A dynamic spinal fixation plate assembly includes a spinal plate, a receiving member, and a fastener resulting in a low profile orthopedic device. The plate may comprise a hole for maintaining the receiving member. The relationship between the receiving member and the plate may allow the plate to adjust during graft settling. The receiving member may be locked to the plate utilizing the mechanical or chemical properties of the device, or the receiving member may be configured to move and rotate freely within the plate hole, even after the fastener has been secured to the bone. The receiving member may have a tapered sidewall defining a through hole to matingly engage the fastener, which may also have a tapered portion forming a tapered lock-fit therebetween. The receiving member may comprise a lip for retaining the fastener within said receiving member.