Patent Description:
Fusion cages, as well as other types of bodies and/or devices, are frequently utilized in spinal surgery inside a vertebra (intravertebral) and/or between vertebrae of a patient (interbody). With interbody devices, one or more such spinal bodies are placed between vertebrae to provide support and promote fusion between adjacent vertebrae where such is necessary due to disease, injury, general deterioration or congenital problem. With intravertebral devices, one or more spinal bodies are placed within a vertebra. Spinal devices, such as fusion cages and/or the like, are inserted into a spinal space either anteriorly, posteriorly, laterally or posteriolaterally.

A problem with most spinal interbody and intravertebral devices is that they are static in size. This poses various problems with their use and/or implantation. Particularly, static sized spinal devices are fairly large in order to properly bridge the gap between adjacent vertebrae. This large size does not lend itself to microsurgery, arthroscopic surgery or the like.

A few interbody devices, however, are now being made that are expandable. Examples of expandable spinal interbody devices are disclosed in <CIT> and <CIT>. Expandable interbody devices allow the interbody device to be initially smaller than traditional non-expandable (static) interbody devices such that expandable interbody devices may be more easily inserted or implanted into the vertebral space. Moreover, expandable interbody devices allow the surgeon to set the amount of expansion necessary for the particular patient rather than the static interbody device dictating the spacing.

The present invention relates to a device as claimed hereafter. Preferred embodiments of the invention are set forth in the dependent claims. While methods of implantation and use described herein do not form part of the invention, they are disclosed as they represent useful background for understanding the invention. One embodiment relates to an expandable implant, comprising a top support assembly defining an upper surface configured to engage a first portion of vertebral bone; a bottom support assembly defining a lower surface configured to engage a second portion of vertebral bone; a control assembly coupled to the top support assembly and the bottom support assembly and configured to control relative movement between the top support assembly and the bottom support assembly between a collapsed position and an expanded position; wherein in the collapsed position, the upper surface is generally parallel to the lower surface, and wherein in the expanded position, a portion of the upper surface extends at an acute angle relative to a portion of the lower surface.

Another embodiment relates to an expandable implant comprising a top support assembly defining an upper surface configured to engage a first portion of vertebral bone; a bottom support assembly defining a lower surface configured to engage a second portion of vertebral bone; a first wedge member slidably coupled to the top and bottom support assemblies; a second wedge member slidably coupled to the top and bottom support assemblies; and a control assembly coupled to the first and second wedge members and configured to control relative movement between the top support assembly and the bottom support assembly between a collapsed position and an expanded position; wherein in the collapsed position, the upper surface is generally parallel to the lower surface, and wherein in the expanded position, a portion of the upper surface extends at an angle relative to a portion of the lower surface.

Another embodiment relates to a method of using (not claimed) an expandable implant, comprising providing an expandable implant comprising a top support assembly, a bottom support assembly, and a control assembly coupled to the top and bottom support assemblies; manipulating the control assembly in a first manner to move the top support assembly in a linear fashion relative to the bottom support assembly; and manipulating the control assembly in a second manner to move at least a portion of the top support assembly in a non-linear fashion relative to at least a portion of the bottom support assembly.

Another embodiment relates to an expandable implant, comprising a top support configured to engage a first portion of vertebral bone; a bottom support configured to engage a second portion of vertebral bone; and a control assembly coupled to the top support and the bottom support and configured to control relative movement between the top support and the bottom support, wherein the control assembly includes a control member including a head and a body portion; and wherein the head includes a recess and the body portion includes at least one access port in fluid communication with the recess to enable delivery of fluid to an interior of the implant via the recess and at least one access port.

Another example relates to an expandable implant, comprising a top support including a top surface configured to engage a first portion of vertebral bone; a bottom support including a bottom surface configured to engage a second portion of vertebral bone, wherein the top and bottom surfaces define a taper; and a control assembly coupled to the top support and the bottom support and configured to control relative movement between the top support and the bottom support, wherein the control assembly includes a control member having a recess and at least one access port in fluid communication with the recess to enable delivery of fluid to an interior of the implant via the recess and at least one access port.

Another example relates to an implant comprising a top support configured to engage a first portion of vertebral bone; a bottom support configured to engage a second portion of vertebral bone; and a control assembly coupled to the top support and the bottom support and configured to control relative movement between the top support and the bottom support, wherein the control assembly includes a front portion configured to slidably engage the top and bottom supports; a rear portion configured to slidably engage the top and bottom supports; and a control member including a head disposed within the rear portion, and a threaded portion threadingly engaging the front portion; wherein the head includes a recess and at least one access port in fluid communication with the recess to enable delivery of fluid to an interior of the implant via the recess and at least one access port.

The foregoing and other features of the present invention will become more apparent to one skilled in the art upon also reading the following description of embodiments with reference to the accompanying drawings. The embodiments of the invention are set forth as "embodiments" <NUM> and <NUM> and are respectively illustrated in the figures <FIG>. The implants referred to as "exemplary embodiments" <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> and <NUM>, and illustrated in the other figures, do not form part of the invention but represent background art that is useful for understanding the invention.

Corresponding reference characters indicate corresponding parts throughout the several views. Although the drawings represent embodiments of the invention, the drawings are not necessarily to scale and certain features may be exaggerated in order to better illustrate and explain the principles of the present invention. The exemplifications set out herein illustrate several embodiments of the invention, but the exemplifications are not to be construed as limiting the scope of the invention in any manner.

The present disclosure relates to expandable and/or dynamic interbody (between adjacent vertebrae), intravertebral-body (inside the vertebrae) and/or spinal stabilization devices that may or may not be used as interbody fusion cages or devices, interbody/intravertebral bodies/body stabilization devices and/or the like (collectively hereinafter, spinal device(s)) for providing support, stabilization and/or promoting bone growth between or inside vertebrae that have been destabilized or otherwise due to injury, illness and/or the like. Particularly, the present disclosure provides various versions of dynamic (expandable and/or expandable and retractable) interbody/intravertebral body devices that are usable in a spinal column of a human.

As representative of each one of the various versions of the present disclosure, <FIG> illustrates a representative dynamic spinal body device or expandable implant <NUM>. The implant <NUM> is depicted as implanted or inserted into a human spine <NUM> of which only a lower portion of the spine <NUM> is shown. The implant <NUM> is illustrated implanted between adjacent upper and lower vertebrae <NUM>, <NUM> of the spine <NUM> in <FIG> (hence interbody or intervertebral). Vertebrae <NUM> and <NUM> have portions that face anteriorly ("A", and from the right as viewed in <FIG>) and portions that face posteriorly ("P", and from the left as viewed in <FIG>).

