Abstract: Prosthetic intervertebral discs and methods for using the same are described. The subject prosthetic discs include upper and lower endplates separated by a compressible core member. The prosthetic discs described herein include one-piece, two-piece, three-piece, and four-piece structures. The subject prosthetic discs exhibit stiffness in the vertical direction, torsional stiffness, bending stiffness in the sagittal plane, and bending stiffness in the front plane, where the degree of these features can be controlled independently by adjusting the components of the discs. The interface mechanism between the endplates and the core members of several embodiments of the described prosthetic discs enables a very easy surgical operation for implantation.

Abstract: 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.

Abstract: A device to space vertebral members with first and second members that may have at least one ramped section. The first and second members may be positioned in a vertically overlapping arrangement with interior sides of the members facing together. The device may be positionable between a first orientation with the ramped section of the first member positioned away from the ramped section of the second member, and a second orientation with the ramped section of the first member positioned against the ramped section of the second member. The device may include a greater height measured between the exterior sides in the second orientation than in the first orientation.

Abstract: A spinal fusion device that is expandable. The device features a top and bottom surface for engaging adjacent vertebrae, a hollow center for stacking of bone or bone growth material, and a slidable mechanism with grooves for expanding or unexpanding the device.

Abstract: An expandable interbody device for implantation within an intervertebral space is provided, together with methods and tools for use therewith. The interbody devices of the present invention include upper and lower bearing members configured to expand via an expansion mechanism configured to allow the insertion of osteoconductive materials and other structures into the interior of the interbody device before and after implantation, and before and after expansion of the interbody device. The insertion tool is configured expand the interbody device and to allow insertion of materials into the interbody device through a protected pathway.

Abstract: A method of manufacturing a composite interbody device includes assembling superior and inferior endplates, this including forming or layering micro-porous titanium on opposing sides of a solid titanium sheet. A first of the opposing sides provides a micro-porous bone interface layer and a second of the opposing sides provides a micro-porous core interface side. The solid titanium sheet therebetween forms a central barrier layer. The inferior and superior endplates are placed in a mold, on each side of a core cavity, with the core interface sides facing the core cavity and the bone interface sides facing away from the cavity. Molten plastic is injection-molded into the core cavity to form a plastic core between the endplates, the molten plastic extruding into pores of the microporous core interface sides. The plastic is set to bond the core with the endplates.

Abstract: A Spinous Process (SP) staple including a top claw, a bottom claw, a staple pin pivotally connecting the top claw and the bottom claw, a ratchet mechanism that limits an opening force of the top claw with respect to the bottom claw, a first hemi-spacer positioned on the top claw and a second hemi-spacer positioned on the bottom claw. Upon the stapling of two adjacent spinous processes, the SP staple claws approximate, and the first and second hemi-spacers interdigitate, interlock, and unite to become a single interspinous process spacer which can be wedged between two adjacent spinous processes. Adjacent spinous process separation and/or distraction leading to spinal canal decompression and alleviation of the symptoms of spinal stenosis are accomplished.

Abstract: An expandable interbody device for placement between adjacent vertebrae having an upper structure, a lower structure and a screw mechanism, wherein actuation of the screw mechanism moves the upper and lower structures between a collapsed configuration and an expanded configuration. A deployment tool couples to the expandable interbody device for positioning the device between adjacent vertebrae, actuating the screw mechanism and delivering a material to a chamber of the expandable interbody device.

Abstract: An expandable fusion device may include a first endplate and a second endplate. The expandable fusion device may also include first and second ramps configured to mate with both the first and second endplates. An inserter instrument includes an outer shaft having a bore extending longitudinally therethrough and an inner shaft extending through the bore in the outer shaft. The outer shaft is configured to engage the first or second opening in the second ramp, and the inner shaft is configured to engage the corresponding first or second opening in the first ramp to control implant height and/or lordotic angle.

Abstract: Systems and methods for flexibly stabilizing a vertebral motion segment by connecting a first vertebra and a second vertebra. The system includes an elongate connection element with end portions interconnected by a flexible coupling member. The system includes first and second attachment portions for connecting the connection element to the vertebrae. A first resilient member is positioned between the first end portion and the first attachment portion, and a second resilient member is positioned between the first attachment portion and the second attachment portion. The system is designed such that the second resilient member is compressed when the first and second attachment portions move towards each other, and the first resilient member is compressed when the first and second attachment portions extend away from each other.

