Patent Publication Number: US-2022211512-A1

Title: Expandable implant

Description:
TECHNICAL FIELD 
     The present disclosure is directed to an implant, and more particularly, to an expandable implant. 
     BACKGROUND OF THE DISCLOSURE 
     Conventional spinal implants are used to treat conditions, injuries, and diseases that degrade a functioning of the spinal column. Existing spinal implants may be adjustable to assist in treating such conditions in the spinal column. 
     Conventional implants, however, are often moved or displaced from their appropriate positions prior to achieving desired growth or fusion with spinal bone structure. Further, conventional implants do not provide a sufficient degree of adjustability for achieving a desired position relative to the spinal column. For example, conventional implants do not provide sufficient adjustability in desired directions, and do not provide sufficient adjustment between desired directions independently from each other in order to achieve and maintain a desired position relative to the spinal column. 
     The exemplary disclosed system and method of the present disclosure is directed to overcoming one or more of the shortcomings set forth above and/or other deficiencies in existing technology. 
     SUMMARY OF THE DISCLOSURE 
     In one exemplary aspect, the present disclosure is directed to an implant. The implant includes a first endplate, a second endplate, a base disposed between the first endplate and the second endplate, a plurality of adjustment arms operably connecting the base with the first endplate and the second endplate, and a plurality of pins disposed on at least one of the first endplate and the second endplate. The plurality of pins have different lengths. The plurality of adjustment arms are rotatably connected to a plurality of hubs that are axially slidable on at least some of the plurality of pins. 
     In another aspect, the present disclosure is directed to an implant. The implant includes a first endplate, a second endplate, a base disposed between the first endplate and the second endplate, a plurality of adjustment arms, which include a plurality of height adjustment arms and a plurality of lordotic adjustment arms, operably connecting the base with the first endplate and the second endplate, a plurality of pins disposed on at least one of the first endplate and the second endplate, and a first and second plurality of hubs that are rotatably disposed on the plurality of pins. The plurality of pins have different lengths. The plurality of adjustment arms are rotatably connected to the first and second plurality of hubs. The first plurality of hubs are axially slidable on the plurality of pins. The second plurality of hubs are axially stationary on the plurality of pins 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Accompanying this written specification is a collection of drawings of exemplary embodiments of the present disclosure. One of ordinary skill in the art would appreciate that these are merely exemplary embodiments, and additional and alternative embodiments may exist and still within the spirit of the disclosure as described herein. 
         FIG. 1  illustrates a perspective view of an exemplary device in unexpanded position; 
         FIG. 2  illustrates an anterior view of the exemplary disclosed device in unexpanded position; 
         FIG. 3  illustrates a proximal view of the exemplary device in unexpanded position; 
         FIG. 4  illustrates a posterior view of the exemplary device in unexpanded position; 
         FIG. 5  illustrates a distal view of the exemplary device in unexpanded position; 
         FIG. 6  illustrates a section view of the exemplary device in unexpanded position with anterior face at top, looking from the bottom up; 
         FIG. 7  illustrates a perspective view of the exemplary device in parallel expanded position; 
         FIG. 8  illustrates an anterior view of the exemplary device in parallel expanded position; 
         FIG. 9  illustrates a proximal view of the exemplary device in parallel expanded position; 
         FIG. 10  illustrates a section view of the exemplary device in parallel expanded position with anterior face at top, looking from the bottom up; 
         FIG. 11  illustrates a perspective view of the exemplary device in lordotic expanded position; 
         FIG. 12  illustrates an anterior view of the exemplary device in lordotic expanded position; 
         FIG. 13  illustrates a proximal view of the exemplary device in lordotic expanded position; 
         FIG. 14  illustrates a section view of the exemplary device in lordotic expanded position with anterior face at top, looking from the bottom up; 
         FIG. 15  illustrates a perspective view of the exemplary device in lordotic expanded position with locking screws; 
         FIG. 16  illustrates a section view of the exemplary device in lordotic expanded position with anterior face at top, looking from the bottom up with lock screws; 
         FIG. 17  illustrates a perspective view of the exemplary device in unexpanded position with body component, arms, and cross braces sectioned; 
         FIG. 18  illustrates a perspective view of the exemplary device in unexpanded position with body component, arms, cross braces, and height drive block sectioned; 
         FIG. 19  illustrates a perspective view of the exemplary device in unexpanded position with body component, arms, cross braces, height drive block, and lordosis drive block sectioned; 
         FIG. 20  illustrates a perspective view of the exemplary device in unexpanded position with body component, arms, cross braces, height drive block, lordosis drive block, and height drive gear sectioned; 
         FIG. 21  illustrates a detail view of an exemplary disclosed drive assembly with height drive block, lordosis drive block, and height drive gear sectioned; 
         FIG. 22  illustrates a perspective view of an exemplary disclosed base component; 
         FIG. 23  illustrates a perspective view of an exemplary disclosed lower endplate, with dual pivot hubs and hub pins attached; 
         FIG. 24  illustrates a perspective view of an exemplary disclosed height drive block; 
         FIG. 25  illustrates a perspective view of the exemplary disclosed height drive block sectioned; 
         FIG. 26  illustrates a perspective view of an exemplary disclosed height drive gear; 
         FIG. 27  illustrates a perspective view of the exemplary disclosed height drive gear sectioned; 
         FIG. 28  illustrates a perspective view of an exemplary disclosed lordosis drive gear; 
         FIG. 29  illustrates a perspective view of an exemplary disclosed lordosis drive block; 
         FIG. 30  illustrates a perspective view of the exemplary disclosed lordosis drive block sectioned; 
         FIG. 31  illustrates a perspective view of an exemplary disclosed height adjustment arm; 
         FIG. 32  illustrates a perspective view of an exemplary disclosed lordosis adjustment arm; 
         FIG. 33  illustrates a perspective view of an exemplary disclosed cross brace; 
         FIG. 34  illustrates a perspective view of an exemplary disclosed height adjustment pin; 
         FIG. 35  illustrates a perspective view of an exemplary disclosed height adjustment counter pin; 
         FIG. 36  illustrates a perspective view of an exemplary disclosed dual pivot block; and 
         FIG. 37  illustrates an exploded view of the exemplary disclosed device. 
