Spinal correction system and method

An implant connector comprises a first surface defining a first cavity configured for disposal of a first implant. A second surface defines a second cavity configured for disposal of a coupling member. A third surface defines a third transverse cavity configured for disposal of a second implant. The third surface includes a projection configured to engage the second implant in a provisional locking orientation. Methods of use are disclosed.

TECHNICAL FIELD

The present disclosure generally relates to medical devices for the treatment of musculoskeletal disorders, and more particularly to a surgical system and method for correction of a spine disorder.

BACKGROUND

Spinal pathologies and disorders such as scoliosis and other curvature abnormalities, kyphosis, degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, tumor, and fracture may result from factors including trauma, disease and degenerative conditions caused by injury and aging. Spinal disorders typically result in symptoms including deformity, pain, nerve damage, and partial or complete loss of mobility.

Non-surgical treatments, such as medication, rehabilitation and exercise can be effective, however, may fail to relieve the symptoms associated with these disorders. Surgical treatment of these spinal disorders includes correction, fusion, fixation, discectomy, laminectomy and implantable prosthetics. Correction treatments used for positioning and alignment may employ implants, such as vertebral rods, bone screws and sub-laminar wire, for stabilization of a treated section of a spine. This disclosure describes an improvement over these prior art technologies.

SUMMARY

Accordingly, a spinal correction system is provided. In one embodiment, in accordance with the principles of the present disclosure, a spinal correction system is provided, which comprises an implant connector. The implant connector comprises a first surface defining a first cavity configured for disposal of a first implant. A second surface defines a second cavity configured for disposal of a coupling member. A third surface defines a third transverse cavity configured for disposal of a second implant. The third surface includes a projection configured to engage the second implant in a provisional locking orientation.

In one embodiment, the spinal correction system comprises a plurality of tethers including a first flexible tether. A spinal rod defines a central axis and includes an arcuate outer surface. A plurality of connectors include a first connector comprising a body including an outer surface and a first inner surface defining a first passageway extending through the body. The first passageway defines a first axis and is configured for disposal of the first flexible tether. The body further includes a second threaded inner surface defining a second passageway extending through the body. The second passageway defines a second axis disposed at an angular orientation relative to the first axis and is configured for disposal of a set screw. The set screw defines a central axis and a tapered tip including a concave surface. The body further includes a third surface defining a third passageway having an oblong cross section extending through the body. The third passageway defines a third axis disposed in a transverse orientation relative to the first axis and the second axis. The third passageway is configured for disposal of the spinal rod. The second passageway communicates with the third passageway such that the concave surface is engageable with the arcuate outer surface to translate the spinal rod laterally along the oblong cross section of the third passageway and the first passageway communicates with the third passageway such that the spinal rod is engageable with the first flexible tether for fixation therewith.

In one embodiment, a method for treating a spine disorder is provided. The method comprises the steps of: providing a first flexible implant; disposing the first flexible implant with a first vertebra; providing a first connector comprising: a first surface defining a first cavity, a second surface defining a second cavity configured for disposal of a coupling member, and a third surface defining a third transverse cavity and including a projection; providing a second implant; disposing the second implant with the third cavity such that the projection engages the second implant in a provisional locking orientation; disposing the first flexible implant with the first cavity; engaging the coupling member with the second implant to overcome the provisional locking orientation of the projection such that the second implant engages the first flexible implant for fixation therewith.

Like reference numerals indicate similar parts throughout the figures.

DETAILED DESCRIPTION

The exemplary embodiments of a surgical system and related methods of use are discussed in terms of medical devices for the treatment of musculoskeletal disorders and more particularly, in terms of a spinal correction system. It is envisioned that the spinal correction system may be employed in applications for correction of deformities, such as scoliosis and kyphosis.

In one embodiment, the spinal correction system includes a closed connector. The closed connector includes a setscrew having a tip that forces a spinal rod laterally. The closed connector includes a hole for disposal of a tether. In one embodiment, the hole has a threaded diameter that increases grip strength with a tether. In one embodiment, the closed connector includes a bump that provides provisional locking with a vertebral rod. Upon application of sufficient torque to the setscrew, an axial force is applied to the vertebral rod to overcome a force resistance of the bump, which allows the rod to engage the tether for fixation therewith. This configuration reduces component assembly issues such as misalignment of parts and cumbersome handling. It is contemplated that the bump may be fabricated from metal or a compliant member, such as, for example, silicone, which resists final tightening in the provisional locking configuration.

