An intervertebral implant can include a housing having a first end and second end with a top side and bottom side therebetween, with at least one engagement opening in the top side and/or bottom side, the implant having a first dimension from the top side to the bottom side; a shaft rotatably located within the housing and having a shaft head exposed through an end opening in the first end, the shaft head having a tool coupling member; the cam mechanism operably coupled with the shaft such that rotation of the shaft rotates the cam mechanism; and at least one engaging surface operably coupled to the cam mechanism such that rotation of the shaft protrudes and/or retracts each engaging surface through an engagement opening, wherein when each engaging surface protrudes through the engagement opening, the implant has a second dimension that is greater than the first dimension.