A two step locking screw assembly includes a receiving member for receiving a fixation member and an anchor having an enlarged portion and a shank. The enlarged portion of the anchor may be seated in the receiving member. An insert may also extend inside the receiving member. An outer fastener may be positioned in the receiving member. The outer fastener may include a central opening and a pair of ramped flanges. An inner fastener may be disposed inside the central opening of the outer fastener.