     
    
    
     DETAILED DESCRIPTION AND INDUSTRIAL APPLICABILITY 
     The exemplary disclosed system, apparatus, and method may be an expandable implant. For example, the exemplary disclosed system, apparatus, and method may be a lumbar intervertebral implant. The exemplary disclosed system, apparatus, and method may include dual independent expansion capabilities. The exemplary disclosed system, apparatus, and method may be an implant having a height that may be adjusted (e.g., expanded) and/or a lordotic angle that may be adjusted. The exemplary disclosed dual expansion capabilities may be controlled independently of each other. For example, an adjustment such as an expansion of the height and the lordotic angle may be controlled independently of one another. In at least some exemplary embodiments and as described for example herein, exemplary disclosed endplates of the exemplary disclosed apparatus may be adjusted in parallel to one another, and then the lordotic angle may be modified in order to suitably fit (e.g., best fit) a patient&#39;s anatomy. 
       FIGS. 1-37  illustrates an exemplary embodiment of the exemplary disclosed system, apparatus, and method. Implant  10  may be a lumbar intervertebral implant. For example, implant  10  may be a dual expanding, lumbar intervertebral implant. 
     In at least some exemplary embodiments and as illustrated in  FIG. 37 , implant  10  may include a base  20  with an upper endplate  30  and lower endplate  40 . The upper endplate  30  and lower endplate  40  are connected to each other via a pair of height adjustment arms  90 , a pair of lordosis adjustment arms  100 , and a pair of cross braces  220 . In turn, the pair of height adjustment arms  90  are linked to a height drive block  50  via a height adjustment pin  110 . The height drive block  50  sits within a block cavity  25  of the base  20 , for example as illustrated in  FIG. 6 . Likewise, as illustrated in  FIG. 1 , the pair of lordosis adjustment arms  100  are linked to a lordosis drive block  80  via a lordosis adjustment pin  120 . The lordosis drive block  80  sits within the block cavity  25  of the base  20 , for example as illustrated in  FIG. 6 . Returning to  FIG. 37 , the positions of the height drive block  50  and lordosis drive block  80  are determined by a height drive gear  60  and a lordosis drive gear  70 . 
     In at least some exemplary embodiments and for example as illustrated in  FIG. 1 , the base component  20  is a substantially rectangular cube. Extending longitudinally from the proximal end of the base  20  is a set of inserter/locking threads  21 . These threads  21  are generally left-handed or counterclockwise, and intended to mate with an inserter device (not shown for clarity) as well as a height locking screw  240  for example as illustrated in  FIGS. 15 and 16 . Extending from the locking threads  21  is a height gear cylindrical cavity  23 , which allows the height drive gear  60  to spin freely inside the cavity  23 . The height gear cylindrical cavity  23  is intersected by a pair of retaining pin holes  29 . Height gear retaining pins  210  fit into the retaining pin holes  29  and the corresponding retaining groove  62  of the height drive gear  60 . This holds the height drive gear  60  in place with regards to the base  20 . 
     In at least some exemplary embodiments, the height drive gear  60  is generally cylindrical and hollow. At the proximal end is a drive feature  61  which allows it to be rotated by a screwdriver device (not shown for clarity), for example as illustrated in  FIGS. 3 and 9 . Just distal of the drive feature  61  is an external retaining groove  62  which mates with the height gear retaining pins  210 , for example as illustrated in  FIG. 17 . Distal of the retaining groove  62  is an external drive thread  63 , for example as illustrated in  FIG. 18 . These external drive threads  63  are right-handed or clockwise threads. The external drive threads  63  mate with the internal drive threads  51  of the height adjustment block  50 . Inside of the height drive gear  60  are internal locking threads  64  which are left-handed or counterclockwise threads, for example as illustrated in  FIG. 20 . The internal locking threads  64  mate with the lordosis locking screw  250 . 
