Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20060149375 A1
Publication typeApplication
Application numberUS 11/276,541
Publication dateJul 6, 2006
Filing dateMar 3, 2006
Priority dateMay 14, 2003
Also published asCA2524022A1, CN1787795A, EP1628600A1, EP1628600B1, US8409254, US20040230304, US20070168029, US20080275505, WO2004103227A1
Publication number11276541, 276541, US 2006/0149375 A1, US 2006/149375 A1, US 20060149375 A1, US 20060149375A1, US 2006149375 A1, US 2006149375A1, US-A1-20060149375, US-A1-2006149375, US2006/0149375A1, US2006/149375A1, US20060149375 A1, US20060149375A1, US2006149375 A1, US2006149375A1
InventorsHansen Yuan, David Stinson, Lawrence Jones, Mark Reiley
Original AssigneeYuan Hansen A, David Stinson, Jones Lawrence R, Reiley Mark A
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Prostheses, Tools And Methods For Replacement Of Natural Facet Joints With Artificial Facet Joint Surfaces
US 20060149375 A1
Abstract
Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. The cephalad prostheses are adapted and configured to be attached to a lamina portion of a vertebra without blocking a pedicle portion of the cephalad vertebra.
Images(16)
Previous page
Next page
Claims(26)
1-102. (canceled)
103. A facet implant comprising:
a superior implant having an articulating surface and a fixation surface and being configured for placement on a superior articular facet;
a inferior implant having an articulating surface and a fixation surface and being configured for placement on an inferior articular facet and for interacting with a translaminar fixation mechanism, whereby the articulating surface of the superior implant and the articulating surface of the inferior implant are configured to interact; and
a translaminar fixation mechanism for securing the inferior implant to the inferior articular facet.
104. The facet implant of claim 103 wherein the translaminar fixation mechanism comprises at least one of: a translaminar screw, a bolt and a fixation pin.
105. The facet implant of claim 103 wherein at least one of the superior implant and the inferior implant comprises a surface fixation mechanism.
106. The facet implant of claim 105 wherein the surface fixation mechanism comprises at least one of: one or more pegs, one or more pips, ridges, one or more screws.
107. The facet implant of claim 105 wherein the surface fixation mechanism comprises multiple regions wherein each of the regions has ridges oriented in a different direction.
108. The facet implant of claim 103 wherein at least one of the fixation surfaces of the inferior implant and the superior implant has at least one of: a porous coating, a porous onlay material, a biologic coating, and a surface treatment.
109. The facet implant of claim 103 wherein the articulating surface of the superior implant is generally curved.
110. The facet implant of claim 103 wherein the fixation surface of the superior implant is generally curved.
111. The facet implant of claim 103 wherein the articulating surface of the inferior implant is generally curved.
112. The facet implant of claim 103 wherein at least one of the articulating surfaces of the inferior implant and the superior implant is composed of at least one of: cobalt, chromium alloy, ceramic, UHMWPE, pyrolytic carbon, and Ti/Al/V.
113. A facet implant comprising:
a superior implant having a fixation surface and a generally curved articulating surface, the superior implant being configured for placement on a specifically prepared articulating surface of a superior articular facet; and
an inferior implant having a fixation surface and a generally convex articulating surface, the inferior implant being configured for placement on a specifically prepared articulating surface of an inferior articular facet, whereby the generally curved articulating surface of the superior implant and the generally convex articulating surface of the inferior implant being configured to interact.
114. The facet implant of claim 113 wherein at least one of the superior implant and the inferior implant comprises a surface fixation mechanism.
115. The facet implant of claim 114 wherein the surface fixation mechanism comprises at least one of: one or more pegs, one or more pips, ridges, and one or more screws.
116. The facet implant of claim 114 wherein the surface fixation mechanism comprises multiple regions wherein each of the regions has ridges oriented in a different direction.
117. The facet implant of claim 113 wherein at least one of the fixation surfaces of the inferior implant and the superior implant has at least one of: a porous coating, a porous onlay material, a biologic coating, and a surface treated to facilitate bone ingrowth.
118. The facet implant of claim 113 wherein at least one of the articulating surfaces of the inferior implant and the superior implant is composed of at least one of: cobalt, chromium alloy, ceramic, UHMWPE, paralytic carbon, and Ti/Al/V.
119. A facet implant comprising:
a superior implant having a fixation surface and a generally curved articulating surface, the superior implant being configured for placement on a specifically prepared articulating surface of a superior articular facet;
a inferior implant having a fixation surface and a generally convex articulating surface, the inferior implant being configured for placement on a specifically prepared articulating surface of an inferior articular facet and for interacting with a translaminar screw, whereby the articulating surface of the superior implant and the articulating surface of the inferior implant being configured to interact; and
a translaminar fixation mechanism for securing the inferior implant to the inferior articular facet.
120. A method for providing articulating surfaces for facet joint articular facets comprising:
removing a portion of a superior articular facet or an inferior articular facet;
using a surgical instrument to prepare the articulating surface of the inferior articular facet for an inferior implant;
using a surgical instrument to prepare the articulating surface of the superior articular facet for a superior implant;
placing the inferior implant on the inferior articular facet such that an articulating surface of the inferior implant is positioned on the articulating surface of the inferior articular facet;
placing the superior implant on the superior articular facet such that an articulating surface of the superior implant is positioned on the articulating surface of the superior articular facet;
wherein the articulating surface of the superior implant and the articulating surface of the inferior implant are configured to articulate with one another.
121. The method of claim 120 wherein each of the steps are repeated on articular facets on a contralateral side of the facet joint.
122. The method of claim 120 wherein the articulating surfaces of the superior and inferior articular facets are prepared to accommodate the superior and inferior implants.
123. The method of claim 122 wherein the articulating surfaces of the superior and inferior articular facets are prepared such that the shape and dimension of superior articular facet resembles the superior implant and the shape and dimension of the inferior articular facet resembles the inferior implant.
124. The method of claim 120 wherein the inferior and superior articulating surfaces are prepared by the same surgical instrument.
125. The method of claim 120, further comprising securing the inferior implant to the inferior articular facet with a translaminar fixation mechanism.
126. The method of claim 125 wherein securing the inferior implant to the inferior articular facet with a translaminar fixation mechanism comprises using an aiming device to position the translaminar fixation mechanism.
127. The method of claim 125 further comprising drilling a translaminar hole for the translaminar fixation mechanism.
Description
    FIELD OF THE INVENTION
  • [0001]
    This invention relates to prostheses for treating various types of spinal pathologies, as well as to methods of treating spinal pathologies.
  • BACKGROUND OF THE INVENTION
  • [0000]
    I. Vertebral Anatomy
  • [0002]
    As FIG. 1 shows, the human spinal column 10 is comprised of a series of thirty-three stacked vertebrae 12 divided into five regions. The cervical region includes seven vertebrae 12, known as C1-C7. The thoracic region includes twelve vertebrae 12, known as T1-T12. The lumbar region contains five vertebrae 12, known as L1-L5. The sacral region is comprised of five vertebrae 12, known as S1-S5. The coccygeal region contains four vertebrae 12, known as Co1-Cu4.
  • [0003]
    FIG. 2 shows a normal human lumbar vertebra 12. Although the lumbar vertebrae 12 vary somewhat according to location, they share many features common to most vertebrae 12. Each vertebra 12 includes a vertebral body 14 and posterior elements as follows:
  • [0004]
    Two short bones, the pedicles 16, extend backward from each side of the vertebral body 14 to form a vertebral arch 18. At the posterior end of each pedicle 16 the vertebral arch 18 flares out into broad plates of bone known as the laminae 20. The laminae 20 fuse with each other to form a spinous process 22. The spinous process 22 serves for muscle and ligamentous attachment. A smooth transition from the pedicles 16 into the laminae 20 is interrupted by the formation of a series of processes.
