Abstract:
Embodiments of bony region stabilization implants are described generally herein including a controllable expandable implant for placement between two bony segments including vertebrae. Other embodiments may be described and claimed.

Description:
TECHNICAL FIELD 
     Various implant embodiments described herein relate generally to stabilizing mammalian bony segments, including fenestrated implants to stabilize one or more mammalian bony segments. 
     BACKGROUND INFORMATION 
     It may be desirable to stabilize one or more bony segments via one or more implants; the present invention provides such implants. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1A  is a simplified diagram of mammalian bony segment stabilization architecture with an implant system in an unexpanded configuration according to various embodiments. 
         FIG. 1B  is a simplified diagram of mammalian bony segment stabilization architecture with an implant system in an expanded configuration according to various embodiments. 
         FIG. 2A  is a simplified, isometric view of an expandable mammalian bony segment stabilization implant system in a substantially unexpanded configuration according to various embodiments. 
         FIG. 2B  is a simplified, isometric view of an expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2C  is a simplified, top view of an expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2D  is a simplified, front view of an expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2E  is a simplified, rear view of an expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2F  is a simplified, front view of another expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2G  is a simplified, right view of an expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2H  is a simplified, left view of an expandable mammalian bony segment stabilization implant system in an expanded configuration according to various embodiments. 
         FIG. 2I  is a simplified, left view of an expandable mammalian bony segment stabilization implant system in an unexpanded configuration according to various embodiments. 
         FIG. 2J  is a simplified, isometric view of a mammalian bony segment stabilization implant system lower bony segment interface body according to various embodiments. 
         FIG. 2K  is a simplified, isometric view of a mammalian bony segment stabilization expansion mechanism according to various embodiments. 
         FIG. 3A-3C  are simplified, side, profile views of mammalian bony segment stabilization implant system upper bony segment interface bodies according to various embodiments. 
     
    
    
