Expandable fusion device with independent expansion systems
Expandable spinal fusion devices, systems, and methods of using them are provided, and they can be inserted in a subject in a collapsed state through a small surgical corridor, and the expand cephalocaudal only, transverse only, or in both directions, in which direction of expansion can also be obtained independently, if desired, after the insertion. These inventions are valuable in reducing risk and surgical complexity, allowing for an on-the-fly selection of a desirable width footprint, a desired control of height expansion through a gradual cephalocaudal expansion, and a desired control of the alignment of the adjacent vertebral bodies. Devices, systems, and methods are also offered to provide a desired control of the contact area desired between the device and the upper and lower vertebral endplates achieved, for example, using an interdigitated endplate system.
1. An expandable fusion device that is expandable in length, the device comprising:
a first expandable device coupled to a second expandable device;
a first actuator for expanding the first expandable device and the second expandable device wherein, the first actuator is part of a drive system having a first wedge assembly for the first expandable device coupled to the first actuator; and, a first ramp assembly slidably coupled with the first wedge assembly;
and,
a second actuator configured for coupling the first expandable device to the second expandable device, a second wedge assembly for the second expandable device coupled to the first actuator; and, a second ramp assembly slidably coupled with the second wedge assembly,
each of the first expandable device and the second expandable device include a first endplate, a second endplate, a third endplate, and a fourth endplate, each endplate of which is slidably coupled with its respective ramp assembly.
2. A laterally expandable fusion device, comprising
an upper endplate assembly having a first endplate with a first plurality of protrusions and a second endplate with a second plurality of protrusions; and
a lower endplate assembly having a third endplate with a third plurality of protrusions and a fourth endplate with a fourth plurality of protrusions;
wherein,
the first plurality of protrusions are interdigitated with the second plurality of protrusions to telescope upon lateral expansion and provide a surface for contact with an upper vertebral endplate in an intervertebral space;
the third plurality of protrusions are interdigitated with the fourth plurality of protrusions to telescope upon lateral expansion and provide a surface for contact with a lower vertebral endplate in an intervertebral space; and,
each of the first endplate, second endplate, third endplate, and fourth endplate has (i) a plurality of grooves for receiving each of the respective plurality of protrusions upon a collapse of the device, and, (ii) translation of each of the respective plurality of interdigitated protrusions upon expansion of the device.
3. The laterally expandable fusion device of claim 2 , wherein
the first plurality of protrusions and the second plurality of protrusions slidably translate with a tongue-in-groove configuration to provide additional rigidity to the upper endplate assembly upon the lateral expansion; and,
the third plurality of protrusions and the fourth plurality of protrusions slidably translate with a tongue-in-groove configuration to provide additional rigidity to the lower endplate assembly upon the lateral expansion.