Expandable intervertebral implant

Abstract

This invention relates to an intervertebral implant configured to be implanted into an intervertebral space in a first initial configuration. Subsequently, an actuator is configured to be driven in an actuation direction such that the actuator forces the implant to extend in a first extension direction. Once the implant has been fully extended in the first extension direction, the actuator is configured to be further driven in that actuation direction to extend the implant in a second extension direction perpendicular to the first extension direction.

Description

Technical Field

[0001] This disclosure relates to orthopedic implantable devices, and more specifically, implantable devices for stabilizing the spine. Even more specifically, this disclosure relates to a stretchable, angle-adjustable intervertebral cage including an articulation mechanism that allows extension from a first insertion configuration with reduced dimensions to a second insertion configuration with extended dimensions. The intervertebral cage is configured to adjust and accommodate lordosis angles, particularly larger lordosis angles, while restoring sagittal balance and alignment of the spine. Background Technology

[0002] The use of implantable intervertebral devices (commonly called cages or spacers) to promote fusion is a well-known standard of care for the treatment of certain spinal conditions or diseases. For example, in one type of spinal condition, the intervertebral discs become deteriorated or damaged due to acute injury or trauma, disc disease, or simply the natural aging process. Healthy intervertebral discs serve to stabilize the spine and distribute forces between vertebrae, as well as cushion the vertebrae. Therefore, weakened or damaged discs lead to force imbalances and spinal instability, resulting in discomfort and pain. Typical treatment may involve surgical removal of part or all of the diseased or damaged disc in a procedure called partial or total discectomy. Following discectomy, a cage or spacer is typically inserted to stabilize the weakened or damaged area of ​​the spine. This cage or spacer is used to reduce or inhibit movement in the treated area to prevent further development of the damage and / or reduce or alleviate pain caused by the damage or injury. Furthermore, these types of cages or spacers act as mechanical or structural supports to restore and maintain normal disc height and, in some cases, promote bone fusion between adjacent vertebrae.

[0003] However, one of the current challenges of these types of procedures is the very limited working space available to surgeons to manipulate and insert the cage into the intervertebral space to be treated. Access to the intervertebral space requires navigation around retracted adjacent vessels and tissues such as the aorta, vena cava, dura mater, and nerve roots, leaving a very narrow path for entry. The opening to the intervertebral space itself is also relatively small. Therefore, there are physical limitations on the actual size of the insertable cage without significantly damaging the surrounding tissues or the vertebral body itself.

[0004] To further complicate matters, the vertebrae are not positioned parallel to each other in a normal spine. Due to the angular relationship between the vertebrae and each other, the spine exhibits natural curvature. An ideal cage must be able to accommodate this angular relationship between the vertebrae; otherwise, the cage will not sit correctly within the intervertebral space. An improperly assembled cage will shift or migrate out of position and fail over time, or worse, further damage already weakened areas.

[0005] Therefore, it is desirable to provide intervertebral cages or spacers that not only have the mechanical strength or structural integrity to restore the intervertebral disc height or vertebral alignment to the spinal segment to be treated, but are also constructed to easily pass through narrow access pathways into the intervertebral space and then adapt to the angular constraints of that space, especially for larger lordosis angles. Summary of the Invention

[0006] In one example, the intervertebral implant may include an implant body defining an upper body configured to face an upper vertebra and a lower body configured to face an inferior vertebra. The implant may also include an actuator supported by the implant body, which is movable within the implant body from an initial position to a first extended position and subsequently from the first extended position to a second extended position. The movement of the actuator from the initial position to the first extended position causes the actuator to extend the implant body along a first extension direction, and the movement of the actuator from the first extended position to the second extended position causes the actuator to extend the implant body along a second extension direction perpendicular to the first extension direction.

[0007] The actuator can be translated from the initial position to the first extended position. The actuator can also be translated from the first extended position to the second extended position.

[0008] The actuator can be translated from an initial position to a first extended position in the distal direction. The actuator can also be translated from the first extended position to a second extended position in the distal direction.

[0009] The first direction of extension can be perpendicular to the distal direction. The second direction of extension can be perpendicular to both the distal direction and the first direction.

[0010] The actuator may define a head that forces the implant body to extend along a first extension direction and a second extension direction.

[0011] In some examples, the movement of the actuator from the initial position to the first extension position does not force the implant body to extend in the second extension direction.

[0012] In some examples, the movement of the actuator from the first extension position to the second extension position does not force the implant body to extend along the first extension direction.

[0013] The first direction of extension allows each of the upper and lower bodies to extend. The second direction of extension allows at least one of the upper and lower bodies to move away from the other of the upper and lower bodies.

[0014] In some examples of intervertebral implants: 1) the implant body may define opposing inclined medial surfaces and inclined upper and lower surfaces, and at least corresponding portions of the inclined upper and lower surfaces may be spaced distally from the inclined medial surfaces; 2) the actuator may travel along the inclined medial surfaces to force the implant body to extend in a first extension direction; and 3) the actuator may travel along the inclined upper and lower surfaces to force the implant body to extend in a second extension direction.

[0015] The inclined upper and lower surfaces can be stepped.

[0016] The actuator may include a shaft portion and an enlarged head that extends from the shaft portion along both a first extension direction and a second extension direction. The enlarged head may force the implant body to extend along both the first and second extension directions.

[0017] The extension of the implant body along the second extension direction can change the lordosis angle defined by the outer upper surface of the upper body and the outer lower surface of the lower body.

[0018] The extension of the implant body along the second extension direction can increase the lordosis angle.

[0019] The implant body may include a frame that includes a base and each of an upper body and a lower body extending distally from the base.

[0020] When the implant body extends along the second extension direction, the upper and lower bodies can flex around the base.

[0021] In some examples of intervertebral implants: 1) the upper body may include a first upper body portion, a second upper body portion and a stretchable net that can connect the first upper body portion to the second upper body portion, and 2) the lower body portion may include a first lower body portion, a second lower body portion and a stretchable lower net that can connect the first lower body portion to the second lower body portion.

[0022] The extension of the implant body along the first extension direction can cause: 1) at least one of the first upper body portion and the second upper body portion to move away from the other of the first upper body portion and the second upper body portion, and 2) at least one of the first lower body portion and the second lower body portion to move away from the other of the first lower body portion and the second lower body portion.

[0023] The upper net can extend when at least one of the first upper body portion and the second upper body portion moves away from the other of the first upper body portion and the second upper body portion. The lower net can extend when at least one of the first lower body portion and the second lower body portion moves away from the other of the first lower body portion and the second lower body portion.

