Orthopedic fixation devices and methods of installation thereof

1. A method of installing an orthopedic fixation device comprising:

inserting a locking clamp assembly into a bore in a coupling element, wherein the locking clamp assembly comprises a wedge element and a clamp element secured to the wedge element;

moving the locking clamp assembly through the bore in the coupling element until a recessed surface on the wedge element engages a protuberance on an interior surface of the coupling element to secure the locking clamp assembly in the coupling element;

inserting a head of a bone fastener into the clamp element such that the clamp element engages the head; and

moving the wedge element downward past the protuberance on the interior surface of the coupling element such that exterior surfaces of the clamp element engage the interior surface of the coupling element forcing the clamp element to clamp onto the head of the bone fastener to secure the bone fastener in the coupling element,

wherein the wedge element comprises downwardly extending tabs configured to be received in corresponding slots in the head of the bone fastener.

2. The method of claim 1 , wherein the bone fastener is loaded from the bottom of the coupling element.

3. The method of claim 1 , wherein the locking clamp assembly is assembled prior to insertion into the coupling element.

4. The method of claim 1 , wherein after the bone fastener is inserted into the clamp element, the locking clamp assembly and coupling element are free to rotate with respect to the bone fastener.

5. The method of claim 1 further comprising loading a rod into the coupling element.

6. The method of claim 1 , wherein the bone fastener comprises a head and an extension that extends from the head, wherein the head is configured for loading into the coupling element through the bottom of the bore in the coupling element.

7. The method of claim 6 , wherein the clamp element comprises a first clamp portion and a second clamp portion, wherein the first and second clamp portions each have an outer surface and an inner surface, wherein at least a portion of the outer surface is configured to engage the interior surface of the coupling element, and wherein at least a portion of the inner surface is configured to engage the head of the bone fastener.

8. The method of claim 7 , wherein the wedge element comprises a wedge bore configured to receive an upper portion of the clamp element and an inner wedge surface disposed around at least a lower portion of the wedge bore, wherein the inner wedge surface is configured to engage at least portion of the outer surface of the first and second clamp portions.

9. A method of installing an orthopedic fixation device comprising:

implanting a bone fastener into a vertebrae;

securing the bone fastener, the bone fastener comprising a head, to a tulip element, the tulip element containing a locking clamp assembly within a bore in the tulip element, wherein the locking clamp assembly comprises a wedge element and a clamp element secured to the wedge element, wherein a recessed surface on the wedge element engages a protuberance on an interior surface of the tulip element to secure the locking clamp assembly in the tulip element;

rotating the tulip element to a desired position with respect to the bone fastener; and

locking the position of the tulip element relative to the bone fastener by moving the wedge element downward past the protuberance on the interior surface of the tulip element such that exterior surfaces of the clamp element engage the interior surface of the tulip element forcing the clamp element to clamp onto the bone fastener,

wherein the wedge element comprises downwardly extending tabs configured to be received in corresponding slots in the head of the bone fastener.

10. The method of claim 9 , wherein the bone fastener is loaded from the bottom of the tulip element.

11. The method of claim 9 further comprising loading a rod into the tulip element such that the rod is secured in a fixed position relative to the vertebrae.

12. The method of claim 9 , wherein the tulip element comprises a body and arms that extend from the bore, wherein an interior surface of each arm comprises a threaded portion, a slot above the threaded portion, and a recessed surface above the slot, wherein at least a portion of the interior surface of the tulip forms a conical wedge.

13. The method of claim 12 , wherein the bone fastener comprises an extension that extends from the head, wherein the head is configured for loading into the tulip element through the bottom of the bore.

14. The method of claim 13 , wherein the clamp element comprises a first clamp portion and a second clamp portion, wherein the first and second clamp portions each have an outer surface, an inner surface, and an upper lip, wherein at least a portion of the outer surface is configured to engage the conical wedge formed by the interior surface of the tulip element, and wherein at least a portion of the inner surface is configured to engage the head of the bone fastener.

15. The method of claim 14 , wherein the wedge element comprises a wedge bore configured to receive an upper portion of the clamp element, an inner wedge surface disposed around at least a lower portion of the wedge bore, and an outer surface that is generally elliptical in shape, wherein the inner wedge surface is configured to engage at least portion of the outer surface of the first and second clamp portions, and wherein the outer surface of the wedge element comprises a recessed surface configured to engage the protuberances on the interior surface of the tulip element.

16. The method of claim 15 further comprising coupling a locking cap assembly to the tulip element, wherein the locking cap assembly comprises a body having at least one lower tab that extends from the body and at least one upper tab that extends from the body, wherein the upper tab is positioned above the lower tab.