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.

The present disclosure provides for a bone screw that may include a first portion extending from a first end to a second end in a longitudinal direction, for example. The first portion may have a head that defines the first end and a shank that defines the second end. Additionally, the first portion may include a metallic material and/or be formed of a metallic material, for example Titanium. The second portion may be mechanically coupled to the first portion and surround the shank, for example the second portion is screwed to the first portion or the second portion may be directly formed to the first portion by an overmold process. The second portion may have an exposed thread pattern and an exposed leading tip. Additionally, the second portion may include a thermoplastic material and/or be formed of a thermoplastic material such as PEEK.

A bone fixation assembly includes a plurality of bone fixation elements that each include a bone anchor configured to be implanted into underlying bone, such as a vertebra. Each bone anchor is received in an anchor seat, and the anchor seats are joined by a fixation rod so as to operatively couple and fix the position and orientation of the vertebrae relative to each other. The bone anchor is free to rotate relative to the anchor seat, and is also free to pivot in a desired direction relative to the anchor seat.

A spinal cross-connector comprises an elongated member, a first connector and a second connector. The first connector and the second connector are configured to receive spinal rods and adaptable to directly attach with pedicle screws. The first connector includes a first collet head, a first clamp and a first locking means. The second connector includes a second collet head, a second clamp and a second locking mans. The first locking means is configured to tighten over a first collet head and engage with the first connector. Similarly, the second locking means is configured to tighten over a second collet head and engage with the second connector. The engagement of the first locking means with the first connector and the second locking means with the second connector locks the spinal cross-connector.

A modular pivotal bone anchor assembly includes a receiver having a central bore with a locking region adjacent a bottom opening, an expansion region above the locking region, an interference abutment surface above the expansion region, and a retaining groove above the interference abutment surface. The assembly also includes a bone screw having a head uploadable through the bottom opening, an insert positionable within the central bore with protruding engagement structures received within the retaining groove, an upper open ring positionable below the insert, and a lower open ring positionable below the upper open ring for capturing the head within the locking region, after which the upper open ring occupies the expansion region and the insert is downward deployed by tooling, with the engagement structures moving out of the retaining groove and into an overlapping arrangement with the interference abutment surface to inhibit upward movement.

The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of a spinal fixation procedure. A bone anchor is provided. The anchor can include a bone fastener. The bone fastener can include a head and a second end adapted to engage an anatomy. The bone fastener can extend along a longitudinal axis. The anchor can also include a coupling arrangement coupled to the head of the bone fastener so that the bone fastener is rotatable about the longitudinal axis to define a first plane of motion. The anchor can further include a saddle, which can be coupled to the coupling arrangement. The saddle can be movable relative to at least one of the bone fastener and the coupling arrangement to define a second plane of motion.

A method of assembling a pivotal bone anchor assembly includes positioning a bushing into a body member having an axial bore with a lower interior surface adjacent a bottom opening, a channel for receiving a fixation rod, and hollow spaces formed into sidewalls of the axial bore. The bushing includes a curved upper surface for receiving the fixation rod and outwardly protruding structures that resiliently snap into the hollow spaces to inhibit the bushing from moving upward in the axial bore. The method also includes positioning the head of a bone anchor into the axial bore with the bone anchor extending downward through the bottom opening and with the lower interior surface supporting head of the bone anchor to provide for pivotal movement between the bone anchor and the body member prior to locking the pivotal bone anchor assembly via the fixation rod and a closure.

A spinal implant system includes a first bone fastener including a first head and a first shaft. The first head including a medial rod receiver offset from the first shaft. A second bone fastener is provided including a second head and a second shaft. The second head including a lateral rod receiver offset from the second shaft. The shafts are configured for fixation with vertebral tissue in alignment along a selected trajectory of the vertebral tissue. Surgical instruments, implants and methods are disclosed.

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.

An orthopedic fixation device for affixing the screw head of a polyaxial pedicle screw has a tulip, a saddle, and a ring. The tulip has an interior cavity and two opposed threaded arms and a lower ledge. The saddle is inserted into the tulip body, and has a U shaped groove for receiving a spinal fixation rod. The ring has a diameter that is smaller than the widest diameter of the screw head, and is formable into a diameter larger than the widest diameter of the screw head when the screw head is pushed into the ring. The ring has a connection portion that mates with a connection portion of the saddle. The screw head is clamped within the tulip body between the saddle and the ring when a cap is threaded between the tulip arms.