A spinal correction system includes a tensioning member and a fulcrum tensioner device including a housing defining a chamber having a biasing member therein and a camming pin operatively coupled with the biasing member. The tensioning member is configured to be received in the biasing member and looped around the camming pin, such that a first end of the tensioning member is oriented in a first direction and a second end of the tensioning member is oriented in a second direction. The camming pin is transitionable between an extended position in which the biasing member applies tension to the tensioning member and a retracted position in which the biasing member is compressed to inhibit application of tension to the tensioning member.

A reusable surgical implement is provided that is formed of a core positioned within an enclosure. The core is formed of a suitable rigid, and optionally flexible material to enable the implant to conform to the desired use for the implement in a surgical procedure. The material forming the enclosure is also stretchable and flexible to accommodate the configuration and/or any flexing of the core, and is biologically inert to enable the implant to be sterilized after use for use in subsequent surgical procedures while protecting the material forming the core. The enclosure can be molded around the core in separate portions or components using multiple molding steps to form an enclosure with the desired attributes.

A spinal fixation construct for aligning vertebral bodies includes a bone screw, a spinal rod, a flexible member, and a fixation member. The spinal rod is disposed within a saddle portion of a housing of the bone screw, and includes an elongated body having a first end and a second end. The spinal rod is formed from a first material having a first modulus of elasticity. The flexible member is coupled to the spinal rod, and includes an elongated body having a first end portion and a second end portion. The flexible member is formed from a second material having a second modulus of elasticity that is different from the first modulus of elasticity. The fixation member includes a threaded body portion and a head portion defining a hole therethrough. A portion of the flexible member extends through the hole of the head portion.

A pivotal bone anchor assembly includes a shank, a receiver with an open channel in communication with an axial bore, and a pressure insert with an upwardly-facing seating surface for receiving an elongate rod. The axial 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 axial 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 axial 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 axial bore.

Systems and methods for reducing the risk of PJK, PJF, and other conditions are disclosed herein. In some embodiments, a longitudinal extension can be added to a primary fixation construct to extend the construct to one or more additional vertebral levels. The extension can be attached to a first attachment point, such as a bone anchor implanted in a vertebra that is superior to the primary construct. The extension can also be attached to a second attachment point, such as a component of the primary construct or an anatomical structure disposed inferior to the first attachment point. The extension can be more flexible than the primary construct and/or can limit motion to a lesser degree than the primary construct, thereby providing a more-gradual transition from the instrumented vertebrae to the natural patient anatomy adjacent thereto. The extension can be placed with little or no soft tissue disruption.

A bone anchoring system having a flexible member with a first end and a second end opposite the first end. A fastener provided at a first end of the flexible member for retaining the flexible member within a bone. A rigid member is provided to ensure movement or pull-through of the flexible member does not occur.

A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having a channel configured to receive the elongate rod and a helically wound receiver guide and advancement structure formed into interior surfaces of the receiver. The receiver assembly further includes a threaded plug configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the threaded plug having a lower axially protruding portion configured to engage the rod so as to lock the rod in the receiver in the locked configuration.

A method of assembling a receiver assembly includes aligning an insert with a receiver such that a second channel of the insert is in non-alignment with a first channel of the receiver, followed by loading the insert into a through-space of the receiver that extends between a bottom opening and an upper opening. The through-space includes an internal recess beneath a helically wound guide and advancement structure and an internal ridge projecting inwardly below the internal recess. The insert includes side structures protruding laterally outward and spaced below top surfaces. The method further includes rotating the insert within the through-space of the receiver to align the second channel with the first channel so as to together receive an elongate rod, while also rotating the side structures of the insert into the internal recess of the through-space with the side structures being adjacent to and above the internal ridge.

A receiver assembly for capturing an elongate rod in a receiver of a bone anchor includes the receiver, a first threaded closure, and a second threaded closure. The receiver includes an upper portion that defines a first channel, interior surfaces that have helically wound thread, and a lower pressure insert that can be positioned within the first channel and has upright arms. Each of the first threaded closure and the second threaded closure have a cylindrical body with an external surface having continuous helically wound thread that can rotatably mate with the helically wound receiver thread. The first threaded closure and the second threaded closure are interchangeable for different locking configurations in the receiver assembly. The first threaded closure has a downward protrusion that can compressively engage the elongate rod. The second threaded closure has a bottom surface that can compressively engage the upright arms of the lower pressure insert.

Provided is a fixture rod having improved bonding strength between a core member and a reinforcing fiber layer, high rigidity, and high durability against a deformation load. The fixture rod according to one embodiment of the present disclosure comprises: a core member containing fibers; and a reinforcing fiber layer provided on the core member, and a part of the fibers of the core member is exposed from the core member, and a part of the fibers with the exposed part is embedded in the reinforcing fiber layer.