Spinal correction system

Abstract

A spinal correction system has (i) receivers including a base and opposing arms extending proximally from the base to form a rod receiving cavity, (ii) a pair of extender tabs each having a threaded interior wall for receiving threads of a set screw, (iii) a pair of tab extenders each releasably connected to one of the extender tabs, (iv) a cap instrument releasably connected to the tab extenders, and (v) a pair of breakaway portions each connecting one of the extender tabs to one of the receiver arms and each configured to be readily breakable to separate the extender tab from the receiver arm. The distal base defines a bone screw cavity to receive a bone screw head so that the head can move relative to the base. Each receiver arm has a threaded interior wall for receiving threads of a set screw. The rod receiving cavity has a geometry corresponding to a geometry of the set screw and a spinal correction rod.

Description

Technical Field

[0001] This disclosure generally relates to surgical systems, and more specifically to a spinal correction system having a capped tab extender connectable to a screw assembly having a threaded extender tab that is brittlely connected to a threaded monoaxial or multiaxial rod receiver and a bone screw. Background Technology

[0002] Surgical rods are commonly used to correct spinal abnormalities. Pedicle screw assemblies are typically used to facilitate fixation of one or more spinal rods relative to the spine. A pedicle screw assembly includes a bone screw attached to a rod receiver. The bone screw is attached to the patient's vertebra, and the receiver accommodates a portion of the spinal rod.

[0003] In some cases, the receiver of a typical pedicle screw assembly can be angled relative to the bone screw to facilitate selective positioning of the spinal rod relative to the vertebra. When the bone screw is secured to the vertebra, the user can guide the spine towards the desired shape when the rod is attached to the receiver.

[0004] Positioning the rod within each receiver can be challenging in some surgeries. Compared to standard open spinal surgery, minimally invasive surgery presents greater limitations in visibility and maneuverability, making manipulation particularly difficult.

[0005] A system is needed to facilitate the return of the rod to the receiver anchored to the patient's vertebrae. Summary of the Invention

[0006] The systems and processes disclosed herein generally relate to surgical systems, and more specifically to spinal surgical systems having a covered tab extender connectable to a screw assembly having a threaded extender tab that is brittlely connected to a threaded monoaxial or multiaxial rod receiver and a bone screw. In a contemplated embodiment, the receiver and bone screw may be fixed in form, thereby eliminating the need for additional receivers relative to the screw.

[0007] On one hand, this disclosure provides a spinal correction system having (i) a receiver having a distal base and a pair of opposing arms extending proximally from the base and forming a rod receiving cavity, (ii) a pair of extender tabs, each arm having a threaded inner wall sized and shaped to receive threads of a fixing screw, (iii) a pair of tab extenders, each tab extender being releasably connected to an extender tab, (iv) a cap instrument releasably connected to the proximal end of the tab extenders, and (v) a pair of disconnect portions, each disconnect portion connecting an extender tab to a receiver arm, and each disconnect portion being configured to be easily broken during system operation to separate the extender tab from the receiver arm.

[0008] The distal base of the receiver defines a bone screw cavity, the size and shape of which are designed to receive the head of the bone screw, allowing the head to move relative to the base. Each receiver arm has a threaded inner wall for receiving the threads of a fixation screw. Furthermore, the rod receiving cavity has dimensions and shape corresponding to the size and shape of the fixation screw and the spinal correction rod to be secured within the cavity by the fixation screw during system operation.

[0009] In some embodiments, the threaded shape of each inner wall of the extender tab extends from the distal end of the extender tab to the proximal end for at least about half the height of the extender tab.

[0010] In some cases, the threaded shape of each inner wall of the extender tab extends from the distal end of the extender tab to the proximal end by at least two-thirds of the height of the extender tab.

[0011] In various embodiments, each extender tab may have a locking hole, and each extender tab may have a locking protrusion for engaging with a corresponding locking hole to releasably engage the tab extender to the extender tab. In some cases, each tab extender has a cantilever spring locking member that connects to the tab extender's balancer only at its distal end, and the locking protrusion is positioned at or near the proximal end of the cantilever spring locking member.

[0012] In various embodiments, the cover instrument extends from the proximal end to the distal end and has an inner wall extending from the proximal end to the distal end of the cover instrument, the inner wall defining (a) a central guide channel extending between the proximal and distal ends of the instrument, and (b) a tab extender channel on each side of the central guide channel.

[0013] In some cases, the cover instrument has (I) an outer wall extending between a proximal and a distal end, and (II) opposing engagement openings in each tab extender channel. Each engagement opening extends between an inner and outer wall of the cover instrument, and each tab extender extends from a proximal end to a distal end having a forked tip with a pair of opposing forked teeth. At least one of the opposing forked teeth has forked tooth protrusions for engaging with one of the engagement openings of the cover instrument during use of the system.

[0014] Each fork tooth has a fork tooth protrusion, which in various embodiments is configured to act as a cantilever spring that biases the fork tooth protrusion outward away from the opposite fork tooth at the fork tip, thereby forcing the fork tooth protrusion into the engagement opening of the tip in the engagement opening of the cover instrument when the fork tip is inserted into the tab extender channel of the cover instrument.

[0015] In various embodiments, each tab extender has an inner wall and an outer wall, each tab extender extending from a proximal end to a distal end, and an extender tab receiving channel is formed on the inner wall at the distal end, the extender tab receiving channel having a rear wall, opposing side walls and an inner shoulder wall extending from each side inner wall, which forms a generally U-shaped extender tab receiving channel.

[0016] The receiver can be configured as a single axis, allowing it to move only relative to the bone screw along a single plane, or it can be configured as a multi-axis, allowing it to move at any position relative to the bone screw within a generally conical space. In a contemplated embodiment, the receiver and bone screw are fixed in place, thus there are no additional receivers relative to the screw.

[0017] On the other hand, this disclosure provides a spinal correction system comprising (A) a receiver having a distal base and one or two opposing arms extending proximally from the base and forming a rod receiving cavity; (B) a pair of extender tabs, each arm having a threaded inner wall sized and shaped to receive a threaded fixation screw, the threaded shape of each inner wall of the extender tab extending proximally from the distal end of the extender tab by at least approximately two-thirds of the total height of the extender tab; and (C) a pair of disconnected portions, each disconnected portion connecting an extender tab to a receiver arm, and each disconnected portion being configured to be easily broken during system operation to separate the extender tab from the receiver arm. The distal base of the receiver defines a bone screw cavity sized and shaped to receive the head of a bone screw, such that the head is movable relative to the base. Each receiver arm has a threaded inner wall for receiving a threaded fixation screw. The rod receiving cavity has dimensions and shapes corresponding to the dimensions and shapes of the fixation screw and the spinal correction rod to be fixed in the cavity by the fixation screw during system operation.

