A multi-piece vertebral attachment device with a first member, one or more second members, and optionally, a removable plug. The first member may have a fixed, threaded exterior surface to engage a vertebral member. The first member may further include a hollow, threaded interior. The hollow interior may be positioned inside the threaded exterior surface and at least partly positioned within the vertebral member when the first member is inserted in the vertebral member. The second member may have an outer diameter sized to fit within the hollow interior of the first member. A spinal implant device may be coupled to the second member. The second member may be installed during a separate surgical procedure from that of the first. The removable plug may be installed in the first member until the second member is installed. Revision may be performed by removing the second member and inserting a third member.