(19) United States
`(12) Patent Application Publication (10) Pub. No.: US 2014/0163683 A1
`(43) Pub. Date:
`Jun. 12, 2014
`Seifert et al.
`
`US 2014O163683A1
`
`EXPANDABLE VERTEBRALIMPLANT
`
`Publication Classification
`
`(2006.01)
`
`(51) Int. Cl.
`A6IF 2/44
`(52) U.S. Cl.
`CPC ...................................... A61F 2/442 (2013.01)
`USPC ....................................................... 623/17.15
`ABSTRACT
`(57)
`A joint spacer therapeutically maintains separation of bones
`of a joint. A carriage is slideably retained within the frame and
`has at least one ramped Surface. An actuator screw is thread
`ably engaged with the frame, and rotatably connected to the
`carriage, to cause the carriage to slideably move within the
`frame when the actuator screw is rotated. First and second
`endplates engage the bones of the joint, and each has at least
`one ramped surface that is mateable with the ramped Surface
`of the carriage, whereby when the carriage is slideably moved
`by rotation of the actuator screw, the endplates ramped Sur
`face slides against the carriage ramped Surface to cause the
`endplates to move along an axis transverse to the longitudinal
`axis of the frame, to increase the height of the spacer. Piercing
`elements are connected to the carriage to pierce bone of the
`joint when the carriage is moved.
`
`(54)
`(71)
`
`(72)
`
`Applicants: Jody L. Seifert, Birdsboro, PA (US);
`Chad Glerum, Pennsburg, PA (US);
`Mark Weiman, Coatesville, PA (US);
`Mark Adams, coatesville, PA (US);
`David C. Paul, Phoenixville, PA (US)
`Jody L. Seifert, Birdsboro, PA (US);
`Chad Glerum, Pennsburg, PA (US);
`Mark Weiman, Coatesville, PA (US);
`Mark Adams, coatesville, PA (US);
`David C. Paul, Phoenixville, PA (US)
`
`Inventors:
`
`(21)
`
`Appl. No.:
`
`13/837,452
`
`(22)
`
`Filed:
`
`Mar 15, 2013
`
`(63)
`
`Related U.S. Application Data
`Continuation-in-part of application No. 13/711,204,
`filed on Dec. 11, 2012.
`
`
`
`Exhibit 1010
`LIFE SPINE, INC.
`IPR2022-01602
`
`000001
`
`

`

`Patent Application Publication
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`FIG, 22
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`000005
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`Patent Application Publication
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`US 2014/0163683 A1
`
`Jun. 12, 2014
`
`EXPANDABLE VERTEBRAL MPLANT
`
`CROSS REFERENCE TO RELATED
`APPLICATIONS
`0001. This patent application is a continuation-in-part
`application of U.S. patent application Ser. No. 13/711.204,
`filed on Dec. 11, 2012, the entire contents of which are incor
`porated by reference.
`
`FIELD OF THE INVENTION
`0002 This invention relates to stabilizing adjacent verte
`brae of the spine by inserting an intervertebral spacer, and
`more particularly, an intervertebral spacer that is adjustable in
`height with plates for fixation.
`
`BACKGROUND OF THE INVENTION
`0003 Bones and bony structures are susceptible to a vari
`ety of weaknesses that can affect their ability to provide
`Support and structure. Weaknesses in bony structures have
`numerous potential causes, including degenerative diseases,
`tumors, fractures, and dislocations. Advances in medicine
`and engineering have provided doctors with a plurality of
`devices and techniques for alleviating or curing these weak
`SSS.
`0004. In some cases, the spinal column requires additional
`Support in order to address such weaknesses. One technique
`for providing Support is to insert a spacer between adjacent
`vertebrae.
`
`SUMMARY OF THE INVENTION
`0005. In accordance with the disclosure, a joint spacer for
`therapeutically maintaining a separation of bones of a joint,
`comprises a frame having distal and proximal ends defining a
`longitudinal axis extending therebetween; a carriage slide
`ably retained within the frame and having at least one ramped
`Surface, the carriage further including a threaded portion; an
`actuator Screw threadably engaged with the frame, the actua
`tor screw configured to bear against the carriage to cause the
`carriage to slideably move within the frame when the actuator
`screw is rotated; a first endplate configured to engage a first
`bone of the joint, and having at least one surface mateable
`with the at least one carriage ramped or a feature surface,
`whereby when the carriage is slideably moveable by rotation
`of the actuator screw, the at least one endplate ramped Surface
`slides against the at least one carriage ramped Surface to cause
`the first endplate to move along an axis transverse to the
`longitudinal axis to increase a height of the spacer; and a
`second endplate configured to engage a second bone of the
`joint.
