US20140148858A1 - Transverse connector - Google Patents

Abstract

A transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system. The transverse connector includes a first coupling assembly proximate a first end, a second coupling assembly proximate a second end, a first fastener having external threading configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor, and a second fastener having external threading configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper surface, such as a spherically concave upper surface. A spherical surface of each of the first and second coupling assemblies mates with the spherical upper surface of the respective fastener to provide multi-axial rotation of the transverse connector relative to the housings to permit a desired orientation of the transverse connector.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• This application is a continuation of U.S. patent application Ser. No. 13/041,031, filed on Mar. 4, 2011, the entire disclosure of which is incorporated herein by reference.
TECHNICAL FIELD
• The disclosure is directed to transverse connectors for use in a spinal stabilization system. More particularly, the disclosure is directed to transverse connectors which may be attached between vertebral anchors in a spinal stabilization system.
BACKGROUND
• The spinal column is a highly complex system of bones and connective tissues that provides support for the body and protects the delicate spinal cord and nerves. The spinal column includes a series of vertebrae stacked one on top of the other. Each vertebra includes a vertebral body including an inner or central portion of relatively weak cancellous bone and an outer portion of relatively strong cortical bone. An intervertebral disc is situated between each vertebral body to cushion and dampen compressive forces experienced by the spinal column. A vertebral canal, called the foramen, containing the spinal cord and nerves is located posterior to the vertebral bodies. In spite of the complexities, the spine is a highly flexible structure, capable of a high degree of curvature and twist in nearly every direction. For example, the kinematics of the spine normally includes flexion, extension, rotation and lateral bending.
• There are many types of spinal column disorders including scoliosis (abnormal curvature and twisting of the spine), kyphosis (abnormal forward curvature of the spine, usually in the thoracic spine), excess lordosis (abnormal backward curvature of the spine, usually in the lumbar spine), spondylolisthesis (forward displacement of one vertebra over another, usually in a lumbar or cervical spine) and other disorders caused by abnormalities, disease, or trauma, such as ruptured or slipped discs, degenerative disc disease, fractured vertebra, and the like. Patients that suffer from such conditions usually experience extreme and debilitating pain as well as diminished range of motion and nerve function. These spinal disorders may also threaten the critical elements of the nervous system housed within the spinal column.
• In some instances, a spinal stabilization system may be installed on a segment of the spinal column to stabilize a portion of the spinal column to treat a spinal disorder. One particular spinal stabilization technique includes immobilizing portions of the spine of a patient by using elongate members such as relatively rigid orthopedic spinal rods that run generally parallel to the spine on opposite sides of the spinous processes. Another technique utilizes less rigid elongate members to provide a more dynamic stabilization of the affected regions of the spine. One example of such a spinal stabilization system is the Dynesys® system available from, Zimmer Spine, Inc., of Minneapolis, Minn.
• Installation of such systems may be accomplished, for example, by accessing the spine posterially and fastening hooks, bone screws, or other types of vertebral anchors to the pedicles or other bony structures of the appropriate vertebrae. The vertebral anchors may be generally placed in a quantity of two per vertebra, one on either side of the spinous processes, and serve as anchor points for the elongate members.
• It may be desirable in some circumstances to provide a cross connector, such as a transverse connector, to bridge across the spinal column from a first assembly of vertebral anchors and associated elongate member to a second assembly of vertebral anchors and associated elongate member of the spinal stabilization system to provide additional stability to the spinal stabilization system. Accordingly, there exists a need to provide alternative transverse connector assemblies which may be coupled between first and second vertebral anchors of a spinal stabilization system.
SUMMARY
• The disclosure is directed to several alternative designs, materials and methods of manufacturing medical device structures and assemblies.
• Accordingly, one illustrative embodiment is a transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system. The transverse connector includes a first coupling assembly proximate a first end of the transverse connector and a second coupling assembly proximate a second end of the transverse connector. The transverse connector also includes a first fastener having external threading configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor and a second fastener having external threading configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper surface. A spherical surface of the first coupling assembly mates with the spherical upper surface of the first fastener and a spherical surface of the second coupling assembly mates with the spherical upper surface of the second fastener.
• Another illustrative embodiment is a spinal stabilization system including first, second, third and fourth vertebral anchors, each including a housing and a bone engagement portion extending from the housing, with a first elongate member extending between the first and third vertebral anchors and a second elongate member extending between the second and fourth vertebral anchors. The spinal stabilization system further includes a first fastener securing the first elongate member in a channel of the housing of the first vertebral anchor and a second fastener securing the second elongate member in a channel of the housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper portion having a spherically convex surface and a threaded lower portion threadably engaging the housing of the respective vertebral anchor. The spinal stabilization system also includes a transverse connector including a first coupling housing proximate a first end of the transverse connector and a second coupling housing proximate a second end of the transverse connector. The first coupling housing includes an aperture therethrough for receiving the spherical upper portion of the first fastener and the second coupling housing includes an aperture therethrough for receiving the spherical upper portion of the second fastener. Each aperture has a concave annular sidewall configured to mate with the spherically convex surface of the spherical upper portion of the respective fastener to allow rotational movement therebetween.
• The above summary of some example embodiments is not intended to describe each disclosed embodiment or every implementation of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
• The invention may be more completely understood in consideration of the following detailed description of various embodiments in connection with the accompanying drawings, in which:
• FIG. 1 is a perspective view of an exemplary spinal stabilization system including a transverse connector extending between vertebral anchors;
• FIG. 2 is a perspective view of the transverse connector shown inFIG. 1;
• FIG. 3 is a cross-sectional view of the transverse connector ofFIG. 1;