     DETAILED DESCRIPTION 
       FIG. 1A  is a simplified diagram of mammalian bony segment stabilization architecture  220 A with an implant system  10 A in an unexpanded configuration according to various embodiments. The architecture  220 A includes at least one implant system  10 A inserted between bony regions  222 C,  222 B. In an embodiment the implant system  10 A may be inserted any axial direction between two bony regions  222 C,  222 B,  222 A including laterally, anteriorly, and posteriorally. In another embodiment one or more implant systems  10 A,  10 B ( FIG. 2F ) may be inserted posteriorally between any two bony regions  222 A,  222 B,  222 C. Further one or more implant systems  10 A,  10 B,  10 C may be inserted laterally and one or more implant systems  10 A,  10 B,  10 C may be inserted posteriorally between any two bony regions  222 A,  222 B,  222 C. Additionally the implant systems  10 A,  10 B may be inserted at any angle between two bony regions  222 A,  222 B,  222 C as a function of anatomy adjacent the respective two bony regions  222 A,  222 B,  222 C. 
       FIG. 1B  is a simplified diagram of mammalian bony segment stabilization architecture  220 B with an implant system  10 A in an expanded configuration according to various embodiments. In an embodiment one or more implant systems  10 A may be inserted between two bony segments  222 A,  222 B,  222 C with a reduced height profile between an upper implant  20 A and a lower implant  20 B. The implant system  10 A profile or distance between an upper implant  20 A and a lower implant  20 B may be expanded via an expansion mechanism  100  ( FIG. 2K ). 
     In an embodiment the distance between the upper bony segment interface body (BSIB)  20 A front edge  22 A and lower bony segment interface body (BSIB)  20 B front edge  22 B (front distance) and the upper BSIB  20 A rear edge  27 A and lower BSIB  20 B rear edge  27 B (rear distance) may be simultaneously adjusted via a rear ratcheting mechanism  90  ( FIG. 2E ). In another embodiment the front distance and the rear distance may be simultaneously adjusted via a rear ratcheting mechanism  70  ( FIG. 2F ). In a further embodiment the front distance may be adjusted via a front ratcheting mechanism  70  ( FIG. 2F ) and the rear distance may be independently adjusted via a rear ratcheting mechanism  90  ( FIG. 2E ). 
     In an embodiment an implant system  10 A,  10 B may be inserted between two bony segments  222 A,  222 B,  222 C in a substantially unexpanded state ( FIG. 1A ) and then expanded via the rear mechanism  90  ( FIG. 2E ), the front mechanism  70  ( FIG. 2F ) or a combination of both mechanisms  70 ,  90 . The expanded implant system  10 A,  10 B may increase the separation between two, adjacent bony segments  222 A,  222 B,  222 C. As a function of the mechanisms  70 ,  90  operation and implant system  10 A,  10 B placement (between bony segments  222 A,  222 B,  222 C) the expanded implant system  10 A,  10 B may increase the anterior distance between adjacent bony segments  222 A,  222 B,  222 C, the superior distance between adjacent bony segments  222 A,  222 B,  222 C, or a combination of both separately or simultaneously. Further as a function of the mechanisms  70 ,  90  operation and implant system  10 A,  10 B placement (between bony segments  222 A,  222 B,  222 C) the expanded implant system  10 A,  10 B may increase a first lateral distance between adjacent bony segments  222 A,  222 B,  222 C, and a second, opposite lateral distance between adjacent bony segments  222 A,  222 B,  222 C, or a combination of both separately or simultaneously. 
     In an embodiment one or more implant systems  10 A,  10 B may be inserted via a first axial direction between a first, adjacent bony segments  222 A,  222 B,  222 C and one or more implant systems  10 A,  10 B may be inserted via a second axial direction between a second, adjacent bony segments  222 A,  222 B,  222 C where the first axial direction and the second axial direction may be the same or different. Further an implant system  10 A,  10 B may be inserted in a substantially unexpanded state ( FIG. 1A ) or partially expanded state ( FIG. 1B ). The implant system  10 A,  10 B front distance or rear distance may be increased separately or simultaneously via the rear ratcheting mechanism  90  or the front ratcheting mechanism  70  as desired or required. In an embodiment the front distance and rear distance may be equal or unequal as a function of the implant system  10 A,  10 B placement between two adjacent bony segments  222 A,  222 B,  222 C. In an embodiment the front distance or separation between BSIB  20 A,  20 B may be less than the rear distance to promote lordosis between the adjacent bony segments  222 A,  222 B,  222 C. 