[0024] The intervertebral implant may also include a stretchable first lateral mesh connecting a first upper body portion to a first lower body portion. The intervertebral implant may also include a stretchable second lateral mesh connecting a second upper body portion to a second lower body portion. The first and second lateral meshes can extend when the implant body extends along a second direction. Attached Figure Description

[0025] The foregoing description of the invention and the following detailed description of exemplary embodiments of the present application will be better understood when read in conjunction with the accompanying drawings. Exemplary embodiments are shown in the drawings to illustrate the locking structure of the present application. However, it should be understood that the present application is not limited to the precise arrangement and means shown. In the drawings:

[0026] Figure 1A A pair of intervertebral implants inserted into the intervertebral space in a first insertion configuration is shown;

[0027] Figure 1B It shows the extension along the first extension direction. Figure 1A Intervertebral implants;

[0028] Figure 1C It shows further extension along the second extension direction. Figure 1B Intervertebral implants;

[0029] Figure 2A yes Figure 1A A first perspective view of the implant body of a pair of intervertebral disc implants shown;

[0030] Figure 2B yes Figure 2A The second perspective view of the implant body shown;

[0031] Figure 3A yes Figure 1A An exploded perspective view of one of the two intervertebral implants shown;

[0032] Figure 3B yes Figure 3A A cross-sectional perspective view of the intervertebral disc implant shown;

[0033] Figure 3C yes Figure 3A The anatomical view of the intervertebral disc implant shown is a side frontal view.

[0034] Figure 4A yes Figure 3A The cross-sectional side view of the intervertebral implant shown illustrates the implant in its first or initial configuration.

[0035] Figure 4B yes Figure 4AA cross-sectional side front view of the intervertebral implant, but showing the implant extending along the first extension direction;

[0036] Figure 5A yes Figure 4B Another cross-sectional side view of the intervertebral disc implant shown;

[0037] Figure 5B yes Figure 5A The side view of the intervertebral implant shown illustrates the implant extending along the second extension direction;

[0038] Figure 5C yes Figure 5B The side view of the intervertebral implant shown illustrates the implant extending further along the second extension direction;

[0039] Figure 6A yes Figure 3A An exploded perspective view of a portion of an intervertebral implant, showing a locking component constructed according to one embodiment; and

[0040] Figure 6B yes Figure 6A An exploded perspective view of a portion of an intervertebral implant, showing the locking component in a locking configuration. Detailed Implementation

[0041] This disclosure provides various spinal or intervertebral implants, such as interbody fusion spacers or cages, for insertion between adjacent vertebrae. The device can be configured for use in the cervical or lumbar region of the spine. In some embodiments, these devices are configured as PLIF cages or posterior lumbar interbody fusion cages. These cages restore and maintain intervertebral height of the spinal segment to be treated and stabilize the spine by restoring sagittal balance and alignment. In some embodiments, the cage may include an articulation mechanism to allow extension and angular adjustment. This articulation mechanism allows the upper and lower plate components to slide smoothly relative to each other.

[0042] like Figure 1AAs shown, one or more intervertebral implants 20 can be inserted into an intervertebral space 22 in a first insertion configuration characterized by a first reduced dimension at their insertion ends to facilitate insertion through a narrow access channel. One or more intervertebral implants 20 can be inserted into an intervertebral space using the PLIF method. However, it should be appreciated that one or more intervertebral implants 20 can be inserted along any suitable path as needed. Although a pair of intervertebral implants 20 are shown inserted into an intervertebral space, it is also understood that a single implant can be inserted into an intervertebral space of any suitable size and shape as needed. The intervertebral space 22 is defined by an upper vertebra 24 and a lower vertebra 26 spaced apart from each other along a transverse T, which defines a cephalotail direction when the intervertebral implants 20 are positioned in the intervertebral space 22. As described herein, unless otherwise specified, structures, elements, devices, and method steps described in the plural form apply equally effectively to the singular. For example, although in Figure 1A The illustration shows a pair of intervertebral implants 20 implanted in an intervertebral space 22, but it should be understood that a single intervertebral implant 20 may alternatively be implanted in the intervertebral space 22. Conversely, as described herein, unless otherwise specified, structures, elements, devices, and method steps described in the singular form are applied equally in the plural form.

[0043] Intervertebral implant 20 can be as Figure 1A As shown, insert with the first reduced size, then as... Figure 1B and Figure 1C The cage, once implanted, extends into a second extended configuration with an extended dimension. This second extended dimension is greater than the first reduced dimension in at least one direction. In some embodiments, the second extended dimension is greater than the first reduced dimension along two perpendicular directions, each perpendicular to the insertion direction. In its second extended configuration, the cage maintains proper intervertebral disc height and stabilizes the spine by restoring sagittal balance and alignment.

[0044] For example, such as Figure 1B As shown, the second extension configuration may include a first extension in a lateral direction A, which is oriented perpendicular to the transverse direction T. Specifically, the intervertebral implant 20 may extend in the first extension direction to achieve a first extension along lateral A. Therefore, the first extension direction may be along lateral A. That is, the implant has a first width along lateral A in the first reduced size and a second width along lateral A in the second extended size, the second width being greater than the first width.

[0045] In addition, such as Figure 1C As shown, the second extension configuration may include a second extension in the transverse T. Specifically, the intervertebral implant 20 may extend in the second extension direction to achieve a second extension along the transverse T. Therefore, the second extension direction may be along the transverse T.

[0046] As detailed below, the intervertebral implant 20 may extend only in the first extension direction and not in the second extension direction. Subsequently, the intervertebral implant may extend only in the second extension direction and not in the first extension direction. In some examples, the implant may extend in both the first and second extension directions simultaneously, after extending only in the first extension direction and before extending only in the second extension direction. Furthermore, in some examples, the intervertebral implant 20 may extend in the second extension direction only after extension in the first extension direction has been completed.

[0047] It is conceivable that, in some embodiments, the intervertebral implant 20 may also be designed to extend in a freely selectable (or stepless) manner along either or both of the first and second extension directions to achieve its second extension configuration. The intervertebral implant 20 may also be configured to adjust the angle of lordosis and accommodate a greater angle of lordosis in its second extension configuration. Furthermore, the intervertebral implant 20 may promote fusion to further enhance spinal stability by stabilizing adjacent vertebral bodies.

[0048] Alternatively, the intervertebral implant 20 can be manufactured using selective laser melting (SLM), a form of additive manufacturing. Other similar technologies, such as 3D printing, electron beam melting (EBM), layer deposition, and rapid fabrication, can also be used to manufacture the intervertebral implant 20. Utilizing these manufacturing technologies, an integrated, multi-part device can be created, which can have interconnected and movable components without requiring further external fixation or attachment elements to hold the components together. Therefore, the intervertebral implant 20 disclosed herein can be formed from multiple interconnected components without the need for additional external fixation elements to hold these interconnected components together.

[0049] Intervertebral implants 20 manufactured in this manner, in some examples, do not have connecting seams, whereas conventionally manufactured devices would have joining seams to connect one component to another. These connecting seams often represent weakened areas in conventionally manufactured implantable devices, especially when the adhesion of these seams wears off or breaks over time under stress due to repeated use. By using additive manufacturing to manufacture this intervertebral implant 20, connecting seams are completely avoided, and thus the problem is avoided.