[0018] In another aspect, this disclosure provides a spinal correction system comprising (i) a receiver having a distal base and a pair of opposing arms extending proximally from the base and forming a rod receiving cavity; (ii) a pair of extender tabs, each arm having a threaded inner wall sized and shaped to receive threads for a fixation screw, the threaded form of each inner wall of the extender tab extending proximally from the distal end of the extender tab by at least approximately half the total height of the extender tab; (iii) a pair of disconnected portions, each disconnected portion connecting an extender tab to a receiver arm, and each disconnected portion being configured to be easily broken during system operation to separate the extender tab from the receiver arm; and (iv) a pair of tab extenders, each extender tab releasably connected to an extender tab. The distal base of the receiver defines a bone screw cavity sized and shaped to receive the head of a bone screw, such that the head is movable relative to the base. Each receiver arm has a threaded inner wall for receiving threads for a fixation screw. The rod receiving cavity has dimensions and shape corresponding to the size and shape of the fixing screw and the spinal correction rod to be fixed in the cavity by the fixing screw during system operation. Each extender tab has a locking hole. And each tab extender has a locking protrusion for engaging with a corresponding locking hole to releasably engage the tab extender to the extender tab.

[0019] Details of various aspects of this disclosure will be set forth in the following drawings and description. Other features, objectives, and advantages of the present technology will become apparent from the description, drawings, and claims. Attached Figure Description

[0020] Figure 1 This is a perspective view of a cover extender system for correcting spinal deformities according to an embodiment of the present technology;

[0021] Figure 2 yes Figure 1 Side view of the overlay extender system including the extension plate screw implant of the bone screw;

[0022] Figure 3 yes Figure 1 A perspective view of the tab extender of the cover extender system;

[0023] Figure 4 yes Figure 1 A three-dimensional view of the cover instrument of the cover extension system;

[0024] Figure 5 yes Figure 1 A 3D view of the capping extender system being assembled;

[0025] Figure 6 The bone screw driver is positioned to drive the assembly. Figure 1A perspective view of the screws in the capped extender system;

[0026] Figure 7 A three-dimensional view of the bone screw driver being fully inserted into the assembled capped extender system and positioned to drive the bone screw into the pedicle of the patient's vertebra.

[0027] Figure 8 It is a top plan view of the patient's lumbar spine and the multiple overlay extension systems anchored thereon;

[0028] Figure 9 It is based on Figure 8 Before introducing the fixing screw into each capped extender system, the pre-bent rod is temporarily positioned by the extender tab of the capped extender system anchored to the vertebra, and the fixing screw is temporarily tightened into the view of the extender tab facing the rod.

[0029] Figure 10 It is a close-up 3D view showing the fixing screws being temporarily tightened into the extender tabs of the capped extender system;

[0030] Figure 11 It is based on Figure 9 The diagram shows the use of a lever holder to rotate the lever to adjust the spine to the desired orientation, such as a plan view of the normal kyphotic orientation of the spine.

[0031] Figure 12 It is a 3D view of the surgeon finally tightening the fixation screws;

[0032] Figure 13 It is a planar view showing that the vertebrae are oriented in a roughly straight line in the longitudinal or sagittal plane;

[0033] Figure 14 A three-dimensional view of an example double-convex tab disconnector is shown.

[0034] Figure 15 The steps of removing a tab extender from an extender tab that is disconnected from the extender, according to an embodiment of the present disclosure, are shown in perspective.

[0035] Figure 16 The steps of removing an extender tab from a tab extender using a tab remover according to an embodiment of the present disclosure are shown in perspective.

[0036] Figure 17 This is a plan view of the corrected spine after the fixation screws have been fully tightened and the extension plate has broken off from the extension plate screw implant. Detailed Implementation

[0037] Bone screw assemblies are used to attach rods to a patient's spine during spinal surgery. The assembly can be (i) fixed, where there is no relative movement between the receiver and the bone screw; (ii) multiaxial, where the receiver can rotate relative to the bone screw within a conical space to any desired angle; and (iii) uniaxial, where the receiver can only move relative to the bone screw along a single plane. Although much of this disclosure relates to uniaxial screw assemblies, the described structures and techniques can be readily implemented with multiaxial or fixed screw assemblies.

[0038] The spinal correction system of this technology includes a screw assembly with an extender tab that is brittlely connected to a rod receiver of the assembly. The screw assembly can be connected to an instrument that includes the tab extender and a cover instrument. In addition to positioning and repositioning the rod (lowering it into the receiver), the tab extender can also be used to retract or pull back the patient's skin and other soft tissues during surgical procedures. This function eliminates or reduces the need for additional retraction instruments, such as surgical tissue retractors.

[0039] The spinal correction system includes a cover instrument that can be connected to a tab extender to form a reduction tower, which can be used to facilitate the reduction of the rod and fixation into the screw assembly receiver.

[0040] In various embodiments, the uniaxial screw implant has an extender tab connected to the base via a disconnected portion. The base has a retaining screw thread, and the extender tab may include a complementary thread profile located above the disconnected portion, through which the retaining screw is screwed downward toward the base and abuts against the rod.

[0041] Although external reduction instruments can be used, this system eliminates the need for additional external reduction instruments, as further described below. The system also eliminates the need for external reduction instruments, as further described below. Not using such external instruments offers several advantages, such as resource savings by avoiding storage, transportation, space requirements, and preparation and handling work in the operating room, as well as cost savings through these and other factors, including the cost of external instruments.

[0042] Uniaxial screw implants can be used during deformity surgery via minimally invasive, incisional, or small incision approaches. The implants are used to correct the spine through rod reduction procedures.

[0043] This system can be used to surgically correct adolescent idiopathic scoliosis (AIS) or other spinal abnormalities or injuries.

[0044] Now turn to the accompanying figures, and more specifically to the first accompanying figure. Figure 1 A perspective view of a capping extender system for correcting spinal deformities according to an embodiment of the present invention is shown. The capping extender system or component is generally indicated by reference numeral 100.

