fig1 shows the spinal implant 100 releasably attached to an insertion instrument 200 . the implant 100 may be made by made of peek plastic commonly used in spinal implants . the implant includes a hemispherical mount 105 and slanted cam surface 106 from which the mount protrudes . the tip of rod 201 pivotably attaches to the mount such that the implant may pivot with respect to the axis of the instrument . the pivoting of the implant is controlled by the a knob on the instrument that rotates the cam wings 205 about the hemispherical surface . the rotation of the cam , slides the front edges of the cam wings across the and cam surface 106 and thereby forces the implant to pivot with respect to the axis of the instrument . a knob ( e . g . actuator wings ) 206 on the on the proximal end of the instrument enables a surgeon to rotate the cam and thereby adjust the angle between the implant and the axis of the instrument . pivoting of the implant is caused as the actuator pushers 205 ( e . g ., cam ) act on the slanted surface 106 of the implant 100 . as the cammed actuator 202 rotate and slide across the slanted surface 106 , the implant makes a yaw movement with respect to the axis of the instrument . actuator 202 is equipped with the actuator wings 206 used to rotate pushers 205 ( cam ) from outside of the patient &# 39 ; s body . locking knob 207 may be tightened to bind the actuator against the implant effectively locking the implant with respect to the instrument . when locked , axial force and torque can be applied to the handle 204 to advance the implant into the spinal space and position the implant in the space . turning the locking knob 207 that is threaded inside and engages threads on the proximal end of the rod causes the actuator 202 that is hollow to slide axially forward over the threaded rod 201 and thereby loosen or tighten the actuator against the implant . fig2 shows the details of the attachment of the implant 100 to the instrument 200 . threaded pin 102 is inserted into the channel 107 in the spherical protrusion ( mount ) 105 and retained there by a snap ring 103 . a threaded hollow shaft 108 in the threaded pin 102 is aligned with the slot opening 109 of the implant so that the treaded rod 201 can be threaded into the shaft 108 of the pin 102 . slot opening allows pivoting of the implant by accommodating the pendulum motion of the rod 201 . pin 104 is made of a material that enhances x - ray imaging . making the pin visible assists the physician in the positioning of the implant while viewing a real - time x - ray image of the implant and vertebra . the actuator 202 may be a hollow tube that is coaxial with the rod 201 . the pushers are fixed to the distal end of the actuator . the pushers 205 include cams that engage a cam surface 106 on the implant . the proximal end of the tube has a knob ( e . g . actuator wings ) 206 to turn the tube and thereby move the cams against the cam surface . the angle of the implant with respect to the implant is adjusted by moving the cam against the cam surface . adjusting the angle may allow the surgeon to properly place the implant in the spine area . fig3 illustrates the interaction between the actuator 202 of the instrument and the implant 100 . the actuator 202 is rotated around the axis of the threaded rod 201 that is engaged in the threaded pin 102 . as the cammed pushers 205 rotate , they push against the surface 106 . as a result the implant 100 turns around the axis of the pin 102 . it can be envisioned as if the implant is performing a “ dog wagging its tail ” motion with respect to the insert instrument 200 . if the locking knob 207 ( fig1 ) is rotated , the actuator 202 is pushed against the implant 100 . both pushers are advanced towards the surface 106 to bind the actuator against the implant so as to lock the implant with respect to the instrument . when locked , the assembly of the implant and instrument can be advanced while retaining the desired angle of the implant 100 in relation to the insertion instrument 200 . fig4 shows the implant 100 with the insertion instrument 200 attached and in position on a patient vertebra 401 . rotation of the actuator 202 in relation to the axis of the threaded rod 201 results in the rotation of the implant 100 around the axis of the pin 102 . rotation of the knob 207 pushes the actuator 202 into the implant locking the assembly . when the assembly is locked hammer tapping can be applied to the handle 204 to advance the assembly forward . a spinal implant may be used to stabilize a portion of a spine . the implant may promote bone growth between adjacent vertebra that fuses the vertebra together . an implant may include an opening through a height of a body of the implant . the body of the implant may include curved sides . a top and / or a bottom of the implant may include protrusions that contact and / or engage vertebral surfaces to prevent backout of the implant from the disc space . a spinal implant may be used to provide stability and promote fusion of adjacent vertebra . the implant may be used