  • [0005]
    Two transverse processes 24 thrust out laterally on each side from the junction of the pedicle 16 with the lamina 20. The transverse processes 24 serve as levers for the attachment of muscles to the vertebrae 12. Four articular processes, two superior 26 and two inferior 28, also rise from the junctions of the pedicles 16 and the laminae 20. The superior articular processes 26 are sharp oval plates of bone rising upward on each side from the union of the pedicle 16 with the lamina 20. The inferior processes 28 are oval plates of bone that extend in an inferior direction on each side.
  • [0006]
    The superior and inferior articular processes 26 and 28 each have a natural bony structure known as a facet. The superior articular facet 30 faces upward or superiorly, while the inferior articular facet 31 faces downward. As FIG. 3 shows, when adjacent (i.e., cephalad and caudal) vertebrae 12 are aligned, the facets 30 and 31, capped with a smooth articular cartilage, interlock to form a facet joint 32, also known as a zygapophysial joint.
  • [0007]
    The facet joint 32 is composed of a superior half and an inferior half. The superior half is formed by the vertebral level below the joint 32, and the inferior half is formed by the vertebral level above the joint 32. For example, in the L4-L5 facet joint, the superior portion of the joint is formed by bony structure on the L-5 vertebra (e.g., a superior articular surface and supporting bone on the L-5 vertebra), and the inferior portion of the joint is formed by bony structure on the L-4 vertebra (e.g., an inferior articular surface and supporting bone on the L-4 vertebra).
  • [0008]
    As also shown in FIG. 3, an intervertebral disc 34 between each pair of vertebrae 12 permits relative movement between vertebrae 12. Thus, the structure and alignment of the vertebrae 12 permit a range of movement of the vertebrae 12 relative to each other.
  • [0000]
    II. Facet Joint Dysfunction
  • [0009]
    Back pain, particularly in the “small of the back”, or lumbosacral (L4-S1) region, is a common ailment. In many cases, the pain severely limits a person's functional ability and quality of life. Such pain can result from a variety of spinal pathologies.
  • [0010]
    Through disease or injury, the laminae, spinous process, articular processes, or facets of one or more vertebrae can become damaged, such that the vertebrae no longer articulate or properly align with each other. This can result in an undesired anatomy, pain or discomfort, and loss of mobility.
  • [0011]
    For example, the vertebral facet joints can be damaged by either traumatic injury or by various disease processes. These disease processes include osteoarthritis, ankylosing spondylolysis, and degenerative spondylolisthesis. The damage to the facet joints often results in pressure on nerves, also called a “pinched” nerve, or nerve compression or impingement. The result is pain, misaligned anatomy, and a corresponding loss of mobility. Pressure on nerves can also occur without facet joint pathology, e.g., a herniated disc.
  • [0012]
    One type of conventional treatment of facet joint pathology is spinal stabilization, also known as intervertebral stabilization. Intervertebral stabilization prevents relative motion between the vertebrae. By preventing movement, pain can be reduced. Stabilization can be accomplished by various methods.
  • [0013]
    One method of stabilization is posterior spinal fusion. Another method of stabilization is anterior spinal fusion, fixation of any number of vertebrae to stabilize and prevent movement of the vertebrae.
  • [0014]
    Another type of conventional treatment is decompressive laminectomy. This procedure involves excision of the laminae to relieve compression of nerves.
  • [0015]
    These traditional treatments are subject to a variety of limitations and varying success rates. Furthermore, none of the described treatments puts the spine in proper alignment or return the spine to a desired anatomy. In addition, stabilization techniques, by holding the vertebrae in a fixed position, permanently limit the relative motion of the vertebrae, altering spine biomechanics.
  • SUMMARY OF THE INVENTION
  • [0016]
    There is a need for prostheses, installation tools, and methods that overcome the problems and disadvantages associated with current strategies and designs in various treatments for spine pathologies.
  • [0017]
    The invention provides prostheses, installation tools, and methods designed to replace natural facet joints at virtually all spinal levels including L1-L2, L2-L3, L3-L4, L4-L5, L5-S1, T-11-T12, and T12-L1. The prostheses, installation tools, and methods can restore a desired anatomy to a spine and give back to an individual a desired range of relative vertebral motion. The prostheses, installation tools, and methods also can lessen or alleviate spinal pain by relieving the source of nerve compression or impingement.
  • [0018]
    For the sake of description, the prostheses that embody features of the invention will be called either “cephalad” or “caudal” with relation to the portion of a given natural facet joint they replace. As previously described, a given natural facet joint has a superior half and an inferior half. In anatomical terms, the superior half of the joint is formed by the vertebral level below the joint (which can thus be called the caudal portion of the facet joint, i.e., because it is near the feet). The inferior half of the joint is formed by the vertebral level above the joint (which can thus be called the cephalad portion of the facet joint, i.e., because it is near the head). Thus, a prosthesis that, in use, replaces the caudal portion of a facet joint (i.e., the superior half) will be called a “caudal” prosthesis. Likewise, a prosthesis that, in use, replaces the cephalad portion of a facet joint (i.e., the inferior half) will be called a “cephalad” prosthesis.
  • [0019]
    One aspect of the invention provides a cephalad facet joint prosthesis to replace a cephalad portion of a natural facet joint (e.g., an inferior articular surface and its supporting bone structure on the posterior elements of the vertebra) in the posterior elements of a vertebra. According to this aspect of the invention, the prosthesis includes an artificial facet joint element adapted and configured to replace a cephalad portion of the natural facet joint and a fixation element extending from the artificial facet joint element, the fixation element being adapted and configured to be inserted through a lamina portion of a vertebra to affix the artificial facet joint element to the vertebra, preferably without blocking access to a pedicle portion of the vertebra. The fixation element may also extend through a second lamina portion of the vertebra, such as by traversing the midline of the vertebra through or adjacent to the spinous process. In one embodiment, after installation the cephalad bearing element is disposed between a caudal facet joint bearing surface and a portion of the vertebra, such as a lamina portion.
  • [0020]
    This aspect of the invention also provides a method of implanting an artificial cephalad facet joint prosthesis on a vertebra and/or the posterior elements of a vertebra. According to this method, a fixation element is inserted through a lamina portion of the vertebra, and a cephalad facet joint bearing surface is placed in a position to form a cephalad portion of a facet joint. An artificial facet joint element is attached to a distal end of the fixation element either after or prior to insertion of the fixation element. The fixation element preferably does not block access to a pedicle portion of the vertebra. The fixation element may also extend through a second lamina portion of the vertebra, such as by traversing the midline of the vertebra through or adjacent to the spinous process. In one embodiment, the placing step includes disposing the artificial facet joint bearing surface between a caudal facet joint bearing surface and a portion of the vertebra, such as a lamina portion. The method may also include the steps of using a guide to define an insertion path for the fixation element and forming a passage through the lamina corresponding to the insertion path.
  • [0021]
    Another aspect of the invention provides a prosthesis to replace a cephalad portion of a natural facet joint on a vertebra. In this aspect of the invention the prosthesis includes an artificial facet joint element adapted and configured to replace a cephalad portion of the natural facet joint; and a fixation element adapted and configured to affix the artificial facet joint element to the vertebra without blocking access to a pedicle portion of the vertebra. In one embodiment, after installation the cephalad bearing element is disposed between a caudal facet joint bearing surface and a portion of the vertebra, such as a lamina portion.
  • [0022]
    This aspect of the invention also provides a method for implanting a cephalad facet joint prosthesis to replace a removed cephalad portion of a natural facet joint on a vertebra. The method includes the steps of aligning the cephalad facet joint prosthesis with a caudal facet joint bearing surface; and attaching the cephalad facet joint prosthesis to the vertebra without blocking a pedicle portion of the vertebra. The attaching step of the method may also include disposing the cephalad facet joint prosthesis between the caudal facet joint bearing surface and a portion of the vertebra. The attaching step may also include the step of inserting a fixation element through a portion of the vertebra, such as the lamina. In this case, the method may include the steps of defining an insertion path in the vertebra prior to the inserting step and forming a passage in the vertebra corresponding to the insertion path. A guide may be used to direct the location and orientation of the insertion path.
