A vertebral implant device is described comprising a wedge, a plate having an external surface configuration and one or more plate tine, a staple having one or more staple tine and a coupling device. The coupling devices is configured to couple the wedge, the plate and the staple whereby when the vertebral implant is secured in a vertebral body, the external surface configuration of the plate alters the relative orientation of a superior endplate surface plane and an inferior endplate surface plane of the vertebral body and alters the alignment of the spine. In some embodiments, plate tines and staple tine are configured to frictionally engage the vertebral body. In some embodiments, the coupling device is a screw and a nut. In some embodiments, interchangeable wedges are used to provide multiple implant device configurations.

An expandable interbody spacer for the spine is provided. The interbody spacer includes a housing, a top endplate and a bottom endplate. An actuator is located inside the housing between the top and bottom endplates. A locking screw is configured to drive the actuator and move the endplates between collapsed and expanded configurations. Variations of the expandable spacer are provided in which the endplates move bilaterally outwardly into uniform and parallel expansion along the latitudinal axis, the endplates angulate about a pivot point along a longitudinal axis such that the distal end of the spacer increases in height relative to the proximal end, and the endplates angulate about a pivot along a lateral axis such that the height along one lateral side of the spacer increases in height relative to the other lateral side.

In some embodiments, an intervertebral implant may include a body including a superior and an inferior surface. The implant may include a first channel extending from an anterior end towards the posterior end of the body. The implant may include a first anchor channel. The implant may include a first guide member positionable in the first channel. The implant may include a first anchor. When the first guide member moves from a first position to a second position the first anchor may be conveyed through the first anchor channel and couple the body to an adjacent vertebra. In some embodiments, the implant may include a first locking mechanism which inhibits, during use, the first guide member from moving from the second position to the first position upon activation of the first locking mechanism.

A joint spacer has first and second endplates, with each having a bone engaging surface, and at least two cams with an inclined cam surface positioned on an opposite side. First and second slides, each having ramps with an inclined surface are engaged with the cams of the endplate. The first slide has an angled portion at an end, and the second slide has a hinge portion. A threaded shaft has a hinge portion connected to the slide hinge portion, connecting the shaft to the slide, enabling the shaft to pivot. A nut is threaded to the shaft, and can contact and interfere with the angled portion of the first slide to drive the first slide with respect to the second slide. This results in engagement of the cams and ramps to drive the endplates apart to increase the spacer height.

An expandable interbody fusion implant device has a frame, two ramp assemblies and two overlying base plates driven by two independent drive shafts. The two ramp assemblies include a distal ramp assembly and a proximal ramp assembly. Each ramp assembly has a translating ramp, a first pivoting hinged ramp and a second pivoting hinged ramp. The two overlying base plates include a first base plate overlying a second base plate. Each base plate is hinged to the distal ramp assembly and the proximal ramp assembly at an end of one of said pivoting hinged ramps of each ramp assembly. The two independently driven drive shafts include a first drive shaft for translating the distal ramp assembly and a second drive shaft for translating the proximal ramp assembly to independently expand the implant proximally or distally or both.

Anchoring devices for rachidian implants, implants, surgical instruments, and surgical systems and methods are disclosed. In some embodiments, an anchor comprises a stiff plate with a longitudinal axis, configured for penetration of its anterior end into a vertebral surface while its posterior end remains engaged with the implant. An implant may include a locking mechanism for the anchor. An anchor may include an abutment configured to abut a complementary abutment of an implant. In some configurations, inserting an anchor in a passage of an implant may displace a locking mechanism, which may resile and lock the anchor in the implant with complementary abutments of the anchor and implant abutting.

A spacer for insertion between two vertebrae includes a variable axial length and comprises a first member having a hollow interior and a tubular wall and a second member having a hollow interior and a tubular wall the second member being slidable within the first member in an axial direction for adjusting an overall length. At least the first member or the second member comprises an access opening in its wall, the opening having a size which is adapted for inserting bone grafts through the opening into the interior. The spacer further comprises a length adjustment structure being engageable with an expansion tool for telescoping the second member relative to the first member and a locking structure for fixing the axial length. The access opening, the length adjustment structure and the locking structure are arranged so as to be accessible from the same side of the spacer. The spacer allows in situ filling of bone grafts into its interior and an improved handling.

A bi-directional fixating transvertebral (BDFT) screw/cage apparatus is provided. The BDFT apparatus includes an intervertebral cage including a plurality of internal angled screw guides, a plurality of screw members, and a cage indentation adjacent to the screw guides that independently or supplemented by other screw locking mechanisms prevents the screw members from pulling out of the internal angled screw guides. The internal angled screw guides orient a first screw member superiorly and a second screw member inferiorly. The intervertebral cage is adapted for posterior lumbar intervertebral placement, anterior lumbar intervertebral placement, anterio-lateral thoracic intervertebral placement, or anterior cervical intervertebral placement.

A spinal interbody implant includes a two-component cage and expander. The two-component cage, when assembled, accepts the expander through a reverse dovetail configuration between the assembled cage and the expander. The expander has a pair of legs that move within and along lateral channels formed by and between the two cage components for increasing the height of the two cage components relative to one another. The amount of expansion of the cage is determined by the height of the pair of expander legs. The cage accepts different expanders each having pairs of legs of different heights in order to provide different amounts of cage expansion and thus the interbody implant. The front of each expander leg is arch shaped for reception in the lateral channels of the assembled cage and to progressively expand the two cage components relative to one another as the expander is received by the assembled cage.

An interbody spinal fusion cage for posterior interbody fusion procedures includes a superior member and an inferior member connected to each other via a joint. The joint allows the interbody spinal fusion cage to achieve lordosis even if implanted non-orthogonal to the sagittal plane. For example, the joint can be a hinge oriented non-normal to a longitudinal axis of the interbody spinal fusion cage, a polyaxial ball joint, and/or a universal joint. Complementary locking mechanisms, such as locking teeth or a ratchet-and-pawl arrangement, can be provided near the posterior ends of the superior and inferior members in order to prohibit the posterior ends of the superior and inferior members from separating from each other in situ. Bone holes can be provided in the superior and inferior members.