A soft dynamic stabilization assembly includes a core, typically in the form of a tensioned cord, at least one pair of bone anchors, a spacer surrounding the core located between the bone anchors, typically, at least one elastic bumper and at least one fixing or blocking member. The core is slidable with respect to at least one of the bone anchors and cooperating spacer.

A dynamic fixation medical implant having at least two bone anchors includes a longitudinal connecting member assembly having a core portion made from at least one pre-tensioned flexible member and a cooperating pre-compressed surrounding outer sleeve. The sleeve surrounds the core and is disposed between cooperating rigid end members that are attached to the bone anchors.

A dynamic stabilization assembly includes a core, typically in the form of a tensioned cord, at least one pair of bone anchors, a spacer surrounding the core located between the bone anchors, at least one elastic bumper and at least one fixing or blocking member. The core is slidable with respect to at least one of the bone anchors, the spacer and the bumper. The bumper is compressed. Bone screws of the assembly include closure structures that lock against the bone screw independent of any fixing or sliding of the core with respect to the bone screw.

A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in an integral receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A down-loadable compression insert, a down-loadable friction fit split retaining ring having inner and outer tangs and an up-loadable shank upper portion cooperate to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra. The shank and receiver once assembled cannot be disassembled.

A pivotal bone anchor assembly includes a shank, a receiver with an open channel in communication with a central bore, and a pressure insert with an upwardly-facing seating surface for receiving an elongate rod. The receiver bore includes a downwardly-facing surface below a closure top mating feature and one or more integral structures protruding inwardly toward a central longitudinal axis. The insert includes one or more notches formed into an outer side surface and an upwardly-facing surface positioned radially outward from the seating surface. Upon installation into the receiver bore, the insert is rotatable about the longitudinal axis until the insert upwardly-facing surface is rotated under the receiver downwardly-facing surface to inhibit upward movement of the insert within the receiver bore along the longitudinal axis and the receiver inwardly-protruding structures become positioned within the insert outer notches to prevent further rotation of the insert within the receiver bore.

An improved dynamic longitudinal connecting member includes a rod portion joined with a tensioned cord portion, for use in a medical implant assembly having at least two bone attachment structures, a spacer covering the join of the rod and cord portions and extending between the at least two bone attachment structures, a sleeve, a bumper and a cord blocker. The spacer and bumper are compressed. The cord portion is slidable with respect to at least one of the bone attachment members.

A bone fastener comprises a first member defining an implant cavity and a plurality of adjacent grooves. A first band is configured for disposal within the grooves. A second band is configured for disposal within the grooves. A second member is configured to penetrate tissue and includes a head engageable with the first band to provisionally connect the members. The second band is movable for disposal adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

A vertebral support device (1) is disclosed, which in various embodiments comprises at least two osseous anchoring implants (2), each designed to be anchored to a vertebra, and at least one linking element (3) fixed to the osseous anchoring implants (2) by fasteners (20) that maintain a fixed angle between the longitudinal axis (L) of the linking element (3) passing through rigid elements (34) of the linking element (3) and the insertion axis (DV) of the implants (2). The linking element (3) includes at least one elastic dampening element (31) that that allows the implant-bearing vertebrae some freedom of movement. The dampening element (31) accommodates the stresses imposed on the linking element (3) during movement of the vertebrae and tends to return the support device (1) to its normal configuration.

This disclosure describes a variety of transitional or terminal components that may be implanted as part of a spinal fixation construct to decrease the potential for subsequent development of junctional disease. The fixation construct may extend any number of levels from a single level construct to a long construct spanning multiple spinal levels and multiple spinal regions from the lumbosacral to cervical regions, and with any variety of combination of anchors, rods, and connectors. Terminal and/or transitional components maybe utilized at the caudal and or cephalad ends of the fixation construct to reduce stresses endured by the construct adjacent pathology and prevent or reduce incidence and degree of junctional disease.

A bone screw has a threaded screw shank and a screw head that in turn has two opposite legs defining a receptacle between them and integrally connected to a tissue-protecting sleeve. The tissue-protecting sleeve has a slot that runs from the sleeve's one edge to the opposite edge. Further, a sleeve remover has a corpus structured as a hollow cylinder, which has a separation element at one end, on its inside circumference, which element extends over part of the circumference direction.