  • [0023]
    Another aspect of the invention provides a facet joint prosthesis to replace, on a vertebra, a caudal portion of a natural facet joint (e.g., a superior articular surface and supporting bone structure on the vertebra). The prosthesis includes an artificial facet joint element with a vertebra contacting surface and a caudal bearing surface, the caudal bearing surface being adapted and configured to replace a caudal portion of a natural facet joint and to be substantially entirely posterior of a contact portion of the vertebra when the vertebra contacting surface contacts the contact portion. The prosthesis also includes a fixation element extending from the artificial facet joint element, the fixation element being adapted and configured to be inserted into the vertebra to affix the prosthesis to the vertebra.
  • [0024]
    Another aspect of the invention provides a prosthesis for replacing a caudal portion and a cephalad portion of a natural facet joint of cephalad and caudal vertebrae of a spine motion segment. The prosthesis includes an artificial cephalad facet joint element adapted and configured to replace a cephalad portion of the natural facet joint, the artificial cephalad facet joint element having a cephalad bearing surface; a cephalad fixation element, the cephalad fixation element being adapted and configured to be inserted through a lamina portion of a vertebra to affix the artificial cephalad facet joint element to the cephalad vertebra; and an artificial caudal facet joint element adapted and configured to replace a caudal portion of the natural facet joint, the artificial caudal facet joint element including a caudal bearing surface adapted and configured to mate with the cephalad bearing surface.
  • [0025]
    Yet another aspect of the invention provides a method for implanting a facet joint prosthesis to replace removed cephalad and caudal portions of a natural facet joint of cephalad and caudal vertebrae. The method includes the steps of: affixing an artificial caudal facet joint element to the caudal vertebra; inserting a cephalad fixation element through a lamina portion of the cephalad vertebra; and placing an artificial cephalad facet joint bearing surface in a position to form a cephalad portion of a facet joint. The method may also include attaching an artificial cephalad facet joint element comprising the cephalad facet joint bearing surface to an end of the fixation element either prior to or after the inserting step. In one embodiment, the fixation element does not block access to a pedicle portion of the cephalad vertebra. The cephalad fixation element may also extend through a second lamina portion of the cephalad vertebra, such as by traversing the midline of the cephalad vertebra through or adjacent to the spinous process. The placing step may also include the step of disposing the artificial cephalad facet joint bearing surface between the artificial caudal facet joint element and a portion of the cephalad vertebra. An installation fixture may be used to align the caudal and cephalad elements, although the prosthesis may also be installed without using an installation fixture. The method may also include the step of using a guide to define an insertion path for the cephalad fixation element, although the prosthesis may also be installed without using a guide.
  • [0026]
    Another aspect of the invention provides a prosthesis to replace a caudal portion and a cephalad portion of a natural facet joint of cephalad and caudal vertebrae. The prosthesis may include an artificial cephalad facet joint element adapted and configured to replace a cephalad portion of the natural facet joint, with the artificial cephalad facet joint element including a cephalad bearing surface; a cephalad fixation element adapted and configured to affix the artificial cephalad facet joint element to the cephalad vertebra without blocking access to a pedicle portion of the cephalad vertebra; and an artificial caudal facet joint element adapted and configured to replace a caudal portion of the natural facet joint, the artificial caudal facet joint element including a caudal bearing surface adapted and configured to mate with the cephalad bearing surface. In one embodiment, after installation the cephalad facet joint bearing surface is disposed between a caudal facet joint bearing surface and a portion of the vertebra, such as a lamina portion. In one embodiment, the cephalad bearing surface and the caudal bearing surface each has a width along its respective transverse axis, with the cephalad bearing surface width being shorter than the caudal bearing surface width. The artificial caudal facet joint element may also include a vertebra contacting surface, with the entire caudal bearing surface being adapted and configured to be posterior of a contact portion of the caudal vertebra when the vertebra contacting surface contacts the contact portion.
  • [0027]
    This aspect of the invention also includes a method for implanting a facet joint prosthesis to replace removed cephalad and caudal portions of a natural facet joint of cephalad and caudal vertebrae. The method includes the steps of affixing an artificial caudal facet joint element to the caudal vertebra; and affixing an artificial cephalad facet joint element to the cephalad vertebra in alignment with the artificial caudal facet joint element and without blocking access to a pedicle portion of the cephalad vertebra. The second affixing step may also include the step of disposing the artificial cephalad facet joint element between the artificial caudal facet joint element and a portion of the cephalad vertebra. An installation fixture may be used to align the caudal and cephalad element, although the prosthesis may also be installed without using an installation fixture. The method may also include the step of using a guide to define an insertion path for the cephalad fixation element, although the prosthesis may also be installed without using a guide.
  • [0028]
    Other features and advantages of the inventions are set forth in the following Description and Drawings, as well as in the appended Claims.
  • DESCRIPTION OF THE DRAWINGS
  • [0029]
    FIG. 1 is a lateral elevation view of a normal human spinal column;
  • [0030]
    FIG. 2 is a superior view of a normal human lumbar vertebra;
  • [0031]
    FIG. 3 is a lateral elevation view of a vertebral lumbar facet joint;
  • [0032]
    FIG. 4 is a posterior view of an artificial facet joint prosthesis installed in a patient according to one embodiment of this invention;
  • [0033]
    FIG. 5 is a left side view of the embodiment of FIG. 4, as installed in a patient;
  • [0034]
    FIG. 6 is yet another view of the embodiment of FIG. 4, as installed in a patient;
  • [0035]
    FIG. 7A is a cross-sectional view of a cephalad bearing element and fixation element according to the embodiment of FIG. 4;
  • [0036]
    FIG. 7B is a posterior view of a pair of artificial cephalad and caudal facet joint prostheses according to one embodiment of this invention;
  • [0037]
    FIG. 7C is a top view of a pair of artificial cephalad and caudal facet joint prostheses in the embodiment of FIG. 7A;
  • [0038]
    FIG. 7D is a left view of a pair of artificial cephalad and caudal facet joint prostheses in the embodiment of FIG. 7A;
  • [0039]
    FIG. 7E is a bottom view of a pair of artificial cephalad and caudal facet joint prostheses in the embodiment of FIG. 7A;
  • [0040]
    FIG. 7F is an anterior view of a pair of artificial cephalad and caudal facet joint prostheses in the embodiment of FIG. 7A;
  • [0041]
    FIG. 8A is a perspective view of an installation fixture according to one embodiment of this invention;
  • [0042]
    FIG. 8B is a top view of the installation fixture of FIG. 8A;
  • [0043]
    FIG. 8C is a side view of the installation fixture of FIG. 8A;
  • [0044]
    FIG. 8D is a back view of the installation fixture of FIG. 8A;
  • [0045]
    FIG. 9 is an exploded view of the installation fixture of FIG. 8 along with a pair of caudal facet bearing elements and a pair of cephalad facet bearing elements according to one embodiment of the invention;
  • [0046]
    FIGS. 10A-D are views of a guide tool according to one embodiment of the invention;
  • [0047]
    FIG. 11 is a posterior view of the installation fixture of FIGS. 8 and 9 to which a pair of caudal facet bearing elements and a pair of cephalad bearing elements have been attached and with the caudal bearing elements attached to the patient;
  • [0048]
    FIG. 12 is a left side view of the installation fixture and bearing elements of FIG. 11 with the caudal bearing elements attached to the patient;
  • [0049]
    FIG. 13 is a perspective view of the installation fixture and bearing elements of FIGS. 11 and 12 showing a guide tool according to one embodiment of this invention;
  • [0050]
    FIG. 14 is a perspective view of the installation fixture and bearing elements of FIGS. 11 and 12 showing the use of a drill bit with the guide tool according to one embodiment of this invention.