According to various exemplary embodiments, the components of implant <NUM> may be made of any suitable material(s), including a variety of metals, plastics, composites, or other suitable bio-compatible materials. In some embodiments, one or more components of implant <NUM> may be made of the same material, while in other embodiments, different materials may be used for different components of implant <NUM>.

Referring now to <FIG>, expandable implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure.

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM> (e.g., a first wedge member), a second, or rear portion <NUM> (e.g., a second wedge member), and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis <NUM> of implant <NUM>. A first, or upper support <NUM> (e.g., an upper plate, support member, assembly, etc.) and a second, lower support <NUM> (e.g., a lower plate, support member, assembly), are coupled to the body assembly and extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second supports <NUM>, <NUM> define a height of implant <NUM> extending between outer or top surface <NUM> of first support <NUM> and outer or lower surface <NUM> of second support <NUM>.

In one embodiment, front portion <NUM> includes a rounded, or bull nose portion intended to facilitate insertion of implant <NUM> into a patient. Front portion <NUM> also includes ramped surfaces <NUM>, <NUM> and projections <NUM>, <NUM> that facilitate controlled sliding movement between front portion <NUM> and first and second supports <NUM>, <NUM>. An aperture <NUM> may be threaded to receive control member <NUM> to provide an adjustable control mechanism for implant <NUM>.

Referring to <FIG>, ramped surface <NUM> extends at an angle relative to axis <NUM>, and projection <NUM> extends upward relative to ramped surface <NUM>. Ramped surface <NUM> is a generally flat surface configured to engage a correspondingly ramped surface (surface <NUM>) on first support <NUM>. Projection <NUM> extends laterally across front portion <NUM>. In some embodiments, projection <NUM> may have a dovetail shape, while in other embodiments, projection <NUM> may take other shapes, including having an undercut portion, etc. The dovetail shape provides a relatively larger top portion and an undercut lower portion such that front portion <NUM> and first support <NUM> can slide relative to one another, but the parts cannot be separated, for example, by merely lifting first support <NUM> away from front portion <NUM> (e.g., in an upward direction generally perpendicular to axis <NUM>).

Ramped surface <NUM> and projection <NUM> share similar features to ramped surface <NUM> and projection <NUM>, except that ramped surface <NUM> and projection <NUM> interface with corresponding surfaces on second support <NUM>, rather than first support <NUM>. It should be noted that ramped surfaces <NUM>, <NUM> may be inclined relative to axis <NUM> to provide any desirable adjustment features, as changing the incline of the ramped surfaces will change the rate at which the first and second support members move up/down.

Referring further to <FIG>, according to an exemplary embodiment, rear portion <NUM> includes ramped surfaces <NUM>, <NUM>, projections <NUM>, <NUM>, an aperture, or through-hole <NUM>, and a counterbore <NUM>. Rear portion <NUM> may define a generally flat rearward-most surface being generally rectangular in shape. In other embodiments, the shape of rear portion <NUM> may be varied to suit a particular application.

Ramped surface <NUM> extends at an angle relative to axis <NUM>, and projection <NUM> extends upward relative to ramped surface <NUM>. Ramped surface <NUM> is a generally flat surface configured to engage a correspondingly ramped surface (surface <NUM>) on first support <NUM>. Projection <NUM> extends laterally across rear portion <NUM>. In some embodiments, projection <NUM> may have a dovetail shape (see, e.g., <FIG>), while in other embodiments, projection <NUM> may take other shapes, including having an undercut portion etc. The dovetail shape provides a relatively larger top portion and an undercut lower portion such that rear portion <NUM> and first support <NUM> can slide relative to one another, but the parts cannot be separated, for example, by merely lifting first support <NUM> away from rear portion <NUM> (e.g., in an upward direction generally perpendicular to axis <NUM>).

According to an exemplary embodiment, first and second supports <NUM>, <NUM> are configured to be moveable relative to the body or control assembly (e.g., front and rear portions <NUM>, <NUM> and control portion <NUM>) such that implant <NUM> is reconfigurable between a first configuration (e.g., a retracted, collapsed, or minimal configuration), as shown in <FIG>, and a second configuration (e.g., an expanded or maximum configuration), as shown in <FIG> and any intermediate position therebetween. Control member <NUM> is rotatable and threadingly received by front portion <NUM> such that rotation of control member <NUM> in a first (e.g., clockwise) direction causes front and rear portions <NUM>, <NUM> to move toward each other, thereby causing first and second supports <NUM>, <NUM> to move outward toward the expanded configuration. Conversely, rotation of control member <NUM> in a second (e.g., counter-clockwise) direction causes front and rear portions <NUM>, <NUM> to move away from each other, thereby causing first and second supports <NUM>, <NUM> to move inward toward the collapsed configuration. It should be noted that in use, control member <NUM> may be adjusted so as to maintain first and second supports <NUM>, <NUM> in a fully collapsed configuration, a fully expanded configuration, or any desired configuration or intermediate position therebetween.

First and second supports <NUM>, <NUM> and front and rear portions <NUM>, <NUM> have corresponding geometric features (e.g., correspondingly ramped surfaces) such that displacement of front portion <NUM> relative to rear portion <NUM> along axis <NUM> causes relative planar and/or linear displacement of first and second supports <NUM>, <NUM>. As discussed above, the geometric features of the various components may be varied to provide for varying adjustment features for first and second supports <NUM>, <NUM>.

In one embodiment, first and second supports <NUM>, <NUM> are generally similar in structure. Referring to <FIG>, first support <NUM> includes outer, or top surface <NUM>, ramped surfaces <NUM>, <NUM>, channels <NUM>, <NUM>, and two pairs of opposing projections - projections <NUM>, <NUM>, and projections <NUM>, <NUM>. First support <NUM> further includes sidewalls <NUM>, <NUM>, pin or retaining member apertures <NUM>, and inner, or bottom surface <NUM>. Top surface <NUM> includes a number of ridges, or projections <NUM>, intended to provide a gripping surface for adjacent vertebrae, and a bone graft cavity, or window <NUM> intended to provide a space to receive bone graft material.