Abstract: An expandable assembly for insertion into an intervertebral space is presented. The assembly, in particular aspects, includes an elongate body comprising an upper portion and a lower portion, wherein the elongate body defines an internal longitudinal channel extending from a proximal opening to a distal cavity. The assembly may include an expander that is sized and shaped for insertion into the distal cavity, thereby selectively expanding the upper portion away from the lower portion. The elongate body may also include one or more bone graft windows a cap that is sized and shaped for insertion into the proximal opening.

Abstract: This invention improves upon prior art total disc replacements (TDRs) by more closely replicating the kinematics of a natural disc. The preferred embodiments feature two or more fixed centers of rotation (CORs) and an optional variable COR (VCOR) as the artificial disk replacement (ADR) translates from a fixed posterior COR that lies posterior to the COR of the TDR to facilitate normal disc motion. The use of two or more CORs allows more flexion and more extension than permitted by the facet joints and the artificial facet (AF). AF joint-like components may also be incorporated into the design to restrict excessive translation, rotation, and/or lateral bending.

Abstract: In some embodiments a method comprises disposing an implant into contact with a first bone portion and into contact with a second bone portion, the implant having (1) a first interface configured to receive a restraining member, and (2) a second interface. The method further comprises inserting a portion of the fastener member into the first interface. The method further comprises securing the fastener member such that the first bone portion and the second bone portion are fixed to each other, at least in part by a substance after the securing, at least a portion of the substance disposed through the second interface.

Abstract: An implant couples a first bone of a hand to a second bone of the hand. The implant includes a body that defines a median plane. The body also defines a first joint surface having a first central region that articulates with the first bone. The body further defines a second joint surface having a second central region that articulates with the second bone, and the second central region is disposed on an opposite side of the median plane of the body relative to the first central region. The first and second central regions correspond to profiles of first and second axial segments, respectively, the first and second axial segments are each one of a cylinder, a cone and a torus and are centered on first and second axes, respectively, and the first and second axes, as projected on the median plane, are substantially perpendicular to each other.

Abstract: An intervertebral prosthesis includes: a body; a first aperture extending from within the body and opening; a first anchoring element disposed within the first aperture and including a shaft having proximal and distal ends, where the proximal end of the first anchoring element includes a first portion of a first articulation mechanism; and a drive mechanism having: (i) a threaded shaft defining a longitudinal axis thereof and a head at a proximal end of the threaded shaft, (ii) a translator element having a threaded bore in threaded engagement with the threaded shaft.

Abstract: An expandable implant with an upper plate and a lower plate which serve for anchoring on/in the vertebral support surfaces, and at least two gears for the expansion of the implant, which are coupled to each other via toothed wheels. Each gear includes threaded spindles and threaded sleeves, the threaded spindles are connected rigidly to the upper plate, and the threaded sleeves are mounted rotatably in the lower plate, and on one gear a drive shaft is provided, which is connected rigidly to the one threaded sleeve, and wherein a force acting on the drive shaft of an operating instrument can be transferred to the gear by the drive shaft, and the implant includes a mechanism for rigidly securing, screwing or fixing the operating instrument on the implant. The invention also relates to an operating instrument for an implant.

Abstract: An apparatus supports the spine between vertebrae and promotes spinal fusion. The apparatus generally includes a first supporting member, a second support member, and an expansion member. The first support member has a first longitudinal passage extending therethrough, a first supporting end configured to engage tissue, and a rack configured to engage a tool. The second supporting member contains a second longitudinal passage extending therethrough and a second supporting end configured to engage tissue. The second longitudinal passage is dimensioned to receive at least a portion of the first supporting member. The first and second supporting members are configured to move with respect to each other. The expansion member is removably positioned between the first and second supporting members and is adapted to maintain the first and second supporting members in a fixed relative position.

Abstract: A bone fusion device for insertion between bones that are to be fused together, such as, for example, the vertebrae of a spinal column. The bone fusion device comprises at least one extendable tab and one or more tab extension assemblies. Each tab extension assembly is able to be adjusted in order to individually control the extension or contraction of a side of the tab thereby enabling adjustment of the height and/or angle of the tab with respect to the body of the bone fusion device. Each tab extension assembly is able to be individually adjusted such that the side controlled by each assembly is raised or lowered until the desired tab angle is achieved. The tab is advantageously positioned and angled to correspond to the vertebrae to help brace the device until the bone has fused.