  • [0051]
    The invention may be embodied in several forms without departing from its spirit or essential characteristics. The scope of the invention is defined in the appended claims, rather than in the specific description preceding them. All embodiments that fall within the meaning and range of equivalency of the claims are therefore intended to be embraced by the claims.
  • DETAILED DESCRIPTION
  • [0052]
    Although the disclosure hereof is detailed and exact to enable those skilled in the art to practice the invention, the physical embodiments herein disclosed merely exemplify the invention that may be embodied in other specific structure. While the preferred embodiment has been described, the details may be changed without departing from the invention, which is defined by the claims.
  • [0053]
    FIGS. 4-7 show artificial cephalad and caudal facet joint prostheses 36 and 50 for replacing a natural facet joint according to one aspect of this invention. Cephalad prosthesis 36 has a bearing element 38 with a bearing surface 40. In this embodiment, bearing surface 40 has a convex shape. Bearing element 38 may be formed from biocompatible metals (such as cobalt chromium steel, surgical steels, titanium, titanium alloys, tantalum, tantalum alloys, aluminum, etc.), ceramics, polyethylene, biocompatible polymers, and other materials known in the prosthetic arts, and bearing surface 40 may be formed from biocompatible metals (such as cobalt chromium steel, surgical steels, titanium, titanium alloys, tantalum, tantalum alloys, aluminum, etc.), ceramics, polyethylene, biocompatible polymers, and other materials known in the prosthetic arts.
  • [0054]
    Depending on the patient's disease state, the condition of the patient's natural facet joint—including the facet joint's strength, location and orientation—may not be acceptable. As shown in FIGS. 4-7, therefore, the natural cephalad and caudal facet joint surfaces have been removed to enable the installation of a prosthetic facet joint without limitations presented by remaining portions of the natural facet joint.
  • [0055]
    In one embodiment of the invention, fixation element 42 attaches cephalad prosthesis 36 to a vertebra 60 in an orientation and position that places bearing surface 40 in approximately the same location as the natural facet joint surface the prosthesis replaces. The prosthesis may also be placed in a location other than the natural facet joint location without departing from the invention, such as by orienting the fixation element along a different angle, by moving the joint cephalad or caudad, or by moving the joint medially or laterally.
  • [0056]
    In the embodiment shown in FIGS. 4-7, fixation element 42 is a screw. Other possible fixation elements include headless screws, stems, corkscrews, wire, staples, adhesives, bone cements, and other materials known in the prosthetic arts.
  • [0057]
    In this embodiment of the invention, the cephalad facet joint prosthesis attaches to a posterior element of the vertebra, such as one or portions of the lamina and/or the spinous process. For example, as shown in FIGS. 4-6, fixation element 42 may extend through a lamina portion 62 of vertebra 60 at the base of spinous process 64, traversing the vertebra midline as defined by the spinous process 64 and through another lamina portion 66. This orientation of the fixation element is similar to that used in translaminar facet joint screw fixation, as known in the art. Other orientations of fixation element 42 are possible, of course, depending on the dictates of the specific vertebral anatomy and the desires of the clinician. For example, fixation element 42 may extend through only one lamina portion, only through the spinous process, etc.
  • [0058]
    Unlike other facet joint prostheses that attach to the pedicle, this embodiment's use of one or more posterior elements of the vertebra to attach the cephalad facet joint prosthesis of this invention does not block access to the pedicle area, leaving this area free to be used to attach other prostheses or devices. Other embodiments of the invention may block the pedicle area, of course, without departing from the scope or spirit of the invention. In addition, because of the inherent strength of the lamina, the cephalad facet joint prosthesis may be affixed without the use of bone cement, especially when using a bone ingrowth surface or trabecular metal.
  • [0059]
    In the orientation shown in FIGS. 4-6 as well as in some alternative embodiments, after insertion the fixation element's proximal end 43 (preferably formed to mate with a suitable insertion tool) and distal end 44 lie on opposite sides of the lamina. Bearing element 38 attaches to the distal end 44 of fixation element 42 to be disposed between a caudal facet joint bearing surface (either natural or artificial, such as the artificial caudal facet joint prosthesis described below) and a portion of the vertebra, such as the lamina portion shown in FIGS. 4-6. To attach bearing element 38 to fixation element 42 in the embodiment shown in FIG. 4, a hole 46 in bearing element 38 is formed with a Morse taper that mates with the distal end 44 of fixation element 42. Other means of attaching bearing element 38 to fixation element 42 may be used, of course, such as other Morse or other taper connections, machine screw threads, NPT screw threads or other known mechanical fastening means. Fixation element 42 may be coated with antimicrobial, antithrombotic, hydroxyapatite, or osteoinductive materials to promote bone ingrowth and fixation. Bearing element 38 may be attached to fixation element 42 before or after implantation in the patient, depending on the manner of implantation and the requirements of the situation.
  • [0060]
    Prosthesis 36 may be used to form the cephalad portion of a facet joint with either a natural caudal facet joint portion or an artificial caudal facet joint prosthesis.
  • [0061]
    FIGS. 4-7 also show an artificial caudal joint prosthesis 50 for replacing the superior half of a natural facet joint according to one aspect of this invention. Caudal prosthesis 50 has a bearing element 52 with a bearing surface 54. In this embodiment, bearing surface 54 is concave. Bearing element 52 may be formed from biocompatible metals (such as cobalt chromium steel, surgical steels, titanium, titanium alloys, tantalum, tantalum alloys, aluminum, etc.), ceramics, polyethylene, biocompatible polymers, and other materials known in the prosthetic arts, and bearing surface 54 may be formed from biocompatible metals (such as cobalt chromium steel, surgical steels, titanium, titanium alloys, tantalum, tantalum alloys, aluminum, etc.), ceramics, polyethylene, biocompatible polymers, and other materials known in the prosthetic arts.
  • [0062]
    In one embodiment, the natural caudal facet surface has been removed, and fixation element 56 attaches prosthesis 50 to a vertebra 70 via a pedicle in an orientation and position that places bearing surface 54 in approximately the same location as the natural facet joint surface the prosthesis replaces. In an alternative embodiment, the bearing surface 54 may be placed in a location different than the natural facet joint surface, either more medial or more lateral, more cephalad or more caudad, and/or rotated from the natural anatomical orientation and orientation. In addition, in other embodiments the caudal component can be attached to the vertebral body in addition to the pedicle or to the vertebral body alone.
  • [0063]
    As shown in the embodiment of FIGS. 4-7, fixation element 56 is a screw attached to bearing element 54 via a hole 58 formed in bearing element 52 and is inserted into a pedicle portion 72 of vertebra 70. Other possible fixation elements include stems, corkscrews, wire, staples, adhesives, bone cements, and other materials known in the prosthetic arts. Fixation element 56 can also be inserted into the vertebral body in addition to or in place of the pedicle.
  • [0064]
    In this embodiment, bearing element 52 has a serrated fixation surface 57 adapted to contact a contact portion 74 of vertebra 70. This optional fixation surface 57 helps prevent rotation of the bearing element 52. In addition, fixation surface 57 may be coated with bone ingrowth material, and any optional serrations increase the surface area for bone ingrowth. As shown in FIG. 5, in this embodiment the entire bearing surface 54 is posterior to surface 57 and contact portion 74.
  • [0065]
    Prosthesis 50 may be used to form the caudal portion of a facet joint with either a natural cephalad facet joint portion or an artificial cephalad facet joint prosthesis.
  • [0066]
    FIGS. 7A-F show the artificial facet joint prosthesis according to one embodiment of this invention apart from the vertebrae. As shown, cephalad bearing surface 40 and caudal bearing surface 54 meet to form an artificial facet joint. As seen best in FIG. 7B, the width of caudal bearing surface 54 along its transverse axis is greater than the width of cephalad bearing surface 40 along its transverse axis. This feature helps align the cephalad and caudal joints during implant. In addition, this feature permits the point of contact between the two bearing surface to change with flexion, extension, left and right rotation and lateral bending of the patient's spine.
