Variable front plate for expandable cage

Abstract

An articulating plate for use with a spinal implant is disclosed. The articulating plate includes a first face and a second face. A first aperture extends between the first face and second face. The articulating plate is couplable to the spinal implant. The articulating plate is configured to translate along a longitudinal axis of the spinal implant and tilt about a lateral axis of the spinal implant.

Description

A0013274W001VARIABLE FRONT PLATE FOR EXPANDABLE CAGE

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 760,232, filed 19 February 2025, the entire content of which is incorporated herein by reference.FIELD

[0002] The present disclosure generally relates to medical devices for the treatment of musculoskeletal disorders, and more particularly to interbody device systems including various embodiments of endplates, locking mechanisms, and expandable spinal implants and systems. In another aspect, the disclosure relates to methods for implanting and manipulating the interbody device systems such as expanding and aligning an endplate relative to patient anatomy.BACKGROUND

[0003] Spinal disorders such as degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumor, and fracture may result from factors including trauma, disease and degenerative conditions caused by injury and aging. Spinal disorders typically result in symptoms including pain, nerve damage, and partial or complete loss of mobility.

[0004] Non-surgical treatments, such as medication, rehabilitation and exercise can be effective, however, they may fail to relieve the symptoms associated with these disorders. Surgical treatment of these spinal disorders includes fusion, fixation, correction, discectomy, laminectomy and implantable prosthetics. As part of these surgical treatments, spinal constructs, such as, for example, bone screws, spinal rods and interbody devices can be used to provide stability to a treated region. For example, during surgical treatment, interbody devices may be introduced to a space between adjacent vertebral bodies (the interbody space) to properly space the vertebral bodies and provide a receptacle for bone growth promoting materials, e.g., grafting.

[0005] More recently, interbody devices have been introduced that provide additional capability beyond static spacing of the vertebral bodies. For example, some devices have expansion capability such that the implant may be introduced to the interbody space in a collapsed state and165143016.2Attorney Docket No. A0013274W001then expanded to produce additional spacing and, in some cases, introduce or restore curvature to the spine by expanding selectively.

[0006] Additionally, some interbody devices include plates for supporting fasteners for securing the interbody device to anatomy, such as bone screws and bone pins. Such plates sometimes need to be assembled to the interbody device at the time of insertion, which slows down surgical workflows and introduces additional risk into surgical workflows. In addition, such plates may limit the surgeon to a particular installation configuration, e.g. , a particular anterior-posterior depth of the interbody device.

[0007] The present disclosure seeks to address these and other shortcomings in the existing relevant arts.SUMMARY

[0008] In one aspect of the disclosed technology, an articulating plate for use with a spinal implant is disclosed. The articulating plate may include a first face, a second face and an aperture extending therebetween. The articulating plate may be coupled to a spinal implant and be configured to move relative to the spinal implant about a longitudinal and lateral axis. The longitudinal axis may extend longitudinally through the spinal implant. The lateral axis may extend laterally through the spinal implant and intersect the longitudinal axis. The articulating plate may be configured to translate longitudinally along the longitudinal axis and tilt about the lateral axis when the articulating plate is coupled to the spinal implant.

[0009] In another aspect of the disclosed technology, a spinal implant system is disclosed. The spinal implant system may include an articulating plate having a first face, a second face and an aperture extending therebetween. The system may also include a locking mechanism coupled to the articulating plate and at least partially received in one or more cutouts on the first face of the articulating plate. The articulating plate may be configured to couple to the spinal implant and the articulating plate may be configured to move relative to the spinal implant about a longitudinal axis and a lateral axis. The longitudinal axis may extend longitudinally through the spinal implant. The lateral axis may extend laterally through the spinal implant and intersect the longitudinal axis. The articulating plate may be configured to translate longitudinally along theAttorney Docket No. A0013274W001longitudinal axis and tilt about the lateral axis when the articulating plate is coupled to the spinal implant.

[0010] In another aspect of the disclosed technology, a method of securing an articulating plate to patient anatomy is disclosed. The method may include coupling an articulating plate to a spinal implant, wherein coupling an articulating plate to a spinal implant, wherein coupling may include engaging a first feature of the spinal implant to a corresponding second feature of the articulating plate to thereby allow the articulating plate to translate along a longitudinal axis of the spinal implant and tilt about a lateral axis of the spinal implant. The method may further include securing a locking mechanism to the articulating plate so that the locking mechanism restricts movement of an expansion mechanism of the spinal implant while allowing translation and tilting of the articulating plate about the longitudinal axis and the lateral axis, respectively. The method may still further include aligning the articulating plate relative to patient anatomy, wherein aligning the articulating plate relative to patient anatomy may include translating the articulating plate along the longitudinal axis and tilting the articulating plate about the lateral axis. The first feature may include at least one of an outdent or a support tang of the articulating plate and the second feature may include at least one of an indentation or an aperture of the spinal implant.

[0011] The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.BRIEF DESCRIPTION OF THE DRAWINGS

[0012] FIG. 1 depicts a front perspective view of one embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;

[0013] FIG. 2 depicts a rear perspective view of one embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;

[0014] FIG. 3 depicts a first exploded parts view of one embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;

[0015] FIG. 4 depicts a first exploded parts view of one embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0016] FIG. 5 depicts a top view showing various section lines of one embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;

[0017] FIG. 6 depicts a perspective cross section drawing through section A3 of FIG. 5

[0018] FIG. 7 depicts a perspective cross section drawing through section Ai of FIG. 5;

[0019] FIG. 8 depicts a perspective cross section drawing through section A4 of FIG. 5;

[0020] FIG. 9 depicts a front perspective view of one embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;

[0021] FIG. 10 depicts a front perspective view of the embodiment of FIG. 9 in a partially expanded first position in accordance with the principles of the present disclosure;

[0022] FIG. 11 depicts a front perspective view of the embodiment of FIG. 9 in a partially expanded second position in accordance with the principles of the present disclosure;

[0023] FIG. 12 depicts a front perspective view of the embodiment of FIGS. 9-12 in a fully expanded position in accordance with the principles of the present disclosure;

[0024] FIG. 13 depicts a partial parts view of the embodiment of FIG. 12 with the superior endplate removed for ease of understanding in accordance with the principles of the present disclosure;

[0025] FIG. 14 depicts a front perspective view of one embodiment in accordance with the principles of the present disclosure;

[0026] FIG. 15 depicts a front perspective view of one embodiment in accordance with the principles of the present disclosure;

[0027] FIG. 16 depicts a top-down view of one embodiment in accordance with the principles of the present disclosure;

[0028] FIG. 17 depicts an embodiment of an expandable spinal implant in accordance with the principles of the present disclosure;

[0029] FIG. 18 depicts an alternate perspective view of the embodiment of FIG. 17 in accordance with the principles of the present disclosure;

[0030] FIG. 19 depicts an exploded parts view diagram of the embodiment of FIG. 17 in accordance with the principles of the present disclosure;

[0031] FIG. 20A depicts an embodiment of a set screw in accordance with the principles of the present disclosure in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0032] FIG. 20B depicts an alternative view of the embodiment of a set screw of FIG. 20A in accordance with the principles of the present disclosure;

[0033] FIG. 21 A depicts a perspective view of an embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0034] FIG. 21B depicts a side view of the embodiment of an interbody device system of FIG. 21 A including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0035] FIG. 21C depicts a front view of the embodiment of an interbody device system of FIG. 21 A including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0036] FIG. 21D depicts a side view depicting the tilting capability of the embodiment of an interbody device system of FIG. 21 A in accordance with the principles of the present disclosure;

[0037] FIG. 22A depicts a front view of an embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;

[0038] FIG. 22B depicts a front perspective of the embodiment of an endplate depicted in FIG. 22A in accordance with the principles of the present disclosure;

[0039] FIG. 23A depicts a rear view of the embodiment of an endplate depicted in FIG. 22A in accordance with the principles of the present disclosure;

[0040] FIG. 23B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 22A in accordance with the principles of the present disclosure;

[0041] FIG. 24A depicts a perspective view of the endplate of FIG. 22A and an embodiment of a screw guide in accordance with the principles of the present disclosure;

[0042] FIG. 24B depicts an embodiment of a screw guide and an embodiment of a support block in accordance with the principles of the present disclosure;

[0043] FIG. 25A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 22A in accordance with the principles of the present disclosure;

[0044] FIG. 25B depicts a rear view of the locking mechanism of FIG. 25A in accordance with the principles of the present disclosure;

[0045] FIG. 25C depicts a side view of the locking mechanism of FIG. 25A in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0046] FIG. 25D depicts a front perspective view of the locking mechanism of FIG. 25A in accordance with the principles of the present disclosure;

[0047] FIG. 25E depicts a rear perspective view of the locking mechanism of FIG. 25A with a detached shaft in accordance with the principles of the present disclosure;

[0048] FIG. 25F depicts a side view depicting the translating capability of the locking mechanism of FIG. 25A in accordance with the principles of the present disclosure;

[0049] FIG. 25 G depicts a side view depicting the tilting capability of the locking mechanism of FIG. 25A in accordance with the principles of the present disclosure;

[0050] FIG. 26 depicts a perspective view of an alternative embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0051] FIG. 27 A depicts a front view of an alternative embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;

[0052] FIG. 27B depicts a front perspective of the embodiment of an endplate depicted in FIG. 27A in accordance with the principles of the present disclosure;

[0053] FIG. 28A depicts a rear view of the embodiment of an endplate depicted in FIG. 27A in accordance with the principles of the present disclosure;

[0054] FIG. 28B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 27A in accordance with the principles of the present disclosure;

[0055] FIG. 29 depicts a view of an aperture of the embodiment of an endplate depicted in FIG. 27A in accordance with the principles of the present disclosure. A portion of an embodiment of a locking mechanism is received in the aperture;

[0056] FIG. 30A depicts an exploded parts view of an the embodiment of an endplate of FIG.27A, a first trolley, a second trolley and a support block in accordance with the principles of the present disclosure;

[0057] FIG. 30B depicts an alternative view of the embodiment of a support block depicted in FIG. 30A in accordance with the principles of the present disclosure;

[0058] FIG. 30C depicts an alternative view of the embodiment of a support block depicted in FIG. 30A in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0059] FIG. 30D depicts a cross-sectional view of the embodiment of a support block of FIG.30C taken along section line A-A in FIG. 30C in accordance with the principles of the present disclosure;

[0060] FIG. 31 A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 27 A in accordance with the principles of the present disclosure;

[0061] FIG. 3 IB depicts a rear view of the locking mechanism of FIG. 31 A in accordance with the principles of the present disclosure;

[0062] FIG. 31C depicts a side view of the locking mechanism of FIG. 31 A in accordance with the principles of the present disclosure;

[0063] FIG. 3 ID depicts a front perspective view of the locking mechanism of FIG. 31 A in accordance with the principles of the present disclosure;

[0064] FIG. 3 IE depicts a rear perspective view of the locking mechanism of FIG. 31A in accordance with the principles of the present disclosure;

[0065] FIG. 32 depicts a perspective view of an alternative embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0066] FIG. 33A depicts a front view of an alternative embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;

[0067] FIG. 33B depicts a front perspective of the embodiment of an endplate depicted in FIG. 33A in accordance with the principles of the present disclosure;

[0068] FIG. 34 A depicts a rear view of the embodiment of an endplate depicted in FIG. 33 A in accordance with the principles of the present disclosure;

[0069] FIG. 34B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 33A in accordance with the principles of the present disclosure;

[0070] FIG. 35A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 33A in accordance with the principles of the present disclosure;

[0071] FIG. 35B depicts a rear view of the locking mechanism of FIG. 35A in accordance with the principles of the present disclosure;

[0072] FIG. 35C depicts a side view of the locking mechanism of FIG. 35A in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0073] FIG. 35D depicts a front perspective view of the locking mechanism of FIG. 35A in accordance with the principles of the present disclosure;

[0074] FIG. 35E depicts a rear perspective view of the locking mechanism of FIG. 35A in accordance with the principles of the present disclosure;

[0075] FIG. 36 depicts a perspective view of an alternative embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0076] FIG. 37 A depicts a front view of an alternative embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;

[0077] FIG. 37B depicts a front perspective of the embodiment of an endplate depicted in FIG. 37A in accordance with the principles of the present disclosure;

[0078] FIG. 38A depicts a rear view of the embodiment of an endplate depicted in FIG. 37A in accordance with the principles of the present disclosure;

[0079] FIG. 38B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 37A in accordance with the principles of the present disclosure;

[0080] FIG. 39A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 37A in accordance with the principles of the present disclosure;

[0081] FIG. 39B depicts a rear view of the locking mechanism of FIG. 39A in accordance with the principles of the present disclosure;

[0082] FIG. 39C depicts a side view of the locking mechanism of FIG. 39A in accordance with the principles of the present disclosure;

[0083] FIG. 39D depicts a front perspective view of the locking mechanism of FIG. 39A in accordance with the principles of the present disclosure;

[0084] FIG. 39E depicts a rear perspective view of the locking mechanism of FIG. 39A in accordance with the principles of the present disclosure;

[0085] FIG. 40 depicts a perspective view of an alternative embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0086] FIG. 41 A depicts a front view of an alternative embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0087] FIG. 41B depicts a front perspective of the embodiment of an endplate depicted in FIG. 41 A in accordance with the principles of the present disclosure;

[0088] FIG. 42 A depicts a rear view of the embodiment of an endplate depicted in FIG. 41 A in accordance with the principles of the present disclosure;

[0089] FIG. 42B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 41 A in accordance with the principles of the present disclosure;

[0090] FIG. 43A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 41 A in accordance with the principles of the present disclosure;

[0091] FIG. 43B depicts a rear view of the locking mechanism of FIG. 43A in accordance with the principles of the present disclosure;

[0092] FIG. 43C depicts a side view of the locking mechanism of FIG. 43A in accordance with the principles of the present disclosure;

[0093] FIG. 43D depicts a front perspective view of the locking mechanism of FIG. 43A in accordance with the principles of the present disclosure;

[0094] FIG. 43E depicts a rear perspective view of the locking mechanism of FIG. 43A in accordance with the principles of the present disclosure;

[0095] FIG. 44A depicts a perspective view of an alternative embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0096] FIG. 44B depicts a side view of the embodiment of an interbody device system depicted in FIG. 44A in accordance with the principles of the present disclosure;

[0097] FIG. 44C depicts a front view of the embodiment of an interbody device system depicted in FIG. 44A in accordance with the principles of the present disclosure;

[0098] FIG. 45A depicts a front view of an alternative embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;

[0099] FIG. 45B depicts a front perspective of the embodiment of an endplate depicted in FIG. 45A in accordance with the principles of the present disclosure;

[0100] FIG. 46A depicts a rear view of the embodiment of an endplate depicted in FIG. 45A in accordance with the principles of the present disclosure;

[0101] FIG. 46B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 45A in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0102] FIG. 47A depicts a front perspective view of an embodiment of a screw guide;

[0103] FIG. 47b depicts a rear perspective view of the embodiment of a screw guide depicted in FIG. 47A in accordance with the principles of the present disclosure;

[0104] FIG. 48 depicts a rear perspective view of the embodiment of an endplate depicted in FIG. 45 A interfaced with the embodiment of a screw guide depicted in FIG. 47 A and 47B in accordance with the principles of the present disclosure;

[0105] FIG. 49A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 45 A in accordance with the principles of the present disclosure;

[0106] FIG. 49B depicts a rear view of the locking mechanism of FIG. 49A in accordance with the principles of the present disclosure;

[0107] FIG. 49C depicts a side view of the locking mechanism of FIG. 49A in accordance with the principles of the present disclosure;

[0108] FIG. 49D depicts a front perspective view of the locking mechanism of FIG. 49A in accordance with the principles of the present disclosure;

[0109] FIG. 49E depicts a rear perspective view of the locking mechanism of FIG. 49A in accordance with the principles of the present disclosure;

[0110] FIG. 50 depicts an alternative front perspective view of the embodiment of a locking mechanism of FIG. 49A interfaced with the embodiment of an endplate depicted in FIG. 45A in accordance with the principles of the present disclosure;

[0111] FIG. 51 depicts a perspective view of an alternative embodiment of an interbody device system including an embodiment of an endplate in accordance with the principles of the present disclosure;

[0112] FIG. 52A depicts a front view of an alternative embodiment of an endplate for use with an expandable spinal implant in accordance with the principles of the present disclosure;

