SAMAY SURGICAL - Manufacturer,exporter,supplier of cannulated screws, cannulated bone screws, bone screws, small bone screws, large bone screws, surgical bone screws, orthopedic bone screws, locking screw, bone locking screws, cannulated screws from India.
Techniques disclosed herein include systems and methods for a bone screw and self-retaining driver. The system includes a mechanism that enables a bone screw to be rigidly attached to a screwdriver for manipulation and transfer of bone fragments and grafts to a fixation site, such as during surgery. The system includes a cannulated bone screw that has a drive connection that engages with a drive structures of a screwdriver. The bone screw also includes a structural connector that securely attaches to or receives an internal shaft or rod of the screwdriver. The internal shaft or rod of the screwdriver can rotate and slide independent of an outer shaft of screwdriver. Accordingly, the internal shaft of the screwdriver can rigidly connect with the bone screw enabling applied torque to the screwdriver to be transferred to the bone screw, without the bone screw falling off of the drive connection.
TY - JOUR. T1 - Accuracy and reliability of spinal navigation. T2 - An analysis of over 1000 pedicle screws. AU - Shree Kumar, Dinesh. AU - Ampar, Nishanth. AU - Wee Lim, Loo. PY - 2020/3/1. Y1 - 2020/3/1. N2 - Purpose: To estimate the rate of pedicle screw malpositioning associated with placing pedicle screws using intraoperative computed tomography (CT)-guided spinal navigation. Methods: We analysed the records of 219 patients who underwent pedicle screw fixation using O-arm-based navigation. Screw placement accuracy was evaluated on intraoperative CT scans acquired after pedicle screw insertion. Breaches were graded according to the Gertzbein classification (grade 0-III). Results: Of 1152 pedicle screws included, 47 had pedicle violations noted on intraoperative CT. Pedicle screw violation was noted for 17 of 241 screws placed in the cervical spine (overall breach rate, 7.05%; 3.73% and 3.3% with grade I and II, respectively), for 11 of 300 screws placed in the thoracic spine (overall breach ...
Manufacturer of Cortical Screw - Orthopedic Bone Screws, Orthopedic Cortical Screws, Steel Cortical Screw and Large Cortical Screw offered by NRV OrthoTech Private Limited, Ahmedabad, Gujarat.
363981451 - EP 2460484 A1 20120606 - Variable angle bone screw fixation assembly - The arrangement has a clamping sleeve (4 ) receiving a bone screw (1 ). The bone screw includes a shaft (10 ) with a bone thread (11 ) and a head (12 ) at a rear end. A holder (2 ) is provided with a holding opening and an adapting seat. The clamping sleeve is pivotably and movably mounted in the seat. The shaft includes a thickening part (15 ) in front of the head in a rear region. Width of the thickening part is increased toward the head. Width of the clamping sleeve is larger than width of the shaft in front of the thickening part and smaller than a largest width of the head.[origin: EP2460484A1] The arrangement has a clamping sleeve (4 ) receiving a bone screw (1 ). The bone screw includes a shaft (10 ) with a bone thread (11 ) and a head (12 ) at a rear end. A holder (2 ) is provided with a holding opening and an adapting seat. The clamping sleeve is pivotably and movably mounted in the seat. The shaft includes a
Scaphoid fractures can be managed with a cast or with screw fixation. The latter offers a shorter time of immobilisation with a faster return to function, whilst having the same long-term outcome. Ideal screw length is an area of discussion. Theoretically, longer screws provide more stability, but there is a higher risk of protrusion of the screw in the cartilage resulting in more adverse effects. Objectives: The goal of this study was to compare the fixation strength for long and short screws in order to evaluate if the choice for the longer screw is worth the increased risk of protrusion.. Study design & methods: Thirteen pairs of fresh frozen cadaveric scaphoids were randomized to have one side fixed with a long and one with a shorter screw (longest screw possible and longest length minus 4 mm). Under fluoroscopic control a central guidewire was inserted and a cannulated screw placed. A wedge osteotomy was made to simulate a horizontal oblique fracture plane. The proximal pole of the scaphoid ...
Cortical Screws. Engage manufacturer, Exporte, & Supplier type of cortical Screws,like Bone Screws, Cortex Screw, Cannulated Screws.