[0045] The capping extender system 100 includes a bone screw assembly 200, a pair of tab extenders 300, and a capping instrument 400. When assembled, the receiver of the bone screw assembly, the tab extenders 300, and the capping instrument 400 extend along the longitudinal axis 10 of the system 100.

[0046] The features of screw assembly 200, tab extender 300, and cover instrument will be combined Figure 2 , 3 4. Further description.

[0047] The components of system 100 can be arranged in any combination, such as as one or more kits or groups (e.g., for manufacture, sale, distribution, or use). In some embodiments, for example, the screw assembly 200 is arranged separately from the tab extender 300 and the cap instrument 400. And the tab extender 300 can be arranged together with or separately from the cap instrument 400. In various embodiments, Figure 1 The system components shown, or any subset thereof, are pre-assembled. Figure 5 The main subsystems that have been disassembled are shown.

[0048] In various embodiments, any component can be provided with more than one size option. For example, a surgical kit with screws 210 of various sizes according to the present technology can be provided to the user.

[0049] Figure 2 This is a side view of the screw assembly 200. The screw assembly 200 extends from the proximal end 202 to the distal end 204.

[0050] The bone screw assembly 200 includes a bone screw 210 connected to the receiver assembly 220. The bone screw 210 has any desired or suitable form. In various embodiments, the screw 210 has a double-lead thread profile. The double-lead thread profile provides a secure fixation of the screw to the bone.

[0051] In some cases, the bone screw 210 and the instruments used with the screw 210 are hollow or perforated, as described in more detail below.

[0052] The receiver assembly 220 includes a base receiver 230 and a pair of opposing removable extender tabs 240. The receiver 230 may be referred to by other terms such as receiver, base, or screw assembly head.

[0053] Any of a variety of receiver sizes can be used. Receiver 230 can be a 5.5 or 6.0 mm receiver, for example, for receiving a 5.5 or 6.0 mm rod.

[0054] An extender tab 240 extends from an arm 232 of a receiver 230. Opposite tabs 240 define the proximal end of a channel 250 between them. The arm 232 of the receiver 230 defines the distal end of a channel 250.

[0055] The receiver assembly 220 can be sized in any desired manner to achieve the objectives and benefits of this disclosure. In various embodiments, the extender tabs 240 have a height 247 between the proximal end 203 and the distal end 205 corresponding to the proximal end 202 of the bone screw assembly 200. In various embodiments, each tab 240 has a height 247 of approximately 16.5 mm. In some embodiments, the height of each extender tab 240 is within a range. An example range is approximately 16 mm to approximately 17 mm.

[0056] The receiver device 220 can be uniaxial, multiaxial (or multi-axis), or fixed. In the fixed form, the receiver 230 and the bone screw 210 are connected such that there is no relative movement between the receiver 230 and the bone screw 210.

[0057] For both multi-axial and uni-axial configurations, the head of the bone screw extends into the distal cavity of the receiver (not shown in detail), and this head is movable within the cavity.

[0058] In the multi-axis configuration, the receiver 230 and the screw 210 are configured and connected such that the receiver 230 can rotate relative to the screw 210 within a conical space to any desired angle. (Conversely, the screw 210 can move relative to the receiver 230 to any desired angle within the possible conical range of screw movement.) The possible relative motion can be referred to as conical angular measurement.

[0059] In the uniaxial configuration, the receiver 230 and screw 210 are configured and connected such that the receiver 230 can move relative to the screw 210 along only a single plane. (Conversely, the screw 210 can move relative to the receiver 230 along only the same plane.) This plane may be referred to as the screw / receiver plane. An example of the screw 210's movement along the plane is shown by... Figure 2 As indicated by the arrow in the diagram. The uniaxial screw has a head that is secured within the distal cavity of the uniaxial receiver 230. (The screw head and cavity are not shown in detail.)

[0060] A uniaxial configuration may include a screw head and a receiver 230 having corresponding planes. The screw head and receiver 230 are thus movable relative to each other, wherein the planes are in contact, allowing the head and receiver to move within a plane, while the interface at the plane prevents the head and receiver from moving relative to each other out of the plane.

[0061] In various embodiments, in the implementation of system 100, one or more uniaxial screw assemblies are anchored to adjacent vertebrae, such that the receiver 230 can move only in the cranial / coccygeal plane relative to the patient.

[0062] Further reference Figure 2 In the receiver assembly 220, the extender tab 240 is connected to the receiver 230 via a disconnection portion 260. The disconnection portion is configured to facilitate easy or relatively easy disconnection of the receiver 230 and the extender tab 240. For example, the breakage can be achieved by a surgeon or robotic device (not shown). In various embodiments, the disconnection portion 260 is configured to be easily broken or snapped by a material having a weaker structure than the adjacent material of the system 100 (such as the adjacent material of the receiver 230 and / or the material of the extender tab 240).

[0063] The break portion 260 can be configured in any of a variety of ways to be weaker for fracture. In some embodiments, the break portion 260 is weaker by being smaller than the thickness (measured from the inner wall to the outer wall) of one or both of (i) the arm 232 of the receiver 230 and (ii) the extender tab 240. The portion 260 may alternatively or may also be configured to be easily fractured based on its material, such as by including a brittle or relatively fragile material (relative to the arm 232 and / or the extender tab 240).

[0064] Each receiver arm 232 has an inner surface thread 234 for receiving a fixing screw to secure the rod in the receiver 230. (Rod 900 in) Figures 9 to 12 As shown in Figures 1 and 14; the fixing screw 1000 is in Figure 10 and 14 (As shown in the figure) Each arm 232 may include one or more recesses 236 that facilitate gripping and manipulation of the receiver 230 by surgical instruments (not shown). The recesses also reduce the weight of the instruments without affecting the strength of the arms 232 and reduce the amount of material required to manufacture the receiver 300.

[0065] Each extender tab 240 has a locking hole 246 formed on its outer surface 244. In various embodiments, the hole 246 extends completely through the wall of the tab 240 between the outer surface 240 and the inner surface of the tab 240.

[0066] The locking hole 246 is sized, shaped, and positioned to receive the protrusion 316 of the mating locking member 312 of the tab extender 300. In some embodiments, the locking hole 246 is positioned proximal to the proximal end of the threaded profile 242 of the extender tab, such as... Figure 2 As shown.

