Abstract: An intervertebral implant includes a body formed as an open lattice structure by a plurality of struts. Some of the struts of the plurality of struts intersect at nodes. The nodes can include an enlarged contact member that extends over the node and at least a portion of the width of some of the struts. Enlarged contact members may have an asymmetrical shape with respect to the intersection of struts. The enlarged contact members can provide improved bone contact for the implant. The plurality of struts can have a cross-sectional shape that includes a flattened portion. The flattened portion of the plurality of struts can provide improved bone contact for the implant. An additive manufacturing process can be used to build the implant in a substantially vertical direction.

Abstract: A spine implant (e.g., for a TLIF surgical procedure) is configured to be steered into place during implantation in conjunction with a complementary insertion instrument. The cage of the implant is constrained to a limited range of rotation about a post carried by the cage. The insertion instrument is configured to hold the post while controllably rotating the cage relative to the post in order to angularly position the implant during implantation. Range of rotational motion is controlled by the configuration of a groove in the post. A retaining pin of the implant extends from the cage into the groove of the post to rotationally connect the cage to the post.

Abstract: Self-aligning plating systems and methods are disclosed. The self-aligning plating system may include an interbody spacer, a medical device plate, and an insertion member. The interbody spacer may be inserted between a top vertebra and a bottom vertebra of a patient's spinal column. A medical device plate may slide along an insertion member in operable connectivity with the interbody spacer so that the medical device plate comes into contact with and can be secured to the patient's anatomy.

Abstract: A support device for supporting a biological membrane includes a support bar that is elongated, that extends along a length direction and that has at least one cylindrical surface extending along the length direction for supporting the biological membrane. A method of using the support device, which is suitable for mounting on a space of a bone defect structure of a human body and which is suitable for supporting a biological membrane, is also disclosed.

Abstract: A balloon, a medical device, and a medical procedure for discoplasty are disclosed. The balloon has a compressed, collapsed or folded balloon body containing a first chamber for, in use, receiving injected bone cement. With the bone cement filled and cured therein, the balloon acts as a support in tissue of an intervertebral disc while preventing the bone cement from leakage and dispersion. The deployed balloon body defines a second chamber running therethrough. The second chamber is configured to receive a material or cells that activate osteogenesis and/or osteo-induction, so that the material or cells injected into the second chamber through a second sprue form osteocytes or induce human spontaneous local cellular differentiation to in turn form osteocytes in the cavity of the intervertebral disc and connect vertebrae above and below the intervertebral disc, thereby securely anchoring the balloon within the intervertebral space.

Abstract: A method of performing a transcorporeal procedure including placement of a Vertebral Body Replacement device into a transcorporeal void within a cervical spine is disclosed. The method includes creating a working channel through a vertebral body of a vertebra by removing at least a portion of the vertebral body of the vertebra, beginning anteriorly and extending inwardly toward the epidural space, the working channel extending from an anterior wall through a posterior wall, and placing the Vertebral Body Replacement device within the working channel, the placement of the Vertebral Body Replacement device leaving the inferior and superior endplates to perform their function and leaving at least a portion of the intervertebral disc functional thereby avoiding an intervertebral fusion to an adjacent vertebra, where the Vertebral Body Replacement device has at least one of a width of less than 12 millimeters and a diameter of less than 12 millimeters.

Abstract: A fixation member inserter instrument attaches to an interbody spacer and assists in the insertion of the interbody spacer into the intravertebral spacer. The distal end of the fixation member inserter instrument includes a fixation member guide with two or more fixation members that is configured to simultaneously deliver the two or more fixation members during the fixation member impaction process. The interbody spacer is attached to the inserter instrument by a threaded rod adjacent to the main body of the fixation member inserter instrument. There is an impaction rod extending through the device which connects to the two or more fixation members in the fixation member guide. When the impaction rod is impacted on a proximal end, the distal end contacts the two or more fixation members simultaneously and forces them into the vertebral body at the same time.