     In an embodiment the adjacent bony segments  222 A,  222 B,  222 C may be adjacent vertebra including the sacrum with a disc  224 A between adjacent vertebra. The disc  224 A may include an annulus and a disc nucleus pulposus. In an embodiment an implant system  10 A,  10 B may be inserted into a disc nucleus via an opening in the annulus (annulotomy) to increase the distance between adjacent vertebra  222 A,  222 B,  222 C. An implant system  10 A,  10 B may be expanded to increase a distance between adjacent vertebra  222 A,  222 B,  222 C (uniformly, front, or rear distance) of the implant system  10 A,  10 B to effectively decompress an intervertebral disc  224 A. 
       FIG. 2A  is a simplified, isometric view of an expandable mammalian bony segment stabilization implant system  10 A in a substantially unexpanded configuration according to various embodiments. The implant system  10 A may include an upper bony segment interface body (“BSIB”)  20 A, a lower bony segment interface body (“BSIB”)  20 B, and an expansion mechanism  100 A. The expansion mechanism  100 A may be operatively coupled to the upper BSIB  20 A and the lower BSIB  20 B to expand or change the distance between the upper BSIB  20 A and the lower BSIB  20 B. 
     The upper BSIB  20 A may be shaped to engage a portion of a first bony segment  222 A,  222 B,  222 C and the lower BSIB  20 B may be shaped to engage a portion of a second bony segment  222 A,  222 B,  222 C adjacent the first bony segment. In an embodiment the upper BSIB  20 A may be substantially rectangular with rounded corners or elliptical in shape and include a sloped front edge  22 A. The upper BSIB  20 A may also include a large central fenestration  24 A where the fenestration  24 A may also be substantially rectangular with rounded corners or elliptical in shape. The upper BSIB  20 A upper surface may include a plurality of teeth  25 A configured to engage a surface of the first bony segment (including an endplate of a vertebral body). The teeth  25 A may be racked or angled to the BSIB  20 A rear fenestration  23 A to limit or prevent slippage of the upper BSIB  20 A against the first bony segment. The upper BSIB  20 A may include side wall protrusions  26 A to engage anatomy (such as disc  224 A) adjacent or part of the first bony segment. As shown in  FIG. 2A  the side wall protrusions may have triangular or pyramid shape. 
     In an embodiment the lower BSIB  20 B may also be substantially rectangular with rounded corners or elliptical in shape and a sloped front edge  22 B. The lower BSIB  20 B may also include a large central fenestration  24 B where the fenestration  24 B may also be substantially rectangular with rounded corners or elliptical in shape. The lower BSIB  20 B lower surface may include a plurality of teeth  25 B ( FIG. 2D ) to engage a surface of the second bony segment. The teeth  25 B may be racked or angled (to the rear in an embodiment) to limit or prevent slippage of the lower BSIB  20 B against the second bony segment. The lower BSIB  20 B may include side wall protrusions  26 B to engage anatomy (such as disc  224 A) adjacent or part of the second bony segment. As shown in  FIG. 2A  the side wall protrusions may have triangular or pyramid shape. 
     The upper BSIB  20 A may also include a first extension fenestration  21 A and a second extension fenestration  23 A. The first extension fenestration  21 A may be shaped to provide a slot for an expansion mechanism arm or extension  80  ( FIG. 2A )  70 A ( FIG. 2F ). The second extension fenestration  23 A may be shaped to provide a slot for a rear ratchet mechanism  90  arm  90 A or an expansion mechanism arm or extension  80  ( FIG. 2A ). In an embodiment the first and second fenestrations  21 A,  23 A may be rectangular, square, or elliptical in shape as a function of the corresponding extension  80 , and ratcheting mechanism  70  or  90  respectively. Similarly the lower BSIB  20 B may also include a first extension fenestration  21 B and a second extension fenestration  23 B ( FIG. 2J ). The first extension fenestration  21 B may be shaped to provide a slot for an expansion mechanism arm or extension  70 A. The second extension fenestration  23 B may be shaped to provide a slot for an ratcheting mechanism  90  arm  90 A ( FIG. 2E ) or expansion mechanism arm or extension  80  ( FIG. 2A ). In an embodiment the first and second fenestrations  21 B,  23 B may be rectangular, square, or elliptical in shape as a function of the corresponding extension  90 A,  80 , and extension  70  respectively. 