[0067] As each tab extender 400 moves distally and partially around or abuts against the proximal end 203 of the corresponding extender tab 240, the extender tab 240 slides into the channel 310 of the tab extender 300. In this step, the node or protrusion 313 of the locking member 312 slides along the outer wall 244 of the extender tab 240 until the protrusion 313 reaches the locking hole 246 of the extender tab 240. As the extender tab 240 moves further into the tab extender 300, the protrusion 313, biased inward by the action of the spring-type extender locking member 312, is pushed into engagement with the locking hole 246, thereby releasably locking the tab extender 300 to the extender tab 240 (above).

[0068] The extender locking member 312 and the extender tab 240 including the hole 246 are configured such that when the engaging protrusion 313 of the tab extender 300 springs into the locking hole 246 of the extender tab 240, the user—e.g., a surgeon or a sensor device—receives one or both of tactile and auditory feedback, such as an auditory and tactile click.

[0069] The extender tab 240 has an inner surface thread 242, the size and shape of which are designed to receive a retaining screw (reference). Figure 10 and 14 (Ref. 1000 in the reference numeral 1000 in the extension tab). The tab thread 242 is close to the receiver thread 234 and is designed in size and shape to be similar to the receiver thread 234 so that the retaining screw can be easily or smoothly screwed from the distal end of the tab thread 242 onto the receiver thread 234.

[0070] In various embodiments, the tab thread 242 begins at or near the distal end 205 of the extender tab 240, where the break portion 260 begins to break. In various embodiments, the tab thread 242 extends from the distal end 205 toward the proximal end any desired or suitable distance, which may be referred to as the tab thread height 249. In various embodiments, the tab thread height 249 is at least half the height 247 of the extender tab. In some embodiments, the tab thread height 249 extends from the distal end toward the proximal end along at least about two-thirds of the height 247 of the extender tab. In various embodiments, the tab thread height 249 is between about 8 mm and about 14 mm.

[0071] In various embodiments, the extender tab thread 242 extends proximally from the distal end 205 to the locking hole 246 or its vicinity. In these embodiments, the higher the hole 246 is on the tab 240, the greater the thread height 249. In a contemplated embodiment, the tab thread 242 extends higher than the lower or distal edge of the hole 246. In these embodiments, threaded portions exist on both sides of the hole 246. The thread 242 may also extend proximally to the top or proximal edge of the hole 246 and beyond, including until it terminates proximally or near the tab 203.

[0072] Figure 3 This is a perspective view of a pair of tab extenders 300 of the cover extender system 100. The extenders 300 are selectively attached to and removed from the extender tabs 240 of the screw assembly 200.

[0073] In various embodiments, the tab extender 300 is reusable. While the bone screw 210 and receiver 230 are implants left in the patient's body, the tab extender 240 and tab extender 300 are removed. The tab 240 and extender 300 are removed together by manipulating the tab 240 and / or the extender 300 attached to the tab 340 to destroy the material of the disconnected portion 260.

[0074] Each tab extender 300 extends from a proximal end 302 to a distal end 304. Each extender 300 includes a channel 310 extending from a distal opening at or near the distal end 304 of the extender 300 to a proximal opening 320. The channel 310 is sized and shaped to fit snugly engage or receive at least a portion of the extender tab 240.

[0075] Channel 310 is formed by the inner wall 301 of the tab extender 300. In various embodiments, the shape of the inner wall is designed to form a generally U-shaped channel 310, such as... Figure 3 The front view and cross-sectional illustrations are shown.

[0076] In some cases, the wall 301 forming the U-shaped channel includes a rear wall 303, a side wall or side wall 305, and a shoulder or protruding wall 307 extending inward from the side wall 315. The side wall 305 and the protruding wall 307 help ensure that the extender tabs 240 remain in the channel 310 once they are received in the channel 310 until the user removes them.

[0077] The channel geometry also ensures that the outer wall 244 of the extender tab 244 is typically flush with or slides along the corresponding rear wall 303 of the tab extender 300. In this way, when the tab extender 300 slides sufficiently far on or along the extender tab 240, the inwardly biased (towards the system central axis) extender protrusion 313 will securely engage with the locking hole 246 of the extender tab 240.

[0078] In one hypothetical embodiment, the shoulders 307 extend completely toward each other, forming a single wall opposite the rear wall 303, such as Figure 3 The dotted lines in the illustration roughly indicate this.

[0079] In various embodiments, the rear wall 303 is curved, such as... Figure 3 As shown in the illustration, this curve corresponds to the curve in the outer surface 244 of the extender tab 240. The corresponding curve facilitates flush engagement or sufficient inter-surface sliding between the rear wall 303 of the extender 300 and the outer surface 244 of the tab 240. When the tab extender 300 slides sufficiently on or along the distal end of the extender tab 240, this also facilitates engagement of the protrusion 313 into the locking hole 246.

[0080] In various embodiments, the tab extender locking member 312 extends from the distal end 314 to the proximal end 316. In various embodiments, the extender locking member 312 is connected to the balance member of the extender 300 only at the distal end 314. The extender locking member 312 is located in other portions of the extender 300 separated from the adjacent portion 318 by the space 319.

[0081] In various embodiments, the extender locking member 312 is configured as a spring that biases inwardly toward the extender tab 240 toward the protrusion 313, which is positioned in the channel 310 of the tab extender 300 for use by the system 100. The extender locking member 312 may be a linear bending spring, such as a cantilever type.

[0082] In various embodiments, each tab extender 300 includes a cap engagement end 330. The cap engagement end 330 can be configured in any of a variety of ways (e.g., size, shape, material) suitable for engagement with the cap instrument 400. For example, the cap engagement end 330 can have a forked configuration, such as... Figure 3 As shown. The fork-shaped configuration has a pair of opposing fork teeth 340 spaced apart by a space 350. Each fork tooth 340 may include an engaging protrusion or node 360 ​​for engaging with the cover instrument 400. Figure 4 The engagement opening 420 of the fork is engaged. The fork tooth 340 can be referred to by other terms, such as tooth, fork arm, fork tip, etc.

[0083] Now go to Figure 4 This is a perspective view of an example cap instrument 400 of the cap extension system 100. The cap instrument 400 or cap extends from the proximal end 402 to the distal end 404.