`0006. In one embodiment thereof, the carriage includes at
`least two ramped Surfaces, and the second endplate includes
`at least one ramped surface mateable with at least one of the
`at least two ramped surfaces of the carriage, whereby when
`the carriage is slideably moved by rotation of the actuator
`screw, the at least one second endplate ramped surface slides
`against the at least one additional carriage ramped Surface to
`cause the second endplate to move along an axis transverse to
`the longitudinal axis to increase a height of the spacer.
`0007. In other embodiments thereof, the first endplate is
`configured to abut the frame as the first endplate is moved
`along an axis transverse to the longitudinal axis, whereby the
`first endplate moves Substantially only along an axis trans
`verse to the longitudinal axis; the first endplate includes at
`
`least one aperture through which a fastener may pass to secure
`the first endplate to a bone of the joint; the spacer further
`includes a blocking mechanism to prevent backing out of a
`fastener passed through the first endplate; and the first end
`plate includes one or more projections configured to engage
`bone of the joint when the implant is positioned between
`bones of the joint.
`0008. In further embodiments thereof, at least one of the
`first and second endplates is composed of two interconnected
`portions of dissimilar materials; one of the dissimilar mate
`rials is metallic and includes at least one aperture through
`which a fastener may be passed to attach the implant to a bone
`of the joint; and one dissimilar material is polymeric, and
`another dissimilar material is metallic. Other possible mate
`rials include carbon fiber, bone, etc.
`0009. In yet further embodiments thereof, the actuator
`screw includes a flange (or a pocket or other feature), and the
`carriage includes a flange (or c-clip or other feature) rotatably
`mateable with the actuator screw flange; the spacer further
`includes a thrust washer interposed between the actuator
`screw and the carriage; the spacer further includes a poly
`meric material configured to press against the actuator Screw
`to reduce a potential for unintended rotation of the actuator
`screw; and the spacer further includes a plate having at least
`one aperture sized and dimensioned to receive an elongated
`fastener for fastening the spacer to bone of the joint, the plate
`being releaseably detachable from the spacer to reduce an
`profile of the spacer during insertion of the spacer into the
`body, the plate attached to the spacer inside the body.
`0010. In other embodiments thereof, the plate and the
`frame include mating portions of a twist-lock connector oper
`able to connect the plate to the frame when the spacer is inside
`the body; the plate and the frame include mating portions of a
`Snap-fit interference connector operable to connect the plate
`to the frame when the spacer is inside the body or outside; the
`plate includes hinged portions, the hinged portions foldable to
`reduce a profile of the plate during insertion of the plate into
`the body; the at least one surface mateable with the at least one
`carriage ramped surface is at least one ramp; the at least one
`carriage ramp is disposed upon at least one cam, the cam
`rotatable to bear the at least one carriage ramp against the at
`least one surface of the first endplate; the first endplate
`includes a rotatable portion having first and second transverse
`axes of different lengths; and the rotatable portion is passable
`through an interior of the spacer.
`0011. In other embodiments thereof, the first endplate
`includes an aperture sized and dimensioned to receive an
`elongated fastener operable to pass through the aperture to
`affix the spacer to bone of the joint, the aperture movable with
`the first endplate as the first endplate is moved along the axis
`transverse to the longitudinal axis; and the first endplate
`includes a first portion having at least one aperture through
`which a fastener may pass to secure the first endplate to a bone
`of the joint, and a second portion configured to Support bone
`of the joint, the first and second portions mutually connected
`by a dovetail or other type of connection.
