Patent Description:
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. As part of these surgical treatments, spinal constructs such as vertebral rods are often used to provide stability to a treated region. Rods redirect stresses away from a damaged or defective region while healing takes place to restore proper alignment and generally support the vertebral members. During surgical treatment, one or more rods and bone fasteners can be delivered to a surgical site. The rods may be attached via the fasteners to the exterior of two or more vertebral members. Surgical instruments are employed, for example, to engage the fasteners for attachment to the exterior of two or more vertebral members. This disclosure describes an improvement over these prior technologies.

From e.g. <CIT> a spinal implant is known, comprising: a distal portion configured for penetrating tissue and a proximal portion including a socket defining recesses each including a drive surface.

Further spinal implants having an interface for engagement of a spinal instrument are known from, e.g. <CIT> and <CIT>.

The present invention provides a spinal implant with the features according to claim <NUM> and a surgical system with the features according to claim <NUM>. Further preferred embodiments of the spinal implant are described in the dependent claims.

Associated methods are also described herein to aid understanding of the invention, but these do not form part of the claimed invention.

The exemplary embodiments of a spinal implant and a surgical system are discussed in terms of medical devices for the treatment of musculoskeletal disorders and more particularly, in terms of a surgical system for delivering and/or fastening implants with a surgical site and a method for treating a spine. The surgical methods described in the following as well as the embodiment of <FIG> do not form part of the invention but are helpful in understanding the invention. In some embodiments, the surgical system includes a surgical instrument, such as, for example, an implant driver and a spinal implant, such as, for example, a bone screw.

In some embodiments, the surgical system includes a surgical instrument including a drive surface and a retention surface. The surgical system includes a spinal implant including a drive surface and a retention surface. The retention surfaces of the spinal implant is tapered, and the retention surfaces are engageable to define a retention interface. In some embodiments, the retention surface of the surgical instrument is cylindrical, and the retention surfaces are engageable to define a retention interface. In some embodiments, rotational engagement is facilitated due to the retention surfaces holding the surgical instrument axially independently of the drive geometry.

The spinal implant includes a distal portion configured for penetrating tissue. The spinal implant includes proximal portion having a drive surface, a guide surface and a retention surface. The surfaces are disposed in a serial configuration. The retention surface is engageable with a surface of a surgical instrument to define a retention interface.

In some examples, the surgical system may be employed to treat spinal disorders such as, for example, degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumor and fractures. In some examples, the surgical system may be employed with other osteal and bone related applications, including those associated with diagnostics and therapeutics. In some examples, the surgical system may be alternatively employed in a surgical treatment with a patient in a prone or supine position, and/or employ various surgical approaches to the spine, including anterior, posterior, posterior mid-line, lateral, postero-lateral, and/or antero-lateral approaches, and in other body regions. The surgical system may also be alternatively employed with procedures for treating the lumbar, cervical, thoracic, sacral and pelvic regions of a spinal column. The surgical system of the present disclosure may also be used on animals, bone models and other non-living substrates, such as, for example, in training, testing and demonstration.

The present disclosure may be understood more readily by reference to the following detailed description of the embodiments taken in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this application is not limited to the specific devices, methods, conditions or parameters described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting. In some embodiments, as used in the specification and including the appended claims, the singular forms "a," "an," and "the" include the plural, and reference to a particular numerical value includes at least that particular value, unless the context clearly dictates otherwise. Ranges may be expressed herein as from "about" or "approximately" one particular value and/or to "about" or "approximately" another particular value. Similarly, when values are expressed as approximations, by use of the antecedent "about," it will be understood that the particular value forms another embodiment. It is also understood that all spatial references, such as, for example, horizontal, vertical, top, upper, lower, bottom, left and right, are for illustrative purposes only and can be varied within the scope of the disclosure. For example, the references "upper" and "lower" are relative and used only in the context to the other, and are not necessarily "superior" and "inferior".