[0084] The cover 400 has two extender receiving channels 410, each channel being sized, shaped, and positioned to receive all or part of the cover engaging end 330 of the tab extender 300. The cover 400 has an inner surface 412 that defines a portion of each extender receiving channel 410. The inner surface 412 also defines a set of opposing engaging openings 420 in each extender receiving channel. It should be understood that... Figure 4 One of the opposing engagement openings 420 in each set is clearly shown, and the mating openings 420 of each pair are located on opposite sides of the cover (with). Figure 4 (The three-dimensional image is relative). For example, Figure 4 As shown, the engagement opening can extend completely from the inner wall 412 through the cover 400 to the outer wall 413.

[0085] The inner wall 412 of the cover instrument 400 also defines an instrument or guide channel 430. In various embodiments, the instrument channel 430 is located at the center of the cover and is generally centered on the longitudinal axis 10 of the system 100. The size, shape, and position of the guide channel 430 are designed to receive one or more instruments during operation of the system 100, as further described below. The size and shape of the guide channel 430 may be designed to facilitate guiding instruments, such as directly along the system axis 10 to the bone screw 210 or the fixation screw 1000. Figure 10 and 14 The cover instrument 400 can therefore be referred to as a guide cover, cover guide, etc.

[0086] In various embodiments, the retaining screw 1000 is a non-disconnecting retaining screw. These non-disconnecting retaining screws are smaller (shorter) than disconnecting retaining screws.

[0087] Now for reference Figure 3 and 4 To further describe the engagement between the tab extender 300 and the cover instrument 400.

[0088] Each fork arm 340 can be used as a spring, with its engagement node 360 ​​biased outwards, away from the inter-fork space 350. Each fork arm 340 can be a linear bending spring, such as a cantilever type.

[0089] When the cover instrument 400 engages with the fork-shaped engagement end 330 of the tab extender 300, the protrusion 360 and therefore the fork 340 of the extender 300 are slightly pushed toward the inter-fork space 350, making the space 350 smaller.

[0090] As the cover instrument 400 moves distally onto the proximal end 330 of the tab extender 300, the fork arm 340 slides into the channel 410 of the cover 400, and each pair of opposing fork nodes 360 slides along the inner wall 412 of the cover 400 until the node 460 reaches the engagement opening 420 of the cover 400. As the fork arm 340 moves further into the cover 400, the opposing nodes 360, which are spring-loaded outward by the fork arm 340, are pushed into engagement with the cover engagement opening 420, thereby releasably locking the cover 400 onto the tab extender 300.

[0091] As mentioned, the cap engagement end 330, including the forked arm 340 and its engagement node 360 ​​in various embodiments, and the cap instrument 400, including the engagement opening 420, are configured to allow a user—e.g., a surgeon or sensor device—to receive tactile and auditory feedback, such as an audible and tactile click when the engagement node 360 ​​makes a click in the engagement opening 420.

[0092] The cover 400, together with the guiding instrument through its central guiding channel 430, counteracts the tendency of the extender 300 to possibly open at least at its proximal end 330. The cover 400 keeps the opposing tab extenders 300 from moving away from each other.

[0093] Figure 5 This is a perspective view of the cap extender system 100 assembled. As shown, opposing tab extenders 300 engage with extender tabs 240 of the screw assembly 200. A cap instrument 400 engages with the engagement end 330 of the tab extender 300. In various embodiments, the cap 400 is attached to the extender 300 after the extender has been connected to the screw assembly 200.

[0094] In the use of system 100, bone screw 210 is anchored to the patient's vertebra 700. Figure 7 The user uses a bone screw driver to anchor the bone screw. Figure 6 An example driver 600 is shown. The distal end of the driver is sized and shaped to engage with the head of a bone screw, which in... Figure 6 and 7 The middle part is not visible. For embodiments where the bone screw 210 is hollow, a hollow bone screw driver, such as a hollow retaining bone screw driver, can be used.

[0095] The actuator 600 is inserted through the guide channel 430 of the cover 400 and between the opposing tab extenders 300 held together by the cover 400. The actuator 600 moves further to the distal end until its tip is located at the head of the screw 210.

[0096] Figure 7This is a perspective view of the bone screw driver 600 fully inserted into the assembled capped extender system 100. As mentioned, the screw assembly 200 may have a multi-axial, fixed, or uniaxial configuration. Example axial movement of the screw 210 relative to the receiver 230 is shown in... Figure 7 The line is indicated by a curved double-headed line. In an alternative, this line is considered to represent single-axis and multi-axis motion (depending on whether component 200 has a single-axis or multi-axis form).

[0097] System 100 is manipulated to prepare for driving the bone screw 210 into a portion of the patient's vertebra 700. The movement of the screw 210 toward the insertion point of the vertebra 700... Figure 7 The image is schematically shown by a single arrow. In various embodiments, the screw 210 is guided and driven into the pedicle 710 of the vertebral 700.

[0098] Before screw driving, a bone tap (not shown) can be used to prepare the hole into which the screw 210 will be driven. For embodiments using hollow screws 210, a hollow tap can be used.

[0099] Multiple capping extender systems 100 are driven into adjacent vertebrae 700. The drive of the bone screws 210 can be performed by a surgeon or robotic device (not shown). For example, a powered surgical instrument such as a power actuator can be used to perform the drive.

[0100] Figure 8 This is a top view of the lumbar vertebrae 700 on which multiple covered extender systems 100 are anchored.

[0101] In various embodiments, system 100 is implanted in a specific sequence. When the subject portion of the spine deviates undesirably from a line, it may be beneficial for the vertebrae 700 to deviate from that line on both sides. This curvature... Figure 8 As shown in the diagram. The side of vertebra 700 can be relative to a curve, i.e., as a convex surface 801 (in Figure 8 The concave side (facing upwards in the view) and the convex side 801 (facing downwards in the view) are mentioned. The concave side 803 can also be referred to as the primary reduction side, and the convex side 801 can also be referred to as the secondary reduction side.

[0102] In various embodiments, the system 100 is first placed on the primary concave side 803 of the vertebra being tested. Although in some embodiments, the user may determine that it is best to start from the convex side 801, this document primarily describes starting from the concave side 803.

[0103] In one proposed embodiment, system 100 is inserted into both concave and convex sides, such as by first implanting system 100 into each side 801 / 803 of the most caudal vertebra 700. System 100 may be implanted alternately, such as by first implanting one into one side of the most caudal test vertebra 700, then implanting one into the other side of the most cranial test vertebra 700, and then implanting system 100 into the other side of both the most caudal and most cranial test vertebrae, or into the apex vertebra. The apex or vertex vertebra is the vertebra 700 where the undesirable curve of the spine is at its maximum.