• FIG. 4 is an enlarged perspective view of components of a coupling portion of the transverse connector ofFIG. 2;
• FIG. 5 is a cross-sectional view of components of the coupling portion shown inFIG. 4;
• FIG. 6 is a cross-sectional view of the components of the coupling portion assembled together;
• FIG. 7 is a cross-sectional view of the transverse connector ofFIG. 2 taken through line7-7;
• FIG. 8 is a perspective view of another transverse connector for use in a spinal stabilization system;
• FIG. 9 is a cross-sectional view of the transverse connector ofFIG. 8;
• FIG. 10 is an enlarged perspective view of components of a coupling portion of the transverse connector ofFIG. 8;
• FIG. 11 is a cross-sectional view of components of the coupling portion shown inFIG. 10;
• FIG. 12 is a top view of the set screw of the transverse connector ofFIG. 8;
• FIG. 13 is a perspective view of another transverse connector for use in a spinal stabilization system;
• FIG. 14 is a cross-sectional view of the transverse connector ofFIG. 13;
• FIG. 15 is an enlarged perspective view of components of a coupling portion of the transverse connector ofFIG. 13;
• FIG. 16 is a perspective view of yet another transverse connector for use in a spinal stabilization system;
• FIG. 17 is a cross-sectional view of the transverse connector ofFIG. 16;
• FIG. 18 is a perspective view of another transverse connector for use in a spinal stabilization system; and
• FIG. 19 is a cross-sectional view of the transverse connector ofFIG. 18.
• While the invention is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit aspects of the invention to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention.
DETAILED DESCRIPTION
• For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.
• All numeric values are herein assumed to be modified by the term “about”, whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the term “about” may be indicative as including numbers that are rounded to the nearest significant figure.
• The recitation of numerical ranges by endpoints includes all numbers within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
• Although some suitable dimensions, ranges and/or values pertaining to various components, features and/or specifications are disclosed, one of skill in the art, incited by the present disclosure, would understand desired dimensions, ranges and/or values may deviate from those expressly disclosed.
• As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
• The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The detailed description and the drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the invention. The illustrative embodiments depicted are intended only as exemplary. Selected features of any illustrative embodiment may be incorporated into an additional embodiment unless clearly stated to the contrary.
• Now referring to the drawings, an exemplaryspinal stabilization system2 for stabilizing a portion of a spinal column, such as one or more spinal segments of a spinal column, is illustrated inFIG. 1. As used herein, a spinal segment is intended to refer to two or more vertebrae, the intervertebral disc(s) between the vertebrae and other anatomical elements between the vertebrae. For example, a spinal segment may include first and second adjacent vertebrae and the intervertebral disc located between the first and second vertebrae. Thespinal stabilization system2 may provide support to the spinal segment subsequent bone fusion, may help preserve the facet joints between adjacent vertebrae by providing facet offloading and/or may stabilize or reverse neural foraminal narrowing of the spinal column, in some instances.
• In some embodiments, thespinal stabilization system2 may be used to treat discogenic low back pain, degenerative spinal stenosis, disc herniations, facet syndrome, posterior element instability, adjacent level syndrome associated with spinal fusion, and/or other maladies associated with the spinal column.
• Thespinal stabilization system2 may include one or more or a plurality of vertebral anchors10. Although the vertebral anchors10 are depicted as threaded vertebral fasteners (e.g., pedicle screws, bone screws), in some embodiments the vertebral anchors10 may be vertebral hooks (e.g., laminar hooks) or other types of fastening members for attachment to a bony structure such as a vertebra of the spinal column. Each of the vertebral anchors10 may be configured to be secured to a vertebra of a spinal column.
• Thespinal stabilization system2 may be used in any desired region of the spinal column, such as the cervical, thoracic, thoracolumbar, and lumbar regions. Thevertebral stabilization system2 may be installed multi-laterally on opposite sides of the sagittal plane of the spinal column, with the first and third vertebral anchors10a,10cand the firstelongate member4 positioned on one lateral side of the sagittal plane and the second and fourth vertebral anchors10b,10dand the secondelongate member4 positioned on the other lateral side (i.e., contra-lateral side) of the sagittal plane. For instance, the firstvertebral anchor10aand the secondvertebral anchor10bmay be secured to a first vertebra on contra-lateral sides of the sagittal plane, while the third vertebral anchor10cand the fourth vertebral anchor10dmay be secured to a second vertebra on contra-lateral sides of the sagittal plane. Additional vertebral anchors10 may be secured to additional vertebrae as desired.
• Thevertebral anchor10 may include ahousing12 and a bone engagement portion, such as abone screw14 extending from thehousing12 along a longitudinal axis of thevertebral anchor10. In some embodiments, thevertebral anchor10 may be a monoaxial screw in which thehousing12 is stationary relative to thebone screw14, while in other embodiments thevertebral anchor10 may be a polyaxial screw in which thehousing12 is actuatable (e.g., pivotable) relative to thebone screw14. In some embodiments, thebone screw14 may be configured to be installed into a bony region of a vertebra of the spinal column. For example, thebone screw14 may be installed into a pedicle of a vertebra, or other region of a vertebra. In some embodiments, thebone screw14 may include helical threads configured to be screwed into a pedicle of a vertebra, or other bony region of a vertebra.
• Thehousing12 may include a base portion and first andsecond legs8 extending from the base portion and defining achannel6, such as a U-shaped channel, therebetween extending into thehousing12 from an upper extent of thehousing12 opposite thebone screw14. In some embodiments each of the first andsecond legs8 may include a threaded portion for threadedly engaging a threaded portion of a fastener. In other embodiments, the first andsecond legs8 may include other engagement features for engaging with a securing member positioned in thehousing12 between the first andsecond legs8.
• Thespinal stabilization system2 may also include one or more, or a plurality ofelongate stabilization members4, such as elongate rods, extending between vertebral anchors10 of thespinal stabilization system2. As an illustrative example, thespinal stabilization system2 shown inFIG. 1 includes a firstelongate member4 extending between and secured to the firstvertebral anchor10aand the third vertebral anchor10c, and a secondelongate member4 extending between and secured to the secondvertebral anchor10band the fourth vertebral anchor10d.
• Theelongate members4 may be secured in thechannels6 of thehousings12 of the vertebral anchors10 using threaded fasteners or other securement members. For instance, threaded setscrews15 may be threadably engaged with the threaded portions of thelegs8 of thehousings12 of the third and fourth vertebral anchors10c,10dand press against theelongate member4 to secure theelongate members4 in thechannels6.