  • [0067]
    The prostheses of FIGS. 4-7 may be implanted without special tools. One embodiment of the invention, however, includes an installation fixture to assist with the implantation procedure. FIGS. 8-14 show installation tools used to implant two artificial facet joints, i.e., two cephalad facet joint prostheses and two corresponding caudal facet joint prostheses. The invention also includes installation tools for implanting a single facet joint prosthesis, two caudal facet joint prostheses, two cephalad facet joint prostheses, a caudal and cephalad joint prosthesis, or any other combination of facet joint prostheses.
  • [0068]
    As shown in FIGS. 8 and 9, installation fixture 80 has alignment elements 82 to align the cephalad bearing elements 38 and caudal bearing elements 52. In this embodiment, the alignment elements are two dowels for each bearing element. Alignment elements 82 mate with corresponding alignment elements in the bearing elements, such as holes 84 (shown, e.g., in FIG. 7B) formed in cephalad bearing elements 38 and caudal bearing elements 52. Other alignment elements may be used, of course, such as pins, grooves, indentations, etc. Attachment elements such as screws 86 attach the bearing elements 38 and 52 to the installation fixture via screw holes 88 (shown, e.g., in FIG. 7B) formed in the bearing elements and in installation fixture 80.
  • [0069]
    When attached to installation fixture 80, cephalad and caudal bearing surfaces 40 and 54 are in contact and in proper alignment with respect to each other, as shown in FIG. 8. In one embodiment, the cephalad and caudal bearing surfaces 40 and 54 are preloaded to be in compression when attached to installation fixture 80. To bring the pairs of bearing surfaces in proper alignment with respect to the patient's vertebrae, the spacing between the pairs of bearing surfaces might need to be adjusted. In the embodiment of FIGS. 8, 9 and 11-14, installation fixture 80 has two bearing support components 90 and 92 that move in a controlled manner with respect to each other. Specifically, in this embodiment a threaded shaft 94 extends between support components 90 and 92. Shaft 94 engages bores formed in support components 90 and 92; one or both of the bores are threaded so that rotation of shaft 94 causes support components 90 and 92 to move towards or away from each other. Shaft 94 may be provided with a thumbwheel 96 or other actuator for ease of use. One or more guide rods 98 may be provided to maintain the alignment of support components 90 and 92. Other means of moving the cephalad/caudal bearing elements pairs with respect to each other may be used, such as a guided or unguided sliding connection between installation fixture elements.
  • [0070]
    In use, after preparing the implant site by removal of all or a portion of existing natural cephalad and caudal facet joint portions of the cephalad and caudal vertebrae 60 and 70, respectively, of the spine motion segment, bearing elements 38 and 52 are attached to installation fixture 80 as described above. The spacing between the bearing element pairs is then adjusted using thumbwheel 96 to align the fixation holes 58 of caudal bearing elements 52 with the proper fixation screw insertion sites in the pedicle portions of the caudal vertebra (or other suitable location), thus placing the artificial facet joints in positions corresponding to the position of natural facet joints or in any other position desired by the physician, including positions that do not correspond to the position of natural facet joints. Passages aligning with holes 58 are formed and in the pedicle—or into another part of the caudal vertebra near or adjacent to the pedicle—using a drill, awl, pedicle probe, or other tool known in the surgical arts. Fixation screws 56 are then inserted through holes 58 into the pedicle or other portion of the caudal vertebra to attach the caudal bearing elements as well as the entire prosthesis and installation fixture to the caudal vertebra 70, as shown in FIGS. 11 and 12. Alternatively, self-tapping screws or other caudal fixation elements may be used, thereby eliminating the need to pre-form the passages.
  • [0071]
    Thereafter, the cephalad bearing elements are attached to the cephalad vertebra 60. In one embodiment, an insertion path is first determined for each fixation element, then a passage is formed along the insertion path corresponding to cephalad bearing element holes 46 (e.g., in the lamina at the base of the spinous process and through the lamina on the other side, through only one lamina portion, through the spinous process, etc.). Fixation screws 42 can then be inserted through the holes 46 into the passages. Alternatively, self-tapping screws or other caudal fixation elements may be used, thereby eliminating the need to pre-form the passages.
  • [0072]
    After all four bearing elements have been affixed, the installation fixture 80 may be detached and removed. Installation fixture 80 may be used to implant fewer than four bearing elements, of course.
  • [0073]
    FIGS. 10, 13 and 14 show a tool that may be used to define the insertion path (location, orientation, etc.) for the fixation element of the left cephalad bearing element. For example, the tool may be used to guide the formation of a cephalad bearing element attachment passage for the left bearing element. A corresponding mirror image tool may be used for the right cephalad bearing element. In alternative embodiments, a single tool may be used for defining the insertion path for both left and right cephalad bearing elements.
  • [0074]
    As shown, tool 100 has a handle 102 and an alignment interface (such as dowels 104 in tool 100 and holes 106 in fixture 80) to align the tool in the proper orientation with respect to installation fixture 80 and a cephalad facet joint bearing element. With the caudal and cephalad bearing elements still attached to installation fixture 80 and preferably with caudal bearing elements already affixed to the caudal vertebra 70, tool 100 engages installation fixture through the alignment interface as shown in FIGS. 13 and 14. In this position, tool 100 may be used to define an insertion path for the cephalad fixation elements.
  • [0075]
    In the embodiment shown in FIGS. 10, 13 and 14, the insertion path guide is a drill guide 108 supported by arms 110 and 112 and is aligned with hole 46 in cephalad bearing element 38 by the alignment interface between installation fixture 80 and guide tool 100. In this embodiment, drill guide 108 is a tube, but other guide elements may be used, such as a guide groove or surface. A drill bit 114 may be inserted through drill guide 108 to form an insertion passage, such as a passage through a lamina portion of the cephalad vertebra. A fixation screw may then be inserted through the passage in the cephalad vertebra and into the Morse taper connection of hole 46 (or other type connection, as discussed above) of cephalad bearing element 38. As discussed above, the fixation screw may be coated with a bone ingrowth material. Alternatively, a self-tapping screw may be used, thereby removing the need to pre-form a passage.
  • [0076]
    A mirror image tool may then be used to define an insertion path or to form a hole for the right cephalad bearing element, which is then affixed to the vertebral body in the same way. The installation fixture is then removed, such as by unscrewing screws 86.
  • [0077]
    As mentioned above, in alternative embodiments the guide tool may be used to define a path for a self-tapping screw or other fixation element that does not require the use of a drill. In those embodiments, element 108 may be used to define a path for the self-tapping screw or other fixation element. The fixation element path may be through only a single lamina portion, through the spinous process alone, or any other suitable path.
  • [0078]
    In some embodiments, the entire prosthesis other than the bearing surface may be coated with bone ingrowth material.