A bone screw, and method of using the same, are described. The bone screw includes (1) a distal threaded portion having a first orientation, (2) a proximal head portion, and (3) an intermediate portion including a compressive member, such as but not limited to a single or double helix, integral with the distal and proximal portions, wherein the compressive member has a second orientation opposite that of the first orientation. When a force (e.g., rotational or axial) is applied to the bone screw in the first direction, the spaces between the surfaces of the compressive member increase, due to the difference in orientation. In this stressed state, a resorbable material is then applied within the spaces and is allowed to cure. Once the bone screw is inserted into the bone member, the resorbable material will begin to be resorbed, whereupon the compressive member will relax and exert tension between the bone member and any other object the bone screw is secured to.
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The Bone Screw System is an important resource that provides comprehensive information to evaluate all aspects of the market related to the market. It represents a well organized and clear view of the Bone Screw System market, presenting a detailed analysis of the various sectors, companies, associations, manufacturers, and suppliers that contribute to market shares. The Bone Screw System contains important information on applications, categorization, expected growth trends, supply chain, financial and economic terminology, and many other important market features. At the same time, the report also contains important information on key market participants DePuy Synthes, Instratek, Acumed, Stryker Corporation, Custom Spine, SmithNephew, Medtronic, Zimmer Biomet, Wright Medical Technology., OsteoMed, Integra LifeSciences Corporation, Orthofix Holdings, BioPro at the global level, such as industry profiles, product specifications, demand, and annual sales, services provided and after-sales ...
Disclosed is a self-tapping bone screw, in particular for use as a compression screw or a locking screw for an implant. The bone screw has screw shank, which has a front tip, a cutting region, an intermediate region, and a rear head region. In a transition region including mutually adjoining parts of the cutting region and the intermediate region, the root diameter of the screw shank in the cutting region is greater than the root diameter of the screw shank in the intermediate region, and the outside diameter of the screw shank is constant.
Introduction Pedicle screw insertion is the mainstay of thora-cic and lumbosacral posterior spinal instrumentation. However, it may be associated with complications such as screw mal-positioning. The purpose of this study was to develop a pilot study to compare the accuracy of robot-guided screw insertion versus hand-guided screw placement for spinal instrumentation. The hand-guided screws were placed with assistance from computerized tomography (CT) stealth guidance or fluoroscopy. Materials and methods A retrospective analysis of medical records was done for all patients that had pedicle screw insertion for instrumentation between the dates of December 2013 and January 2016 with post-screw placement CT imaging. The analysis was conducted on screw accuracy between the two categories based on the Gertzbein-Robbins classification. Results A total of 49 screws were analyzed for accuracy in six patients. There was no statistically significant difference between the accuracy of hand-placed pedicle
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A pedicle screw assembly and method of assembly comprises a longitudinal member; a screw head comprising a bulbous end, wherein the screw head has a slot adapted to receive the longitudinal member; a bone fixator component comprising a concave socket having a biased angled top and a rounded bottom adapted to receive the screw head; a locking pin adapted to engage the screw head, the bone fixator component, and the longitudinal member; and a blocker adapted to engage the screw head and to secure the longitudinal member. Additionally, the bone fixator component may be configured as any of a bone screw and a hook.
Amedica has announced the successful completion of the first surgery using its Taurus pedicle screw system.. The surgery was performed by Thomas Scioscia, in Richmond, USA. Scioscia remarked on the features of the system, "The surgery went well and the Taurus system was beneficial. Taurus modularity was easy to use and improved visualisation of the disc space. Being able to choose a reduction or standard headbody after the screws were placed was a key benefit. The bite of the screw was great and the screw purchase in osteoporotic bone was excellent. The Taurus cannulated screw integrated well with the navigation system used in surgery.". The Taurus system received US Food and Drug Administration (FDA) clearance in November 2016.. ...
0047] At the start of the implantation process, the rear, threaded segment 7 of the bone screw 1 is screwed completely and up to a depth Tin the internal thread 20 into the central borehole of the implantation instrument 15. By rotating the implantation instrument 15 about the longitudinal axis 2, the bone screw may then screwed into the pre-drilled boreholes 21 in the two bone fragments 13, 14. Since the rear threaded segment 7 of the bone screw 1 is taken up completely in the implantation instrument 15, the external thread 9 of the rear threaded segment 7 cannot engage the proximal bone fragments 13, so that, as the implantation instrument 15 is rotated, only the front threaded segment 5 of the bone screw 1 can be screwed into the distal bone fragment 14. In this phase, the front end 18 of the implantation instrument 15 assumes the task of a screw head, so that, after the bone screw 1 has been brought into the two bone fragments 13, 14 far enough that the front end 18 of the implantation ...