Abstract: An articulating fusible support cage comprises a first support member having a first and second end and a second support member having a first and second end. A first end cap is pivotally connected to the first and second support members at the first ends. The first end cap supports a jackscrew for rotation. A second end cap is pivotally connected to the first and second support members at the second ends opposite the first ends. The second end cap has a threaded sleeve configured to engage a portion of the jackscrew. Rotation of the jackscrew into the threaded sleeve causes the first and second support members to extend outwardly from a collapsed condition to a deployed condition.

Abstract: An adjustable spinal fusion intervertebral implant including upper and lower body portions each having proximal and distal surfaces at proximal and distal ends thereof. The implant can include a proximal wedge member disposed at the proximal ends of the respective ones of the upper and lower body portions, and a distal wedge member disposed at the distal ends of the respective ones of the upper and lower body portions. First and second linkages can connect the upper and lower body portions. Rotation of an actuator shaft can cause the distal and proximal wedge members to be drawn together such that longitudinal movement of the distal wedge member against the distal surfaces and the longitudinal movement of the proximal wedge member against the proximal surfaces causes separation of the upper and lower body portions.

Abstract: An expandable interbody fusion device includes superior and inferior endplates that are configured to receive a sequentially inserted stack of expansion members or wafers in interlocking engagement. The expansion members are formed to each have a generally U-shaped rearward facing opening. The superior and inferior endplates have openings through their outer surfaces in at least partial alignment and communication with the rearward facing openings of the expansion members. The inferior endplate has a fully bounded cavity for telescoping receipt of the superior endplate. The inferior endplate also has a fully bounded channel extending through the rear endwall thereof in direct communication with the rearward facing opening of at least one expansion member for the receipt of bone graft material into the device to promote fusion between opposing vertebral bodies of the spine.

Abstract: Provided are devices, systems and methods related to articulating interbody cages. The device includes a caudal plate configured to be positioned adjacent a first vertebral endplate within an intervertebral disc space, a cephalad plate configured to be positioned adjacent a second vertebral endplate within the intervertebral disc space; and a first and second sidewall each rotatably coupled to both the caudal and cephalad plates. At least one of the first and second sidewalls includes a hinge element restricted from achieving an on-center or over-center rotational position around the hinge element upon dimensional expansion of the device in at least a first dimension.

Abstract: Disclosed is an expandable interbody fusion implant that is configured to have an initial configuration having a first footprint width suitable for being inserted into an intervertebral space and an expanded configuration having a second footprint width that is greater than the first footprint width. The implant may include a first body member and a second body member that is pivotally coupled to the first body member. The implant may be expanded using an inflatable balloon. The implant may be expanded bilaterally such that both body members rotate relative to the other or the implant may be expanded unilaterally such that one of the body members rotates relative to the other.

Abstract: A prosthetic component suitable for long-term implantation is provided. The prosthetic component includes electronic circuitry and sensors to measure a parameter of the muscular-skeletal system. The prosthetic component comprises a first structure having at least one support surface, a second structure having at least one feature configured to couple to bone. The electronic circuitry and sensors are hermetically sealed within the prosthetic component. Sensors can be used to monitor synovial fluid in proximity to the joint to determine joint health. The prosthetic component can include a temperature sensor, a pH sensor, and an optical sensor. The temperature, pH, color, and turbidity of the synovial fluid can be correlated to a variety of joint conditions. Measurements over time can be analyzed for trends. The temperature, pH, color, and tubidity can be calibrated for the patient. The measurements are compared against this patient reference.

Abstract: An intervertebral implant includes a body portion defining a longitudinal axis. The body portion includes a distal end portion, a proximal end portion, anterior and posterior walls that extend between the distal and proximal end portions, and top and bottom surfaces. At least one of the top and bottom surfaces includes a plurality of substantially concentrically arranged ridges configured and adapted to engage vertebral bodies. In particular, the plurality of substantially concentrically arranged ridges are a plurality of ring-shaped protrusions that define a generally saw-tooth pattern in a radial direction.

