Orthopedic implant assembly

Abstract

An orthopedic implant assembly comprising a stabilizing element, a securing element which attaches the stabilizing element to the bone, and a stopping member in the stabilizing element which inhibits the securing element from loosening or backing out of the bone. The stabilizing element has at least one bore with the stopping member therein. In one embodiment, the stopping member has a reversibly expandable inner and outer diameter to allow the securing element to pass posteriorly through the stopping member, but thereafter prevent or inhibit the securing element from anteriorly backing out of the posterior section of the transverse passageway. In another embodiment, the stopping member is secured to an anterior section of the transverse passageway, and the head of the securing element generally has a compressed configuration with a diameter less than the diameter of the stopping member, in which configuration the head can pass through the stopping member, and an uncompressed configuration with a diameter larger than the diameter of the stopping member.

1. An orthopedic implant assembly, comprising
 a) a stabilizing element having an anterior surface, a posterior surface, and at least one bore, the bore having a first opening in the anterior surface, a second opening in the posterior surface smaller than the first opening, and a transverse passageway extending from the first opening to the second opening; 
 b) a biased stopping member defining at least in part a reversibly expandable passageway having a smaller diameter configuration and a larger diameter configuration; and 
 c) a securing element having an elongated body, and a head at one end of the body and integral therewith, the head having a maximum diameter greater than the smaller diameter configuration of the passageway defined by the biased stopping member and greater than the second opening in the stabilizing element, so that the head is retained within the transverse passageway between the biased stopping member and the second opening in the stabilizing element. 
 
     
     
       2. The assembly of  claim 1  wherein the biased stopping member comprises a collar defining a passageway, enlargeable from an unexpanded inner diameter to an expanded inner diameter, wherein the head of the securing element has a maximum diameter greater than the unexpanded inner diameter of the collar and less than the expanded inner diameter of the collar. 
     
     
       3. The assembly of  claim 2  wherein the head of the securing element has a curved posterior surface which has a minimum outer diameter smaller than the unexpanded inner diameter of the collar, configured to be displaceable posteriorly of the collar through the passageway of the collar from an anterior to a posterior surface thereof. 
     
     
       4. The assembly of  claim 2  wherein the bore has a groove in an anterior portion of the transverse passageway having a diameter and a height, and wherein the collar is a reversibly expandable annular collar seated in the groove, the collar having an expanded outer diameter, and an unexpanded outer diameter which is less than the diameter of the groove and greater than a diameter of the transverse passageway. 
     
     
       5. The assembly of  claim 4  wherein the head of the securing element has a curved posterior surface which has a minimum outer diameter smaller than the unexpanded inner diameter of the collar, and which is configured to contact the collar anterior surface and expand the collar as the head is displaced posteriorly through the collar passageway. 
     
     
       6. The assembly of  claim 2  wherein the collar is secured to an anterior section of the transverse passageway, and has a plurality of slots and circumferentially spaced members, the circumferentially spaced members having a deflected configuration defining the expanded inner diameter of the collar. 
     
     
       7. The assembly of  claim 6  wherein the head of the securing element has a curved posterior surface which has a minimum outer diameter smaller than the unexpanded inner diameter of the collar, and which is configured to contact the collar anterior surface and deflect the circumferentially spaced members away from a longitudinal axis of the transverse passageway as the head is displaced posteriorly through the collar passageway. 
     
     
       8. The assembly of  claim 6  wherein the collar has an anterior surface which tapers toward a center of the transverse passageway. 
     
     
       9. The assembly of  claim 3  wherein a posterior portion of the transverse passageway is curved to conform to the curved posterior surface of the head. 
     
     
       10. The assembly of  claim 1  wherein the head of the securing element is longitudinally displaceable within the transverse passageway between a posterior surface of the biased stopping member and the second opening in the posterior surface of the stabilizing element. 
     
     
       11. The assembly of  claim 10  wherein the body of the securing element has a diameter smaller than the second opening in the stabilizing element, and the securing element may be angularly displaced within the transverse passageway and the second opening in the stabilizing element. 
     