     In at least some exemplary embodiments, extending distally along the same axis as the height gear cylindrical cavity  23  is the rectangular block cavity  25 , for example as illustrated in  FIG. 6 . This block cavity  25  is designed to hold the height drive block  50  and the lordosis drive block  80 , allowing them to slide distally-proximally, but not rotate within the cavity  25 . Running perpendicular to the block cavity  25  is a longitudinal slot  22 . At the distal end of the block cavity  25 , and along the same axis as the height gear cylindrical cavity  23  is a lordosis gear cylindrical cavity  24 . The lordosis gear cylindrical cavity  24  holds the cylindrical tip  74  of the lordosis drive gear  70 , allowing it to spin freely. 
     In at least some exemplary embodiments, the height drive block  50  threads over the height drive gear  60  using internal drive thread  51 , which correspond to the external drive threads  63  of the height drive gear  60 . Rotating the height drive gear  60  clockwise moves the height drive block  50  distally within the block cavity  25  of the base  20 . These internal drive threads  51  extend from the proximal side partially through the center of the height drive block  50 , for example as illustrated in  FIG. 18 . Distally, along the same axis as the internal drive threads  51 , extends an internal cylindrical cavity  53 . The internal cylindrical cavity  53  allows the lordosis drive gear  70  to sit inside of it, and rotate freely. Perpendicular to the internal cylindrical cavity  53  are adjustment pin threads  52 , for example as illustrated in  FIG. 21 . The threaded portion  112  of the height adjustment pin  110  threads into the posterior adjustment pin threads  52 , while the threaded portion  132  of the height adjustment counter pin  130  threads into the anterior adjustment pin threads  52 . 
     In at least some exemplary embodiments, the lordosis drive gear  70  is generally cylindrical. The proximal portion of the lordosis drive gear  70  has an internal drive feature  71  which allows it to be rotated by a screwdriver device (not shown for clarity). Just distal of the drive feature  71  is an external retaining groove  72  which mates with the retaining tip  113  of the height adjustment pin  110  and the retaining tip  133  of the height adjustment counter pin  130 . The retaining tips  113 ,  133  extend through the adjustment threads  52  of the height drive block  50 . This captures the lordosis drive gear  70  within the height drive block  50  while allowing it to rotate. So, as the height drive block  50  moves distally within the base  20 , the lordosis drive gear  70  moves with the height drive block  50 . Distal of the retaining groove  72  is an external drive thread  73 , for example as illustrated in  FIG. 19 . These external drive threads  73  are right-handed or clockwise threads. The external drive threads  73  mate with the internal drive threads  81  of the height adjustment block  80 . The distal cylindrical tip  74  of the lordosis drive gear  70  sits within the lordosis gear cylindrical cavity  24 . 
     In at least some exemplary embodiments, the lordosis drive block  80  threads over the lordosis drive gear  70  using internal drive thread  81 , which correspond to the external drive threads  73  of the lordosis drive gear  70 . Rotating the lordosis drive gear  70  clockwise moves the lordosis drive block  80  distally within the block cavity  25  of the base  20 . These internal drive threads  81  extend from the entire lordosis drive block  80 , for example as illustrated in  FIG. 19 . Perpendicular to the internal drive threads  81  are adjustment pin threads  82 . The threaded portion  122  of the lordosis adjustment pin  120  threads into the anterior adjustment pin threads  82 , while the threaded portion  142  of the lordosis adjustment counter pin  140  threads into the posterior adjustment pin threads  82 . Unlike the height adjustment pin  120  and height adjustment counter pin  130 , the lordosis adjustment pin  120  and lordosis adjustment counter pin  140  do not touch or interact with the lordosis drive gear  70 . 
     In at least some exemplary embodiments, extending parallel to the block cavity  25  of the base  20  on the posterior side is the rectangular height arm cavity  26 , for example as illustrated in  FIG. 6 . Like the block cavity  25 , the longitudinal slot  22  extends perpendicular through the height arm cavity  26 . The height adjustment pin  110  passes through the longitudinal slot  22  allowing it to move distally-proximally within the longitudinal slot  22 . The height arm cavity  26  also holds the pair of height adjustment arms  90 . Each of these height adjustment arms  90  has a central pin hole  92  through its central beam  91 . The central pin hole  92  is perpendicular to the length of the height adjustment arms  90 . The height adjustment pin  110  goes through this central pin hole  92 . The height adjustment arms  90  can then rotate about the height adjustment pin  110 . The enlarged head  111  of the height adjustment pin  110  sits outside the base  20  to help counteract binding and unsuitable rotation along a cephalad-caudal axis. Distal to the height adjustment pin  110 , the lordosis adjustment counter pin  140  also protrudes into the longitudinal slot, although its head  141  rests within the slot  22  and does not extend into the height arm adjustment cavity  26 . The lordosis adjustment counter pin  140  helps to counter the axial rotation of the lordosis drive block  80 . 