In one embodiment, the spinal correction system includes an open connector. In one embodiment, the tether can be cylindrical having a diameter. In one embodiment, the tether can have a flat configuration having a thickness and allowing ease of passing the tether under a lamina of vertebrae. It is contemplated that the open connector includes a bump or provisional tightening feature to prevent a rod from contacting the tether until final tightening.

In one embodiment, the spinal correction system is employed with a procedure for placing multiple tethers. The multiple tethers are placed one at a time with each vertebral level. Each tether has a loop on one end. After placing the tether under lamina/transverse process of a vertebral level, the tether is placed through a loop for attachment to the vertebral level, similar to a lasso or stringer attachment configuration. The connector is mounted onto the rod and provisionally locked to maintain the connector from sliding, spinning and/or disengaging from the rod. The tethers are then passed through the connector.

It is contemplated that one or all of the components of the spinal correction system may be disposable, peel-pack, pre-packed sterile devices. One or all of the components of the system may be reusable. The system may be configured as a kit with multiple sized and configured components.

The following discussion includes a description of a spinal correction system in accordance with the principles of the present disclosure. Alternate embodiments are also disclosed. Reference will now be made in detail to the exemplary embodiments of the present disclosure, which are illustrated in the accompanying figures. Turning now toFIGS. 1-6, there is illustrated components of a system, such as, for example, a spinal correction system20in accordance with the principles of the present disclosure.

System20is employed, for example, with an open, mini-open or minimally invasive including percutaneous surgical technique to attach a longitudinal element to a spine that has a spinal disorder. In one embodiment, the longitudinal element may be affixed to a selected section of the spine and/or other anatomy while allowing for growth and adjustments to a concave side of a plurality of vertebrae for a correction treatment to treat various spine pathologies, such as, for example, adolescent idiopathic scoliosis and Scheuermann's kyphosis.

Spinal correction system20includes a first implant, such as, for example, a tether22(FIGS. 7 and 8). Tether22is a flexible longitudinal element that extends between a first end24and a second free end26. First end24includes a loop28defining a cavity30. Cavity30is configured for disposal of a portion of tether22such that tether22can be tensioned about a targeted portion of an anatomy of a body for attachment of tether22with the targeted portion of the anatomy, as will be described. It is contemplated that tether22may manipulated manually and/or with a surgical tensioning instrument. It is further contemplated that the targeted portion of the anatomy may include a lamina, transverse process and/or pedicle regions of a vertebral level. It is envisioned that spinal correction system20may include one or a plurality of tethers22, each tether being configured for disposal about a single and separate vertebral level. It is further envisioned that a single vertebral level may include one or a plurality of tethers22.

Tether22has a flexible configuration and may be fabricated from materials, such as, for example, fabric, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubbers, polyolefin rubbers, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers and elastomeric composites. In one embodiment, the flexibility of tether22includes movement in a lateral or side to side direction and prevents expanding and/or extension in an axial direction upon tensioning of first end24and attachment with a targeted portion of the anatomy. It is envisioned that all or only a portion of tether22may have a semi-rigid, rigid or elastic configuration, and/or have elastic properties such that tether22provides a selective amount of expansion and/or extension in an axial direction. It is further envisioned that tether22may be compressible in an axial direction. Tether22can include a plurality of separately attachable or connectable portions or sections, such as bands or loops, or may be monolithically formed as a single continuous element.

Tether22can have a uniform thickness/diameter. It is envisioned that tether22may have various surface configurations, such as, for example, smooth and/or surface configurations to enhance fixation, such as, for example, rough, arcuate, undulating, porous, semi-porous, dimpled, polished and/or textured according to the requirements of a particular application. It is contemplated that the thickness defined by tether22may be uniformly increasing or decreasing, or have alternate diameter dimensions along its length. It is further contemplated that tether22may have various cross section configurations, such as, for example, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable and/or tapered. It is contemplated that the surface of tether22may include engaging structures, such as, for example, barbs, raised elements and/or spikes to facilitate engagement with tissue of the targeted anatomy.