     
       12. The assembly of  claim 1  wherein the stabilizing element includes at least two bores. 
     
     
       13. The assembly of  claim 1  wherein the stabilizing element is configured to conform to and extend between at least two bone segments. 
     
     
       14. The assembly of  claim 13  wherein the stabilizing element has a curved surface. 
     
     
       15. The assembly of  claim 1  wherein the stabilizing element is selected from the group consisting of rods and plates. 
     
     
       16. The assembly of  claim 1  wherein the securing element is selected from the group consisting of screws and nails. 
     
     
       17. The assembly of  claim 2  wherein the collar is formed of an elastically deformable material. 
     
     
       18. The assembly of  claim 2  wherein the collar is formed of a material selected from the group consisting of titanium and superelastic material. 
     
     
       19. The assembly of  claim 2  wherein the collar has a posterior surface perpendicular to a longitudinal axis of the transverse passageway. 
     
     
       20. The assembly of  claim 4  wherein the collar has a height less than the height of the groove. 
     
     
       21. A method of attaching an orthopedic implant assembly to a bone of a patient, comprising
 a) positioning a stabilizing element against a surface of the patient's bone, the stabilizing element having an anterior surface, a posterior surface, and at least one bore, the bore having a first opening in the anterior surface, a second opening in the posterior surface smaller than the first opening, and a transverse passageway extending from the first opening to the second opening, and a biased stopping member within the bore and defining at least in part a reversibly expandable passageway having a smaller diameter configuration and a larger diameter configuration; 
 b) providing a securing element having an elongated body, and a head at one end of the body and integral therewith, the head having a maximum diameter greater than the smaller diameter configuration of the passageway defined by the biased stopping member and greater than the second opening in the stabilizing element, so that the head is retained within the transverse passageway between the biased stopping member and the second opening in the stabilizing element; 
 c) positioning the body of the securing element in the transverse passageway and posteriorly advancing the head of the securing element within the passageway defined by the biased stopping member and thereby displacing the biased stopping member to form the larger diameter configuration passageway defined thereby; and 
 d) attaching the stabilizing element to the bone by advancing the head of the securing element posteriorly of the biased stopping member so that the passageway defined thereby returns to the smaller diameter configuration, to position the head within a posterior section of the transverse passageway between the biased stopping member and the second opening in the stabilizing element, and to position the body of the securing element within the patient's bone, so that the securing element is attached to the bone and is retained within the posterior section of the transverse passageway of the stabilizing element. 
 
     
     
       22. The method of  claim 21  including, after the head of the securing element is positioned between the biased stopping member and the second opening in the stabilizing element, the step of longitudinally and angularly displacing the head of the securing element within the transverse passageway, so that the body of the securing element is positioned at an angle within the patient's bone relative to the surface of the bone. 
     
     
       23. An orthopedic implant assembly, comprising
 a) a stabilizing element having an anterior surface, a posterior surface, and at least one bore, the bore having a first opening in the anterior surface, a second opening in the posterior surface smaller than the first opening, and a transverse passageway extending from the first opening to the second opening, and a stopping member at an anterior section of the transverse passageway; and 
 b) a securing element having an elongated body and a head secured to one end of the body, the head having a reversibly compressed configuration with a compressed diameter less than the diameter of the first opening and an uncompressed configuration with a diameter greater than a diameter of the stopping member and the second opening, so that the head of the securing element is retained within the transverse passageway between the stopping member and the second opening in the stabilizing element. 
 
     
     
       24. The assembly of  claim 23  wherein the head of the securing element is configured to be displaceable posteriorly through the stopping member from an anterior to a posterior surface thereof. 
     
     
       25. The assembly of  claim 23  wherein the head of the securing element has a plurality of slots and circumferentially disposed members, the circumferentially disposed members having posterior ends secured to the body of the securing element, and anterior ends radially moveable toward a longitudinal axis of the head of the securing element to form the compressed configuration and away from the longitudinal axis to form the uncompressed configuration. 
     