In use, control member <NUM> extends through through-hole <NUM> in rear portion <NUM> and into front portion <NUM>. Head portion <NUM> of control member <NUM> seats in counterbore <NUM> of rear portion <NUM>, and threaded portion <NUM> threadingly engages aperture <NUM> of front portion <NUM>. Head portion <NUM> may include an annular recess <NUM> configured such that a collar <NUM> can be positioned (e.g., press-fit, welded, etc.) into counterbore <NUM> rearward of head portion <NUM> to retain control member <NUM> in place. As a user rotates control member <NUM>, front portion <NUM> and rear portion <NUM> move toward/away from each other (depending on the direction of rotation), and first and second supports <NUM>, <NUM> in turn move away from / toward each other.

As shown in <FIG>, opposing projections <NUM>, <NUM> on first support <NUM> form a recess, or channel <NUM>. In one embodiment, channel <NUM> has a dovetail shape corresponding in shape to projection <NUM> on front portion <NUM>. Likewise, projections <NUM>, <NUM> in first support <NUM> form channel <NUM> having a dovetail shape similar in shape to projection <NUM> on rear portion <NUM>. Projections <NUM>, <NUM> slide within channels <NUM>, <NUM> as first support <NUM> moves up/down. Retaining members or pins <NUM> extend through first and second supports <NUM>, <NUM> and act to limit the range of movement of first and second supports <NUM>, <NUM> relative to front and rear portions <NUM>, <NUM>, and prevent first and second supports <NUM>, <NUM> from being completely removed from front and rear portions <NUM>, <NUM>.

Second support <NUM> is similar to first support <NUM> and includes outer, or bottom surface <NUM>, ramped surfaces <NUM>, <NUM>, channels <NUM>, <NUM>, and two pairs of opposing projections - projections <NUM>, <NUM>, and projections <NUM>, <NUM>. Second support <NUM> further includes sidewalls <NUM>, <NUM>, pin or retaining member apertures <NUM>, and inner, or top surface <NUM>. Bottom surface <NUM> includes a number of ridges, or projections <NUM>, intended to provide a gripping surface for adjacent vertebrae, and a bone graft cavity, or window <NUM> intended to provide a space to receive bone graft material. In one embodiment, the components of second support <NUM> are similar in structure and function to the corresponding components of first support <NUM>. In other embodiments, the components of second support <NUM> may provide additional and/or different structural and/or functional features relative to the corresponding components of first support <NUM>.

It should be noted that implant <NUM> may share various features with the other implants described herein, and be made of the same, similar, or different materials. For example, various components of implant <NUM> may be made of metal, plastic, composites, or other suitable bio-compatible materials. Further, implant <NUM> may be usable in connection with the spine or other parts of the body.

Referring now to <FIG>, an expandable implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to implant <NUM> in structure and function except with respect to the additional alignment features discussed below.

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis <NUM> of implant <NUM>. A first, or upper support <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support <NUM> (e.g., a lower plate or support member), are coupled to the body or control assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second supports <NUM>, <NUM> define a height of implant <NUM> extending between outer or top surface <NUM> of first support <NUM> and outer or lower surface <NUM> of second support <NUM>.

In one embodiment, front portion <NUM> includes a rounded, or bull nose portion intended to facilitate insertion of implant <NUM> into a patient. Front portion <NUM> also includes ramped surfaces and projections (e.g., similar to ramped surfaces <NUM>, <NUM> and projections <NUM>, <NUM>) that facilitate controlled sliding movement between front portion <NUM> and first and second supports <NUM>, <NUM>. An aperture may be threaded to receive control member <NUM> to provide an adjustable control mechanism for implant <NUM>.

As shown in <FIG>, the ramped surfaces extend at an angle relative to axis <NUM>, and the projections extend upward/downward relative to the ramped surfaces. The ramped surfaces are generally flat surfaces configured to engage a correspondingly ramped surface on first support <NUM>. The projections extend laterally across front portion <NUM>. In some embodiments, the projections may have a dovetail shape, while in other embodiments, the projections may take other shapes, including having an undercut portion, etc. The dovetail shape provides a relatively larger top portion and an undercut lower portion such that front portion <NUM> and first support <NUM> can slide relative to one another, but the parts cannot be separated, for example, by merely lifting first support <NUM> away from front portion <NUM> (e.g., in an upward direction generally perpendicular to axis <NUM>). It should be noted that similar to implant <NUM>, implant <NUM> includes front and rear, upper and lower ramped surfaces and projections configured to provide the interface between front and rear portions <NUM>, <NUM> and first and second supports <NUM>, <NUM>.

As with implant <NUM>, according to an exemplary embodiment, first and second supports <NUM>, <NUM> and front and rear portions <NUM>, <NUM> have corresponding geometric features (e.g., correspondingly ramped surfaces) such that displacement of front portion <NUM> relative to rear portion <NUM> along axis <NUM> causes relative planar and/or linear displacement of first and second supports <NUM>, <NUM>. As discussed above, the geometric features of the various components may be varied to provide for varying adjustment features for first and second supports <NUM>, <NUM>.

In use, control member <NUM> includes a head portion and a body portion and extends through a through-hole in rear portion <NUM> and into front portion <NUM>. The head portion of control member <NUM> seats in a counterbore of rear portion <NUM>, and the threaded portion of the body threadingly engages an aperture of front portion <NUM>. The head portion may include an annular recess (similar to head portion <NUM> of implant <NUM>) configured such that a collar <NUM> can be positioned (e.g., press-fit, welded, etc.) into the counterbore rearward of the head portion to retain control member <NUM> in place. As a user rotates control member <NUM>, front portion <NUM> and rear portion <NUM> move toward/away from each other (depending on the direction of rotation), and first and second supports <NUM>, <NUM> in turn move away from / toward each other. While the Figures generally show control member <NUM> threadingly engaging front portion <NUM>, in other embodiments, other adjustment mechanisms may be used (e.g., ratchet mechanisms, indents/detents, etc.).

Opposing projections <NUM>, <NUM> on first support <NUM> form a recess, or channel <NUM>. In one embodiment, channel <NUM> has a dovetail shape corresponding in shape to projection <NUM> on front portion <NUM>. Likewise, projections <NUM>, <NUM> in first support <NUM> form channel <NUM> having a dovetail shape similar in shape to projection <NUM> on rear portion <NUM>. Projections <NUM>, <NUM> slide within channels <NUM>, <NUM> as first support <NUM> moves up/down. In some embodiments, retaining members or pins (e.g., similar to pins <NUM>) extend through first and second supports <NUM>, <NUM> and act to limit the range of movement of first and second supports <NUM>, <NUM> relative to front and rear portions <NUM>, <NUM>, and prevent first and second supports <NUM>, <NUM> from being completely removed from front and rear portions <NUM>, <NUM>. Second support <NUM> includes similar features such as an outer, or bottom surface, ramped surfaces, channels, and two pairs of opposing projections.