It is contemplated that tether22may have various lengths, according to the requirements of a particular application. It is further contemplated that tether22may be braided, such as a rope, or include a plurality elongated elements to provide a predetermined force resistance. It is envisioned that tether22may be made from autograft and/or allograft, and be configured for resorbable or degradable applications. In one embodiment, the first implant is a cadaver tendon. In one embodiment, the first implant is a tendon that may be harvested, for example, from a patient or donor. It is contemplated that a tendon harvested from a patient may be affixed in remote locations with the patient's body.

Spinal correction system20includes a second implant, such as, for example, a spinal rod32having a cylindrical cross section configuration. Spinal rod32defines a central axis c1and includes an arcuate outer surface34. Spinal rod32extends between a first end36and a second end38. It is envisioned that spinal correction system20may include one or a plurality of spinal rods32, which may be relatively disposed in a side by side, irregular, uniform, non-uniform, offset and/or staggered orientation or arrangement.

It is contemplated that spinal rod32can have a uniform thickness/diameter. It is envisioned that spinal rod32may have various surface configurations, such as, for example, rough, threaded for connection with surgical instruments, arcuate, undulating, dimpled, polished and/or textured according to the requirements of a particular application. It is contemplated that the thickness defined by spinal rod32may be uniformly increasing or decreasing, or have alternate diameter dimensions along its length. It is further contemplated that spinal rod32may have various cross section configurations, such as, for example, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable and/or tapered. It is contemplated that spinal rod32may have various lengths, according to the requirements of a particular application.

Spinal correction system20includes an implant connector, such as, for example, a connector40. Connector40includes a body42having an angled configuration. Body42includes an outer surface44. It is contemplated that spinal correction system20may include one or a plurality of implant connectors spaced apart and disposed along spinal rod32, as will be described, which may be relatively disposed in a side by side, irregular, uniform, non-uniform, offset and/or staggered orientation or arrangement, along one or a plurality of spinal rods.

It is contemplated that all or only a portion of body42can have a uniform thickness/diameter. It is envisioned that outer surface44may have various surface configurations, such as, for example, rough, threaded for connection with surgical instruments, arcuate, undulating, dimpled, polished and/or textured according to the requirements of a particular application. It is contemplated that the thickness defined by body42may be uniformly increasing or decreasing, or have alternate diameter dimensions along its length. It is further contemplated that all or only a portion of body42may have various cross section configurations, such as, for example, oval, oblong, triangular, rectangular, square, polygonal, irregular, uniform, non-uniform, variable and/or tapered.

Body42includes a first inner surface46that defines a first cavity, such as, for example, a first passageway48. First passageway48is substantially cylindrical and extends through body42from a first face50of outer surface44to a second face52of outer surface44. First inner surface46includes a gripping element, such as, for example, an internal thread form54configured to enhance fixation with tether22, as will be described, according to the requirements of a particular application. It is contemplated that thread form54may include a single thread turn or a plurality of discrete threads. It is further contemplated that other gripping elements may be located on first inner surface46, such as, for example, a nail configuration, barbs, expanding elements, raised elements and/or spikes to facilitate engagement of first inner surface46with tether22. It is envisioned that first inner surface46may include one or a plurality of gripping elements.

First passageway48defines a first axis a1and is configured for disposal of tether22. First passageway48facilitates movement of tether22therealong and fixation with first inner surface46upon tensioning of tether22, according to the requirements of a particular application, for fixation with a targeted portion of the anatomy.

It is envisioned that all or only a portion of first passageway48may have alternate cross section configurations, such as, for example, oval, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. It is contemplated that first passageway48may include one or a plurality of openings that may extend through body42to outer surface44. It is contemplated that all or only a portion of first inner surface46may have alternate surface configurations to enhance fixation with tether22, including or alternative to a gripping element, such as, for example, rough, arcuate, undulating, mesh, porous, semi-porous, dimpled and/or textured according to the requirements of a particular application.

Body42includes a second inner surface56that defines a second cavity, such as, for example, a second passageway58. Second passageway58is substantially cylindrical and extends through body42from a third face60of outer surface44to a third interior cavity, as will be discussed. Second inner surface56includes an internal thread form62configured for engagement with a coupling member, as will be discussed. It is contemplated that thread form62may include a single thread turn or a plurality of discrete threads.

It is envisioned that all or only a portion of second passageway58may have alternate cross section configurations, such as, for example, oval, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. It is contemplated that second passageway58may include one or a plurality of openings that may extend through body42to outer surface44.

