An intervertebral scaffolding system is provided having a central beam having a proximal portion having an end, a grafting portion having a top and a bottom, a distal portion having a end, a central beam axis, a graft distribution channel having an entry port at the end of the proximal portion, a to
An intervertebral scaffolding system is provided having a central beam having a proximal portion having an end, a grafting portion having a top and a bottom, a distal portion having a end, a central beam axis, a graft distribution channel having an entry port at the end of the proximal portion, a top exit port at the top of the grafting portion, and a bottom exit port at the bottom of the grafting portion. These systems can also include a laterovertically-expanding frame operable for a reversible collapse from an expanded state into a collapsed state. The expanded state, for example, can be configured to have an open graft distribution window that at least substantially closes upon the reversible collapse.
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1. An intervertebral scaffolding system, comprising; a central beam having a central beam axis;a proximal portion and a distal portion;a top surface with a first top-lateral surface and a second top-lateral surface;a bottom surface with a first bottom-lateral surface and a second bottom-lateral surf
1. An intervertebral scaffolding system, comprising; a central beam having a central beam axis;a proximal portion and a distal portion;a top surface with a first top-lateral surface and a second top-lateral surface;a bottom surface with a first bottom-lateral surface and a second bottom-lateral surface;a first side surface with a first top-side surface and a first bottom-side surface; and,a second side surface with a second top-side surface and a second bottom-side surface;and,a laterovertically-expanding frame configured for operably contacting the central beam to create an intervertebral scaffolding system in vivo, the frame havinga collapsed state and an expanded state, the expanded state operably contacting with the central beam in the intervertebral space;a proximal portion having an end, a distal portion having an end, and a central frame axis of the expanded state;a first top beam including a proximal portion having an end and a distal portion having an end, the first top beam configured for contacting the first top-lateral surface of the central beam and the first top-side surface of the central beam in the expanded state, a central axis of the first top beam at least substantially on (i) a top plane containing the central axis of the first top beam and a central axis of a second top beam and (ii) a first side plane containing the central axis of the first top beam and a central axis of a first bottom beam;the second top beam including a proximal portion having an end and a distal portion having an end, the second top beam configured for contacting the second top-lateral surface of the central beam and the second top-side surface of the central beam in the expanded state, the central axis of the second top beam at least substantially on (i) the top plane and (ii) a second side plane containing the central axis of the second top beam and a central axis of a second bottom beam;the first bottom beam including a proximal portion having an end and a distal portion having an end, the first bottom beam configured for contacting the first bottom-lateral surface of the central beam and the first bottom-side surface of the central beam in the expanded state, the central axis of the first bottom beam at least substantially on (i) a bottom plane containing the central axis of the first bottom beam and the central axis of the second top beam and (ii) the first side plane;the second bottom beam including a proximal portion having an end and a distal region having an end, the second bottom beam configured for contacting the second bottom-lateral surface of the central beam and the second bottom-side surface of the central beam in the expanded state, the central axis of the second bottom beam being at least substantially on (i) the bottom plane and (ii) a second side plane containing the central axis of the second bottom beam and the central axis of the second top beam;a plurality of top connector elements configured to expandably connect the first top beam to the second top beam, the expanding consisting of a flexing at least substantially on the top plane;a plurality of bottom connector elements configured to expandably connect the first bottom beam to the second bottom beam, the expanding consisting of a flexing at least substantially on the bottom plane;a plurality of first side connector elements configured to expandably connect the first top beam to the first bottom beam, the expanding consisting of a flexing at least substantially on the first side plane;a plurality of second side connector elements configured to expandably connect the second top beam to the second bottom beam, the expanding consisting of a flexing at least substantially on the second side plane;wherein,the framing is configured for engaging with the central beam in vivo to support the framing in the expanded state; and,the connector elements are struts configured to have a cross-sectional aspect ratio of longitudinal thickness to transverse thickness adapted to maintain structural stiffness in the laterovertically expanding frame in a direction perpendicular to the central frame axis of the expanded state of the frame. 2. The scaffolding system of claim 1, the distal end of the frame having a slidably translational connection with a guide plate that restricts the first top beam, the first bottom beam, the second top beam, and the second bottom beam to laterovertical movement relative to the guide plate. 3. The scaffolding system of claim 1, the central beam comprising an I-beam. 4. The scaffolding system of claim 1, the central beam further comprising a grafting port. 5. The scaffolding system of claim 1, wherein each of the plurality of connector elements are struts configured in an at least substantially parallel alignment in the expanded state. 6. The scaffolding system of claim 1, wherein each of the plurality of connector elements are struts configured in an at least substantially parallel alignment in the collapsed state. 7. The scaffolding system of claim 1, wherein each of the plurality of connector elements are struts configured in an at least substantially parallel alignment in the expanded state and the collapsed state. 