In addition to including various features of implant <NUM>, implant <NUM> further includes an alignment feature intended to maintain alignment between first and second supports <NUM>, <NUM> during use. In one embodiment, second support <NUM> includes one or more alignment members <NUM>, <NUM> (e.g., extensions, projections, etc.) that extend generally upward as shown in <FIG> (e.g., in a direction generally perpendicular to axis <NUM>). Members <NUM>, <NUM> are received in recesses <NUM>, <NUM> (e.g., channels, grooves, slots, etc.), respectively, formed in first support <NUM>. Members <NUM>, <NUM> and recesses <NUM>, <NUM> have corresponding geometric features to ensure a snug fit between components. For example, as shown in <FIG>, members <NUM>, <NUM> are generally U-shaped in cross-section, and recesses <NUM>, <NUM> are shaped to receive the U-shaped members. The alignment features prevent relative "rocking" of the supports, and in some embodiments serve to maintain a generally parallel relationship between the supports. In some embodiments, spaces or gaps may be provided between members <NUM>, <NUM> and recesses <NUM>, <NUM> to enable a predetermined amount of angular offset between the supports.

In one embodiment members <NUM>, <NUM> are formed so as to be generally flush with the exterior surface of first support <NUM> (e.g., along a side or top surface). In other embodiments, members <NUM> may be recessed from, or alternatively protrude beyond, the exterior surface of first support <NUM>. Further, while <FIG> show two alignment members <NUM>, <NUM>, in various alternative embodiments fewer or more alignment members and/or recesses may be utilized (e.g., <NUM>, <NUM>, <NUM>, etc.). Further yet, members <NUM>, <NUM> may be integrally formed with, or removably coupled to, a remainder portion of second support <NUM>. In further embodiments, the relative positions of alignment members <NUM>, <NUM> and recesses <NUM>, <NUM> are reversed (e.g., such that members <NUM>, <NUM> are provided on first support <NUM> and recesses <NUM>, <NUM> are provided on second support <NUM>). Other variations in the size, number, and placement of members <NUM>, <NUM> and recesses <NUM>, <NUM> may be made according to various embodiments.

It should be noted that implant <NUM> may share various features with the other implants described herein, and be made of the same, similar, or different materials. For example, various components of implant <NUM> may be made of metal, plastic, composites, or other suitable bio-compatible materials. Further, implant <NUM> may be usable in connection with the spine or other parts of the body. Further yet, pins similar to pins <NUM> may be used in conjunction with implant <NUM> or any of the other implants shown and described herein.

In various embodiments, the implants shown in <FIG> and <FIG> share various common features. For example, the control member or screw (e.g., <NUM>, <NUM>) is contained within the device, such that neither end of the control member or screw protrudes past the end members. For example, as shown in <FIG>, the control member <NUM> may be received by or through rear portion <NUM> in a counterbore and held captive by collar or ring <NUM>, such that control member <NUM> is free to rotate within rear portion <NUM>, but does not threadingly engage rear portion <NUM>. As such, rear portion <NUM> remains fixed relative to control member <NUM> as control member <NUM> is rotated. Control member <NUM> threadingly engages a threaded aperture <NUM> defined by a boss extending rearward from front portion <NUM>, such that as control member <NUM> rotates, front portion <NUM> moves relative to control member <NUM> (e.g., control member <NUM> moves into or out of the threaded boss of front portion <NUM>). As such, control member <NUM> is contained entirely within the periphery of front and rear portions <NUM>, <NUM>. The control member <NUM> may in some embodiments be configured to be flush with the outer sides of front and rear portions <NUM>, <NUM>. In other embodiments, the control member <NUM> is recessed within front and/or rear portions <NUM>, <NUM>. For example, as shown in <FIG>, front portion <NUM> has a solid, bull-nose configuration such that control member <NUM> is concealed therein. In various embodiments, the implants include grooves that may help secure the implant in the body of a patient, by providing spaces for structures in the body of a patient to engage the grooves.

Referring now to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to implants <NUM> and <NUM> in structure and function except with respect to the additional access port features discussed below. As such, implant <NUM> is understood to include any or all of the features of implants <NUM> and <NUM> to the extent consistent with the additional features of implant <NUM> described herein (e.g., retention pins, dovetail projections and ramped surfaces, alignment features, etc.).

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis of implant <NUM>. A first, or upper support <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support <NUM> (e.g., a lower plate or support member), are coupled to the body assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second supports <NUM>, <NUM> define a height of implant <NUM> extending between the outer or top surface of first support <NUM> and the outer or lower surface of second support <NUM>.

In one embodiment, control member <NUM> includes a head portion <NUM>, a collar recess <NUM>, a threaded portion <NUM>, a tool recess <NUM>, and access ports <NUM>. Threaded portion <NUM> and the non-threaded portion of control member <NUM> including access ports <NUM> collectively form a body portion for control member <NUM>. Head portion <NUM> is received within a counterbore in rear portion <NUM>. Collar recess <NUM> is configured to enable placement of collar <NUM> into a position to retain head portion <NUM> within the counterbore in rear portion <NUM>. Threaded portion <NUM> is configured to threadingly engage a threaded aperture provided by front portion <NUM>. Tool recess <NUM> is formed in the rearward portion of head portion <NUM> and communicates with access ports <NUM>, which extend to opposite sides of control member <NUM>. Tool recess <NUM> is configured to receive a tool to enable threading manipulation of control member <NUM>. Tool recess <NUM> and access ports <NUM> are collectively configured to provide a fluid path to an interior of implant <NUM> and enable delivery of fluid, bone growth material, or other material to an interior of implant <NUM>.

As shown in <FIG>, in one embodiment, two access ports <NUM> are in communication with tool recess <NUM> and extend to opposite sides of control member <NUM>. In other embodiments, more or fewer access ports <NUM> may be utilized, and the size and shape of the individual access ports <NUM> may be varied to suit a particular application, size of implant, and the like. Access ports <NUM> are positioned to provide fluid communication with an interior area of implant <NUM>.

Referring to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other interiintra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to implants <NUM>, <NUM>, and <NUM> (and the other implants described herein) in structure and function except with respect to the additional conical projection, side bone graft window, and elongated component features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein (e.g., retention pins, dovetail projections and ramped surfaces, alignment features, control member access port(s), etc.).