     As shown in  FIG. 2B ,  FIG. 2G , and  2 H, the upper BSIB  20 A may be pivotally coupled to the extension mechanism  100 A,  100 B via a plurality of links  50 F,  50 E,  50 G,  50 H. The plurality of links  50 F,  50 E,  50 G,  50 H may be pivotally coupled to the upper BSIB  20 A via pins  60 J,  60 I,  60 K,  60 L, respectively placed in BSIB pin fenestrations  29 A ( FIG. 2J ). Similarly as shown in  FIG. 2B ,  FIG. 2G , and  2 H, the lower BSIB  20 B may be pivotally coupled to the extension mechanism  100 A,  100 B via a plurality of links  50 B,  50 A,  50 C,  50 D. The plurality of links  50 B,  50 A,  50 C,  50 D may be pivotally coupled to the lower BSIB  20 B via pins  60 N,  60 M,  60 O,  60 P, respectively placed in BSIB pin fenestrations  29 A ( FIG. 2J ). 
       FIG. 2B  is a simplified, isometric view of an expandable mammalian bony segment stabilization implant system  10 A in an expanded configuration according to various embodiments. As shown in  FIG. 2B  the distance between the upper BSIB  20 A and the lower BSIB  20 B has increased, increasing the overall height of the implant system  10 A. As also shown in  FIG. 2B  the links  50 F,  50 E,  50 G,  50 H coupled to the upper BSIB  20 A via pins  60 J,  60 I,  60 K,  60 L, respectively have pivoted vertically relative to their position shown in  FIG. 2A . Similarly, the links  50 B,  50 A,  50 C,  50 D coupled to the lower BSIB  20 B via pins  60 N,  60 M,  60 O,  60 P, respectively have pivoted vertically relative to their position shown in  FIG. 2A . 
       FIG. 2C  is a simplified, top view of an expandable mammalian bony segment stabilization implant system  10 A in an expanded configuration according to various embodiments.  FIG. 2C  shows the pins  60 J,  60 I,  60 K,  60 L that pivotally couple the links  50 F,  50 E,  50 G,  50 H to the upper BSIB  20 .  FIG. 2C  also shows a ratchet screw  40  of an extension mechanism  100 A,  100 B. The extension mechanism  100 A,  100 B screw may have a first thread pitch  42 A that may drive into a front screw nut and link pivot connection arm  30 A. The extension mechanism  100 A,  100 B screw  40  may have a second thread pitch  42 B that may drive into a back screw nut and link pivot connection arm  30 B. The second thread pitch  42 B may be opposite the pitch of the first thread pitch  42 A where the first and second thread sections  42 A and  42 B are linked by section  43 . 
     In this embodiment when the screw  40  is rotated by the ratcheting mechanism  70  ( FIG. 2F ) or  90  ( FIG. 2E ), the respective pivot arms  30 A,  30 B may be moved simultaneously either toward each other or away from each other. In another embodiment the first screw section  42 A may not be rotatably linked to the second screw section  42 B via the section  43 . In this embodiment the front ratcheting mechanism  70  may separately enable the rotation of the screw section  42 A of the screw  40  and separately move the front screw nut and link pivot connection arm  30 A relative to the rear screw nut and link pivot connection arm  30 B. Similarly, the second screw section  42 B may not be rotatably linked to the first screw section  42 A via the section  43 . In this embodiment the rear ratcheting mechanism  90  may separately enable the rotation of the screw section  42 B of the screw  40  and separately move the rear screw nut and link pivot connection arm  30 B relative to the front screw nut and link pivot connection arm  30 A. 
       FIG. 2D  is a simplified, front view of an expandable mammalian bony segment stabilization implant system  10 A in an expanded configuration according to various embodiments. As shown in  FIG. 2D  the expansion mechanism  100 A may include an end cap and extension  80  in front of the arm  30 A. The end cap and extension  80  may an opening  82  for the screw  40  second section  42 A end. The end cap and extension  80  screw opening  82  may enable the screw  40  second section  42 A to rotate within the end cap and extension  80  so the front screw nut and link pivot connection arm  30 A may move inwardly and accordingly the increase the distance between the upper BSIB  20 A from the lower BSIB  20 B, expanding the front of the implant system  10 A when the implant system  10 A rear is also expanding. As noted the first screw section  42 A thread pitch may be opposite the second section  42 B to cause the arms  30 A,  30 B to either move toward each at the same time or away from each other at the same time. 
       FIG. 2E  is a simplified, rear view of an expandable mammalian bony segment stabilization implant system  10 A in an expanded configuration according to various embodiments. As shown in  FIG. 2E  the implant system  10 A may include a rear ratchet mechanism  90 . The rear ratchet mechanism  90  may include a cover and extension  90 A, a lower pawl  90 B, an upper pawl  90 C, and a direction level  90 D. The screw  40  section  42 B end may include a gear  44 B having a plurality of teeth and a recessed tool interface  45 B. 
