The disclosed subject matter includes a fastener (10), a system (100) and methods for use and manufacture. The fastener includeS a head (36) disposed at a proximal end of the fastener, a shaft (38) connected to the head, and at least one of the head and the shaft includes a plurality of flat surfaces (52). A collar (40) extends about the longitudinal axis of the fastener and has a proximal-most surface spaced in a longitudinal axis direction away from a proximal-most surface of the fastener. The collar includes a plurality of petals (48) spaced about the longitudinal axis, each of the plurality of petals including a flat surface (54) facing a respective one of the plurality of flat surfaces of the at least one of the head and the shaft. A plate and/or a cage can be included with the fastener for use in a spinal connection, kit or repair system.