Bone anchoring device

A method of attaching a polyaxial bone anchoring device to a bone or vertebra, the polyaxial bone anchoring device comprising a shank to be anchored in a bone or vertebra, a head, a ring, and a receiving part for connecting the shank to a rod, the shank, the head, and the ring being separate parts, the head having a bore with a cylindrical inner surface defining a smallest diameter of the bore, wherein a ring-shaped groove is provided on the inner surface, the shank having a first portion for anchoring in the bone or vertebra and a second portion with a cylindrical outer surface that is sized for insertion into the portion of the bore defined by the cylindrical inner surface of the head, wherein a ring-shaped groove is provided on the cylindrical outer surface, and wherein a cross-section taken at a free end of the shank at the second portion forms an endless ring, wherein the receiving part has a longitudinal bore extending from a first end to a second end of the receiving part, the longitudinal bore having a reduced diameter adjacent to the first end of the receiving part forming a seat for accommodating the head, the receiving part further having a U-shaped recess adjacent to the second end of the receiving part, the U-shaped recess intersecting the longitudinal bore and forming two free legs and a channel for receiving the rod, wherein the shank is insertable into the head when the head is in the receiving part, and wherein a pressure element is configured to be arranged in the longitudinal bore and to fix an angular orientation of the shank relative to the receiving part, the method comprising:

• attaching the shank to the bone or vertebra;
• inserting the head in the bore of the receiving part to seat the head at the first end of the receiving part;
• connecting the head to the shank by inserting the second portion of the shank in the bore of the head, wherein after insertion of the shank into the head to an insertion position, the ring is positioned in the grooves of the head and the shank, respectively, such that when a force is applied to the shank in a direction opposite a direction of the insertion while the free end of the shank is exposed to an outside of the head, engaging surfaces between the ring and the head prevent the ring from radially compressing while engaging surfaces between the ring and the shank prevent the ring from radially expanding, to prevent removal of the shank from the bore of the head;
• and
• inserting the pressure element in the receiving part and urging the head towards the seat of the receiving part to fix the angular orientation of the shank relative to the receiving part.

A bone anchoring device comprising:

• a shank to be anchored in a bone or vertebra, a head, a ring, and a receiving part for connecting the shank to a rod;
• the shank, the head, and the ring being separate parts;
• the head having a bore with a cylindrical inner surface defining a smallest diameter of the bore, wherein a ring-shaped groove is provided on the inner surface;
• the shank having a first portion for anchoring in the bone or vertebra and a second portion with a cylindrical outer surface that is sized for insertion into the portion of the bore defined by the cylindrical inner surface of the head, wherein a ring-shaped groove is provided on the cylindrical outer surface, wherein a radially inwardly facing surface defines a recess for a tool that is formed in a free end of the shank at the second portion, and wherein the recess extends into at least part of the second portion having the cylindrical outer surface;
• and
• the receiving part having a longitudinal bore extending from a first end to a second end of the receiving part, and a U-shaped recess adjacent to the second end that intersects the longitudinal bore and that forms two free legs and a channel for receiving the rod;
• wherein when the head is in the receiving part and the ring is in the groove of the head, the shank is insertable into the head, such that at a first insertion position, the free end of the shank is configured to engage the ring to expand the ring while the entire recess for the tool at the free end of the shank is unobstructed, and such that at a second insertion position, the ring is positioned in the grooves of the head and the shank, respectively, and is configured such that when a force is applied to the shank in a direction opposite a direction of the insertion while the entire recess for the tool at the free end of the shank remains unobstructed, engaging surfaces between the ring and the head prevent the ring from radially compressing while engaging surfaces between the ring and the shank prevent the ring from radially expanding, to prevent removal of the shank from the bore of the head.