As used in the specification and including the appended claims, "treating" or "treatment" of a disease or condition refers to performing a procedure that may include administering one or more drugs to a patient (human, normal or otherwise or other mammal), employing implantable devices, and/or employing instruments that treat the disease, such as, for example, microdiscectomy instruments used to remove portions bulging or herniated discs and/or bone spurs, in an effort to alleviate signs or symptoms of the disease or condition. Alleviation can occur prior to signs or symptoms of the disease or condition appearing, as well as after their appearance. Thus, treating or treatment includes preventing or prevention of disease or undesirable condition (e.g., preventing the disease from occurring in a patient, who may be predisposed to the disease but has not yet been diagnosed as having it). In addition, treating or treatment does not require complete alleviation of signs or symptoms, does not require a cure, and specifically includes procedures that have only a marginal effect on the patient. Treatment can include inhibiting the disease, e.g., arresting its development, or relieving the disease, e.g., causing regression of the disease. For example, treatment can include reducing acute or chronic inflammation; alleviating pain and mitigating and inducing re-growth of new ligament, bone and other tissues; as an adjunct in surgery; and/or any repair procedure. Also, as used in the specification and including the appended claims, the term "tissue" includes soft tissue, ligaments, tendons, cartilage and/or bone unless specifically referred to otherwise.

The following discussion includes a description of a surgical system including a surgical instrument, spinal implants, related components in accordance with the principles of the present disclosure. Alternate embodiments are also disclosed. Reference is made in detail to the exemplary embodiments of the present disclosure, which are illustrated in the accompanying figures. Turning to <FIG>, there are illustrated components of a surgical system <NUM>.

The components of surgical system <NUM> can be fabricated from biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and bone material and/or their composites. For example, the components of surgical system <NUM>, individually or collectively, can be fabricated from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, Grade <NUM> titanium, super-elastic titanium alloys, cobalt-chrome alloys, stainless steel alloys, superelastic metallic alloys (e.g., Nitinol, super elasto-plastic metals, such as GUM METAL®), ceramics and composites thereof such as calcium phosphate (e.g., SKELITE™), thermoplastics such as polyaryletherketone (PAEK) including polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO<NUM> polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers, elastomeric composites, rigid polymers including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy, bone material including autograft, allograft, xenograft or transgenic cortical and/or corticocancellous bone, and tissue growth or differentiation factors, partially resorbable materials, such as, for example, composites of metals and calcium-based ceramics, composites of PEEK and calcium based ceramics, composites of PEEK with resorbable polymers, totally resorbable materials, such as, for example, calcium based ceramics such as calcium phosphate, tri-calcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate, or other resorbable polymers such as polyaetide, polyglycolide, polytyrosine carbonate, polycaroplaetohe and their combinations.

Surgical system <NUM> includes a surgical instrument, such as, for example, a driver <NUM> engageable with a spinal implant, such as, for example, a bone screw <NUM>, as shown in <FIG>. In some embodiments, driver <NUM> may be utilized with other devices, such as, for example, set screws and/or interbody cages.

Driver <NUM> includes a member, such as, for example, an elongated shaft <NUM>. Shaft <NUM> extends between an end, such as, for example, a proximal end <NUM> and an end, such as, for example, a distal end <NUM>. Shaft <NUM> has a cylindrical cross sectional configuration between ends <NUM>, <NUM> and includes a diameter D1. In some embodiments, a portion of shaft <NUM> may have alternate cross section configurations, such as, for example, oval, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and/or tapered. Shaft <NUM> defines a longitudinal axis X1.

In some embodiments, end <NUM> is configured for engagement and connection with a handle <NUM>, which is configured to facilitate manipulation of driver <NUM>. In some embodiments, the handle may be disposed at alternate orientations relative to shaft <NUM>, such as, for example, transverse, perpendicular and/or other angular orientations such as acute or obtuse. In some embodiments, end <NUM> is configured for engagement and connection with an adaptor, extension and/or other connection to facilitate manipulation of driver <NUM>.

In some embodiments, end <NUM> includes a tool engagement surface (not shown) configured to engage an actuator, such as, for example, a surgical instrument and/or hand drill to rotate end <NUM> in a first direction and/or an opposing second direction, such as, for example, clockwise and counter-clockwise directions. In some embodiments, end <NUM> may include an interchangeable driving handle removably connected to end <NUM> such that torque applied manually or by a motorized actuator to the handle is transmitted to shaft <NUM>.

In some embodiments, end <NUM> is configured to engage an actuator, such as, for example, a motorized actuator, such as, for example, a powered drill (not shown). In some embodiments, the motorized actuator includes a mating connector, such as, for example, a chuck. In some embodiments, the chuck includes a socket that is configured to mate with end <NUM>. In some embodiments, the motorized actuator includes an electric motor, such as, for example, an electric drill motor that is connected to a power source, such as, for example, a battery and/or AC source, for rotating end <NUM>. In one embodiment, the motorized actuator may be pneumatic or hydraulic.