Second passageway58defines a second axis, such as, for example, axis a2disposed at an angular orientation, such as, for example, an angle α relative to axis a1. It is envisioned that all or only a portion of axis a2corresponding to second passageway58may be disposed at alternate orientations, relative to axis a1corresponding to second passageway48, such as, for example, transverse, perpendicular and/or other angular orientations such as acute or obtuse and/or may be offset or staggered.

Second passageway58is configured for disposal of a coupling member, such as, for example, a set screw64. Set screw64defines a central axis c2, which is disposed in a co-axial alignment with axis a2upon disposal of set screw64with second passageway58. Set screw64has a tubular body that includes an outer surface66and an inner surface68.

Outer surface66includes a thread form70formed circumferentially about a distal end72. Thread form70threadably engages thread form62such that application of torque to set screw64causes set screw64to translate axially along axis a2. Inner surface68is configured to have a wall shear strength such that set screw64shears at a pre-determined amount of torque. It is envisioned that set screw64may be disposed with inner surface68in alternate fixation configurations, such as, for example, friction fit, pressure fit, locking protrusion/recess and/or locking keyway. It is further envisioned that set screw64may be a non-breakoff setscrew that is not configured to shear at a pre-determined amount of torque. In one embodiment, set screw64may includes internal and/or external drive features.

Set screw64includes a tapered tip76including a concave outer surface78disposed circumferentially thereabout. Concave surface78is configured for engagement with outer surface34to drive spinal rod32into engagement with tether22, as will be described. In one embodiment, set screw64may include a tapered or conical tip.

Body42includes a third inner surface80that defines a third cavity, such as, for example, a third passageway82. Third passageway82has an oblong configuration and extends through body42from a side face84of outer surface44to a side face86of outer surface44. It is envisioned that all or only a portion of third passageway82may have alternate cross section configurations, such as, for example, oval, cylindrical, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, undulating, arcuate, variable and/or tapered. It is contemplated that third passageway82may include one or a plurality of openings that may extend through body42to outer surface44.

Third passageway82defines a third axis, such as, for example, axis a3disposed in a transverse orientation relative to axis a1and axis a2. It is envisioned that all or only a portion of axis a3may be disposed at alternate orientations, relative to axis a1and/or axis a2, such as, for example, transverse, perpendicular and/or other angular orientations such as acute or obtuse and/or may be offset or staggered. First passageway48intersects with third passageway82such that first passageway48communicates with third passageway82. Second passageway58intersects with third passageway82such that second passageway58communicates with third passageway82.

Third passageway82is configured for disposal of spinal rod32such that connector40can be mounted with spinal rod32, according to the requirements of a particular application. Third inner surface80includes a projection88configured to engage spinal rod32in a provisional locking orientation. Projection88is employed as a provisional and/or working feature to temporarily support spinal rod32with connector40during a corrective procedure. The configuration of projection88temporarily stabilizes and fixes the components of spinal correction system20in an orientation, prevents spinal rod32from contacting tether22until final tightening and/or maintains connector40from sliding, spinning and/or disengaging from spinal rod32, according to the requirements of a particular application. In one embodiment, projection88has a bump or dimple configuration. In one embodiment, projection88is a ridge or edge that extends across a portion of third inner surface80. In one embodiment, inner surface80has a uniform and even surface configuration, for example, not including a projection88within passageway82.

In operation, spinal rod32is disposed in a first configuration (FIGS. 3-5) such that projection88engages spinal rod32with a resistance to maintain a provisional locking orientation between connector40and spinal rod32, as described above. Second passageway58communicates with third passageway82such that concave surface78is engageable with arcuate outer surface34. A driving tool engages and applies a torque to set screw64and causes set screw64to translate axially along axis a2, as shown by arrow A inFIGS. 5 and 6. As set screw64translates, concave surface78engages outer surface34.

As concave surface78engages outer surface34, such engagement overcomes the resistance of projection88to permit axial translation of spinal rod32. This configuration causes spinal rod32to translate laterally, in the direction shown by arrow B inFIGS. 5 and 6, along the oblong cross section of third passageway82. First passageway48communicates with third passageway82such that spinal rod32is engageable with tether22(FIG. 8). As such, spinal rod32is movable from the first configuration to a second configuration, as shown inFIG. 6, such that spinal rod32translates into engagement with tether22for fixation therewith.