8. The scaffolding system of claim 1, wherein each plurality connector elements are struts; wherein, the top struts are configured monolithically integral to the first top beam and the second top beam; and,the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam;wherein, the top struts and bottom struts of the laterovertically-expanding frame are each configured to open a graft distribution window upon expansion, expanding from the first top beam to the second top beam, the first top beam to the first bottom beam, the second top beam to the second bottom beam, or the first bottom beam to the second bottom beam. 9. The scaffolding system of claim 1, wherein, the top connector struts are configured monolithically integral to the first top beam and the second top beam; and,the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam;the first side struts are configured monolithically integral to the first top beam and the first bottom beam; and,the second side struts are configured monolithically integral to the second top beam and the second bottom beam;wherein, the top, bottom, first side, and second side of the laterovertically-expanding frame form a monolithically integral frame. 10. A method of fusing an intervertebral space using the scaffolding system of claim 1, the method comprising: creating a point of entry into an intervertebral disc, the intervertebral disc having a nucleus pulposus surrounded by an annulus fibrosis;removing the nucleus pulposus from within the intervertebral disc through the point of entry, leaving the intervertebral space for expansion of the scaffolding system of claim 1 within the annulus fibrosis, the intervertebral space having a top vertebral plate and a bottom vertebral plate;inserting the laterovertically expanding frame in the collapsed state through the point of entry into the intervertebral space;inserting the central beam into the frame to form the scaffolding system;and,adding a grafting material to the intervertebral space. 11. The method of claim 10, wherein the struts are adapted to stack in the collapsed state to minimize void space for a low profile entry of the frame into the intervertebral space. 12. The method of claim 10, wherein the expanding includes selecting an amount of lateral expansion independent of an amount of vertical expansion. 13. The method of claim 12, wherein the lateral dimension of the point of entry ranges from about 5 mm to about 15 mm, and the amount of lateral expansion is selected to exceed the lateral dimension of the point of entry. 14. The method of claim 10, wherein the expanding includes expanding the laterovertically expanding frame laterally to a width that exceeds the width of the point of entry; and,inserting the central beam to expand the laterovertically expanding frame vertically to support the frame in the expanded state. 15. The method of claim 10, wherein the inserting of the central beam into the laterovertically expanding frame includes engaging a means for preventing the central beam from backing out of the laterovertically-expanding frame after the expanding. 16. A kit, comprising: the scaffolding system of claim 1;a cannula for inserting the scaffolding system into the intervertebral space;a guidewire adapted for guiding the central beam into the laterovertically expanding frame; and,an expansion handle for inserting the central beam into the laterovertically expanding frame to form the scaffolding system. 17. The kit of claim 16, the distal end of the frame having a slidably translational connection with a guide plate that restricts the first top beam, the first bottom beam, the second top beam, and the second bottom beam to laterovertical movement relative to the guide plate when converting the frame from the collapsed state to the expanded state in vivo. 18. The kit of claim 16; wherein, the top struts are configured monolithically integral to the first top beam and the second top beam; and,the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam;wherein, the top struts and bottom struts of the laterovertically-expanding frame are each configured to open a graft distribution window upon expansion to facilitate graft distribution within the intervertebral space. 19. The kit of claim 16; wherein, the top struts are configured monolithically integral to the first top beam and the second top beam;the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam;the first side struts are configured monolithically integral to the first top beam and the first bottom beam; and,the second side struts are configured monolithically integral to the second top beam and the second bottom beam;wherein, the top, bottom, first side, and second side of the laterovertically-expanding frame form a monolithically integral frame. 20. An intervertebral scaffolding system, comprising: a central beam having a proximal portion having an end, a distal portion having a end, and a central beam axis;a laterovertically-expanding frame having a lumen, a first top beam, a second top beam, a first bottom beam, and a second bottom beam, each having a proximal portion and a distal portion, and each operably connected to each other with connector elements to form the laterovertically-expanding frame having an expanded state and a collapsed state;wherein,the laterovertically-expanding frame is adapted for receiving the central beam to support the frame in the expanded state; and,the connector elements are struts configured to have a cross-sectional aspect ratio of longitudinal thickness to transverse thickness to maintain structural stiffness in the laterovertically expanding frame in a direction perpendicular to the central frame axis of the expanded state of the frame. 21. The scaffolding system of claim 20, wherein, the top struts are configured monolithically integral to the first top beam and the second top beam; and,the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam. 22. The scaffolding system of claim 20, the connector elements including top struts, bottom struts, first side struts, and second side struts; wherein, the top struts are configured monolithically integral to the first top beam and the second top beam;the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam;the first side struts are configured monolithically integral to the first top beam and the first bottom beam;the second side struts are configured monolithically integral to the second top beam and the second bottom beam; and,the beams and struts are monolithically integral in the frame. 