`0012. In additional embodiments thereof, the spacer fur
`ther includes a rotatable plate having at least two apertures
`through each of which a fastener may pass to secure the
`spacer to a bone of the joint, the rotatable plate rotatable after
`the spacer has been implanted within the body, to overlie the
`at least two apertures with bone of the joint; the spacer further
`includes a rotatable plate having at least two apertures
`through each of which a fastener may pass to secure the
`
`000016
`
`

`

`US 2014/0163683 A1
`
`Jun. 12, 2014
`
`spacer to a bone of the joint, the rotatable plate rotatable after
`the spacer has been implanted within the body, to overlie the
`at least two apertures with bone of the joint; the spacer further
`includes at least one rotatable plate having an aperture
`through which a fastener may pass to secure the spacer to a
`bone of the joint, the rotatable plate rotatable after the spacer
`has been implanted within the body, to overlie the aperture
`with bone of the joint; and the spacer further includes at least
`two plates rotatably connectable to the spacer, each plate
`slidably connected to the other by a dovetail joint, each plate
`having at least one aperture through which a fastener may
`pass to secure the spacer to bone of the joint, the plates
`rotatable after the spacer has been implanted within the body,
`and each of the at least two plates slideable with respect to the
`other, to overlie the aperture of each plate with bone of the
`joint.
`0013. In yet further embodiments thereof, at least one of
`the carriage ramped surfaces is operative to push a piercing
`element through an aperture in the first endplate, the piercing
`element operative to pierce bone of the joint to secure the
`spacer within the body; the spacer further includes a bone
`screw having bone engaging threads and gear teeth, and the
`actuator Screw including gear teeth engageable with the gear
`teeth of the bone screw, the actuator screw thereby rotated
`when the bone screw is threaded into bone of the joint; the
`spacer further includes a plate having an aperture through
`which a fastener may be passed to connect the spacer to bone
`of the joint, the plate including a dovetail portion; and the first
`endplate including a dovetail portion mateable with the dove
`tail portion of the plate, the plate and the first endplate thereby
`securely connectable to each other; and the spacer further
`includes a channel formed within the first endplate, the chan
`nel sized and dimensioned to receive an elongate portion of a
`fastener operative to secure the spacer within the body.
`0014. In other embodiments thereof, the spacer further
`includes at least one elongate rotatable deployer pivotally
`connected to the frame; at least one piercing element con
`nected to the deployer, the at least one piercing element
`operable to pierce bone of the joint when the rotatable
`deployer is rotated within the body; the at least one piercing
`element is pivotally connected to the deployer to thereby
`enter bone of the body at a desired angle relative to a plane of
`the first endplate; the at least one rotatable deployer rotates
`about a common axis with respect to the actuator screw; the at
`least one rotatable deployer rotates when the actuator screw is
`rotated; and the at least one rotatable deployer rotates inde
`pendently of the actuator screw.
`0015. In yet further embodiments thereof, the first end
`plate is pivotally connected to the frame; the first endplate
`pivots about the pivotal connection, about an axis extending
`transverse to the longitudinal axis; and the first endplate is
`connected to the frame to allow roll, pitch, and yaw move
`ment of the first endplate with respect to the frame.
`0016. In another embodiment of the disclosure, a joint
`spacer for therapeutically maintaining a separation of bones
`of a joint, comprises a frame having distal and proximal ends
`defining a longitudinal axis extending therebetween; a car
`riage slideably retained within the frame and having at least
`one ramped Surface, the carriage further including a flange; an
`actuator Screw threadably engaged with the frame, the actua
`tor Screw including a flange rotatably mateable with the car
`riage flange, whereby the carriage is slideably moved when
`the actuator screw is rotated; a first endplate configured to
`engage a first bone of the joint, and having at least one ramped
`
`Surface mateable with the at least one carriage ramped Sur
`face, whereby when the carriage is slideably moved by rota
`tion of the actuator screw in a first direction, the at least one
`endplate ramped Surface slides against the at least one car
`riage ramped surface to cause the first endplate to move along
`an axis transverse to the longitudinal axis to increase a height
`of the spacer; and a second endplate configured to engage a
`second bone of the joint.
`0017. In various embodiments thereof, when the actuator
`screw is rotated in an opposite, second direction, the at least
`one endplate ramped Surface is slideable against the at least
`one carriage ramped Surface to cause the first endplate to
`move along an axis transverse to the longitudinal axis to
`decrease a height of the spacer; the first endplate includes a
`metallic portion having an aperture through which a fastener
`may be passed for connecting the implant to body tissue, the
`first endplate further having a polymeric portion connected to
`the metallic portion, the polymeric portion sized and dimen
`sioned to support a bone of the joint; the frame and the first
`endplate include mateable dovetailed portions configured to
`maintain an orientation of the first endplate and the frame
`when the first endplate is positioned proximate the frame.
