An instrument may be coupled to a multi-axis expandable intervertebral cage so that the cage may be inserted into an intervertebral space, expanded along multiple different directions, filled with bone graft, and locked with a fastener. The instrument may be part of an instrument set that includes auxiliary instruments to determine implant size, insert bone graft into the cage, and deliver the fastener.

A fusion cage may include an upper endplate directly hinged to a lower endplate. The fusion cage may be adjustable to provide various angles between the endplates. An insert may be coupled between the endplates to lock the endplates at a selected angle. Fasteners may extend through the fusion cage into adjacent bone portions. An instrument may couple to an endplate so that the hinged-together endplates may be inserted between bone portions. The instrument may be used to adjust the angle between the endplates and to couple the insert between the endplates.

An instrument may be coupled to a multi-axis expandable intervertebral cage so that the cage may be inserted into an intervertebral space, expanded along multiple different directions, filled with bone graft, and locked with a fastener. The instrument may be part of an instrument set that includes auxiliary instruments to determine implant size, insert bone graft into the cage, and deliver the fastener.

A fusion cage may include an upper endplate directly hinged to a lower endplate. The fusion cage may be adjustable to provide various angles between the endplates. An insert may be coupled between the endplates to lock the endplates at a selected angle. Fasteners may extend through the fusion cage into adjacent bone portions. An instrument may couple to an endplate so that the hinged-together endplates may be inserted between bone portions. The instrument may be used to adjust the angle between the endplates and to couple the insert between the endplates.