There were 10 procedures with neuromonitoring alarms related to pedicle screw misplacement in group one but only three procedures had these alarms in group two. This, according to Ovadia et al, meant that the use of ECD significantly reduced the incidence of clinically relevant misplaced screws. They reported: "Pedicle screw placement in deformity patients, particularly at more strategic areas, that is, the concavity and apices of spinal curvature, continue to pose a major challenge for the spine surgeon. This study has demonstrated that the use of the ECD, a simple tool with a short learning curve, significantly increased the safety of pedicle screw insertion and decreased the incidence of clinically relevant misplaced screws in scoliosis patients.". The ECD, a free-hand drilling instrument, has an electronic conductivity sensor at its tip that can translate relative values of electronic conductivity into audible and visual signals. Ovadia et al report: "It works on the premise that cancellous ...
Retrospective study. To evaluate the radiological results of fusion with segmental pedicle screw fixation in juvenile idiopathic scoliosis with a minimum 5-year follow-up. Progression of spinal deformity after posterior instrumentation an
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In summary, with simultaneous two-rod segmental translation using polyaxial pedicle screws with dorsal height adjustability, there was no statistical difference between convex side screw dropouts and concave side screw dropouts. Periapical screw dropouts may more likely result in lower bone-screw force increase than alternate level screw dropouts. The number of vertebrae spanned by the major curve or the sharpness of the curve affects the bone-screw forces; screw dropouts should be reduced within short structural curves with high local curvature. Screw density and distribution should be determined by taking into account the local geometric characteristics of the curve in both the sagittal and coronal planes and the shape of the rods in addition to the curve type, deformity magnitude, and spinal stiffness.. Different correction techniques and instrumentation construct designs may have important roles in curve correction and bone-screw forces. Since the simulated correction technique was ...
TABLE-US-00001 List of reference numerals 1 Bone screw 2 Shaft 3 Screw part 4 Predetermined breaking point 5 Screw head 6 Threading 7 Screw shaft 8 Groove 9 Section/ledge 10 Hole 11 Notch 12 Screw driver 13 Base part 14 Holder 15 Shaft and screw recess 16 Opening 17 Aperture 18 Section 19 Lug 20 Clam screw 21 Clamp 22 23 Base 24 Retaining plate 25 Web 26 Hook 27 Slit 28 Tapered end 29 Depression 30 Sleeve section 31 Magazine 32 Holder plate 33 Opening 34 Opening 35 36 37 Rod 38 Recess 39 Notch 40 Engaging lug 41 Knob 42 Recess 43 Connector 44 Channel 45 Channel 46 Channel 47 Channel 48 Depression 49 Driver 50 Internal serration 51 Connector 52 Threading 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 D Diameter d Diameter of 2 B Breadth P Arrow direction .sup. d1 Diameter of 5 .sup. D2 Diameter of 9 ...
Of these hardware-related complications, 75 were further specified and 1 was unspecified. There were 31 cases with cage or pedicle screw malpositioning, 30 with cage migration, 3 with cage subsidence, 9 with pedicle screw loosening or backing out and 2 with a rod fracture. However, none of these cases were comparable to the one described in the present report, which uniquely consisted of loosening of the polyaxial sacral screws, fracturing of the set screws and cage dislocation.. Although our report provides no causal explanation for this kind of implant failure, we assume that the size and placement of the implant did matter in our patient. Furthermore, we believe that the dorsal fixation device may have been too small for our patients biomechanical needs. Cho and coworkers reported that pull-out strength of the pedicle screws increased with the outer diameter of the screws [23]. Therefore, we assume that our primary choice to use pedicle screws with a smaller outer diameter led to early ...