End <NUM> includes an engagement portion <NUM>. Portion <NUM> is configured for engagement with bone screw <NUM>, as described herein. Portion <NUM> includes a drive portion <NUM> and a retention portion <NUM>. Portions <NUM>, <NUM> are disposed in a serial configuration along axis X1, as shown in <FIG>.

Portion <NUM> includes a plurality of spaced apart lobes <NUM> disposed circumferentially about portion <NUM>, as shown in <FIG>. Lobes <NUM> includes a hexalobe configuration. In some embodiments, Portion <NUM> may have alternate configurations, such as, for example, thread form, triangular, square, polygonal, star, torx, irregular, uniform, non-uniform, offset, staggered, and/or tapered.

Each lobe <NUM> includes a drive surface <NUM> and a trailing surface <NUM> that is spaced apart from drive surface <NUM>. In some embodiments, all or a portion of lobe <NUM> may include various configurations and/or be disposed in various orientations, such as, for example, angular, arcuate, undulating, series, parallel, offset and/or staggered. Drive surface <NUM> is configured to contact a portion of a socket <NUM> of bone screw <NUM>, as described herein, at a drive interface <NUM> to drive, torque, insert or otherwise rotate bone screw <NUM>.

Portion <NUM> includes a distal face <NUM>. Distal face <NUM> includes a flat or even surface. In some embodiments, distal face <NUM> may have various surface configurations, such as, for example, rough, threaded, arcuate, undulating, porous, semi-porous, dimpled, polished and/or textured.

Portion <NUM> includes an extension <NUM> extending from distal face <NUM>. In some embodiments, extension <NUM> is monolithically formed with distal face <NUM>. In some embodiments, extension <NUM> is integrally connected with distal face <NUM>. In some embodiments, extension <NUM> is attachable with distal face <NUM> with fastening elements and/or instruments.

Extension <NUM> includes a cylindrical cross-sectional configuration, as shown in <FIG>. some embodiments, all or only a portion of extension <NUM> may have alternate cross section configurations, such as, for example, oval, oblong, triangular, square, polygonal, irregular, uniform, non-uniform, offset, staggered, and/or tapered.

Extension <NUM> includes a diameter D2. Diameter D2 is less than diameter D1. Extension <NUM> includes a surface <NUM> that facilitates engaging and retaining of driver <NUM> with bone screw <NUM>. Surface <NUM> is configured to contact a portion of bone screw <NUM> at a retention interface <NUM>, as described herein. Retention interface <NUM> provides for a connection between extension <NUM> and bone screw <NUM> that is independent of the geometry of driver <NUM> and socket <NUM>. For example, as bone screw <NUM> is driven into the bone, slight distortions occur under a normal driving force, retention interface <NUM> resists and/or prevents driver <NUM> from disengaging from bone screw <NUM> unexpectedly. In some embodiments, retention interface <NUM> is configured to cause wear on a surface of bone screw <NUM> rather than driver <NUM> providing for a more durable connection. Retention interface <NUM> is configured to resist and/or prevent stripping of socket <NUM> by distributing the torque load across drive interface <NUM> and retention interface <NUM>. In some embodiments, retention interface <NUM> provides a configuration that resists and/or prevents toggle between driver <NUM> and bone screw <NUM>.

Bone screw <NUM> extends along an axis X2, as shown in <FIG>. Bone screw <NUM> shown in <FIG> includes a distal portion <NUM> and a proximal portion <NUM>. Distal portion <NUM> includes a shaft <NUM> configured to penetrate tissue, such as, for example, bone. Shaft <NUM> includes a thread form on an outer surface thereof. In some embodiments, the thread form may extend such that shaft <NUM> is threaded along the entire length thereof. In some embodiments, all or only a portion of shaft <NUM> may have various surface configurations, such as, for example, rough, threaded, arcuate, undulating, porous, semi-porous, dimpled, polished and/or textured.

Proximal portion <NUM> includes a socket <NUM>. Socket <NUM> defines recesses <NUM> configured for disposal of lobes <NUM>. In some embodiments, recesses <NUM> includes a hexalobe configuration. In some embodiments, recesses <NUM> may have alternate configurations, such as, for example, thread form, triangular, square, polygonal, star, torx, irregular, uniform, non-uniform, offset, staggered, and/or tapered.

Each recess <NUM> includes a drive surface <NUM> configured for engagement with drive surface <NUM> at drive interface <NUM>, as shown in <FIG>, causing drive surface <NUM> to drive, torque, insert or otherwise rotate bone screw <NUM> by applying a force to drive surface <NUM>.