In one embodiment, control member <NUM> includes a head portion <NUM>, a collar recess <NUM>, a threaded portion <NUM>, a tool recess <NUM>, and access ports <NUM>. Head portion <NUM> is received within a counterbore in rear portion <NUM>. Collar recess <NUM> is configured to enable placement of collar <NUM> into a position to retain head portion <NUM> within the counterbore of rear portion <NUM>. Threaded portion <NUM> is configured to threadingly engage a threaded aperture provided by front portion <NUM>. Tool recess <NUM> is formed in the rearward portion of head portion <NUM> and communicates with access ports <NUM>, which extend to opposite sides of control member <NUM>. Tool recess <NUM> is configured to receive a tool to enable threading manipulation of control member <NUM>. Tool recess <NUM> and access ports <NUM> are collectively configured to provide a fluid path to an interior of implant <NUM> and enable delivery of fluid, bone growth material, or other material to an interior of implant <NUM>.

Referring to <FIG>, in one embodiment implant <NUM> defines a first side <NUM> and a second, opposite side <NUM>. First and second sides <NUM>, <NUM> are generally formed by the sidewalls of top and bottom supports <NUM>, <NUM>. In one embodiment, one or both of first and second sides <NUM>, <NUM> include side bone graft apertures or windows. For example, as shown in <FIG>, in some embodiments, first side <NUM> includes side apertures <NUM> and second side <NUM> forms a generally solid sidewall. While <FIG> illustrates first side <NUM> as including two bone graft apertures <NUM>, according to various alternative embodiments, one or both of first side <NUM> and second side <NUM> may include more or fewer side apertures. In some embodiments, one or both of top and bottom supports <NUM>, <NUM> may include a projection <NUM> (e.g., a conical projection) at one or both ends. Projections <NUM> may extend above the other portions of top and bottom supports <NUM>, <NUM> (e.g., teeth, etc.).

In some embodiments, top and bottom supports <NUM>, <NUM> have a generally symmetric profile about control member <NUM>, as shown for example, in <FIG>. Implant <NUM> may further be elongated relative to other implants illustrated herein, having an overall length to overall width ratio (in the collapsed configuration) of <NUM>, <NUM>, <NUM>, or more (or another ratio, such as a range of between <NUM> and <NUM>, between <NUM> and <NUM>, etc.).

Referring to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to implants <NUM> (and the other implants described herein) in structure and function except with respect to the additional asymmetric component features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein (e.g., retention pins, dovetail projections and ramped surfaces, alignment features, control member access port(s), etc.).

In one embodiment, implant <NUM> defines a first side portion <NUM> and a second side portion <NUM>. In one embodiment, one or both of first and second side portions <NUM>, <NUM> include side bone graft apertures or windows. For example, as shown in <FIG>, in some embodiments, first side <NUM> includes side apertures <NUM>. While <FIG> illustrates first side <NUM> as including two bone graft apertures <NUM>, according to various alternative embodiments, one or both of first side <NUM> and second side <NUM> may include more or fewer side apertures.

In some embodiments, first side portion <NUM> and second side portion provide an asymmetric profile about control member <NUM>, as shown for example in <FIG>. In some embodiments, a portion of first side portion <NUM> extends away from control member <NUM> a further distance than the corresponding portions of second side portion <NUM>, forming an asymmetric shape (e.g., a "D" or similar shape). Providing an asymmetric profile may provide benefits in particular applications where additional support is desired and/or when placement of implant <NUM> is difficult. While <FIG> shown implant <NUM> having a general "D" asymmetric shape, according to various alternative embodiments, other asymmetric shapes and configurations may be utilized.

Referring to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to implants <NUM> and <NUM> (and the other implants described herein) in structure and function except with respect to the additional lateral taper features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein (e.g., retention pins, dovetail projections and ramped surfaces, alignment features, control member access port(s), etc.).

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis of implant <NUM>. A first, or upper support <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support <NUM> (e.g., a lower plate or support member), are coupled to the body or control assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second supports <NUM>, <NUM> define a height of implant <NUM> extending between the outer or top surface of first support <NUM> and the outer or lower surface of second support <NUM>. As discuss in greater detail below, the height of implant <NUM> decreases in a lateral direction.

In one embodiment, implant <NUM> defines a first side portion <NUM> and a second side portion <NUM>. In one embodiment, one or both of first and second side portions <NUM>, <NUM> include side bone graft apertures or windows. For example, as shown in <FIG>, in some embodiments, second side <NUM> includes side apertures <NUM>. While <FIG> illustrates second side <NUM> as including two bone graft apertures <NUM>, according to various alternative embodiments, one or both of first side <NUM> and second side <NUM> may include more or fewer side apertures.

In one embodiment, implant <NUM> is configured to provide a predetermined lateral taper that remains constant as implant <NUM> is moved between a collapsed configuration (see <FIG>) and an expanded configuration (see <FIG>). For example, referring to <FIG>, in a collapsed configuration, a first lateral side such as side <NUM> may have a first height that is larger than a height of second lateral side <NUM>. The degree of taper between the first and second lateral sides <NUM>, <NUM> may be adjusted to suit a particular embodiment (e.g., a desired spinal curvature). As such, both the top and bottom supports <NUM>, <NUM> may include outer surfaces (e.g. top and bottom surfaces) that define a lateral angular offset from a parallel configuration (e.g., a configuration where the top and bottom supports <NUM>, <NUM> are generally parallel).

As shown in <FIG> and <FIG>, top and bottom supports <NUM> and <NUM> move toward and away from each other in a linear manner, such that the degree of taper remains constant. In other embodiment, other configurations may be utilized to provide non-linear movement and a varying lateral taper. Furthermore, while <FIG> illustrate an implant having a constant lateral taper, according to various alternative embodiments, implants may be provided having a variable longitudinal taper.

Referring to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to implants <NUM> and <NUM> (and the other implants described herein) in structure and function except with respect to the additional longitudinal taper features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein (e.g., retention pins, dovetail projections and ramped surfaces, alignment features, control member access port(s), etc.).

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis of implant <NUM>. In some embodiments, front portion <NUM> includes a through hole <NUM> configured to enable control member <NUM> to extend through front portion <NUM><NUM>. A first, or upper support <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support <NUM> (e.g., a lower plate or support member), are coupled to the body or control assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second supports <NUM>, <NUM> define a height of implant <NUM> extending between the outer or top surface of first support <NUM> and the outer or lower surface of second support <NUM>. As discuss in greater detail below, the height of implant <NUM> decreases in a longitudinal direction (e.g., to provide a longitudinal taper feature).