     In at least some exemplary embodiments, extending parallel to the block cavity  25  of the base  20  on the anterior side is the rectangular lordosis arm cavity  27 . Like the block cavity  25 , the longitudinal slot  22  extends perpendicular through the lordosis arm cavity  27 . The lordosis adjustment pin  120  passes through the longitudinal slot  22  allowing it to move distally-proximally within the longitudinal slot  22 . The lordosis arm cavity  27  also holds the pair of lordosis adjustment arms  100 . Each of these lordosis adjustment arms  100  has a central pin hole  102  through its central beam  101 . The central pin hole  102  is perpendicular to the length of the lordosis adjustment arms  100 . The lordosis adjustment pin  120  goes through this central pin hole  102 . The lordosis adjustment arms  100  can then rotate about the lordosis adjustment pin  120 . The enlarged head  121  of the height adjustment pin  120  sits outside the base  20  to help counteract binding and unsuitable rotation along a cephalad-caudal axis. Proximal to the lordosis adjustment pin  120 , the height adjustment counter pin  130  also protrudes into the longitudinal slot, although its head  131  rests within the slot  22  and does not extend into the lordosis arm adjustment cavity  27 . The height adjustment counter pin  130  helps to counter the axial rotation of the height drive block  50 . 
     In at least some exemplary embodiments, while the central pin hole  92  of the height adjustment arms  90  are constrained by the height adjustment pin  110 , the proximal end is defined by an h-shaped proximal gap  93  with a proximal pin hole  94  running perpendicularly through the proximal gap  93 , for example as illustrated in  FIG. 31 . The proximal gap  93  allows the dual pivot hub  150  to sit between its forks. Likewise, the proximal gap  93  also allows space for the proximal height hub pair  33  of the upper endplate  30  and the proximal height hub pair  43  of the lower endplate  40 . The proximal gaps  93  are attached to the side holes  152  of the dual pivot hubs  150  with hub arms pins  200  through the proximal pin holes  94 . The dual pivot hub  150  is in turn connected to the proximal height hub pair  33  of the upper endplate  30  via the proximal height hub pin  160  through the axial hole  151  of the dual pivot hub  150 . Similarly, another dual pivot hub  150  is connected to the proximal height hub pair  43  of the lower endplate  40  via the proximal height hub pin  160  through the axial hole  151  of the dual pivot hub  150 . Because the spacing of the proximal height hub pairs  33 ,  43  are wider than the length of the dual pivot hub  150 , the dual pivot hub  150  can slide axially along the proximal height hub pin  160 . Additionally, the dual pivot hub  150  can rotate around the proximal height hub pin  160 . 
     In at least some exemplary embodiments, the distal end of the height adjustment arm  90  is defined by an h-shaped distal gap  95  with a distal pin hole  96  running perpendicularly through the distal gap  95 , for example as illustrated in  FIG. 31 . The distal gap  95  allows the dual pivot hub  150  to sit between its forks. Likewise, the distal gap  95  also allows space for the distal height hub pair  34  of the upper endplate  30  and the distal height hub pair  44  of the lower endplate  40 . The distal gaps  95  are attached to the side holes  152  of the dual pivot hubs  150  with hub arms pins  200  through the distal pin holes  96 . The dual pivot hub  150  is in turn connected to the distal height hub pair  34  of the upper endplate  30  via the distal height hub pin  170  through the axial hole  151  of the dual pivot hub  150 . Similarly, another dual pivot hub  150  is connected to the distal height hub pair  44  of the lower endplate  40  via the distal height hub pin  170  through the axial hole  151  of the dual pivot hub  150 . Because the spacing of the distal height hub pairs  34 ,  44  are the same width as the length of the dual pivot hub  150 , the dual pivot hub  150  cannot slide axially along the distal height hub pin  170 . However, the dual pivot hub  150  can still rotate around the distal height hub pin  170 . 
