Abstract: Disclosed herein are systems and methods for intervertebral body fusion that provide more robust support within the disc space. Intervertebral body fusion devices can have a unitary monolithic body including a plurality of body segments interconnected with each other by flexure members. Devices can be configured to be inserted through an opening in a compressed configuration and then expanded within the disc space to an expanded configuration. In the expanded configuration, devices can have a greater mediolateral or transverse to the disc space footprint. This wider footprint provides greater support for the vertebrae relative to the size of the opening through which the device is inserted. Insertion devices for inserting, expanding and extracting such implants are also disclosed.

Abstract: An expandable intervertebral cage device includes a first base plate and a second base plate, a proximal block with internal threading that mechanically couples the first base plate and the second base plate, and a distal block comprising an internal passage. The device has exactly two arm assemblies, one on each side. Each arm assembly includes a first arm mechanically coupled to the first base plate and the distal block, and a second arm is mechanically coupled to the second base plate and the distal block. A screw is arranged partially within the internal threading of the proximal block and passes through the internal passage of the distal block, such that rotation of the screw relative to the proximal block causes a change in distance between the proximal block and the distal block, and a corresponding change in the spacing and lordosis of the device.

Abstract: A system for implanting an implant screw into one or more bones of a patient, such as the sacrum and the ilium, can include a rod and a screw. The screw can be generally hollow and have a blunt distal end. The rod can include a threaded and pointed distal end that is inserted through the rod to drive the screw through the bones. Once the screw is at a desired position, the rod can be removed such that the sharp driving edge used to seat the screw does not remain in the bone. The system can further include an extraction tool having a generally hollow body sized to be inserted over the rod and a distally located screw engagement portion configured to engage the screw to adjust positioning of the screw after it is initially seated.

Abstract: An expandable intervertebral cage device includes a first base plate and a second base plate, a proximal block with internal threading that mechanically couples the first base plate and the second base plate, and a distal block comprising an internal passage. The device has exactly two arm assemblies, one on each side. Each arm assembly includes a first arm mechanically coupled to the first base plate and the distal block, and a second arm is mechanically coupled to the second base plate and the distal block. A screw is arranged partially within the internal threading of the proximal block and passes through the internal passage of the distal block, such that rotation of the screw relative to the proximal block causes a change in distance between the proximal block and the distal block, and a corresponding change in the spacing and lordosis of the device.

Abstract: Improved flexible joint arrangements employ at least one flexure member that interfaces with wrapping surfaces defined on the bases to which the ends of the flexure member are connected. The flexure members are configured to define a traveling instantaneous axis of rotation that moves along a path defined by the interface of the flexure and the wrapping surfaces as the bases move relative to each other. The flexure members and the bases can be constructed of a monolithic material. The wrapping surfaces of the bases can be asymmetric in cross-sectional shape. The radius of curvature of the traveling instantaneous axis of rotation can be configured to change only in discrete quantum steps without reversals. In other embodiments, the flexible joint arrangement can be configured as one or more three bar linkages in which the middle bar is rigid and the outer bars are flexure members in accordance with the various embodiments.

Abstract: An expandable intervertebral cage device includes a first base plate and a second base plate, a proximal block with internal threading that mechanically couples the first base plate and the second base plate, and a distal block comprising an internal passage. The device has exactly two arm assemblies, one on each side. Each arm assembly includes a first arm mechanically coupled to the first base plate and the distal block, and a second arm is mechanically coupled to the second base plate and the distal block. A screw is arranged partially within the internal threading of the proximal block and passes through the internal passage of the distal block, such that rotation of the screw relative to the proximal block causes a change in distance between the proximal block and the distal block, and a corresponding change in the spacing and lordosis of the device.

Abstract: A system for implanting an implant screw into one or more bones of a patient, such as the sacrum and the ilium, can include a rod and a screw. The screw can be generally hollow and have a blunt distal end. The rod can include a threaded and pointed distal end that is inserted through the rod to drive the screw through the bones. Once the screw is at a desired position, the rod can be removed such that the sharp driving edge used to seat the screw does not remain in the bone. The system can further include an extraction tool having a generally hollow body sized to be inserted over the rod and a distally located screw engagement portion configured to engage the screw to adjust positioning of the screw after it is initially seated.

Abstract: Improved methods and apparatuses for vertebral body distraction and fusion in accordance with various embodiments employ mechanisms for stabilizing a device so that the device can stay in the body and stably support the disc space during vertebral fusion following distraction of the adjacent vertebra by operation of the device. The device is inserted into the disc space and distracted from a compressed configuration to an expanded configuration to distract the disc space. Mechanisms for stabilizing the device in the expanded configuration constrain the device to zero degrees of freedom of movement to allow the device to stably support the disc space. A bone growth stimulant for promoting vertebral fusion can be inserted into an open space defined by the device, which continues to stably support the disc space during vertebral fusion.

