The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectively detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area. In one embodiment, the integrated fusion cage is an expandable integrated fusion cage.

A method for treating a spine includes the steps of: creating a surgical pathway in a body along a first surgical approach to a surgical site including vertebral tissue; creating a surgical pathway in the body along a second surgical approach to the surgical site including the vertebral tissue; disposing a fulcrum with an intervertebral disc space of the vertebral tissue via the first surgical approach; and manipulating the vertebral tissue via the second surgical approach. Spinal implants, surgical instruments and systems are disclosed.

A spinal implant for placement between vertebral bodies includes a first member for engaging one of the vertebral bodies, a second member for engaging an opposing one of the vertebral bodies, and at least one extendable support element for inducing movement of the entire first member away from the second member. The first member is connected to the second member such that the first member moves away from the second member by a larger distance at a first end of the implant than at a second end of the implant. A connecting member may connect the first and second members together at the second end of the implant. The connecting member may include one or more rotatable linkages, or the connecting member may be an extension of one of the first and second members slidably received within a track defined within the other of the first and second members.

Expandable spinal interbody implants include a body and at least one extendable support element connected thereto. Such an implant may include a second extendable support element and a tool selectively positionable with respect to the implant so as to independently or simultaneously expand both extendable support elements. In another example, such an implant may include, at each of a first and second location, a respective movable member and a respective locking element. The at least one extendable support element may be actuatable to expand so as to induce movement of at least one of the movable members away from the body. The locking elements at each of the first and second locations may be selectively lockable such that, when locked, the locking element restrains movement of the associated movable member at that location away from the body without restraining movement of the other movable member away from the body.

A bone graft delivery kit includes a hollow tube having a proximal end and a distal end. The hollow tube is configured to convey graft material to a graft receiving area in a patient. The hollow tube can be connected to an implant. The kit further includes a plunger to facilitate moving the graft material through the hollow tube.

A bone structural device including a plurality of bone structural segments, wherein adjacent bone structural segments are pivotally connected to one another about a pivot axis, and the bone structural segments are expandable in height, which is in a direction generally parallel to the pivot axis.

An expandable, intervertebral spacer includes a top component and a base component in engagement with the top component, the base component defining at least one channel for receiving a hardening material, and placement of the hardening material within the channel causes the top component to move between a first position in which the top component is a first distance from the base component and a second position in which the top component is a second distance from the base component, the second distance being greater than the first distance. The hardening material can be removed from the channel by a flexible coring tool, and the top component forced toward the base component to collapse the spacer.

Inflatable spinal implants are disclosed for intra-vertebral or inter-vertebral reduction and fixation of osteoporotic fractures in a spine. An inflatable implant may include an inflatable member having an interior for receiving a hardenable fluid and an expandable jacket to cause differential and directional expansion of the inflatable member. A one-way valve may be configured to prevent hardenable fluid from escaping out of the inflatable member. An inflatable implant may include a connection fixation device having a fluid coupling configured for releasable engagement with an inflation cannula and an anchoring portion configured for holding the implant in place within a vertebra. The fluid coupling may also be configured for releasable engagement with an anti-rotation device, which may be used to hold the implant stationary to facilitate engagement and disengagement of the inflation cannula with the fluid coupling. Related systems and methods are also described.

An expandable, intervertebral spacer includes a top component and a base component in engagement with the top component, the base component defining at least one channel for receiving a hardening material, and placement of the hardening material within the channel causes the top component to move between a first position in which the top component is a first distance from the base component and a second position in which the top component is a second distance from the base component, the second distance being greater than the first distance. The hardening material can be removed from the channel by a flexible coring tool, and the top component forced toward the base component to collapse the spacer.

An expandable interbody implant is expandable from a contracted configuration to an expanded configuration by moving opposing first and second vertebral-engaging surfaces apart from one another. The implant includes a locking system for restraining contraction of the implant. The locking system may have a locked configuration, in which the first and second surfaces are prevented from moving back towards the contracted configuration, and the locking system may have an unlocked configuration, in which the first and second surfaces are permitted to move back towards the contracted configuration. The locking system may be controlled by rotation of one or more pinions. The pinions may, in turn, be controlled by linear movement of a rack. The rack may be configured so as to bias the locking system towards the locked configuration. The implant may also include a stop for constraining the maximum expansion of the implant.