[0113] FIG. 52B depicts a front perspective of the embodiment of an endplate depicted in FIG. 52A in accordance with the principles of the present disclosure;

[0114] FIG. 53A depicts a rear view of the embodiment of an endplate depicted in FIG. 52A in accordance with the principles of the present disclosure;

[0115] FIG. 53B depicts a rear perspective of the embodiment of an endplate depicted in FIG. 52A in accordance with the principles of the present disclosure;Attorney Docket No. A0013274W001

[0116] FIG. 54A depicts an embodiment of a screw for use with the embodiment of an endplate depicted in FIG. 52A in accordance with the principles of the present disclosure;

[0117] FIG. 54B depicts front perspective view of an alternative embodiment of a screw guide in accordance with the principles of the present disclosure;

[0118] FIG. 54C depicts rear perspective view of an alternative embodiment of a screw guide in accordance with the principles of the present disclosure;

[0119] FIG. 55 depicts a perspective view of an assembly including the embodiment of an endplate depicted in FIG. in FIG. 52A, the embodiment of a screw depicted in FIG. 54A and the embodiment of a screw guide depicted in FIGS. 54B and 54C in accordance with the principles of the present disclosure;

[0120] FIG. 56A depicts a front view of an embodiment of a locking mechanism for use with the endplate of FIG. 52A in accordance with the principles of the present disclosure;

[0121] FIG. 56B depicts a rear view of the locking mechanism of FIG. 56A in accordance with the principles of the present disclosure;

[0122] FIG. 56C depicts a side view of the locking mechanism of FIG. 56A in accordance with the principles of the present disclosure;

[0123] FIG. 56D depicts a front perspective view of the locking mechanism of FIG. 56A in accordance with the principles of the present disclosure;

[0124] FIG. 56E depicts a rear perspective view of the locking mechanism of FIG. 56A in accordance with the principles of the present disclosure;

[0125] FIG. 57 depicts an exploded parts view of an embodiment of an insertion tool in accordance with the principles of the present disclosure;

[0126] FIG. 58 A depicts an assembled view of the embodiment of an insertion tool depicted in FIG. 57 in accordance with the principles of the present disclosure;

[0127] FIG. 58B depicts an alternative view of a portion of the embodiment of an insertion tool depicted in FIG. 58A in accordance with the principles of the present disclosure;

[0128] FIG. 58C depicts an embodiment of an articulating plate attached to the insertion tool of FIG. 58A in a first position in accordance with the principles of the present disclosure;

[0129] FIG. 58D depicts an embodiment of an articulating plate attached to the insertion tool of FIG. 58A in a second position in accordance with the principles of the present disclosure; and

[0130] FIG. 59 depicts a flowchart of an example method of using a variable endplate.Attorney Docket No. A0013274W001DETAILED DESCRIPTION

[0131] The example embodiments of, for example, an anterior expandable interbody device, lateral expandable interbody device, interbody device systems, and interbody device methods of use are discussed in terms of medical devices for the treatment of musculoskeletal disorders and more particularly, in terms of various interbody devices suitable as spinal implants for anterior surgical techniques, oblique surgical techniques, and lateral surgical techniques. Example embodiments are also discussed with related emphasis on specialized adjustment instruments such as, for example, an instrument capable of adjusting a spacing of the aforementioned various interbody devices between adjacent vertebrates of a spine by expansion and contraction as well as adjusting an angle of inclination with respect to the coronal plane and / or sagittal plane of a patient. Disclosed devices and systems may be capable of adjusting the curvature of a patient’s spine for lordosis correction and a kyphosis correction. Likewise, an instrument capable of installing various anchoring screws is described in conjunction with the disclosed interbody devices.

[0132] It should be noted that some features described in this disclosure are depicted as dotted lines or phantom lines in the accompanying drawings. Other features described in this disclosure are depicted as solid lines in the accompanying drawings. The dotted lines, or phantom lines, denote tangent lines to curved features of the various embodiments of the present disclosure. The solid lines denote edges of the various embodiments of the present disclosure. Phantom lines are also depicted in some figures, such as FIGS. 21B and 21D to portray the movement capability, e.g., tilting and translating, discussed later herein, of the various embodiments of the present disclosure and their associated components. This use of phantom lines and solid lines is to promote ease of understanding and is not intended to limit the disclosure.

[0133] As used herein, standard anatomical terms of location have their ordinary meaning as they would be understood by a person of ordinary skill in the art unless clearly defined or explained otherwise. It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. For example, characteristics of one embodiment may be combined or substituted with characteristics of another different embodiment unless those characteristics are clearly explained as being mutually exclusive. It should also be understoodAttorney Docket No. A0013274W001that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the disclosed techniques and methods). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a medical device.

[0134] In some embodiments, the present system includes an expandable spinal implant suitable for insertion for oblique techniques, postero-lateral procedures and / or transforaminal lumbar interbody fusions (sometimes referred to as TLIF procedures), direct posterior (sometimes referred to as PLIF procedures), direct lateral (sometimes referred to as DLIF procedures), anterior lumbar interbody fusions (sometimes referred to as ALIF procedures), or variations of these procedures, in which the present implant is inserted into an interverterbral space and then expanded in order to impart and / or augment a lordotic and / or kyphotic curve of the spine.

[0135] In some embodiments, the spinal implant system may also be employed to restore and / or impart sagittal balance to a patient by increasing and / or restoring an appropriate lordotic and / or kyphotic angle between vertebral bodies at a selected level where the spinal implant is implanted and expanded. Additionally, some embodiments may also be employed to restore and / or impart coronal balance for correction of, for example, scoliosis. In the various embodiments described, the spinal implant system may be useful in a variety of complex spinal procedures for treating spinal conditions beyond one-level fusions. Furthermore, the spinal implant system described in the enclosed embodiments may also be used as a fusion device with an expandable height for tailoring the implant to a particular interbody disc space to restore the spacing between adjacent vertebral bodies and facilitate spinal fusion between the adjacent vertebral bodies.

[0136] In some embodiments, and as mentioned above, the present disclosure may be employed to treat spinal disorders such as, for example, degenerative disc disease, disc herniation, osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvature abnormalities, kyphosis, tumor and fractures. In some embodiments, the present disclosure may be employed with other osteal and bone related applications, including those associated with diagnostics and therapeutics.Attorney Docket No. A0013274W001In some embodiments, the disclosed spinal implant system may be alternatively employed in a surgical treatment with a patient in a prone or supine position, and / or employ various surgical approaches to the spine, including anterior, posterior, posterior mid-line, direct lateral, posterolateral oblique, and / or antero lateral oblique approaches, and in other body regions. The present disclosure may also be alternatively employed with procedures for treating the lumbar, cervical, thoracic, sacral and pelvic regions of a spinal column. The spinal implant system of the present disclosure may also be used on animals, bone models and other non-living substrates, such as, for example, in training, testing and demonstration.

[0137] The present disclosure may be understood more readily by reference to the following detailed description of the embodiments taken in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this application is not limited to the specific devices, methods, conditions or parameters described and / or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting. In some embodiments, as used in the specification and including the appended claims, the singular forms “a,” “an,” and “the” include the plural, and reference to a particular numerical value includes at least that particular value, unless the context clearly dictates otherwise. Ranges may be expressed herein as from “about” or “approximately” one particular value and / or to “about” or “approximately” another particular value. When such a range is expressed, another embodiment includes from the one particular value and / or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment. It is also understood that all spatial references, such as, for example, horizontal, vertical, top, upper, lower, bottom, left and right, are for illustrative purposes only and can be varied within the scope of the disclosure. For example, the references “upper” and “lower” are relative and used only in the context to the other and are not necessarily “superior” and “inferior”. Generally, similar spatial references of different aspects or components, e.g., a “proximal end” of an end plate and a “proximal end” of a wedge, indicate similar spatial orientation and / or positioning, i.e., that each “proximal end” is situated on or directed towards the same end of the device. Further, the use of various spatial terminology herein should not be interpreted to limit the various insertion techniques or orientations of the implant relative to the positions in the spine.Attorney Docket No. A0013274W001

[0138] Terms such as “same,” “equal,” “planar,” “coplanar,” “parallel,” “perpendicular,” etc. as used herein are intended to encompass a meaning of exactly the same while also including variations that may occur, for example, due to manufacturing processes. The term “substantially” may be used herein to emphasize this meaning, particularly when the described embodiment has the same or nearly the same functionality or characteristic, unless the context or other statements clearly indicate otherwise. Additionally, it shall be understood that the term “about” encompasses a variation of at least + / - 10% from the example values provide herein.

[0139] As used in the specification and including the appended claims, “treating” or “treatment” of a disease or condition refers to performing a procedure that may include administering one or more drugs, biologies, bone grafts (including allograft, autograft, xenograft, for example) or bone-growth promoting materials to a patient (human, normal or otherwise or other mammal), employing implantable devices, and / or employing instruments that treat the disease, such as, for example, micro-discectomy instruments used to remove portions bulging or herniated discs and / or bone spurs, in an effort to alleviate signs or symptoms of the disease or condition. Alleviation can occur prior to signs or symptoms of the disease or condition appearing, as well as after their appearance. Thus, treating or treatment includes preventing or prevention of disease or undesirable condition (e.g., preventing the disease from occurring in a patient, who may be predisposed to the disease but has not yet been diagnosed as having it). In addition, treating or treatment does not require complete alleviation of signs or symptoms, does not require a cure, and specifically includes procedures that have only a marginal effect on the patient. Treatment can include inhibiting the disease, e.g., arresting its development, or relieving the disease, e.g., causing regression of the disease. For example, treatment can include reducing acute or chronic inflammation; alleviating pain and mitigating and inducing re-growth of new ligament, bone and other tissues; as an adjunct in surgery; and / or any repair procedure. Also, as used in the specification and including the appended claims, the term “tissue” includes soft tissue, ligaments, tendons, cartilage and / or bone unless specifically referred to otherwise. The term “bone growth promoting material” as used herein may include, but is not limited to: bone graft (autograft, allograft, xenograft) in a variety of forms and compositions (including but not limited to morselized bone graft); osteoinductive material such as bone morphogenetic proteins (BMP) (including but not limited to INFUSE® available from Medtronic) and alternative small molecule osteoinductive substances; osteoconductive materials such as demineralized boneAttorney Docket No. A0013274W001matrix (DBM) in a variety of forms and compositions (putty, chips, bagged (including but not limited to the GRAFTON® family of products available from Medtronic)); collagen sponge; bone putty; ceramic-based void fillers; ceramic powders; and / or other substances suitable for inducing, conducting or facilitating bone growth and / or bony fusion of existing bony structures. Such bone growth promoting materials may be provided in a variety of solids, putties, liquids, colloids, solutions, or other preparations suitable for being packed or placed into or around the various implants and embodiments described herein.

[0140] Various embodiments and components may be coated with a ceramic, titanium, and / or other biocompatible material to provide surface texturing at (a) the macro scale, (b) the micro scale, and / or (c) the nano scale, for example. Similarly, components may undergo a subtractive manufacturing process providing for surface texturing configured to facilitate osseointegration and cellular attachment and osteoblast maturation. Example surface texturing of additive and subtractive manufacturing processes may comprise (a) macro-scale structural features having a maximum peak-to-valley height of about 40 microns to about 500 microns, (b) micro-scale structural features having a maximum peak-to-valley height of about 2 microns to about 40 microns, and / or (c) nano-scale structural features having a maximum peak-to-valley height of about 0.05 microns to about 5 microns. In various embodiments, the three types of structural features may be overlapping with one another, for example. Additionally, such surface texturing may be applied to any surface, e.g., both external exposed facing surfaces of components and internal non exposed surfaces of components. Further discussion regarding relevant surface texturing and coatings is described in, for example, U.S. Pat. No. 11,096,796, titled Interbody spinal implant having a roughened surface topography on one or more internal surfaces, and filed on March, 4, 2013 - the entire disclosure of which is incorporated herein by reference in its entirety. Accordingly, it shall be understood that any of the described coating and texturing processes of U.S. Pat. No. 11,096,796, may be applied to any component of the various embodiments disclosed herein, e.g., the exposed surfaces and internal surfaces of endplates. Another example technique for manufacturing an orthopedic implant having surfaces with osteoinducting roughness features including micro-scale structures and nano-scale structures is disclosed in U.S. Pat. No. 10,821,000, the entire contents of which are incorporated herein by reference. Additionally, an example of a commercially available product may be the Adaptix™Attorney Docket No. A0013274W001Interbody System sold by Medtronic Spine and comprising a titanium cage made with Titan nanoLOCK™.

[0141] The components of the expandable spinal implant systems described herein can be fabricated from biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and bone material and / or their composites. For example, the components of expandable spinal implant system, individually or collectively, can be fabricated from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, Grade 5 titanium, super-elastic titanium alloys, cobalt-chrome alloys, stainless steel alloys, superelastic metallic alloys (e.g., Nitinol, super elasto-plastic metals, such as GUM METAL®), ceramics and composites thereof such as calcium phosphate (e.g., SKELITE™), thermoplastics such as polyaryletherketone (PAEK) including polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO4 polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers, elastomeric composites, rigid polymers including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy, bone material including autograft, allograft, xenograft or transgenic cortical and / or corticocancellous bone, and tissue growth or differentiation factors, partially resorbable materials, such as, for example, composites of metals and calcium-based ceramics, composites of PEEK and calcium based ceramics, composites of PEEK with resorbable polymers, totally resorbable materials, such as, for example, calcium based ceramics such as calcium phosphate, tri-calcium phosphate (TCP), hydroxyapatite (HA)-TCP, calcium sulfate, or other resorbable polymers such as polyaetide, polyglycolide, polytyrosine carbonate, polycaprolactone and their combinations.

[0142] Various components of spinal implant system may be formed or constructed of material composites, including but not limited to the above-described materials, to achieve various desired characteristics such as strength, rigidity, elasticity, compliance, biomechanical performance, durability and radiolucency or imaging preference. The components of expandable spinal implant system, individually or collectively, may also be fabricated from a heterogeneous material such as a combination of two or more of the above-described materials. The components of the expandable spinal implant systems may be monolithically formed, integrally connected or include fastening elements and / or instruments, as described herein. For example, in some embodiments theAttorney Docket No. A0013274W001expandable spinal implant systems may comprise PEEK and / or titanium structures with radiolucent markers (such as tantalum pins and / or spikes) selectively placed in the implant to provide a medical practitioner with placement and / or sizing information when the expandable spinal implant is placed in the spine. The components of the expandable spinal implant system may be formed using a variety of subtractive and additive manufacturing techniques, including, but not limited to machining, milling, extruding, molding, 3D-printing, sintering, coating, vapor deposition, and laser / beam melting. Furthermore, various components of the expandable spinal implant system may be coated or treated with a variety of additives or coatings to improve biocompatibility, bone growth promotion or other features. For example, the endplates 110, 120 of expandable spinal implants 310 and 320, may be selectively coated with bone growth promoting or bone ongrowth promoting surface treatments that may include, but are not limited to: titanium coatings (solid, porous or textured), hydroxyapatite coatings, or titanium plates (solid, porous or textured).

[0143] The expandable spinal implant system may be employed, for example, with a minimally invasive procedure, including percutaneous techniques, mini-open and open surgical techniques to deliver and introduce instrumentation and / or one or more spinal implants at a surgical site within a body of a patient, for example, a section of a spine. In some embodiments, the expandable spinal implant system may be employed with surgical procedures, as described herein, and / or, for example, corpectomy, discectomy, fusion and / or fixation treatments that employ spinal implants to restore the mechanical support function of vertebrae. In some embodiments, the expandable spinal implant system may be employed with surgical approaches, including but not limited to: anterior lumbar interbody fusions (ALIF), posterior lumbar interbody fusion (PEIF), oblique lumbar interbody fusion, transforaminal lumbar interbody fusion (TEIF), various types of anterior fusion procedures, and any fusion procedure in any portion of the spinal column (sacral, lumbar, thoracic, and cervical, for example).

[0144] Various embodiments of expandable spinal implants are contemplated for use with the endplates, locking mechanisms and interbody device systems that are the subject of the present disclosure, such as those described in U.S. Patent Application 17 / 123,897, U.S. Patent Application 17 / 887,957, U.S. Patent Application 17 / 307,706, U.S. Patent Application No.17 / 246,932, and U.S. Patent Application No. 17 / 123,889, herein incorporated by reference in their entirety.Attorney Docket No. A0013274W001

[0145] As used herein, forward and backward or forward and back may include inward and outward (in and out) movement e.g., angulation or translation, from the perspective of a front view. Upward and downward or up and down movement may include vertical movement from the perspective of a front view. Likewise, forward and backward movement may include horizontal movement from the perspective of a side view. Inward and outward movement may also include horizontal movement from the perspective of a side view.