`0018. In another embodiment of the disclosure, a method
`for therapeutically maintaining a separation of bones of a
`joint, comprises inserting a spacer between bones of the joint,
`the spacer including—a frame having distal and proximal
`ends defining a longitudinal axis extending therebetween; a
`carriage slideably retained within the frame and having at
`least one ramped Surface, the carriage further including a
`flange; an actuator Screw threadably engaged with the frame,
`the actuator Screw including a flange rotatably mateable with
`the carriage flange, whereby the carriage is slideably moved
`when the actuator screw is rotated; a first endplate configured
`to engage a first bone of the joint, and having at least one
`ramped surface mateable with the at least one carriage
`ramped surface, whereby when the carriage is slideably
`moved by rotation of the actuator screw in a first direction, the
`at least one endplate ramped surface slides against the at least
`one carriage ramped Surface to cause the first endplate to
`move along an axis transverse to the longitudinal axis to
`increase a height of the spacer; and a second endplate config
`ured to engage a second bone of the joint; the spacer inserted
`when the first endplate is positioned proximate the frame; and
`slideably moving, by rotation of the actuator Screw, the at
`least one endplate ramped surface against the at least one
`carriage ramped Surface to cause the first endplate to move
`along an axis transverse to the longitudinal axis to increase a
`height of the spacer to maintain a separation of bones of the
`joint.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`0019. A more complete understanding of the present
`invention, and the attendant advantages and features thereof,
`will be more readily understood by reference to the following
`detailed description when considered in conjunction with the
`accompanying drawings, in which:
`0020 FIG. 1 depicts a perspective view of a spacer in
`accordance with the disclosure, including bone fasteners, the
`spacer in a reduced height, or compressed configuration;
`0021
`FIG. 2 depicts the spacer of FIG. 1, in an increased
`height, or expanded configuration;
`(0022 FIG.3 depicts a front view of the spacer of FIG. 1;
`(0023 FIG. 4 depicts a front view of the spacer of FIG. 2;
`
`000017
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`

`

`US 2014/0163683 A1
`
`Jun. 12, 2014
`
`0024 FIG.5 depicts a cross-section taken through a center
`of the spacer of FIG. 2;
`0025 FIG. 6 depicts a top view of the spacer of FIG. 1;
`0026 FIG. 7 is a diagram of a possible implantation loca
`tion in the body, for the spacer of FIG. 1;
`0027 FIG. 8 depicts an embodiment of a spacer in accor
`dance with the disclosure, including a fixation plate that is
`removeably connectable to a remainder of the spacer, the
`fixation plate shown removed;
`0028 FIG.9 depicts a connector for connecting the fixa
`tion plate to a remainder of the spacer, with respect to FIG. 8:
`0029 FIG. 10 depicts the spacer of FIG. 8, the fixation
`plate attached;
`0030 FIG. 11 depicts a reverse side of the spacer of FIG.
`10:
`0031 FIG. 12 depicts a front view of the spacer of FIG. 10;
`0032 FIG. 13 depicts a side view of an embodiment of a
`spacer in accordance with the disclosure, the spacer including
`a detached fixation plate having a Snap-fit attachment;
`0033 FIG. 14 depicts the spacer of FIG. 13, the fixation
`plate Snap-fit into attachment;
`0034 FIG. 15 depicts the fixation plate of FIG. 13:
`0035 FIG.16 depicts a hinged fixation plate inaccordance
`with the embodiment of FIG. 13:
`0036 FIG. 17 depicts the hinged fixation plate of FIG. 16,
`the hinged portions folded, and further showing barbs upon
`the hinged portion;
`0037 FIG. 18 depicts an embodiment of a spacer in accor
`dance with the disclosure, including cams operative to
`increase a height of the spacer, the spacer in a reduced height
`configuration;
`0038 FIG. 19 depicts the spacer of FIG. 18, the cams
`actuated to increase a height of the spacer,
`0039 FIG. 20 depicts an embodiment of a spacer in accor
`dance with the disclosure, the spacer including rotatable end
`plate portions;
`0040 FIG. 21 depicts an end view of the spacer of FIG.20;
`004.1
`FIG. 22 depicts the spacer of FIG. 21, the rotatable
`endplate portion rotated;
`0042 FIG. 23 depicts an embodiment of a spacer in accor
`dance with the disclosure, having endplates that translate
`together with endplates, as endplates are moved to increase a
`height of the spacer,
`0043 FIG. 24 depicts the spacer of FIG. 23, the spacer
`expanded to have an increased or expanded height;
`0044 FIG. 25 depicts a side view of an embodiment of a
`spacer in accordance with the disclosure, the spacer having
`connectable fixation portions and endplate Support portions;
`0045 FIG. 26 depicts a cross-section of the spacer of FIG.