[0050] Furthermore, by using additive manufacturing methods to manufacture the intervertebral implant 20, all components of the intervertebral implant 20 (including the implant body and the actuator configured to deploy the implant body as described below) maintain their complete construction during both the insertion and extension processes. That is, multiple components of the intervertebral implant 20 can be provided together as a single unit of an assembly, such that the single unit of the assembly is inserted into the patient, actuated to allow extension, and then allowed to remain in situ as a single unit of the assembly. Compared to other implantable implants that require the insertion of external screws or wedges for extension, in embodiments of the invention, in some examples the actuator does not need to be inserted into the cage at any stage during the process, nor does it need to be removed from the cage. This is because the actuator is manufactured to be contained within the implant body and, although free to move within the cage, is already included within the implant body, making it unnecessary to additionally insert or remove the actuator.

[0051] In some embodiments, the implantable implant 20 may be made partly or entirely of an engineered microporous structure comprising a network of pores, microstructures, and nanostructures to facilitate bone suturing. For example, the engineered microporous structure may include pores and an interconnected network of other micron- and nanoscale structures presenting a mesh-like appearance. These engineered microporous structures can be provided by etching or spraying to alter the surface of the device at the nanoscale. One type of etching process may utilize, for example, HF acid treatment. Furthermore, these cages may include internal imaging markers that allow the user to properly align the implantable implant 20 and are typically facilitated by visualization during navigation. For example, the imaging markers appear as solid bodies in a grid under X-ray, fluoroscopy, or CT scan.

[0052] Another benefit provided by the implantable implants 20 of this disclosure is their ability to be specifically tailored to the patient's needs. Customization of the implantable implants 20 relates to providing a preferred modulus match between the implant and the various qualities and types of bone being treated, such as cortical versus cancellous, bony prominence versus central, and sclerotic versus osteopenia, each with its own distinct compression for structural failure data. Similarly, similar data can be generated for various implant designs, such as porous versus solid, trabecular versus non-trabecular, etc. Such data can be cadaveric or generated computer finite element data. Clinical relevance with, for example, DEXA data also allows implantable devices to be specifically designed for use with sclerotic, normal, or osteopenia. Therefore, the ability to provide customized implantable devices (such as those provided herein) allows for matching the elastic modulus (EMOCS) of complex structures, enabling the implantable devices to be designed to minimize mismatch, reduce sinking, and optimize healing, thereby providing better clinical outcomes.

[0053] Turn now Figures 2A to 3CThe intervertebral implant 20 includes an implant body 28 and an actuator 29 disposed within the implant body 28. The actuator 29 is configured to drive the implant body 28, thereby driving the intervertebral implant body 20 to extend from a first insertion configuration to a second extension configuration. The implant body 28 and the intervertebral implant body 20 define a distal end 30 and a proximal end 32 opposite to the distal end 30. Thus, the distal direction is defined as the direction from the proximal end 32 toward the distal end 30. Conversely, the proximal direction is defined as the direction from the distal end toward the proximal end 32. The distal and proximal directions can be oriented along a longitudinal direction L. The longitudinal direction L can be perpendicular to each of the transverse direction T and the lateral direction A. The distal end 30 defines an anterior end relative to the direction of insertion into the intervertebral space, and the proximal end 32 defines a posterior end relative to the direction of insertion into the intervertebral space.

[0054] See now for details. Figures 2A to 2B The implant body 28 includes an upper body 34 and a lower body 36 opposite to the upper body 34 along a transverse direction T. The upper body 34 defines an outer upper surface 35 configured to face and abut the upper vertebra 24, and the lower body 36 defines an outer lower surface 37 configured to face and abut the lower vertebra 26. In one example, the upper body 34 and the lower body 36 may define protrusions in the form of teeth, screws, ridges, etc., configured to clamp the upper body 34 and the lower body 36 to restrict or prevent the intervertebral implant 20 from migrating in the intervertebral space.

[0055] The upper body 34 can be divided into a first upper body portion 34a and a second upper body portion 34b. The first upper body portion 34a and the second upper body portion 34b can be aligned with each other laterally A. Furthermore, the first upper body portion 34a and the second upper body portion 34b can be mirror images of each other. The implant body 28 may include an extendable mesh portion 38 extending between the first upper body portion 34a and the second upper body portion 34b. For example, the mesh portion 38 can extend from the first upper body portion 34a to the second upper body portion 34b. Thus, the mesh portion 38 connects the first upper body portion 34a to the second upper body portion 34b. The mesh portion 38 can extend to the distal end of the implant body 28, or can terminate at a position spaced apart from the distal end of the implant body 28 in the proximal direction. The mesh portion 38 can be oriented laterally A. Therefore, as detailed below, the internet portion 38 is extendable so that when the intervertebral implant 20 extends laterally A, it allows one or both of the first upper body portion 34a and the second upper body portion 34b to move away from the other of the first upper body portion 34a and the second upper body portion 34b.

[0056] The implant body 28 may define a base 40 positioned such that a first upper body portion 34a and a second upper body portion 34b extend distally from the base 40. The base 40 may define a proximal end 32 of the implant body 28 and may also define an orifice configured to receive an actuation tool configured to apply actuation force to an actuator 29. The base 40 may be configured as an annular body extending continuously around the periphery of the implant body 28. Thus, in one example, the base 40 may be located in a plane oriented transversely (T) and laterally (A). When the intervertebral implant 20 is in a first insertion configuration, the first upper body portion 34a and the second upper body portion 34b may extend parallel to each other. Furthermore, when the intervertebral implant 20 is in the first insertion configuration, the first upper body portion 34a and the second upper body portion 34b may be spaced apart from each other by a first distance. Alternatively, when the intervertebral implant 20 is in the first insertion configuration, the first upper body portion 34a and the second upper body portion 34b may be adjacent to each other.

[0057] The lower body 36 can be divided into a first lower body portion 36a and a second lower body portion 36b. The first lower body portion 36a and the second lower body portion 36b can be aligned with each other laterally A. Furthermore, the first lower body portion 36a and the second lower body portion 36b can be mirror images of each other. The first lower body portion 36a can be aligned with the first upper body portion 34a laterally T. Similarly, the second lower body portion 36b can be aligned with the second upper body portion 34b laterally T. The implant body 28 may include a stretchable lower mesh portion 42 extending from the first lower body portion 36a and the second lower body portion 36b. For example, the lower mesh portion 42 can extend from the first lower body portion 36a to the second lower body portion 36b. Thus, the lower mesh portion 42 connects the first upper body portion 34a to the second upper body portion 34b. The lower mesh portion 42 can also extend distally from the base 40. The lower mesh portion 42 may extend to the distal end of the implant body 28, or may terminate at a position spaced apart from the distal end of the implant body 28 in the proximal direction. The lower mesh portion 42 may be oriented laterally A. Therefore, as detailed below, the lower mesh portion 42 is extendable so as to allow one or both of the first lower body portion 36a and the second lower body portion 36b to move away from the other of the first upper body portion 36a and the second upper body portion 36b when the intervertebral implant 20 extends laterally A.