Surface <NUM> defines a cavity <NUM> configured for disposal of extension <NUM>. Cavity <NUM> includes a tapered configuration, as shown in <FIG>. Cavity <NUM> tapers from proximal portion <NUM> towards distal portion <NUM>. Surface <NUM> of extension <NUM> is configured to contact surface <NUM> at retention interface <NUM>, as described herein and shown in <FIG>. Retention interface <NUM> provides for a connection between driver <NUM> and bone screw <NUM> that is independent of the geometry of driver <NUM> and socket <NUM>. Retention interface <NUM> is configured to facilitate engagement of driver <NUM> with bone screw <NUM> during a final tightening check before closing the surgical site. In some embodiments, portion <NUM> is not wedged rotationally into socket <NUM>, as shown in <FIG>. In some embodiments, this facilitates disengagement of driver <NUM> from bone screw <NUM> by requiring only a slight wiggle of driver <NUM> and rotating counter-clockwise to clockwise and back to disengage driver <NUM> from bone screw <NUM> without requiring any additional force.

A surface <NUM> is disposed between socket <NUM> and cavity <NUM>, as shown in <FIG>. Surface <NUM> defines a cavity <NUM>. Surface <NUM> includes an undercut, such as, for example, a ramp <NUM>. Ramp <NUM> defines a cone shaped cross section of cavity <NUM>, as shown in <FIG>. Ramp <NUM> is oriented to decline from proximal portion <NUM> towards distal portion <NUM>. Ramp <NUM> facilitates aligning and/or guiding extension <NUM> into cavity <NUM>. In some embodiments, surface <NUM> is configured to facilitate retaining driver <NUM> with bone screw <NUM>. Surface <NUM> defines a gap <NUM> having an angled surface configured to direct extension <NUM> into cavity <NUM>. Gap <NUM> facilitates manipulation and angling of extension <NUM> into cavity <NUM>.

For example, extension <NUM> is guided into cavity <NUM>. Extension <NUM> having the cylindrical shape, as described herein, is translated into cavity <NUM> causing surface <NUM> to contact surface <NUM> of tapered cavity <NUM>. An interference fit and/or friction fit is formed between surface <NUM> and surface <NUM> at retention interface <NUM> retaining driver <NUM> with bone screw <NUM>.

In assembly, operation and use, surgical system <NUM>, similar to surgical systems is employed with a surgical procedure for treatment of a spinal disorder affecting a section of a spine of a patient, as discussed herein. For example, surgical system <NUM> can be used with a surgical procedure for treatment of a condition or injury of an affected section of the spine including vertebrae (not shown). In some embodiments, one or all of the components of surgical system <NUM> can be delivered or implanted as a pre-assembled device or can be assembled in situ. Surgical system <NUM> may be completely or partially revised, removed or replaced.

For example, surgical system <NUM> can be employed with a surgical 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, vertebrae. In some examples, surgical system <NUM> may be employed with one or a plurality of vertebra To treat a selected section of the vertebrae, a medical practitioner obtains access to a surgical site including the vertebrae in any appropriate manner, such as through incision and retraction of tissues. In some embodiments, surgical system <NUM> can be used in any existing surgical method or technique including open surgery, mini-open surgery, minimally invasive surgery and percutaneous surgical implantation, whereby the vertebrae are 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 surgical system <NUM>. A preparation instrument (not shown) can be employed to prepare tissue surfaces of the vertebrae, as well as for aspiration and irrigation of a surgical region.

Pilot holes or the like are made in selected vertebra of the vertebrae for receiving bone screws <NUM>. Surgical system <NUM> is disposed adjacent the vertebrae at a surgical site and the components of surgical system <NUM> including driver <NUM>, are manipulable to drive, torque, insert or otherwise connect bone screws <NUM> to the vertebrae.

As shown in <FIG>, driver <NUM> is manipulated relative to bone screw <NUM> such that extension <NUM> is disposed with cavity <NUM>. Extension <NUM> contacts surface <NUM> of ramp <NUM>. Ramp <NUM> aligns and distally directs extension <NUM> to axially translate extension <NUM>, in a direction shown by arrow A in <FIG>, into cavity <NUM>. As driver <NUM> translates, extension <NUM> translates into cavity <NUM> and an interference fit and/or friction fit is formed between surface <NUM> and surface <NUM> at retention interface <NUM> retaining driver <NUM> with bone screw <NUM>.

