A pressure insert and a polyaxial bone screw assembly are disclosed. The pressure insert being (14) for use in conjunction with a polyaxial bone screw assembly (1,301, 501) having a receiver (10, 310, 510) with an upper channel (56) and an internal cavity (78), a shank (4, 304, 504) having an upper portion operably received in the cavity and a rod (108) operably received in the receiver channel of the pressure insert. The insert is sized and shaped to be received in the receiver above the shank； the insert has a lower body (404) that engages the shank and a pair of upstanding spaced arms (408) forming an insert channel (407) therebetween that during use operably receives and cradles the rod.