Abstract: A methodology for grafting together adjacent bony structures is provided using an implant device having an endplate with an inner disc portion and outer ring portion spaced from the inner disc portion by a connecting wall disposed there between. An endplate interior surface includes a retaining structure for securing the endplate to one of the bony structures, and endplate an exterior surface has an integrally formed socket. A ball-joint rod has a longitudinally extending body and an end, and at least a portion of the ball-joint rod end is curvilinear in shape. The curvilinear ball-joint rod end is rotatably disposed in the endplate socket to fixedly interconnect the bony structures.

Abstract: An expandable bone device that includes a plurality of linking elements pivotally connected to one another about a hinge, wherein each of the linking elements has upper and lower support plates. An expansion mechanism is operatively connected to the linking elements and can move the upper support plate closer or further with respect to the lower support plate.

Abstract: An adjustable complex of an artificial cervical vertebra and an intervertebral connector includes: a vertebra body; and two end plates respectively connected to a top end and a bottom end of the vertebra body by spherical joint structures; wherein the vertebra body comprises: an upper vertebra body; and a lower vertebra body; wherein the upper vertebra body is axially connected to the lower vertebra body by a screw thread; a plurality of radial screw holes are correspondingly provided on side surfaces of the upper vertebra body and the lower vertebra body; a length-fixing screw is provided though the radial screw holes of the upper vertebra body and the lower vertebra body; wherein end plate fixing screws are respectively provided on the two end plates. The adjustable complex has a support function of an artificial vertebra and movability of an artificial intervertebral disc.

Abstract: An artificial disc is provided which more closely matches the movement of the natural spine. The artificial disc uses one or more projections and corresponding recesses to provide a sliding articulation. The artificial joint is inherently stable in that compressive forces placed on the disc such as the weight placed upon the joint or the tension of surrounding tissues urges the joint towards a neutral position and not farther away from a neutral position.

Abstract: A pedicle screw system that includes a pedicle screw and a collar. The pedicle screw includes an insertion portion, a shaft portion that extends from the insertion portion, and a head portion that is attached to the shaft portion. The head portion has a diameter that is larger than the shaft portion. The collar includes a first aperture and a second aperture. The first aperture and the second aperture are both adapted to receive the head portion. The first aperture includes a first aperture section and a second aperture section. The first aperture section is larger than the head portion. The second aperture section is smaller than the head portion.

Abstract: The present invention teaches an improved spinal fusion implant and method of implanting same. The implant includes a shell and an insert, the insert capable of situating first and second plates of the shell with respect to each other and of preventing unwanted loosening of fasteners placed through the shell and into the adjacent vertebral bodies. The method includes implanting a shell, selecting an insert from a plurality of inserts, and placing an insert between first and second plates of the shell.

Abstract: An intervertebral artificial disc is provided with a first endplate having a plurality of protrusions for attaching to an adjacent vertebrae and an extension portion extending towards a second adjacent vertebrae. A second endplate is provided with a plurality of protrusions for attaching to a second adjacent vertebrae and an extension portion extending towards the first adjacent vertebrae. A flexible member having an upper portion and a lower portion and a slider plate positioned within the upper portion of the flexible member is also provided. The extension portion of the first endplate is adapted to fit within a first cavity in the upper portion of the flexible member and the extension portion of the second endplate is adapted to fit within a second cavity in the lower portion of the flexible member.

Abstract: A trapeziometacarpal joint implant includes a body defining a median plane, a metacarpal joint surface, and a trapezium joint surface. A first central region of the metacarpal joint surface is situated on an opposite side of the median plane from a second central region of the trapezium joint surface. The first and second central regions correspond to profiles of a first axial segment and a second axial segment, respectively. The first and second axial segments are one of a cylinder, a cone and a torus and are centered on a first axis and a second axis, respectively, where the first and second axes, as projected on the median plane, are substantially perpendicular to each other.

Abstract: An expandable interbody device for implantation within an intervertebral space is provided, together with methods and tools for use therewith. The interbody devices include a leading first and trailing second bearing member configured to expand laterally via connecting portions disposed at the trailing end of the first being member and at least the leading end of the second bearing member. In some forms, the connecting portions have an arcuate configuration. The insertion tool is configured expand the interbody device by holding the first bearing member while shifting the second bearing member.