[0104] In some embodiments, preferably, the system 100 is implanted starting from the caudal test vertebra 700 on the concave side 803. In various embodiments, the second and third implanted systems 100 are implanted into the caudal test vertebra 700 and the apex vertebra 700 on the concave side 803.

[0105] Planting the initial system 100 in such a strategic location has benefits including improved visibility and location for subsequent system 100 plantings. Separating the systems 100 from each other during the initial system planting also helps ensure that the towers of the initially planted systems do not interfere with each other.

[0106] Any implanted system 100, especially those initially implanted in strategic locations such as those mentioned (tail-most, apical, and cranial-most), can also retract tissues, such as the patient's skin and other soft tissues. The retraction capability of the system 100 improves the patient's visibility and maneuverability during the procedure. The incision edges are... Figure 8 Reference is made to the figure 810. The retraction point at the system incision interface is referenced to the figure 820. This feature is particularly useful in minimally invasive or small-incision surgeries where space and visibility are particularly limited by design constraints. The retraction function reduces the need for a separate retractor instrument (not shown) and, in some cases, eliminates the need for a separate retractor, thereby saving on equipment costs (e.g., production, distribution, storage) as well as work and time during the procedure.

[0107] In various embodiments, after the caudal system 100 is first implanted on the concave side 803, the next system 100 is implanted into the concave side 803 of the second caudal test vertebra 700. Subsequent implantations of the system 100 can continue sequentially toward the cranial side. Alternatively, after the placement of the first caudal implant, the next two implants can be placed in either order on the concave sides 803 of the cephalic and apical vertebrae.

[0108] In some other embodiments, after the most cranial system 100 is first implanted on the concave side 803, the next implanted system 100 is implanted on the concave side 803 of the second most cranial test vertebra 700. Subsequent implantations of the system 100 can continue sequentially toward the caudal side. Alternatively, after the placement of the first most cranial implant, the next two implants can be placed on the concave sides 803 of the most caudal and apical vertebrae in any order.

[0109] In various embodiments, after the caudal system 100 is first implanted on the concave side 803, the next implanted system 100 is implanted into the concave side 803 of the caudal, cranial, or apical vertebra 700.

[0110] In various implementations, after all systems 100 required for the procedure have been inserted, the heights of the various towers (e.g., the horizontal height of the cover 400) should be approximately the same outside the patient 800.

[0111] Once all systems 100 are implanted, the user can confirm placement and location radiologically, such as by taking X-rays to confirm screw placement and location. A blue towel placed between the towers may help to separate them for this purpose. A neural monitoring system can also be used to confirm placement and location.

[0112] Once the correct system 100 placement has been verified, the user can measure and model the selected rod, taking into account the current and target spinal orientation. The current and target orientations can be represented relative to the patient's sagittal and coronal planes.

[0113] Figure 9 It is based on Figure 8 The image shows a view of the spinal rod 900 temporarily positioned via the implanted system 100. For example, the rod 900 may be pre-bent using a rod bending machine (not shown) before insertion. In various embodiments, each rod has a visible orientation reference line 901 formed thereon or in it. The line 901 may be formed by etching, inking, or other marking methods. The user can reference the line 901 during bending, considering the desired position of the rod and thus the orientation of the line, so that the rod is oriented when it is subsequently secured in the system 100.

[0114] Users can clamp rod 900 onto a static structure, either at or near its end, to facilitate rod contouring. Clamping helps prevent unwanted rod rotation or other movement during contouring. Another method of securing the rod for bending is to attach a hex wrench to the rod end as a reference and then contour rod 900 using a rod bending machine, such as an in-situ bending machine. Rods 900 can be contoured before and / or after they are placed in system 100.

[0115] The insertion rod 900 can be inserted using any suitable instrument, such as a rod holder 920 or a percutaneous insertion instrument.

[0116] In various embodiments, the rod 900 is inserted starting from the first system 100, such as the most distal system 100. When a lined rod is used, the liner can be used to orient the rod during and after initial insertion. A line 901 can be used to position the rod in a temporary position, later redirecting it to a final position, such as via the rod holder 920, and locking it in place by a retaining screw 1000. Figure 10 and 14 ).

[0117] Figure 10 It is a close-up perspective view showing the temporary tightening of the fixing screw 1000 into the extender tab 240 of the cover extender system 100.

[0118] Similar to the benefits of implanting the system 100 in a specific order, the benefits can also be achieved by inserting the fixation screws 1000 in a selected order. In various embodiments, the user places the fixation screws 1000 starting from the tail end and cranial end of the rod 900. In some embodiments, the first fixation screw or one of the first fixation screws temporarily inserted may be a tip screw—that is, a screw inserted into the system 100 at the apex of the curve corrected by the surgery.

[0119] A temporary actuator 1010, such as a stir bar, can be used to temporarily (not fully tightened) insert the retaining screw 1000 into the extender tab 240, or even initially into the receiver 230.

[0120] Figure 11 It is similar to Figure 9 The diagram shows the use of a lever holder 920 to rotate lever 900 to adjust the spine to the desired orientation. This may involve adjusting or positioning the lever to promote normal or more normal kyphosis. The concave surface or primary reduction lever (in...) can be used first. Figure 11 (Lower in the view), or the secondary convex rod can be oriented first. The user can use azimuth line 901 as described above to orient the rod 900 to ensure the rod profile is in the desired orientation in system 100 and patient 800.

[0121] Once the correct orientation is achieved, the user can hold the rod 900 in place with the rod holder 920 during the start or continuation of fixing screw 900, thereby achieving rod restoration or further rod restoration - restoring the rod 900 to its final position in the receiver 230.

[0122] Once the rod 900 is secured, the user can further rotate the rod 900 in the sagittal plane using the rod holder 920 and the reference line 901, toward or to a final position that may include normal kyphosis. The user then secures the rod 900 by further screwing the fixing screw 1000 down into the thread 234 of the receiver 230. This securing can be done initially at the tail end of the structure.

[0123] In some embodiments, the user secures the rod 900 in a manner appropriate to the patient's condition. For example, for a patient 800 with a double thoracic curve spine, the user may first secure the rod 900 to the cranial end (upper thoracic curve region) and then move it to lock the rod 900 downward at the tail end or towards the tail end (lower thoracic curve region).