Abstract: 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. An access cannula may be introduced over the first dilator tube. A drill may be inserted through the access cannula and used to perform a foraminoplasty, Surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Abstract: An augment device for a joint endoprosthesis, the device including a sleeve surrounding a channel extending through the sleeve. The sleeve is formed of porous material for ingrowth of bony material, the sleeve comprising an inner face and an outer face. The sleeve further comprises a wall surrounding the channel, the wall being made of solid material and forming a sandwich structure with the porous material, wherein the wall forms a bulkhead between the inner face and the outer face. Thereby, the bulkhead wall will stop inflow of any cement across the sleeve from its inner to its outer face. The porous material on the outer face will be kept free from cement and its capability to promote bone ingrowth is reliably preserved. The augment devices are preferably provided as a set having different sizes and straight or stepped bottoms for improved versatility and maximum preservation of natural bone matter.

Abstract: Sacro-iliac joint stabilizing implants adapted for implanting across a SI joint from a dorsal approach. Methods of, and delivery tools adapted for implanting sacro-iliac joint stabilizing implants across a SI joint from a dorsal approach.

Abstract: A system configured to increase height of a vertebral body. An implant includes plates each defining a bearing surface configured to be moved away from one another to expand the implant within the vertebral body. Supports are each coupled to one of the plates and include a reduced thickness portion defining a material web configured to plastically deform during expansion of the implant. The system includes an implant carrier with which an end element of the implant is removably coupled, and a rod configured to be translated relative to the implant carrier to cause expansion of the implant. An opposed portion may be coupled to the supports and configured to receive a longitudinal force to be moved relative to the end element. Second supports may be each coupled to the end element and one of the plates. Each of the second supports may plastically deform during expansion of the implant.

Abstract: The embodiments provide various interbody fusion spacers, or cages, for insertion between adjacent vertebrae. The cages may have integrated ratchet assemblies that allow the cage to change size and angle as needed, with little effort. The cages may have a first, insertion configuration characterized by a reduced size to facilitate insertion through a narrow access passage and into the intervertebral space. The cages may be inserted in a first, reduced size and then expanded to a second, larger size once implanted. In their second configuration, the cages are able to maintain the proper disc height and stabilize the spine by restoring sagittal balance and alignment. Additionally, the intervertebral cages are configured to be able to adjust the angle of lordosis, and can accommodate larger lordotic angles in their second, expanded configuration. Further, these cages may promote fusion to further enhance spine stability by immobilizing the adjacent vertebral bodies.

Abstract: A spinal implant system includes an inserter that passes through a spinal implant for attachment to a distal end of the spinal implant. By this arrangement, stability of the implant system is enhanced for placement of the spinal implant while reducing local stresses imparted at the attachment. The disclosed spinal implant system may include an access tube that is coupled to a proximal end of the spinal implant. After placement of the spinal implant, the inserter may be removed from the spinal implant and access tube, providing access via the access tube to an interior of the spinal implant and the corresponding space between the vertebral endplates.

Abstract: An expandable intervertebral implant having an upper body portion, a lower body portion opposite the upper body portion, a wedge member connecting the upper body portion to the lower body portion, a nose member having a tapered distal end and a proximal end opposite the distal end, and an actuator disposed between the nose member and the wedge member, for translation of the wedge member along a longitudinal axis of the implant. A pin connects to the actuator for positioning the nose member relative to the actuator. Translation of the wedge member along the longitudinal axis of the implant displaces the upper body portion and the lower body portion away from each other, thereby expanding the intervertebral implant.

Abstract: A unibody implant movable between an expanded position and a contracted position is disclosed. The unibody implant may include a unitary expandable body defined by an inferior portion and a superior portion that are connected together. In various embodiments, a set screw may be rotatably supported by the body and configured to move a plug having a first inclined surface facing the distal side. In various embodiments, the set screw may be movable in the longitudinal direction towards the distal side upon rotation of the set screw along the rotation axis, for example. In various embodiments, movement of the set screw urges the plug against the superior portion thereby expanding a vertical distance between the superior and inferior sides of the body. In some embodiments, the plug may include a stabilizing element configured to transfer compressive forces between the superior portion and inferior portion.

