A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver. Further alternative bone screws are hinged, polyaxial or fixed and include lordosing or kyphosing lateral surfaces.

A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver. Further alternative bone screws are hinged, polyaxial or fixed and include lordosing or kyphosing lateral surfaces.

The invention features bone screws having a threaded screw body and a screw head attached to one end of the screw body, the bone screw further including: a) an interior channel extending longitudinally through the screw head and through at least a portion of the screw body, wherein the interior channel has a width of less than 5.0 millimeters; and b) a plurality of radially-disposed delivery channels connecting the interior channel to the exterior of the screw body, each delivery channel having exterior openings. The invention further features devices that include a bone screw and a delivery manifold detachably attached to the screw head of the bone screw. In addition, the invention features methods of treating a patient having a bone defect by using a bone screw described herein.

A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver. Further alternative bone screws are hinged, polyaxial or fixed and include lordosing or kyphosing lateral surfaces.

A bone fastener includes a distal member having a proximal portion and a closed distal tip. The distal member includes an outer surface engageable with a first cortical surface and a second cortical surface. The proximal portion includes an inner surface that defines a longitudinal cavity and at least one fenestration in communication therewith. Systems, spinal constructs, surgical instruments and methods are disclosed.

A method and system for performing bone fusion and/or securing one or more bones, such as adjacent vertebra, are disclosed. The screws include a threaded tip connected to a main shaft and a threaded outer sleeve that rotates relative to the outer shaft until locked down. Independent rotation of the threaded outer sleeve relative to the threaded distal tip allows compression or distraction to modify the gap between the vertebral bodies. The screws are passed from the inferior to superior vertebra or superior to inferior, for example, through a transpedicular route to avoid neurological compromise. At the same time, the path of screw insertion is oriented to reach superior or inferior vertebra. An intervertebral cage of the system is configured for lateral expansion from a nearly straight configuration to form a large footprint in the disc space. The screws and cage may be combined for improved fixation with minimal invasiveness.

In one aspect, a bone anchor assembly is provided having a bone anchor with a head, a resilient locking cap extending about a portion of the bone anchor head, and a cap drive member having a depending annular wall. In another form, a bone plate system is provided including a bone plate having an elongated throughbore and a resilient support member received therein. In another aspect, an insertion device is provided for manipulating and inserting a spinal device at or within a spinal joint. The insertion device is configured to actively pivot the implant about the implant gripping end of the device and to allow manipulation and release of the implant in any pivoted orientation from approximately 0 to 90 degrees.

A provisional engagement feature for selectively connecting a fastener such as a screw to a driving tool, the fastener incorporating a head with a recess extending therein and a projection contained within the recess for engagement with a corresponding engagement feature and/or selective locking feature of the driving tool.

A surgical system includes a bone fastener having a head and a shaft, The head has a drive interface surface including elliptical edges. A surgical instrument includes an inner drive and an outer sleeve that is engageable with an outer surface of the head to dispose the inner drive and the outer sleeve with the head in a co-axial, capture orientation, The inner drive has a drive interface surface including a plurality of spaced apart lobes. Each lobe has an elliptical edge engageable with one of the elliptical edges of the drive interface surface of the head. Spinal constructs, implants and methods are disclosed.

A fastener cartridge can be used with a shaft of a tool during an orthopedic procedure. The fastener cartridge can have a main housing that can be attached to fastener housing including a fastener chamber and a backstop component. The fastener chamber includes a plurality of non-flexible tabs and the backstop component includes a plurality of resiliently flexible tabs. The fastener housing is configured to include a plurality of fasteners that are arranged therein such that the longitudinal axes of the fastener chamber and the plurality of fasteners are collinear. The plurality non-flexible tabs prevent one of the fasteners from inadvertently passing entirely out of an outlet of the fastener chamber and the plurality of resiliently flexible tabs allow the fasteners to move axially in the first direction and restrict movement of the fasteners in a second direction opposite the first direction.