[0058] The first lower main body portion 36a and the second lower main body portion 36b may extend distally from the base 40. When the intervertebral implant 20 is in the first insertion configuration, the first lower main body portion 36a and the second lower main body portion 36b may extend parallel to each other. Furthermore, when the intervertebral implant 20 is in the first insertion configuration, the first lower main body portion 36a and the second lower main body portion 36b may be spaced apart from each other by a first distance. Alternatively, when the intervertebral implant 20 is in the first insertion configuration, the first upper main body portion 36a and the second upper main body portion 36b may be adjacent to each other.

[0059] The implant body 28 may further include an extendable first lateral mesh portion 44 extending between the first upper body portion 34a and the first lower body portion 36a. For example, the first lateral mesh portion 44 may extend from the first upper body portion 34a to the first lower body portion 36a. Thus, the first lateral mesh portion 44 connects the first upper body portion 34a to the first upper body portion 34a. The first lateral mesh portion 44 may also extend distally from the base 40. The first lateral mesh portion 44 may extend to the distal end of the implant body 28, or may terminate at a position spaced proximally from the distal end of the implant body 28. The first lateral mesh portion 44 may be oriented generally transversely T. Thus, as detailed below, the first lateral mesh portion 44 may extend transversely T to allow one or both of the first upper body portion 34a and the first lower body portion 36a to move away from the other of the first upper body portion 34a and the first lower body portion 36a when the intervertebral implant 20 extends transversely T.

[0060] The implant body 28 may further include an extendable second lateral mesh portion 46 extending between the second upper body portion 34b and the second lower body portion 36b. For example, the second lateral mesh portion 46 may extend from the second upper body portion 34b to the second lower body portion 36b. Thus, the second lateral mesh portion 46 connects the second upper body portion 34b to the second upper body portion 34b. The second lateral mesh portion 46 may also extend distally from the base 40. The second lateral mesh portion 46 may extend to the distal end of the implant body 28, or may terminate at a location spaced proximally from the distal end of the implant body 28. The second lateral mesh portion 46 may be generally oriented transversely T. Thus, as detailed below, the second lateral mesh portion 46 may extend transversely to allow one or both of the second upper body portion 34b and the second lower body portion 36b to move away from the other of the first upper body portion 34b and the first lower body portion 36b when the intervertebral implant 20 extends transversely T.

[0061] In one example, the implant body 28 may be configured such that the base 40, in conjunction with the first upper body portion 34a and the second upper body portion 34b, and the first lower body portion 36a and the second lower body portion 36b, defines a frame 48. Thus, the implant body 28 may include a frame 48 and mesh portions 38, 42, 44, and 46, each mesh portion extending distally from the base 40. The first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b, may be configured as arms extending distally from the frame 48. Furthermore, the first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b, may define corresponding corners of the outer periphery of the implant body in planes oriented along each of the transverse T and lateral A directions.

[0062] As shown in the figure, the first upper body portion 34a and the second upper body portion 34b can be L-shaped in a plane oriented along the transverse T and lateral A. That is, the first upper body portion 34a and the second upper body portion 34b can each have a first region and a second region, the first region extending laterally to define an outer upper surface 35, and the second region extending downward toward the first lower body portion 36a and the second lower body portion 36b, respectively. Similarly, the first lower body portion 36a and the second lower body portion 36b can be L-shaped in a plane oriented along the transverse T and lateral A. That is, the first lower body portion 36a and the second lower body portion 36b can each have a corresponding first region and a second region, the first region extending laterally to define an outer lower surface 37, and the second region extending upward toward the first upper body portion 36a and the second upper body portion 36b, respectively.

[0063] Therefore, the net portion 38 can extend from a first region of the first upper main body portion 34a to a first region of the second upper main body portion 34b. The net portion can extend from a first region of the first lower main body portion 36a to a first region of the second lower main body portion 36b. The first side net portion 44 can extend from a second region of the first upper main body portion 34a to a second region of the first lower main body portion 36a. The second side net portion 46 can extend from a second region of the second upper main body portion 36a to a second region of the second lower main body portion 36b. It should be understood that any one or more of the net portions may be interspersed with one or more additional upper main body portions, lower main body portions, or side main body portions.

[0064] The second regions of the first upper body portion 34a and the first lower body portion 36a may define corresponding first and second portions of the first sidewall 50 of the implant body 28. The second regions of the second upper body portion 34b and the second lower body portion 36b may define corresponding first and second portions of the second sidewall 52 of the implant body 28. Thus, in one example, the first and second portions of the first sidewall 50 and the second sidewall 52 are respectively connected to the first regions of the first upper body portion 34a and the second upper body portion 34b, and the first lower body portion 36a and the second lower body portion 36b, along corresponding planes oriented along the transverse T and the lateral A. In other examples, the first and second portions of the first sidewall 50 and the second sidewall 52 may be spaced apart from the first upper body portion 34a and the second upper body portion 34b, and the first lower body portion 36a and the second lower body portion 36b, respectively, along corresponding planes oriented along the transverse T and the lateral A.

[0065] The first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b, may extend distally from the base 40. When the intervertebral implant 20 is in the first insertion configuration, the first lower body portion 36a and the second lower body portion 36b may extend parallel to each other. Furthermore, when the intervertebral implant 20 is in the first insertion configuration, the first lower body portion 36a and the second lower body portion 36b may be spaced apart by a first distance. Alternatively, when the intervertebral implant 20 is in the first insertion configuration, the first upper body portion 36a and the second upper body portion 36b may be adjacent to each other. Similarly, the first upper body portion 34a and the first lower body portion 36a may extend parallel to each other. Furthermore, when the intervertebral implant 20 is in the first insertion configuration, the first upper body portion 34a and the first lower body portion 36a may be spaced apart by, for example, a first distance. Alternatively, when the intervertebral implant 20 is in the first insertion configuration, the first upper body portion 34a and the first lower body portion 36a may be adjacent to each other. Similarly, the second upper body portion 34b and the second lower body portion 36b may extend parallel to each other. Furthermore, when the intervertebral implant 20 is in the first insertion configuration, the second upper body portion 34b and the second lower body portion 36b may be spaced apart from each other, for example, by a first distance. Alternatively, when the intervertebral implant 20 is in the first insertion configuration, the second upper body portion 34b and the second lower body portion 36b may be adjacent to each other.