     In at least some exemplary embodiments, while the central pin hole  102  of the lordosis adjustment arms  100  are constrained by the lordosis adjustment pin  120 , the proximal end is defined by an h-shaped proximal gap  103  with a proximal pin hole  104  running perpendicularly through the proximal gap  103 , for example as illustrated in  FIG. 32 . The proximal gap  103  allows the dual pivot hub  150  to sit between its forks. Likewise, the proximal gap  103  also allows space for the proximal lordosis hub pair  35  of the upper endplate  30  and the proximal lordosis hub pair  45  of the lower endplate  40 . The proximal gaps  103  are attached to the side holes  152  of the dual pivot hubs  150  with hub arms pins  200  through the proximal pin holes  104 . The dual pivot hub  150  is in turn connected to the proximal lordosis hub pair  35  of the upper endplate  30  via the proximal lordosis hub pin  180  through the axial hole  151  of the dual pivot hub  150 . Similarly, another dual pivot hub  150  is connected to the proximal lordosis hub pair  45  of the lower endplate  40  via the proximal lordosis hub pin  180  through the axial hole  151  of the dual pivot hub  150 . Because the spacing of the proximal lordosis hub pairs  35 ,  45  are wider than the length of the dual pivot hub  150 , the dual pivot hub  150  can slide axially along the proximal lordosis hub pin  180 . Additionally, the dual pivot hub  150  can rotate around the proximal lordosis hub pin  180 . 
     In at least some exemplary embodiments, the distal end of the lordosis adjustment arm  100  is defined by an h-shaped distal gap  105  with a distal pin hole  106  running perpendicularly through the distal gap  105 , for example as illustrated in  FIG. 32 . The distal gap  105  allows the dual pivot hub  150  to sit between its forks. Likewise, the distal gap  105  also allows space for the distal lordosis hub pair  36  of the upper endplate  30  and the distal lordosis hub pair  46  of the lower endplate  40 . The distal gaps  105  are attached to the side holes  152  of the dual pivot hubs  150  with hub arms pins  200  through the distal pin holes  106 . The dual pivot hub  150  is in turn connected to the distal lordosis hub pair  36  of the upper endplate  30  via the distal lordosis hub pin  190  through the axial hole  151  of the dual pivot hub  150 . Similarly, another dual pivot hub  150  is connected to the distal lordosis hub pair  46  of the lower endplate  40  via the distal lordosis hub pin  190  through the axial hole  151  of the dual pivot hub  150 . Because the spacing of the distal lordosis hub pairs  36 ,  46  are the same width as the length of the dual pivot hub  150 , the dual pivot hub  150  cannot slide axially along the distal lordosis hub pin  190 . However, the dual pivot hub  150  can still rotate around the distal lordosis hub pin  190 . 
     In at least some exemplary embodiments, the upper endplate  30  is defined as a thin rectangular cube. On the superior face is a series of anti-migration spikes  31  intended to embed in the adjacent vertebral endplate. Extending from the interior to superior faces of the upper endplate is a graft area  32 , for example as illustrated in  FIG. 1 . On the proximal posterior portion of the inferior face is the proximal height hub pair  33 , for example as illustrated in  FIG. 6 . Further distally on the posterior portion of the inferior face is the distal height hub pair  34 . On the proximal anterior portion of the inferior face is the proximal height hub pair  35 . Further distally on the anterior portion of the inferior face is the distal height hub pair  36 . Towards the posterior distal corner of the inferior face is cross brace hub  38 , while in line with the cross-brace hub  38 , running anterior to posterior, is the cross-brace slot hub  37 . 
     In at least some exemplary embodiments, the lower endplate  40  is defined as a thin rectangular cube. On the inferior face is a series of anti-migration spikes  41  intended to embed in the adjacent vertebral endplate. Extending from the interior to superior faces of the upper endplate is a graft area  42 , for example as illustrated in  FIG. 23 . On the proximal posterior portion of the superior face is the proximal height hub pair  43 . Further distally on the posterior portion of the superior face is the distal height hub pair  44 . On the proximal anterior portion of the superior face is the proximal height hub pair  45 . Further distally on the anterior portion of the superior face is the distal height hub pair  46 . Towards the posterior distal corner of the superior face is cross brace hub  48 , while in line with the cross-brace hub  48 , running anterior to posterior, is the cross-brace slot hub  47 . 
     In at least some exemplary embodiments, the distal portion of the base  20  is defined by the rectangular cross-brace cavity  28 , which runs perpendicular to the block cavity  25 , for example as illustrated in  FIG. 6 . The cross-braces  220  sit inside of this cross-brace cavity  28 . The cross-brace has an h-shaped posterior gap  224  with a posterior pin holes  225  running perpendicularly through the posterior gap  224 . The posterior gap  224  allows the cross-brace hub  38  of the upper endplate  30  to sit between its forks. Likewise, the posterior gap  224  of the other cross-brace  220  also allows the cross-brace hub  48  of the lower endplate  40  to sit between its forks. This allows the cross-braces  220  to rotate about the cross-brace hubs  38 ,  48 . The cross-braces  220  are connected to the cross-brace hub  38 ,  48  via cross-brace pins  230  through the posterior pin hole  225 . The central beam  221  of the cross-brace  220  connects the posterior gap  224  to the h-shaped anterior gap  222 . Like the posterior gap  224 , the anterior gap  222  also has an anterior gap pin hole  223 . The anterior gap  222  allows the cross-brace slot hub  37  of the upper endplate  30  to sit between its forks. Likewise, the anterior gap  222  of the other cross-brace  220  also allows the cross-braces slot hub  47  of the lower endplate  40  to sit between its forks. This allows the cross-braces  220  to slide along the cross-brace hubs  37 ,  47 , while also rotating. The cross-braces  220  are connected to the cross-brace slot hub  37 ,  47  via cross-brace pins  230  through the anterior pin hole  223 . 