• Thespinal stabilization system2 may also include atransverse connector20 which may be positioned generally perpendicular to theelongate members4 to provide additional stability to thespinal stabilization system2 in some instances. Thetransverse connector20 may be configured to be coupled to thehousings12 of contra-laterally positioned vertebral anchors10. For example, thetransverse connector20 may be coupled between the first and second vertebral anchors10a,10bin an orientation generally perpendicular to theelongate members4. Thetransverse connector20 may includefasteners40 having external threading configured to threadably engage an internal threaded portion of thehousing12 between thelegs8 of avertebral anchor10. Thefasteners40 may press against theelongate member4 to secure theelongate members4 in thechannels6 of thehousings12 of the first and second vertebral anchors10a,10b.
• In some instances, it may be desirable to install thetransverse connector20 between vertebral anchors10 on a single side of the spinal column, thus thetransverse connector20 may extend generally parallel to theelongate member4 coupled between adjacent vertebral anchors10. For instance, theelongate member4 may be coupled to the first and third vertebral anchors10a,10con a single side of the sagittal plane of the spinal column, with thetransverse connector20 also secured to and extending between the first and third vertebral anchors10a,10con the same side of the sagittal plane of the spinal column. Thus, thetransverse connector20 may extend parallel to theelongate member4 in a vertical direction generally parallel with the longitudinal axis of the spinal column.
• Additional features and components of thetransverse connector20 are further illustrated inFIGS. 2-7. As shown inFIG. 2, thetransverse connector20 may include afirst connector member22 and asecond connector member24 coupled together. For instance, thefirst connector member22, which may be considered a male connector member, may include acoupling housing26 and anelongate extension28 extending from thecoupling housing26. Furthermore, thesecond connector member24, which may be considered a female connector member, may include acoupling housing26 and anelongate extension30 extending from thecoupling housing26. Theelongate extension30 may include areceiver34 with anopening36 therethrough for receiving theelongate extension28 of thefirst connector member22.
• Thetransverse connector20 may be configured such that thefirst connector member22 may be moved in multiple degrees of freedom relative to thesecond connector member24. For example, thefirst connector member22 may translate along a longitudinal axis (see arrow A,FIG. 2) and rotate about the longitudinal axis (see Arrow B,FIG. 7) relative to thesecond connector member24, in some instances. In some embodiments, thetransverse connector20 may include additional degrees of freedom, such as pivot about an axis transverse to the longitudinal axis. When thefirst connector member22 is positioned at a desired orientation relative to thesecond connector member24, the lockingscrew38, threadably engaged in a threaded bore of thereceiver34, may be rotated into engagement against theelongate extension28 of thefirst connector member22 to apply a clamping force between thefirst connector member22 and thesecond connector member24 to thereby prevent further movement therebetween.
• Referring toFIG. 7, the lockingscrew38 may include aprotuberance37, which may be a spherical protuberance, extending into anelongate recess32 of theelongate extension28 of thefirst connector member22. The arcuate lower surface of theprotuberance37, the arcuate surface of therecess32 and the arcuate lower wall of theopening36 may share a common center of curvature. Thus, as can be seen by the arrow B, theelongate extension28 of thefirst connector member22 may rotate about the common center of curvature relative to thesecond connector member24 to adjust the orientation of thefirst connector member22 relative to thesecond connector member24. As shown inFIG. 3, therecess32 may include end surfaces which limit the longitudinal travel of theprotuberance37 in therecess32, and thus prevent decoupling of thefirst connector member22 from thesecond connector member24.
• Thetransverse connector20 may includecoupling assemblies80 configured to secure thetransverse connector20 to thehousings12 of vertebral anchors10. As shown inFIG. 3, afirst coupling assembly80 proximate the first end of thetransverse connector20 may couple thetransverse connector20 to a firstvertebral anchor10 and asecond coupling assembly80 proximate the second end of thetransverse connector20 may couple thetransverse connector20 to a secondvertebral anchor10.
• Turning now toFIG. 4, acoupling assembly80 of thetransverse connector20 will be further described. It is noted that although onecoupling assembly80 at one end of thetransverse connector20 is described herein, thecoupling assembly80 at the other end of thetransverse connector20 may be similarly configured and include similar components.
• Thecoupling assembly80 may include thecoupling housing26, thefastener40, and aset screw50 configured to threadably engage a threadedbore46 of thefastener40. Thefastener40 may include external threading configured to threadably engage an internal threaded portion of thehousing12 of avertebral anchor10, and a spherical upper surface. For instance, thefastener40 may include a lower threadedportion42 including the external threading and an upperspherical portion44 including a sphericallyconvex surface56. In some instances, thefastener40 may be a monolithic member including the upperspherical portion44 and the lower threadedportion42.
• The upperspherical portion44 may include a plurality ofconvex segments48 withslots49 therebetween radially arranged. The presence of theslots49 betweenadjacent segments48 may permit thesegments48 of the upperspherical portion44 to flex or deflect relative to each other.
• The upperspherical portion44 may be configured to be positioned in theaperture52 of thecoupling housing26 such that the sphericallyconvex surface56 faces and mates with a spherically concaveannular sidewall54 of theaperture52. Thus, theaperture52 may receive the upperspherical portion44 of thefastener40 therein to permit rotational movement therebetween. As shown inFIG. 6, theset screw50 may be threadably disposed in the threaded bore46 to exert a radially outward force F on theconvex segments48 of the upperspherical portion44 to press the sphericallyconvex surface56 against the spherically concave surface of theannular sidewall54 to lock the upperspherical portion44 in theaperture52 and prevent further rotational movement therebetween. In some instances, theset screw50 and thefastener40 may be configured such that the force F exerted on theconvex segments48 from theset screw50 is substantially radially outward, without appreciable force being generated axially.
• One possible configuration of the threading of theset screw50 and the threading of the threaded bore46 of thefastener40 which achieves a substantially radially outward force F is illustrated atFIG. 5. In this embodiment, theset screw50 includes anexternal thread60 having a major diameter D1 that is constant from an upper portion of theset screw50 to a lower portion of theset screw50, and a minor diameter that tapers from a larger diameter D2 proximate the upper portion of theset screw50 to a smaller diameter D3 proximate the lower portion of theset screw50. Thus the height of thethread60 increases from the upper portion to the lower portion of theset screw50 while the major diameter D1 remains substantially constant.
• Furthermore, in this embodiment, the threaded bore46 of the upperspherical portion44 of thefastener40 includes aninternal thread70 that has a major diameter D4 that is constant from an upper portion of the threaded bore46 to a lower portion of the threaded bore46, and a minor diameter that tapers from a larger diameter D5 proximate the upper portion of the threaded bore46 to a smaller diameter D6 proximate the lower portion of the threaded bore46. Thus the height of thethread70 increases from the upper portion of the threaded bore46 to the lower portion of the threaded bore46 while the major diameter D4 remains substantially constant.