[0066] The distal end 30 of the implant body 28 may be tapered to facilitate insertion of the intervertebral implant 20 into the intervertebral space. That is, each of the first upper body portion 34a and the second upper body portion 34b, and the first lower body portion 36a and the second lower body portion 36b may be tapered at the distal end 30 of the implant body 28 toward at least one or more, or at most all, of the other portions of the first upper body portion 34a and the second upper body portion 34b, and the first lower body portion 36a and the second lower body portion 36b.

[0067] See now Figures 3A to 3C The implant body 28 is configured to support the actuator 29 within an actuation cavity 50 of the implant body 28. Specifically, the actuator 29 may be disposed within the actuation cavity 50, which is manufactured by an additive manufacturing method. Therefore, in one example, it is not necessary to separately insert the actuator 29 into the actuation cavity 50. Furthermore, the actuator 29 may be sized such that it cannot be inserted into the actuation cavity. However, it should be understood that, unless otherwise specified, this disclosure is not limited to additionally manufacturing the intervertebral implant 20.

[0068] Actuator 29 may include a shaft portion 53 and an enlarged head 54 extending from the shaft portion 53 in a transverse direction T and a lateral direction A. For example, the enlarged head 54 may extend upward and downward from the shaft portion 53 in the transverse direction T, and may also extend from the shaft portion 53 in the opposite lateral direction A. The enlarged head 54 defines a first lateral extension surface and a second lateral extension surface 55, as well as a first transverse extension surface and a second lateral extension surface 57. The enlarged head 54 may extend from a distal end of the shaft portion 53. When an actuating force is applied to actuator 29 in the longitudinal direction L, implant body 28 may cause actuator 29 to translate in the longitudinal direction L within an actuation cavity. For example, implant body 28 may include one or more guide arms 33 oriented in the longitudinal direction L and received in a slot 31 of actuator 29, thereby causing actuator 29 to translate in the longitudinal direction L. As detailed below, the enlarged head 54 is configured to force implant body 28 to extend in a first extension direction and a second extension direction. Although in one example the enlarged head 54 defines the lateral extension surface 55 and the transverse extension surface 57, it should be understood that any part of the actuator 29 may alternatively define the lateral extension surface 55 and the transverse extension surface 57, such as the shaft portion 53 of the actuator 29.

[0069] The implant body 28 may define a first inner surface 56 and a second inner surface 58 spaced apart from each other along the lateral direction A. The inner surfaces 56 and 58 may be inclined so that they extend laterally along the longitudinal direction L. That is, each of the first inner surface 56 and the second inner surface 58 may include a corresponding first inclined inner surface 60 and second inclined inner surface 62 at the lateral extension region 59 of the implant body 62. The first inclined inner surface 60 and the second inclined inner surface 62 taper inward toward the other of the first inner surface 56 and the second inner surface 58 as they extend in the distal direction. The first inclined inner surface 60 and the second inclined inner surface 60 may be mirror images of each other with respect to a midplane oriented along the longitudinal direction L and the lateral direction T. Thus, in one example, the first inclined inner surface 60 and the second inclined inner surface 62 may define equal and opposite slopes. Furthermore, the first inclined inner surface 60 and the second inclined inner surface 62 may be aligned with each other laterally A. Alternatively, the slopes of the first inclined inner surface 60 and the second inclined inner surface 62 may be different from each other. The first inclined side surface 60 may be defined by both the first upper body portion 34a and the first lower body portion 36a. Similarly, the second inclined side surface 62 may be defined by both the second upper body portion 34b and the second lower body portion 36b.

[0070] The implant body 28 may define an inner upper surface 64 and an inner lower surface 66 spaced apart from each other along a transverse direction T. As the inner upper surface 64 and inner lower surface 66 extend longitudinally L at a transverse extension region 61 of the implant body 28, they may be inclined along the transverse direction T. That is, the inner upper surface 64 defines an upwardly inclined surface 65, and the inner lower surface 66 defines a downwardly inclined surface 67. As the inclined surfaces 65 and 67 extend in a distal direction, they each taper inward toward the other of the inner upper surface 64 and inner lower surface 66. In one example, the upwardly inclined surface 65 and the downwardly inclined surface 67 may define equal and opposite slopes. Alternatively, the slopes of the upwardly inclined surface 65 and the downwardly inclined surface 67 may be different from each other.

[0071] One or both of the inclined surfaces 65 and 67 may be stepped. Therefore, inclined surfaces 65 and 67 may include inclined surface segments 68 and vertical plates 70 disposed between adjacent inclined surface segments 68. The slope of the vertical plates 70 may be greater than the slope of the inclined surface segments 68. Furthermore, each vertical plate 70 of the upper inclined surface 65 may have the same slope, and each vertical plate 70 of the lower inclined surface 67 may have the same slope. The vertical plates 70 of the upper inclined surface 65 and the lower inclined surface 67 may have the same slope as each other. The length of the vertical plate 70 along the longitudinal direction L may be less than the length of the inclined surface segment 68 along the longitudinal direction L.

[0072] Inclined surfaces 65 and 67 can be mirror images of each other around a midplane oriented along the longitudinal direction L and the transverse direction T. Therefore, each inclined surface segment 68 of the upper inclined surface 65 can have the same slope, and each inclined surface segment 68 of the lower inclined surface 67 can have the same slope. Furthermore, the inclined surface segments 68 of the upper inclined surface 65 and the lower inclined surface 67 can have the same slope. Inclined surfaces 65 and 67 can be aligned with each other along the transverse direction T, such that the inclined surface segments 68 of inclined surfaces 65 and 67 can be aligned with each other along the transverse direction T, and the vertical plates 70 of inclined surfaces 65 and 67 can be aligned with each other along the transverse direction T.

[0073] See also Figure 3C The actuator 29 may define at least one actuator ratchet tooth 72, such as a plurality of actuator ratchet teeth 72. The actuator ratchet teeth 72 may be located on one side of the actuator 29 or on opposite sides of the actuator 29. In one example, the actuator 29 includes a first row and a second row of actuator ratchet teeth 72 oriented longitudinally. The first row and the second row of actuator ratchet teeth 72 may be opposite each other in a transverse direction T. Alternatively, the first row and the second row of actuator ratchet teeth 72 may be opposite each other in a lateral direction A. Alternatively, the actuator ratchet teeth 72 may have a length extending around the actuator 29 by a distance sufficient to define a first portion and a second portion at their opposite positions on the actuator 29. The actuator ratchet teeth 72 may be disposed on the shaft portion 53 of the actuator 29, but may also be disposed as needed.

[0074] The implant body 28 may further define at least one implant ratchet tooth 74 configured to interlock with at least one actuator ratchet tooth 72. The ratchet teeth 72 and 74 are configured to interlock to resist movement of the actuator 29 in an extension direction that causes the implant body 28 to iterate from a first insertion configuration to a second extension configuration and in a contraction direction that causes the implant body 28 to iterate from the second extension configuration to the first insertion configuration. In one example, the implant body 28 may include a first row and a second row of at least one implant ratchet tooth 74. The first row and the second row of at least one implant ratchet tooth may be aligned with the first row and the second row of at least one actuator tooth 72. Thus, the first row and the second row of at least one implant ratchet tooth may interlock with the first row and the second row of at least one actuator ratchet tooth 72.