In assembly, operation and use, a surgical system including spinal correction system20, similar to that described above, is employed with a surgical procedure, such as, for example, a correction treatment to treat adolescent idiopathic scoliosis and/or Scheuermann's kyphosis of a spine. It is contemplated that one or all of the components of spinal correction system20can be delivered or implanted as a pre-assembled device or can be assembled in situ. The system including spinal correction system20may be completely or partially revised, removed or replaced.

For example, spinal correction system20can be employed with a surgical correction treatment of an applicable condition or injury of an affected section of a spinal column and adjacent areas within a body, such as, for example, at least a first vertebra V1, a second vertebra V2, a third vertebra V3and a fourth vertebra V4of vertebrae V. It is envisioned that spinal correction system20may be employed with one or a plurality of vertebrae.

In use, to treat a selected section of vertebrae V, a medical practitioner obtains access to a surgical site including vertebrae V in any appropriate manner, such as through incision and retraction of tissues. It is envisioned that the spinal correction system can be used in any existing surgical method or technique including open surgery, mini-open surgery, minimally invasive surgery and percutaneous surgical implantation, whereby vertebrae V is accessed through a mini-incision, or sleeve that provides a protected passageway to the area. Once access to the surgical site is obtained, the particular surgical procedure can be performed for treating the spine disorder.

An incision is made in the body of a patient and a cutting instrument (not shown) creates a surgical pathway for implantation of components of spinal correction system20. A preparation instrument (not shown) can be employed to prepare tissue surfaces of vertebrae V, as well as for aspiration and irrigation of a surgical region according to the requirements of a particular surgical application.

Referring toFIGS. 7-9, a first tether22is delivered along the surgical pathway to a surgical site adjacent vertebrae V. First tether22is disposed with vertebra V1. In one embodiment, as shown inFIGS. 7-9, loop28is disposed about a lamina of vertebra V1by passing first end24continuously about the lamina. Second free end26is passed through cavity30and drawn away from vertebra V1. Second free end26is drawn and/or tensioned to tighten first end24with the outer surface of the lamina in a loop knot. This configuration fixes and/or attaches first end24with the lamina. In one embodiment, as shown inFIGS. 10-11, loop28is disposed about a transverse process of vertebra V1by passing first end24continuously about the transverse process. Second free end26is passed through cavity30and drawn away from vertebra V1. Second free end26is drawn and/or tensioned to tighten first end24with the outer surface of the transverse process in a loop knot. This configuration fixes and/or attaches first end24with the transverse process and/or lamina.

A first spinal rod32is disposed with first connector40such that projection88engages first spinal rod32in a provisional locking orientation, as described above. It is contemplated that first connector40and first spinal rod32can be delivered or implanted as pre-assembled components or can be assembled in situ. First connector40and first spinal rod32are delivered along the surgical pathway to the surgical site adjacent vertebrae V.

First tether22is slidably drawn or threaded through first passageway48, as shown inFIG. 8, to dispose first connector40and first spinal rod32at the surgical site and in contact with vertebra V1. First spinal rod32is disposed in a first configuration (FIG. 5), as described above. A driving tool engages and applies a torque to set screw64and causes set screw64to translate axially along axis a2(as shown by arrow A inFIGS. 5 and 6). As set screw64translates, concave surface78engages outer surface34.

As concave surface78engages outer surface34, such engagement overcomes the resistance of projection88to permit axial translation of first spinal rod32. This configuration causes first spinal rod32to translate laterally (as shown by arrow B inFIGS. 5 and 6) along the oblong cross section of third passageway82. First spinal rod32is movable from the first configuration to a second configuration (FIG. 6) such that first spinal rod32translates into engagement with first tether22for fixation therewith.

Spinal correction system20includes a second connector40, similar to first connector40, spaced apart from the first connector40along spinal rod32, as shown inFIG. 9. Second connector40is configured for disposal of a second flexible tether22, separate from the first flexible tether22, which is tensioned with vertebra V2. Spinal correction system20includes a third connector40and a fourth connector40, similar to first connector40, which are configured for disposal of tethers22tensioned with vertebrae V3, V4, respectively. First spinal rod32is disposed with vertebrae V along a first side of the spinous process. Spinal correction system20includes a second spinal rod32mounted with a plurality of connectors40and tethers22along a second side of the spinous process. The spinal rods32are mounted with vertebrae V in a side by side orientation according to the requirements of a particular application. As such, spinal correction system20stabilizes vertebrae V and affects growth for a correction treatment to treat various spine pathologies.