     
       26. The assembly of  claim 23  wherein the stopping member is at the anterior end of the transverse passageway and defines the first opening in the stabilizing element. 
     
     
       27. The assembly of  claim 23  wherein the stopping member has a posterior surface perpendicular to a longitudinal axis of the transverse passageway. 
     
     
       28. A method of attaching an orthopedic implant assembly to a bone of a patient, comprising
 a) positioning a stabilizing element against a surface of the patient's bone, the stabilizing element having an anterior surface, a posterior surface, and at least one bore, the bore having a first opening in the anterior surface, a second opening in the posterior surface smaller than the first opening, and a transverse passageway extending from the first opening to the second opening, and a stopping member at an anterior section of the transverse passageway; 
 b) providing a securing element having an elongated body and a head secured to one end of the body, the head having a reversibly compressed configuration with a compressed diameter less than a diameter of the first opening and an uncompressed configuration with a diameter greater than the diameter of the stopping member and the second opening, so that the head of the securing element is retained within the transverse passageway between the stopping member and the second opening in the stabilizing element; 
 c) positioning the body of the securing element in the transverse passageway and posteriorly advancing the head of the securing element within a passageway defined by the stopping member and thereby compressing the diameter of the head of the securing element; and 
 d) attaching the stabilizing element to the bone by advancing the head of the securing element posteriorly of the stopping member so that the diameter of the head of the securing element returns to the uncompressed configuration, to position the head within a posterior section of the transverse passageway between the stopping member and the second opening in the stabilizing element and the body of the securing element within the patient's bone, so that the securing element is attached to the bone and is retained within the posterior section of the transverse passageway of the stabilizing element. 
 
     
     
       29. The assembly of claim 4 wherein the collar has a height less than the height of the groove. 
     
     
       30. The assembly of claim 10 wherein the body of the securing element has a transverse dimension smaller than the second opening of the stabilizing element, and wherein the securing element may be angularly displaced within a posterior portion of the bore of the stabilizing element. 
     
     
       31. The assembly of claim 10 wherein the stabilizing element is selected from the group consisting of rods and plates. 
     
     
       32. The assembly of claim 10 wherein the securing element is selected from the group consisting of screws and nails. 
     
     
       33. The assembly of claim 13 wherein the stabilizing element has a concave posterior surface. 
     
     
       34. The assembly of claim 1 wherein the stabilizing element includes at least two bores. 
     
     
       35. The assembly of claim 1 wherein the stabilizing element is configured to conform to and extend between at least two bone segments. 
     
     
       36. A method of attaching an orthopedic implant assembly to a bone of a patient, comprising
 a) providing
 a securing member with an elongated body and an enlarged integral portion having a maximum transverse dimension, 
 an attachment member which has an anterior surface and a posterior surface and which has at least one bore extending through the attachment member from the anterior surface to the posterior surface and is configured to receive the securing member, the bore having an anterior bore portion, and a posterior bore portion with at least one transverse dimension smaller than a transverse dimension of the anterior bore portion and smaller than the maximum transverse dimension of the enlarged integral portion of the securing member, and 
 a stopping member which has a first configuration which allows passage of the enlarged integral portion of the securing member and has a second configuration that reduces a transverse dimension of the bore that is smaller than the maximum transverse dimension of the enlarged integral portion of the securing member in order to retain the enlarged integral portion of the securing member within the posterior bore portion of the attachment member wherein the stopping member has an anterior surface and a posterior surface; 
   b) positioning the attachment member with at least part of the posterior surface thereof against a surface of the patient's bone; and   c) attaching the securing member to the patient's bone by advancing the securing member within the bore of the attachment member until the enlarged integral portion of the securing member passes the stopping member thereby displacing the stopping member to the first configuration and is disposed in the posterior bore portion, the stopping member then returning to the second configuration to retain the enlarged integral portion within the posterior bore portion; and wherein the enlarged integral portion of the securing member is retained within the posterior bore portion below the posterior surface of the stopping member.   
     