[0075] Furthermore, when the actuator 29 translates longitudinally L relative to the implant body 28, at least one actuator ratchet tooth 72 and at least one implant ratchet tooth 74 can engage with each other. For example, at least one or both of the at least one actuator ratchet tooth 72 and at least one implant ratchet tooth 74 can be displaced away from the other of the at least one actuator ratchet tooth 72 and at least one implant ratchet tooth 74.

[0076] In one example, the implant body 28 includes at least one flexible arm 76 that carries at least one implant ratchet tooth 74. The at least one implant ratchet tooth 74 can be a single ratchet tooth 74 as shown, or multiple ratchet teeth 74. For example, the implant body 28 includes a first flexible arm and a second flexible arm 76, each carrying at least one implant ratchet tooth 74. Furthermore, at least one actuator tooth 72 is configured as a plurality of actuator teeth 72. When the actuator 29 translates in both distal and proximal directions, at least one implant ratchet tooth 74 selectively cams with the actuator tooth 72 as the flexible arm 76 elastically flexes away from the actuator tooth 72. When at least one implant ratchet tooth 74 is positioned between adjacent actuator teeth 72, the teeth 72 and 74 limit mechanical interference to prevent accidental movement of the actuator 29. Mechanical interference can be overcome by applying an actuating force to the actuator 29 longitudinally. This allows the actuator 29 to translate within the implant body 28, aligning the actuator ratchet teeth 72 longitudinally with the implant ratchet teeth 74. In other words, the implant body 28 prevents the actuator 29 from rotating relative to the implant body by an amount that would disengage the actuator teeth 72 from longitudinal alignment with the implant ratchet teeth.

[0077] Although in the illustrated example each arm of arm 76 carries a single implant ratchet tooth 74 and actuator 29 carries multiple actuator ratchet teeth 72, other configurations are contemplated. For example, each row of implant body 28 may alternatively include multiple implant ratchet teeth 74 configured to mesh with at least one actuator ratchet tooth 72. Furthermore, each row of actuator 29 may include a single actuator ratchet tooth 72 or multiple actuator ratchet teeth 72. Additionally, if desired, actuator ratchet teeth 72 may be positioned on a flexible actuator arm.

[0078] See another example. Figures 6A to 6BThe actuator 29 is rotatable about its central longitudinal axis. Therefore, when the actuator is in the first rotational position, the actuator ratchet tooth 72 may be misaligned with the implant ratchet tooth 74 relative to the longitudinal direction L. Thus, the actuator 29 can translate freely along the longitudinal direction L within the implant body 28 without causing mechanical interference between the actuator ratchet tooth 72 and the implant ratchet tooth 74. Once the actuator 29 has been translated to the desired longitudinal position, it can be rotated to a second rotational position, whereby at least one implant ratchet tooth 74 is positioned between adjacent actuator ratchet teeth 72. In one example, the second rotational position may be offset by ninety degrees from the first rotational position. Alternatively or otherwise, at least one actuator tooth 72 may be positioned between adjacent implant ratchet teeth among the plurality of implant ratchet teeth 74. When the actuator 29 is in the second rotational position, the mechanical interference defined by the ratchet teeth 72 and 74 prevents the actuator 29 from moving relative to the implant body 28 along the longitudinal direction L.

[0079] Now see the overall view Figures 4A to 5C The operation of the intervertebral implant 20 will now be described. Specifically, the actuator 29 can be generated from within the implant body 28. Figure 4A The initial position shown is moved to Figure 4B The first extended position is shown, and then the movement from the first extended position to... Figures 5B to 5C The second extension position is shown. The movement of actuator 29 from the initial position to the first extension position causes actuator 29 to force the implant body 28 along the first extension direction from... Figure 4A The first configuration shown extends to Figure 4B The first extension is shown. Movement of actuator 29 from the first extension position to the second extension position causes actuator 29 to force the implant body 28 to extend along a second extension direction perpendicular to the first extension direction, as shown. Figures 5B to 5C As shown. In one example, actuator 29 can be translated in the distal direction from an initial position to a first extended position, and further translated from the first extended position to a second extended position. For example, actuator 29 can translate in the distal direction without undergoing rotation. Alternatively, in an alternative example, actuator 29 can be configured as a screw that can rotate when it translates in the distal direction.

[0080] See now for details. Figures 4A to 4BWhen actuator 29 is in the initial position, implant body 28 is in a first or initial configuration. When implant body 28 is in the first or initial configuration, implant body 28 defines a first width along the lateral direction A and a first height along the transverse direction T. Furthermore, when actuator 29 is in the initial position, the enlarged head 54 may be spaced apart from the inclined side surfaces 60 and 62 in the proximal direction. Alternatively, the enlarged head 54 may be aligned with the inclined side surfaces 60 and 62 along the lateral direction A. Therefore, when actuator 29 is in the initial position, the actuator has not yet forced the implant body to extend in a first extension direction, which may be defined by the lateral direction A.

[0081] When actuator 29 translates distally from a first or initial position to a first extended position in the lateral extension region 59, the lateral extension surface 55 travels along the first inclined side surface 60 and the second inclined side surface 62, thereby extending the implant body 28 laterally from an initial configuration to a lateral extension configuration that defines the first extension. The implant body 28 defines a first lateral distance along lateral A between the proximal ends of the inclined side surfaces 60 and 62, and a second lateral distance between the distal ends of the inclined side surfaces, which is less than the first lateral distance. Therefore, as the lateral extension surface 55 travels along the first inclined side surface 60 and the second inclined side surface 62, the lateral extension surface 55 forces the implant body 28 to extend along the first extension direction to a second width along lateral A, which is greater than the first width. The first width and the second width can be measured from the outer surface of the first sidewall 50 to the outer surface of the second sidewall 52.

[0082] Specifically, each of the upper body 34 and the lower body 36 can extend laterally A. For example, actuator 29 forces the first upper body portion 34a and the second upper body portion 34b (see...) Figure 2A At least one or both of the first upper body portion 34a and the second upper body portion 34b are moved laterally away from the other of the first upper body portion 34a and the second upper body portion 34b. Furthermore, actuator 29 forces at least one or both of the first lower body portion 36a and the second lower body portion 36b (see...) Figure 2B The actuator 29 can also force either or both of the first sidewall 50 and the second sidewall 52 away from the other of the first sidewall 50 and the second sidewall 52 as the implant body 28 extends laterally A. The net portion 38 and the lower net portion 42 can also extend laterally A as the implant body 28 extends laterally A.

