A spinal construct comprises a body defining a first groove. A transverse rod is formed with the body. A first band is disposable in the first groove. A base is connectable with the body and engageable with the first band. The base defines a second groove and a slot. A second band is disposable in the second groove and defines an opening aligned with the slot. A shaft is connectable with the base and engageable with the second band. The shaft is configured to penetrate tissue. The opening is aligned with the slot to facilitate an angular range of movement of the shaft relative to the body. Implants, systems, instruments and methods are disclosed.

A spinal stabilization system including an insert positionable in the channel of the housing of a vertebral anchor, and an associated support construct including a spacer and at least one cord extending through the insert. In some instances the construct includes first and second cords extending through first and second bores of the insert. A clamping member clamps the cord(s) in the insert. In some instances the clamping member includes first and second tabs movable in channels in first and second flanges of the insert.

The present disclosure provides an adjustable double-slot internal spinal fixation apparatus, including a first base, a second base and a connecting rod. The first base and the second base each contains a U-shaped slot from top to bottom. An inner wall of each U-shaped slot contains inner threads. The connecting rod is disposed along a horizontal direction. The second base contains a long slot along the horizontal direction. One end of the connecting rod is inserted in the first base, and the other end of the connecting rod is inserted in the long slot of the second base. The connecting rod can swing in the long slot. The first base and the second base are capable of relatively rotating on the connecting rod.

A pivotal bone anchor assembly configured for independent positional locking with tooling prior to securing an elongate rod to patient bone with a closure. The assembly includes a bone anchor having a capture portion and a body portion for fixation to patient bone. The assembly also includes a receiving member having an upper portion for receiving the elongate rod and a lower portion for receiving the capture portion, with the bone anchor having pivotal movement with respect to the receiving member. The assembly further includes a locking member in non-threaded engagement with the receiving member and configured for vertical displacement by the tooling into a locked configuration, so as to lock an angular position of the bone anchor relative to the receiving member. The locking member is also releasable by the tooling to re-establish the pivotal movement of the bone anchor with respect to the receiving member.

An anchor assembly for use in spinal fixation to interconnect a longitudinal spinal rod with a patient's vertebra. The anchor assembly preferably includes a bone anchor, a body with a rod-receiving channel, an insert member (preferably a bushing), and a locking cap. The anchor assembly enables in-situ assembly where the bone anchor may be secured to the patient's vertebra prior to being received within the body of the bone anchor assembly. Accordingly, the anchor assembly enables a surgeon to implant the bone anchor without the body to maximize visibility and access around the anchoring site. Once the bone anchor has been secured to the patient's vertebra, the body may be snapped onto the bone anchor and a spinal rod may be inserted into the rod-receiving channel.

Embodiments include a system that facilitates placement of a rod through receiving portions of screws placed along the spine. The system includes a rod and a cable detachably connectable to the rod to pull the rod through the receiving portions of the screws. Some embodiments include methods and devices for inserting a rod into a plurality of screws and for ex situ templating of a rod. These can include connecting a cable to a rod, inserting the cable through the plurality of screws, and using the cable to pull the rod into position. The methods of ex situ templating of the rod can include contacting a templating member to each of the screws so that a portion of the templating members replicate the relative positioning of the screws and shaping a rod to match the relative positioning of the portion of the templating members.

A method of conducting a surgical procedure including implanting an anchor into a bone, wherein the anchor comprises a receiving portion and a screw, the screw including a screw head contained within the receiving portion and pivotally engageable with a surface of the receiving portion, and wherein the receiving portion and the screw comprising a different material. The method further includes selecting a rod from a group of rod types and coupling the rod with the receiving portion to stabilize a position of a portion of the spine.

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.

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.

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 derotating the spine to correct the spinal deformity by adjusting an effective length of the lateral coupling, and securing a second rod on a second side of the spine to provide secondary stabilization to the spine.