  • [0079]
    The above described embodiments of this invention are merely descriptive of its principles and are not to be limited. The scope of this invention instead shall be determined from the scope of the following claims, including their equivalents.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2502902 *Jan 25, 1946Apr 4, 1950Tofflemire Benjamin FIntraoral fracture and orthodontic appliance
US2930133 *Jul 8, 1957Mar 29, 1960Thompson Joseph ClayApparatus to aid in determining abnormal positions of spinal vertebrae
US3710789 *Dec 4, 1970Jan 16, 1973Univ MinnesotaMethod of repairing bone fractures with expanded metal
US3867728 *Apr 5, 1973Feb 25, 1975Cutter LabProsthesis for spinal repair
US3875595 *Apr 15, 1974Apr 8, 1975Froning Edward CIntervertebral disc prosthesis and instruments for locating same
US3941127 *Oct 3, 1974Mar 2, 1976Froning Edward CApparatus and method for stereotaxic lateral extradural disc puncture
US4502161 *Aug 19, 1983Mar 5, 1985Wall W HProsthetic meniscus for the repair of joints
US4795469 *Jul 23, 1986Jan 3, 1989Indong OhThreaded acetabular cup and method
US4805602 *Nov 3, 1986Feb 21, 1989Danninger Medical TechnologyTranspedicular screw and rod system
US4904260 *Jul 25, 1988Feb 27, 1990Cedar Surgical, Inc.Prosthetic disc containing therapeutic material
US4911718 *Jun 10, 1988Mar 27, 1990University Of Medicine & Dentistry Of N.J.Functional and biocompatible intervertebral disc spacer
US4917701 *Sep 12, 1988Apr 17, 1990Morgan Douglas HTemporomandibular joint prostheses
US4987904 *Mar 22, 1990Jan 29, 1991Wilson James TMethod and apparatus for bone size gauging
US5000165 *May 15, 1989Mar 19, 1991Watanabe Robert SLumbar spine rod fixation system
US5091866 *Mar 2, 1990Feb 25, 1992Kabushiki Kaisha ToshibaInformation processing apparatus displaying multiple windows and distinguishing indicia
US5108399 *Sep 15, 1989Apr 28, 1992Boehringer Ingelheim GmbhDevice for osteosynthesis and process for producing it
US5192326 *Sep 9, 1991Mar 9, 1993Pfizer Hospital Products Group, Inc.Hydrogel bead intervertebral disc nucleus
US5284655 *Feb 4, 1992Feb 8, 1994Osteotech, Inc.Swollen demineralized bone particles, flowable osteogenic composition containing same and use of the composition in the repair of osseous defects
US5300073 *Jan 28, 1992Apr 5, 1994Salut, Ltd.Sacral implant system
US5303480 *Nov 27, 1992Apr 19, 1994Chek Paul WCranio-cervical sagittal-alignment caliper and universal measurement system
US5306308 *Oct 23, 1990Apr 26, 1994Ulrich GrossIntervertebral implant
US5306309 *May 4, 1992Apr 26, 1994Calcitek, Inc.Spinal disk implant and implantation kit
US5401269 *Mar 10, 1993Mar 28, 1995Waldemar Link Gmbh & Co.Intervertebral disc endoprosthesis
US5405390 *Jun 2, 1993Apr 11, 1995Osteotech, Inc.Osteogenic composition and implant containing same
US5491882 *Sep 13, 1994Feb 20, 1996Walston; D. KennethMethod of making joint prosthesis having PTFE cushion
US5496318 *Aug 18, 1993Mar 5, 1996Advanced Spine Fixation Systems, Inc.Interspinous segmental spine fixation device
US5501684 *Jun 25, 1992Mar 26, 1996Synthes (U.S.A.)Osteosynthetic fixation device
US5507823 *Sep 15, 1994Apr 16, 1996Walston; D. KennethJoint prosthesis having PTFE cushion
US5510396 *Mar 9, 1994Apr 23, 1996Osteotech, Inc.Process for producing flowable osteogenic composition containing demineralized bone particles
US5603713 *Sep 29, 1994Feb 18, 1997Aust; Gilbert M.Anterior lumbar/cervical bicortical compression plate
US5609641 *Jan 31, 1995Mar 11, 1997Smith & Nephew Richards Inc.Tibial prosthesis
US5704941 *Nov 3, 1995Jan 6, 1998Osteonics Corp.Tibial preparation apparatus and method
US5716415 *Mar 8, 1996Feb 10, 1998Acromed CorporationSpinal implant
US5725527 *Mar 27, 1996Mar 10, 1998Biedermann Motech GmbhAnchoring member
US5738585 *Aug 8, 1996Apr 14, 1998Hoyt, Iii; Raymond EarlCompact flexible couplings with inside diameter belt support and lock-on features
US5741255 *Jun 5, 1996Apr 21, 1998Acromed CorporationSpinal column retaining apparatus
US5741261 *Jun 25, 1996Apr 21, 1998Sdgi Holdings, Inc.Minimally invasive spinal surgical methods and instruments
US5860977 *Oct 27, 1997Jan 19, 1999Saint Francis Medical Technologies, LlcSpine distraction implant and method
US5863293 *Oct 18, 1996Jan 26, 1999Spinal InnovationsSpinal implant fixation assembly
US5865846 *May 15, 1997Feb 2, 1999Bryan; VincentHuman spinal disc prosthesis
US5866113 *Mar 7, 1997Feb 2, 1999Medtronic, Inc.Medical device with biomolecule-coated surface graft matrix
US5868745 *Dec 19, 1996Feb 9, 1999Alleyne; NevilleSpinal protection device
US5879350 *Sep 24, 1996Mar 9, 1999Sdgi Holdings, Inc.Multi-axial bone screw assembly
US5879396 *Apr 25, 1997Mar 9, 1999Walston; D. KennethJoint prosthesis having PTFE cushion
US5885285 *Dec 16, 1996Mar 23, 1999Simonson; Peter MelottSpinal implant connection assembly
US5885286 *Feb 11, 1997Mar 23, 1999Sdgi Holdings, Inc.Multi-axial bone screw assembly
US5891145 *Jul 14, 1997Apr 6, 1999Sdgi Holdings, Inc.Multi-axial screw
US5893889 *Jun 20, 1997Apr 13, 1999Harrington; MichaelArtificial disc
US6010503 *Apr 3, 1998Jan 4, 2000Spinal Innovations, LlcLocking mechanism
US6014588 *Apr 7, 1998Jan 11, 2000Fitz; William R.Facet joint pain relief method and apparatus
US6019759 *Dec 6, 1996Feb 1, 2000Rogozinski; ChaimMulti-Directional fasteners or attachment devices for spinal implant elements
US6019792 *Apr 23, 1998Feb 1, 2000Cauthen Research Group, Inc.Articulating spinal implant
US6022350 *May 12, 1997Feb 8, 2000Stryker France S.A.Bone fixing device, in particular for fixing to the sacrum during osteosynthesis of the backbone
US6039763 *Oct 27, 1998Mar 21, 2000Disc Replacement Technologies, Inc.Articulating spinal disc prosthesis
US6190388 *Jan 19, 2000Feb 20, 2001Gary K. MichelsonAnterior spinal instrumentation and method for implantation and revision
US6193724 *Nov 25, 1998Feb 27, 2001Kwan-Ho ChanApparatus and method for determining the relative position of bones during surgery
US6193758 *Oct 2, 1998Feb 27, 2001Acumed, Inc.Shoulder prosthesis
US6200322 *Aug 13, 1999Mar 13, 2001Sdgi Holdings, Inc.Minimal exposure posterior spinal interbody instrumentation and technique
US6340361 *Sep 2, 1999Jan 22, 2002Karl H. KrausExternal fixator clamp and system
US6340477 *Apr 27, 2000Jan 22, 2002LifenetBone matrix composition and methods for making and using same
US6342054 *Dec 28, 1999Jan 29, 2002Stryker Trauma SaPositioning and locking device
US6361506 *Jul 20, 2000Mar 26, 2002Sulzer Orthopedics Inc.Incremental varus/valgus and flexion/extension measuring instrument
US6514253 *Nov 22, 2000Feb 4, 2003Meei-Huei YaoApparatus for locating interlocking intramedullary nails
US6520963 *Aug 13, 2001Feb 18, 2003Mckinley Lawrence M.Vertebral alignment and fixation assembly
US6524315 *Aug 8, 2000Feb 25, 2003Depuy Acromed, Inc.Orthopaedic rod/plate locking mechanism
US6712818 *Jul 17, 2000Mar 30, 2004Gary K. MichelsonMethod for connecting adjacent vertebral bodies of a human spine with a plating system