     
       37. The method of claim 36 wherein the securing member is angularly displaceable within the posterior bore portion so that the securing member may be secured within the patient's bone at an angle relative to a longitudinal axis of the bore. 
     
     
       38. An orthopedic implant assembly, comprising:
 a) a securing element with an elongated body and an enlarged head;   b) an attachment member comprising
 an attachment component which has at least one bore configured to receive the securing element, the bore having a first bore portion, and a second bore portion having at least one smaller transverse dimension than transverse dimensions of the first bore portion; 
 a stopping surface which reduces a transverse configuration of the first bore portion to retain the enlarged head of the securing element within the bore of the attachment member between the stopping surface and the second bore portion, and 
 a third bore portion between the stopping surface and the second bore portion having a surface configured to conform at least in part to part of the enlarged head of the securing element received by the bore; and 
   c) the enlarged head of the securing element having a reversibly compressed configuration with transverse dimensions less than the reduced transverse configuration of the first bore portion formed at least in part by the stopping surface and having an uncompressed configuration with a transverse dimension greater than the reduced transverse configuration of the first bore portion and the second bore portion, so that the head of the securing element is retained within the bore between the stopping surface and the second bore portion in the attachment component.   
     
     
       39. The implant assembly of claim 38 wherein the head of the securing element is configured to be displaceable posteriorly through the stopping surface from an anterior to a posterior portion thereof. 
     
     
       40. The implant assembly of claim 38 wherein the head of the securing element has a plurality of slots and circumferentially disposed members having posterior ends secured to the body of the securing element, and anterior ends radially moveable toward a longitudinal axis of the head of the securing element to form the compressed configuration and away from the longitudinal axis to form the uncompressed configuration. 
     
     
       41. The implant assembly of claim 38 wherein the stopping surface is at the anterior end of the bore and defines a first opening in the attachment component. 
     
     
       42. The implant assembly of claim 38 wherein the stopping surface is perpendicular to a longitudinal axis of the bore. 
     
     
       43. A method of attaching an orthopedic implant assembly to a bone of a patient, comprising
 a) providing an attachment member comprising
 an attachment component which has at least one bore configured to receive a securing element with an enlarged head, the bore having a first bore portion, and a second bore portion having at least one smaller transverse dimension than transverse dimensions of the first bore portion, 
 a stopping surface which reduces a transverse configuration of the first bore portion to retain the enlarged head of a securing element within the bore of the attachment member between the stopping surface and the second bore portion; 
   b) positioning the attachment member against a surface of the patient's bone;   c) providing a securing element having an elongated body and an enlarged head at one end of the body which has a reversibly compressed configuration with transverse dimensions less than the reduced transverse configuration of the first bore portion formed by the stopping surface and which has an uncompressed configuration with a transverse dimension greater than the reduced transverse configuration of the second bore portion, so that the head of the securing element is retained within the second bore portion in the attachment component; and   d) attaching the securing element to the patient's bone by advancing the securing element within the bore of the attachment component until the enlarged head of the securing element is in the second bore portion.   
     
     
       44. An orthopedic implant assembly, comprising:
 a. a stabilizing element having an anterior surface, a posterior surface, and at least one bore extending through the stabilizing element from the anterior surface to the posterior surface and the bore having an anterior bore portion with a transverse dimension and a posterior bore portion which has a posterior opening with a transverse dimension smaller than the transverse dimension of the anterior bore portion;   b. a securing element which is configured to be slidably disposed within the bore of the stabilizing element and which has an elongated body and an enlarged integral portion with a maximum transverse dimension; and   c. a stopping member which is at least partially disposed within the bore of the stabilizing element, which has a posterior stopping surface, a first configuration within the bore allowing passage of the securing element into the posterior bore portion with the enlarged integral portion of the securing element disposed in the posterior bore portion posterior to the stopping member and a second configuration within the bore which has smaller transverse dimensions than the first configuration and smaller than the maximum transverse dimension of the enlarged integral portion of the securing element to facilitate retention of the enlarged integral portion of the securing element within the posterior bore portion of the stabilizing element; and wherein the enlarged integral portion of the securing element is retained below the posterior surface of the stopping member.   
     