Portion <NUM> is disposed with socket <NUM> such that lobes <NUM> are disposed within recesses <NUM>, as shown in <FIG>. Driver <NUM> is rotated, as shown by arrow B in <FIG>, causing drive surface <NUM> to contact drive surface <NUM> of socket <NUM>, as shown in <FIG>, to provide a driving torque to fasten bone screw <NUM> with vertebrae.

Interfaces <NUM>, <NUM> of driver <NUM> with bone screw <NUM> resist and/or prevent toggle between driver <NUM> and bone screw <NUM>. Disengagement of driver <NUM> is facilitated by requiring only a slight wiggle of driver <NUM> and rotating counter-clockwise to clockwise and back to disengage driver <NUM> from bone screw <NUM> without requiring any additional force.

Once access to the surgical site is obtained, the particular surgical procedure is performed. The components of surgical system <NUM>, including bone screw <NUM> are employed to augment the surgical treatment. For example, bone screw <NUM> may be inserted into bone or other tissue with driver <NUM>, for example, via clockwise or counterclockwise rotation. Bone screw <NUM> may be delivered, introduced, inserted and/or removed from bone or other tissue with driver <NUM>.

Surgical system <NUM> can include one or a plurality of bone fasteners such as those described herein and/or fixation elements, which may be employed with a single vertebral level or a plurality of vertebral levels. In some embodiments, the bone fasteners may be engaged with vertebrae in various orientations, such as, for example, series, parallel, offset, staggered and/or alternate vertebral levels. In some embodiments, the bone fasteners and/or fixation elements may include one or a plurality of multi-axial screws, sagittal angulation screws, pedicle screws, mono-axial screws, uni-planar screws, fixed screws, tissue penetrating screws, conventional screws, expanding screws, wedges, anchors, buttons, clips, snaps, friction fittings, compressive fittings, expanding rivets, staples, nails, adhesives, posts, fixation plates and/or posts.

In some embodiments, surgical system <NUM> may comprise various instruments including the configuration of the present disclosure, such as, for example, inserters, extenders, reducers, spreaders, distractors, blades, retractors, clamps, forceps, elevators and drills, which may be alternately sized and dimensioned, and arranged as a kit.

In some embodiments, surgical system <NUM> includes an agent, which may be disposed, packed or layered within, on or about the components and/or surfaces of surgical system <NUM>. In some embodiments, the agent may include bone growth promoting material, such as, for example, bone graft to enhance fixation with vertebrae V. The components of surgical system <NUM> can be made of radiolucent materials such as polymers. Radiomarkers may be included for identification under x-ray, fluoroscopy, CT or other imaging techniques. In some embodiments, the agent may include one or a plurality of therapeutic agents and/or pharmacological agents for release, including sustained release, to treat, for example, pain, inflammation and degeneration. Upon completion of the procedure, the surgical instruments, assemblies and non-implant components of surgical system <NUM> are removed from the surgical site and the incision is closed.

As shown in <FIG>, surgical system <NUM>, similar to the systems described above with regard to <FIG>, includes a driver <NUM> similar to driver <NUM> described herein. Driver <NUM> includes an elongated shaft <NUM>, similar to shaft <NUM> described herein.

Shaft <NUM> includes an engagement portion <NUM>, similar to portion <NUM> as described herein. Portion <NUM> is configured for engagement with a bone screw <NUM>, similar to bone screw <NUM> described herein. Portion <NUM> includes a drive portion <NUM> and a retention portion <NUM>.

Portion <NUM> includes a plurality of spaced apart lobes <NUM>, similar to lobes <NUM> disposed circumferentially about portion <NUM>. Each lobe <NUM> includes a drive surface <NUM>, similar to drive surface <NUM> as described herein. Drive surface <NUM> is configured to contact a portion of a socket <NUM> of bone screw <NUM>, as described herein, at a drive interface <NUM> to drive, torque, insert or otherwise rotate bone screw <NUM>.

Shaft <NUM> includes an extension <NUM>, similar to extension <NUM> as described herein. Extension <NUM> includes a tapered cross-sectional configuration, as shown in <FIG>. Extension tapers from a proximal portion towards a distal portion. Extension <NUM> includes a surface <NUM> that facilitates engaging and retaining of driver <NUM> with bone screw <NUM>. Surface <NUM> is configured to contact a portion of bone screw <NUM> at a retention interface <NUM>, as described herein.

Bone screw <NUM> includes a distal portion <NUM> and a proximal portion <NUM>. Distal portion <NUM> includes a shaft <NUM> configured to penetrate tissue, such as, for example, bone, as described herein. Shaft <NUM> includes a thread form on an outer surface thereof.

