Spinal correction system and method

1. A spinal construct comprising:

at least one tether extending between a first end connectable with a first fastener connected with spinal tissue and a second end connectable with a second fastener connected with spinal tissue, the at least one tether having a tension between the fasteners; and

a ratchet engageable with the at least one tether to adjust the tension, the ratchet includes a rotatable reel configured for rotation in two directions to adjust the tension, the rotatable reel being axially movable between a first configuration in which the reel is rotatable relative to the ratchet and a second configuration in which rotation of the reel is resisted.

2. A spinal construct as recited in claim 1 , wherein the at least one tether includes a first tether connected to the first fastener and the ratchet and a second tether connected to the second fastener and the ratchet.

3. A spinal construct as recited in claim 1 , further comprising a third fastener including the ratchet and being configured for penetrating spinal tissue between the first fastener and the second fastener.

4. A spinal construct as recited in claim 3 , wherein the at least one tether includes a first tether having an adjustable tension and being connected with the first fastener and the ratchet, and a second tether having a fixed tension and being connected with the second fastener and the third fastener.

5. A spinal construct as recited in claim 1 , wherein the rotatable reel includes a male mating part engageable with the ratchet.

6. A spinal construct as recited in claim 1 , further comprising a third fastener configured for penetrating spinal tissue and including the ratchet, the ratchet comprising a rotatable reel engagable with the tether to selectively adjust the tension.

7. A spinal construct as recited in claim 6 , wherein the reel is lockable to prevent rotation thereof.

8. A spinal construct as recited in claim 7 , wherein the reel is biased to a locked configuration.

9. A spinal construct as recited in claim 1 , wherein the ratchet is configured for magnetic actuation to adjust the tension.

10. A spinal construct as recited in claim 1 , wherein the ratchet is configured to dynamically adjust the tension.

11. A spinal construct as recited in claim 1 , wherein at least one of the fasteners comprises a C-shaped clamp having a coupling member engagable with the tether.

12. A spinal construct as recited in claim 1 , wherein at least one of the fasteners comprises a clamp having an inner surface defining ribs.

13. A spinal construct comprising:

a fastener including a ratchet having a reel engageable with an intermediate portion of a tether having a tension between ends thereof,

wherein the reel is rotatable in two directions relative to the ratchet to adjust the tension, and wherein the reel is axially movable between a first configuration such that the reel is rotatable relative to the ratchet and a second configuration such that the rotation of the reel is resisted.

14. A spinal construct as recited in claim 13 , wherein the ratchet extends between a first end defining a first cavity configured for disposal of a first end of the reel in the second configuration and a second end defining a second cavity configured for disposal of a second end of the reel.

15. A spinal construct as recited in claim 14 , wherein the ratchet includes a biasing member disposed in the second cavity between the second end of the ratchet and the second end of the reel to resiliently bias the reel to the second configuration.

16. A spinal construct as recited in claim 13 , wherein the reel includes an inner surface defining a bore configured for disposal of the at least one tether.

17. A method of treating a spine disorder, the method comprising the steps of:

providing at least one tether extending between a first end connected with a first fastener and a second end connected with a second fastener, the at least one tether having a tension between the fasteners;

providing a ratchet for connection with an intermediate portion of the at least one tether;

engaging the first fastener with a first costo-vertebral surface and engaging the second fastener with a second costo-vertebral surface; and

engaging the ratchet and a reel to rotate the reel in two directions to selectively adjust the tension, wherein the step of engaging the ratchet comprises axially translating the reel between a first configuration such that the reel is rotatable relative to the ratchet and a second configuration such that rotation of the reel is resisted.