[0083] Although in one example the first inner surface 56 and the second inner surface 58 are inclined, it should be understood that alternatively or otherwise, the lateral extension surface 55 may be inclined. That is, as the lateral extension surface extends in the distal direction, the lateral extension surfaces may taper toward each other along the lateral A. Thus, when the actuator 29 moves in the distal direction, the lateral extension surface 55 may force the implant body 28 to extend along the lateral A.

[0084] As described above, the first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b, can each extend distally from the base 40. Therefore, when the implant body 28 extends along the first extension direction, the first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b, can laterally flex outward relative to the base 40. Therefore, the width of the implant body 28 along the lateral direction A at the proximal ends of the first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b, can be smaller than the width along the lateral direction A at the distal ends of the first upper body portion 34a and the second upper body portion 34b, as well as the first lower body portion 36a and the second lower body portion 36b.

[0085] See also Figures 5A to 5C When the implant body 28 has extended along the first extension direction, the actuator can further translate from the first extension position to a second extension position in the distal direction, thereby extending the implant body into a second or extended configuration. The second extension position can be any position where the implant body 28 extends along the second extension direction after extension along lateral A is completed. As will now be described, the second extension direction moves at least one or both of the upper body 34 and the lower body 36 away from the other of the upper body 34 and the lower body 36.

[0086] When actuator 29 is in the first extended position, implant body 28 has a first height along the transverse direction T. When actuator 29 is in the initial position and implant body 28 is in the first or initial configuration, implant body 28 also has the first height. Furthermore, when actuator 29 is in the first extended position, the enlarged head 54 may be spaced proximally from the upper inclined surface 65 and the lower inclined surface 67. Alternatively, the enlarged head 54 may be aligned along the transverse direction T with the upper inclined surface 65 and the lower inclined surface 67. When actuator 29 is in the first extended position, actuator 29 has not yet forced implant body 28 to extend in a second extension direction, which may be defined by the transverse direction T.

[0087] As actuator 29 translates distally from a first extended position to a second extended position, the lateral extension surface 57 travels along the upper inclined surface 65 and the lower inclined surface 67, thereby forcing the implant body 28 to extend laterally along the lateral T. The implant body 28 defines a first distance along the lateral T between the proximal ends of the upper inclined surface 65 and the lower inclined surface 67, and a second lateral distance between the distal ends of the upper inclined surface 65 and the lower inclined surface 67, which is less than the first lateral distance. Therefore, as the lateral extension surface 57 travels along the upper inclined surface 65 and the lower inclined surface 67, the lateral extension surface 57 forces the implant body 28 to extend laterally along the lateral A to a second height along the lateral T, which is greater than the first height. Specifically, actuator 29 forces the upper body 34 and the lower body 36 (see Figure 2A At least one or both of the upper body 34 and the lower body 36 are located away from the other. The first side mesh portion 44 and the second side mesh portion 46 can extend laterally as the implant body 28 extends along the transverse T. The mesh portions 38, 42, 44, and 46 can be constructed as needed according to any suitable embodiment. In one example, the mesh portions may include a plurality of interconnected connectors that are movable relative to each other to allow the mesh portions to extend in corresponding directions.

[0088] like Figure 5C As shown, when the implant 20 is fully extended along the second extension direction, the upper inclined surface 65 and the lower inclined surface 67 may change from the aforementioned slope to a second orientation with a smaller angle relative to the longitudinal direction L. For example, at least one or more of the upper inclined surface 65 and the lower inclined surface 67 may be oriented substantially along the longitudinal direction L, such as within + / - 5 degrees of the longitudinal direction L.

[0089] As described above, the upper body 34 and the lower body 36 can each extend distally from the base 40. Therefore, when the implant body 28 extends along the second extension direction, the upper body 34 and the lower body 36 can flex outwards along the transverse T relative to the base 40. Therefore, the height of the implant body 28 along the transverse T at the proximal ends of the upper body 34 and the lower body 36 can be less than the height of the implant body 28 along the transverse T at the distal ends of the upper body 34 and the lower body 36. Therefore, the extension of the implant body 28 along the second extension direction can be altered, for example, by increasing the lordosis angle defined by the outer upper surface 35 and the outer lower surface 37. Further extension of the implant body 28 along the second extension direction can further alter the lordosis angle.

[0090] As described above, inclined surfaces 65 and 67 may include inclined surface segments 68 and vertical plates 70 disposed between adjacent inclined surface segments 68. Therefore, as the actuator 29 translates distally, the lateral extension surface 57 alternately travels along the inclined surface segments 68 and the vertical plates 70. When the actuator 29 has translated to a position where it no longer translates distally, the implant body 28 can reach a fully extended height. Further as described above, the implant body 28 and the actuator 29 include corresponding ratchet teeth 72 and 74, which are configured to engage with each other to lock the implant body 28 in a second or extended position. When the ratchet teeth 72 and 74 engage with each other, translation of the actuator 29 relative to the implant body 28 in the proximal direction is prevented. Specifically, at least one of the proximal surface of the implant ratchet tooth 74 and the distal surface of the actuator ratchet tooth 72 may be oriented to prevent the ratchet teeth 72 and 74 from cam-acting with each other in the proximal direction. Therefore, the actuator 29 can be prevented from translating in the proximal direction relative to the implant body 28.

[0091] Therefore, actuator 29 can be translated in the distal direction to a position where the lateral extension surface 57 engages with the corresponding inclined surfaces 65 and 67. Engagement of ratchet teeth 72 and 74 prevents actuator 29 from translating in the proximal direction, which would cause the implant to collapse along the transverse T. Thus, the implant can extend to a position where the height along the transverse T is less than the fully extended height. Furthermore, ratchet teeth 72 and 74 can engage when actuator 29 is in the first extended position. Therefore, implant 28 can be locked in a lateral extension configuration to prevent implant 28 from contracting laterally A without extending along the transverse T. Furthermore, implant 28 can be locked in both a lateral extension configuration and a transverse extension configuration with an extension height less than the fully extended height. Therefore, after implant 20 has fully extended laterally A, the extension of implant 20 along the transverse T can be controlled.

[0092] The first inner surface 56 and the second inner surface 58 in the lateral extension region 61 can be oriented along a corresponding plane defined by the lateral T and longitudinal L when the implant 20 has reached the first extension. Therefore, as the actuator translates in the lateral extension region 61 during the distal translation of the actuator 29, the lateral extension surface 55 travels along the first inner surface 56 and the second inner surface 58, without forcing the implant body 28 to extend laterally A. Thus, the distal translation of the actuator head 54 in the lateral extension region 61 causes the implant to extend laterally T but not laterally A. Alternatively, as the first inner surface 56 and the second inner surface 68 extend in the distal direction, they can be tilted inward towards each other laterally A. Therefore, the distal translation of the actuator 29 in the lateral extension region 61 allows the lateral extension surface 55 of the actuator 29 to force the implant body 28 to extend further laterally A. In one example, the slopes of the first inner surface 56 and the second inner surface 68 may be less than the slopes of the inclined inner surfaces 60 and 62.