     As shown in  FIG. 2E  the gear  44 B teeth spacing may enable the lower pawl  90 B or upper pawl  90 C to engage teeth at spaced intervals. The gear  44 B may include 16 teeth in an embodiment. The level  90 D may be employed to engage the upper pawl  90 C and disengage the lower pawl  90 B to enable rotation of the screw  40  section  42 B in a first counter-clockwise direction. Similarly, the level  90 D may be employed to engage the lower pawl  90 B and disengage the upper pawl  90 C to enable rotation of the screw  40  section  42 B in a second clockwise direction. In an embodiment, rotation of the screw  40  section  42 B in a clockwise direction may cause the rear screw nut and link pivot connection arm  30 B to move inward and accordingly increase the distance between the upper BSIB  20 A from the lower BSIB  20 B, expanding at least the rear of the implant system  10 A. In an embodiment rotation of the screw  40  second screw section  42 B may cause the first screw section  42 A to rotate simultaneously. As shown in  FIG. 2D , the implant system  10 A front may include an end cap and extension  80  with an opening  82  that enables the screw  40  first section  42 A to rotate freely while the second section  42 B is rotated via the tool recess  45 B. 
       FIG. 2F  is a simplified, front view of an expandable mammalian bony segment stabilization implant system  10 B in an expanded configuration according to various embodiments. As shown in  FIG. 2F  the implant system  10 A may include a front ratchet mechanism  70 . The front ratchet mechanism  70  may include a cover and extension  70 A, lower pawl  70 B, upper pawl  70 C, and direction level  70 D. The screw  40  section  42 A end may include a gear  44 A having a plurality of teeth and a recessed tool interface  45 A. As shown in  FIG. 2F  the gear  44 A teeth spacing may enable the lower pawl  70 B or upper pawl  70 C to engage teeth at spaced intervals. The gear  44 A may include 16 teeth in an embodiment. The level  70 D may be employed to engage the upper pawl  70 C and disengage the lower pawl  70 B to enable rotation of the screw  40  section  42 A in a first counter-clockwise direction. Similarly, the level  70 D may be employed to engage the lower pawl  70 B and disengage the upper pawl  70 C to enable rotation of the screw  40  section  42 A in a second clockwise direction. In an embodiment, rotation of the screw  40  section  42 A in a counter-clockwise direction may cause the front screw nut and link pivot connection arm  30 A to move inward and accordingly the distance between the upper BSIB  20 A to increase from the lower BSIB  20 B, expanding at least the front of the implant system  10 A. In the implant system  10 B rear may include an end cap and extension  80  with an opening  82  that enables the screw  40  second section  42 B to rotate freely while the first section  42 A is rotated via the tool recess  45 A. 
       FIG. 2G  is a simplified, right view of an expandable mammalian bony segment stabilization implant system  10 A in an expanded configuration according to various embodiments.  FIG. 2H  is a simplified, left view of an expandable mammalian bony segment stabilization implant system  10 A in an expanded configuration according to various embodiments. As shown in  FIG. 2G  and  FIG. 2H  the implant system  10 A upper BSIB  20 A may be connected to the expansion mechanism  100  front screw nut and link pivot connection  30 A via the link  50 G and related pins  60 K and  60 H, link  50 H and related pins  60 L and  60 D, link  50 F and related pins  60 J and  60 B, and link  50 E and related pins  60 I and  60 F. As shown in  FIG. 2G  and  FIG. 2H  the implant system  10 A lower BSIB  20 B may be connected to the expansion mechanism  100  front screw nut and link pivot connection  30 A via the link  50 C and related pins  60 O and  60 G, link  50 D and related pins  60 P and  60 C, link  50 B and related pins  60 N and  60 A, and link  50 A and related pins  60 M and  60 E. 
       FIG. 2I  is a simplified, left view of an expandable mammalian bony segment stabilization implant system  10 A in an unexpanded configuration according to various embodiments. As shown in  FIG. 2I  the upper BSIB  20 A and the lower BSIB  20 B may rest against the front screw nut and link pivot connection arm  30 A and the rear screw nut and link pivot connection arm  30 B when the implant system  10 A is substantially unexpanded. The end cap and extension  80  may extend into the upper BSIB  20 A rear fenestration  23 A and the lower BSIB  20 B rear fenestration  23 B. Similarly the front ratcheting mechanism  70  extension  70 A may extend into the upper BSIB  20 A front fenestration  21 A and the lower BSIB  20 B front fenestration  21 B. For implant system  10 B (shown in  FIG. 2F ), the rear ratcheting mechanism  90  extension  90 A may extend into the upper BSIB  20 A rear fenestration  23 A and the lower BSIB  20 B rear fenestration  23 B. 