`25;
`0046 FIG. 27 illustrates an embodiment of a spacer
`including connectable fixation portions and endplate Support
`portions, the portions connectable by a dovetailed connec
`tion;
`0047 FIG. 28 depicts across-section of the device of FIG.
`27;
`0048 FIG. 29 depicts an embodiment of a spacer of the
`disclosure, including a rotatable fixation plate;
`0049 FIG. 30 depicts the spacer of FIG. 29, the fixation
`plate rotated;
`0050 FIG.30A depicts an embodiment of a spacer of the
`disclosure, including two rotatable fixation plates, rotated to
`a deployment position;
`
`FIG. 31 depicts an embodiment of a spacer of the
`0051
`disclosure including two rotatable fixation portions con
`nected by a sliding dovetail connection;
`0052 FIG. 32 depicts the spacer of FIG. 31, the fixation
`portions relatively displaced and rotated;
`0053 FIG. 33 depicts a cross-section the spacer of FIG.
`31;
`0054 FIG. 34 depicts an embodiment of a spacer of the
`disclosure, including deployable piercing elements;
`0055 FIG. 35 depicts the spacer of FIG. 34, the piercing
`elements deployed;
`0056 FIG. 36 depicts an embodiment of a spacer of the
`disclosure, including a bone fixation device having gear teeth
`mateable with gear teeth of an endplate actuator screw;
`0057 FIG. 37 depicts the spacer of FIG. 36, the bone
`fixation device deployed to engage bone, and to increase a
`height of the spacer,
`0058 FIG. 38 depicts an embodiment of a spacer of the
`disclosure, including a dovetail connection between a fixation
`portion, and a bone endplate Support portion;
`0059 FIG. 39 depicts the fixation portion of the spacer of
`FIG.38:
`0060 FIG. 40 depicts the bone endplate support portion of
`the spacer of FIG.38:
`0061
`FIG. 41 depicts an embodiment of a spacer in accor
`dance with the disclosure, including channels in endplate
`portions;
`0062 FIG. 42 depicts a top view of an embodiment of a
`spacer in accordance with the disclosure having deployment
`arms rotatably supporting piercing elements;
`0063 FIG. 43 depicts a cross section of the spacer of FIG.
`42;
`0064 FIG. 44 depicts the spacer of FIG. 43, the piercing
`elements deployed;
`0065 FIG. 45 depicts an embodiment of a spacer in accor
`dance with the disclosure, including a deployment arm hav
`ing a common axis with an actuator screw;
`0.066
`FIG. 46 depicts a cross section of the spacer of FIG.
`45:
`0067 FIG. 47 depicts the spacer of FIG. 46, the piercing
`elements deployed;
`0068 FIG. 48 illustrates an alternative spacer in accor
`dance with FIG. 45, the deployment arm independently rotat
`able; and
`0069 FIG. 49 illustrates an embodiment of a spacer in
`accordance with the disclosure, an endplate pivotable about a
`transverse axis.
`(0070 FIG.50 illustrates an exploded view of an alterna
`tive spacer according to some embodiments.
`(0071
`FIG. 51 illustrates a top perspective view of the
`alternative spacer of FIG. 50 with upper endplate removed.
`0072 FIG. 52 illustrates a side cross-sectional view of the
`alternative spacer of FIG. 50.