     
       45. The assembly of claim 44 wherein the stopping member is configured to prevent the back-out of the securing element through the bore of the stabilizing element. 
     
     
       46. The assembly of claim 44 wherein the stopping member is biased to the second configuration. 
     
     
       47. The assembly of claim 46 wherein the stopping member comprises a biased collar having a passageway therethrough. 
     
     
       48. The assembly of claim 47 wherein the bore has a groove in an anterior portion thereof configured to receive the biased collar, and wherein the biased collar is configured to be reversibly expandable when seated in the groove. 
     
     
       49. The assembly of claim 48 wherein the curved posterior surface of the enlarged integral portion of the securing element is configured to expand the collar as the enlarged integral portion of the securing element is displaced posteriorly through the collar passageway. 
     
     
       50. The assembly of claim 49 wherein the curved posterior surface of the enlarged integral portion of the securing element has a minimum transverse dimension smaller than a transverse dimension of the passageway of the unexpanded collar, and which is configured to contact an anterior surface of the collar and deflect the collar away from a longitudinal axis of the collar passageway as the enlarged integral portion of the securing element is displaced posteriorly through the collar passageway. 
     
     
       51. The assembly of claim 50 wherein the collar has an anterior surface which tapers toward the collar passageway. 
     
     
       52. The assembly of claim 51 wherein the posterior bore portion has a curved posterior surface that is configured to receive at least in part the curved posterior surface of the enlarged integral portion of the securing element. 
     
     
       53. The assembly of claim 44 wherein the enlarged integral portion of the securing element has a curved posterior surface. 
     
     
       54. The assembly of claim 44 wherein the enlarged integral portion of the securing element is configured to be longitudinally displaceable within the posterior bore portion of the bore of the stabilizing element. 
     
     
       55. An orthopedic implant assembly, comprising:
 a. a stabilizing element having an anterior surface, a posterior surface, and at least one bore, the bore having an anterior bore portion, a posterior bore portion with a transverse dimension smaller than a transverse dimension of the anterior portion,   b. a stopping member at the anterior portion of the bore; and   c. a securing element having an elongated body and a head secured to the body which is reversibly compressible with a compressed transverse dimension less than the transverse dimension of the anterior portion of the bore and with an uncompressed transverse dimension greater than an inner transverse dimension of the stopping member and the posterior portion of the bore, so that the head of the securing element is retained between the stopping member and the smaller transverse dimension of the posterior portion of the bore of the stabilizing element.   
     
     
       56. The implant assembly of claim 55 wherein the head of the securing element is configured to be displaceable posteriorly through the stopping member from an anterior to a posterior surface thereof. 
     
     
       57. The implant assembly of claim 55 wherein the head of the securing element has a plurality of slots and circumferentially disposed members, the circumferentially disposed members having posterior ends secured to the body of the securing element, and anterior ends radially moveable toward a longitudinal axis of the head of the securing element to form the compressed configuration and away from the longitudinal axis to form the uncompressed configuration. 
     
     
       58. The assembly of claim 55 wherein the stopping member has a posterior surface perpendicular to a longitudinal axis of the bore. 
     
     
       59. An orthopedic attachment assembly, comprising:
 a. an elongated securing element having an enlarged integral portion with a length, an anterior surface, a posterior surface and a transverse dimension;   b. an attachment element which has an anterior surface and a posterior surface and which has at least one bore extending through the attachment element from the anterior surface to the posterior surface and is configured to receive the securing element, the bore having an anterior bore portion, and a posterior bore portion, the posterior bore portion having at least one transverse dimension smaller than the transverse dimension of the enlarged integral portion of the securing element to facilitate retention of the enlarged integral portion of the securing member within the posterior bore portion; and   c. a biased stopping member which has a posterior stopping surface, a first configuration which extends within the bore that is elastically deformed to a second configuration as the enlarged portion of the securing member passes into the posterior bore portion, the biased stopping member returning to the first configuration upon passage of the enlarged integral portion into the posterior bore portion, the posterior stopping surface of the biased stopping member configured to engage with the anterior surface of the enlarged integral portion of the securing member facilitating retention of the enlarged portion of the securing member within the posterior bore portion of the attachment member.   
     