[0146] Referring generally to FIGS. 1-16 expandable spinal implants 310, 320, 330, and 340 are disclosed. Spinal implants 310, 320, 330, and 340 may also be used in conjunction or as a substitute for any previously disclosed system and method. In various embodiments, implants 310, 320, 330, and 340 may be configured for lateral, oblique, antero-lateral, and etc. insertion type techniques although those with skill in the art will readily recognize that implants 310, 320, 330, and 340 may also be optimized and utilized for other surgical techniques.

[0147] FIG. 1 is a front perspective view of expandable spinal implant 310 and FIG. 2 is a rear perspective view of expandable spinal implant 310. In the example embodiment, implant 310 may include a first endplate 110 (superior endplate or cephalad endplate) and a second endplate 120 (inferior endplate or caudal endplate) that are movable with respect to one another via a moving mechanism 250. In some embodiments, outside surfaces of endplates 110 and 120 may have a substantially linear surface profile across exposed faces of endplates and in other embodiments endplates 110 and 120 may have curved surface profiles across faces of textured, microtextured, or non-textured surfaces. Similarly, implant 310 may include various contours, guides, cavities, and other operable characteristics that cooperate with moving mechanism 250 to facilitate movement and / or provide mechanical advantage to other corresponding parts to facilitate expansion, contraction, angular adjustment, lateral bending, absorption of compression forces, shear forces, etc.

[0148] In the example embodiment, implant 310 may extend in a proximal-to-distal direction from a proximal end 101 to a distal end 102. Similarly, implant 310 may extend in a widthwise direction between a first lateral end 103 and a second lateral end 104, for example. In various embodiments, the proximal end 101 may include an exposed screw guide 105 defining a corresponding screw guide aperture 107, disposed between endplates 110 and 120. The screw guide 105 and guide aperture 107 may be the same as or substantially the same as described in U.S. Patent Application No. 17 / 887,957, hereby incorporated by reference in its entirety. ForAttorney Docket No. A0013274W001example, screw guide 105 may have one or more attachment points 112 for attachment of implant 310 to a tool, e.g., an insertion tool. Likewise, guide aperture 107 may include a threaded surface 107a for attachment of implant 310 to a tool. When implant 310 is inserted in a disc space, implant 310 may extend in the proximal-to-distal direction in the coronal plane, for example.

[0149] FIG. 3 is a first exploded parts view of implant 310 and FIG. 4 is a second exploded parts view of implant 310 from an alternate and substantially opposite viewing angle. In the example embodiment, first endplate 110 may include a pair of first proximal ramps 114 and a pair of first distal ramps 116 opposite the first proximal ramps 114. Each ramp of the first proximal ramps 114 may include an inclined surface extending away from an inside surface of first endplate 110 and moving mechanism 250. Although the example embodiment illustrates corresponding “pairs” of proximal ramps 114 and distal ramps 116 other embodiments may include at least one proximal ramp 114 and at least one distal ramp 116, for example a single proximal ramp 114 and a single distal ramp 116. Each ramp of first distal ramps 116 may include an inclined surface extending away from an inside surface of first endplate 110 and moving mechanism 250. Similarly, second endplate 120 may include a pair of second proximal ramps 124 and a pair of second distal ramps 126 opposite the second proximal ramps 124. Each ramp of the second proximal ramps 124 may include an inclined surface extending away from an inside surface of second endplate 120 and moving mechanism 250. Each ramp of second distal ramps 126 may include an inclined surface extending away from an inside surface of second endplate 120 and moving mechanism 250. Although the example embodiment illustrates corresponding “pairs” of proximal ramps 124 and distal ramps 126 other embodiments may include at least one proximal ramp 124 and at least one distal ramp 126, for example a single proximal ramp 124 and a single distal ramp 126. In various embodiments, the ramps 116, 114 of the superior endplate 110 may not be (or may not be) aligned vertically with the ramps 126, 124 of the inferior endplate 120.

[0150] Moving mechanism 250 may be operably coupled to superior endplate 110 and inferior endplate 120 in any suitable way. In the illustrated embodiment, moving mechanism 250 may include a support block 257 rotatably supporting a first set screw 252 and a second set screw 254 which are threadably coupled to a first trolley 256 and a second trolley 258, respectively. In the example embodiment, the first trolley 256 and second trolley 258 may include ramped surfacesAttorney Docket No. A0013274W001260. In various embodiments, ramped surfaces 260 may be a lateral protrusion having a shape resembling a chamfered diamond that may simultaneously push against and / or directly contact a corresponding ramped surface of the first endplate 110 and second endplate 120. In the example embodiment, first trolley 256 and second trolley 258 may each include at least one catch surface 261 in the form of an inclined protrusion that may be disposed within a corresponding guide wall 130 (may also be referred to as a channel 130). At least one advantage of this configuration may be that catch surfaces 261 and guide walls 130 may facilitate closing of implant 310, i.e., decreasing a vertical distance between first endplate 110 and second endplate 210. In the example embodiment, each lateral end of the first trolley 256 and second trolley 258 includes a superior catch surface 261 and an inferior catch surface 261. Additionally, in this embodiment support block 257 may be constrained from moving in the proximal-to-distal direction due to lateral protrusions 259 being seated in vertical slots 359 of endplates 110, 120, for example. In this way, support block 257 may slide up and down vertically within vertical slots 359 as implant 310 expands and contracts. Additionally, in some embodiments, support block 257 may be inclinable during expansion of implant 310 on account of vertical slots 359 having gap spaces and / or chamfered ends. In some embodiments, screw guide 105 may include support tangs 106 that extend through an opening of second trolley 258 and couple to support block 257. In this way, movement of second trolley 258 may not interfere with a position of screw guide 105 and screw guide 105 may be rigidly coupled to support block 257, for example.

[0151] A first functional feature of the example moving mechanism 250 is that it may be further configured to increase and decrease a spacing between the superior and inferiorendplates 110, 120 at the proximal end 101 and distal end 102 equally upon simultaneous rotation of first and second set screws 252, 254. This type of expansion may be referred to as “parallel” expansion and / or “parallel” distraction. A second functional feature of moving mechanism 250 is that it may be further configured to increase and decrease an angle of inclination between superior and inferior endplates 110, 120 at a proximal end 101 upon rotation of the first set screw 252 in a clockwise and counterclockwise direction, respectively. A third functional feature of moving mechanism 250 is that it may be further configured to increase and decrease an angle of inclination between superior and inferior endplates 110, 120 at a distal end 102 upon rotation of the second set screw 254 in a clockwise and counterclockwise direction, respectively. Accordingly, moving mechanism 250 may be considered to have at least threeAttorney Docket No. A0013274W001different modalities of expansion and each modality may be performed independently of the other modalities.

[0152] FIG. 5 is a top view showing various section lines taken through implant 310. Section line Ai may extend in a proximal-to-distal direction lengthwise through a center of implant 310. In some embodiments, section line Ai may be coextensive and / or coaxial with a rotation axis of the first and second set screws 252, 254. Section line A3 may extend in a proximal-to-distal direction lengthwise through a first side portion of implant 310 corresponding to a location of ramped surfaces 114, 116. Similarly, Section line A4 may extend in a proximal-to-distal direction lengthwise through a second side portion of implant 310 corresponding to a location of ramped surfaces 124, 126.

[0153] FIG. 6 is a perspective cross section drawing through section A3 of FIG. 5. In the example embodiment, ramped surfaces 260 of trolley 256 resemble a chamfered diamond that can act against corresponding inclined surfaces of ramped surfaces 116. Similarly, ramped surfaces 260 of trolley 258 resemble a chamfered diamond that can act against corresponding inclined surfaces of ramped surfaces 114. Additionally, catch surfaces 261 may be slidably disposed within guide walls 130. Furthermore, lateral protrusion 259 may be disposed within vertical slot 359.

[0154] FIG. 7 is a perspective cross section drawing through section Ai of FIG. 5. In the example embodiment, first and second set screws 252, 254 are rotatably coupled to support block 257 such that the first and second set screws 252, 254 may be constrained from moving in the proximal-to-distal direction. In this way, rotation of set screw 252 may independently move trolley 256 and rotation of set screw 252 may independently move trolley 258.

[0155] FIG. 8 is a perspective cross section drawing through section A4 of FIG. 5. In the example embodiment, a first distance between section A4 and section Ai may be slightly less than a second distance between section A3 and section Ai. Accordingly, the cross section drawing of FIG. 8 illustrates superior catch surfaces 261 (rather than inferior catch surfaces 261 shown in FIG. 6) and a portion of ramped protrusion 260 that has a different cross-sectional shape from the chamfered diamond portion shown in FIG. 6. However, it shall be appreciated that in various embodiments, the geometry of ramped surfaces 260 of each trolley 256, 258 may include corresponding geometry to both sections A4 and A3 or either section A4 or A3. In FIG. 8, upper ends of ramped surfaces 260 of trolley 256 may act against corresponding inclined lowerAttorney Docket No. A0013274W001surfaces of ramped surfaces 126. Similarly, upper ends of ramped surfaces 260 of trolley 258 may act against corresponding inclined lower surfaces of ramped surfaces 124. Additionally, superior catch surfaces 261 may be slidably disposed within guide walls 130. Furthermore, lateral protrusion 259 may be disposed within vertical slot 359.

[0156] FIG. 9 is a front perspective view of an expandable spinal implant 320 including a proximal plate 850. Implant 320 may have the same, similar, and or substantially the same features and functionality as explained above with respect to implant 310. Accordingly, duplicative description will be omitted or only briefly described. In the example embodiment, implant 320 may include a proximal plate 850 in lieu of screw guide 105. Proximal plate 850 may be coupled to support block 257 in the same, similar, and / or substantially the same way as explained above with respect to screw guide 105. In some embodiments, proximal plate 850 may be rigidly coupled to support block 257 and in other embodiments proximal plate 850 may be pivotally coupled to support block 257 to allow for some lateral movement and / or vertical movement. Additionally, in some embodiments, proximal plate 850 may be rotationally coupled to support block 257 to allow for about + / - 10 degrees of relative movement in any direction. Furthermore, in various embodiments, proximal plate 850 may not be directly coupled (directly contact) endplates 110, 120. In this embodiment, proximal plate 850 may include a superior bone fastener aperture 852 and an inferior bone fastener aperture 851. In various embodiments, each bone fastener aperture 852, 851 may be configured to orient and support a bone fastener in a target trajectory while allowing for some angular deviation of a respective bone fastener of about + / - 5 degrees of relative movement in any direction. In the example embodiment, the superior bone fastener aperture 852 and inferior bone fastener aperture 851 are vertically aligned and oriented to one lateral side of the proximal plate 850. For example, the superior bone fastener aperture 852 and inferior bone fastener aperture 851 are offset towards a lateral side of implant 320 with respect to a rotation axis of the first set screw 252, and second set screw 254.

[0157] Additionally, each endplate 110, 120 may include a bone fastener cutout 822 such that the target bone fastener trajectory of a respective bone fastener aperture 851, 852 may prevent the corresponding bone fastener from contacting the corresponding endplate 110, 120. Furthermore, proximal plate 850 may include at least one bone fastener lock 803. In the example embodiment, bone fastener lock 803 may be rotated between an unlocked position in which each of the bone fastener apertures 851, 852 are freely exposed and a locked position in which each of the boneAttorney Docket No. A0013274W001fastener apertures 851, 852 are blocked (or at least partially blocked). In this embodiment, in the locked position bone fastener lock 803 may be configured to simultaneously lock a first bone fastener disposed in the superior bone fastener aperture 852 and a second bone fastener disposed in the inferior bone fastener aperture 851. An end user can rotate the bone fastener lock 803 with any corresponding drive tool, e.g., hexaganol, hexolobular, torx, square, polygonal, etc.

[0158] FIG. 10 is a front perspective view of the embodiment of FIG. 9 in a partially expanded first position. In the example configuration, it may be seen that the distal end 102 is expanded and the proximal end 101 is collapsed. For example, trolley 256 has moved distally to expand the distal end 102 while trolley 258 has remained unmoved and / or insubstantially moved.

[0159] FIG. 11 is a front perspective view of the embodiment of FIG. 9 in a partially expanded second position. In the example configuration, it may be seen that the proximal end 101 is expanded and the distal end 102 is collapsed and / or semi collapsed. For example, trolley 258 has moved proximally to expand the proximal end 101 while trolley 256 has remained unmoved and / or insubstantially moved.

[0160] FIG. 12 is a front perspective view of an embodiment in a fully expanded position. FIG.13 is a partial parts view of the embodiment of FIG. 12 with the superior endplate 110 removed for ease of understanding. In the example configuration, it may be seen that the proximal end 101 and distal end 102 are each expanded. For example, trolley 258 has moved proximally to expand the proximal end 101 and trolley 256 has moved distally to expand the distal end 102.

[0161] FIGS. 14 and 15 are various front perspective views of an expandable spinal implant 330. Spinal implant 330 may have the same, similar, and / or substantially the same components and functionality as explained above with respect to spinal implant 310. Accordingly, duplicative description will be omitted. In the example embodiment, it can be seen that a first height Hi between the outside surface of the superior endplate 110 and the outside surface of the inferior endplate 120 is greater on a first lateral side 103 than a second height H2 between the outside surface of the superior endplate 110 and the outside surface of the inferior endplate 120 on the second lateral side 104. At least one advantage of this configuration may be that when implant 330 is inserted within a disc space from a lateral perspective it may provide additional correction of the disc space. For example, depending on a chosen side of insertion, implant 330 may provide for additional kyphotic correction or lordotic correction.Attorney Docket No. A0013274W001

[0162] FIG. 16 is a top-down comparative view of an expandable spinal implant 340 and an expandable spinal implant 310. Spinal implant 340 may have the same, similar, and / or substantially the same components and functionality as explained above with respect to spinal implant 310. Accordingly, duplicative description will be omitted. In the example embodiment, it can be seen that a first length Li of implant 340 in a proximal to distal direction may be relatively greater than a second length L2 of implant 310. Accordingly, it shall be appreciated that various implants in accordance with the principles of this description may have various lengths, widths, heights, etc. to suit a particular patient’s anatomy in view of any particular surgical technique(s). For example, some lateral embodiments may be relatively longer to accommodate different portions of the spine and / or differently sized patients. It shall also be appreciated that various components, features, and functionality of any one specific implant embodiment disclosed herein may be substituted, modified, and / or replaced with any other component, feature, or functionality of any other specific implant embodiment unless the context clearly indicates otherwise.

[0163] FIGS. 17 and 18 are perspective views of an additional embodiment of an expandable spinal implant 800 including an anterior endplate 810 in accordance with the principles of the present disclosure. In some embodiments, anterior endplate 810 may be referred to as a third endplate, or may be referred to as a medial, lateral, or posterior endplate depending upon orientation or approach employed and the specific configuration and shape of the implant and the location, side or end to which the third plate is affixed or located. FIG. 19 is an exploded parts view diagram of the embodiment of FIGS. 17 and 18 in accordance with the principles of the present disclosure. Expandable spinal implant 800 may include the same, substantially the same, and / or similar features as the various above disclosed embodiments. For example, moving mechanism 250 may operate in the same, substantially the same, and / or similar manner as explained above. Accordingly, duplicative disclosure will be omitted.

[0164] Implant 800 may include an anterior side 800a, a posterior side 800p and two opposing lateral sides 8001, for example. Additionally, the outside contours of implant 800 may include a superior endplate 820 (top endplate), inferior endplate 830 (bottom endplate) and an anterior endplate 810 (front endplate), for example. In various embodiments, the superior endplate 820 and inferior endplate 830 may collectively define the posterior side 800p (rear side) of implant 800. Anterior endplate 810 may include a plurality of circular bone fastener apertures 801, forAttorney Docket No. A0013274W001example. In the example embodiment, four circular bone fastener apertures 801 are disclosed although in other embodiments the number of bone fastener apertures 801 may be more or less. For example, in some embodiments there may be an additional 5thand 6thbone fastener aperture in the medial location of anterior endplate 810. In other embodiments, there may be a total of two bone fastener apertures 801 including a left bone fastener aperture 801 diagonally projecting over the superior endplate 820 and a right bone fastener aperture 801 diagonally projecting over the bottom endplate 820.

