A spinal implant includes a first member configured to penetrate tissue and a second member. The second member has an abutment engageable with a surgical instrument and at least one peripheral capture element engageable with a moveable arm of the surgical instrument. Systems, spinal constructs, surgical instruments and methods are disclosed.

Various implant holding systems are provided herein that include an outer tube, an inner tube, and a holder. The implant holding systems can be designed to hold various implants, such as bone anchors used in spinal operations. For example, one embodiment of an implant holding system can have an outer tube, an inner tube that can be disposed within the outer tube, and an implant holder that can be disposed within the inner tube. An individual bone anchor that has various configurations and sizes can be disposed within the holder, and the holder can engage the bone anchor to assist in maintaining an orientation of the bone anchor relative to the holder.

A variable length headless compression screw insertion system includes a compression screw and a driver assembly for driving the compression screw into a bone. The compression screw has a bone screw and a compression sleeve coupled to the bone screw. The bone screw includes a proximal end having an external threading threadably received in the compression sleeve, and the compression sleeve includes a proximal end having a predefined drive feature and an external threading. The driver assembly includes a sleeve coupler adapted to threadably receive the external threading of the compression sleeve. A ram driver is coupled to the sleeve coupler and has a predetermined length such that its distal end is shaped to contact the proximal end of the bone screw to prevent translation of the bone screw relative to the compression sleeve.

Bone graft comprising cortical bone material having a screw shank with an external thread and a screw head. Screw head has an outer jacket surface which is rotationally symmetrical about a screw head axis and has an external thread. At least two recesses, which are distributed about the screw head axis, extend axially in the direction of the screw head axis and open into an end face of a free end of the screw head, for receiving an insertion tool. The recesses are each formed by side faces, which extend from the outer jacket surface in the direction of the screw head axis and merge into one another in a surface section close to the axis. By this design, introduction of an insertion torque is optimized and new surgical areas of application such as in intramedullary splinting, arthroscopic insertion and deep insertion of the graft into an bearing bone are possible.

A surgical guidance device is cannulated for passage of a guidewire or pin and includes a hand grip and differential control assembly for driving the guidewire or pin and differentially driving a screw, such as but not limited to a pedicle screw, into bone. The differential control assembly resides in a housing, and includes a differential control assembly for gripping and locking or releasing the guidewire or pin and effecting directional movement (relative to the user holding the surgical guidance device) either distally into the bone or proximally away from bone to thereby drive or retract the guidewire. The differential control assembly also allows distal or proximal drive of a screw, such that one or both the guidewire and screw can be passed proximally or distally alone or together.

A screw insertion system has a screw having a threaded shaft and a head. The head has a conically tapered outer surface, the taper increasing in distance from a central longitudinal axis of the screw from a free end of the head towards a larger diameter adjacent the connection between the head and the threaded shaft. The conically tapered head outer surface has preferably two helically extending partially rounded threads. The head has a drive element for engaging a driver. A tubular screw holder has an outer surface and internal bore extending between a leading end and a trailing end for receiving the screw. The leading end having a conically tapered inner threaded portion for engaging the conically tapered outer thread of the screw head. The tubular screw holder outer surface having a diameter less than or equal to the maximum diameter of the conically tapered head.

A pivotal bone anchor assembly includes a receiver comprising a base defining a lower portion of a central bore, a pair of receiver arms extending upward from the base to define a first channel, and a non-threaded curvate tool engagement groove extending horizontally across an outward facing surface of each receiver arm. The assembly also includes a shank comprising an anchor portion and a partially spherical-shaped head configured for positioning into the lower portion of the central bore. The assembly further includes an insert configured for positioning into the central bore above the head of the shank and having a lower body with partially-cylindrical outer surfaces and a pair of insert arms extending upward from the lower body to define a second channel alignable with the first channel and configured to receive the elongate rod, with each of the insert arms having a flared-out upper portion.

A screw insertion system has a screw having a threaded shaft and a head. The head has a conically tapered outer surface, the taper increasing in distance from a central longitudinal axis of the screw from a free end of the head towards a larger diameter adjacent the connection between the head and the threaded shaft. The conically tapered head outer surface has preferably two helically extending partially rounded threads. The head has a drive element for engaging a driver. A tubular screw holder has an outer surface and internal bore extending between a leading end and a trailing end for receiving the screw. The leading end having a conically tapered inner threaded portion for engaging the conically tapered outer thread of the screw head. The tubular screw holder outer surface having a diameter less than or equal to the maximum diameter of the conically tapered head.

A surgical instrument system and method of use is disclosed. The system includes a bone fixation pin and a surgical instrument configured for use with the bone fixation pin. The surgical instrument includes a sheath extending over the distal end of an elongated shaft and a locking mechanism operable to permit selectively movement of the elongated shaft along the longitudinal axis relative to the sheath.

A fixation device includes a head, a tapered body coupled to the head and extending along a central longitudinal axis, and a flexible tail extending distally from the tapered body and defining a central bore therethrough. The flexible tail is movable from an initial configuration aligned with the central longitudinal axis to a deflected configuration that extends away from the central longitudinal axis when a force is applied to the flexible tail.