     
       60. The attachment assembly of claim 59 wherein
 the first configuration of the stopping member has inner transverse dimensions that are smaller than transverse dimensions of the enlarged integral portion of the securing member to facilitate retention of the enlarged integral portion of the securing member within the posterior bore portion and   the second configuration of the stopping member has inner transverse dimensions that are greater than transverse dimensions of the enlarged integral portion of the securing member to allow passage of the enlarged integral portion of the securing member into the posterior bore portion.   
     
     
       61. The attachment assembly of claim 59 wherein the securing element having an enlarged integral portion is slidably disposed within the bore. 
     
     
       62. The attachment assembly of claim 61 wherein a portion of the securing member posterior to the enlarged integral portion has transverse dimensions sufficiently smaller than the transverse dimensions of the posterior bore portion so the securing member may be angularly displaced within the bore. 
     
     
       63. The attachment assembly of claim 62 wherein the posterior surface of the enlarged integral portion of the securing member is configured at least in part to conform to the posterior surface of the posterior bore portion to facilitate angulation of the securing member within the posterior bore portion. 
     
     
       64. The attachment assembly of claim 63 wherein the posterior surface of the posterior bore portion has a bowl shape. 
     
     
       65. The attachment assembly of claim 64 wherein the bowl-shaped posterior surface of the posterior bore portion at least in part is a hemispherical zone. 
     
     
       66. The attachment assembly of claim 61 wherein the securing member is selected from the group consisting of screws and nails. 
     
     
       67. The attachment assembly of claim 61 wherein a posterior surface of the posterior bore portion is configured to conform at least in part to the posterior surface of the enlarged integral portion of the securing member so as to facilitate angular displacement within the posterior bore portion. 
     
     
       68. The attachment assembly of claim 71 wherein the collar is formed of an elastically deformable material. 
     
     
       69. The attachment assembly of claim 71 wherein the collar is formed of a material selected from the group consisting of titanium and superelastic material. 
     
     
       70. The attachment assembly of claim 71 wherein the collar has a posterior surface perpendicular to a longitudinal axis of the bore extending through the attachment member. 
     
     
       71. The attachment assembly of claim 59 wherein the biased stopping member is a collar having at least in part a passageway enlargeable from a first inner dimension to a second inner dimension by the passage of the enlarged integral portion of the securing member therethrough. 
     
     
       72. The attachment assembly of claim 71 wherein the bore has a groove which receives the collar. 
     
     
       73. The attachment assembly of claim 71 wherein the enlarged integral portion of the securing member has a curved posterior surface which is configured to contact an anterior surface of the collar and expand the collar as the enlarged integral portion of the securing member is displaced posteriorly through the collar passageway. 
     
     
       74. The attachment assembly of claim 73 wherein the anterior surface of the collar tapers inwardly toward the collar passageway. 
     
     
       75. The attachment assembly of claim 59 wherein the attachment member includes at least two bores. 
     
     
       76. The attachment assembly of claim 59 wherein the attachment member is configured to conform to and extend between at least two bone segments. 
     
     
       77. The attachment assembly of claim 59 wherein the posterior surface of the attachment member is at least in part a concave surface. 
     
     
       78. The attachment assembly of claim 59 wherein the attachment member is selected from the group consisting of rods and plates. 
     
     
       79. The attachment assembly of claim 59, wherein
 a. the enlarged integral portion of the elongated securing member has a curved posterior surface; and   b. the posterior bore portion has a curved posterior surface configured to conform at least in part to part of the curved posterior surface of the enlarged integral portion of the securing member received by the bore.   
     