[0124] In some implementations, the user translates the construct (e.g., formed by all the extenders and rods) by compression and / or retraction. For translation, the surgeon or assistant may apply a restorative force on the apex system 100 to induce some rotational force on the local spine, such as at the construct. The user can consider any further restorative or adjustment there or at other systems 100 (e.g., rod bending), the remaining restorative distance between the apex and rod 900.

[0125] The user can then attach the remaining fixation screws 1000 to the other parts of the system 100. When inserting the remaining fixation screws 100, the user can work towards the center of the apex. It may be helpful to reduce the number of fixation screws at the tail end of the rod 900 (by further screwing the fixation screws down onto the rod 900 in the system 100) before reducing the number of top fixation screws 1000. The user can then use one or half a turn of the fixation screw 900 to move the concave side up and down to pull the spine into or towards the shape of the rod.

[0126] Once all the fixing screws 900 are in place, the user can rotate each fixing screw 1000 one full turn or half a turn to move the concave side up and down, depending on the tension applied to translating the spine onto the rod 900. This up-and-down movement of the spine balances the restoring forces at multiple anchor points. The user moves the concave side 303 rod 900 up and down until all the fixing screws 1000 are restored.

[0127] Users can add rotational force to the concave system 100 to maximize the restoration.

[0128] Once the initial restoration is completed on the concave rod 900, the user can ensure that the convex screw 900 is at least temporarily, and in some cases, securely fastened to the rod. Once the rod 900 has been restored and / or calibrated, the user can use X-rays and / or neuromonitoring to confirm the screw placement / position.

[0129] In some implementations, the user can perform an optional lever restoration process, such as by using a lever restoration instrument (not shown). The user uses the lever restorer to restore lever 900 sequentially along each lever. The restorer may include a window for manipulating / orienting lever 900. For example, the user can ensure that the marker line 901 is aligned with a first initial indication at or near the window when viewed through the window. The position of line 901 in the lever restorer window during restoration indicates how close lever 900 is to being fully restored.

[0130] The rod 900 can be manipulated as needed by loosening one or more retaining screws 1000, such as at the head end of the construct. The size and shape of the rod restorer may correspond to the size and shape of a portion of the extender 300. For example, the restorer may be configured to slide over a pair of extenders 300. In some embodiments, to insert the rod restorer, the user removes the corresponding cap 400 and slides the restorer over the uncapped extender 300.

[0131] Users can use additional instruments to facilitate rod reduction via the rod reduction device. Users can use a nut driver (such as a nut driver with a quick-connect ratchet-egg handle) to more easily reduce rod 900, such as by attaching it to the top of the rod reducer.

[0132] Use the rod restorer to restore rod 900 until rod line 901 corresponds to the second restore indicator of the rod restorer, indicating that rod 900 has been fully restored into receiver 230.

[0133] If a rod restorer is used, a long set screw driver can be used with the rod restorer to finally tighten the set screw.

[0134] Figure 12 The surgeon ultimately tightened the fixation screws by 1200 (in...). Figure 10 As can be seen, in Figure 12 A three-dimensional view (not visible in the image). Final tightening is performed after confirming the placement of the bone screw assembly. This technology helps the user ensure that the bone screw assembly 200 and the rod 900 are aligned with each other and allows the rod 900 to be fully seated in the receiver 230 upon final tightening.

[0135] Final tightening may include using a ring-shaped anti-torque instrument 1210 to finally tighten the fixing screw 1000.

[0136] Figure 13 It is a plan view showing that vertebra 700 has been oriented to a generally straight position in the longitudinal or sagittal plane.

[0137] After finally tightening the retaining screw 1000, the user connects the receiver 230 to the extender tab 240. Figure 2The break at the disconnected portion 260 causes each implant to break. In doing so, for each system 100, if the cap is still attached to the extender 300, the two extender tabs 240, the pair of tab extenders 300, and the cap 400 are removed together.

[0138] To achieve the breakage, the user can use a tab breaking instrument. Figure 14 A perspective view of an example double-flange breaker 1400 is shown. The user inserts the double-flange breaker 1400 through the cover 400 (if still present) until it is fully or adequately located or positioned in the system 100, and then pushes the instrument 1400 at the break portion 260 to break the extender tab 240 from the receiver 230. For example, moving the instrument 1400 may include pushing it inward, pulling it laterally, and then pushing it inward again to break it.

[0139] Once disconnected, the extender tab 240 and tab extender 300, as well as the cap 400 (if not already removed), can be disassembled, as the user can remove the cap 400 manually or using a pre-designed cap removal tool (not shown) at any different stage of the procedure for restoration or other reasons.

[0140] Figure 15 The postoperative steps of removing the tab extender 300 from the extender tab 240 disconnected from the extender 300 in the receiver 230 are shown in the form of a three-dimensional diagram using a tab remover 1500; the tab remover 1500 may be referred to by other terms such as disconnection removal tool, extender remover, tab extender remover, extender tab remover, tab / extender separator, etc.

[0141] To disconnect the extender tabs, the user (e.g., a surgeon or assistant) positions (e.g., slides) the tab remover 1500 over or against each tab extender 300. Alternatively, the user places the extender 300 over the tab remover 1500.

[0142] The extender 300 is positioned within the extender receiving groove 1510 of the remover 1500. The groove 1510 includes a protrusion 1520 for engaging and abutting a protrusion 313 of the locking member 312 of the tab extender 300. When the locking member protrusion 313 is pushed upward by the tab remover protrusion 1520, the locking member protrusion 313 is pushed out and disengaged from the locking hole 246 of the extender tab 240.

[0143] By disengaging, the tab extender 300 can be easily slid or otherwise removed from the extender tab 240, which remains stationary with the tab remover 1500 at this stage. The remover 1500 holds the tab 240 in place by engagement between the remover protrusion 1520 and the tab locking hole 246 of the extender tab 240. The tab 240 can then be retrieved from the remover 1500 and discarded or recycled.

[0144] In some cases, the tab extender 300 is attached to the screw assembly 200 (which includes the extender tab 240, but is not implanted) and therefore will not detach from the extender tab 240. The user may wish to remove the extender 300 from the screw assembly 200. Figure 16 The steps of removing the tab extender 240 from the extender tab 230, which is still connected to the receiver 230, are shown in a perspective view. The user uses a second end slot 1610 with a protrusion 1620 for this purpose, in a manner similar to how the user uses the first remover slot 1510 and the protrusion 1520.