• Thethread60 of theset screw50 may be configured such that theupper flank62 of thethread60 is perpendicular to the central longitudinal axis of theset screw50 and thelower flank64 of thethread60 is perpendicular to the central longitudinal axis of theset screw50. Thus, theupper flank62 may be parallel to thelower flank64. Furthermore, thecrest66 of thethread60 may be perpendicular to the upper andlower flanks62,64 and theroot68 of thethread60 may be perpendicular to the upper andlower flanks62,64. Thus, thecrest66 and/or root68 of thethread60 may be parallel to the central longitudinal axis of theset screw50.
• Similarly, thethread70 of the threaded bore46 may be configured such that theupper flank72 of thethread70 is perpendicular to the central longitudinal axis of the threaded bore46 and thelower flank74 of thethread70 is perpendicular to the central longitudinal axis of the threaded bore46. Thus, theupper flank72 may be parallel to thelower flank74. Furthermore, thecrest76 of thethread70 may be perpendicular to the upper andlower flanks72,74 and theroot78 of thethread70 may be perpendicular to the upper andlower flanks72,74. Thus, thecrest76 and/or root78 of thethread70 may be parallel to the central longitudinal axis of the threaded bore46.
• Such a configuration may provide positive engagement between thethread60 of theset screw50 and thethread70 of the threaded bore46 even at the onset of threading theset screw50 into the threaded bore46. In other words, thethread60 may engage thethread70 as theset screw50 initially enters the threaded bore46. As theset screw50 is continued to be threaded into the threaded bore46, theroot68 of thethread60 of theset screw50 presses against thecrest76 of thethread70 of the threaded bore46, exerting a radially outward force F normal to the surfaces of theroot68 andcrest76 on theconvex segments48 of the upperspherical portion44 of thefastener40, which in turn presses theconvex segments48 against theconcave sidewall54 of thecoupling housing26, as shown inFIG. 6. Due to the perpendicular orientation of theflanks62/64,72/74 and the parallel orientation of thecrests66/76 androots68/78 relative to the central longitudinal axes, no appreciable force is generated other than in a direction perpendicular to the central longitudinal axis.
• Referring again toFIG. 3, in use, thetransverse connector20 may be coupled between first and second vertebral anchors10. Initially, the first and second vertebral anchors10 may be secured to a vertebra, followed by positioning anelongate member4 in thechannel6 of thehousing12 of each of the vertebral anchors10. With theelongate member4 in thechannel6 of thehousing12, thefastener40 may be threaded into the threaded opening in thehousing12 between thelegs8 of thehousing12 to secure theelongate member4 in thechannel6. For example, thefastener40 may include aninternal driver interface45, such as a hex socket, or other driver interface for receiving a driver to rotatably advance thefastener40 against theelongate member4. In some instances, thevertebral anchor10 may include aseat5 against which theelongate member4 is pressed against to transfer a locking force to thehead16 of thebone screw14 to lock thehousing12 from further pivotable movement relative to thebone screw14. In other instances, theelongate member4 may be pressed directly against thehead16 of thebone screw14. This process may be followed to secure each of theelongate members4 to thehousing12 of the respectivevertebral anchor10.
• If not already coupled to thefastener40, thefirst connector member22 may then be coupled to the upperspherical portion44 of thefastener40 secured to the firstvertebral anchor10aand/or thesecond connector member24 may be coupled to the upperspherical portion44 of thefastener40 secured to the secondvertebral anchor10b. The spherical interface between the sphericallyconvex surface56 of the upperspherical portion44 and the sphericallyconcave sidewall54 of theaperture52 of thecoupling housing26 allows for multi-axial rotation of thetransverse connector20 relative to thehousings12 to permit a desired orientation of thetransverse connector20.
• With thecoupling housing26 properly oriented around the upperspherical portion44, theset screw50 may be threadably engaged in the threaded bore46 of thefastener40 to apply a radially outward locking force F between the sphericallyconvex surface56 of the upperspherical portion44 and the sphericallyconcave sidewall54 of theaperture52 of thecoupling housing26. This may be repeated for each end of thetransverse connector20 to fixedly lock thetransverse connector20 to thehousing12 of eachvertebral anchor10.
• The lockingscrew38 may also be tightened once the desired orientation between thefirst connector member22 and thesecond connector member24 is achieved to fix thefirst connector member22 to thesecond connector member24. As shown inFIG. 3, when thetransverse connector20 is secured to thehousings12 of the vertebral anchors10, the first andsecond connector members22,24 may be spaced away from direct contact with thehousings12 of the vertebral anchors10 such that there is a gap between the upper extent of thehousings12 and thecoupling housings26.
• Anothertransverse connector120, which may be coupled between the first and second vertebral anchors10a,10bis shown inFIG. 8. Thetransverse connector120 may include afirst connector member122 and asecond connector member124 coupled together. For instance, thefirst connector member122, which may be considered a male connector member, may include acoupling housing126 and anelongate extension128 extending from thecoupling housing126. Furthermore, thesecond connector member124, which may be considered a female connector member, may include acoupling housing126 and anelongate extension130 extending from thecoupling housing126. Theelongate extension130 may include areceiver134 with anopening136 therethrough for receiving theelongate extension128 of thefirst connector member122.
• Thetransverse connector120 may be configured such that thefirst connector member122 may be adjustable relative to thesecond connector member124. For example, thefirst connector member122 may translate along a longitudinal axis relative to thesecond connector member124, in some instances. When thefirst connector member122 is positioned at a desired orientation relative to thesecond connector member124, the lockingscrew138, threadably engaged in a threaded bore of thereceiver134, may be rotated into engagement against theelongate extension128 of thefirst connector member122 to apply a clamping force between thefirst connector member122 and thesecond connector member124 to thereby prevent further movement therebetween.
• Referring toFIG. 9, the lockingscrew138 may include aprotuberance137 extending into anelongate recess132 of theelongate extension128 of thefirst connector member122. Therecess132 may include end surfaces which limit the longitudinal travel of theprotuberance137 in therecess132, and thus prevent decoupling of thefirst connector member122 from thesecond connector member124.
• Thetransverse connector120 may includecoupling assemblies180 configured to secure thetransverse connector120 to thehousings12 of vertebral anchors10. As shown inFIG. 9, afirst coupling assembly180 proximate the first end of thetransverse connector120 may couple thetransverse connector120 to a firstvertebral anchor10aand asecond coupling assembly180 proximate the second end of thetransverse connector120 may couple thetransverse connector120 to a secondvertebral anchor10b.
