An implant or endoprosthesis suitable to be implanted in human or animal tissue includes two (or more than two) parts to be joined in situ. Each one of the parts includes a joining location, the two joining locations facing each other when the device parts are positioned for being joined together, wherein one of the joining locations includes a material which is liquefiable by mechanical vibration and the other one of the joining locations includes a material which is not liquefiable by mechanical vibration and a structure (e.g. undercut cavities or protrusions) suitable for forming a positive fit connection with the liquefiable material. The joining process is effected by pressing the two device parts against each other and by applying ultrasonic vibration to one of the device parts when the two parts are positioned relative to each other such that the two joining locations are in contact with each other.

Stand-alone interbody fusion devices for engagement between adjacent vertebrae. The stand-alone interbody fusion devices may include frames and one or more endplates coupled to the frame. The frame may be configured and designed to provide the apertures which are designed to retain bone fasteners, such as screws or anchors, and secure the implant to the adjacent vertebrae.

An expandable spinal implant is provided having a frame with a distal wall for retaining an expansion plug such that bone growth promoting material may be introduced to a proximal portion of the implant after expansion. Various implants, systems and methods are disclosed.

According to some embodiments, a method of inserting a lateral implant within an intervertebral space defined between an upper vertebral member and a lower vertebral member includes creating a lateral passage through a subject in order to provide minimally invasive access to the intervertebral space, at least partially clearing out native tissue of the subject within and/or near the intervertebral space, positioning a base plate within the intervertebral space, wherein the base plate comprise an upper base plate and a lower base plate and advancing an implant between the upper base plate and the lower base plate so that the implant is urged into the intervertebral space and the upper vertebral member is distracted relative to the lower vertebral member.

An intervertebral implant has a hollow space formed within the implant and accessible through an elongate opening extending through a recessed portion of the side wall, and the hollow space is shaped to receive an engagement portion of a drive shaft of an insertion tool; and the intervertebral implant includes at least two guiding surfaces facing each other and being configured for sliding engagement by a portion of a sleeve of the insertion tool movably holding the drive shaft.

An implant for therapeutically separating bones of a joint has two endplates each having an opening through the endplate, and at least one ramped surface on a side opposite a bone engaging side. A frame is slideably connected to the endplates to enable the endplates to move relative to each other at an angle with respect to the longitudinal axis of the implant, in sliding connection with the frame. An actuator screw is rotatably connected to the frame. A carriage forms an open area aligned with the openings in the endplates. The openings in the endplates pass through the carriage to form an unimpeded passage from bone to bone of the joint. The carriage has ramps which mate with the ramped surfaces of the endplates, wherein when the carriage is moved by rotation of the actuator screw, the endplates move closer or farther apart.

A surgical instrument suitable for preparing an intervertebral disc space includes an outer sleeve, an instrument head, an inner shaft, a handle, a universal joint, a coupling member, and a drive mechanism. The outer sleeve includes a proximal end, a distal end and a longitudinal axis. The instrument head defines a longitudinal axis and is disposed at the distal end of the outer shaft. The inner shaft is slidably disposed within the outer sleeve and includes a proximal end, a distal end and a longitudinal axis coaxially aligned with the longitudinal axis of the outer sleeve. The drive mechanism is coupled between the outer sleeve and the inner shaft and actuates the outer sleeve axially relative to the inner shaft, thereby setting an angle of the longitudinal axis of the instrument head in relation to the longitudinal axis of the inner shaft.

An expandable fusion device may include a first endplate and a second endplate. The expandable fusion device may also include first and second ramps configured to mate with both the first and second endplates. An inserter instrument includes an outer shaft having a bore extending longitudinally therethrough and an inner shaft extending through the bore in the outer shaft. The outer shaft is configured to engage the first or second opening in the second ramp, and the inner shaft is configured to engage the corresponding first or second opening in the first ramp to control implant height and/or lordotic angle.

An improved cage that has an anchoring system and method of use thereof. The anchoring system has movable/expandable jaw portions that can expand vertically (i.e., upward and downward relative to the respective superior and inferior surfaces of the cage) so that the cage can be more securely implanted in position. The superior and inferior expandable portions of the anchoring system move vertically by the rotation of one or more spindles that is incorporated in the jaw mechanism (and/or by the rotation of a lead screw that is incorporated in the cage). In some embodiments, the medical implant (such as a cage) is itself non-expandable (i.e., the height of the medical implant does not change). In other embodiments, the medical implant (such as a cage) can be expanded independently of the anchoring system.

An expandable interbody spacer for the spine is provided. The interbody spacer includes a housing, upper and lower endplates, an anterior actuator, a posterior actuator, an anterior drive screw, and a posterior drive screw. The anterior and posterior drive screws are independently or simultaneously rotated with respect to each other by a driver to wedge one or more of the anterior and posterior actuators between the endplates moving them into parallel and/or angular expansion.