     
       80. The assembly of claim 59 wherein the stopping element comprises a biased collar. 
     
     
       81. The assembly of claim 80 wherein the biased collar is elastically deformable to the second configuration. 
     
     
       82. The assembly of claim 81 wherein the biased collar extends at least partially within the bore of the stabilizing element. 
     
     
       83. The attachment assembly of claim 59, wherein the stopping member is a biased stopping member which reduces a transverse configuration of the anterior bore portion to retain the enlarged integral portion of the securing member within the posterior bore portion of the attachment member. 
     
     
       84. The attachment assembly of clam 59 wherein the biased stopping member resiliently returns to the first configuration after passage of the enlarged integral portion of the securing member. 
     
     
       85. The orthopedic attachment assembly of claim 59 wherein the posterior bore portion has a length sufficiently greater than the length of the enlarged integral portion of the securing element so that the enlarged integral portion of the securing element is longitudinally displaceable within the posterior bore portion when retained therein. 
     
     
       86. The orthopedic attachment assembly of claim 59 wherein,
 a. the elongated securing element has an enlarged integral portion with a length, a posterior surface and a transverse dimension and a shaft extending from the enlarged integral portion configured to be secured within bone;   b. the attachment element has an anterior surface and a posterior surface and has at least one bore extending through the attachment element from the anterior surface to the posterior surface and is configured to receive the securing element, the bore having an anterior bore portion, a posterior bore portion having at least one transverse dimension smaller than the transverse dimension of the enlarged integral portion of the securing element to retain the enlarged integral portion of the securing element within the posterior bore portion; and   c. the stopping member defines in part a passageway in the posterior bore portion, said posterior bore portion being longer than the length of the enlarged integral portion of the securing element to allow longitudinal displacement of the enlarged integral portion of the securing element within the posterior bore portion.   
     
     
       87. The orthopedic attachment assembly of claim 86 wherein the securing element has a portion posterior to the enlarged integral portion that has a transverse dimension smaller than a transverse dimension of an opening in the posterior bore portion to provide angular displacement of the securing element within the posterior bore portion. 
     
     
       88. The orthopedic attachment assembly of claim 87 wherein the enlarged integral portion of the securing element has a maximum transverse dimension which is greater than the second transverse dimension of the stopping member. 
     
     
       89. The orthopedic attachment assembly of claim 88 wherein the enlarged integral portion of the securing element has a tapered posterior surface configured to expand the stopping member upon the passage therethrough. 
     
     
       90. The orthopedic attachment assembly of claim 86 wherein the second configuration of the stopping member has a transverse dimension that is larger than the transverse dimension of the stopping member in the first configuration. 
     
     
       91. The assembly of claim 59 wherein the posterior stopping surface of the stopping member is perpendicular to the longitudinal axis of the bore. 
     
     
       92. An orthopedic attachment assembly, comprising:
 a. an elongated securing member having a biased enlarged portion with a length, an anterior surface, a posterior surface and a transverse dimension;   b. an attachment member which has an anterior surface and a posterior surface and which has at least one bore extending through the attachment member from the anterior surface to the posterior surface and is configured to receive the securing member, the bore having an anterior bore portion, a posterior bore portion having at least one transverse dimension smaller than the transverse dimension of the biased enlarged portion of the securing member to facilitate retention of the enlarged portion of the securing member within the posterior bore portion; and   c. a stopping member which has an anterior surface, and a posterior stopping surface which extends within the bore;   d. the biased enlarged portion of the securing member is elastically deformed from a first configuration to a second configuration as the biased enlarged portion passes the stopping member during the passage of the biased enlarged portion of the securing member into the posterior bore portion of the attachment member, the biased enlarged portion of the securing member returning to the first configuration after passage of the biased enlarged portion into the posterior bore portion of the attachment member, engagement of the posterior stopping surface of the stopping member with the anterior surface of the biased enlarged portion of the securing member facilitating retention of the biased enlarged integral portion of the securing member within the posterior bore portion of the attachment member.   
     