     As the implant system  10 A expands as shown in  FIGS. 2G and 2H  the front screw nut and link pivot connection arm  30 A and the rear screw nut and link pivot connection arm  30 B may move inward to the implant system  10 A screw  40  middle section  43  causing the links  50 A to  50 H to rotate about the pins  60 A to  60 P and cause the BSIB  20 A and BSIB  20 B to move apart from the arms  30 B,  30 A. As noted in an embodiment activation of the rear ratcheting mechanism  90  in a first rotation may cause the entire screw  40 , sections  42 A and  42 B to rotate in the same first direction. In another embodiment, activation of the rear ratcheting mechanism  90  in a first rotation may only cause the adjacent screw  40  rear section  42 B to rotate in the same first direction. Similarly in an embodiment activation of the front ratcheting mechanism  70  ( FIG. 2F ) in a first rotation may cause the entire screw  40 , sections  42 A (front) and  42 B (rear) to rotate in the same first direction. In another embodiment, activation of the front ratcheting mechanism  70  in a first rotation may only cause the adjacent screw  40  front section  42 A to rotate in the same first direction. 
       FIG. 2J  is a simplified, isometric view of a mammalian bony segment stabilization implant system  10 A,  10 B lower BSIB  20 B according to various embodiments. As shown in  FIG. 2J  the BSIB  20 B may include a front fenestration  21 B, a rear fenestration  22 B, and a central, elliptical fenestration  24 B. The front and rear fenestrations  21 B,  23 B may have a shape that mates with the rear ratcheting mechanism  90  extension  90 A, the end cap and extension  80 , and the front ratcheting mechanism  70  extension  70 A. The front and rear fenestrations  21 B,  23 B may be rectangular in shape in an embodiment. As shown in  FIG. 2J  the lower BSIB  20 B may include fenestrations  29 A for pins  60 M to  60 P where the pins  60 M to  60 P rotatably couple a link  50 A to  50 D to the lower BSIB  20 B. In an embodiment the lower BSIB  20 B may include openings  28 A for each link  50 A to  50 D where the openings  28 A are shaped to provide complementary shape for a link  50 A to  50 D so the link  50 A to  50 D may be at least partially recessed in the lower BSIB  20 B when the implant system  10 A,  10 B is not fully expanded. 
     As shown in  FIG. 2J  a link  50 A to  50 D accommodating opening  28 A may include a slanted recess or ramp  28 B and deep section  28 C. The deep section  28 C may accommodate the curved end portion of a link  50 A to  50 D and the slanted recess or ramp  28 B may accommodate the central arm of a link  50 A to  50 D.  FIG. 2K  is a simplified, isometric view of a mammalian bony segment stabilization expansion mechanism  100 A according to various embodiments. As shown in  FIGS. 2A-2E ,  2 G- 2 I the expansion mechanism  100 A links  50 A to  50 H may be rotatably coupled to an upper BSIB  20 A and a lower BSIB  20 B via the pins  60 I to  60 P. As shown in  FIG. 2K , the expansion mechanism  100 A may include a rear ratcheting mechanism  90 , a rear end cap and extension  80 , front screw nut and link pivot connection arm  30 A, rear screw nut and link pivot connection arm  30 B, links  50 A- 50 H, pins  60 A to  60 P, and screw  40 . In another embodiment the front end cap and extension  80  may be replaced by a front ratcheting mechanism  70  as shown in  FIG. 2F . 
     In an embodiment the expansion mechanism  100 A may include a different ratcheting mechanism  70 ,  90 . The mechanism  100 A may include additional links  50 A to  50 H. In a further embodiment the mechanism may not include end cap and extension  80 . In another embodiment the expansion mechanism may only be pivotally coupled to the one of the upper BSIB  20 A and the lower BSIB  20 B. In the embodiment the expansion mechanism  10 A,  10 B may only lift one of the two BSIB  20 A,  20 B relative to the other of the BSIB  20 A,  20 B. The expansion mechanism  10 A,  10 B may be fixably coupled the other of the BSIB  20 A,  20 B. 