`0073 FIG. 53 illustrates a different cross-sectional view
`of the alternative spacer of FIG. 50.
`0074 FIGS. 54A and 54B illustrate a rear view of the
`alternative spacer of FIG. 50.
`(0075 FIG.55 illustrates a top cross-sectional view of the
`alternative spacer of FIG. 50.
`0076 FIG.56 illustrates a close-up cross-sectional view of
`the actuation member and translation member of the alterna
`tive spacer of FIG. 50.
`
`000018
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`

`

`US 2014/0163683 A1
`
`Jun. 12, 2014
`
`DETAILED DESCRIPTION OF THE INVENTION
`0077. As required, detailed embodiments are disclosed
`herein; however, it is to be understood that the disclosed
`embodiments are merely examples and that the systems and
`methods described below can be embodied in various forms.
`Therefore, specific structural and functional details disclosed
`herein are not to be interpreted as limiting, but merely as a
`basis for the claims and as a representative basis for teaching
`one skilled in the art to variously employ the present subject
`matter in virtually any appropriately detailed structure and
`function. Further, the terms and phrases used herein are not
`intended to be limiting, but rather, to provide an understand
`able description of the concepts.
`0078. The terms “a” or “an', as used herein, are defined as
`one or more than one. The term plurality, as used herein, is
`defined as two or more than two. The term another, as used
`herein, is defined as at least a second or more. The terms
`“including and “having, as used herein, are defined as com
`prising (i.e., open language).
`0079. With reference to FIGS. 1-7, spacer 100 is operative,
`when positioned between adjacent bones of a joint, Such as
`for example vertebrae 10, 12 (shown in FIG. 7), to stabilize a
`joint formed between adjacent vertebrae. Spacer 100 has a
`collapsed state or height, illustrated in FIGS. 1 and 3, and an
`expanded state or height, illustrated in FIGS. 2, 4 and 5.
`Spacers 100 of the disclosure may be inset into the interver
`tebral disc space at a collapsed height, and then expand axi
`ally (Superior/inferior) to restore height loss in the disc space.
`Spacer 100 provides distraction as well as achieves optimal
`separation of adjacent vertebrae, or disc height restoration.
`When inserted in a collapsed state, Spacers 100 have a
`reduced height profile which reduces adverse impact to tissue
`adjacent to and within the joint space during insertion, while
`presenting the least visually blocking or physically obstruct
`ing profile. Spacer 100 may be reduced in height after implan
`tation, for example by inserting a tool through a minimal
`incision, to perform a therapeutic height adjustment. Spacer
`100 may also be reduced in height to a compressed configu
`ration, to facilitate removal from the body. Spacer 100 Sup
`ports the cortical rim of adjacent vertebrae, and distributes
`forces across the vertebra, thereby maximizing vertebral end
`plate preservation.
`0080 Spacer 100 includes two separable endplates 110,
`112. A surface 114 of an endplate 110, 112 can be provided
`with teeth or other projections 116 which can penetrate body
`tissue to reduce a likelihood of migration of spacer 100 after
`implantation. Spacer 100 is further secured with one or more
`fasteners, such as bone screws 300, which pass through an
`adapter, such as bone screw socket 118 within spacer 100, and
`into body tissue of the patient. In the embodiment illustrated
`in FIGS. 1-5, two sockets 118 for two bone screws are pro
`vided, although one or more than two fasteners and fastener
`adapters, may be provided. Bone screws 300 can be retained
`in connection with spacer 100 by blocking fasteners 120.
`Bone screw 300 can be a polyaxial screw, and sockets 118
`correspondingly shaped, whereby bone screw 300 may be
`inserted into body tissue at an optimal angle with respect to
`spacer 100, whereby optimal purchase may be obtained, or
`certain body tissue may be avoided.
`0081
`Endplates 110, 112 are moveably connectable to an
`actuator 150 operable to change a relative relationship of
`endplates 110 and 112. Actuator 150 includes a frame 152
`rotatably supporting an actuator screw 154, and a moveable
`carriage 156. As actuator screw 154 rotates within frame 152,
`
`carriage 156 slides within frame 152, driven by cooperation
`between threads 158 upon actuator screw 154, and mating
`threads 160 within frame 152. An implantation tool engage
`ment surface 330 may be provided upon or within spacer 100,
`configured to receive a tool to enable secure manipulation of
`spacer 100 during implantation or removal from the body.