Abstract: An expandable interspinous spacer implant that is configured to be inserted into an interspinous space that is defined between a spinous process of a superior vertebral body and a spinous process of an inferior vertebral body is provided. The implant may include a superior housing, an inferior housing, and a distracting member. The superior housing may have an outer surface that is configured to engage the spinous process of the superior vertebral body and the inferior housing may have an outer surface that is configured to engage the spinous process of the inferior vertebral body. The distracting member may be disposed between the superior and inferior housings, such that activation of the distracting member distracts the superior and inferior housings apart from each other.

Abstract: An intervertebral scaffolding system is provided having a laterovertically-expanding frame operable for a reversible collapse from an expanded state into a collapsed state, the laterovertically-expanding frame having a stabilizer that slidably engages with the distal region of the laterovertically-expanding frame and is configured for retaining the laterovertically-expanding frame from a lateral movement that exceeds the expanded state. The expanded state, for example, can be configured to have an open graft distribution window that at least substantially closes upon the reversible collapse.

Abstract: An implant for insertion into the disc space between vertebrae. The implant including a spacer portion, a plate portion coupled to the spacer portion, a plurality of bone fixation elements for engaging the vertebrae and a retention mechanism for preventing the bone fixation elements from postoperatively uncoupling from the implant.

Abstract: An orthopedic surgical instrument for use in knee surgeries includes an elongated body, a pair of output shafts, and a user control. A first output shaft extends out from a first side of the body along a first output axis substantially perpendicular to a longitudinal axis of the elongated body. A second output shaft also extends out from the first side of the elongated body along a second output axis substantially perpendicular to the longitudinal axis of the elongated body. The user control is coupled to the elongated body near a first end and the first and second output shafts are situated near the second end of the elongated body. Each of the first output shaft and the second output shaft are configured to turn independent of one another in response to operation of the user control. Various joint distractors for use with the orthopedic surgical instrument are also disclosed.

Abstract: A prosthesis for a vertebral column has an upper part (10) for attachment to an upper vertebrae, a lower part (12) for attachment to a lower vertebrae and a middle part (11) located between the upper and the lower parts, wherein the upper part has a lower surface portion with a first radius of curvature, the middle part has an upper surface portion with a second radius of curvature and a lower surface with a third radius of curvature and the lower part has an upper surface with a fourth radius of curvature. The centre of the radius of curvature for at least two surfaces is offset rearwardly with respect to a central vertical axis (13) through the upper and lower vertebrae and/or the upper and lower parts. Also defined is device for linking bones, in the form of a band with attachment portions having a number of filaments that provide zones conducive to cellular growth as well as a method of modelling a prosthesis and a process for analysing performance of a prosthesis.

Abstract: 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 one embodiment, the fusion device includes a central ramp, a first endplate, and a second endplate, the central ramp capable of being moved in a first direction to move the first and second endplates outwardly and into an expanded configuration. The fusion device is capable of being deployed down an endoscopic tube.

Abstract: An instrument for use in a procedure for inserting a spinal implant between human vertebrae may include a shaft and an end member. The end member may rotate with respect to the shaft. An angle of the end member with respect to the shaft may be varied when the end member is in a disc space between the human vertebrae. The instrument may include a slide for securing the end member at selected angles relative to the shaft. The end member may be separable from the shaft when the end member is in a selected orientation with the shaft. An instrument kit may include a shaft assembly and modular end members for various steps in a surgical procedure, such as disc space preparation, disc space evaluation, and spinal implant insertion.

Abstract: A push-in orthopedic implant having an expandable height. The implant includes an upper member, a lower member, and a blocker pivotally attached to one of the upper and lower members. The blocker is attached proximate one of the proximal and distal ends of the one of the upper and lower members, and is adapted to pivot into cooperative engagement with another of the one of the upper and lower members. The blocker is adapted to hold at least a portion of the upper and lower members apart so as to maintain an increased height of the implant and resist the collapse of the implant to a collapsed implant height when the implant is in a final deployed position.

Abstract: Systems for and methods of fusing a sacroiliac joint are provided which include an implant assembly adapted to be inserted into the joint space defined by the bones of a sacrum and an ilium, a delivery tool and means for inserting the implant assembly into the joint. The implant assembly includes a body disposed intermediate distal and proximate end portions thereof and having oppositely disposed side members adapted to expandably engage the sacroiliac joint following insertion of the assembly into the joint space. A tool is provided and provides a means for placing the implant assembly adjacent the sacroiliac joint, inserting it into the joint space and expanding means are thereafter applied to expand the oppositely disposed side members into operative engagement with the joint.

