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 moveable for disposal adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

A pivotal bone anchor assembly includes a shank with a head and an anchor portion, and a receiver with a channel for receiving a rod and a lower portion of an axial bore for receiving the shank head, with the axial bore including a stop structure and a downwardly-facing surface beneath a helically wound thread. The assembly also includes an insert having an upwardly-facing seat, a lower surface for engaging the shank head, a side structure for engaging the stop structure, and an upwardly-facing surface positioned radially outward from the upwardly-facing seat, with the insert being installed into the axial bore in a first angular position. Subsequent rotation of the insert within the axial bore moves the upwardly-facing surface under the downwardly-facing surface to inhibit upward movement of the insert within the axial bore, with further rotation being inhibited by the side structure coming into engagement with the stop structure.

A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in a receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. The upper portion expands a retaining member in the receiver cavity to capture the shank upper portion in the receiver. In some embodiment either the retaining member or an insert provide for a friction fit of the shank upper portion in the receiver resulting in non-floppy placement of the shank with respect to the receiver. Some retainers and inserts have a lock-and-release feature. Final locking of the polyaxial mechanism is provided by frictional engagement between the shank upper portion and the retaining member. A pre-assembled receiver, retaining member and optional insert may be popped-on or snapped-on to the shank upper portion prior to or after implantation of the shank into a vertebra.

A system for fixing spinal vertebrae utilizes a spinal rod that has varying properties along its length such that a lower stiffness portion is placed in the cranial or caudal end positions of the spinal rod to address potential adjacent level failure. The spinal rod includes a core member formed of a first material having a first modulus of elasticity and a sheath member formed of a second material having a second modulus of elasticity different from the first modulus of elasticity. The core member includes a first portion having a uniform outer diameter and a second portion extending from the first portion. At least a portion of the second portion has an outer diameter smaller than the uniform outer diameter of the first portion. The sheath member has a lumen extending therethrough that is sized for slidably receiving the second portion of the core member therein.

A receiver subassembly adapted to couple with a universal shank to form a bone anchor assembly. The universal shank having an integral upper capture structure with opposed spaced apart flat side surfaces. The receiver subassembly including a receiver including a distal opening for bottom loading of the capture structure of the universal shank there-through. The receiver supporting a retainer and a positioner within the receiver. The positioner supporting a position of the retainer within the receiver. The retainer configured to couple with the capture structure when the capture structure extends at least partially through the distal opening.

Devices, assemblies, kits, systems and methods for shaping of elongated elements containing thermoplastic polymers 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.

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 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 has a lower friction fit collet and an outer receiver press fit surface. A down-loadable retaining ring has at least one inner edge and outer tiered surfaces. The ring cooperates with the shank 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 uni-planar assembly is included.

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 with tool receiving arm extensions, a down-loadable friction fit split retaining ring 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.