     In an embodiment, the implant system&#39;s  10 A,  10 B unexpanded height between the upper BSIB  20 A front edge  22 A and the lower BSIB  20 B front edge  22 BA may range from 5 to 16 mm. In an embodiment, the implant system&#39;s  10 A,  10 B expanded height between the upper BSIB  20 A front edge  22 A and the lower BSIB  20 B front edge  22 BA may range from 8 to 30 mm. The implant system&#39;s  10 A,  10 B maximum length between the front 70 and rear 80, 90 may range from 8 to 35 mm. The implant system&#39;s  10 A,  10 B maximum width may range from 6 mm to 25 mm. Each BSIB  20 A,  20 B central fenestration  24 A,  24 B may have a length from about 5 to 30 mm and a width from about 3 to 5 mm. Each BSIB  20 A,  20 B front fenestration  21 A,  21 B may have a length from about 1 to 6 mm and a width from about 1 to 9 mm in an embodiment. Further, each BSIB  20 A,  20 B rear fenestration  23 A,  23 B may have a length from about 1 to 6 mm and a width from about 1 to 9 mm in an embodiment. 
     In an embodiment the upper BSIB front edges  22 A,  22 B may have a slope ranging from 10 to 30 degrees with about 25 degrees in an embodiment. Further the top and bottom surfaces  12 ,  14  may have an effective radius of ranging from 20 to 60 mm and about 40 mm in an embodiment. The implant systems  10 A,  10 B upper BSIB  20 A and lower BSIB  20 B teeth  25 A,  25 B may be spaced about 0.5 to 3.0 mm apart and have a height of about 0.2 to 1.2 mm. The teeth  25 A,  25 B may have a reverse rack (relative to the upper BSIB  20 A front edge  22 A and the lower BSIB  20 B front edge  22 B) of about 46 to 65 degrees (obtuse). 
       FIG. 3A-3C  are simplified, side, profile views of mammalian bony segment stabilization implant system upper bony segment interface bodies  120 A,  120 B, and  120 C according to various embodiments. As shown in these figures a BSIB  120 A,  120 B,  120 C may have a rounded or shaped front edge  122 A,  122 B,  122 C. A lower BSIB  20 B of an implant system  10 A,  10 B may also include rounded or shaped edges  122 A,  122 B,  122 C. An BSIB  120 A,  120 B,  120 C edge  122 A,  122 B,  122 C may have an outer diameter of about 0.5 mm to 4 mm (0.5 mm, 1.2 mm, and 1.5 mm in an embodiment respectively for  122 A,  122 B, and  122 C.) An upper or lower BSIB with additionally rounded or shaped edges  122 A,  122 B,  122 C,  22 A,  22 B may ease the entry of an implant system  10 A,  10 B between adjacent bony segments. 
     In an embodiment the implant system  10 A,  10 B upper BSIB  20 A and lower BSIB  20 B may include a radio lucent material including polymers/thermoplastics such as (Polyetheretherketone). The implant system  10 A,  10 B upper BSIB  20 A and lower BSIB  20 B may also include radio markers including radio opaque materials including metal alloys such as titanium and tantalum. In an embodiment the implant system  10 A,  10 B upper BSIB  20 A and lower BSIB  20 B may include porous openings that may enable bony in-growth in the BSIB  20 A,  20 B. The BSIB  20 A,  20 B material may include a bone growth activator or bio-active elements including a calcium based hydroxylapatite or hydroxyapatite. Further the implant system  10 A,  10 B upper BSIB  20 A and lower BSIB  20 B surfaces may be coated with a bio-active element or coatings including a hydroxyapatite to encourage bony growth between a bony surface  222 A,  222 B,  222 C and an BSIB  20 A,  20 B. It is noted that the BSIB  20 A,  20 B and expansion mechanisms  100 A,  100 B may be comprised of any biocompatible material including bone, polymers, and metals. 
     The accompanying drawings that form a part hereof show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. The embodiments illustrated are described in sufficient detail to enable those skilled in the art to practice the teachings disclosed herein. Other embodiments may be utilized and derived therefrom, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. This Detailed Description, therefore, is not to be taken in a limiting sense, and the scope of various embodiments is defined only by the appended claims, along with the full range of equivalents to which such claims are entitled. 
     Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term “invention” merely for convenience and without intending to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is in fact disclosed. Thus, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. Combinations of the above embodiments, and other embodiments not specifically described herein, will be apparent to those of skill in the art upon reviewing the above description. 
     The Abstract of the Disclosure is provided to comply with 37 C.F.R. §1.72(b), requiring an abstract that will allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. In the foregoing Detailed Description, various features are grouped together in a single embodiment for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted to require more features than are expressly recited in each claim. Rather, inventive subject matter may be found in less than all features of a single disclosed embodiment. Thus the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment. 
     