In one embodiment, implant <NUM> is configured to provide a predetermined longitudinal taper that remains constant as implant <NUM> is moved between a collapsed configuration (see <FIG>) and an expanded configuration (see <FIG>). As such, both the top and bottom supports <NUM>, <NUM> may include outer surfaces (e.g. top and bottom surfaces) that define a lateral angular offset from a parallel configuration (e.g., a configuration where the top and bottom supports <NUM>, <NUM> are generally parallel).

In some embodiments, implant <NUM> defines a longitudinal axis extending along control member <NUM>. Top support <NUM> defines a first end <NUM>, a second end <NUM>, and a top surface <NUM> extending between first and second ends <NUM>, <NUM>. First and second ends <NUM>, <NUM> define an overall taper to top surface <NUM>. In some embodiments, top surface <NUM> may define an arcuate shape between first end <NUM> and second end <NUM> (e.g., such that top surface <NUM> has a slight curvature between first and second ends <NUM>, <NUM>). In other embodiments, top surface <NUM> may define a substantially planar surface between first and second ends <NUM>, <NUM>. Bottom support <NUM> defines a first end <NUM>, a second end <NUM>, and a bottom surface <NUM> extending between first and second ends <NUM>, <NUM>. First and second ends <NUM>, <NUM> define an overall taper to top surface <NUM>. In some embodiments, top surface <NUM> may define an arcuate shape between first end <NUM> and second end <NUM> (e.g., such that top surface <NUM> has a slight curvature between first and second ends <NUM>, <NUM>). In other embodiments, top surface <NUM> may define a substantially planar surface between first and second ends <NUM>, <NUM>.

As shown in <FIG>, top and bottom supports <NUM> and <NUM> move toward and away from each other in a linear manner, such that the degree of taper remains constant. In other embodiment, other configurations may be utilized to provide non-linear movement and a varying longitudinal taper. Furthermore, while <FIG> illustrate an implant having a constant longitudinal taper, according to various alternative embodiments, implants may be provided having a variable longitudinal taper.

Referring to <FIG>, in some embodiments, implant <NUM> includes one or more retaining members to retain control member <NUM> in a desired longitudinal position. For example, as shown in <FIG>, in one embodiment, implant <NUM> includes retaining members <NUM> received in side apertures <NUM> on opposing sides of rear support <NUM>. Control member <NUM> includes a head portion <NUM>, a groove <NUM>, and a threaded portion <NUM>. Control member <NUM> further includes a tool recess <NUM> in fluid communication with access ports <NUM>. Retaining members <NUM> are configured to extend through rear support <NUM> and be received within groove <NUM> of control member <NUM>, such that control member <NUM> is longitudinally fixed relative to rear support <NUM>, but also rotatable relative to rear support <NUM>. <FIG> illustrates retaining members <NUM> extending into rear support <NUM> from opposing lateral sides. In various alternative embodiments, retaining members may be used that extend through other portions, such as opposing top and bottom sides.

For example, referring to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to the other implants described herein in structure and function except with respect to the additional retaining member features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein (e.g., retention pins, dovetail projections and ramped surfaces, alignment features, control member access port(s), etc.).

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis of implant <NUM>. A first, or upper support <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support <NUM> (e.g., a lower plate or support member), are coupled to the body or control assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second supports <NUM>, <NUM> define a height of implant <NUM> extending between the outer or top surface of first support <NUM> and the outer or lower surface of second support <NUM>. In some embodiments, top and bottom supports <NUM>, <NUM> may include tapered corner sections <NUM>, <NUM> to facilitate insertion / removal of implant <NUM>, etc..

In one embodiment, top and bottom supports <NUM>, <NUM> are retained by upper and lower pins <NUM>, <NUM>. In one embodiment, upper pins <NUM> extend through opposite sides of one end of top support <NUM>, and lower pins <NUM> extend through opposite sides of an opposite end of bottom support <NUM>. Pins <NUM>, <NUM> act to limit expansion of implant <NUM> and prevent removal of top and bottom supports <NUM>, <NUM> from front and rear portions <NUM>, <NUM>. As shown in <FIG>, in one embodiment, two retaining pins extend into each side of implant <NUM>. In other embodiments, other numbers of retaining pins may be used, as shown for example in various other embodiments herein.

Referring further to <FIG>, in some embodiments, implant <NUM> includes one or more retaining members to retain control member <NUM> in a desired longitudinal position. For example, as shown in <FIG>, in one embodiment, implant <NUM> includes retaining members <NUM> received in top and bottom apertures <NUM> on opposing top and bottom sides of rear support <NUM>. Control member <NUM> includes a head portion <NUM>, a groove <NUM>, and a threaded portion <NUM>. Control member <NUM> further includes a tool recess <NUM> in fluid communication with access ports <NUM>. Retaining members <NUM> are configured to extend through rear support <NUM> and be received within groove <NUM> of control member <NUM>, such that control member <NUM> is longitudinally fixed relative to rear support <NUM>, but also rotatable relative to rear support <NUM>. <FIG> illustrates retaining members <NUM> extending into rear support <NUM> from opposing top and bottom sides. In various alternative embodiments, retaining members may be used that extend through other portions, such as opposing lateral sides. (e.g., as discussed with respect to implant <NUM>).

Referring now to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to the other implants discussed herein in structure and function except with respect to the two-piece top and bottom support member features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein.

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, and a third, intermediate, or control member or portion <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis of implant <NUM>. A first, or upper support assembly <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support assembly <NUM> (e.g., a lower plate or support member), are coupled to the control assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second support assemblies <NUM>, <NUM> define a height of implant <NUM> extending between the outer or top surface of first support assembly <NUM> and the outer or lower surface of second support assembly <NUM>.

Front portion <NUM> includes ramped surfaces <NUM> and a threaded bore <NUM>. Rear portion <NUM> includes dovetailed projections <NUM> and recess or aperture <NUM>. Ramped surfaces <NUM> and dovetailed projections <NUM> facilitate controlled expansion and contraction of top support assembly <NUM> and bottom support assembly <NUM> relative to one another.