Upon completion of the procedure, the surgical instruments and assemblies are removed and the incision is closed. The system including spinal correction system20can be made of radiolucent materials such as polymers. Radiomarkers may be included for identification under x-ray, fluoroscopy, CT or other imaging techniques. It is envisioned that the use of microsurgical and image guided technologies may be employed to access, view and repair spinal deterioration or damage, with the aid of the system including spinal correction system20.

It is contemplated that the components of the system including spinal correction system20may be employed to treat progressive idiopathic scoliosis with or without sagittal deformity in either infantile or juvenile patients, including but not limited to prepubescent children, adolescents from 10-12 years old with continued growth potential, and/or older children whose growth spurt is late or who otherwise retain growth potential. It is further contemplated that the components of spinal correction system20and related methods may be used to prevent or minimize curve progression in individuals of various ages.

In one embodiment, as shown inFIGS. 12-16, spinal correction system20, similar to the apparatus and methods described above with regard toFIGS. 1-11, includes an implant connector, such as, for example, a connector140. Connector140includes a body142having a C-shaped configuration. Body142includes an outer surface144.

Body142includes a first inner surface146that defines a first cavity, such as, for example, a first passageway148. First passageway148has an oblong cross section configuration and extends through body142. First passageway148defines a first axis a11and is configured for disposal of tether22, as described above. First passageway148facilitates movement of tether22therealong and fixation with first inner surface146upon tensioning of tether22, according to the requirements of a particular application, for fixation with a targeted portion of the anatomy.

Body142includes a second inner surface156that defines a second cavity, such as, for example, a second passageway158. Second passageway158is substantially cylindrical and extends through body142to a third interior cavity, as will be discussed. Second inner surface156includes an internal thread form162configured for engagement with a coupling member, as will be discussed.

Second passageway158defines a second axis, such as, for example, axis a12disposed at an angular orientation, such as, for example, an angle α1relative to axis a11. Second passageway158is configured for disposal of a coupling member, such as, for example, a set screw164. Set screw164defines a central axis c2, which is disposed in a co-axial alignment with axis a12upon disposal of set screw164with second passageway158. Set screw164has a tubular body that includes an outer surface166and an inner surface168.

Outer surface166includes a thread form170formed circumferentially about a distal end172. Thread form170threadably engages thread form162such that application of torque to set screw164causes set screw164to translate axially along axis a12. Inner surface168receives a driving tool that applies a rotary driving force to set screw164for engagement with inner surface168.

Set screw164includes a tapered tip176including a concave outer surface178disposed circumferentially thereabout. Concave surface178is configured for engagement with outer surface34to drive spinal rod32, described above, into engagement with tether22.

Body142includes a third inner surface180that defines a third cavity, such as, for example, a third passageway182. Third passageway182has a C-shaped configuration and extends through body142. Third passageway182includes an open end configured for disposing and/or loading spinal rod32with body142. Third passageway182defines a third axis, such as, for example, axis a13disposed in a transverse orientation relative to axis a11and axis a12. First passageway148intersects with third passageway182such that first passageway148communicates with third passageway182. Second passageway158intersects with third passageway182such that second passageway158communicates with third passageway182.

Third passageway182is configured for disposal of spinal rod32such that connector140can be mounted with spinal rod32, according to the requirements of a particular application. Third inner surface180includes a projection188configured to engage spinal rod32in a provisional locking orientation, similar to that described above.

In operation, spinal rod32is disposed in the first configuration (described above with regard toFIGS. 3-5for example) such that projection188engages spinal rod32with a resistance to maintain a provisional locking orientation between connector140and spinal rod32. A driving tool applies torque to set screw164such that set screw164translates axially along axis a12and concave surface178engages outer surface34. Such engagement overcomes the resistance of projection188and spinal rod32translates laterally within third passageway182such that spinal rod32moves from the first configuration to the second configuration (described above with regard toFIG. 6for example) such that spinal rod32translates into engagement with tether22for fixation therewith. In one embodiment, connector140includes open end184, which is configured to facilitate passage of an existing rod, disposed within a body of a patient, into third passageway182for disposing and/or loading the existing rod with body142. In one embodiment, the open end of connector140is configured to allow connection for placement and/or mounting of the components of spinal correction system20, such as, for example, tether(s) and/or connector(s) with a previously implanted and/or existing vertebral construct such as, for example, a spinal rod with a body of a patient.