• Turning now toFIG. 10, acoupling assembly180 of thetransverse connector120 will be further described. It is noted that although onecoupling assembly180 at one end of thetransverse connector120 is described herein, thecoupling assembly180 at the other end of thetransverse connector120 may be similarly configured and include similar components.
• Thecoupling assembly180 may include thecoupling housing126, a threadedfastener142, aspherical member144, and atapered screw160 configured to threadably engage a threadedbore145 of thefastener142. Thefastener142 may include external threading configured to threadably engage an internal threaded portion of thehousing12 of avertebral anchor10 to secure anelongate member4 in thechannel6 of thehousing12. The upper surface of thefastener142 may be a spherically concaveupper surface143.
• Thespherical member144 may include a plurality ofconvex segments148 withslots149 therebetween radially arranged. The presence of theslots149 betweenadjacent segments148 may permit thesegments148 of thespherical member144 to flex or deflect relative to each other.
• Thespherical member144 may be configured to be positioned in theaperture152 of thecoupling housing126 such that the sphericallyconvex surface156 faces and mates with a spherically concaveannular sidewall154 of theaperture152. Thus, theaperture152 may receive thespherical member144 therein to permit rotational movement therebetween. The sphericallyconvex surface156 is also configured to rest against and mate with the sphericallyconcave surface143 of thefastener142.
• As shown inFIG. 11, atapered screw160 may be inserted through thebore146 of thespherical member144 such that a threadedportion164 of the tapered screw threadably engages the threaded bore145 of thefastener142. A taperedhead portion162 of the taperedscrew160 may contact atapered surface163 of thebore146 of thespherical member144 to exert a radially outward force on theconvex segments148 of thespherical member144 when thetapered screw160 is threadedably engaged with thefastener142. Thetapered screw160 may include aninternal driver interface161, such as a hex socket, or other driver interface for receiving a driver to rotatably advance the taperedscrew160 into the threaded bore145 such that the taperedhead portion162 presses against the tapered surface153 of thebore146.
• Referring again toFIG. 9, in use, thetransverse connector120 may be coupled between first and second vertebral anchors10. Initially, the first and second vertebral anchors10 may be secured to a vertebra, followed by positioning anelongate member4 in thechannel6 of thehousing12 of each of the vertebral anchors10. With theelongate member4 in thechannel6 of thehousing12, thefastener142 may be threaded into the threaded opening in thehousing12 between thelegs8 of thehousing12 to secure theelongate member4 in thechannel6. For example, thefastener142 may include an internal driver interface, such as a hex socket, or other driver interface formed in the threadedbore145 for receiving a driver to rotatably advance thefastener142 against theelongate member4.
• As shown inFIG. 12, thebore145 may be configured withhexagonal sidewalls149 defining the internal driver interface for receiving a hex wrench. The threading of thebore145 may be configured such that themajor diameter147 of the internal threading of thebore145 circumscribes thehexagonal sidewalls149, while theminor diameter165 of the threadedportion164 of the taperedscrew160 would be inscribed within thehexagonal sidewalls149. It is contemplated that the driver interface may be otherwise configured into thebore145 while preserving the internal threading for threadably receiving the threadedportion164 of the taperedscrew160.
• Thespherical member144, rotatably coupled in thecoupling housing126 of thefirst connector member122 and/or thesecond connector member124, may then be positioned against the spherically concaveupper surface143 of thefastener142 secured to the respectivevertebral anchor10. The spherical interface between the sphericallyconvex surface156 of thespherical member144 and the sphericallyconcave sidewall154 of theaperture152 of thecoupling housing126 allows for multi-axial rotation of thetransverse connector120 relative to thehousings12 to permit a desired orientation of thetransverse connector120.
• With the sphericallyconvex surface156 of thespherical member144 positioned against the spherically concaveupper surface143 of thefastener142, the taperedscrew160 may be advanced through thebore146 of thespherical member144 and threadably engaged in the threaded bore145 of thefastener142 to apply a radially outward locking force F between the sphericallyconvex surface156 of thespherical member144 and the sphericallyconcave sidewall154 of theaperture152 of thecoupling housing126. This may be repeated for each end of thetransverse connector120 to fixedly lock thetransverse connector120 to thehousing12 of eachvertebral anchor10.
• The lockingscrew138 may also be tightened once the desired orientation between thefirst connector member122 and thesecond connector member124 is achieved to fix thefirst connector member122 to thesecond connector member124. As shown inFIG. 9, when thetransverse connector120 is secured to thehousings12 of the vertebral anchors10, the first andsecond connector members122,124 may be spaced away from direct contact with thehousings12 of the vertebral anchors10 such that there is a gap between the upper extent of thehousings12 and thecoupling housings126.
• Anothertransverse connector220, which may be coupled between the first and second vertebral anchors10a,10bis shown inFIG. 13. Thetransverse connector220 may include afirst coupling housing226, asecond coupling housing226 and across member222 pivotably coupled to each of thecoupling housings226 at a pivot point, such as at pins224.
• Thetransverse connector220 may includecoupling assemblies280 configured to secure thetransverse connector220 to thehousings12 of vertebral anchors10. As shown inFIG. 14, afirst coupling assembly280 proximate the first end of thetransverse connector220 may couple thetransverse connector220 to a firstvertebral anchor10aand asecond coupling assembly280 proximate the second end of thetransverse connector220 may couple thetransverse connector220 to a secondvertebral anchor10b.
• Turning now toFIG. 15, acoupling assembly280 of thetransverse connector220 will be further described. It is noted that although onecoupling assembly280 at one end of thetransverse connector220 is described herein, thecoupling assembly280 at the other end of thetransverse connector220 may be similarly configured and include similar components.
• Thecoupling assembly280 may include thecoupling housing226, a threadedfastener242, and a threadedscrew260 configured to extend through theelongated opening230 and threadably engage a threadedbore245 of thefastener242. Thefastener242 may include external threading configured to threadably engage an internal threaded portion of thehousing12 of avertebral anchor10 to secure anelongate member4 in thechannel6 of thehousing12. The upper surface of thefastener242 may be a spherically concaveupper surface243.
• Thecoupling housing226 may include anupper surface228 such as a spherically concave surface, alower surface229 such as a spherically convex surface, and an aperture extending through thecoupling housing226 from theupper surface228 to thelower surface229. In some instances, the aperture may be anelongated opening230 having a width W and a length L greater than the width W. Theelongated opening230 may includepartial threading232 along a portion of the sidewall of theelongated opening230. For example, each of two opposing sidewalls of theelongated opening230 may include discontinuous threads.