[0165] In various embodiments, each bone fastener aperture 801 may include at least one circular ring portion 801a that facilitates seating of a bone fastener or other fastener and / or facilitates the alignment of a drill in a coaxial relationship, e.g., surgical tool 500 as disclosed above.

[0166] Anterior endplate 810 may include at least one bone fastener lock 803 for preventing bone fasteners from backing out. For example, bone fastener lock 803 may be a rotatable lock that may rotate about 90° between an open position and a closed position to prevent bone fasteners from backing out, for example. In various embodiments, anterior endplate 810 may include at least one attachment point 805 for connecting implant 800 with a surgical tool. In the disclosed embodiment, a plurality of attachment points 805 are distributed around screw guide aperture 807. In the disclosed embodiment, six attachment points 805 are radially distributed around screw guide aperture 807 although other embodiments may have more or less, e.g., 2, 3, 4, 5, 7 or 8.

[0167] As understood best with reference to FIG. 19, anterior endplate 810, superior endplate 820, and inferior endplate 830 may be operably coupled to moving mechanism 250. For example, moving mechanism 250 serves as a central attachment location for each of the endplates 810, 820, 830 and each of the endplates 810, 820, 830 may interact independently with moving mechanism 250, for example. In the disclosed embodiment, anterior endplate 810 may be operably coupled to moving mechanism 250 by inserting posts 855 into a corresponding post retaining aperture 255 having a size and shape configured to securely couple the two together. In various embodiments, posts 855 may extend from an inside surface of anterior endplate 810 in a direction towards the posterior side 800p of implant 800 and towards moving mechanism 250. In this way, anterior endplate 810 is independently secured to moving mechanism 250 from superior endplate 820 and inferior endplate 830, for example.Attorney Docket No. A0013274W001

[0168] FIG. 20A and 20B show an embodiment of a set screw 400. Set screw 400 may be of the same, similar or substantially the same structure and functionality as set screws 252 and 254, described in relation to FIGS. 2, 4 and 7 and may be used with the various spinal implants described herein. Set screw 400 includes a body 402, having a recess 408 running through the length of the body 402. In addition, the set screw 400 includes an interior surface 410 having ridges 406 and valleys 404. The ridges 406 may be convex relative to valleys 404 and valleys 404 may be concave relative to ridges 406 giving interior surface 410 contour. The contour of interior surface 410 may allow mating with other tools, including but not limited to, a drive key, hex driver, screwdriver.

[0169] FIGS. 21 A through 59 relate to interbody device systems that include endplates capable of translation and or rotation relative to an expandable spinal implant of the interbody device system. These endplates may also be referred to a variable plates or articulating plates.

[0170] Referring to FIG. 21A, 21B, 21C and 21D, an embodiment of an interbody device system 1000 is shown. Interbody device system 1000 includes an expandable spinal implant 1004 having a superior plate 1002 and an inferior plate 1003. It should be noted that expandable spinal implant 1004 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody device system 1000 also includes an articulating plate 2000 coupled to the implant 1004 and a locking mechanism 3000 coupled to the articulating plate 2000. Both articulating plate 2000 and locking mechanism 3000 are discussed in more detail below.Articulating plate 2000 includes bone fasteners 1001, which may be bone screws as disclosed in U.S. Patent No. 11,8333,059, incorporated by reference herein in its entirety.

[0171] The longitudinal or lengthwise direction of implant 1004 extends parallel or substantially parallel with the central axis one or more set screws housed in the interior of implant 1004 e.g., set screws 252, 254 and / or 400 as shown in FIGS. 20A and 20B while the set screws 400 are oriented in the interior of implant 1004 in any of the orientations shown in FIGS. 1-2, FIGS. 5-7 and FIG. 19, for example. Stated another way, the longitudinal or lengthwise direction may extend parallel with the central axis of set screws 252, 254 and / or 400 as they are oriented in the interior of implant 1004 when implant 1004 is in an assembled state. The lateral or widthwise direction of implant 1004 extends perpendicular or substantially perpendicular to the longitudinal or lengthwise direction. The foregoing definitions apply equally to the various other embodiments of implants described herein.Attorney Docket No. A0013274W001

[0172] FIG. 21B includes longitudinal axis 1008z extending through implant 1004 between proximal end 1009p and distal end 1009d of implant 1004 and passing through center 1008c (see FIG. 21C) of articulating plate 2000. FIG. 21C includes lateral axisl008x passing from a first side 1009s to a second side 1009d of implant 1004 and through center point 1008c of endplate 2002. Center point 1008c is coextensive with the axis of rotation of set screws 252 and 254 of moving mechanism 250 (see FIG. 4 and FIG. 19). Lateral axis 1008x extends perpendicularly or substantially perpendicularly to longitudinal axis 1008z.

[0173] Referring to FIGS. 22A, 22B, 23A and 23B, various views of articulating plate 2000 are shown. Articulating plate 2000 extends in a lengthwise direction between a superior side 2001a and an inferior side 2001b. A longitudinal axis (not shown) extends in the lengthwise direction of articulating plate 2000 and passes through the center of articulating plate 2000. On superior side 2001a is a centrally disposed bone fastener aperture 2003. Additionally, on inferior side 2001b are two additional bone fastener apertures 2003 on the ends of inferior side 2001b. Each of bone fastener aperture 2003 extends through articulating plate 2000 through front face 2008a (see FIGS. 22A and 22B) and rear face 2008b (see FIGS. 23A and 23B).

[0174] Bone fastener apertures 2003 may include conical surfaces 2004a and conical surfaces 2004b. Conical surfaces 2004a and 2004b may be configured to orient and support a bone fastener in a target trajectory while allowing for some angular deviation of a respective bone fastener of about + / - 5 degrees of relative movement in any direction. Bone fasteners 1001 may be oriented along a target trajectory relative to superior plate 1002 or inferior plate 1003 at an angle of up to about 10 degrees. Orienting the bone fasteners at angles between 0 and 10 degrees is advantageous because straight drivers may be used to drive the bone fasteners into patient anatomy as opposed to curved drivers. In addition, there is less of a requirement for bone exposure in using straight drivers to drive bone fasteners of angles up to ten degrees when compared to bone fasteners oriented at steeper angles.

[0175] Articulating plate 2000 also includes cutouts 2006a and 2006b, which extend partially through front face 2008a. The size and shape of cutouts 2006a and 2006b corresponds to the size and shape of extensions 3007a and 3007b on locking mechanism 3000 (see FIGS. 25 A through 25G) in order to provide seats for extensions 3007a and 3007b. Cutouts 2006a and 2006b wrap around the sides of articulating plate 2000 to rear face 2008b and also extend partially throughAttorney Docket No. A0013274W001rear face 2008b. In this manner, extensions 3007a and 3007b of locking mechanism 3000 can securely fasten locking mechanism 3000 to articulating plate 2000.

[0176] In addition, articulating plate 2000 includes cutouts 2005a and 2005b in front face 2008a. Collectively cutouts 2005a and 2005b correspond to the size and shape of face 3001 of locking mechanism 3000 and provide a seat for face 3001 to sit securely on articulating plate 2000.

[0177] Rear surface 2008b of articulating plate 2000 also includes surfaces 2009a and 2009b on superior side 2001a and inferior side 2001b, respectively. Surfaces 2009a and 2009b may not be flat, but rather, have curvature as seen in FIG. 23B. Such curvature may mimic the curvature of patient anatomy, e.g., a face of one or more vertebrae. For example, surfaces 2009a and 2009b may correspond to the curvature of the anterior face of one or more vertebrae thereby positioning the implant in an optimal position.

[0178] Articulating plate 2000 includes an aperture 2002, which extends through front face 2008a and rear face 2008b. Aperture 2002 is of a size and shape configured to receive face 4001 of screw guide 4000 (see FIG. 24A). It should be noted that screw guide 4000 may be the same or similar to other screw guides disclosed herein, such as screw guide 105 (see FIG. 1), and may couple to implant 1004 in the same or similar manner as screw guide 105 couples to various implants disclosed herein. Screw guide 4000 includes attachment points 4012 for connection to or alignment with a tool, for example. Screw guide 4000 also includes aperture 4007 having a threaded surface 4007a for connection to a tool or for mating with a threaded surface of another component of interbody device system 1000. Diametrically opposed on opposite sides of aperture 2002 are indentations 2007a and 2007b. Indents 2007a and 2007b are of a size and shape to receive a corresponding protrusion 4002a and 4002b, respectively, on screw guide 4000. In the embodiment shown, indentations 2007a and 2007b and protrusions 4002a and 4002b each have a hemispherical or substantially hemispherical geometry. Aperture 2002 also allows access to set screws housed within the interior of implant 1004, which may be rotated to adjust superior plate 1002 and inferior plate 1003, as described above in relation to other implants described herein.

[0179] Aperture 2002 is sized so that articulating plate 2000 may translate (move forward and backward or in and out) relative to implant 1004 in the direction of straight arrows 30 and 40 (shown in FIG. 2 IB) along axis 1008z. The translating capability of articulating plate 2000 is shown in phantom in FIG. 2 IB. For example, aperture 2002 may be larger than face 4001 ofAttorney Docket No. A0013274W001screw guide 4000 to provide sufficient clearance for translation of articulating plate 2000. In addition, indentations 2007a and 2007b may be larger than protrusions 4002a and 4002b to allow translation of protrusions 4002a and 4002b within indentations 2007a and 2007b, respectively. As shown in FIG. 2 IB, articulating plate 2000 may translate in the direction of arrow 40 (towards implant 1004) until articulating plate 2000 is constrained from further translation by implant 1004. Likewise, articulating plate 2000 may translate in the direction of arrow 30 (away from implant 1004) until protrusions 4002a and 4002b contact rear surfaces 2007c and 2007d of indentations 2007a and 2007b, respectively. Rear surfaces 2007c and 2007d function as a stop surface that limits translation of articulating plate 2000 in the direction of arrow 30. This configuration allows articulating plate 2000 to translate within the extent allowed by its relative positioning with implant 1004 and the interface between protrusions 4002a and 4002b with indentations 2007a and 2007b creating a secure connection between the articulating plate 2000 and implant 1004 while accommodating movement of the articulating plate 2000.

[0180] Articulating plate 2000 may also angulate (tilt) relative to implant 1004. From the perspective of FIG. 21C, articulating plate 2000 may tilt about lateral axis 1008x, or from the perspective of FIG. 21D, articulating plate may tilt about lateral axis 1008x forward in the direction of arrows 10a and 10b and backwards in the direction of arrow 20a and 20b. The forwards and backwards tilting capability is shown in phantom in FIG. 2 ID. For example, superior side 2001a may tilt forwards in the direction of arrow 10b and inferior side 2001b may tilt backwards in the direction of arrow 20b. Conversely, superior side 2001a may tilt backwards in the direction of arrow 20a and inferior side 2001b may tilt forwards in the direction of arrow 10a. In some embodiments, the aperture 2002 may be larger than face 4001 of screw guide 4000 to provide sufficient clearance for angulation of articulating plate 2000. In addition, indentations 2007a and 2007b may be larger than protrusions 4002a and 4002b to allow pivoting of protrusions 4002a and 4002b within indentations 2007a and 2007b, respectively.

[0181] As best shown by FIGS. 24 A and 24B, screw guide 4000 interfaces with a support block 1057 in the interior of implant 1004 so that screw guide 4000 remains stationary or substantially stationary when articulating plate 2000 angulates and / or translates. Prongs 2014 of screw guide 4000 are each received in a corresponding aperture 1021 of support block 1057. On an interior surface of apertures 1021 is a corresponding indentation 1021a. Corresponding indentationsAttorney Docket No. A0013274W0011021a catch a corresponding lips 2014a of each of prongs 2014 so that screw guide 4000 is not disconnected from implant 1004 during translation of articulating plate 2000.

[0182] The translation and angulation of articulating plate 2000 offers several advantages, such as, facilitating implant placement by simplifying alignment during installation, accommodating vertebral variations, reducing time of surgical workflows, and minimizing the risk of misalignment. In addition, the translation of articulating plate 2000 relative to implant 1004 provides a user with more flexibility in positioning implant 1004 relative to positioning an implant with a plate that does not translate. For example, a user, such as a surgeon, may position the implant 1004 at various depths within a patient, e.g., the user may place the implant 1004 so that the implant 1004 provides more support on the anterior side of the patient’s spine or so that the implant provides more support to the posterior side of the patient’s spine. The user also has the flexibility to place the implant 1004 where optimal bone purchase can be achieved by bone fasteners 101. In addition, the angulation of articulating plate 2000 relative to implant 1004 is advantageous in that it allows the articulating plate 2000 to better align with portions of vertebral wall that may be curved or angled.

[0183] Articulating plate 2000 may be coupled to implant 1004 at different stages throughout the lifetime of articulating plate 2000. For example, articulating plate 2000 may be coupled to implant 1004 at the point of manufacture. Alternatively, articulating plate 2000 may be coupled to implant 1004 at the time of a surgical procedure prior to insertion of implant 1004 in situ, e.g., articulating plate 2000 may be coupled to implant 1004 near the time of insertion of implant 1004 into a patient and placed coupled to implant 1004 on a surgical back table or otherwise made available to an end user. Coupling articulating plate 2000 prior to insertion of implant 1004 in situ allows articulating plate 2000 and implant 1004 to be inserted into a patient as an assembly. The advantages outlined above extend to the other embodiments described herein.

[0184] Now referring to FIGS. 25 A, 25B, 25C, 25D and 25E, locking mechanism 3000 will now be discussed. FIGS 25 A, 25B, 25C, 25D and 25E show front, rear, side, from perspective and rear perspective views of locking mechanism 3000, respectively. Locking mechanism 3000 includes a proximal end 3000p and a distal end 3000d. A face 3001 is located at proximal end 3000p. Face 3001 includes a front surface 3001a and a rear surface 3001b. A shaft 3002 having a spigot 3006 joins face 3001 at proximal end 3000p and extends from proximal end 3000p to distal end 3000d. The thickness of shaft 3002 gradually increases near face 3001 to form spigotAttorney Docket No. A0013274W0013006. Spigot 3006 has a gap 3009 extending therethrough to facilitate attachment of spigot 3006 to face 3001. Spigot 3006 joins face 3001 by fitting into a slotted aperture 3011 on rear surface 3001b (shown in FIG. 25E).

[0185] Referring to FIG. 25A, which shows a front view of locking mechanism 3000, an axis 3008y extends vertically through coaxial center point 3008c of shaft 3002 in a heightwise direction. Additionally, an axis 3008x extends horizontally through center point 3008c of shaft 3002 in a widthwise direction and perpendicularly or substantially perpendicularly to axis 3008y. Axis 3008x also extends through a center of circular outdents 3010 (discussed below and shown in FIG. 25E) of shaft 3002. Referring to FIG. 25C, an axis 3008z extends coaxially with shaft 3002 through center point 3008c.

[0186] Face 3001 is moveably coupled to shaft 3002. Spigot 3006 includes one or more circular outdents 3010 that may be received in a corresponding slot 3013 within slotted aperture 3011. Corresponding slots 3013 may be configured as “elongate slots”, i.e., slots 3013 may have a length greater than its width. Slots 3013 may be of any suitable geometry for receiving circular outdents 3010, for example, elongate, oblong, narrow, wide, linear, tapered, rounded etc. Circular outdents 3010 have a center 3010c defining a pivot axis about which face 3001 may pivot.Circular outdents 3010 allow pivoting of face 3001 about center 3010c of circular outdents 3010 within slots 3013 to allow face 3001 to pivot on shaft 3002 about axis 3008x (shown in FIG. 25A).

[0187] Referring now to FIGS. 25F and 25G, arrows 50a and 50b indicate pivoting of face 3001 forward and backwards. The various pivoting positions of face 3001 are depicted in phantom. Such pivoting takes place about axis 3008x from the perspective of the front view of face 3001 shown in FIG. 25 A. During pivoting, superior side 3031a may tilt forwards in the direction of arrow 50b and inferior side 303 lb may tilt backwards in the direction of arrow 60b. Conversely, superior side 3031a may tilt backwards in the direction of arrow 60a and inferior side 3031b may tilt forwards in the direction of arrow 50a. In addition, face 3001 may translate vertically, or up and down. Arrows 70 and 80 (shown in FIG. 25F) indicate translation of face 3001 upwards and downwards or up and down. Such translation takes place along axis 3008y (shown in FIG. 25 A). Slots 3013 extend vertically in the direction of axis 3008y so that face 3001 may translate along axis 3008y relative to shaft 3002 in the direction of arrows 70 and 80 to the extent allowed by slots 3013. In other words, face 3001 may translate along axis 3008y to anAttorney Docket No. A0013274W001extent defined by the length of slots 3013. In some embodiments face 3001 may move forward and backward in the direction of arrows 55 and 65 i.e., along axis 3008z (shown in FIG. 25C). In other embodiments face 3001 is constrained from moving in one or more of the various manners described above. In other embodiments face 3001 may be rigidly coupled to shaft 3002 restricting movement entirely or substantially entirely. The translation and pivoting of face 3001 allows face 3001 to pivot and translate with articulating plate 2000. In addition, the extent of translation and pivoting of face 3001 may correspond to the translation and angulation of articulating plate 2000.

