A vertebral column correction system for correcting a spinal deformity without fusing the joint segments is disclosed. The vertebral column correction system may have first and second vertebral anchors secured to first and second vertebrae. The vertebral column correction system may further comprise one or more intermediate vertebral anchors secured to vertebrae between the first and second vertebrae. A connection member may be disposed within a head portion of the vertebral anchors. At least a portion of the connection member may be a flexible member, such as a flexible cord, configured for tensioning between at least two vertebral anchors for providing a desired amount of tension to apply a correctional force to the spinal column. A spring member, or other tensioning member, may maintain the tension of the connection member.

A method of assembling a pivotal bone screw assembly includes applying tooling to a receiver assembly comprising a receiver with a channel for receiving a rod and a cavity with an interior support surface adjacent a lower opening, a retaining structure located in the cavity above the interior support surface, and an insert held in a first position above the retaining structure via a first interference engagement between the insert and the receiver. The method further includes uploading a capture portion of a shank through the lower opening until the capture portion is captured by the retaining structure, and then directly contacting the insert with the tooling to drive the insert downward to a second position to establish a biased overlapping engagement between the outer surface of the insert and the interior surface in the receiver that inhibits the insert from moving back up within the receiver to the first position.

A system to stabilize and guide the growth of the spinal column includes an elongated support member having a width and a length and a guiding connector having a bone connecting portion and a guiding portion. The bone connecting portion secures the guiding connector to a vertebrae and the guiding portion has a bearing element with a passageway adapted to receive the elongated support member. The bearing element permits relative sliding movement of the elongated support element in the passageway of the bearing element. The system may further include a bone fixation element has an elongated support member receiving channel, a locking mechanism and a bone anchoring portion. The bone anchoring portion secures the bone fixation element to bone. The locking mechanism secures the elongated support member in the channel. The guiding connector is moveable along the elongated support member to permit and control the growth of the spinal column along a predetermined path.

A closed-head polyaxial screw for use in spinal instrumentation for spinal fusion, treatment of deformity, or the like. Polyaxial screws may have a two-part design, with the screw fitting into an aperture in the closed head. One or more clamps may secure the bone screw in the aperture. A closed-head polyaxial screw having a one part design is also disclosed. In addition, a one-part monaxial screw is described.

An articulating assembly includes a first elongated element for attachment to a first anatomical region, and a second elongated element for attachment to a second anatomical region. In at least one embodiment, a coupling connects the first and second elongated elements. The coupling includes a moveable joint configured to allow polyaxial movement of the first elongated element with respect to the second elongated element. The assembly further includes a locking mechanism. The locking mechanism is operable in an unlocked condition to permit polyaxial movement of the first elongated element with respect to the second elongated element, and a locked condition to immobilize the movable joint and fix the position of the first elongated element with respect to the second elongated element.

A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

A connection assembly configured to securely connect a spinal implant to a bone anchor. In particular, a variable angle connection assembly that is able to securely connect the spinal implant to the anchors even when there is a variance in the angle and position of the anchors with respect to the spinal implant. Furthermore, a connection assembly that will not inadvertently lock the components of the connection assembly preventing the relative movement of the components.

A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

Methods of correcting a spinal deformity, including securing a first rod on a first side of a spine, securing an anchor on a second side of a spine, securing a lateral coupling between the rod and the anchor, translating and/or derotating the spine and securing a second rod on a second side of the spine to provide secondary stabilization to the spine.

A system for replacing at least a portion of a natural facet joint includes a fixation member implantable in a vertebra, an inferior facet articular surface and an inferior strut which may be formed separately from the inferior articular surface. The inferior strut has a first end securable to the fixation member and a second end which may comprise a sphere with a hemispherical surface. An attachment mechanism may include a capture feature shaped to receive the second end of the inferior strut, and the mechanism may provide an adjustable configuration, allowing polyaxial adjustment between the inferior articular surface and the second end. A locking member may be actuated to exert force on the second end to provide a locked configuration. The system may further include a superior facet joint implant with a superior articular surface shaped to articulate with the inferior articular surface.