Apparatus for connecting a longitudinal member to a bone portion

An apparatus for connecting a longitudinal member to a bone portion comprising:

• a fastener having a threaded shank for engaging a bone portion and an enlarged head;
• a housing having a first passage and a second passage having a longitudinal axis extending transverse to the first passage, said first passage configured to receive a longitudinal member, said second passage configured to receive said fastener, said fastener extending through an opening in said housing into said second passage and being movable relative to said housing, said longitudinal axis of said fastener being positionable in any one of a plurality of angular positions relative to the longitudinal axis of said second passage;
• a spacer configured to be received in said second passage, said spacer having a top surface configured to engage said longitudinal member at an angle that is not orthogonal to a longitudinal axis of said longitudinal member;
• and
• a clamping member configured to be received in threaded engagement within said housing, wherein a first end of said clamping member includes a surface angled less than 90 degrees relative to an axis along which the clamping member is advanced.

An apparatus for connecting a longitudinal member to a bone portion comprising:

• a fastener having first and second ends and a longitudinal axis, said first end engageable with a bone portion;
• a longitudinal member;
• a housing having a first passage configured to receive said longitudinal member, and a second passage configured to receive said fastener, said fastener extending through an opening in said housing into said second passage and being movable relative to said housing, said longitudinal axis of said fastener being positionable in any one of a plurality of angular positions relative to a longitudinal axis of said second passage;
• a clamping member configured to be received in threaded engagement within said housing, said clamping member having a first end configured such that, when said longitudinal member is positioned in said first passage, said first end of said clamping member engages said longitudinal member at an angle not orthogonal to an axis along which the clamping member is advanced.

An apparatus for connecting a longitudinal member to a bone portion comprising:

• a fastener having a threaded shank for engaging a bone portion and an enlarged head;
• a housing having a first passage and a second passage having a longitudinal axis extending transverse to the first passage, said first passage configured to receive a longitudinal member, said second passage configured to receive said fastener, said fastener extending through an opening in said housing into said second passage and being movable relative to said housing, said longitudinal axis of said fastener being positionable in any one of a plurality of angular positions relative to the longitudinal axis of said second passage;
• a spacer configured to be received in said second passage, said spacer having a top surface angled to engage said longitudinal member at an angle that is not orthogonal to a longitudinal axis of said longitudinal member;
• a retaining member having an inner dimension sized to fit over at least a portion of said spacer and an outer dimension sized to engage an inner surface of said housing;
• and
• a clamping member configured to be received in threaded engagement within said housing, wherein a first end of said clamping member includes a surface angled less than 90 degrees relative to an axis along which the clamping member is advanced.

A method of securing vertebrae at a surgical site in a patient, said method comprising:

• inserting an access device into the patient to a surgical site adjacent the spine, the access device having a distal end larger than a proximal end, and an access path therebetween;
• inserting a first fixation device through the access device;
• securing the first fixation device to a first vertebra, the first fixation device including a first fastener and a first housing, the first housing having a first passage configured to receive a longitudinal member and a second passage configured to receive the first fastener, the first fastener extending through an opening in the first housing and being universally pivotable relative to said first housing, wherein said securing step includes positioning said first housing such that a longitudinal axis of the first fastener is in any one of a plurality of angular positions relative to a longitudinal axis of said second passage of said first housing;
• inserting a longitudinal member through the access device and into said first housing;
• and
• inserting a first clamping member into said first housing, said first clamping member having a first end configured to engage said longitudinal member at a first angle, wherein said first angle is not orthogonal to an axis along which the first clamping member is advanced;
• wherein said first housing is positioned such that an access trajectory along which said first clamping member is inserted passes through said access device.