[0188] Shaft 3002 can be inserted into implant 1004 through aperture 2002 of articulating plate 2000 while face 3001 secures locking mechanism 3000 to the exterior of endplate 2002. Shaft 3002 can extend through a recess of an interbody implant and through one or more set screws housed within interior of implant 1004, e.g., recess 408 of set screw 400 in FIGS. 20A and 20B. In this way, once locking mechanism 3000 is secured to implant, the shaft 3002 prevents the set screw(s) that operate the implant for expansion and angulation from moving. In this sense, the locking mechanism 3000 may fix the relative expansion and angulation of the interbody implant and lock it into place.

[0189] The shaft 3002 includes a ridged portion 3003 and a smooth portion 3004. The ridged portion 3003 includes ridges 3003a and valleys 3003b. The ridges 3003a may be convex relative to the valleys 3003b forming a contoured surface on shaft 3002. When the shaft 3002 is received in the recess 408 of set screws 400 the ridged portion 3003 of shaft 3002 aligns with the ridges 406 and valleys 404 of recess 408 creating a meshing between the shaft 3002 and interior surface 410 that facilitates in preventing rotation of set screws 400. Because the relative angle and spacing of the superior endplate 1002 and inferior endplate 1003 are dependent on rotation of set screws 400, as described earlier herein in the context of FIGS. 1-16, the locking mechanism 3000 prevents change in angulation or spacing of superior endplate 1002 and inferior endplate 1003, e.g., by preventing movement of the set screws 400.

[0190] It should be noted that locking mechanism 3000 engages spinal implant 1004 in a manner that allows rotation of the set screws 400 to be restricted while simultaneously allowing other components of the interbody device system some degree of movement. For example, superior endplate 1002 may tilt or pivot laterally up to a predetermined degree relative to inferior endplate 1003 due to the various disclosed projections, guide walls, cavities, recesses, and other featuresAttorney Docket No. A0013274W001of the spinal implants disclosed herein and in the various references incorporated herein by reference.

[0191] Face 3001 has a size and shape corresponding to the collective size and shape of cutouts 2006a, 2006b, 2005a, and 2005b, i.e., face 3001 is at least partially received in a recess in front face 2008a of articulating plate 2000 formed collectively by cutouts 2006a, 2006b, 2005a, and 2005b. It can be seen that when locking mechanism 3000 is attached to articulating plate 2000 (as in FIG. 21 A through 2 ID) portions 3012 of face 3001 at least partially cover bone fastener apertures 2003 and the bone fasteners contained within the bone fastener apertures 2003. For example, head 1001a of bone fastener 1001 is covered by portion 3012. Portions 3012 may extend in a plane that is substantially perpendicular to the trajectory of bone fasteners contained within bone fasteners apertures 2003. In addition, portions 3012 may include a non-linear surface or curved surface 3012a as shown in FIG. 25E. Curved surface 3012a may create space for portions 3012 to extend over a portion of a bone fastener, such as head 1001a shown in FIG. 21 A. In this manner, locking mechanism 3000 prevents bone fasteners received in the apertures 2003 from backing out of articulating plate 2000.

[0192] Also on front surface 3001a of face 3001 is an oblong aperture 3014 through which threaded aperture 3005 of spigot 3006 may be accessed. Threaded aperture 3005 may connect locking mechanism 3000 to a corresponding tool, e.g., a tool for insertion or removal of the locking mechanism 3000 and / or other components of the interbody device system 1000.

[0193] Locking mechanism 3000 includes two extensions 3007a and 3007b extending from face 3001. Extensions 3007a and 3007b may be configured as clips that grip opposing sides of articulating plate 2000. More specifically, extensions 3007a and 3007b can be at least partially received in a corresponding one of cutouts 2006a and 2006b of articulating plate 2000 and flex and / or bend around opposing sides of articulating plate 2000 to facilitate securing locking mechanism 3000 to articulating plate 2000. Extensions 3007a and 3007b at least partially wrap around opposing sides of articulating plate 2000 in cutouts 2006a and 2006b. In some embodiments, extensions 3007a and 3007b may wrap around opposing sides of articulating plate 2000 in an interference fit.

[0194] Referring to FIG. 26, an alternative embodiment of an interbody device system 1100 is shown. Interbody device system 1100 includes an expandable spinal implant 1104 having a superior plate 1102 and an inferior plate 1103. It should be noted that expandable spinal implantAttorney Docket No. A0013274W0011104 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody-device system 1100 also includes an articulating plate 2100 coupled to the implant 1104 and a locking mechanism 3100 coupled to the articulating plate 2100. Both articulating plate 2100 and locking mechanism 3100 are discussed in more detail below.Articulating plate 2100 includes bone fasteners 1101, which may be the same or similar to other bone fasteners described herein.

[0195] Referring to FIGS. 27 A, 27B, 28 A, and 28B, various views of articulating plate 2100 are shown. Articulating plate 2100 includes a superior side 2101a and an inferior side 2101b. On superior side 2101a is a bone fastener aperture 2103. Additionally, on inferior side 2101b are two additional bone fastener apertures 2103. Each of bone fastener apertures 2103 extends through articulating plate 2100 through front face 2108a and rear face 2108b.

[0196] Bone fastener apertures 2103 may include conical surfaces 2104a and conical surfaces 2104b, which may orient bone fasteners 1101 in apertures 2103 in the same or similar manner as conical surfaces 2004a and 2004b, discussed previously. Bone fasteners 1101 may be oriented relative to superior plate 1203 or inferior plate 1202 at an angle of up to about 10 degrees.

[0197] Articulating plate 2100 also includes cutouts 2106a and 2106b, which extend partially through front face 2108a. The size and shape of cutouts 2106a and 2106b correspond to the size and shape of extensions 3107a and 3107b on locking mechanism 3100 in order to provide seats for extensions 3107a and 3107b. Located on and extending through cutouts 2106a and 2106b through rear face 2108b are apertures 2111a and 2111b. Apertures 2111a and 2111b each receive one or more prongs 3108, of locking mechanism 3100 to secure locking mechanism 3100 to articulating plate 2100. For example, apertures 2111a and 2111b may each receive a pair of prongs 3108, each pair being located on a back side of a corresponding one of extensions 3107a and 3107b. As best seen in FIG. 29, prongs 3108 terminate in an L-shaped end 3108a and wrap around lip 2113a of aperture 2111a and lip 2113b of aperture 2111b to secure locking mechanism 3100 in apertures 2111a and 2111b.

[0198] In addition, articulating plate 2100 includes cutouts 2105a and 2105b in front face 2108a. Collectively cutouts 2105a and 2105b correspond to the size and shape of face 3101 of locking mechanism 3100 and provide a seat for face 3101 to sit securely on articulating plate 2100 in a recessed configuration such that the exposed face of endplate 3100 is flush or substantially flush with the exposed surfaces of articulating plate 2100. Additionally, this configuration preventsAttorney Docket No. A0013274W001endplate 3100 from rotating clockwise and counterclockwise with respect to articulating plate 2100.

[0199] Articulating plate 2100 includes an aperture 2102, which extends through front face 2008a and rear face 2008b. Aperture 2102 has a threaded surface 2102a so that implant 1104 may be attached to a tool, e.g., an insertion tool. Aperture 2102 also allows access to set screws housed within the interior of implant 1104, which may be rotated to adjust superior plate 1102 and inferior plate 1103, as descried in relation to other implants described herein.

[0200] Rear surface 2108b of articulating plate 2100 also includes surfaces 2109a and 2109b on superior side 2101a and inferior side 2101b, respectively. Surfaces 2109a and 2109b may not be flat, but rather, have curvature. Such curvature may closely resemble or mimic the curvature of patient anatomy, e.g., a face of one or more vertebrae. For example, surfaces 2109a and 2109b may correspond to the curvature of the anterior face of one or more vertebrae.

[0201] The features relevant to the connection of articulating plate 2100 to implant 1104 will now be discussed. Rear surface 2108b includes support tangs 2114a and 2114b. Support tangs 2114a and 2114b may extend into implant 1104 to couple articulating plate 2100 thereto. For example, implant 1104 may include a first trolley 1156 and a second trolley 1158 coupled to a support block 1157. First trolley 1156, second trolley 1158 and support block 1157 may function in the same or similar manner as first trolley 256, second trolley 258 and support block 257. Support tangs 2114a and 2114b extend through second trolley 1158 and into apertures or openings 1121 and 1122 of support block 1157 as shown in FIG. 30A and 30B. Additionally, openings 1121 and 1122 each include a corresponding lip 1121a and 1122a that allows support tangs 2114a and 2114b to remain within openings 1121 and 1122 while still allowing movement of support tangs 2114a and 2114b within openings 1121 and 1122. Lips 2131b and 2131a catch a corresponding one of lips 1121a and 1122a in openings 1121 and 1122, respectively, so that support tangs 2114a and 2114b are substantially fixed and practically speaking are irremovable from openings 1121 and 1122 during the intended operation.

[0202] The secure coupling of support tangs 2114a and 2114b to support block 1157 may increase the efficiency and accuracy of surgical workflows because the articulating plate 2100 is securely attached to implant 1104. Therefore, both components may be inserted simultaneously into a surgical site in a single step in a workflow. Furthermore, the risk of inadvertently decoupling articulating plate 2100 from implant 1104 is reduced or eliminated.Attorney Docket No. A0013274W001

[0203] Articulating plate 2100 may translate and angulate relative to implant 1104 in the same or similar manner as described with respect to articulating plate 2000 and implant 1004. The features relevant to such translation and angulation will now be discussed in reference to FIGS.30C and 30D. FIG. 30D depicts a cross-sectional view of support block 1157 of FIG. 30C taken along the cross-section line A-A shown in FIG. 30C. As best seen in FIG. 30D, gaps 1123 are present between support tang 2114b and the interior surface of opening 1122. Opening 1122 is described for convenience, however, similar gaps are also contemplated in relation to opening 1121. Gaps 1123 provides support tang 2114b with one or more degrees of freedom and / or clearance within opening 1122 to allow for translation and angulation of support tang 2114b within openings 1122. For example, opening 1122 may have a length allowing translation of articulating plate 2100 of up to about 5 mm. In addition, opening 1122 may have a width allowing angulation of articulating plate 2100 of up to about 20 degrees.

[0204] In lieu of interfacing with a screw guide, such as screw guide 4000, articulating plate 2100 includes attachment points 2112 on front face 2108a. Attachment points 2112 may serve to attach articulating plate 2100 and / or implant 1104 to a tool. Attachment points 2112 may extend entirely or partially through articulating plate 2100. In addition, eight attachment points are shown but more or fewer attachment points are contemplated. Extending between front face 2108a and 2108b is aperture 2102. Aperture 2102 may include a threaded surface 2102a for connection of articulating plate 2100 to a tool or threaded surface of another component. Both aperture 2102 and threaded surface 2102a may function in the same or similar manner as equivalent features on the various screw guides disclosed herein. For example, aperture 2102 and threaded surface 2102a may function in the same or similar manner as aperture 4007 and threaded surface 4007a on screw guide 4000.

[0205] Now referring to FIGS. 31 A, 3 IB, 31C, 3 ID and 3 IE, locking mechanism 3100 will now be discussed. FIGS. 31 A, 3 IB, 31C, 3 ID and 3 IE show a front, rear, side, front perspective and rear perspective views of locking mechanism 3100, respectively. Locking mechanism 3100 has features that are the same or similar to features of locking mechanism 3000, e.g., face 3001, shaft 3002. Accordingly, the description of locking mechanism 3000 applies equally to locking mechanism 3100, and duplicative disclosure is omitted for the sake of brevity. Locking mechanism 3100 includes a face 3101 having a front surface 3101a and a rear surface 3101b. Locking mechanism 3100 has a shaft 3102, which prevents movement of set screws in theAttorney Docket No. A0013274W001interior of implant 1104. Spigot 3106 is attached to rear surface 3101b joining shaft 3102 to rear face 3101b. Face 3101, has portions 3112 that at least partially cover bone fastener apertures 2103 to prevent bone fasteners contained in the apertures 2103 from backing out of articulating plate 2100. Extending partially through front surface 3101a is circular recess 3113 and within circular recess 3113 is threaded aperture 3105. Threaded aperture may connect locking mechanism 3100 to a corresponding tool or other component. Face 3101 may angulate and translate relative to shaft 3102 in the same of similar manner as described for analogous components of locking mechanism 3000.

[0206] Locking mechanism 3100 includes two extensions 3107a and 3107b extending from face 3101. Extensions 3107a and 3107b are at least partially received in a corresponding one of cutouts 2106a and 2106b to secure locking mechanism 3100 to articulating plate 2100 and / or prevent locking mechanism 3100 from rotating relative to articulating plate 2100. Extensions 3107a and 3107b may at least partially wrap around opposing sides of articulating plate 2100 in cutouts 2106a and 2106b. Alternatively, extensions 3107a and 3107b may extend parallel to front face 2108a without wrapping around opposing sides of articulating plate 2100.

[0207] On a rear side of extensions 3107a and 3107b are prongs 3108. As discussed previously, a pair of prongs 3108 is located on each extension 3107a and 3107b. Each pair of prongs 3108 is received in a corresponding one of apertures 2111a and 2111b to secure locking mechanism 3100 to articulating plate 2100. In some embodiments, each pair of prongs may be received in their corresponding aperture via an interference fit.

[0208] Referring to FIG. 32, an alternative embodiment of an interbody device system 1200 is shown. Interbody device system 1200 includes an expandable spinal implant 1204 having a superior plate 1202 and an inferior plate 1203. It should be noted that expandable spinal implant 1204 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody-device system 1200 also includes an articulating plate 2200 coupled to the implant 1204 and a locking mechanism 3200 coupled to the articulating plate 2200. Both articulating plate 2200 and locking mechanism 3200 are discussed in more detail below.Articulating plate 2200 includes bone fasteners 1201, which may be the same or similar to other bone fasteners described herein.

[0209] Referring to FIGS. 33A, 33B, 34A, and 34B, various views of articulating plate 2200 are shown. Articulating plate 2200 includes a superior side 2201a and an inferior side 2201b. OnAttorney Docket No. A0013274W001superior side 2201a are two bone fastener apertures 2203. Additionally, on inferior side 2201b are two additional bone fastener apertures 2203. Each of bone fastener apertures 2203 extends through articulating plate 2200 through front face 2008a and rear face 2008b.

[0210] Bone fastener apertures 2203 may include conical surfaces 2204a and conical surfaces 2204b. Conical surfaces 2204a and 2204b may orient bone fasteners 1201 in the same or similar manner as conical surfaces 2004a and 2004b discussed in relation to FIGS. 23 A, 23B, 24 A and 24B. Bone fasteners 1201 may be angled relative to superior plate 1203 or inferior plate 1202 at an angle of up to about 10 degrees.

[0211] Articulating plate 2200 also includes cutouts 2206a and 2206b, which extend partially through front face 2208a. The size and shape of cutouts 2206a and 2206b correspond to the size and shape of extensions 3207a and 3207b on locking mechanism 3200 in order to provide seats for extensions 3207a and 3207b. Cutouts 2206a and 2206b wrap around the sides of articulating plate 2200 to rear face 2208b and also extend partially through rear face 2208b. In this manner extensions 2207a and 2207b of locking mechanism 3200 can securely fasten locking mechanism 3200 to articulating plate 2200.

[0212] In addition, articulating plate 2200 includes cutouts 2205a and 2205b in front face 2208a. Collectively cutouts 2205a and 2205b correspond to the size and shape of face 3201 of locking mechanism 3200 and provide a seat for face 3201 to sit securely on articulating plate 2200.