`I0082 In the embodiment of FIGS. 1-6, endplates 110 and
`112 are formed in two connected portions, includingaportion
`122, 122A which can be polymeric, for example PEEK, and
`a fixation portion 124, 124A, which can be metallic, for
`example titanium, although other materials may be used. For
`example, material used for fixation portion 124 should with
`stand the bending forces exerted by a fastener, for example
`bone screw 300, passing therethrough. In contrast, endplate
`material advantageously resiliently withstands a pressure
`applied by weight of the body. In this regard, both materials
`could also be polymeric, for example, but of different types of
`polymer.
`I0083. The portions 122, 124 or 122A and 124A are joined
`in the embodiment shown by Screws, a mechanical interlock,
`adhesive, or other fasteners, possibly in combination, as
`explained further herein. Metallic portions 124, 124A can
`provide greater strength for portions of spacer 100 which are
`under relatively greater stress, for example portions through
`which a fastener may pass to anchor spacer 100 within the
`body. While portions 122, 122A, 124, 124A are described as
`polymeric or metallic, it should be understood that other
`materials may be used, and that the portions can be of similar
`or dissimilar materials, as described further herein.
`I0084. With reference to FIGS. 1 and 3, it may be seen that
`spacer 100 is in a compressed state, having a lower height
`relative to an expanded state, as shown in FIGS. 2 and 4. A
`functioning of device 100 may be best understood with ref
`erence to FIG. 5, which is a cross-section through the center
`of spacer 100. Endplates 110 and 112 are provided with
`ramps 164, sized to slidingly receive ramps 168 disposed
`upon carriage 156. While three mating ramps 164, 168 are
`illustrated for each endplate 110, 112, it should be understood
`that one, two, or more than three sets of ramps 164, 168 may
`be provided. Mating ramps 164, 168 operate to enable a
`reduction or increase in height by sliding against each otheras
`actuator screw 154 is rotated. Interlocking flanges 204, 204A
`rotatably couple actuator screw 154 and carriage 156,
`whereby actuator screw may rotate and advance or retard in
`connection with frame 152, concomitantly advancing or
`retarding carriage 156 along alongitudinal axis of spacer 100
`extending from a distal end 186 and a proximal end 182 of
`frame 152. A reduction in height is further fostered by a
`pressure exerted by body tissue.
`I0085. As may further be seen in FIG. 5, ramps 164 can
`include channels 164A within endplates 110, 112, and ramps
`168 may include dovetail portions 168A which extend into
`ramps 164. By projecting a dovetail portion 168A of ramp
`168 into channels 164A, endplates are moveably affixed to
`carriage 156. Dovetail portions 168A and channels 164A may
`further support a predetermined relative orientation of end
`plates 110, 112 when in a compressed or expanded configu
`ration, while they are being expanded, and when spacer 100 is
`inserted and removed from the body. It should further be
`understood that a relative orientation of endplates 110, 112
`may be substantially parallel, or may be non-parallel, for
`example to produce an effective lordosis. Further, planes
`
`000019
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`

`

`US 2014/0163683 A1
`
`Jun. 12, 2014
`
`defined by an interior portion of endplates 110, 112 may be
`relatively parallel, but bone contacting Surfaces may be rela
`tively non-parallel.
`I0086
`Carriage 156 is alternatively or further supported by
`frame 152 by lateral engagement means, in the embodiment
`shown there are two Support screws 174 engaged with car
`riage 156, and passable through respective channels 176
`formed in frame 152.
`0087. A hex driver (not shown) is inserted into engage
`ment with an end of actuator screw 154 at a proximal end 182
`of frame 152. As actuator screw 154 is turned, distal end 172
`bears against a thrust washer 184, and an end portion of frame
`152. As actuator screw 154 rotates in one direction, carriage
`156 is driven along actuator screw by interaction of threads
`158 and 160 and flanges 204, 204A. As carriage 156 moves,
`endplates 110, 112 are urged to move along ramps 168, and
`168A if present, causing endplates 110, 112 to thereby mov
`ing relatively apart, and to increase a height of spacer 100.
`Endplates 110, 112 are moved relative to carri