     The exemplary disclosed system, apparatus, and method may be used in any suitable application involving implants for humans or animals. For example, the exemplary disclosed system, apparatus, and method may be used in any suitable application for spinal implants. In at least some exemplary embodiments, the exemplary disclosed system, apparatus, and method may be used in any suitable application for lumbar intervertebral implants. 
     An exemplary operation of the exemplary disclosed system will now be described. In at least some exemplary embodiments, the implant  10  is inserted between two adjacent vertebral bodies while the endplates  30 , 40  are in the un-expanded position, as in  FIGS. 1-6 . Once in place the height drive gear  60  is then rotated clockwise. This moves the height drive block  50  distally. In turn, the height drive block  50  carries the height adjustment pin  110  distally with it. The height adjustment pin  110  also pushes the central pin hole  92  of the height adjustment arms  90  distally as well. However, because the distal gap  95  and distal pin hole  96  cannot slide in relation to the distal height hub pair  34 ,  44  of the endplates  30 ,  40 , it forces the endplates  30 ,  40  to separate away from each in a superior-inferior direction. This is aided by the cross-braces  220  which hold the endplates  30 ,  40  in place in the distal-proximal plane in relation to the base  20 . As the endplates  30 ,  40  expanded, the proximal gap  93  pulls the corresponding dual pivot hub  150  along the proximal height hub pin  160 . 
     Additionally in at least some exemplary embodiments, because the lordosis drive gear  70  is held in place in relation to height drive block  50 , and because the proximal face of the lordosis drive block  80  rests against the distal face of the height drive block  50 , as the height drive block  50  moves distally within the base  20 , it forces the lordosis drive block  80  distally as well. Likewise, the lordosis drive block  80  carries the lordosis adjustment pin  120  distally with it. The lordosis adjustment pin  120  also pushes the central pin hole  102  of the lordosis adjustment arms  100  distally as well. However, because the distal gap  105  and distal pin hole  106  cannot slide in relation to the distal lordosis hub pair  36 ,  46  of the endplates  30 ,  40 , it forces the endplates  30 ,  40  to separate away from each in a superior-inferior direction. This is aided by the cross-braces  220  which hold the endplates  30 ,  40  in place in the distal-proximal plane in relation to the base  20 . As the endplates  30 ,  40  expand, the proximal gap  103  pulls the corresponding dual pivot hub  150  along the proximal height hub pin  180 . This process creates a parallel expansion of the endplates  30 ,  40 , because the height adjustment arms  90  and lordosis adjustment arms  100  are moving at the same time and same distance. This parallel expansion can be seen in  FIGS. 7-10 . 
     In at least some exemplary embodiments, once the desired parallel expanded height of the implant  10  is reached, the lordosis drive gear  70  can then be rotated clockwise. This moves the lordosis drive block  80  distally, while maintaining the position of the height drive block  50 . Subsequently, the lordosis drive block  80  carries the lordosis adjustment pin  120  distally with it. The lordosis adjustment pin  120  also pushes the central pin hole  102  of the lordosis adjustment arms  100  distally as well. However, because the distal gap  105  and distal pin hole  106  cannot slide in relation to the distal lordosis hub pair  36 ,  46  of the endplates  30 ,  40 , it forces the endplates  30 ,  40  to separate away from each in a superior-inferior direction. This is aided by the cross-braces  220  which hold the endplates  30 ,  40  in place in the distal-proximal plane in relation to the base  20 . As the endplates  30 ,  40  expanded, the proximal gap  103  pulls the corresponding dual pivot hub  150  along the proximal height hub pin  180 . Because the anterior portions of the endplates  30 ,  40  are expanding while the posterior portions are not, this process changes the lordotic angle of the implant  10 . Additionally, because the dual pivot hubs  150  can rotate about the various hub pins  160 ,  170 ,  180 ,  190 , the endplates  30 ,  40  are able to also rotate in relation to the base  20 , thereby creating the lordotic angle without binding or twisting of the components. This lordotic expansion can be seen in  FIGS. 11-14 . 