     
       93. The orthopedic implant assembly of claim 92 wherein the biased enlarged portion of the securing element comprises at least one resilient member that deflects longitudinally when the securing element is advanced posteriorly through the bore of the stabilizing element. 
     
     
       94. The assembly of claim 92 wherein the biased enlarged portion of the securing element comprises a biased collar. 
     
     
       95. The assembly of claim 92 wherein the compressible part of the enlarged portion of the securing element comprises at least one circumferentially disposed member. 
     
     
       96. The assembly of claim 95 wherein the at least one circumferentially disposed member has a posterior end secured to the shaft of the securing element. 
     
     
       97. The assembly of claim 96 wherein the securing element comprises a plurality of circumferentially disposed members having posterior ends secured to the shaft of the securing element. 
     
     
       98. An orthopedic attachment assembly, comprising:
 a. an elongated securing element having an enlarged integral portion with a length, an anterior surface, a posterior surface and a transverse dimension;   b. an attachment member which has an anterior surface and a posterior surface and which has at least one bore extending through the attachment member from the anterior surface to the posterior surface and is configured to receive the securing element, the bore having an anterior bore portion, a posterior bore portion having at least one transverse dimension smaller than the transverse dimension of the enlarged integral portion of the securing element; and   c. a plurality of biased stopping members that are part of the attachment member, each of said stopping members having a posterior stopping surface, a first configuration wherein the stopping members extend within the bore and wherein the stopping members are elastically deformed by the passage of the enlarged portion of the securing element to a second configuration to allow passage of the enlarged portion of the securing element into the posterior bore portion, the biased stopping members returning to the first configuration upon passage of the enlarged portion and the posterior stopping surfaces configured to engage the anterior surface of the securing element facilitating retention of the enlarged integral portion of the securing element within the posterior bore portion of the attachment member.   
     
     
       99. The orthopedic implant assembly of claim 98 wherein the biased stopping members are contractible fingers. 
     
     
       100. The orthopedic implant assembly of claim 98 wherein the plurality of biased stopping members comprise resilient longitudinally deflectable members which have first un-deflected configurations within the anterior bore portion and deflected configurations which allow the enlarged integral portion of the securing element to pass into the posterior bore portion, the one or more deflectable members having posterior surfaces that are configured to engage an anterior surface of the enlarged integral portion of the securing element to prevent the back-out of the enlarged integral head of the securing element from the posterior bore of the stabilizing element and facilitate retention of the enlarged integral head of securing element within the posterior bore portion. 
     
     
       101. An orthopedic implant assembly, comprising:
 a. a stabilizing element having an anterior surface, a posterior surface, and at least one bore extending through the stabilizing element from the anterior surface to the posterior surface with an anterior bore portion which has a transverse dimension, a posterior bore portion which has a posterior opening with a transverse dimension smaller than the transverse dimension of the anterior bore portion;   b. a securing element having an elongated body and an enlarged integral portion having an anterior surface; and   c. a biased stopping member which has a posterior stopping surface, which has a first configuration within the anterior bore portion that has a first transverse dimension and is elastically deformable to a second configuration within the anterior bore portion that has a second transverse dimension larger than the first transverse dimension that allows the enlarged integral portion of the securing element to pass into the posterior bore portion posterior to the biased stopping member, the biased stopping member returning to the first configuration so that the posterior surface of the stopping member is positioned to engage the anterior surface of the securing element and prevents the securing element from backing out of the posterior bore portion and to facilitate retention of the enlarged integral portion of the securing element within the posterior bore portion.   
     
     
       102. The orthopedic implant assembly of claim 101 wherein the biased stopping member elastically returns from the first configuration back to the second configuration. 
     
     
       103. The assembly of claim 101 wherein the biased stopping member comprises a collar. 
     
     
       104. The assembly of claim 103 wherein the biased collar is disposed in part within a recess of the stabilizing element. 
     
     
       105. The assembly of claim 104 wherein the recess is a groove configured to slidably receive the biased collar.