Abstract: An implantable device may comprise a barrel, the barrel having an upper portion and a lower portion. The barrel may be configured to transition from a collapsed form having a first height to an expanded form having a second height and wherein the second height is greater than the first height. The implantable device may further include an actuator assembly disposed in the barrel, the actuator assembly comprising a front ramped actuator in engagement with the barrel, a rear ramped actuator in engagement with the barrel, and a central screw that extends from the rear ramped actuator through the front ramped actuator. The implantable device may further comprise a first plate and a second plate.

Abstract: A computer-implemented technique for generating a data set that geometrically defines a bone plate design is presented. A method implementation of this technique comprises visualizing, based on shape data of a bone, a bone model on a display device, deriving, responsive to a user interaction signal that is indicative of a user interaction relative to the bone model, plate design data representative of a plate-specific design property, and generating a data set that geometrically defines a bone plate design from at least the plate design data and one or more generic plate parameters.

Abstract: A spinal implant system includes at least one interbody implant having a first member including a tissue engaging surface and at least one mating element. A second member includes a tissue engaging surface and at least one mating element. An intermediate member includes at least one mating element. An intra-operative surgical tool is connectable with at least one of the members to engage adjacent mating elements and fix the intermediate member with at least one of the first member and the second member. Implants, surgical instruments and methods are disclosed.

Abstract: An expandable fusion device is capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. The fusion device may include a body portion, a first endplate, and a second endplate, the first and second endplates capable of being moved in a direction away from the body portion into an expanded configuration or capable of being moved towards the body portion into an unexpanded configuration. The fusion device is capable of being deployed and installed in both configurations.

Abstract: An adjustable spinal fusion intervertebral implant is provided that can comprise upper and lower body portions that can each have proximal and distal wedge surf aces disposed at proximal and distal ends thereof. An actuator shaft disposed intermediate the upper and lower body portions can be actuated to cause proximal and distal protrusions to converge towards each other and contact the respective ones of the proximal and distal wedge surfaces. Such contact can thereby transfer the longitudinal movement of the proximal and distal protrusions against the proximal and distal wedge surfaces to cause the separation of the upper and lower body portions, thereby expanding the intervertebral implant. The upper and lower body portions can have side portions that help facilitate linear translational movement of the upper body portion relative to the lower body portion.

Abstract: An expandable intervertebral implant is provided for insertion into an intervertebral space defined by adjacent vertebrae. The expandable intervertebral implant includes a pair of outer sleeve portions and an inner core disposed between the outer sleeve portions. Movement of the inner core relative to the outer sleeve portions causes the outers sleeve portions to deflect away from each other, thereby engaging the expandable intervertebral implant with the vertebrae and adjusting the height of the intervertebral space.

Abstract: An expandable intervertebral implant is provided for insertion into an intervertebral space defined by adjacent vertebrae. The expandable intervertebral implant includes a pair of outer sleeve portions and an inner core disposed between the outer sleeve portions. Movement of the inner core relative to the outer sleeve portions causes the outers sleeve portions to deflect away from each other, thereby engaging the expandable intervertebral implant with the vertebrae and adjusting the height of the intervertebral space.

Abstract: An expandable intervertebral fusion implant, including an inferior component, including a first horizontal member, a first vertical member connected to the first horizontal member, and a first outward facing surface, a superior component hingedly connected to the inferior component, the superior component including a second horizontal member, a second vertical member connected to the second horizontal member, and a second outward facing surface directed away from the first outward facing surface, a first shell hingedly connected to the inferior component, and a first wedging component slidingly arranged between the first shell and the first outward facing surface.

Abstract: The invention relates to a trajectory guidance instrument that is securable to a surgical tool for use in conjunction with X-ray machines. More particularly, the device includes a radiolucent outrigger having radiodense indicia disposed on the outrigger so that the radiodense indicia is visible via an X-ray machine to provide an angular trajectory for the instrument. The outrigger is securable to various surgical tools for the purpose of providing real time trajectory guidance to surgeons during a procedure. In general, the precision trajectory guidance instrument comprises a substantially rigid outrigger device which it securable to a portion of the surgical tool for trajectory guidance. The trajectory guidance instrument may be attached with clips, fasteners, adhesives, hook and loop or the like.