US6712849 *Apr 16, 2002Mar 30, 2004Scandius Biomedical, Inc.Apparatus and method for reconstructing a ligament
US7011658 *Mar 4, 2002Mar 14, 2006Sdgi Holdings, Inc.Devices and methods for spinal compression and distraction
US20020013585 *Jul 2, 2001Jan 31, 2002Jose GournaySpinal implant for an osteosynthesis device
US20020013588 *Sep 24, 2001Jan 31, 2002Spinal Concepts, Inc.Instrument and method for implanting an interbody fusion device
US20020029039 *Apr 26, 2001Mar 7, 2002Zucherman James F.Supplemental spine fixation device and methods
US20030004572 *Mar 4, 2002Jan 2, 2003Goble E. MarloweMethod and apparatus for spine joint replacement
US20030028250 *May 30, 2002Feb 6, 2003Archus Orthopedics, Inc.Prostheses, systems and methods for replacement of natural facet joints with artifical facet joint surfaces
US20030040797 *Jul 16, 2002Feb 27, 2003Fallin T. WadeProsthesis for the replacement of a posterior element of a vertebra
US20030055427 *Dec 1, 2000Mar 20, 2003Henry GrafIntervertebral stabilising device
US20040006391 *Jul 9, 2003Jan 8, 2004Archus Orthopedics Inc.Facet arthroplasty devices and methods
US20040049205 *Nov 21, 2002Mar 11, 2004Endo Via Medical, Inc.Surgical instrument coupling mechanism
US20040049272 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet arthroplasty devices and methods
US20040049273 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet Arthroplasty devices and methods
US20040049274 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet arthroplasty devices and methods
US20040049275 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet arthroplasty devices and methods
US20040049277 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet arthroplasty devices and methods
US20040049278 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet arthroplasty devices and methods
US20040049281 *Sep 9, 2003Mar 11, 2004Archus Orthopedics, Inc.Facet arthroplasty devices and methods
US20040059429 *Sep 17, 2003Mar 25, 2004Uri AminMechanically attached elastomeric cover for prosthesis
US20050010291 *Jul 8, 2003Jan 13, 2005Archus Orthopedics Inc.Prostheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
US20050015146 *Nov 15, 2002Jan 20, 2005Rene LouisPosterior vertebral joint prosthesis
US20050027361 *Jul 6, 2004Feb 3, 2005Reiley Mark A.Facet arthroplasty devices and methods
US20050033434 *Aug 6, 2003Feb 10, 2005Sdgi Holdings, Inc.Posterior elements motion restoring device
US20050043799 *Oct 8, 2004Feb 24, 2005Archus Orthopedics Inc.Facet arthroplasty devices and methods
US20050049705 *Aug 29, 2003Mar 3, 2005Hale Horace WinstonFacet implant
US20050055096 *May 20, 2004Mar 10, 2005Depuy Spine, Inc.Functional spinal unit prosthetic
US20060009847 *Sep 9, 2005Jan 12, 2006Reiley Mark AFacet arthroplasty devices and methods
US20060009848 *Sep 9, 2005Jan 12, 2006Reiley Mark AFacet arthroplasty device and methods
US20060009849 *Sep 9, 2005Jan 12, 2006Reiley Mark AFacet arthroplasty devices and methods
US20060041211 *Jun 20, 2005Feb 23, 2006Hawkinson Carla MHoof bandages
US20060041311 *Aug 18, 2005Feb 23, 2006Mcleer Thomas JDevices and methods for treating facet joints
US20060052785 *Aug 17, 2005Mar 9, 2006Augostino Teena MAdjacent level facet arthroplasty devices, spine stabilization systems, and methods
US20060058791 *Aug 17, 2005Mar 16, 2006Richard BromanImplantable spinal device revision system
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US7674293Mar 9, 2010Facet Solutions, Inc.Crossbar spinal prosthesis having a modular design and related implantation methods
US7691145Oct 25, 2004Apr 6, 2010Facet Solutions, Inc.Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US7722647 *Mar 14, 2005May 25, 2010Facet Solutions, Inc.Apparatus and method for posterior vertebral stabilization
US7815648Sep 29, 2008Oct 19, 2010Facet Solutions, IncSurgical measurement systems and methods
US7846183Dec 7, 2010Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US7914556Dec 20, 2006Mar 29, 2011Gmedelaware 2 LlcArthroplasty revision system and method
US7914560Mar 29, 2011Gmedelaware 2 LlcSpinal facet implant with spherical implant apposition surface and bone bed and methods of use
US7922766Mar 9, 2007Apr 12, 2011Gerraspine A.G.Method for resurfacing a cervical articular facet
US7935134Jun 29, 2006May 3, 2011Exactech, Inc.Systems and methods for stabilization of bone structures
US7988712Aug 2, 2011Gerraspine A.G.Method for resurfacing a lumbar articular facet
US7998172Apr 16, 2009Aug 16, 2011Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US7998175Aug 16, 2011The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for posterior dynamic stabilization of the spine
US7998177Sep 29, 2008Aug 16, 2011Gmedelaware 2 LlcLinked bilateral spinal facet implants and methods of use
US7998178Sep 29, 2008Aug 16, 2011Gmedelaware 2 LlcLinked bilateral spinal facet implants and methods of use
US8025680Sep 27, 2011Exactech, Inc.Systems and methods for posterior dynamic stabilization of the spine
US8066740Oct 21, 2005Nov 29, 2011Gmedelaware 2 LlcFacet joint prostheses
US8066771Nov 29, 2011Gmedelaware 2 LlcFacet arthroplasty devices and methods
US8070811Dec 6, 2011Gmedelaware 2 LlcFacet arthroplasty devices and methods
US8075595Dec 13, 2011The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for posterior dynamic stabilization of the spine
US8092532Jan 10, 2012Gmedelaware 2 LlcFacet arthroplasty devices and methods
US8096996Jan 17, 2012Exactech, Inc.Rod reducer
US8162985Oct 20, 2004Apr 24, 2012The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for posterior dynamic stabilization of the spine
US8163017Apr 24, 2012Gmedelaware 2 LlcFacet arthroplasty devices and methods
US8187303Apr 22, 2004May 29, 2012Gmedelaware 2 LlcAnti-rotation fixation element for spinal prostheses
US8206418Jun 26, 2012Gmedelaware 2 LlcSystem and method for facet joint replacement with detachable coupler
US8211147Jul 3, 2012Gmedelaware 2 LlcSystem and method for facet joint replacement
US8221461Oct 24, 2005Jul 17, 2012Gmedelaware 2 LlcCrossbar spinal prosthesis having a modular design and systems for treating spinal pathologies
US8226690Feb 23, 2006Jul 24, 2012The Board Of Trustees Of The Leland Stanford Junior UniversitySystems and methods for stabilization of bone structures
US8231655Jul 28, 2006Jul 31, 2012Gmedelaware 2 LlcProstheses and methods for replacement of natural facet joints with artificial facet joint surfaces
US8252027Aug 28, 2012Gmedelaware 2 LlcSystem and method for facet joint replacement
US8267969Sep 18, 2012Exactech, Inc.Screw systems and methods for use in stabilization of bone structures
US8398681Aug 17, 2005Mar 19, 2013Gmedelaware 2 LlcAdjacent level facet arthroplasty devices, spine stabilization systems, and methods
US8409254Jun 27, 2008Apr 2, 2013Gmedelaware 2 LlcProstheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
US8425557Apr 23, 2013Gmedelaware 2 LlcCrossbar spinal prosthesis having a modular design and related implantation methods