Abstract: An intervertebral fusion implant for the fusion of two vertebrae comprises an upper bearing body for placing on a lower end-plate of a vertebra, a lower bearing body for placing on an upper end-plate of a vertebra, and a central piece arranged between the bearing bodies. The central piece comprises a claw coupling which, in a coupling position, couples the two bearing bodies in a rotationally fixed manner to each other. In an open position of the claw coupling, the bearing bodies are freely movable in relation to each other. The claw coupling is actuated automatically via a plastic blocking body which, in its initial position, holds the claw coupling open and, under a load transferred from one vertebra to the other vertebra, is slowly deformable until it reaches a final coupling position in which the claw coupling is closed. This results in the slow fusion of the vertebrae.

Abstract: A distractible intervertebral implant configured to be inserted in an insertion direction into an intervertebral space that is defined between a first vertebral body and a second vertebral body is disclosed. The implant may include a first body and a second body. The first body may define an outer surface that is configured to engage the first vertebral body, and an opposing inner surface that defines a rail. The second body may define an outer surface that is configured to engage the second vertebral body, and an inner surface that defines a recess configured to receive the rail of the first body. The second body moves in a vertical direction toward the second vertebral body as the second body is slid over the first body and the rail is received in the recess.

Abstract: A spinal implant includes a first rolling-contact core operably coupled to a first vertebra, said first rolling-contact core having a first convex surface having a first axis, said first convex surface configured to provide a first rolling motion in a first direction to said first vertebra relative to a second vertebra. At least one flexure is connected to said first rolling-contact core, said flexure configured to constrain said first rolling motion.

Abstract: A hybrid mechanical device comprising rigid-body joints, such as rotational and planar joints, and one or more continuum joints that operate based on constitutive properties of materials, such as, for example, flexure, extension and compression. Embodiments include a tripartite nucleus comprising a cap, core, and sled. The cap is rotatably connected to a first end plate and the sled is rotationally and translationally connected to a second end plate. The joint surfaces between the nucleus and end plates of the device provide up to six degrees of freedom. The constitutive properties of the core can further provide a “continuum” joint to complete the hybrid mechanical motion producing structure. In certain embodiments, the cap, core and sled comprise the same or substantially the same material. But, in other embodiments, the cap, core and sled comprise different materials.

Abstract: An intervertebral prosthetic implant having a first endplate having a first surface configured to substantially engage with a first vertebral body and a second surface having an extension with a concave contact surface, the concave contact surface being spaced apart from the second surface. A second endplate is provided with a first surface configured to substantially engage with a second vertebral body and a second surface comprising a convex contact surface, and the second endplate having a securing element positioned along and above the second surface defining a first and second window on opposing sides of the second surface. The securing element extends along the width and length of the lower endplate and configured with an access hole. An extension portion extends from the first surface of the first endplate through the access hole of the securing element and contacts the second surface of the second endplate.

Abstract: An expandable implant for engagement between vertebrae includes an inner member, an outer member, and a gear member positioned coaxial with respect to each other such that the inner and outer members are moveable relative to each other along an axis. The inner member includes a longitudinal groove configured to engage a pin extending through the outer member such that the pin prevents the inner member from translating completely through the outer member and aids in alignment and limits rotation of the second endplate. Portions of the implant may be provided with a series of markings such that when the markings are aligned, the implant is aligned in a specific configuration and for a specific implantation approach.

Abstract: Disclosed herein are devices (100), systems and methods of use relating to articulating interbody cages. In one aspect, disclosed is an intervertebral device (100) for use in a human spine including an anterior end (104); a posterior end (102); and at least four peripheral walls (22,24,26). The peripheral walls (26) define an interior volume surrounding a midline of the device and include a superior wall (22), an inferior wall (24) and a pair of opposing, generally trapezoidal-shaped sidewalls. Each of the trapezoidal-shaped sidewalls (26) includes an internal hinge element (60) that is rotatable from a first configuration to at least a second configuration such that the device is expandable in first dimension. Each of the internal hinge elements includes an axis that is coplanar with the midline of the device.