A spinal fixation system (500) is provided that, in one form, includes a coupling member (514) having a cam lock member (518) that is fixed against translation therealong as it is turned with turning of the cam lock member (518) causing an elongate member (16) such as a spinal rod to be pushed downward in the coupling member (514) for fixing the rod therein. In another aspect, the rod is fixed against a low profile insert (516) that seats in a recess formed in the head of an anchor member (502) projecting from the coupling member (514). The insert has an upper surface against which the rod is fixed and that in one form is flat to provide for line contact against the rod so as to minimize damage thereto.
