US Patent 9615868 Bone fastener and methods of use

A bone fastener includes a first portion that defines a longitudinal axis and includes an inner surface defining an implant cavity. An intermediate portion includes a first part having a wall including a first end surface that defines at least a portion of the implant cavity and a second end surface. The intermediate portion further includes a second part having a wall including an end surface connected with the second end surface of the first part and an inner surface. The second part is rotatable relative to the first part. A second portion includes a first end engageable with the inner surface of the second part and a second end configured to penetrate tissue. Systems and methods are disclosed.