[0213] Rear surface 2208b of articulating plate 2200 also includes surfaces 2209a and 2209b on superior side 2201a and inferior side 2201b, respectively. Surfaces 2009a and 2009b may not be flat, but rather, have curvature. Such curvature may mimic the curvature of patient anatomy, e.g., a face of one or more vertebrae. For example, surfaces 2209a and 2209b may correspond to the curvature of the anterior face of one or more vertebrae.

[0214] Articulating plate 2200 includes an aperture 2202, which extends through front face 2208a and rear face 2208b. Eike aperture 2002, aperture 2202 is of a size and shape to receive a face of a screw guide, such as screw guide 4000 (see FIG. 24A and 24B). Aperture 2202 also allows access to set screws housed within the interior of implant 1204. Diametrically opposed on opposite sides of aperture 2202 are indentations 2207a and 2207b. Indentations 2207a and 2207b are of a size and shape to receive a corresponding protrusions on a screw guide, such as protrusions 4002a and 4002b, respectively, on screw guide 4000. Indentations 2207a and 2207b terminate in rear surfaces 2207c and 2207d, respectively. Articulating plate 2200 may translateAttorney Docket No. A0013274W001and angulate relative to endplate 1204 in the same or similar manner as articulating plate 2000 may translate and angulate relative to implant 1004. Accordingly, such description should be understood to apply equally to articulating plate 2200 and duplicative disclosure is omitted for the sake of brevity.

[0215] Now referring to FIGS. 35A, 35B, 35C, 35D and 35E, locking mechanism 3200 will now be discussed. FIGS. 35A, 35B, 35C, 35D and 35E show front, rear, side, front perspective and rear perspective views of locking mechanism 3200, respectively. Locking mechanism 3200 has features that are the same or similar to features of other locking mechanisms described previously, e.g., locking mechanism 3000. Accordingly, duplicative disclosure is omitted for the sake of brevity. Locking mechanism 3200 has a shaft 3202, which may prevent movement of set screws in the interior of implant 1204. Locking mechanism 3200 also has a face 3201, which has portions 3212 that at least partially cover bone fastener apertures 2203 to prevent bone fasteners contained in the apertures 2203 from backing out of articulating plate 2200.

[0216] Locking mechanism 3200 includes two extensions 3207a and 3207b extending from face 3201. Extensions 3207a and 3207b may be configured as clips that grip opposing sides of articulating plate 2200. More specifically, extensions 3207a and 3207b can be at least partially received in a corresponding one of cutouts 2206a and 2206b and flex and / or bend around opposing sides of articulating plate 2200 to secure locking mechanism 3200 to articulating plate 2200. In the embodiment shown, extensions 3207a and 3207b at least partially wrap around opposing sides of articulating plate 2200 in cutouts 2206a and 2206b.

[0217] Referring to FIG. 36, an alternative embodiment of an interbody device system 1300 is shown. Interbody device system 1300 includes an expandable spinal implant 1304 having a superior plate 1303 and an inferior plate 1302. It should be noted that expandable spinal implant 1304 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody-device system 1300 also includes an articulating plate 2300 coupled to the implant 1304 and a locking mechanism 3300 coupled to the articulating plate 2300. Both articulating plate 2300 and locking mechanism 3300 are discussed in more detail below.Articulating plate 2300 includes bone fasteners 1301, which may be the same or similar to other bone fasteners described herein.

[0218] Referring to FIGS. 37A, 37B, 38A, and 38B, various views of articulating plate 2300 are shown. Articulating plate 2300 includes a superior side 2301a and an inferior side 2301b. OnAttorney Docket No. A0013274W001superior side 2301a are two bone fastener apertures 2303. Additionally, on inferior side 2301b are two additional bone fastener apertures 2303. Each of bone fastener apertures 2303 extends through articulating plate 2300 through front face 2308a and rear face 2308b.

[0219] Bone fastener apertures 2303 may include conical surfaces 2304a and conical surfaces 2304b. Conical surfaces 2304a and 2304b may orient bone fasteners 1301 in the same or similar manner as conical surfaces 2004a and 2004b discussed in relation to FIGS. 23 A, 23B, 24 A and 24B. Bone fasteners 1301 may be oriented relative to superior plate 1303 or inferior plate 1302 at an angle of up to about 10 degrees.

[0220] Articulating plate 2300 also includes cutouts 2306a and 2306b, which extend partially through front face 2308a. The size and shape of cutouts 2306a and 2306b correspond to the size and shape of extensions 3307a and 3307b on locking mechanism 3300 in order to provide seats for extensions 3307a and 3307b. Located on and extending through cutouts 2306a and 2306b through rear face 2308b are apertures 2311a and 231 lb. Apertures 2311a and 2311b receive prongs 3308 of locking mechanism 3300 to secure locking mechanism 3300 to articulating plate 2300. Prongs 3308 terminate in an L-shaped end (see L-shaped end 3108a shown in FIG. 29) and wrap around lip 2313a of aperture 2311a and lip 2313b of aperture 2311b to secure locking mechanism 3300 in apertures 2311a and 2311b.

[0221] In addition, articulating plate 2300 includes cutouts 2305a and 2305b in front face 2308a. Collectively cutouts 2305a and 2305b correspond to the size and shape of face 3301 of locking mechanism 3300 and provide a seat for face 3301 to sit securely on articulating plate 2300.

[0222] Articulating plate 2300 includes an aperture 2302, which extends through front face 2308a and rear face 2308b. Aperture 2302 has a threaded surface 2302a so that implant 1304 may be attached to a tool, e.g., an insertion tool. Aperture 2302 also allows access to set screws housed within the interior of implant 1304, which may be rotated to adjust superior plate 1302 and inferior plate 1303, as descried in relation to other implants described herein.

[0223] Rear surface 2308b of articulating plate 2300 also includes surfaces 2309a and 2309b on superior side 2301a and inferior side 2301b, respectively. Like surfaces 2009a and 2009b and other similar surfaces described previously, surfaces 2309a and 2309b may not be flat, but rather, have curvature that may mimic patient anatomy.

[0224] The features relevant to the connection of articulating plate 2300 to implant 1304 will now be discussed. Rear surface 2308b also includes support tangs 2314a and 2314b. SupportAttorney Docket No. A0013274W001tangs 2314a and 2314b may extend into implant 1304 to couple articulating plate 2300 thereto. For example, implant 1304 may include a first trolley 1156 and a second trolley 1158 coupled to a support block 1157 (shown in FIG. 30A). Support tangs 2314a and 2314b may extend through second trolley 1158 and into openings 1121 and 1122 of support block 1157 as shown in FIG. 30A and 30B. As with support tangs 2114a and 2114b of articulating plate 2100 openings 1121 and 1122 may be of a size and shape so that support tangs 2314a and 2314b have one or more degrees of freedom of movement within openings 1121 and 1122. This freedom of movement allows articulating plate 2300 to translate and angulate relative to implant 1304 in the same or similar manner as articulating plate 2100. Additionally, support tangs 2114a and 2114b remain coupled to implant 1304 while still being free to move within openings 1121 and 1122 because support tangs 2314a and 2314b each include a corresponding lip (see lips 2131a and 2131b in FIG. 30A) that catch a corresponding one of lips 1121a and 1122a in openings 1121 and 1122 so that support tangs 2314a and 2314b are substantially fixed and practically speaking are irremovable from openings 1121 and 1122 during the intended operation.

[0225] Articulating plate 2300 may translate and angulate relative to endplate 1304 in the same or similar manner as articulating plate 2100 may translate and angulate relative to implant 1104. Accordingly, such description should be understood to apply equally to articulating plate 2300 and duplicative disclosure is omitted for the sake of brevity.

[0226] In lieu of interfacing with a screw guide, such as screw guide 4000, articulating plate 2300 includes attachment points 2312 on front face 2308a. Attachment points 2312 may serve to attach articulating plate 2300 and / or implant 1304 to a tool. Attachment points 2312 may extend entirely or partially through articulating plate 2300. In addition, eight attachment points are shown but more or fewer attachment points are contemplated. Extending between front face 2308a and 2308b is aperture 2302. Aperture 2302 may include a threaded surface 2302a. Both aperture 2302 and threaded surface 2302a may function in the same or similar manner as equivalent features on the various screw guides disclosed herein. For example, aperture 2302 and threaded surface 2302a may function in the same or similar manner as aperture 4007 and threaded surface 4007a on screw guide 4000.

[0227] Now referring to FIGS. 39A, 39B, 39C, 39D and 39E, locking mechanism 3300 will now be discussed. FIGS. 39A, 39B, 39C, 39D and 39E show front, rear, side, front perspective and rear perspective views of locking mechanism 3300, respectively. Locking mechanism 3300 hasAttorney Docket No. A0013274W001features that are the same or similar to features of other locking mechanisms described previously, e.g., locking mechanism 3100. Accordingly, duplicative disclosure is omitted for the sake of brevity. Locking mechanism 3300 has a shaft 3302, which may prevent movement of set screws in the interior of implant 1304. Locking mechanism 3300 also has a face 3301, which has portions 3312 that at least partially cover portion bone fastener apertures 2303 to prevent bone fasteners contained in the apertures 2303 from backing out of articulating plate 2300. Also on face 3301 is a threaded aperture 3305.

[0228] Locking mechanism 3300 includes two extensions 3307a and 3307b extending from face 3301. Extensions 3307a and 3307b are at least partially received in a corresponding one of cutouts 2306a and 2306b to secure locking mechanism 3300 to articulating plate 2300 and / or prevent locking mechanism 3300 from rotating relative to articulating plate 2300. Extensions 3307a and 3307b may at least partially wrap around opposing sides of articulating plate 2300 in cutouts 2306a and 2306b. Alternatively, extensions 3307a and 3307b may extend parallel to front face 2308a without wrapping around opposing sides of articulating plate 2300.

[0229] Referring to FIG. 40, an alternative embodiment of an interbody device system 1400 is shown. Interbody device system 1400 includes an expandable spinal implant 1404 having a superior plate 1403 and an inferior plate 1402. It should be noted that expandable spinal implant 1404 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody-device system 1400 also includes an articulating plate 2400 coupled to the implant 1404 and a locking mechanism 3400 coupled to the articulating plate 2400. Both articulating plate 2400 and locking mechanism 3400 are discussed in more detail below.Articulating plate 2400 includes bone fasteners 1401, which may be the same or similar to other bone fasteners described herein.

[0230] Referring to FIGS. 41A, 41B, 42 A and 42B, various views of articulating plate 2400 are shown. Articulating plate 2400 includes a superior side 2401a and an inferior side 2401b. On superior side 2401a are two bone fastener apertures 2403. Additionally, on inferior side 2401b are two additional bone fastener apertures 2403. Each of bone fastener apertures 2403 extends through articulating plate 2400 through front face 2408a and rear face 2408b.

[0231] Bone fastener apertures 2403 may include conical surfaces 2404a and 2404b. Conical surfaces 2404a and 2404b may orient bone fasteners 1401 in the same or similar manner as other conical surfaces described previously. Bone fasteners 1401 may be oriented relative to superiorAttorney Docket No. A0013274W001plate 1403 or inferior plate 1402 at angles ranging from about 0 degrees to about 40 degrees. In the embodiment shown in FIG. 40, the bone fastener 1401 on superior side 2401a is oriented by conical surface 2404a relative to superior plate 1403 at an angle ranging from about 0 degrees to about 10 degrees. The bone fasteners 1401 on inferior side 2401b are oriented by conical surface 2404b relative to inferior plate 1402 at an angle ranging from about 10 degrees to about 40 degrees. This configuration of bone fasteners 1401 reduces the need to mobilize vascular structures when driving the bone fasteners 1401 into patient anatomy.

[0232] Located on inferior side 2401b above bone fastener apertures 2403 are apertures 2415a and 2415b. These apertures may facilitate in driving into patient anatomy a bone fastener 1401 contained in a nearby bone fastener aperture 2403. For example, the apertures 2415a and 2415b may provide a relief for a portion of a drive tool.

[0233] Articulating plate 2400 also includes cutouts 2406a and 2406b, which extend partially through front face 2408a. The size and shape of cutouts 2406a and 2406b correspond to the size and shape of extensions 3407a and 3407b on locking mechanism 3400 in order to provide seats for extensions 3407a and 3407b. Located on and extending through cutouts 2406a and 2406b through rear face 2408b are apertures 2411a and 2411b. Apertures 2411a and 2411b receive one or more prongs 3408 of locking mechanism 3400 to secure locking mechanism 3400 to articulating plate 2400. Prongs 3408 terminate in an L-shaped end (see L-shaped end 3108a shown in FIG. 29) and wrap around lip 2413a of aperture 2411a and lip 2413b of aperture 2411b to secure locking mechanism 3400 in apertures 2411a and 2411b.

[0234] In addition, articulating plate 2400 includes cutout 2405 in front face 2308a. Cutout 2405 corresponds to the size and shape of face 3401 and extensions 3407a and 3407b of locking mechanism 3400 and provide a seat for face 3401 and extensions 3407a and 3407b to sit securely on articulating plate 2400.

[0235] Articulating plate 2400 includes an aperture 2402, which extends through front face 2408a and rear face 2408b. Aperture 2402 has a threaded surface 2402a so that implant 1404 may be attached to a tool, e.g., an insertion tool. Aperture 2402 also allows access to set screws housed within the interior of implant 1404, which may be rotated to adjust superior plate 1402 and inferior plate 1403, as descried in relation to other implants described herein.Attorney Docket No. A0013274W001

[0236] Rear face 2408b of articulating plate 2400 also includes surface 2409. Like similar surfaces described herein, surface 2409 may have curvature that mimics patient anatomy so that surface 2409 may align with patient anatomy that is curved, such as a vertebral wall.

[0237] The features relevant to the connection of articulating plate 2400 to implant 1404 will now be discussed. Rear surface 2408b also includes support tangs 2414a and 2414b. Support tangs 2414a and 2414b may extend into implant 1404 to couple articulating plate 2400 thereto. For example, implant 1404 may include a first trolley 1156 and a second trolley 1158 coupled to a support block 1157 (shown in FIG. 30A). Support tangs 2414a and 2414b may extend through second trolley 1158 and into openings 1121 and 1122 of support block 1157 as shown in FIG. 30A and 30B. As with support tangs 2114a and 2114b of implant 2200 openings 1121 and 1122 may be of a size and shape so that support tangs 2414a and 2414b have one or more degrees of freedom of movement within openings 1121 and 1122. This freedom of movement allows articulating plate 2400 to translate and angulate relative to implant 1404 in the same or similar manner as that of articulating plate 2100 and 2300. Additionally, support tangs 2414a and 2414b remain coupled to implant 1404 while still being free to move within openings 1121 and 1122 because support tangs 2414a and 2414b each include a corresponding lip (see lips 2131a and 2131b in FIG. 30) that catch a corresponding one of lips 1121a and 1122a in openings 1121 and 1122 so that support tangs 2414a and 2414b are substantially fixed and practically speaking are irremovable from openings 1121 and 1122 during the intended operation.

[0238] Articulating plate 2400 may translate and angulate relative to endplate 1404 in the same or similar manner as articulating plate 2100 and 2300 may translate and angulate relative to implants 1104 and 1304, respectively. Accordingly, such description should be understood to apply equally to articulating plate 2400 and duplicative disclosure is omitted for the sake of brevity.

[0239] In lieu of interfacing with a screw guide, such as screw guide 4000, articulating plate 2400 includes attachment points 2412 on front face 2408a. Attachment points 2412 may serve to attach articulating plate 2400 and / or implant 1404 to a tool. Attachment points 2412 may extend entirely or partially through articulating plate 2400. In addition, eight attachment points are shown but more or fewer attachment points are contemplated. Extending between front face 2408a and 2408b is aperture 2402. Aperture 2402 may include a threaded surface 2402a. Both aperture 2402 and threaded surface 2402a may function in the same or similar manner asAttorney Docket No. A0013274W001equivalent features on the various screw guides disclosed herein. For example, aperture 2402 and threaded surface 2402a may function in the same or similar manner as aperture 4007 and threaded surface 4007a on screw guide 4000.

