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A pedicle screw coupling construct for a pedicle screw construct provides fixation of angular orientation thereof relative to a pedicle screw independent of fixation of a received spinal rod to the coupling construct. The pedicle screw construct forms one component or element in a spinal fixation sy

A pedicle screw coupling construct for a pedicle screw construct provides fixation of angular orientation thereof relative to a pedicle screw independent of fixation of a received spinal rod to the coupling construct. The pedicle screw construct forms one component or element in a spinal fixation system. The independent fixation coupling construct also provides for fixation of the angular orientation of the coupling construct while the coupling construct has received the spinal rod. In another form, a coupling head or construct is configured to allow a pedicle screw shaft to pass therethrough but retain the pedicle screw head for rotation of the coupling head about the pedicle screw head. The coupling head or construct is also configured to allow at least a 45° arc of pivot or articulation about a pedicle screw shaft relative to a longitudinal axis of a spinal rod received in the body. This allows the head with a received spinal rod to fold, bend or pivot relative to the pedicle screw shaft, particularly to a greater degree than the prior art.

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1. A pedicle screw coupling device for holding a spinal rod relative to a pedicle screw, the pedicle screw coupling device comprising: a coupling head having a bore therethrough and defining a first end sized to receive a pedicle screw shaft and a pedicle screw head of the pedicle screw and a second

1. A pedicle screw coupling device for holding a spinal rod relative to a pedicle screw, the pedicle screw coupling device comprising: a coupling head having a bore therethrough and defining a first end sized to receive a pedicle screw shaft and a pedicle screw head of the pedicle screw and a second end sized to allow the pedicle screw shaft to pass through but rotatably retain the pedicle screw head, the coupling head further including a channel configured to receive the spinal rod;a collar releasably rotatably coupled directly to the coupling head;a sleeve received in the coupling head bore between the pedicle screw head and the collar, the sleeve having a first end abutting the pedicle screw head and a second end abutting the collar;a spinal rod retention element configured to be received through the collar and to fix the spinal rod received in the channel of the coupling head relative to the coupling head;wherein the collar applies pressure to the pedicle screw head through the sleeve to fix an orientation of the coupling head relative to the pedicle screw head responsive to the collar being rotatably coupled directly to the coupling head;wherein the fixation of the spinal rod relative to the coupling head is separate and independent of the fixation of the coupling head relative to the pedicle screw head. 2. The pedicle screw coupling device of claim 1 wherein the sleeve includes a sidewall having a taper extending from the second end to the first end. 3. The pedicle screw coupling device of claim 1 wherein the coupling head has undercut channels that mateably receive the collar in a snap fit fashion during fixation. 4. The pedicle screw coupling device of claim 1 wherein the coupling head has threads that mateably receive the collar during fixation. 5. The pedicle screw coupling device of claim 1 wherein the spinal rod channel of the coupling head maintains the spinal rod axially above the pedicle screw head. 6. The pedicle screw coupling device of claim 5 wherein the spinal rod is maintained spaced apart from the pedicle screw head. 7. The pedicle screw coupling device of claim 1 wherein the coupling head has a pair of grooves that mateably receive a pair of flanges on the collar during fixation. 8. The pedicle screw coupling device of claim 7 wherein the collar comprises a first detent that engages the sleeve when rotated. 9. The pedicle screw coupling device of claim 8 wherein the first detent is located on a bottom surface of the collar adjacent one of the pair of flanges, and wherein the collar comprises a second detent located on the bottom surface adjacent the other of the pair of flanges. 10. The pedicle screw coupling device of claim 9 wherein each of the detents comprises a ramped portion and a stop surface that are rotated into pressure engagement with an upper surface of the sleeve. 11. The pedicle screw coupling device of claim 9 wherein the spinal rod is received in the slot and retained against the first seating surface and the second seating surface. 12. The pedicle screw coupling device of claim 1 wherein the collar comprises a pair of notches sized to receive a tool for rotating the collar relative to coupling head. 13. The pedicle screw coupling device of claim 1 wherein the sleeve comprises a slot that defines a first seating surface and a second seating surface. 14. A coupling device for holding a spinal rod relative to a pedicle screw having a pedicle screw shaft and a pedicle screw head, the coupling device comprising: a coupling head having a bore and a channel, the bore having a first end sized to allow the pedicle screw shaft and the pedicle screw head to pass through and a second end sized to allow the pedicle screw shaft to pass through but rotatably retain the pedicle screw head, the channel configured to receive the spinal rod;a sleeve received in the bore of the coupling head and having a first end and a second end, the first end configured to abut the pedicle screw head;a collar releasably rotatably coupled directly to the coupling head and abutting the second end of the sleeve, wherein an angular orientation of the coupling head is fixed relative to the pedicle screw by pressure applied by the collar to the pedicle screw head through the sleeve responsive to the collar being rotatably coupled directly to the coupling head;a spinal rod retention element received through the collar to fix the spinal rod relative to the coupling head;wherein the angular orientation of the coupling head relative to the pedicle screw head is separately and releasably fixed independent of the releasable fixation of the spinal rod to the coupling head. 15. The coupling device of claim 14 wherein an exterior feature of the collar is coupled to an interior feature of the coupling head by a rotating movement of the collar relative to the coupling head. 16. The coupling device of claim 15 wherein the exterior feature of the collar comprises a flange and the interior feature of the coupling head comprises a groove. 17. The coupling device of claim 16 wherein the collar comprises a first detent that engages the sleeve when rotated. 18. The coupling device of claim 16 wherein the collar comprises a second detent, the first detent is located on a bottom surface of the collar adjacent one of the pair of flanges, and the second detent is located on the bottom surface adjacent the other of the pair of flanges. 19. The coupling device of claim 16 wherein each of the detents comprises a ramped portion and a stop surface that are rotated into pressure engagement with an upper surface of the sleeve.