In one embodiment, top support assembly <NUM> includes a first portion <NUM> and a second portion <NUM> pivotally coupled to first portion <NUM> by way of a top pivot pin <NUM>. First portion <NUM> defines an extension portion <NUM> that at least partially extends into a recess <NUM> in second portion <NUM>. Top guide pins <NUM> extend through second portion <NUM> and into upper slots <NUM> in first portion <NUM> to limit the range of pivotal motion of first portion <NUM> relative to second portion <NUM> about top pivot pin <NUM>. First portion <NUM> includes a ramped surface <NUM>, and second portion <NUM> includes a dovetailed recess <NUM>. Ramped surface <NUM> slidingly interfaces with a corresponding ramped surface <NUM> on front portion <NUM>, and dovetailed recess <NUM> slidingly interfaces with a dovetailed projection <NUM> on rear portion <NUM>.

In one embodiment, bottom support assembly <NUM> includes a first portion <NUM> and a second portion <NUM> pivotally coupled to first portion <NUM> by way of a bottom pivot pin <NUM>. First portion <NUM> defines an extension portion <NUM> that at least partially extends into a recess <NUM> in second portion <NUM>. Bottom guide pins <NUM> extend through second portion <NUM> and into bottom slots <NUM> in first portion <NUM> to limit the range of pivotal motion of first portion <NUM> relative to second portion <NUM> about bottom pivot pin <NUM>. First portion <NUM> includes a ramped surface <NUM>, and second portion <NUM> includes a dovetailed recess <NUM>. Ramped surface <NUM> slidingly interfaces with a corresponding ramped surface <NUM> on front portion <NUM>, and dovetailed recess <NUM> slidingly interfaces with a dovetailed projection <NUM> on rear portion <NUM>.

In one embodiment, implant <NUM> includes alignment features configured to maintain proper alignment between at least a portion of top support assembly <NUM> and at least a portion of bottom support assembly <NUM>. For example, an upper alignment guide <NUM> on second portion <NUM> of top support assembly <NUM> slidingly engages a correspondingly shaped lower alignment guide <NUM> on second portion <NUM> of bottom support assembly <NUM>. As such, as first portions <NUM> and <NUM> angulate away from each other, second portions <NUM>, <NUM> remain aligned (e.g., move in a linear fashion relative to one another.

In one embodiment, implant <NUM> is moveable from a first, fully collapsed and aligned position, as shown in <FIG>, to a second, collapsed and angulated position, as shown in <FIG>, to a third, expanded and angulated position, as shown in <FIG>. Implant <NUM> may be positioned at any desired intermediate position between the first, second, and third positions. In use, a first amount of rotation of control member <NUM> causes angulation of first portions <NUM>, <NUM> relative to second portions <NUM>, <NUM>. As control member <NUM> is threaded into threaded bore <NUM>, first portion <NUM> rotates about top pivot pin <NUM> and first portion <NUM> rotates about bottom pivot pin <NUM>. First portions <NUM>, <NUM> continue to angulate until top and bottom guide pins <NUM>, <NUM> are retained by upper and lower slots <NUM>, <NUM>, which define the maximum amount of angulation for first portions <NUM>, <NUM>.

Once maximum angulation is reached, further rotation of control member <NUM> causes expansion of second members <NUM>, <NUM> (and therefore also first members <NUM>, <NUM>) relative to one another in a generally linear fashion (e.g., through the interaction of alignment guides <NUM>, <NUM>). It should be noted that to enable angulation of first portions <NUM>, <NUM>, front portion <NUM> and first portions <NUM>, <NUM> have generally flat, correspondingly shaped ramped surfaces <NUM> (on front portion <NUM>), <NUM> (on first portion <NUM> of top support assembly <NUM>), and <NUM> (on first portion <NUM> of bottom support assembly <NUM>). To facilitate linear movement of second portions <NUM>, <NUM>, rear portion <NUM> includes dovetailed projections <NUM>, which are received within dovetailed recesses <NUM> (on second portion <NUM> of top support assembly <NUM>) and <NUM> (on second portion <NUM> of bottom support assembly <NUM>).

The angulation and expansion features enable a user to initially install implant <NUM> in a collapsed, aligned position, as shown in <FIG>, which may facilitate initial insertion and adjustment of the device. Once in proper position, implant <NUM> may be moved to a desired angulated and/or expanded configuration, as shown in <FIG> and <FIG>. In the fully expanded and angulated position, as shown in <FIG>, the outer surfaces (e.g., top and bottom surfaces) of first portions <NUM>, <NUM> are offset (e.g. angularly offset) from the outer surfaces of second portions <NUM>, <NUM>, and angularly offset from the longitudinal axis of implant <NUM> (e.g., an axis extending along control member <NUM>). The amount of angulation may be varied to suit a particular application (e.g., an amount of spinal curvature to be accommodated by the implant, etc.).

Referring now to <FIG>, an implant <NUM> is shown according to an exemplary embodiment. Implant <NUM> is usable, for example, between and/or within vertebral bodies of the spine, and may share many of the features of the other inter/intra-body implants discussed elsewhere herein. It should be understood that implant <NUM> may in some embodiments be usable in other portions of the body in addition to the spine, and all such applications are to be understood to be within the scope of the present disclosure. Implant <NUM> is generally similar to the other implants discussed herein in structure and function except with respect to the two-piece top and bottom support member and specific control member features discussed below. As such, implant <NUM> is understood to include any or all of the features of the other implants described herein to the extent consistent with the additional features of implant <NUM> described herein.

According to an exemplary embodiment, implant <NUM> includes a first, or front portion <NUM>, a second, or rear portion <NUM>, a first, or inner, control member <NUM>, a second, or outer, control member <NUM>, and a receiver member <NUM>, which collectively form a body or control assembly that extends along a longitudinal axis of implant <NUM>. A first, or upper support assembly <NUM> (e.g., an upper plate or support member, etc.) and a second, lower support assembly <NUM> (e.g., a lower plate or support member), are coupled to the control assembly and may extend generally between front and rear portions <NUM>, <NUM>. According to an exemplary embodiment, first and second support assemblies <NUM>, <NUM> define a height of implant <NUM> extending between the outer or top surface of first support assembly <NUM> and the outer or lower surface of second support assembly <NUM>.

Front portion <NUM> includes ramped surfaces <NUM> and a receiver recess or bore <NUM>. Rear portion <NUM> includes ramped surfaces <NUM> and control recess or bore <NUM>. Ramped surfaces <NUM>, <NUM> facilitate controlled expansion and contraction of top support assembly <NUM> and bottom support assembly <NUM> relative to one another.