• The threadedscrew260 may include ahead262 having adriver interface261 and a shank extending from thehead262 having a threadedlower portion264 and an unthreadedupper portion266. The threadedlower portion264 may be sized to pass through theelongate opening230 of thecoupling housing226 only by way of thepartial threads228 of theelongate opening230. In other words, the major diameter of the threadedlower portion264 may be greater than the width W of theelongate opening230 such that the threadedlower portion264 cannot pass freely through theelongate opening230 in an axial direction without being rotatably threaded through the partial threaded portion of theelongated opening230. The unthreadedupper portion266 may have a diameter less than the width W of theelongated opening230 such that once the lower threadedportion264 is threaded through theelongated opening230, the unthreaded upper portion266 (which is now positioned in the elongated opening230) may freely travel back and forth along the length L of theelongated opening230 to any desired position.
• Referring again toFIG. 14, in use, thetransverse connector220 may be coupled between first and second vertebral anchors10. Initially, the first and second vertebral anchors10 may be secured to a vertebra, followed by positioning anelongate member4 in thechannel6 of thehousing12 of each of the vertebral anchors10. With theelongate member4 in thechannel6 of thehousing12, thefastener242 may be threaded into the threaded opening in thehousing12 between thelegs8 of thehousing12 to secure theelongate member4 in thechannel6. For example, similar to thefastener142 discussed above, thefastener242 may include an internal driver interface, such as a hex socket, or other driver interface formed in the threadedbore245 for receiving a driver to rotatably advance thefastener242 against theelongate member4.
• The spherically convexlower surface229 of thecoupling housing226 may then be positioned against the spherically concaveupper surface243 of thefastener242 secured to the respectivevertebral anchor10, and the threaded screw260 (extending through the elongated opening230) may be threaded into the threaded bore245 of thefastener242. The spherical interface between the spherically convexlower surface229 of thecoupling housing226 and the spherically concaveupper surface243 of thefastener242 allows for multi-axial rotation of thetransverse connector220 relative to thehousings12 while the unthreadedupper portion266 of the threadedscrew260 travels along theelongated opening230 to permit a desired orientation of thetransverse connector220. In some instances, the under side of thehead262 of the threadedscrew260 may be spherically convex to mate with the spherically concaveupper surface228 of thecoupling housing226. The spherical interfaces andelongated opening230, along with the pivotable connection between thecoupling housing226 and thecross member222, may allow for a desired degree of lateral adjustability of thetransverse connector220.
• Once in a desired orientation with the spherically convexlower surface229 of thecoupling housing226 positioned against the spherically concaveupper surface243 of thefastener242, the threadedscrew260 may be rotated in the threaded bore245 of thefastener242 to apply a locking force between the spherically convexlower surface229 of thecoupling housing226 and the spherically concaveupper surface243 of thefastener242 to lock thecoupling housing226 from further movement relative to thehousing12. This may be repeated for each end of thetransverse connector220 to fixedly lock thetransverse connector220 to thehousing12 of eachvertebral anchor10.
• As shown inFIG. 14, when thetransverse connector220 is secured to thehousings12 of the vertebral anchors10, thecoupling housings226 of thetransverse connector220 may be spaced away from direct contact with thehousings12 of the vertebral anchors10 such that there is a gap between the upper extent of thehousings12 and thecoupling housings226.
• Yet anothertransverse connector320, which may be coupled between the first and second vertebral anchors10 is shown inFIG. 16. Thetransverse connector320 may include afirst connector member322 and asecond connector member324 coupled together. For instance, thefirst connector member322, which may be considered a male connector member, may include a firstspherical member348 and anelongate extension328 extending from the firstspherical member348. Furthermore, thesecond connector member324, which may be considered a female connector member, may include a secondspherical member348 and anelongate extension330 extending from the secondspherical member348. Theelongate extension330 may include areceiver334 with an opening extending therein for receiving theelongate extension328 of thefirst connector member322.
• Thetransverse connector320 may be configured such that thefirst connector member322 may be adjustable relative to thesecond connector member324. For example, thefirst connector member322 may translate along a longitudinal axis relative to thesecond connector member324, in some instances. When thefirst connector member322 is positioned at a desired orientation relative to the second connector member326, the lockingscrew338, threadably engaged in a threaded bore of thereceiver334, may be rotated into engagement against theelongate extension328 of thefirst connector member322 to apply a clamping force between thefirst connector member322 and thesecond connector member324 to thereby prevent further movement therebetween.
• Thetransverse connector320 may includecoupling assemblies380 configured to secure thetransverse connector320 to thehousings12 of vertebral anchors10. As shown inFIG. 17, afirst coupling assembly380 proximate the first end of thetransverse connector320 may couple thetransverse connector320 to a firstvertebral anchor10aand asecond coupling assembly380 proximate the second end of thetransverse connector320 may couple thetransverse connector320 to a secondvertebral anchor10b.
• Acoupling assembly380 may include thespherical member348, a threadedfastener342, and a threadednut346 configured to threadably engage a threaded upper portion of thefastener342. Thefastener342 may also include a lower portion having external threading configured to threadably engage an internal threaded portion of thehousing12 of avertebral anchor10 to secure anelongate member4 in thechannel6 of thehousing12. The upper surface of thefastener342 may be a spherically concaveupper surface343.
• The threadednut346 may surround at least a portion of thespherical member348 with theextension328/330 extending through abore350 of the threadednut346. Thespherical member348 may be sized larger than thebore350 of the threadednut346 such that thespherical member348 cannot pass through thebore350. A sidewall of thebore350 of thenut346 may be configured to engage a portion of thespherical member348 when the threadednut346 is tightened onto thefastener342.
• Thespherical member348 may include a sphericallyconvex surface356 configured to rest against and mate with the sphericallyconcave surface343 of thefastener342 to provide multi-axial rotational orientation therebetween.
• In use, thetransverse connector320 may be coupled between first and second vertebral anchors10. Initially, the first and second vertebral anchors10 may be secured to a vertebra, followed by positioning anelongate member4 in thechannel6 of thehousing12 of each of the vertebral anchors10. With theelongate member4 in thechannel6 of thehousing12, thefastener342 may be threaded into the threaded opening in thehousing12 between thelegs8 of thehousing12 to secure theelongate member4 in thechannel6. For example, thefastener342 may include aninternal driver interface345, such as a hex socket, or other driver interface for receiving a driver to rotatably advance thefastener342 against theelongate member4.
• Thespherical member348 may then be positioned against the spherically concaveupper surface343 of thefastener342 secured to the respectivevertebral anchor10. The spherical interface between the sphericallyconvex surface356 of thespherical member348 and the spherically concaveupper surface343 allows for multi-axial rotation of thetransverse connector320 relative to thehousings12 to permit a desired orientation of thetransverse connector320.