Abstract: An intervertebral spacer implant (80) is provided with a retention mechanism (86) to help alleviate expulsion and movement of the implant when placed in the spine while providing an implant that is easier to insert in the spine. In one embodiment the retention mechanism comprises a keel on at least one of the inferior or superior faces of the spacer implant preferably extending in an anterior-posterior direction. In another embodiment the implant comprises a spacer (84) and a plate (82), the plate comprising a supplemental or alternative retention mechanism. In one embodiment the retention mechanism comprises one or more holes (88) in the anterior end of the plate. In yet another embodiment, the retention mechanism comprises one or more blades that are in a first position when inserted and are preferably rotated to a second position that engages the superior and inferior vertebrae.

Abstract: An expandable spinal fusion implant including a housing, upper and lower endplates, a wedge positioned within the housing and between the upper and lower endplates and a drive mechanism to urge the wedge distally between the upper and lower endplates to increase the separation between the endplates and expand the overall height of the distal end of the implant.

Abstract: An intervertebral implant component of an intervertebral implant includes an outer surface for engaging an adjacent vertebra and an inner surface. A keel extends from the outer surface and is designed to be disposed in a slot provided in the adjacent vertebra. This keel extends in a plane which is non-perpendicular to the outer surface; and preferably there are two of the keels extending from the outer surface which are preferably offset laterally from one another. In another embodiment, an anterior shelf is provided at an anterior end of the outer surface, and this anterior shelf extends vertically away from the inner surface in order to help prevent bone growth from the adjacent vertebra towards the inner surface. Further in accordance with disclosed embodiments, various materials, shapes and forms of construction of the component and/or keel provide various benefits.

Abstract: The present disclosure relates to an expandable interbody that includes superior and inferior shells enclosing a control mechanism that includes interlocking proximal and distal cages as well as an adjustment screw that longitudinally translates the distal cage relative to the proximal cage and thereby expands interbody by pushing apart the distal ends of the superior and inferior shells.

Abstract: Implants for the fusion or fixation of two bone segments are described. For example, the implants can be used for the fusion or fixation of the sacroiliac joint. The implants can include fenestrations, have a rectilinear overall cross-sectional area, and have a curvature. Some implants can also be used to rescue failed implants.

Abstract: Spinal plates with additional features to improve the stability of the interface between the plate and the underlying bone. A bone plate may include one or more sharp ridges along the periphery of its underside. When attached to bone, the ridge digs into the bone and increases stability. A bone plate may alternatively or additionally include one or more holes for optional spikes, which may be inserted once the plate is attached to the bone. By separating the spikes and including them as an optional component, the plate may enhance stability while reducing or eliminating the chance of the spike injuring the patient. Furthermore, bone screws may incorporate alternating notches and ridges into the head of the screw. The notches and ridges may interface with a set screw, thereby preventing rotation and loosening of the screw.

Abstract: An expandable prosthetic implant for engagement between vertebrae includes a first member having a first end, a second end, a plurality of extensions and a hollow interior portion extending from the first end to the second end, wherein the plurality of extensions extend from the first end to the second end. A second member includes a first end, a second end, a hollow interior portion extending from the first end to the second end, and a plurality of extensions extending from the second end to the first end. The plurality extensions of the first member are configured to coaxially interdigitate with the second member, and the plurality of extensions of the second member are configured to coaxially interdigitate with the first member. The first member of the implant is moveable relative to the second member along a longitudinal axis.

Abstract: Intervertebral spacer assemblies, systems, and methods thereof. A method of insertion includes inserting an intervertebral spacer and plate together using an insertion tool and, upon removal of the insertion tool, the intervertebral spacer and plate are no longer considered connected/coupled and act as separate components.