LOGAN, Utah, May 16, 2016 /PRNewswire/ - First Ray, a start-up medical device company focused on advanced surgical devices for improving outcomes for orthopaedic extremity procedures, announces that it has received FDA 510(k) clearance for its innovative CortiClamp™ System for small bone fixation.. The CortiClamp™ System, a two-part bone screw system for small bone fixation, represents a significant advancement in fracture fixation, osteotomy and arthrodesis procedures that are currently treated using conventional bone screws, such as cortical screws, lag screws and headless compression screws. The CortiClamp™System is the first bone screw system to include a second "screw head" that is attached to the distal end of the screw, providing screw heads on both ends of the screw shaft that create superior bi-cortical clamping force. The CortiClamp™ System also includes an innovative "all-in-one" instrument that serves as a reduction clamp, drill guide, countersink guide, depth gage and ...
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2002 Cortical Screws 3.5mm X 14TPI (Hex) 10mm to 44mm at 2mm Variation 2003 Cortical Screws 3.5mm X 20TPI (Hex) 10mm to 44mm at 2mm Variation 2004 Cortical Screws 4.5mm (Hex) 12mm to 60mm at 2mm Variation 2005 Cancellous Screws 4.0mm (16mm Thread) 20mm to 75mm at 5mm Variation 2006 Cancellous Screws 4.0mm (Full Thread)…
TY - JOUR. T1 - Iliac screw versus S2 alar-iliac screw fixation in adults. T2 - a meta-analysis. AU - De la Garza Ramos, Rafael. AU - Nakhla, Jonathan. AU - Sciubba, Daniel M.. AU - Yassari, Reza. PY - 2018/11/9. Y1 - 2018/11/9. N2 - OBJECTIVEIn a meta-analysis, the authors sought to compare outcomes after iliac screw (IS) versus S2 alar-iliac (S2AI) screw fixation in adult patients.METHODSA PubMed/MEDLINE database search was performed for studies comparing IS and S2AI screw fixation techniques in adults. Levels of evidence were assigned based on the North American Spine Society guidelines. Three outcomes were examined: 1) revision surgery rate secondary to mechanical failure or wound complications, 2) surgical site infection rate, and 3) screw prominence/pain. Data were pooled and outcomes compared between techniques. Absolute risk reductions (ARRs) were also calculated for outcome measures.RESULTSFive retrospective cohort studies (all level III evidence) were included in our analysis. A total ...
A minimally invasive method for stabilizing adjacent vertebrae to be fused is accomplished with a device configured to interlink the pedicles of the adjacent vertebrae and. including multiple pedicle screws (54). Each of the pedicle screws (54) has a screw head (60) configured to receive a connecting rod (66) in a position, in which the rod (66) and the receiving pedicle screw (54) are vertically aligned.
The cancellous screw has an extremely low profile head to reduce soft tissue irritation. A step drill with laser depth marking countersinks the screw head flush to bone when used as a suture fixation post. The smooth shank with suture groove orients the sutures safely under the head during screw insertion. The optional, low profile spiked washer may be used in conjunction with the cancellous screw for fixation of soft tissue or tendons directly to bone. The 6.5 mm diameter screw and washer are manufactured using titanium ASTM F-136 alloy ...
Anatomic points within the body are projected outside the body through the use of extenders (180, 182, 188). The projected points may then be used for measurement, or to facilitate the selection or configuration of an implant that is positioned proximate the anatomic points using a slotted cannula (143). Such an implant may be a rod (270) for a posterior spinal fusion system. Pedicle screws (140, 142, 148) may be implanted into pedicles of the spine, and may then serve as anchors for the extenders. The extenders (180, 182, 188) may have rod interfaces (214, 216, 218) that receive the rod (270) in a manner that mimics the geometry of the pedicle screws (140, 142, 148) so that the selected or configured contoured rod (270) will properly fit into engagement with the pedicle screws (140, 142, 148).
A bone screw having a screw member (1) possessing a threaded section (2) and a head (3) and a receiving part (5) at the head end for receiving a rod to be connected to the bone screw is provided. The receiving part (5) has on open first bore (6) and a substantially U-shaped cross-section having two free legs provided with a thread. Furthermore, the receiving part has a second bore (7) on the end opposite to the first bore (6) whose diameter is greater than that of the threaded section (2) and smaller than that of the head (3). On the bottom of the first bore a seat for the head (3) is provided. In order that the screw member can be pivoted to at least one side by an enlarged angle, the edge bounding the free end of the second bore (7) viewed relative to the axis of the first bore (6) is of asymmetric construction.