       
         
               
             
               
               
             
           
               
                   
               
               
                 Table of Reference Numerals 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                  10A 
                 Expandable Implant system 
               
               
                  10B 
                 Expanded Implant system 
               
               
                  20A 
                 Upper bony segment interface body 
               
               
                  20B 
                 Lower Bony segment interface body 
               
               
                  21A 
                 Upper Bony segment interface body Front Extension fenestration 
               
               
                  21B 
                 Lower Bony segment interface body Front Extension fenestration 
               
               
                  22A 
                 Upper Bony segment interface body Front Edge 
               
               
                  22B 
                 Lower Bony segment interface body Front Edge 
               
               
                  23A 
                 Upper Bony segment interface body Back Extension fenestration 
               
               
                  23B 
                 Lower Bony segment interface body Back Extension fenestration 
               
               
                  24A 
                 Upper Bony segment interface body central fenestration 
               
               
                  24B 
                 Lower Bony segment interface body central fenestration 
               
               
                  25A 
                 Upper Bony segment interface body teeth 
               
               
                  25B 
                 Lower Bony segment interface body teeth 
               
               
                  26A 
                 Upper Bony segment interface body side wall protrusions 
               
               
                  26B 
                 Lower Bony segment interface body side wall protrusions 
               
               
                  27A 
                 Upper Bony segment interface body Back Edge 
               
               
                  27B 
                 Lower Bony segment interface body Back Edge 
               
               
                  28A 
                 Bony segment interface body cavity for pin arm 
               
               
                  28B 
                 Bony segment interface body cavity sloped ram 
               
               
                  28C 
                 Bony segment interface body cavity bottom well 
               
               
                  29A 
                 Bony segment interface body pin fenestration 
               
               
                  30A 
                 Front screw nut and link pivot connection arm 
               
               
                  30B 
                 Back screw nut and link pivot connection arm 
               
               
                  40 
                 Ratchet screw 
               
               
                  42A 
                 First Screw thread pattern 
               
               
                  42B 
                 Second Screw thread pattern 
               
               
                  43 
                 Screw thread center 
               
               
                  44A 
                 Front Screw ratchet teeth 
               
               
                  45A 
                 Front Screw hex tool interface 
               
               
                  44B 
                 Rear Screw ratchet teeth 
               
               
                  45B 
                 Rear Screw hex tool interface 
               
               
                  50A 
                 Link, lower, right, back 
               
               
                  50B 
                 Link, lower, right, front 
               
               
                  50C 
                 Link, lower, left, back 
               
               
                  50D 
                 Link, lower, left, front 
               
               
                  50E 
                 Link, upper, right, back 
               
               
                  50F 
                 Link, upper, right, front 
               
               
                  50G 
                 Link, upper, left, back 
               
               
                  50H 
                 Link, upper, left, front 
               
               
                  60A 
                 Pin coupling link to Front screw nut lower, right 
               
               
                  60B 
                 Pin coupling link to Front screw nut upper, right 
               
               
                  60C 
                 Pin coupling link to Front screw nut lower, left 
               
               
                  60D 
                 Pin coupling link to Front screw nut upper, left 
               
               
                  60E 
                 Pin coupling link to Back screw nut lower, right 
               
               
                  60F 
                 Pin coupling link to Back screw nut upper, right 
               
               
                  60G 
                 Pin coupling link to Back screw nut lower, left 
               
               
                  60H 
                 Pin coupling link to Back screw nut upper, left 
               
               
                  60I 
                 Pin coupling link to Upper Bony segment interface body back, 
               
               
                   
                 right 
               
               
                  60J 
                 Pin coupling link to Upper Bony segment interface body front, 
               
               
                   
                 right 
               
               
                  60K 
                 Pin coupling link to Upper Bony segment interface body back, left 
               
               
                  60L 
                 Pin coupling link to Upper Bony segment interface body front, left 
               
               
                  60M 
                 Pin coupling link to Lower Bony segment interface body back, 
               
               
                   
                 right 
               
               
                  60N 
                 Pin coupling link to Lower Bony segment interface body front, 
               
               
                   
                 right 
               
               
                  60O 
                 Pin coupling link to Lower Bony segment interface body back, left 
               
               
                  60P 
                 Pin coupling link to Lower Bony segment interface body front, left 
               
               
                  70 
                 Front Ratchet Mechanism 
               
               
                  70A 
                 Front Ratchet Mechanism Cover and extension 
               
               
                  70B 
                 Front Ratchet Mechanism Lower Pawl 
               
               
                  70C 
                 Front Ratchet Mechanism Upper Pawl 
               
               
                  70D 
                 Front Ratchet Mechanism Direction Lever 
               
               
                  80 
                 End Cap and extension 
               
               
                  82 
                 End Cap screw end opening 
               
               
                  90 
                 Rear Ratchet Mechanism 
               
               
                  90A 
                 Rear Ratchet Mechanism Cover and extension 
               
               
                  90B 
                 Rear Ratchet Mechanism Lower Pawl 
               
               
                  90C 
                 Rear Ratchet Mechanism Upper Pawl 
               
               
                  90D 
                 Rear Ratchet Mechanism Direction Lever 
               
               
                 100A 
                 Expansion Mechanism 
               
               
                 100B 
                 Expansion Mechanism