Proximal portion <NUM> includes a socket <NUM>. Socket <NUM> defines recesses <NUM> configured for disposal of lobes <NUM>, as described herein. Each recess <NUM> includes a drive surface <NUM> configured for engagement with drive surface <NUM> at drive interface <NUM>, as described herein, causing drive surface <NUM> to drive, torque, insert or otherwise rotate bone screw <NUM> by applying a force to drive surface <NUM>.

Surface <NUM> defines a cavity <NUM> configured for disposal of extension <NUM>, as described herein. Cavity <NUM> includes a cylindrical configuration, as shown in <FIG>. Surface <NUM> of extension <NUM> is configured to contact surface <NUM> at retention interface <NUM>, as described herein and shown in <FIG>.

A surface <NUM> defines a cavity <NUM>. Surface <NUM> includes an undercut, such as, for example, a ramp <NUM>. Ramp <NUM> defines a cone shaped cross section of cavity <NUM>, as shown in <FIG>. Ramp <NUM> is oriented to decline from proximal portion <NUM> towards distal portion <NUM>. Ramp <NUM> facilitates aligning and/or guiding extension <NUM> into cavity <NUM>, as described herein.

In one embodiment, as shown in <FIG>, surgical system <NUM>, similar to the systems and methods described above with regard to <FIG>, includes a driver <NUM>, similar to driver <NUM> described herein. Driver <NUM> includes an elongated shaft <NUM>, similar to shaft <NUM> described herein.

Portion <NUM> includes a plurality of spaced apart lobes <NUM>, similar to lobes <NUM> disposed circumferentially about portion <NUM>. Each lobe includes a drive surface <NUM>, similar to drive surface <NUM> as described herein. Drive surface <NUM> is configured to contact a portion of a socket <NUM> of bone screw <NUM>, as described herein, at a drive interface <NUM> to drive, torque, insert or otherwise rotate bone screw <NUM>.

Proximal portion <NUM> includes socket <NUM>. Socket <NUM> defines recesses <NUM> configured for disposal of lobes <NUM>, as described herein. Each recess <NUM> includes a drive surface <NUM> configured for engagement with drive surface <NUM> at drive interface <NUM>, as described herein, causing drive surface <NUM> to drive, torque, insert or otherwise rotate bone screw <NUM> by applying a force to drive surface <NUM>.

Surface <NUM> defines a cavity <NUM> configured for disposal of extension <NUM>, as described herein. Cavity <NUM> includes a tapered configuration, as shown in <FIG>. Cavity <NUM> tapers from proximal end <NUM> to distal end <NUM>. Surface <NUM> of extension <NUM> is configured to contact surface <NUM> at retention interface <NUM>, as described herein and shown in <FIG>.

Claim 1:
A spinal implant (<NUM>; <NUM>), comprising:
a distal portion (<NUM>; <NUM>) configured for penetrating tissue; and
a proximal portion (<NUM>; <NUM>), including
a socket (<NUM>) defining recesses (<NUM>) each including a drive surface (<NUM>; <NUM>),
a guide surface (<NUM>; <NUM>) and
a retention surface (<NUM>; <NUM>),
the surfaces being disposed from the proximal portion (<NUM>; <NUM>) to the distal portion (<NUM>; <NUM>) in a serial configuration of drive surface (<NUM>; <NUM>), guide surface (<NUM>; <NUM>) and retention surface (<NUM>; <NUM>), wherein
the drive surface (<NUM>; <NUM>) is configured to engage with a drive surface (<NUM>; <NUM>) of a surgical instrument (<NUM>; <NUM>) thereby defining a drive interface (<NUM>; <NUM>; <NUM>),
the guide surface (<NUM>; <NUM>) defines a cavity (<NUM>; <NUM>) disposed between the drive surface (<NUM>; <NUM>) and the retention surface (<NUM>; <NUM>), the cavity (<NUM>; <NUM>) including a cone shaped cross section configured to align and direct the surgical instrument (<NUM>; <NUM>) into engagement with the retention surface (<NUM>; <NUM>), and
the retention surface (<NUM>; <NUM>) is engageable with a surface (<NUM>; <NUM>) of an extension (<NUM>) of the surgical instrument (<NUM>; <NUM>) to define a retention interface (<NUM>; <NUM>) by defining a cavity (<NUM>; <NUM>) tapering from proximal portion (<NUM>; <NUM>) towards distal portion (<NUM>; <NUM>) and configured for disposal of the extension (<NUM>) of the surgical instrument (<NUM>; <NUM>).