Scoliosis is a deformity in which there is an abnormal curvature of the spine. Surgery is the main method of correcting this deformity. Rods are attached to the spine to make it strait. There are two ways to fix these rods to the bone of the spine: laminar hooks or pedicle screws. Hooks are an older form of fixation and do not penetrate the bone, but are instead placed over a part of the vertebra called the lamina. Screws are newer and do penetrate the bone. Screws are placed into the part of the vertebra called the pedicle. Most surgeons think screws correct scoliosis better than hooks. The current literature agrees that screws are better for deformity correction in the lumbar spine and patients with severe deformity. There is disagreement in the literature regarding which works better in the thoracic spine in less severe deformity. There are no randomized, controlled trials in the literature that examine whether constructs that use hooks in the thoracic spine and screws in the lumbar spine ...
China Universal Spinal Internal Fixer Spine Pedicel Screw Spine Implant, Find details about China Spine Pedicle Screw, Poly Axial Pedicle Screw from Universal Spinal Internal Fixer Spine Pedicel Screw Spine Implant - Suzhou Gemmed Medical Instrument Co., Ltd.
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This contribution presents further properties of screw systems generated from the sum of subalgebras of the Lie algebra, se(3 ), of the Euclidean group, SE(3 ). In particular, it is shown that they exhibit the property of having a locally constant rank. This property has been used, without proper formalization, in the design of parallel platforms. In addition, since the order of screws in a screw system - and therefore the order of their corresponding kinematic pairs within the kinematic chain that realize the screw system - is shown to be decisive for fulfilling the property of having a locally constant rank, the name screw systems may be not at all appropriate.. Copyright © 2011 by ASME ...
Available for weight-conscious Baja racers are super lightweight titanium screws! Titanium is as strong as steel but weighs about half as much, so they are a hop-up that saves critical weight for racers. These are TORX screws that help prevent stripping, and the TORX design allows the screw to be stronger where the threads meet the head for extra durability.. Sold in packages of 10 screws. These screws require a T25 TORX wrench: #94951 TITANIUM FLAT HEAD SCREW M5x16mm (10pcs) #94952 TITANIUM FLAT HEAD SCREW M5x20mm (10pcs) These screws require a T20 TORX wrench: #94953 TITANIUM TP. FLAT HEAD SCREW M4x15mm (10pcs). ...
Available for weight-conscious Baja racers are super lightweight titanium screws! Titanium is as strong as steel but weighs about half as much, so they are a hop-up that saves critical weight for racers. These are TORX screws that help prevent stripping, and the TORX design allows the screw to be stronger where the threads meet the head for extra durability.. Sold in packages of 10 screws. These screws require a T25 TORX wrench: #94951 TITANIUM FLAT HEAD SCREW M5x16mm (10pcs) #94952 TITANIUM FLAT HEAD SCREW M5x20mm (10pcs) These screws require a T20 TORX wrench: #94953 TITANIUM TP. FLAT HEAD SCREW M4x15mm (10pcs). ...