[0093] In one example, the upper surface 64 and the lower surface 66 are inclined, and it should be understood that, alternatively or otherwise, the lateral extension surface 57 may be inclined. That is, as the lateral extension surfaces 57 extend in the distal direction, they may taper toward each other along the lateral T. Thus, when the actuator 29 moves in the distal direction, the lateral extension surfaces 57 may force the implant body 28 to extend laterally along the T.

[0094] As described above, at least a portion, or at most the entire portion, of the lateral extension region 61 may be disposed distal to the lateral extension region 59. Therefore, at least corresponding portions, or at most the entire portions, of the upper inclined surface 65 and the lower inclined surface 67 may be disposed distal to the inclined side surfaces 60 and 62. Thus, in one example, movement of the actuator 29 from its initial position to its first extension position does not force the implant body 28 to extend in the second extension direction. Alternatively, a portion of the vertical extension region 61 may partially overlap with the lateral extension region 59. Thus, when the implant body 28 extends laterally T, it may further extend laterally A. In both examples, at least a portion of the vertical extension region 61 extends distal to the lateral extension region 59, and the implant may extend laterally T without extending laterally A.

[0095] As described above, the first extension direction can be along the lateral direction A, and the second extension direction can be along the transverse direction T. Alternatively, the first extension direction can be along the transverse direction T, and the second extension direction can be along the lateral direction A. In this respect, at least a portion of the lateral extension region 59 can be disposed on the distal side of the transverse extension region 61.

[0096] It should be understood that the descriptions and discussions of the embodiments shown in the accompanying drawings are for illustrative purposes only and should not be construed as limiting this disclosure. Those skilled in the art will recognize that various embodiments are contemplated in this disclosure. Furthermore, it should be understood that the concepts described above using the above embodiments can be used alone or in combination with any other of the above embodiments. It should also be understood that, unless otherwise specified, the various alternative embodiments described above with respect to one illustrated embodiment are applicable to all embodiments as described herein.

Claims

1. An intervertebral disc implant, the intervertebral disc implant comprising: An implant body, the implant body defining an upper body configured to face the upper vertebra and a lower body configured to face the lower vertebra; and An actuator, supported by the implant body, is capable of moving within the implant body from an initial position to a first extended position, and subsequently from the first extended position to a second extended position. Wherein, the movement of the actuator from the initial position to the first extension position causes the actuator to force the implant body to extend along a first extension direction, and the movement of the actuator from the first extension position to the second extension position causes the actuator to force the implant body to extend along a second extension direction perpendicular to the first extension direction. Wherein, 1) the implant body defines opposing inclined inner surfaces, an inclined upper inner surface, and an inclined lower inner surface, and at least corresponding portions of the inclined upper inner surface and the inclined lower inner surface are spaced distally from the inclined inner surfaces; 2) the actuator travels along the inclined inner surfaces to force the implant body to extend in the first extension direction; and 3) the actuator travels along the inclined upper inner surface and the inclined lower inner surface to force the implant body to extend in the second extension direction.

2. The intervertebral disc implant according to claim 1, wherein, The actuator is capable of translating from the initial position to the first extended position, and further translating from the first extended position to the second extended position.

3. The intervertebral disc implant according to claim 2, wherein, The actuator is capable of translating in the distal direction from the initial position to the first extended position, and further translating in the distal direction from the first extended position to the second extended position.

4. The intervertebral disc implant according to claim 1, wherein, The first extension direction is perpendicular to the distal direction, and the second extension direction is perpendicular to both the distal direction and the first extension direction.

5. The intervertebral disc implant according to claim 1, wherein, The actuator defines a head that forces the implant body to extend along the first extension direction and the second extension direction.

6. The intervertebral disc implant according to claim 1, wherein, The movement of the actuator from the initial position to the first extension position does not force the implant body to extend along the second extension direction.

7. The intervertebral disc implant according to claim 6, wherein, The movement of the actuator from the first extension position to the second extension position does not force the implant body to extend along the first extension direction.

8. The intervertebral disc implant according to claim 1, wherein, The movement of the actuator from the first extension position to the second extension position does not force the implant body to extend along the first extension direction.

9. The intervertebral disc implant according to claim 1, wherein, The first extension direction causes each of the upper body and the lower body to extend, and the second extension direction causes at least one of the upper body and the lower body to move away from the other of the upper body and the lower body.

10. The intervertebral disc implant according to claim 1, wherein, The inclined inner upper surface and the inclined inner lower surface are stepped.

11. The intervertebral disc implant according to claim 1, wherein, The actuator includes a shaft portion and an enlarged head extending from the shaft portion along both the first and second extension directions, and the enlarged head forces the implant body to extend along the first and second extension directions.

12. The intervertebral disc implant according to claim 1, wherein, The extension of the implant body along the second extension direction changes the lordosis angle defined by the outer upper surface of the upper body and the outer lower surface of the lower body.

13. The intervertebral disc implant according to claim 12, wherein, The extension of the implant body along the second extension direction increases the lordosis angle of the spine.

14. The intervertebral disc implant according to claim 1, wherein, The implant body includes a frame, the frame including a base and each of the upper and lower bodies extending distally from the base.

15. The intervertebral disc implant according to claim 14, wherein, When the implant body extends along the second extension direction, the upper body and the lower body flex around the base.

16. The intervertebral disc implant according to claim 1, wherein, 1) The upper body includes a first upper body portion, a second upper body portion, and a stretchable net, wherein the stretchable net connects the first upper body portion to the second upper body portion, and 2) The lower body includes a first lower body portion, a second lower body portion, and a stretchable lower net, wherein the stretchable lower net connects the first lower body portion to the second lower body portion.

17. The intervertebral disc implant according to claim 16, wherein, The extension of the implant body along the first extension direction causes 1) at least one of the first upper body portion and the second upper body portion to move away from the other of the first upper body portion and the second upper body portion, and 2) at least one of the first lower body portion and the second lower body portion to move away from the other of the first lower body portion and the second lower body portion.

18. The intervertebral disc implant according to claim 17, wherein, The extendable net extends when at least one of the first upper body portion and the second upper body portion moves away from the other of the first upper body portion and the second upper body portion, and the extendable lower net extends when at least one of the first lower body portion and the second lower body portion moves away from the other of the first lower body portion and the second lower body portion.

19. The intervertebral disc implant of claim 18, further comprising a stretchable first side net connecting the first upper body portion to the first lower body portion, and a stretchable second side net connecting the second upper body portion to the second lower body portion, wherein, When the implant body extends along the second extension direction, the stretchable first side mesh and the stretchable second side mesh extend.

Images