[0145] The extender 300 disengages from the extender tab 240 by pushing the extender protrusion 313 out of engagement with the locking hole 246 of the extender tab 140. By disengaging, the extender 300 can easily slide away from the screw assembly 200, during which the screw assembly 200 remains stationary with the tab remover 1500, which holds the screw assembly 200 in place through the engagement between the remover protrusion 1620 and the tab locking hole 246 of the screw assembly 200.

[0146] In various embodiments, the remover 1500 includes a third groove 1630 opposite to the second groove 1610. Groove 1630 may include protrusions, such as protrusion 1620, for engaging opposing locking holes 246 and extender protrusions. In these embodiments, both extenders can be removed without flipping the remover 1500 or keeping system 100 components stationary.

[0147] In some embodiments, the remaining system components (screw assembly 200 and second tab extender 300) are flipped over to remove the second tab extender 300 using the slot 1610 and protrusion 1620.

[0148] When the tab extender 300 is disengaged from the extender tab 240, the unused screw assembly 200 can be removed from the remover 1500 and optionally processed for sterilization and use in future surgeries.

[0149] Figure 17This is an example plan view of spinal correction after the final tightening of the fixing screws 1000 and the breaking of the tower-extender tab 240, tab extender 300, and any remaining caps 400 of the system 100 from the receiver 230.

[0150] It should be understood that the various aspects disclosed herein can be combined in combinations other than those specifically presented in the specification and figures. It should also be understood that, by way of example, certain actions or events of any of the processes or methods described herein may be performed in a different order, added, combined, or omitted entirely (e.g., not all described actions or events are necessary for implementing the technique).

[0151] Furthermore, for clarity, although certain aspects of this disclosure are described as being performed by a single module or unit, it should be understood that the technology of this disclosure can be performed by a combination of units or modules associated with, for example, a medical device.

[0152] Unless otherwise specifically defined herein, all terms shall be interpreted as broadly as possible, including the meaning implied in the specification and the meaning understood by those skilled in the art and / or the meaning as defined in dictionaries, papers, etc. It must also be noted that, unless otherwise specified, the singular forms “a,” “an,” and “the” used in the specification and appended claims include plural references, and the terms “comprises” and / or “comprising” as used in this specification specify the presence of the stated features, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof.

[0153] It should be understood that various modifications can be made to the embodiments in this disclosure. Therefore, the above description should not be construed as limiting, but merely as examples of various embodiments. Those skilled in the art will contemplate other modifications within the scope and spirit of the appended claims.

Claims

1. A spinal correction system comprising: tab remover; A receiver having a distal base and a pair of opposing arms extending from the base toward a proximal end to form a rod receiving cavity; A pair of opposing extender tabs, the extender tabs having threaded inner walls sized and shaped to receive threads of a fixing screw; A pair of tab extenders, each tab extender being releasably connected to the proximal end of one of the extender tabs; A cover instrument that can be releasably connected to the proximal end of the tab extender; as well as A pair of disconnected portions, each disconnected portion connecting one of the extender tabs to a receiver arm, and each disconnected portion being configured to easily break off during operation of the system to separate the extender tab from the receiver arm; in: The distal base of the receiver defines a bone screw cavity, the size and shape of which are designed to receive the head of the bone screw, such that the head is movable relative to the distal base. Each of the receiver arms has a threaded inner wall for receiving the threads of the fixing screw; and The rod receiving cavity has a geometry corresponding to the geometry of the fixing screw and the geometry of the spinal correction rod to be fixed in the rod receiving cavity by the fixing screw during the operation of the system. Each extender tab includes a locking hole; and Each tab extender includes a locking protrusion for engaging with one of the corresponding locking holes to releasably engage the tab extender with the extender tab. The tab remover includes an extender receiving groove, wherein the extender receiving groove includes a protrusion for engaging and pushing against the protrusion of the locking member of the tab extender, and wherein when the protrusion of the locking member is pushed upward by the tab remover protrusion, the protrusion of the locking member is pushed out from the locking hole of the extender tab and disengaged, so that the tab extender can be easily removed from the extender tab.

2. The spinal correction system of claim 1, wherein the threaded shape of each inner wall of the extender tab extends from the distal end to the proximal end of the extender tab for at least half the height of the extender tab.

3. The spinal correction system of claim 1, wherein the threaded shape of each inner wall of the extender tab extends from the distal end to the proximal end of the extender tab for at least two-thirds of the height of the extender tab.

4. The spinal correction system according to claim 3, wherein: Each tab extender includes a cantilever spring-type locking member, which is connected to the balance member of the tab extender only at its distal end; and The locking protrusion is located near or at the proximal end of the locking component.

5. The spinal correction system of claim 1, wherein the cover instrument extends from a proximal end to a distal end and includes an inner wall extending from the proximal end to the distal end of the cover instrument, the inner wall defining: A central guide channel extending between the proximal and distal ends of the cover instrument; and A tab extender channel located on each side of the central guide channel.

6. The spinal correction system according to claim 5, wherein: The cover instrument includes: The outer wall extending between the proximal and distal ends of the cover instrument; and In each of the tab extender channels, there are opposing engagement openings, each engagement opening extending between and through the inner and outer walls of the cover instrument; and Each of the tab extenders extends from a proximal end to a distal end having a forked tip, the forked tip comprising a pair of opposing forked teeth, at least one of the opposing forked teeth having forked protrusions for engaging with one of the engagement openings of the cover instrument during use of the system.

7. The spinal correction system of claim 6, wherein each of the forks having one of the fork protrusions is configured to act as a cantilever spring that biases the fork protrusion outward away from the opposing fork protrusions of the fork tip, thereby forcing the fork protrusion into the engagement opening of the cover instrument when the fork tip is inserted into the tab extender channel of the cover instrument.

8. The spinal correction system of claim 1, wherein each tab extender includes an inner wall and an outer wall, each tab extender extending from a proximal end to a distal end, wherein the inner wall at the distal end forms an extender tab receiving channel, the extender tab receiving channel having a posterior wall, opposing side walls and an inner shoulder wall extending from each side inner wall, the posterior wall, side walls and shoulder wall forming a generally U-shaped extender tab receiving channel.

9. The spinal correction system of claim 1, wherein the receiver is configured in a uniaxial manner such that the receiver is movable relative to the bone screw along only a single plane.

10. The spinal correction system of claim 1, wherein the receiver is configured in a multi-axial form, such that the receiver is movable relative to the bone screw anywhere within a generally conical space.

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