     In at least some exemplary embodiments, once the desired height and lordotic angle of the implant  10  are achieved, the mechanisms can be locked into place. The height locking screw  240  is threaded into the locking threads  21  of the base  20  and up against the proximal face of the height drive gear  60 . Because the height locking screw  240  is left-hand threaded and the height drive gear  60  is right-hand threaded, this prevents the height drive gear  60  from turning counterclockwise and thereby reducing the height of the implant  10 . Similarly, the lordosis locking screw  250  is threaded into the locking threads  64  of the height drive gear  60  and up against the proximal face of the lordosis drive gear  70 . Because the lordosis locking screw  250  is left-hand threaded and the lordosis drive gear  70  is right-hand threaded, this prevents the lordosis drive gear  70  from turning counterclockwise and thereby reducing the lordotic angle of the implant  10 . 
     A list of exemplary parts of the exemplary disclosed system, apparatus, and method is provided below:
       10 —implant     20 —base
         21 —inserter/locking threads     22 —longitudinal slot     23 —height gear cylindrical cavity     24 —lordosis gear cylindrical cavity     25 —block cavity     26 —height arm cavity     27 —lordosis arm cavity     28 —cross brace cavity     29 —retaining pin holes   
         30 —upper endplate
         31 —anti-migration spikes     32 —graft area     33 —proximal height hub pair     34 —distal height hub pair     35 —proximal lordosis hub pair     36 —distal lordosis hub pair     37 —cross brace slot hub     38 —cross brace hub   
         40 —lower endplate
         41 —anti-migration spikes     42 —graft area     43 —proximal height hub pair     44 —distal height hub pair     45 —proximal lordosis hub pair     46 —distal lordosis hub pair     47 —cross brace slot hub     48 —cross brace hub   
         50 —height drive block
         51 —internal drive threads     52 —adjustment pin threads     53 —internal cylindrical cavity   
         60 —height drive gear
         61 —drive feature     62 —retaining groove     63 —external drive threads     64 —internal locking threads   
         70 —lordosis drive gear
         71 —drive feature     72 —retaining groove     73 —external drive threads     74 —cylindrical tip   
         80 —lordosis drive block
         81 —internal drive threads     82 —adjustment pin threads   
         90 —height adjustment arm
         91 —central beam     92 —central pin hole     93 —proximal gap     94 —proximal pin hole     95 —distal gap     96 —distal pin hole   
         100 —lordosis adjustment arm
         101 —central beam     102 —central pin hole     103 —proximal gap     104 —proximal pin hole     105 —distal gap     106 —distal pin hole   
         110 —height adjustment pin
         111 —head     112 —threaded portion     113 —retaining tip   
         120 —lordosis adjustment pin
         121 —head     122 —threaded portion   
         130 —height adjustment counter pin
         131 —head     132 —threaded portion     133 —retaining tip   
         140 —lordosis adjustment counter pin
         141 —head     142 —threaded portion   
         150 —dual pivot hub
         151 —axial hole     152 —side hole   
         160 —proximal height hub pin     170 —distal height hub pin     180 —proximal lordosis hub pin     190 —distal lordosis hub pin     200 —hub arm pin     210 —height gear retaining pin     220 —cross brace
         221 —central beam     222 —anterior gap     223 —anterior pin hole     224 —posterior gap     225 —posterior pin hole   
         230 —cross brace pin     240 —height locking screw     250 —lordosis locking screw   

     In at least some exemplary embodiments, the exemplary disclosed implant may include a first endplate, a second endplate, a base disposed between the first endplate and the second endplate, a plurality of adjustment arms operably connecting the base with the first endplate and the second endplate, and a plurality of pins disposed on at least one of the first endplate and the second endplate. The plurality of pins (e.g., pins  160 ,  170 ,  180 , and  190 ) may have different lengths. The plurality of adjustment arms may be rotatably connected to a plurality of hubs that are axially slidable on at least some of the plurality of pins. The plurality of pins may include a first pin (e.g., pin  170  and  190 ) having a first length, a second pin (e.g., pin  160 ) having a second length that is greater than the first length, and a third pin (e.g., pin  180 ) having a third length that is greater than the second length. The plurality of hubs may include a first hub that is rotatably disposed on and disposed axially stationary on the first pin, a second hub that is rotatably disposed on and axially slidable on the second pin, and a third hub that is rotatably disposed on and axially slidable on the third pin. The third hub may be axially slidable over a first distance on the third pin and the second hub may be axially slidable over a second distance on the second pin, the first distance being greater than the second distance. The exemplary disclosed implant may include a height drive gear, a lordotic drive gear, a height drive block, and a lordotic drive block that are movably disposed in the base. The height drive gear may be rotatably configured to actuate both the height drive block and the lordotic drive block, and the lordotic drive gear may be rotatably configured to actuate the lordotic drive block but not the height drive block. The height drive gear may be configured to actuate the height drive block, which may be configured to actuate a height adjustment arm of the plurality of adjustment arms, which may be attached to a first hub plurality of the plurality of hubs. The first hub plurality of the plurality of hubs may axially slide on at least some of the plurality of pins based on the actuation of the height adjustment arm. The first hub plurality of the plurality of hubs may remain axially stationary on at least some of the plurality of pins based on the actuation of the height adjustment arm, the height adjustment arm moving at least one of the first endplate and the second endplate away from the base. The lordotic drive gear may be configured, following the actuation of the height drive block by the height drive gear, to actuate a lordotic adjustment arm of the plurality of adjustment arms, which may be attached to a second hub plurality of the plurality of hubs. At least one hub of the second hub plurality of the plurality of hubs may axially slide on at least some of the plurality of pins based on the actuation of the lordotic adjustment arm. At least one hub of the second hub plurality of the plurality of hubs may remain axially stationary on at least some of the plurality of pins based on the actuation of the lordotic adjustment arm, the lordotic adjustment arm angling at least one of the first endplate and the second endplate relative to the base. 