Abstract: An expandable intervertebral cage device includes a first base plate and a second base plate, a proximal block with internal threading that mechanically couples the first base plate and the second base plate, and a distal block comprising an internal passage. The device has exactly two arm assemblies, one on each side. Each arm assembly includes a first arm mechanically coupled to the first base plate and the distal block, and a second arm is mechanically coupled to the second base plate and the distal block. A screw is arranged partially within the internal threading of the proximal block and passes through the internal passage of the distal block, such that rotation of the screw relative to the proximal block causes a change in distance between the proximal block and the distal block, and a corresponding change in the spacing and lordosis of the device.

Abstract: An expandable intervertebral cage device includes a first base plate and a second base plate, a proximal block with internal threading that mechanically couples the first base plate and the second base plate, and a distal block comprising an internal passage. The device has exactly two arm assemblies, one on each side. Each arm assembly includes a first arm mechanically coupled to the first base plate and the distal block, and a second arm is mechanically coupled to the second base plate and the distal block. A screw is arranged partially within the internal threading of the proximal block and passes through the internal passage of the distal block, such that rotation of the screw relative to the proximal block causes a change in distance between the proximal block and the distal block, and a corresponding change in the spacing and lordosis of the device.

Abstract: Improved methods and apparatuses for expandable medical devices in accordance with various embodiments of the present invention employ flexure members. Flexure members connect a plurality of structural members to end plates on one end and blocks on another end. A drive screw or similar mechanism can be actuated to drive expansion blocks closer together, which causes flexure members to deflect, resulting in expansion of the structural members and distraction of the end plates.

Abstract: Improved flexible joint arrangements employ at least one flexure member that interfaces with wrapping surfaces defined on the bases to which the ends of the flexure member are connected. The flexure members are configured to define a traveling instantaneous axis of rotation that moves along a path defined by the interface of the flexure and the wrapping surfaces as the bases move relative to each other. The flexure members and the bases can be constructed of a monolithic material. The wrapping surfaces of the bases can be asymmetric in cross-sectional shape. The radius of curvature of the traveling instantaneous axis of rotation can be configured to change only in discrete quantum steps without reversals. In other embodiments, the flexible joint arrangement can be configured as one or more three bar linkages in which the middle bar is rigid and the outer bars are flexure members in accordance with the various embodiments.

Abstract: An expandable intervertebral cage adapted to be implanted into an intervertebral disc space in a patient's body, the expandable intervertebral cage including first and second base plates having outer surfaces configured to interface with vertebra in the intervertebral disc space, a first, second and third arm assembly hingedly connected to first and second base plates, and first and second actuation members, wherein rotation of the first actuation member pulls the second arm assembly towards the first arm assembly and rotation of the second actuation member pulls the third arm assembly towards the second arm assembly, the first actuation member and the second actuation member capable of being actuated independently of each other.

Abstract: Improved methods and apparatuses for vertebral body distraction and fusion in accordance with various embodiments of the present invention employ flexure members. Flexure members connect a plurality of structural members to end plates on one end and blocks on another end. Upon insertion into the disc space, a drive screw or similar mechanism can be actuated to drive expansion blocks closer together, which causes flexure members to deflect, resulting in expansion of the structural members and distraction of the end plates. The distracted device can then remain in the body and be used for vertebral body fusion.

Abstract: Improved methods and apparatuses for vertebral body distraction and fusion in accordance with various embodiments employ mechanisms for stabilizing a device so that the device can stay in the body and stably support the disc space during vertebral fusion following distraction of the adjacent vertebra by operation of the device. The device is inserted into the disc space and distracted from a compressed configuration to an expanded configuration to distract the disc space. Mechanisms for stabilizing the device in the expanded configuration constrain the device to zero degrees of freedom of movement to allow the device to stably support the disc space. A bone growth stimulant for promoting vertebral fusion can be inserted into an open space defined by the device, which continues to stably support the disc space during vertebral fusion.

Abstract: Improved methods and apparatuses for vertebral body distraction and fusion in accordance with various embodiments employ mechanisms for stabilizing a device so that the device can stay in the body and stably support the disc space during vertebral fusion following distraction of the adjacent vertebra by operation of the device. The device is inserted into the disc space and distracted from a compressed configuration to an expanded configuration to distract the disc space. Mechanisms for stabilizing the device in the expanded configuration constrain the device to zero degrees of freedom of movement to allow the device to stably support the disc space. A bone growth stimulant for promoting vertebral fusion can be inserted into an open space defined by the device, which continues to stably support the disc space during vertebral fusion.