[0240] Now referring to FIGS. 43 A, 43B, 43C, 43D and 43E, locking mechanism 3400 will now be discussed. FIGS. 43A, 43B, 43C, 43D and 43E show front, rear, side view, front perspective and rear perspective views of locking mechanism 3400, respectively. Locking mechanism 3400 has features that are the same or similar to features of other locking mechanisms described previously, e.g., locking mechanisms 3100 and 3300. Accordingly, duplicative disclosure is omitted for the sake of brevity. Locking mechanism 3400 has a shaft 3402, which may prevent movement of set screws in the interior of implant 1404. Locking mechanism 3400 also has a face 3401, with portions 3412a, which at least partially covers the superior-most bone fastener aperture 2403 to prevent a bone fastener contained therein from backing out of articulating plate 2400. In addition, extending from face 3401 are extensions 3407a and 3407b, which terminate in portions 3412b. Portions 3412b at least partially cover the two inferior-most bone fastener apertures 2403. Also on face 3401 is a threaded aperture 3405.

[0241] On a rear side of face 3401 are pairs of prongs 3408. As discussed previously, each pair of prongs 3408 is received in a corresponding one of apertures 2411a and 2411b to secure locking mechanism 3400 to articulating plate 2400.

[0242] Referring to FIG. 44A, 44B and 44C, an alternative embodiment of an interbody device system 1500 is shown. Interbody device system 1500 includes an expandable spinal implant 1504 having a superior plate 1503 and an inferior plate 1502. It should be noted that expandable spinal implant 1504 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody-device system 1500 also includes an articulating plate 2500 coupled to the implant 1504 and a locking mechanism 3500 coupled to the articulating plate 2500.

[0243] FIG. 44B includes an axis 1508z, which extends along endplate 1504 in the longitudinal (lengthwise) direction. Axis 1508z is coextensive with the axis of rotation of set screws 252, 254 (see FIG. 4) and passes through center point 1508c of articulating plate 2500. Both articulating plate 2500 and locking mechanism 3500 are discussed in more detail below.

[0244] Referring to FIGS. 45A, 45B, 46A and 46B, various views of articulating plate 2500 are shown. Articulating plate 2500 includes a superior side 2501a and an inferior side 2501b. On each of superior side 2501a and inferior side 2501b is a bone fastener aperture 2503. Each ofAttorney Docket No. A0013274W001bone fastener apertures 2503 extends through articulating plate 2500 through front face 2508a and rear face 2508b.

[0245] Bone fastener apertures 2503 may include a conical surface 2504, which may orient bone fasteners (not shown) in the same or similar manner as other conical surfaces described previously. The conical surfaces 2504 may orient a bone fastener in apertures 2503 at an angle relative to inferior plate 1503 or inferior plate 1502 ranging from about 0 degrees to about 10 degrees.

[0246] Articulating plate 2500 includes an aperture 2502, which extends through front face 2508a and rear face 2508b. Like aperture 2002, aperture 2502 is of a size and shape to receive a face of a screw guide, such as screw guide 4500 (see FIGS. 47A and 47B). Aperture 2502 also allows access to set screws housed within the interior of implant 1504. Diametrically opposed on opposite sides of aperture 2502 are lips 2513a and 2513b. Articulating plate 2500 may translate relative to implant 1504 in the same or similar manner as previously described articulating plate embodiments. Articulating plate 2500 may translate forward away from implant 1504 along axis 1508z (in the direction of arrow 91). When articulating plate 2500 is affixed to implant 1504, lips 2513a and 2513b catch lip 4513 of screw guide 4500 when articulating plate 2500 is translated a maximum distance away from implant 1504 (in the direction of arrow 91 in FIG. 44B).Furthermore, articulating plate 2500 may translate backward towards implant 1504 along axis 1508z (in the direction of arrow 92 in FIG. 44B) until it contacts implant 1504. In this manner articulating plate 2500 is prevented from be decoupled from implant 1504.

[0247] Articulating plate 2500 may angulate or tilt forward and backward relative to implant 1504 in the same or similar manner as previously described articulating plate embodiments. As best shown in FIG. 48, there is clearance between the circumference of aperture 2502 and lip 4513 sufficient to allow angulation of articulating plate 2500 relative to implant 1504. In addition, aperture 2502 is configured such that articulating plate 2500 may rotate 360 degrees face 4501 of about screw guide 4500 in the direction of arrow 93 and arrow 94 (shown in FIG.44C). For example, implant 1504 and articulating plate 2500 may be inserted as an assembly into the patient. The articulating plate 2500 may be coupled to the implant 1504 in a first position upon insertion. The first position of the articulating plate may be such that the longitudinal axis, as defined herein, of the articulating plate 2500 is perpendicular with the longitudinal axis, as defined herein, of the implant 1504. An example first position is depicted in FIG. 44C by theAttorney Docket No. A0013274W001phantom line representation of articulating plate 2500. The articulating plate 2500 may be rotated to a second position, wherein the longitudinal axis of the articulating plate is rotated about axis 1508z of implant 1504. An example second position is depicted in FIG. 44C by the solid line representation of articulating plate 2500. The example first position is of a lower profile than the example second position promoting ease of insertion of the assembly including articulating plate 2500 and implant 1504.

[0248] Aperture 2502 includes a circumferential feature 2521. Circumferential feature 2521 may be configured as a flange integrated into aperture 2502 and extending circumferentially around aperture 2502 i.e. aperture 2502 and circumferential feature 2521 can collectively form a flanged hole.

[0249] Like similar surfaces described herein, rear face 2508b may have curvature that mimics patient anatomy so that rear surface 2508b may align with patient anatomy that is curved, such as a vertebral wall.

[0250] Now referring to FIGS. 49A, 49B, 49C, 49D and 49E, locking mechanism 3500 will now be discussed. FIGS. 49A, 49B, 49C, 49D and 49E show front, rear, side, front perspective and rear perspective views of locking mechanism 3500, respectively. Locking mechanism 3500 has features that are the same or similar to features of other locking mechanisms described previously, e.g., locking mechanism 3000 and 3200. Accordingly, duplicative disclosure is omitted for the sake of brevity. Locking mechanism 3500 has a shaft 3502, which may prevent movement of set screws in the interior of implant 1504. Locking mechanism 3500 also has a face 3501. Face 3501 includes upper portion 3507a and lower portion 3507b that at least partially cover bone fastener apertures 2503 to prevent bone fasteners contained in the apertures 2503 from backing out of articulating plate 2500. Face 3501 also includes wings 3522a and 3522b. In the embodiment shown wings 3522a and 3522b are configured as narrow segments extending from face 3501. Face 3501 is received in aperture 2502 and rests against circumferential feature 2521. Face 3501 may angulate and translate relative to shaft 3502 in the same of similar manner as described for analogous components of locking mechanism 3000.

[0251] As best shown in FIG. 50, wings 3522a and 3522b each include an indentation 3523. Indentations 3523 can be configured as cutouts in a respective end of wings 3522a and 3522b. Respective indentations 3523 of wings 3522a and 3522b grip the perimeter of aperture 2502 atAttorney Docket No. A0013274W001diametrically opposed locations from one another. This configuration facilitates proper alignment of face 3501 in aperture 2502.

[0252] Referring to FIG. 51, an alternative embodiment of an interbody device system 1600 is shown. Interbody device system 1600 includes an expandable spinal implant 1604 having a superior plate 1602 and an inferior plate 1603. It should be noted that expandable spinal implant 1604 may be the same or similar to any of the various expandable spinal implants disclosed herein. Interbody-device system 1600 also includes an articulating plate 2600 coupled to the implant 1604 and a locking mechanism 3600 coupled to the articulating plate 2600. Both articulating plate 2600 and locking mechanism 3600 are discussed in more detail below.Articulating plate 2400 is secured to implant 1604 via screw 5600.

[0253] Referring to FIGS. 52A, 52B, 53A, and 53B, various views of articulating plate 2600 are shown. Articulating plate 2600 includes a superior side 2601a and an inferior side 2601b. On each of superior side 2601a and 2601b is a bone fastener aperture 2603. Each of bone fastener apertures 2203 extends through articulating plate 2600 through front face 2608a and rear face 2608b. Each bone fastener aperture 2603 may include a conical surface 2604.

[0254] Bone fastener apertures 2603 may include a conical surface 2604, which may orient bone fasteners (not shown) in the same or similar manner as other conical surfaces described previously. The conical surfaces 2604 may orient a bone fastener in apertures 2603 at an angle relative to inferior plate 1603 or inferior plate 1602 ranging from about 0 degrees to about 10 degrees.

[0255] Articulating plate 2600 also includes cutouts 2606a and 2606b, which extend partially through front face 2608a. The size and shape of cutouts 2606a and 2606b correspond to the size and shape of extensions 3607a and 3607b on locking mechanism 3600 in order to provide seats for extensions 3607a and 3607b. Cutouts 2606a and 2606b wrap around the sides of articulating plate 2600 to rear face 2608b and also extend partially through rear face 2608b. In this manner extensions 3607a and 3607b of locking mechanism 3600 can securely fasten locking mechanism 3600 to articulating plate 2600.

[0256] In addition, articulating plate 2600 includes cutouts 2605a and 2605b in front face 2608a. Collectively cutouts 2605a and 2605b correspond to the size and shape of portions of face 3601 of locking mechanism 3600 and provide a seat for face 3601 to sit securely on articulating plate 2600.Attorney Docket No. A0013274W001

[0257] Rear surface 2608b of articulating plate 2600 also includes surfaces 2609a and 2609b on superior side 2601a and inferior side 2601b, respectively. Surfaces 2609a and 2609b may not be flat, but rather, have curvature. Such curvature may mimic the curvature of patient anatomy, e.g., a face of one or more vertebrae. For example, surfaces 2609a and 2609b may correspond to the curvature of the anterior face of one or more vertebrae. In addition, rear surface 2608b includes a recessed portion 2620 having a perimeter corresponding to the perimeter of raised face 4603 of screw guide 4600. Raised faced 4603 extends from face 4601 of screw guide 4600. This configuration allows raised face 4603 to at least partially nest in recessed portion 2620, facilitating alignment of articulating plate 2600 with screw guide 4600.

[0258] Articulating plate 2600 includes an aperture 2602, which extends through front face 2608a and rear face 2608b. Aperture 2602 also allows access to set screws housed within the interior of implant 1604. Diametrically opposed on opposite sides of aperture 2602 are holes 2615a and 2615b.

[0259] Screw 5600 is received in aperture 2602. Threaded portion 5601 of screw 5600 extends through aperture 2602 into aperture 4602 of screw guide 4600. Threaded portion 5601 of screw 5600 mates with threaded surface 4602a in interior of aperture 4602 in order to secure articulating plate 2600 to implant 1604.

[0260] Articulating plate 2600 may translate and angulate relative to endplate 1604 in a manner similar to articulating plate 2500. However, the mechanisms governing translation and angulation of articulating plate 2600 differ from those underlying articulating plate 2500.Articulating plate 2600 is secured to screw guide 4600 via screw 5600 so that articulating plate 2600 may translate and angulate with screw guide 4600 in a manner that is substantially analogous to that of articulating plate 2100, for example. As is seen in FIGS. 54B and 54C, screw guide 4600 includes support tangs 4614a and 4614b. Support tangs 4614a and 4614b may have the same or substantially the same structure and function as support tangs 2114a and 2114b (see FIG. 30). Support tangs 4614a and 4614b may couple to a support block, such as support block 1157 (see FIG. 30), and may translate and angulate within apertures, such as apertures 1122a and 1121a, of the support block in the same or similar manner as described with respect in the same or similar manner as described with respect to articulating plate 2100 (see FIG. 30)Attorney Docket No. A0013274W001

[0261] Articulating plate 2600 may be coupled to implant 1604 after insertion of implant 1604 in situ. For example, articulating plate 2600 may be coupled to implant 1604 with insertion tool 6000, discussed later herein.

[0262] Now referring to FIGS. 56A, 56B, 56C, 56D and 56E, locking mechanism 3600 will now be discussed. FIGS. 56A, 56B, 56C. 56D and 56E show front, rear, side, front perspective and rear perspective views of locking mechanism 3600, respectively. Locking mechanism 3600 has features that are the same or similar to features of other locking mechanisms described previously, e.g., locking mechanism 3000, 3200 and 3500. Accordingly, duplicative disclosure will be omitted for the sake of brevity. Locking mechanism 3600 has a shaft 3602, which prevents movement of set screws in the interior of implant 1604. Locking mechanism 3600 also has a face 3601, which has portions 3612 that at least partially cover bone fastener apertures 2603 to prevent bone fasteners contained in the apertures 2603 from backing out of articulating plate 2600. Face 3601 may angulate and translate relative to shaft 3602 in the same of similar manner as described for analogous components of locking mechanism 3000.

[0263] Locking mechanism 3600 includes two extensions 3607a and 3607b extending from face 3601. Extensions 3607a and 3607b may be configured as clips that grip opposing sides of articulating plate 2600. More specifically, extensions 3607a and 3607b can be at least partially received in a corresponding one of cutouts 2606a and 2606b and flex and / or bend around opposing sides of articulating plate 2600 to secure locking mechanism 3600 to articulating plate 2600. In the embodiment shown, extensions 3607a and 3607b at least partially wrap around opposing sides of articulating plate 2600 in cutouts 2606a and 2606b.

[0264] Referring now to FIGS. 57, 58A, and 58B, an embodiment of an insertion tool 6000 will now be discussed. Insertion tool 6000 may be used to insert articulating plate 2600, for example, into a patient. Insertion tool 6000 includes a plate inserter sleeve 6001, a plate inserter fork 6011 and a screw inserter 6021. The plate inserter fork 6011 is housed within a hollow shaft 6002 of plate inserter sleeve 6001. Plate inserter sleeve has projections 6003 on opposing sides that are of a size and shape that allow them to be received in indents 6014 of plate inserter fork 6011. Plate inserter fork 6011 includes a forked end 6013 that can receive an endplate, such as articulating plate 2600. Screw inserter 6021 is housed within a hollow shaft 6012 of plate inserter fork 6011. Screw inserter 6021 includes a shaft 6022 terminating in a drive end 6023. Drive end 6023 mayAttorney Docket No. A0013274W001be of a shape, e.g., a hexagonal shape, so that it may attach to and drive a screw, such as screw 5600.

[0265] Plate inserter fork 6011 is telescopically received in plate inserter sleeve 6001 so that plate inserter fork 6011 may translate within hollow shaft 6002 of plate inserter sleeve 6001. Likewise, screw inserter 6021 is telescopically received in hollow shaft 6012 of plate inserter fork 6011 so that screw inserter 6021 may translate and / or rotate within hollow shaft 6012 of plate inserter fork 6011. Plate inserter fork 6011 and screw inserter 6021 are movable relative to one another and relative to plate inserter sleeve 6001. In order to insert articulating plate 2600 into a patient the user may translate plate inserter fork 6011 in order to push articulating plate 2600 into the surgical site and align articulating plate 2600 with an expandable spinal implant. The user may translate and / or rotate screw inserter 6021 in order to secure it to a component of an interbody device system, such as screw guide 4600 (see FIGS. 54B and 54C).

[0266] FIG. 58B depicts an alternative view of forked end 6013 of plate inserter fork. Forked end 6013 includes aperture 6015, which is in communication with the hollow shaft 6012 of plate inserter fork 6011. A screw 5600 is received in aperture 6015 and is attached to drive end 6023 of screw inserter 6021. Two tines 6016 are on forked end 6013 and each include a respective outdent 6017. The outdents 6017 are received in apertures 2616 of articulating plate 2600 to secure articulating plate 2600 to plate inserter fork. As discussed previously, forked end 6013 also includes indents 6014 on opposing sides that are configured to receive projections 6003 of plate inserter sleeve 6001 to allow plate inserter sleeve 6001 to couple to and / or interface with plate inserter fork 6011.

[0267] A first position and a second position of articulating plate 2600 are shown in FIG. 58C and 58D, respectively. In the first position, articulating plate 2600 is attached to the insertion tool 6000 so that the longitudinal axis, as defined herein, of the articulating plate 2600 is parallel to the longitudinal axis, as defined herein, of implant 1604. The articulating plate 2600 may oriented in a second position, for example, via rotation on insertion tool 6000. In the second position the longitudinal axis of the articulating plate 2600 is perpendicular to the longitudinal axis of the implant 1604. The articulating plate 2600 can be brought near the implant 1604 when in the second position and coupled to the implant 1604 with the insertion tool 6000. The implant 1604 may already be inserted in situ into a patient at the time the articulating plate 2600 isAttorney Docket No. A0013274W001coupled thereto. The first position is a lower profile position relative to the second position promoting ease of insertion.

[0268] Some of the embodiments disclosed above allow variable endplate angulation of + / -about 10 degrees. Other embodiments disclosed above allow variable endplate angulation of + / -about 20 degrees. The above described embodiments may allow translation of up to about 5 mm. Some embodiments disclosed above allow translation of about 2 mm to about 4 mm.