• With the sphericallyconvex surface356 of thespherical member348 positioned against the spherically concaveupper surface343 of thefastener342, the threadednut346 may be threadably engaged onto the threaded upper portion of thefastener342 to apply a locking force between the sphericallyconvex surface356 of thespherical member348 and the spherically concaveupper surface343 of thefastener342. This may be repeated for each end of thetransverse connector320 to fixedly lock thetransverse connector320 to thehousing12 of eachvertebral anchor10.
• The lockingscrew338 may also be tightened once the desired orientation between thefirst connector member322 and thesecond connector member324 is achieved to fix thefirst connector member322 to thesecond connector member324. As shown inFIG. 17, when thetransverse connector320 is secured to thehousings12 of the vertebral anchors10, the first andsecond connector members322,324 may be spaced away from direct contact with thehousings12 of the vertebral anchors10 such that there is a gap between the upper extent of thehousings12 and the threaded nuts346.
• In some instances, it may be desirable to provide a transverse connector having a first end including a coupling assembly for coupling to ahousing12 of avertebral anchor10 and a second end including a coupling assembly for coupling directly to anelongate member4. One such example of atransverse connector420, which may be coupled between avertebral anchor10 and anelongate member4 is shown inFIG. 18. Thetransverse connector420 may include afirst connector member422 and asecond connector member424 coupled together. Similar to transverse connectors discussed above, thetransverse connector420 may be configured such that thefirst connector member422 may be adjustable relative to thesecond connector member424. When thefirst connector member422 is positioned at a desired orientation relative to thesecond connector member424, the lockingscrew438, threadably engaged in a threaded bore of thereceiver434, may be rotated into engagement against theelongate extension428 of thefirst connector member422 to apply a clamping force between thefirst connector member422 and thesecond connector member424 to thereby prevent further movement therebetween. It is noted that, alternatively, thereceiver434 may be associated with thefirst connector member422 and theelongate extension428 may be associated with thesecond connector member424, or the first andsecond connector members422,424 may otherwise be configured to be adjustably secured to another.
• Thetransverse connector420 may include a coupling assembly at one end of thetransverse connector420 configured to secure the first end of thetransverse connector420 to thehousing12 of avertebral anchor10 and a dissimilar coupling assembly at the other end of thetransverse connector420 configured to secure the second end of thetransverse connector420 to theelongate member4.
• Thefirst coupling assembly480 at the first end of thetransverse connector420 may be similar to one of the coupling assemblies described above in regards to thetransverse connectors20,120,220,320. For example, as illustrated thefirst coupling assembly480 may be similar to thecoupling assembly80 of thetransverse connector20, although thecoupling assembly480 may alternatively be constructed similar to thecoupling assemblies180,280,380, or other desired construction. Although thefirst coupling assembly480 is shown associated with thesecond connector member424, in other embodiments thefirst coupling assembly480 may be associated with thefirst connector member422.
• As shown inFIG. 19, thefirst coupling assembly480 may include acoupling housing426, afastener440, and aset screw450 configured to threadably engage a threaded bore of thefastener440. Thefastener440 may include external threading configured to threadably engage an internal threaded portion of thehousing12 of thevertebral anchor10, and a spherical upper surface. For instance, thefastener440 may include a lower threadedportion442 including the external threading and an upperspherical portion444 including a plurality ofconvex segments448 with slots therebetween radially arranged which are flexible or deflectable relative to each other.
• The upperspherical portion444 may be configured to be positioned in the aperture of thecoupling housing426 such that the spherically convex surface of the upperspherical portion444 faces and mates with a spherically concave annular sidewall of the aperture to permit rotational movement therebetween. Theset screw450 may be threadably disposed in the threaded bore to press theconvex segments448 against thecoupling housing426 to lock the upperspherical portion444 in the aperture and prevent further rotational movement therebetween.
• Thesecond coupling assembly490 at the second end of thetransverse connector420 may be configured to be secured directly to anelongate member4. For instance, as shown inFIG. 19, thesecond coupling assembly490 may include acoupler492 having a pair ofdeflectable arms491 and a threadedportion494. Thecoupler492 may be disposed in a bore of acoupling housing496. A threadedfastener498 may be threadably engaged with the threadedportion494 of thecoupler492. Thedeflectable arms491 may be configured to be deflected around theelongate member4 to couple theelongate member4 thereto. Although thesecond coupling assembly490 is shown associated with thefirst connector member422, in other embodiments thesecond coupling assembly490 may be associated with thesecond connector member424.
• In use, thefirst coupling assembly480 of thetransverse connector420 may be coupled to thevertebral anchor10 as described above. Turning to thesecond coupling assembly490, thesecond coupling assembly490 of thetransverse connector420 may be coupled to theelongate member4 by first inserting theelongate member4 into the cavity between thedeflectable arms491. In some instances theelongate member4 may snap into the cavity between thedeflectable arms491 to provisionally lock theelongate member4 to thesecond coupling assembly490. The threadedfastener498, threadably engaged with the threadedportion494 of thecoupler492, may then be rotated to draw thecoupler492 upward into the cavity of thecoupling housing496. As thecoupler492 is drawn upward in thecoupling housing496, thedeflectable arms491 may press against thecoupling housing496 in the bore to clamp onto theelongate member4, thereby securing thecoupling housing490 to theelongate member4.
• Referring to any of the preceding embodiments, in some instances a locking feature may be included to prevent the threaded fastener (e.g.,fastener40,142,242,342,440) from backing out of thehousing12 of thevertebral anchor10 when subjected to torque exerted by the transverse connector through spinal movement. For instance, an engaging member (e.g.,setscrew50,450, threadedscrew160,260 or spherical member348) may be pressed against a feature of the fastener to deform the threads to lock the fastener in place. One of skill in the art will recognize that other locking features may be used to lock the threaded fastener from backing out of thehousing12 once assembled. For instance, the coupling housings may include features designed to insert into or otherwise interact with thechannels6 of thehousing12 or other feature of thehousing12 to prevent relative rotational movement therebetween.
• Those skilled in the art will recognize that the present invention may be manifested in a variety of forms other than the specific embodiments described and contemplated herein. Accordingly, departure in form and detail may be made without departing from the scope and spirit of the present invention as described in the appended claims.