23. The scaffolding system of claim 20, the distal end of the frame having a guide plate that restricts the first top beam, the first bottom beam, the second top beam, and the second bottom beam to laterovertical movement relative to the guide plate when converting the frame from the collapsed state to the expanded state in vivo. 24. The scaffolding system of claim 23, wherein the laterovertically-expandable frame has a lumen, and the guide plate has a luminal side with connector for reversibly receiving a guide wire for inserting the laterovertically-expandable frame into the intervertebral space. 25. The scaffolding system of claim 20, the central beam comprising an I-beam. 26. The scaffolding system of claim 20, the central beam further comprising a graft port. 27. A kit, comprising: the scaffolding system of claim 20;a cannula for inserting the scaffolding system into the intervertebral space;a guidewire adapted for guiding the central beam into the laterovertically expanding frame; and,an expansion handle for inserting the central beam into the laterovertically expanding frame. 28. The kit of claim 27, the distal end of the frame having a slidably translational connection with a guide plate that restricts the first top beam, the first bottom beam, the second top beam, and the second bottom beam to laterovertical movement relative to the guide plate when converting the frame from the collapsed state to the expanded state in vivo. 29. A laterovertically-expanding frame, the frame configured for operably contacting a central beam to support the frame in vivo and having a collapsed state and an expanded state, the expanded state operably contacting with the central beam in the intervertebral space;a proximal portion having an end, a distal portion having an end, and a central frame axis of the expanded state;a first top beam including a proximal portion having an end and a distal portion having an end, the first top beam configured for contacting a first top-lateral surface of the central beam and a first top-side surface of the central beam in the expanded state, a central axis of the first top beam at least substantially on (i) a top plane containing the central axis of the first top beam and a central axis of a second top beam and (ii) a first side plane containing the central axis of the first top beam and a central axis of a first bottom beam;the second top beam including a proximal portion having an end and a distal portion having an end, the second top beam configured for contacting a second top-lateral surface of the central beam and a second top-side surface of the central beam in the expanded state, the central axis of the second top beam at least substantially on (i) the top plane and (ii) a second side plane containing the central axis of the second top beam and a central axis of a second bottom beam;the first bottom beam including a proximal portion having an end and a distal portion having an end, the first bottom beam configured for contacting a first bottom-lateral surface of the central beam and a first bottom-side surface of the central beam in the expanded state, the central axis of the first bottom beam at least substantially on (i) a bottom plane containing the central axis of the first bottom beam and the central axis of the second top beam and (ii) the first side plane;the second bottom beam including a proximal portion having an end and a distal region having an end, the second bottom beam configured for contacting a second bottom-lateral surface of the central beam and a second bottom-side surface of the central beam in the expanded state, the central axis of the second bottom beam being at least substantially on (i) the bottom plane and (ii) a second side plane containing the central axis of the second bottom beam and the central axis of the second top beam;a plurality of top connector elements configured to expandably connect the proximal portion of the first top beam to the proximal portion of the second top beam, the expanding consisting of a flexing at least substantially on the top plane;a plurality of bottom connector elements configured to expandably connect the proximal portion of the first bottom beam to the proximal portion of the second bottom beam, the expanding consisting of a flexing at least substantially on the bottom plane;a plurality of first side connector elements configured to expandably connect the proximal portion of the first top beam to the proximal portion of the first bottom beam, the expanding consisting of a flexing at least substantially on the first side plane;a plurality of second side connector elements configured to expandably connect the proximal portion of the second top beam to the proximal portion of the second bottom beam, the expanding consisting of a flexing at least substantially on the second side plane;wherein,the connector elements are struts extending between their respective beams and have a cross-sectional aspect ratio of longitudinal thickness to transverse thickness adapted to maintain structural stiffness in the laterovertically expanding frame in a direction perpendicular to the central frame axis of the expanded state of the frame. 30. The laterovertically-expandable frame of claim 29, wherein the plurality of top struts are configured to create a top graft distribution window, the top graft distribution window expanding from the first top beam to the second top beam;the plurality of first side struts are configured to create a first side graft distribution window, the first side graft distribution window expanding from the first top beam to the first bottom beam;the plurality of second side struts are configured to create a second side graft distribution window, the second side graft distribution window expanding from the second top beam to the second bottom beam; or,the plurality of bottom struts are configured to create a bottom graft distribution window, the bottom graft distribution window expanding from the first bottom beam to the second bottom beam. 31. The laterovertically-expandable frame of claim 29, wherein the top struts are configured monolithically integral to the first top beam and the second top beam and adapted to flex toward the distal top struts during collapse; and,the bottom struts are configured monolithically integral to the first bottom beam and the second bottom beam and adapted to flex toward the distal bottom struts during collapse;the first side struts are configured monolithically integral to the first top beam and the first bottom beam and adapted to flex toward the distal first side struts during collapse; and,the second side struts are configured monolithically integral to the second top beam and the second bottom beam and adapted to flex toward the distal second side struts during collapse.
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