[0269] FIG. 59 depicts a flowchart of an example method 7000 of using the various embodiments of endplates disclosed herein. Furthermore, the following steps need not be performed in sequence and can be performed in any alternate sequence with or without all of the disclosed method steps.

[0270] In a first step, 7001, an articulating plate is prepared. Preparation of the articulating plate may include cleaning and sterilizing the articulating plate to remove contaminants, inspecting the articulating plate for functionality, and making the articulating plate accessible for use during performance of this method 7000. Preparation may also include removing the articulating plate from a sterilized packaging. At the time of preparing the implant, an expandable spinal implant or locking mechanism may also be prepared in the same or similar manner. The articulating plate may be pre-assembled to the expandable spinal implant, e.g., during the manufacturing process. Alternatively, the articulating plate may be affixed to the expandable spinal implant during this step 7001. Alternatively, the user may refrain from affixing the articulating plate to the spinal implant at this step 7001 and instead opt to affix articulating plate during insertion of, such as with insertion tool 6000 and screw 5600. At this step 7001, the articulating plate, expandable spinal implant and locking mechanism may be attached to a corresponding tool, e.g., a corresponding insertion tool. Alternatively, such tools may be made accessible for use during this method 7000.

[0271] In a second step, 7002, the articulating plate and the expandable spinal implant are inserted into a patient. For example, the user may insert the expandable spinal implant between vertebral bodies at a particular depth relative to the anterior-posterior direction of the patient. The user may insert the articulating plate and the expandable spinal implant simultaneously, i.e., the user may insert the expandable spinal implant with the articulating plate coupled thereto.Because the articulating plate can angulate and translate relative to the expandable spinal implant the placement of the expandable spinal implant in the patient, e.g., between vertebral bodies andAttorney Docket No. A0013274W001subsequent adjustment of spacing and angulation of superior and inferior endplate of the implant are not hindered by the attached articulating plate. In some instances, the user may insert the articulating plate and the expandable spinal implant separately. For example, the user may insert the expandable spinal implant into the patient and then subsequently insert the articulating plate into the patient. In instances of separate insertion, the expandable spinal implant and the articulating plate may each have distinct corresponding insertion tools or, alternatively, the expandable spinal implant and the articulating plate may be inserted with the same insertion tool. During insertion, the articulating plate may be oriented relative to the spinal implant in a first orientation, such as a low -profile orientation or other orientation that facilitates insertion.

[0272] In a third step, 7003, the articulating plate is aligned relative to patient anatomy. The user applies force to the articulating plate so that the articulating plate aligns to the vertebral wall, for example. Alignment of the articulating plate may involve angulation and / or translation relative to the expandable spinal implant. Furthermore, during this step 7003 the user may orient the articulating plate relative to the expandable spinal implant in a second orientation. In some instances, the second orientation may be achieved by rotating the articulating plate 90 degrees from the first orientation. The articulating plate may be oriented in the second orientation prior to alignment of the articulating plate with patient anatomy. It should be noted that the articulating plate may not be actively aligned upon application of force by the user, but rather, at least partially self-align against patient anatomy, e.g., during the course of insertion of the expandable spinal implant in this step 7003 and / or bone fastener impaction in step 7005.

[0273] In a fourth step, 7004 the user may then adjust the spacing and one or more angles of inclination between superior and inferior articulating plates of the expandable spinal implant as described previously in reference to FIGS. 3 and 4, for example, and in accordance with the various disclosures incorporated herein. During this step 7004 the articulating plate may continue to translate and angulate as in step 7003 to accommodate the variation in spacing and / or angulation of the expandable spinal implant while remaining aligned against patient anatomy, e.g., the vertebral wall.

[0274] In a fifth step, 7005, one or more bone fasteners are inserted into the articulating plate, e.g., into bone fastener apertures 2003, 2103, 2203, 2303, 2403, 2503 or 2603. The user may then impact or drive the bone fasteners into patient anatomy. It should be noted this step 7005 and step 7003 and step 7004 may take place simultaneously or substantially simultaneously (e.g.,Attorney Docket No. A0013274W001overlapping for the majority of the durations). For example, the force applied to the articulating plate to align the articulating plate to patient anatomy may be a result from the user adjusting the relative spacing and angulation of superior and inferior endplates of the expandable spinal implant or from the user impacting or driving the one or more bone fasteners.

[0275] In a sixth step, 7006, the user may insert one of the various locking mechanism embodiments described herein into the expandable spinal implant. For example, the user may feed a shaft of the locking mechanism through an aperture of the articulating plate (e.g., aperture 2002 in FIG. 22A), through an aperture of the expandable spinal implant (e.g., screw guide aperture 107 in FIG. 1), and through one or more set screws, such as set screw 400 in FIGS. 20A and 20B, of the expandable spinal implant. The user may insert the locking mechanism with a corresponding insertion tool. Upon insertion , the user may also align the locking mechanism with portions of the articulating plate (e.g., cutouts 2006a, 2006b, 2005a and 2005b in FIG. 22A). The locking mechanism may lock the spacing and angle of inclination of the expandable spinal implant set at step 7004.

[0276] Without excluding further possible embodiments, certain example embodiments are summarized in the following clauses:

[0277] The techniques of this disclosure may also be described in the following examples.

[0278] Example 1. An articulating plate for use with a spinal implant, comprising: a first face of an articulating plate; a second face of the articulating plate; and an aperture extending between the first face and the second face; wherein the articulating plate is configured to couple to the spinal implant and the articulating plate is configured to move relative to the spinal implant about a longitudinal axis and a lateral axis, wherein the longitudinal axis extends longitudinally through the spinal implant, and the lateral axis extends laterally through the spinal implant and intersects the longitudinal axis, and wherein, the articulating plate is configured to translate longitudinally along the longitudinal axis and tilt about the lateral axis when the articulating plate is coupled to the spinal implant.

[0279] Example 2. The articulating plate of example 1, wherein the first face has one or more indentations for at least partially receiving and coupling to a locking mechanism and the second face is defined by a curvature corresponding to a curvature of a vertebral wall of a patient.

[0280] Example 3. The articulating plate of any one of examples 1 through 2, further comprising one or more support tangs extending from the second face, the one or more support tangs beingAttorney Docket No. A0013274W001configured to couple to the spinal implant through a corresponding aperture of the spinal implant.

[0281] Example 4. The articulating plate of example 3, wherein the one or more support tangs each further comprise a corresponding first lip, wherein each of the corresponding first lips is configured to catch a corresponding second lip on an interior surface of each of the corresponding apertures of the spinal implant when the one or more support tangs are coupled to the spinal implant.

[0282] Example 5. The articulating plate of any one of examples 3 through 4, wherein there are one or more gaps between the one or more support tangs and an interior surface of each of the corresponding apertures when the one or more support tangs are coupled to the spinal implant.

[0283] Example 6. The articulating plate of any one of examples 1 through 5, further comprising one or more slots on a surface of the aperture, the one or more slots being configured to receive a corresponding outdent of a screw guide, and wherein the screw guide includes one or more support tangs, the one or more support tangs being configured to couple to the spinal implant through a corresponding aperture of the spinal implant.

[0284] Example 7. The articulating plate of example 6, wherein the corresponding outdents are configured to translate and tilt within the one or more slots when the articulating plate translates along the longitudinal axis and tilts about the lateral axis.

[0285] Example 8. The articulating plate of example 7, wherein the one or more slots further comprise a stop surface configured to engage the outdents and restrict the articulating plate from further translation along the longitudinal axis when the outdents directly contact the stop surface.

[0286] Example 9. The articulating plate of any one of examples 6 through 8, wherein the one or more support tangs each further comprise a corresponding lip, wherein each of the corresponding lips is configured to be received in a corresponding indentation on an interior surface of each of the corresponding apertures of the spinal implant when the one or more support tangs are coupled to the spinal implant.

[0287] Example 10. The articulating plate of example 9, wherein each of the corresponding lips of the one or more support tangs and each of the corresponding indentations of each of the corresponding apertures of the spinal implant are configured to restrict movement of the screw guide when the articulating plate tilts or translates.Attorney Docket No. A0013274W001

[0288] Example 11. A spinal implant system, comprising: a spinal implant; an articulating plate configured to couple to the spinal implant, comprising: a first face; a second face; an aperture extending between the first face and the second face; and a locking mechanism coupled to the articulating plate and at least partially received in one or more cutouts on the first face of the articulating plate; wherein the articulating plate is configured to couple to the spinal implant and the articulating plate is configured to move relative to the spinal implant about a longitudinal axis and a lateral axis, wherein the longitudinal axis extends longitudinally through the spinal implant, and the lateral axis extends laterally through the spinal implant and intersects the longitudinal axis, and wherein, the articulating plate is configured to translate along the longitudinal axis and tilt about the lateral axis when the articulating plate is coupled to the spinal implant.

[0289] Example 12. The system of example 11, further comprising one or more holes on the first face, wherein the one or more holes are each configured to receive a corresponding prong located on the locking mechanism.

[0290] Example 13. The system of example 12, wherein the holes further comprise one or more lips configured to secure each of the one or more prongs of the locking mechanism.

[0291] Example 14. The system of any one of examples 11 through 13, the locking mechanism further comprising: a face having an aperture; an elongate slot disposed on a side of the aperture; and a shaft extending through the aperture and having an outdent disposed within the elongate slot, wherein the elongate slot and the outdent are configured to allow the face to translate in a direction defined by a length of the elongate slot and pivot about a pivoting axis extending through the outdent of the shaft.

[0292] Example 15. The system of any one of examples 11 through 14, wherein the locking mechanism further comprises a shaft configured to be received in an interior of a set screw of the spinal implant when the locking mechanism is coupled to the articulating plate.

[0293] Example 16. A method of securing an articulating plate to patient anatomy, the method comprising: coupling an articulating plate to a spinal implant, wherein coupling comprises engaging a first feature of the spinal implant to a corresponding second feature of the articulating plate to thereby allow the articulating plate to translate along a longitudinal axis of the spinal implant and tilt about a lateral axis of the spinal implant; securing a locking mechanism to the articulating plate so that the locking mechanism restricts movement of an expansion mechanismAttorney Docket No. A0013274W001of the spinal implant while allowing translation and tilting of the articulating plate about the longitudinal axis and the lateral axis, respectively; and aligning the articulating plate relative to patient anatomy, wherein aligning the articulating plate relative to patient anatomy comprises translating the articulating plate along the longitudinal axis and tilting the articulating plate about the lateral axis, wherein the first feature comprises at least one of an outdent or a support tang of the articulating plate and the second feature comprises at least one of an indentation or an aperture of the spinal implant.

[0294] Example 17. The method of example 16, further comprising inserting the spinal implant and the articulating plate as an assembly into the patient.

[0295] Example 18. The method of any one of examples 16 through 17, further comprising: inserting the spinal implant into the patient; attaching a tine of a plate inserter tool to an aperture on a side of the articulating plate; inserting the articulating plate into the patient with the plate inserter tool; fastening the articulating plate to the spinal implant with the plate inserter tool; and aligning the first feature of the articulating plate with the corresponding second feature of the spinal implant.

[0296] Example 19. The method of any one of examples 16 through 18, further comprising: inserting the spinal implant and the articulating plate as an assembly into the patient, wherein the articulating plate is in a first position upon insertion, the first position defined by a longitudinal axis of the articulating plate being perpendicular with the longitudinal axis of the spinal implant; and rotating the articulating plate to a second position, wherein the longitudinal axis of the articulating plate is rotated about the longitudinal axis of the spinal implant.

[0297] Example 20. The method of any one of examples 16 through 19, further comprising: orienting the articulating plate in a first position upon insertion, the first position defined by a longitudinal axis of the articulating plate being parallel with the longitudinal axis of the spinal implant; and orienting the articulating plate in a second position, wherein the longitudinal axis of the articulating plate is perpendicular with the longitudinal axis of the spinal implant.

Claims

Attorney Docket No. A0013274W001WHAT IS CLAIMED IS:

1. An articulating plate for use with a spinal implant, comprising:a first face of an articulating plate;a second face of the articulating plate; andan aperture extending between the first face and the second face;wherein the articulating plate is configured to couple to the spinal implant and the articulating plate is configured to move relative to the spinal implant about a first axis and a second axis,wherein the first axis extends longitudinally along a length of the spinal implant, and the second axis extends laterally from the spinal implant and intersects the first axis, and wherein, the articulating plate is configured to translate longitudinally along the first axis and tilt about the second axis when the articulating plate is coupled to the spinal implant.

2. The articulating plate of claim 1 , wherein the first face has one or more indentations for at least partially receiving and coupling to a locking mechanism and the second face is defined by a curvature corresponding to a curvature of a vertebral wall of a patient.

3. The articulating plate of any one of claims 1 through 2, further comprising one or more support tangs extending from the second face, the one or more support tangs being configured to couple to the spinal implant through a corresponding aperture of the spinal implant.

4. The articulating plate of claim 3, wherein the one or more support tangs each further comprise a corresponding first lip, wherein each of the corresponding first lips is configured to catch a corresponding second lip on an interior surface of each of the corresponding apertures of the spinal implant when the one or more support tangs are coupled to the spinal implant.

5. The articulating plate of any one of claims 3 through 4, wherein there are one or more gaps between the one or more support tangs and an interior surface of each of the corresponding apertures when the one or more support tangs are coupled to the spinal implant.Attorney Docket No. A0013274W0016. The articulating plate of any one of claims 1 through 5, further comprising one or more slots on a surface of the aperture, the one or more slots being configured to receive a corresponding outdent of a screw guide, andwherein the screw guide includes one or more support tangs, the one or more support tangs being configured to couple to the spinal implant through a corresponding aperture of the spinal implant.

7. The articulating plate of claim 6, wherein the corresponding outdents are configured to translate and tilt within the one or more slots when the articulating plate translates along the first axis and tilts about the second axis.

8. The articulating plate of claim 7, wherein the one or more slots further comprise a stop surface configured to engage the outdents and restrict the articulating plate from further translation along the first axis.

9. The articulating plate of any one of claims 6 through 8, wherein the one or more support tangs each further comprise a corresponding lip, wherein each of the corresponding lips is configured to be received in a corresponding indentation on an interior surface of each of the corresponding apertures of the spinal implant when the one or more support tangs are coupled to the spinal implant.

10. The articulating plate of claim 9, wherein each of the corresponding lips of the one or more support tangs and each of the corresponding indentations of each of the corresponding apertures of the spinal implant are configured to prevent movement of the screw guide when the articulating plate tilts or translates.

11. The endplate of any one of claims 1 through 11 , further comprising one or more cutouts on the first face, wherein the one or more cutouts are configured to at least partially receive a locking mechanism coupled to the endplate.Attorney Docket No. A0013274W00112. The endplate of claim 11, the locking mechanism further comprising:a face having an aperture;an elongate slot disposed on a side of the aperture; anda shaft extending through the aperture and having an outdent disposed within the elongate slot.

13. The endplate of claim 12, wherein the elongate slot and the outdent are configured to allow the face to translate in a direction defined by a length of the elongate slot and pivot about a pivoting axis extending through the outdent of the shaft.

14. A method of securing an articulating plate to patient anatomy, the method comprising: coupling an articulating plate to a spinal implant, wherein coupling comprises engaging a first feature of the spinal implant to a corresponding second feature of the articulating plate to thereby allow the articulating plate to translate along a longitudinal axis of the spinal implant and tilt about a lateral axis of the spinal implant;securing a locking mechanism to the articulating plate so that the locking mechanism restricts movement of an expansion mechanism of the spinal implant while allowing translation and tilting of the articulating plate about the longitudinal axis and the lateral axis, respectively; andaligning the articulating plate relative to patient anatomy, wherein aligning the articulating plate relative to patient anatomy comprises translating the articulating plate along the longitudinal axis and tilting the articulating plate about the lateral axis,wherein the first feature comprises at least one of an outdent or a support tang of the articulating plate and the second feature comprises at least one of an indentation or an aperture of the spinal implant.

15. The method of claim 14, further comprising:inserting the spinal implant and the articulating plate as an assembly into the patient, wherein the articulating plate is in a first position upon insertion, the first position defined by a longitudinal axis of the articulating plate being perpendicular with the longitudinal axis of the spinal implant; androtating the articulating plate to a second position, wherein the longitudinal axis of the articulating plate is rotated about the longitudinal axis of the spinal implant.

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