A spinal rod assembly may be formed by attaching an extension portion onto a spinal rod that extends along a longitudinal axis. The extension portion may include a rod coupler that attaches to the spinal rod with a first coupling that includes a first degree of rotational freedom and a first degree of translational freedom in positioning the rod coupler relative to the spinal rod along the longitudinal axis. The extension portion may further include an extender rod including an elongated rod body that may be secured to the rod coupler using a second coupling that includes at least a second degree of rotational freedom in positioning the extender rod relative to the rod coupler about an axis substantially perpendicular to the longitudinal axis. The extension portion may be assembled in situ to a spinal rod that has been previously secured to vertebral bodies in a patient.
