Bone screw threaded enlarger

1. A bone anchor system comprising:

a fastener comprising:

a shaft having a shaft diameter;

an anchoring projection on the shaft; and

a head at an end of the shaft, the head having a head width larger than the shaft diameter and the anchoring projection; and

a first sizing component configured for connection to the fastener, the first sizing component comprising:

a first body portion having a first outer diameter larger than the shaft diameter, the anchoring projection on the shaft and the head width;

a first bore extending through the first body portion, the first bore sized to receive the shaft diameter;

a first sizing feature located in the first bore to receive the anchoring projection on the shaft;

a first outer surface at the first outer diameter; and

a first circumferential bone engaging feature extending from the first outer surface;

wherein the anchoring projection comprises threading and the first sizing feature comprises mating threading.

2. The system of claim 1 , wherein the first circumferential bone engaging feature comprises first enlarging threading on the first outer surface.

3. The system of claim 2 , wherein a pitch of the first enlarging threading matches a pitch of the threading on the shaft.

4. The system of claim 1 , further comprising a second sizing component, the second sizing component comprising:

a second body portion having a second outer diameter larger than the shaft diameter;

a second bore extending through the second body portion; and

mating threading located in the second bore to receive the threading on the shaft.

5. The system of claim 4 , wherein the second outer diameter is approximately equal to the first outer diameter.

6. The system of claim 4 , wherein:

the first sizing component includes a tapered distal tip; and

the second sizing component includes a countersunk proximal end;

wherein the tapered distal tip fits into the countersunk proximal end.

7. The system of claim 1 , wherein:

the shaft further comprises a tapered end portion opposite the head, the shaft extending over a first length from the head to the tapered end portion; and

the first body portion has a second length approximately equal to the first length.

8. The system of claim 1 , wherein the first circumferential bone engaging feature comprises axially extending teeth.

9. The system of claim 8 , wherein the first body portion further includes a radially extending flange connected to the first outer surface and from which the axially extending teeth extend.

10. The system of claim 9 , wherein the axially extending teeth are circumferentially oriented.

11. The system of claim 9 , further comprising tool-engaging surfaces located on the first body portion on an opposite side of the radially extending flange as the axially extending teeth.

12. The system of claim 9 , wherein the first body portion further comprises first enlarging threading on the first outer surface.

13. The system of claim 1 , wherein the fastener further comprises a stop located along the shaft to abut the first body portion such that when the first sizing component is assembled with the fastener to engage the stop, the bone anchor system comprises in axial sequence a distal end of the shaft of the fastener, the first sizing component, the stop and the head of the fastener.

14. The bone anchor system of claim 1 , wherein the first sizing component is configured for connection to the fastener via engagement of the first sizing feature and the anchoring projection such that the first sizing component is spaced from the head of the fastener.

15. The bone anchor system of claim 12 , wherein the axially extending teeth are spaced from and overlap the first enlarging threading on the first outer surface.

16. The bone anchor system of claim 13 , wherein the stop comprises a radially extending disk attached to the shaft of the fastener spaced from the head.

17. A bone anchor system comprising,

a fastener comprising:

a shaft having a shaft diameter;

an anchoring projection on the shaft; and

a head at an end of the shaft; and

a first sizing component configured for connection to the fastener, the first sizing component comprising:

a first body portion having a first outer diameter larger than the shaft diameter;

a first bore extending through the first body portion, the first bore sized to receive the shaft diameter;

a first sizing feature located in the first bore to receive the anchoring projection on the shaft;

a first outer surface at the first outer diameter; and

a first circumferential bone engaging feature extending from the first outer surface,

wherein the first circumferential bone engaging feature comprises:

a flange extending radially outward from the first outer surface; and

a plurality of teeth extending axially from the flange alongside and spaced from the first outer surface;

wherein the anchoring projection and the first sizing feature comprise mating threading.

18. The bone anchor system of claim 17 , wherein the first body portion comprises:

a first end portion from where the flange extends; and

a second end portion opposite the first end portion, wherein the first outer surface extends between the first end portion and the second end portion;

wherein the plurality of teeth extend from the flange toward the second end portion.

19. A method of fastening a bone anchor, the method comprising:

forming a bore having a shaft diameter into a honey structure for a fastener shaft that is threaded, the fastener shaft extending from a head having a head width larger than a diameter of the fastener shaft;

trialing the bore to determine bone integrity;

selecting a sizing component based on the trialing, the sizing component comprising:

a body portion having an outer diameter larger than the diameter of the fastener shaft and the head width;

a bore extending through the body portion, the bore sized to receive the fastener shaft;

a sizing located in the bore to receive the fastener shaft;

an outer surface at the outer diameter; and

a circumferential bone engaging feature extending from the outer surface;

assembling the selected sizing component to the fastener shaft by mating threading of the fastener shaft with threading of the sizing; and

threading the fastener shaft into the bore to engage the circumferential bone engaging feature of the sizing component with the honey structure.

20. The method of claim 19 , wherein:

the circumferential bone engaging feature comprises external threading; and

threading the fastener shaft into the bore comprises engaging the external threading of the sizing component with cancellous bone in the bore in the honey structure.

21. The method of claim 19 , wherein:

the circumferential bone engaging feature comprises axially extending teeth; and

threading the fastener shaft into the bore comprises engaging the axially extending teeth of the sizing component with cortical bone of the honey structure surrounding the bore.

22. The method of claim 19 , further comprising tapping the bore to form threading that mates with the fastener shaft.

23. The method of claim 19 , further comprising assembling the sizing component with the fastener shaft until the sizing component engages a stop feature.

24. The method of claim 19 , further comprising engaging two or more sizing components together along the fastener shaft.

25. The method of claim 19 , wherein:

trialing the bore comprises probing the bore to determine an extent of weakened bone adjacent the bore; and

selecting the sizing component comprises determining a size of the sizing component to compensate for the extent of the weakened bone to increase an anchoring footprint of the fastener shaft with the sizing component beyond the weakened bone.