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.

Placement apparatus and methods of use for impanation of spacers within an inter-vertebral disc space. In one embodiment, the load-bearing superstructure of the implant is subdivided and the bone forming material is positioned within an internal space of the placement instrument but external to the load bearing elements themselves. At least a portion of the bone graft material is freely contained within the disc space. A method of using the device is also described. In one embodiment, the placement device is used to place the implantable spacers at opposing ends of the disc space using a directly lateral surgical approach.

A vertebral body replacement device includes a first member and a first footplate detachably connectable to the first member, a second member and a second footplate detachably connectable to the second member, and a central member detachably connectable to the first member. The first member is axially displaceable relative to the second member in response to rotation of the central member relative to the first member to adjust the length of the vertebral body replacement device. The first member includes a pair of first fastener holes and a pair of second fastener holes angularly offset from the first fastener holes. The first footplate includes an aperture configured to align with one of the first fastener holes to orient the footplate in a first position or one of the second fastener holes to orient the footplate in a second position.

Arcuate fixation members with varying configurations and/or features are provided, along with additional components for use therewith in provided intervertebral implants. The arcuate fixation members may be of different lengths, cross sectional geometries, and/or cross sectional areas. Applications of intervertebral implants utilizing arcuate fixation members are particularly suitable when a linear line-of-approach for delivering fixation members is undesirable.

A central inflatable distractor and a perimeter balloon are inserted into the disc space in uninflated configurations. The central inflatable distractor is then expanded, thereby distracting the vertebral endplates to the controlled height of the central inflatable distractor. The perimeter balloon is then inflated with a curable substance. The perimeter balloon expands as it is filled with the curable substance and conforms to the void remaining in the disc space around the central inflatable distractor, thereby creating a horseshoe shape. Once the flowable material in the perimeter balloon has cured, the central inflated distractor can be deflated and removed. The remaining void (or inner space) is then packed with graft for fusion.

The present invention provides an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. In an exemplary embodiment, the present invention provides an intervertebral implant. The intervertebral implant may be configured to transition from a collapsed configuration having a first height and a first width to an expanded configuration having a second height and a second width.

An intervertebral implant inserter, comprising: a) a elongated central body having a distal end, a proximal end, an outer surface, and a longitudinal throughbore therethrough, b) upper and lower blades, each blade having a distal end portion and a base portion, the base portion of each blade pivotally coupled to the elongated central body, c) a shaft having a longitudinal axis, wherein the shaft is advanceable within the throughbore and rotatable about the longitudinal axis, the shaft having a distal end forming a pusher having an acicular transverse cross-section, d) upper and lower endplates respectively detachably connected to the distal end portion of a respective blade.

A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

An intervertebral spacing implant, including: a seat having an interior surface and an exterior surface; branches having an anterior end and a posterior end, the anterior end of the branches coupled to the seat and extending in a direction away from the seat, each of the branches having an interior surface and an exterior surface opposite the interior surface, the seat and the branches forming a cage, the exterior surface of the seat and the exterior surface of the branches defining an internal volume of the cage, the cage including fenestrations; a spacer configured to fit within the cage and move in the direction away from the seat and toward the posterior end of the plurality of branches, the spacer and the cage configured such that the branches will move from an unexpanded position to an expanded position when the spacer is urged in the direction away from the seat.

A surgical coupling member includes a shaft defining an axis and including at least one thread having an external thread form. The external thread form having a leading flank and a trailing flank. The external thread form defines a pitch and a crest, the crest having a width in a range of about 35% to about 50% of the pitch of the external thread form, wherein the leading flank and the trailing flank are angled in a proximal orientation relative to the thread axis, and wherein the external thread form is configured to interlock with an internal thread form of an implant receiver. Systems, spinal constructs, implants and methods of use are disclosed.