. The receiving part also has a recess for the rod, the recess extending from the top end towards the bottom end and having a bottom that extends along an axis that is perpendicular to the second longitudinal axis. The receiving part or the compression element further has a seat. The compression element is configured to move along the first longitudinal axis while the locking element is configured to move along the second longitudinal axis.

An orthopedic connection assembly is described that comprises a housing member for receiving an implant that is operably connected to a receiving member for receiving an anchor member. The connection assembly is configured to have a locking mechanism that secures and fixes the relative orientation between the implant and the anchor member. The connection assembly can comprise a plate member receivable within the housing member. When a securing member such as a set screw is introduced downwardly into the housing member to secure the implant, the securing member applies a lateral force to the plate member, which presses against an interference member within the receiving member. The interference member presses against the anchor member, such that the anchor member is fixed in a position relative to the implant.

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. The housing can include a proximal portion including an anchor bore and a distal portion including a secondary bore configured to engage the anchor to limit angulation of the anchor relative to the housing.

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 spinal rod anchoring device is disclosed comprising a body comprising a distal end and a proximal end, wherein a threaded bone anchor is positioned toward the distal end, and a U-shaped head portion is positioned toward the proximal end. The head portion and the threaded bone anchor are fixedly attached. The spinal rod anchoring device also comprises a saddle comprising a concave interior region wherein the interior region has an open channel. The saddle is moveably seated within the base of the head portion, and a spinal connection element is disposed on the saddle. The spinal rod anchoring device further comprises a retaining pin configured to be inserted through the channel in the saddle and secured in a groove, wherein the groove is centrally positioned within the head portion, wherein the retaining pin secures the saddle to the head portion.

A spinal construct includes a first member. The first member includes a proximal portion defining a first cavity and a distal portion defining a second cavity disposed at an angle relative to the first cavity. The distal portion is configured for connecting with a second member. The second member is configured for fixation with vertebral tissue. A crown defines a first opening aligned with the first cavity and a second opening aligned with the second cavity. Implants, systems, instruments and methods are disclosed.

A pivotal bone anchor system for securing an elongate rod to patient bone includes a plurality of bone anchors, with each having a rounded capture portion with a capture recess extending circumferentially around a midsection thereof. The system also includes one or more multi-planar receiver sub-assemblies, each comprising a multi-planar receiver defining a cavity with a seating surface, and a multi-planar pivoting retainer configured for multi-planar motion upon engagement with the seating surface and having an inner surface configured to snap into the capture recess to capture the bone anchor within the multi-planar receiver cavity. The system further includes one or more uni-planar receiver sub-assemblies, each comprising a uni-planar receiver defining a cavity with a spherical seating surface, and a uni-planar pivoting retainer configured for uni-planar motion upon engagement with the seating surface and also having an inner surface configured to snap into the capture recess to capture the bone anchor within the uni-planar receiver cavity. The capture portions of the bone anchors are configured for capture by either a multi-planar receiver sub-assembly or a uni-planar receiver sub-assembly without further modification or adjustment to the bone anchor capture portion.

A bone fastener comprises a first member comprising a first surface defining an implant cavity. The first member includes a first part being non-rotatable relative to the first surface and a second part including a second surface defining a portion of the implant cavity and a slot. A second member is configured to penetrate tissue and is connectable with the first member. The first member is rotatable relative to the second member in a first plane of a body and the second part is movable relative to the first part in a second plane of the body such that the first part is relatively translatable in the slot. Implants, systems, instruments and methods are disclosed.