In one embodiment, top support assembly <NUM> includes a first or inner portion <NUM> and a second or outer portion <NUM> pivotally coupled to first portion <NUM> by way of a top pivot pin <NUM>. First portion <NUM> at least partially extends into a recess <NUM> in second portion <NUM>. First portion <NUM> includes a ramped surface <NUM>, and second portion <NUM> includes a ramped surface <NUM>. Ramped surface <NUM> slidingly interfaces with a corresponding ramped surface <NUM> on front portion <NUM>, and ramped surface <NUM> slidingly interfaces with a corresponding ramped surface <NUM> on rear portion <NUM>.

In one embodiment, bottom support assembly <NUM> includes a first or inner portion <NUM> and a second or outer portion <NUM> pivotally coupled to first portion <NUM> by way of a bottom pivot pin <NUM>. First portion <NUM> at least partially extends into a recess <NUM> in second portion <NUM>. First portion <NUM> includes a ramped surface <NUM>, and second portion <NUM> includes a ramped surface <NUM>. Ramped surface <NUM> slidingly interfaces with a corresponding ramped surface <NUM> on front portion <NUM>, and ramped surface <NUM> slidingly interfaces with ramped surface <NUM> on rear portion <NUM>.

In one embodiment, implant <NUM> includes alignment features configured to limit a degree of angulation of second portions <NUM>, <NUM> relative to first portions <NUM>, <NUM>. For example, in some embodiments, first portion <NUM> of top support assembly <NUM> includes a single alignment guide or member <NUM> that is received between two alignment guides or members <NUM> on first portion <NUM> of bottom support assembly <NUM>. Alignment guides <NUM>, <NUM> are collectively received in a top alignment recess in second portion <NUM> of top support assembly <NUM> and a bottom alignment recess <NUM> in second portion <NUM> of bottom support assembly <NUM>. The various alignment components may be configured to enable a predetermined amount of angulation between first portions <NUM>, <NUM> and second portions <NUM>, <NUM>.

In one embodiment, implant <NUM> is moveable from a first, fully collapsed and aligned position, as shown in <FIG> and <FIG>, to a second, expanded and aligned position, as shown in <FIG> and <FIG>, to a third, expanded and angulated position, as shown in <FIG> and <FIG>. Implant <NUM> may be positioned at any desired intermediate position between the first, second, and third positions. Furthermore, the order of expansion and angulation may be reversed, or alternated, during installation.

In use, threading of outer control member <NUM> into (or out of) receiver <NUM> causes linear relative movement (e.g., expansion or contraction) of top support assembly <NUM> and bottom support assembly <NUM>. For example, <FIG> and <FIG> show implant <NUM> with outer control member <NUM> having been threaded into receiver <NUM> by way of threading engagement of the outer threads <NUM> of outer control member <NUM> and the inner threads <NUM> of receiver <NUM>. As front portion <NUM> and rear portion <NUM> move toward / away from each other, top and bottom support assemblies <NUM>, <NUM> likewise move away from / toward each other.

Threading of inner control member <NUM> within outer control <NUM> member causes second portions <NUM>, <NUM> to angulate relative to first portions <NUM>, <NUM>. For example, <FIG> and <FIG> show implant <NUM> with inner control member <NUM> having been threaded into outer control member <NUM>, causing second portions <NUM>, <NUM> to rotate about top and bottom pivot pins <NUM>, <NUM>, causing second portions <NUM>, <NUM> to become angularly offset relative to first portions <NUM>, <NUM>.

The angulation and expansion features enable a user to initially install implant <NUM> in a collapsed, aligned position, as shown in <FIG> and <FIG>, which may facilitate initial insertion and adjustment of the device. Once in proper position, implant <NUM> may be moved to a desired angulated and/or expanded configuration, as shown in <FIG> and <FIG>. In the fully expanded and angulated position, as shown in <FIG> and <FIG>, the outer surfaces (e.g., top and bottom surfaces) of second portions <NUM>, <NUM> are offset (e.g. angularly offset) from the outer surfaces of first portions <NUM>, <NUM>, and angularly offset from the longitudinal axis of implant <NUM> (e.g., an axis extending along outer control member <NUM>). The amount of angulation may be varied to suit a particular application (e.g., an amount of spinal curvature to be accommodated by the implant, etc.).

Referring now to <FIG>, a portion of an implant is shown according to an exemplary embodiment. In one embodiment, the portion includes a member <NUM>, which may be similar to various components described with respect to the various other embodiments disclosed herein. For example, member <NUM> may form part of a control assembly and act as a rear member similar to rear portions <NUM>, <NUM>, <NUM>, etc. As shown in <FIG>, access to the interior of the various implants disclosed herein may be by way of member <NUM>. Member <NUM> includes a control member <NUM> and an access aperture <NUM>. Control member <NUM> acts to control expansion and contraction of the implant, and aperture <NUM> enables access to the interior of the implant. The access features of member <NUM> may be implemented in any of the implant components described herein, including the various front and rear portions, top and bottom supports, etc. All such combinations of features are to be understood to be within the scope of the present disclosure.

Claim 1:
An expandable implant (<NUM>, <NUM>), comprising:
a top support assembly (<NUM>, <NUM>) defining an upper surface configured to engage a first portion of vertebral bone;
a bottom support assembly (<NUM>, <NUM>) defining a lower surface configured to engage a second portion of vertebral bone;
a control assembly (<NUM>, <NUM>) coupled to the top support assembly and the bottom support assembly and configured to control relative movement between the top support assembly and the bottom support assembly between a collapsed position and an expanded position;
wherein in the collapsed position, the upper surface is generally parallel to the lower surface, and wherein in the expanded position, a portion of the upper surface (<NUM>, <NUM>) extends at an acute angle relative to a portion of the lower surface (<NUM>, <NUM>);
wherein the control assembly includes a first wedge member (<NUM>, <NUM>) movably coupled to a second wedge member (<NUM>, <NUM>) such that relative movement between the first wedge member and the second wedge member causes relative movement between the top support assembly and the bottom support assembly;
wherein the control assembly includes a threaded control member (<NUM>, <NUM>) wherein the control member movably couples the first wedge member and the second wedge member such that a first rotation of the control member causes the top support assembly to move away from the bottom support assembly, and a second further rotation of the control member causes the portion of the top support assembly to move in a non-linear fashion relative to the portion of the bottom support assembly; and
wherein the control member rotates freely and is longitudinally fixed relative to the second wedge member, and threadingly engages and longitudinally translates relative to the first wedge member.