AccessGUDID - MONOPOLY (04047844007099)- Indications for Use: The MONOPOLY Pedicle Screw System is intended to help provide immobilization and stabilization of spinal segments as an adjunct to fusion of the thoracic, lumbar and/or sacral spine (T1-S1), specifically as follows: When used as a pedicle screw fixation system of the non-cervical posterior spine in skeletally mature patients, the MONOPOLY Pedicle Screw System is intended for one or more of the following indications: - degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies) - degenerative spondylolisthesis with objective evidence of neurologic impairment - fracture - dislocation - spinal tumor, and/or - failed previous fusion (pseudarthrosis) When used as a non-cervical and non-pedicle screw fixation system, the MONOPOLY Pedicle Screw System is intended for the following indications: - degenerative disc disease (as defined by back pain of discogenic
AccessGUDID - MONOPOLY (04047844004661)- Indications for Use: The MONOPOLY Pedicle Screw System is intended to help provide immobilization and stabilization of spinal segments as an adjunct to fusion of the thoracic, lumbar and/or sacral spine (T1-S1), specifically as follows: When used as a pedicle screw fixation system of the non-cervical posterior spine in skeletally mature patients, the MONOPOLY Pedicle Screw System is intended for one or more of the following indications: - degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies) - degenerative spondylolisthesis with objective evidence of neurologic impairment - fracture - dislocation - spinal tumor, and/or - failed previous fusion (pseudarthrosis) When used as a non-cervical and non-pedicle screw fixation system, the MONOPOLY Pedicle Screw System is intended for the following indications: - degenerative disc disease (as defined by back pain of discogenic
TY - JOUR. T1 - Biomechanics of transvertebral screw fixation in the thoracic spine. T2 - An in vitro study. AU - Rodriguez-Martinez, Nestor G.. AU - Savardekar, Amey. AU - Nottmeier, Eric W.. AU - Pirris, Stephen. AU - Reyes, Phillip M.. AU - Newcomb, Anna G U S. AU - Mendes, George A C. AU - Kalb, Samuel. AU - Theodore, Nicholas. AU - Crawford, Neil R.. PY - 2016/8/1. Y1 - 2016/8/1. N2 - OBJECTIVE: Transvertebral screws provide stability in thoracic spinal fixation surgeries, with their use mainly limited to patients who require a pedicle screw salvage technique. However, the biomechanical impact of transvertebral screws alone, when they are inserted across 2 vertebral bodies, has not been studied. In this study, the authors assessed the stability offered by a transvertebral screw construct for posterior instrumentation and compared its biomechanical performance to that of standard bilateral pedicle screw and rod (PSR) fixation. METHODS: Fourteen fresh human cadaveric thoracic spine segments ...
Summary. The Acumed Cannulated Screw System is intended for fixation of fractures, fusions, and osteotomies of large and small bones appropriate for the size of the device. All screws are cannulated in order to be used over a guide wire, and each screw is either partially or fully threaded using a cancellous thread form.. The global Cannulated Screw System market was xx million US$ in 2018 and is expected to xx million US$ by the end of 2025, growing at a CAGR of xx% between 2019 and 2025.. This report studies the Cannulated Screw System market size (value and volume) by players, regions, product types and end industries, history data 2014-2018 and forecast data 2019-2025; This report also studies the global market competition landscape, market drivers and trends, opportunities and challenges, risks and entry barriers, sales channels, distributors and Porters Five Forces Analysis.. Geographically, this report is segmented into several key regions, with sales, revenue, market share and growth ...
A semi-constrained screw and a cervical plate assembly that engages to a cervical area of the human vertebrae system are disclosed. The semi-constrained screw and cervical plate assembly includes a cervical plate and one or more semi-constrained bone screws. Each semi-constrained bone screw includes an elongated shank, which is mechanically and releasably coupled to a head portion. The head portion includes one or more threaded segments which define one or more slits therebetween. As the semi-constrained bone screw is driven through the screw opening in the cervical plate and into the bone, the head portion allows poly-axial movement of the shank relative to the head portion.
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Biomechanical comparison of translaminar screw versus pedicle screw supplementation of anterior femoral ring allografts in one-level lumbar spine fusion.
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A method of compacting and stabilizing bone in the spine using an expandable screw and bone filler. The method includes placing an expanding screw through a pedicle and into a fractured vertebral body using established techniques; and expanding the screw within the body to create a cavity by tamping bone around the expanded aspect of the screw. The screw can be expanded and rotated about its rotational-axis to tamp bone adjacent to the expanded screw. After compaction, the screw is removed and the cavity is filled with bone filler.
A device to releasably secure an object to a bone is disclosed. The device has a rotation restricting member which, while engaging the bone, prevents rotation of the member. The device also comprises an axial supporting member which axially secures the device to the bone, and preferably comprises a bone screw. While the bone screw and rotation restricting member engage the bone, a fastening mechanism fastens the rotation restricting member to the bone screw. In this way, objects can be releasably secured to the rotation restricting member or the bone screw by means of a clamp to temporarily axially and rotationally secure the objects to the bone. Preferably, the rotation restricting member comprises a sleeve and the fastening mechanism comprises a nut which engages threads on the bone screw. The sleeve comprises serrated teeth which, when biased towards the bone, engage the bone to restrict rotation of the sleeve. Rotation of the nut about the threads on the bone screw axially bias the sleeve towards