     In at least some exemplary embodiments, the exemplary disclosed implant may include a first endplate, a second endplate, a base disposed between the first endplate and the second endplate, a plurality of adjustment arms, which may include a plurality of height adjustment arms and a plurality of lordotic adjustment arms, operably connecting the base with the first endplate and the second endplate, a plurality of pins disposed on at least one of the first endplate and the second endplate, and a first and second plurality of hubs that may be rotatably disposed on the plurality of pins. The plurality of pins (e.g., pins  160 ,  170 ,  180 , and  190 ) may have different lengths. The plurality of adjustment arms may be rotatably connected to the first and second plurality of hubs. The first plurality of hubs may be axially slidable on the plurality of pins. The second plurality of hubs may be axially stationary on the plurality of pins. The plurality of pins may include a first plurality of pins (e.g., pins  170  and  190 ) each having a first length, a second pin (e.g., pin  160 ) having a second length that is greater than the first length, and a third pin (e.g., pin  180 ) having a third length that is greater than the second length. The second plurality of hubs may include a first stationary plurality of hubs that may be rotatably disposed on and disposed axially stationary on the first plurality of pins. The first plurality of hubs may include a second hub that may be rotatably disposed on and axially slidable on the second pin, and a third hub that may be rotatably disposed on and axially slidable on the third pin. The third hub may be axially slidable over a first distance on the third pin and the second hub may be axially slidable over a second distance on the second pin, the first distance being greater than the second distance. The plurality of height adjustment arms may be connected to the first stationary plurality of hubs and the second hub, the plurality of height adjustment arms being configured to move at least one of the first endplate and the second endplate away from the base when the second hub axially slides on the second pin. The plurality of lordotic adjustment arms may be connected to the first stationary plurality of hubs and the third hub, the plurality of lordotic adjustment arms being configured to angle at least one of the first endplate and the second endplate relative to the base when the third hub axially slides on the third pin. 
     In at least some exemplary embodiments, the exemplary disclosed implant may include a first endplate, a second endplate, a base disposed between the first endplate and the second endplate, a plurality of adjustment arms operably connecting the base with the first endplate and the second endplate, a first plurality of pins disposed on the first endplate, a second plurality of pins disposed on the second endplate, and a first and second plurality of hubs that are rotatably disposed on each of the first and second plurality of pins. Each of the first and second plurality of pins may have different lengths. The plurality of adjustment arms may be rotatably connected to the first and second plurality of hubs. The first plurality of hubs may be axially slidable on the first and second plurality of pins. The second plurality of hubs may be axially stationary on the first and second plurality of pins. Each of the first and second plurality of pins may include a first length plurality of pins (e.g., pins  170  and  190 ) each having a first length, a second pin (e.g., pin  160 ) having a second length that is greater than the first length, and a third pin (e.g., pin  180 ) having a third length that is greater than the second length. The second plurality of hubs may include a first stationary plurality of hubs that may be rotatably disposed on and disposed axially stationary on the first length plurality of pins. The first plurality of hubs may include a second hub that may be rotatably disposed on and axially slidable on the second pin, and a third hub that may be rotatably disposed on and axially slidable on the third pin. 
     The exemplary disclosed system, apparatus, and method may provide an efficient and effective technique for providing an implant such as a spinal implant. The exemplary disclosed system, apparatus, and method may provide an implant having a height and a lordotic angle that may be adjusted independently of each other to provide and maintain a desired position relative to a spinal column for treating spinal conditions and diseases. The exemplary disclosed system, apparatus, and method may provide for sufficient height and lordotic angle adjustment to suitably fit a patient&#39;s anatomy. 
     While multiple embodiments are disclosed, still other embodiments of the present disclosure will become apparent to those skilled in the art from this detailed description. There may be aspects of this disclosure that may be practiced without the implementation of some features as they are described. It should be understood that some details have not been described in detail in order to not unnecessarily obscure the focus of the disclosure. The disclosure is capable of myriad modifications in various obvious aspects, all without departing from the spirit and scope of the present disclosure. Accordingly, the drawings and descriptions are to be regarded as illustrative rather than restrictive in nature.