in conjunction with a spinal stabilization device such as a bone plate or rod - and - fastener stabilization system . the implant may establish a desired separation distance between vertebra . the implant may promote bone growth between adjacent vertebra that fuses the vertebra together . instrument at is necessary for insertion of an implant in a patient and alignment of the implant in the space . a discectomy may be performed to establish a disc space between vertebra . the disc space may be prepared for implant insertion by distraction of adjacent vertebra , rasping and filing of the bone to achieve the desired spacing . it is desired to perform insertion of the implant and positioning of the implant using minimum number of inserted instruments and thought the smallest possible insertion channel in the body . implants may be constructed of biocompatible materials sufficiently strong to maintain spinal distraction . implants may include , but are not limited to , allograft bone , xenograft bone , autograft bone , metals , ceramics , inorganic compositions , polymers such as peek , or combinations thereof . if the implant is not made of bone , surfaces of the implant that contact bone may be treated to promote fusion of the implant to the bone . treatment may include , but is not limited to , applying a hydroxyapatite coating on contact surfaces , spraying a titanium plasma on contact surfaces , and / or texturing the contact surfaces by scoring , peening , implanting particles in the surfaces , or otherwise roughening the surfaces . in some embodiments , an implant may include an opening that extends through a body of the implant . the opening may have a regular shape or an irregular shape . bone graft may be placed in the opening . the bone graft may be autogenic bone graft , allogenic bone graft , xenogenic bone graft , and / or synthetic bone graft . some implant embodiments may be constructed from allogenic bone , such as cortical bone from a femur , tibia , or other large bone . in some embodiments , an implant may be formed from one or more pieces of allograft bone cut to a desired shape . in certain embodiments , sides of an implant may be shaped to increase contact between an implant and adjacent vertebra with notches , ribs and other similar features . increasing contact of an implant with adjacent vertebra may inhibit movement of the implant after insertion . an increased contact area between an implant and adjacent vertebra may promote bone growth between adjacent vertebra . in some embodiments , one or more sides of an implant may be curved . one or more curved sides of an implant may allow the implant to be maneuvered in a disc space during insertion of the implant . the curvature of a side may approximate a curvature of an anterior side of a vertebra adjacent to which the implant is inserted . instruments may be used to prepare a space for an implant between adjacent vertebra . an instrument may be used to insert an implant in a prepared space . instruments may be supplied to a surgeon or surgical team in an instrument set . an instrument set may include one or more implants for use during an insertion procedure . an instrument set may include implants of various sizes and / or lordotic angles to allow selection of an implant to suit a patient during surgery . instrument is attached to the implant before the insertion into the body . when the desired position of the implant is achieved , instrument is disengaged from the implant and can be extracted from the body . an instrument acts as an implant inserter . the implant inserter may be used to push the implant and to rotate the implant . after insertion of the implant , the implant may be released from the inserter without the application of significant repositioning forces to the implant . it can be imagined that the insertion instrument can be screwed into the implant using threads or use other techniques such as a tightening collet , jamming or grabbing . in the disclosed embodiment the implant turns around the axis of the implant pin as a result of the rotation of cam pushers . it can be imagined that other mechanisms can be used to rotate the implant such as ratchets or threaded push rods . the implant inserter may have a low profile that allows for visualization of the implant and surrounding area during insertion of the implant . implant is equipped to couple and uncouple from the instrument . while the invention has been described in connection with what is presently considered to be the most practical and preferred embodiment , it is to be understood that the invention is not to be limited to the disclosed embodiment , but on the contrary , is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims .
a spinal implant include a top , wherein at least a portion of the top is configured to contact a first vertebra , a bottom , wherein at least a portion of the bottom is configured to contact a second vertebra , a side having a releasable attachment to receive an insertion device and a cam surface to engage a cam on the insertion device