Abstract: An implant includes a plurality of anchoring members and an interbody device. The interbody device includes a front, a rear, a first lateral side, a second lateral side, a central cavity, and a plurality of bores each configured to receive the plurality of anchoring members. The interbody device further includes a porous portion and a solid portion, the solid portion having a higher density than the porous portion. The solid portion substantially surrounds the porous portion on the lateral outer portions of the front, rear, first lateral side, and second lateral side.

Abstract: Spinal implant trials are provided having various configurations and sizes that aid the selection of spinal implants having similar configurations and sizes. A surgeon during surgery can insert various configurations and sizes of the spinal implant trials into a disc space between two adjacent vertebral bodies of a patient to enable the selection of a spinal implant configured and sized to fit the patient's disc space. Fluoroscopic images can be used in aiding the selection of an appropriately configured and sized spinal implant corresponding to one of the spinal implant trials. The spinal implant trials include features that reveal on the fluoroscopic images whether the spinal implant trials are properly oriented and positioned in the disc space. As such, the selection of the configuration and size of the spinal implants can be made after it is determined that the spinal implant trials are properly oriented and positioned within the disc space.

Abstract: An adjustable spinal fusion intervertebral implant is provided that can comprise upper and lower body portions that can each have proximal and distal wedge surf aces disposed at proximal and distal ends thereof. An actuator shaft disposed intermediate the upper and lower body portions can be actuated to cause proximal and distal protrusions to converge towards each other and contact the respective ones of the proximal and distal wedge surfaces. Such contact can thereby transfer the longitudinal movement of the proximal and distal protrusions against the proximal and distal wedge surfaces to cause the separation of the upper and lower body portions, thereby expanding the intervertebral implant. The upper and lower body portions can have side portions that help facilitate linear translational movement of the upper body portion relative to the lower body portion.

Abstract: An apparatus or a system employs a fixation assembly to stabilize and prevent migration of an interbody fusion device placed between adjacent vertebral bodies, and/or provide supplemental fixation of adjacent vertebral bodies. The fixation assembly may include modular fixation plates insertable and attachable to the interbody fusion device in situ. In certain embodiments, the fixation assembly may include a single fixation plate insertable and/or attachable to the interbody fusion device in situ. In certain embodiments, fixation plates are integrally formed with the interbody fusion device.

Abstract: An implantable device may include a barrel, the barrel having an upper portion and a lower portion. The implantable device may further include an actuator assembly disposed in the barrel, and a central screw that extends from a rear ramped actuator through a front ramped actuator. The implantable device may further include a first plate having multiple projections extending from one side of the first plate. The implantable device may further include a second plate having multiple projections extending from one side of the second plate, the second plate configured to be received on the central screw. The barrel may be configured to transition from a collapsed form having a first height to an expanded form having a second height and wherein the second height is greater than the first height.

Abstract: Computer implemented methods of producing a bone graft are provided. These methods include obtaining a 3-D image of an intended bone graft site; generating a 3-D digital model of the bone graft based on the 3-D image of the intended bone graft site, the 3-D digital model of the bone graft being configured to fit within a 3-D digital model of the intended bone graft site; storing the 3-D digital model on a database coupled to a processor, the processor having instructions for retrieving the stored 3-D digital model of the bone graft and for combining a carrier material with, in or on a bone material based on the stored 3-D digital model and for instructing a 3-D printer to produce the bone graft. A layered 3-D printed bone graft prepared by the computer implemented method is also provided.

Abstract: An implantable device may include a barrel, the barrel having an upper portion and a lower portion. The implantable device may further include an actuator assembly disposed in the barrel, and a central screw that extends from a rear ramped actuator through a front ramped actuator. The implantable device may further include a first plate having multiple projections extending from one side of the first plate. The implantable device may further include a second plate having multiple projections extending from one side of the second plate, the second plate configured to be received on the central screw. The barrel may be configured to transition from a collapsed form having a first height to an expanded form having a second height and wherein the second height is greater than the first height.

