A pedicle screw for insertion into the pedicle portion of a vertebra and having at its exposed end a threaded rod connected in a generally parallel orientation to the longitudinal axis of the pedicle screw but laterally offset from the longitudinal axis of the pedicle screw. The threaded rod may be secured directly to the screw but is preferable provided with a collar that is captured by an enlarged screw head to seat, orient and retain the threaded rod in position. A locking arm and retaining nut are provided over the threaded rod for affixing a spinal rod to the pedicle screw substantially over and aligned with the longitudinal axis of the screw. A yoke may be provided in the collar also to receive and secure the rod. An alternate cap and clamping elements enable the incorporation of cross links between multiple screws and/or rods.