US8425611Apr 23, 2013Warsaw Orthopedic, Inc.Expandable orthopedic implant system and method
US8491635Nov 30, 2007Jul 23, 2013Gmedelaware 2 LlcCrossbar spinal prosthesis having a modular design and related implantation methods
US8496686May 7, 2007Jul 30, 2013Gmedelaware 2 LlcMinimally invasive spine restoration systems, devices, methods and kits
US8496687Dec 14, 2007Jul 30, 2013Gmedelaware 2 LlcCrossbar spinal prosthesis having a modular design and related implantation methods
US8523865Jan 16, 2009Sep 3, 2013Exactech, Inc.Tissue splitter
US8523907Jan 3, 2006Sep 3, 2013Gmedelaware 2 LlcProstheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
US8551142Dec 13, 2010Oct 8, 2013Exactech, Inc.Methods for stabilization of bone structures
US8652137Feb 21, 2008Feb 18, 2014Spinal Elements, Inc.Vertebral facet joint drill and method of use
US8675930Aug 5, 2008Mar 18, 2014Gmedelaware 2 LlcImplantable orthopedic device component selection instrument and methods
US8696708Mar 5, 2009Apr 15, 2014DePuy Synthes Products, LLCFacet interference screw
US8702755Aug 10, 2007Apr 22, 2014Gmedelaware 2 LlcAngled washer polyaxial connection for dynamic spine prosthesis
US8702759Aug 29, 2008Apr 22, 2014Gmedelaware 2 LlcSystem and method for bone anchorage
US8740942Jan 23, 2013Jun 3, 2014Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US8740949Feb 24, 2011Jun 3, 2014Spinal Elements, Inc.Methods and apparatus for stabilizing bone
US8777994Sep 29, 2008Jul 15, 2014Gmedelaware 2 LlcSystem and method for multiple level facet joint arthroplasty and fusion
US8858597Dec 3, 2010Oct 14, 2014Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US8870889Mar 15, 2013Oct 28, 2014George FreyPatient matching surgical guide and method for using the same
US8882804May 6, 2013Nov 11, 2014Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US8906063Sep 29, 2008Dec 9, 2014Gmedelaware 2 LlcSpinal facet joint implant
US8986355Jul 11, 2011Mar 24, 2015DePuy Synthes Products, LLCFacet fusion implant
US8992533Aug 18, 2010Mar 31, 2015Spinal Elements, Inc.Vertebral facet joint drill and method of use
US8998953Aug 30, 2011Apr 7, 2015Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US9050144Aug 29, 2008Jun 9, 2015Gmedelaware 2 LlcSystem and method for implant anchorage with anti-rotation features
US9056016Mar 28, 2008Jun 16, 2015Gmedelaware 2 LlcPolyaxial adjustment of facet joint prostheses
US9060787Aug 14, 2012Jun 23, 2015Spinal Elements, Inc.Method of using a vertebral facet joint drill
US9095384Oct 16, 2008Aug 4, 2015Aro Medical Aps U/StiftelseMethods, systems and apparatuses for torsional stabilization
US9179943Apr 18, 2014Nov 10, 2015Spinal Elements, Inc.Methods and apparatus for stabilizing bone
US9198678Jun 6, 2014Dec 1, 2015George FreyPatient-matched apparatus and methods for performing surgical procedures
US9198766Feb 7, 2008Dec 1, 2015Gmedelaware 2 LlcProstheses, tools, and methods for replacement of natural facet joints with artificial facet joint surfaces
US9271765Feb 23, 2012Mar 1, 2016Spinal Elements, Inc.Vertebral facet joint fusion implant and method for fusion
US9301786Aug 16, 2011Apr 5, 2016Spinal Elements, Inc.Methods and apparatus for stabilizing bone
US9421044Mar 14, 2013Aug 23, 2016Spinal Elements, Inc.Apparatus for bone stabilization and distraction and methods of use
US20050159746 *Jan 21, 2004Jul 21, 2005Dieter GrobCervical facet resurfacing implant
US20060100709 *Jan 3, 2006May 11, 2006Reiley Mark AFacet arthroplasty devices and methods
US20070100341 *Jun 29, 2006May 3, 2007Reglos Joey CSystems and methods for stabilization of bone structures
US20070179619 *Mar 9, 2007Aug 2, 2007Gerraspine A.G.Method for resurfacing a cervical articular facet
US20080015585 *May 7, 2007Jan 17, 2008Philip BergMinimally invasive spine restoration systems, devices, methods and kits
US20080292161 *Aug 5, 2008Nov 27, 2008Funk Michael JImplantable orthopedic device component selection instrument and methods
US20090066845 *May 10, 2006Mar 12, 2009Takao OkudaContent Processing Apparatus, Method of Processing Content, and Computer Program
US20090105761 *Oct 16, 2008Apr 23, 2009Robie Device Group, LlcMethods, systems and apparatuses for torsional stabilization
US20090204152 *Apr 16, 2009Aug 13, 2009Spinal Elements, Inc.Vertebral facet joint prosthesis and method of fixation
US20100087880 *Apr 8, 2010Facet Solutions, Inc.Facet Joint Replacement Instruments and Methods
US20110004247 *Mar 5, 2009Jan 6, 2011Beat LechmannFacet interference screw
USD724733Oct 26, 2011Mar 17, 2015Spinal Elements, Inc.Interbody bone implant
USD738498Jul 10, 2014Sep 8, 2015George FreySacroiliac surgical guide
USD745671Dec 16, 2013Dec 15, 2015George FreyTransitional surgical guide
USD745672Dec 16, 2013Dec 15, 2015George FreyThoracic surgical guide
USD745673Dec 16, 2013Dec 15, 2015George FreyLumbar surgical guide
USD748262Jan 23, 2015Jan 26, 2016Spinal Elements, Inc.Interbody bone implant
USD748793Jan 23, 2015Feb 2, 2016Spinal Elements, Inc.Interbody bone implant
Legal Events
DateCodeEventDescription
Jun 26, 2006ASAssignment
Owner name: ARCHUS ORTHOPEDICS, INC., WASHINGTON
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:YUAN, HANSEN A;STINSON, DAVID;JONES, LAWRENCE R.;AND OTHERS;REEL/FRAME:017844/0733;SIGNING DATES FROM 20030826 TO 20030902
Nov 5, 2009ASAssignment
Owner name: GENERAL ELECTRIC CAPITAL CORPORATION, AS AGENT, MA
Free format text: SECURITY AGREEMENT;ASSIGNOR:FSI ACQUISITION SUB, LLC;REEL/FRAME:023471/0325
Effective date: 20091105
Owner name: GENERAL ELECTRIC CAPITAL CORPORATION, AS AGENT,MAR
Free format text: SECURITY AGREEMENT;ASSIGNOR:FSI ACQUISITION SUB, LLC;REEL/FRAME:023471/0325
Effective date: 20091105
Jan 12, 2010ASAssignment
Owner name: FACET SOLUTIONS, INC., MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ARCHUS ORTHOPEDICS, INC.;REEL/FRAME:023767/0857
Effective date: 20091105
Owner name: FACET SOLUTIONS, INC.,MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ARCHUS ORTHOPEDICS, INC.;REEL/FRAME:023767/0857
Effective date: 20091105
May 4, 2010ASAssignment
Owner name: TRIPLEPOINT CAPITAL LLC,CALIFORNIA
Free format text: SECURITY AGREEMENT;ASSIGNOR:FSI ACQUISITION SUB, LLC;REEL/FRAME:024329/0620
Effective date: 20091105
Owner name: TRIPLEPOINT CAPITAL LLC, CALIFORNIA
Free format text: SECURITY AGREEMENT;ASSIGNOR:FSI ACQUISITION SUB, LLC;REEL/FRAME:024329/0620
Effective date: 20091105
Jan 19, 2011ASAssignment
Owner name: FSI ACQUISITION SUB LLC, MASSACHUSETTS
Free format text: RELEASE BY SECURED PARTY;ASSIGNOR:TRIPLEPOINT CAPITAL LLC;REEL/FRAME:025662/0549
Effective date: 20110118
Jan 20, 2011ASAssignment
Owner name: FSI ACQUISITION SUB, LLC, MASSACHUSETTS
Free format text: RELEASE BY SECURED PARTY;ASSIGNOR:GENERAL ELECTRIC CAPITAL CORPORATION, AS AGENT;REEL/FRAME:025671/0863
Effective date: 20110119
Jan 21, 2011ASAssignment
Owner name: GMEDELAWARE 2 LLC, DELAWARE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:FACET SOLUTIONS, INC.;FSI ACQUISITION SUB, LLC;REEL/FRAME:025675/0193
Effective date: 20110110