Abstract: Intervertebral devices and systems, and methods of their use, are disclosed having configurations suitable for placement between two adjacent vertebrae, replacing the functionality of the disc therebetween. Intervertebral devices and systems contemplated herein are implantable devices intended for replacement of a vertebral disc, which may have deteriorated due to disease for example. The intervertebral devices and systems are configured to allow for ample placement of therapeutic agents therein, including bone growth enhancement material, which may lead to better fusion between adjacent vertebral bones. The intervertebral devices and systems are configured for use in minimally invasive procedures, if desired.

Abstract: A dynamic disc assembly has a superior end plate, an inferior end plate, and a core. The core has surfaces of an annular Fresnel shape and a linear Fresnel-like shape combined to control the dynamic range of motion (ROM) movement arranged to match anatomical ROM. The core is interposed between and held against interior surfaces of the superior end plate and the inferior end plate. The assembly further has a pair of coupling cords, one coupling cord at each lateral end of the superior and inferior end plates wherein each lateral end of each end plate has one or more cord connections attached and affixed to the coupling cord to form and retain the dynamic disc assembly.

Abstract: A standalone anterior cervical interbody spacer (ACIF) that includes a spacer body and plate rigidly couple via flexible pins.

Abstract: A system and method for spinal fusion comprising a spinal fusion implant of non-bone construction releasably coupled to an insertion instrument dimensioned to introduce the spinal fusion implant into any of a variety of spinal target sites, in particular into the thoracic region of the spine.

Abstract: A multi-chamber balloon for a nuclear implant has an elastomeric membrane defining inner and outer chambers integral with a valve body. The valve body includes a core portion and sealing membrane for sealing the inner and outer chambers. An assembly for manufacturing the multi-chamber balloon includes a balloon mandrel which may be dip coated in a silicone dispersion to create an elastomeric membrane for the inner and outer chambers integral with the valve body. The elastomeric membrane formed on the mandrel is partially inverted to form a coaxial elastomeric structure with the smaller inner chamber disposed within the larger outer chamber. The valve is incorporated into the inner and outer chambers to form a unitary structure.

Abstract: Disclosed are devices for the fixation and support of vertebrae, particularly adjustable spinal implant devices.

Abstract: 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.

Abstract: A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distractor apparatus and method and an anchor remover and method are also provided.

Abstract: An interbody fusion device having an accordion-like structure, wherein the device in inserted into the disc space in its collapsed configuration and then expanded into its expanded configuration by compressing the accordion-like portion of the device. In some embodiments, a pre-formed tube with an accordion-like structure over a portion of its length is inserted in a relaxed (collapsed) configuration, giving the tube a minimum possible diameter. This tube has a cable running through it that is fixed to a distal end portion of the tube and extends past the proximal end portion of the tube to the outside of the patient. Once the tube is positioned on the rim of the endplate, the proximal end of the cable is pulled, thereby tensioning the cable and causing the accordion portion of the tube to become shorter in length but larger in diameter.

Abstract: An implantable medical device is disclosed comprising a thermoplastic composite body having anterior, first lateral, second lateral, posterior, superior, and inferior surfaces, and at least one dense portion and at least one porous portion which are integrally formed. The at least one dense portion is formed of a first thermoplastic polymer matrix that is essentially non-porous, and which is continuous through a thickness dimension from the superior surface to the inferior surface. The at least one porous portion is formed of a porous thermoplastic polymer scaffold having a second thermoplastic polymer matrix which is continuous through the thickness dimension. A method for forming the thermoplastic composite body is disclosed comprising disposing a first powder mixture in a first portion of a mold, disposing a second powder mixture in a second portion of the mold, simultaneously molding the first powder mixture and the second powder mixture, and leaching porogen.

Abstract: A device includes a core having proximal and distal ends and defining a first female thread. A drive screw includes first and second ends. The first end includes a first male thread. The second end including a second male thread that engages the first female thread. A first body includes a second female thread that engages the first male thread. A second body is coupled to the drive screw. A first plate is coupled to the core and the first body. The first plate includes a first vertebral engaging surface. A second plate is coupled to the core and includes a second vertebral engaging surface. The drive screw is configured to rotate relative to the core to simultaneously pivot the first plate relative to the core and alter a distance between the first vertebral engaging surface and the second vertebral engaging surface.