Claims (14)

What is claimed is:

1. A transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system, the transverse connector comprising:

a first coupling assembly proximate a first end of the transverse connector, the first coupling assembly including:

a first coupling housing having an upper surface, a lower surface, and an elongated opening extending from the upper surface to the lower surface of the first coupling housing;

a first fastener positionable through the elongated opening of the first coupling housing, the first fastener including a first threaded portion configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor; and

a third fastener including a threaded portion configured to threadably engage a second threaded portion of the first fastener;

a second coupling assembly proximate a second end of the transverse connector, the second coupling assembly including:

a second coupling housing having an upper surface, a lower surface, and an elongated opening extending from the upper surface to the lower surface of the second coupling housing;

a second fastener positionable through the elongated opening of the second coupling housing, the second fastener including a first threaded portion configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor; and

a fourth fastener including a threaded portion configured to threadably engage a second threaded portion of the second fastener;

wherein the first coupling housing of the transverse connector is positionable at a plurality of angular positions relative to a longitudinal axis of the housing of the first vertebral anchor; and

wherein the second coupling housing of the transverse connector is positionable at a plurality of angular positions relative to a longitudinal axis of the housing of the second vertebral anchor.

2. The transverse connector ofclaim 1, wherein the first fastener is configured to secure a first elongate member in the housing of the first vertebral anchor and the second fastener is configured to secure a second elongate member in the housing of the second vertebral anchor.

3. The transverse connector ofclaim 2, wherein a lower surface of the first fastener is configured to press against the first elongate member in the housing of the first vertebral anchor, and a lower surface of the second fastener is configured to press against the second elongate member in the housing of the second vertebral anchor.

4. The transverse connector ofclaim 1, wherein the first fastener and the third fastener are rotatable about the longitudinal axis of the housing of the first vertebral anchor.

5. The transverse connector ofclaim 4, wherein the second fastener and the fourth fastener are rotatable about the longitudinal axis of the housing of the second vertebral anchor.

6. The transverse connector ofclaim 1, wherein:

the first fastener includes a driver socket extending into the first fastener from an upper surface of the first fastener to accommodate a driver instrument for threadably engaging the first fastener in the internal threaded portion of the housing of the first vertebral anchor, and

the second fastener includes a driver socket extending into the second fastener from an upper surface of the second fastener to accommodate a driver instrument for threadably engaging the second fastener in the internal threaded portion of the housing of the second vertebral anchor.

7. The transverse connector ofclaim 6, wherein:

the third fastener extends above the upper surface of the first fastener when threadably engaged to the second threaded portion of the first fastener, and

the fourth fastener extends above the upper surface of the second fastener when threadably engaged to the second threaded portion of the second fastener.

8. The transverse connector ofclaim 7, wherein:

the third fastener includes a head portion having a spherical lower surface, and the threaded portion of the third fastener extends from the spherical lower surface of the third fastener; and

the fourth fastener includes a head portion having a spherical lower surface, and the threaded portion of the fourth fastener extends from the spherical lower surface of the fourth fastener.

9. The transverse connector ofclaim 8, wherein:

the third fastener includes a driver socket extending into the head portion of the third fastener from an upper surface of the head portion of the third fastener to accommodate a driver instrument for threadably engaging the third fastener with the first fastener; and

the fourth fastener includes a driver socket extending into the head portion of the fourth fastener from an upper surface of the head portion of the fourth fastener to accommodate a driver instrument for threadably engaging the fourth fastener with the second fastener.

10. The transverse connector ofclaim 8, wherein:

the spherical lower surface of the third fastener is matingly engageable with a spherical surface of the first coupling assembly; and

the spherical lower surface of the fourth fastener is matingly engageable with a spherical surface of the second coupling assembly.

11. The transverse connector ofclaim 8, wherein:

the spherical lower surface of the third fastener is a convex spherical surface; and

the spherical lower surface of the fourth fastener is a convex spherical surface.

12. The transverse connector ofclaim 1, wherein:

the second threaded portion of the first fastener is an internal threaded portion; and

the second threaded portion of the second fastener is an internal threaded portion.

13. The transverse connector ofclaim 1, wherein:

an upper portion of the first fastener including the second threaded portion has an outer diameter and a lower portion of the first fastener including the first threaded portion has an outer diameter different than the outer diameter of the upper portion of the first fastener; and

an upper portion of the second fastener including the second threaded portion has an outer diameter and a lower portion of the second fastener including the first threaded portion has an outer diameter different than the outer diameter of the upper portion of the second fastener.

14. The transverse connector ofclaim 1, wherein:

the first fastener is translatable in the elongated opening of the first coupling housing in a direction generally transverse to a rotational axis of the first fastener; and

the second fastener is translatable in the elongated opening of the second coupling housing in a direction generally transverse to a rotational axis of the second fastener.

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