Facet arthroplasty devices and methods

• US 20050283238A1
• Filed: 05/27/2005
• Published: 12/22/2005
• Est. Priority Date: 10/22/1999
• Status: Abandoned Application

• Current Assignee: Facet Solutions, Inc. (Globus Medical, Inc.)
• Original Assignee: Facet Solutions, Inc. (Globus Medical, Inc.)
• Inventors: Reiley, Mark A.
• Application Number:
  US11/140,263
• Publication Number:
  US 20050283238A1
• Time in Patent Office: Days
• US Class Current: 623/17.11
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7068 Devices comprising separate rigid parts, assembled in situ, to bear on each side of spinous processes; Tools therefor
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 17/8605 Heads, i.e. proximal ends projecting from bone
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• CPC Class Codes: A61F 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/305 Snap connection
• CPC Class Codes: A61F 2002/30537 adjustable
• CPC Class Codes: A61F 2002/30604 modular
• CPC Class Codes: A61F 2002/30777 Oblong apertures
• CPC Class Codes: A61F 2002/30873 Threadings machined on non-cylindrical external surfaces
• CPC Class Codes: A61F 2002/449 comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0041 using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2250/0004 adjustable
• CPC Class Codes: A61F 2310/00017 Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: A61F 2310/00329 : Glasses, e.g. bioglass
• CPC Class Codes: A61F 2310/00604 : Coating made of aluminium oxide or hydroxides
• CPC Class Codes: A61F 2310/00634 : Coating made of zirconium oxide or hydroxides
• CPC Class Codes: A61F 2310/0097 : Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics
• CPC Class Codes: A61F 2310/00976 : Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF
• CPC Class Codes: Y10S 606/902 : Cortical plate specifically adapted for a particular bone
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/91 : Polymer
• CPC Class Codes: Y10S 623/902 : Method of implanting

Abstract

Devices and surgical methods treat various types of adult spinal pathologies, such as degenerative spondylolisthesis, spinal stenosis, degenerative lumbar scoliosis, and kypho-scoliosis. Various types of spinal joint replacement prostheses, surgical procedures for performing spinal joint replacements, and surgical instruments are used to perform the surgical procedures.

Claims

1. A prosthesis to replace a cephalad portion of a left natural facet joint on a vertebral body and a cephalad portion of a right natural facet joint on the vertebral body, the prosthesis comprising

an integrated base member including left and right side regions and a mid-region joining the side regions without fixation of the mid-region to bone, to form the integrated base member,

a fixation area on at least one of the left and right side regions to accommodate fixation of the integrated base member to the vertebral body,

an artificial left facet joint structure on the left side region adapted and configured to replace a cephalad portion of the left natural facet joint, and

an artificial right facet joint structure on the right side region adapted and configured to replace a cephalad portion of the right natural facet joint.

2. A prosthesis according to claim 1

wherein the fixation area is located superior to the artificial facet joint structure to accommodate fixation of the integrated base member to the vertebral body at or near a pedicle.

3. A prosthesis according to claim 1

wherein the fixation area is located superior to the artificial facet joint structure to accommodate fixation of the integrated base member to a pedicle of the vertebral body.

4. A prosthesis according to claim 1

further including an auxiliary fixation area on the mid-region to accommodate fixation of the integrated base member to the vertebral body at or near a spinous process.

5. A prosthesis according to claim 1

further including an auxiliary fixation area on the mid-region to accommodate fixation of the integrated base member to a spinous process of the vertebral body.

6. A prosthesis according to claim 1

wherein at least one of the left and right artificial facet joint structures includes means for replacing a cephalad portion of a respective one of the left and right natural facet joints after removal of the cephalad portion of the respective natural facet joint from the vertebral body.

7. A prosthesis according to claim 1

wherein the left and right artificial facet joint structures include means for replacing a cephalad portion of the left and right natural facet joints after removal of the cephalad portion of the left and right natural facet joints from the vertebral body.

8. A prosthesis according to claim 1

further including a third artificial facet joint structure on one of the left and right side regions superior to the respective artificial left or right facet joint structure adapted and configured to replace a caudal portion of a natural facet joint formed by a vertebral body.

9. A prosthesis according to claim 8

wherein the third artificial facet joint structure includes means for replacing a caudal portion of a natural facet joint after removal of the caudal portion of the natural facet joint from the vertebral body.

10. A prosthesis according to claim 1

wherein at least one of the left and right artificial facet joint structures includes means for replacing a cephalad portion of at least one of the left and right natural facet joints after removal of at least one inferior articular process and at least a portion of a lamina from the vertebral body.

11. A prosthesis according to claim 1

wherein the left and right artificial facet joint structures include means for replacing a cephalad portion of the left and right natural facet joints after removal of left and right inferior articular processes and at least a portion of a lamina from the vertebral body.

12. A prosthesis according to claim 8

wherein the third artificial facet joint structure includes means for replacing a caudal portion of a natural facet joint after removal of at least a portion of a mamillary process, or an accessory process, or part of a transverse process, or part of a pedicle from the vertebral body.

13. A method of replacing, on a vertebral body, a cephalad portion of a left natural facet joint and a cephalad portion of a right natural facet joint using the prosthesis as defined in claim 1 to provide improved support for the spinal column, the method comprising the steps of

(i) removing the cephalad portions of the left and right natural facet joints from the vertebral body, and

(ii) after step (i), fixing the prosthesis as defined in claim 1 to the vertebral body to replace both removed cephalad portions of the first and second natural facet joints with the first and second artificial facet joint structures.

14. A method according to claim 13

wherein the removing step includes removing left and right inferior articular processes and at least a portion of a lamina from the vertebral body.

31. A prosthesis according to claim 1

wherein the fixation area accommodates fixation of the integrated base member to the vertebral body without fixation of the integrated base member to a lamina of the vertebral body.

15. A prosthesis to replace a cephalad portion of a natural facet joint on a vertebral body comprising

a base member,

a fixation area on the base member to accommodate fixation of the base member to the vertebral body, and

an artificial facet joint structure on the base member including means for replacing a cephalad portion of a natural facet joint after removal of at least a portion of an inferior articular processes and at least a portion of a lamina from the vertebral body.

16. A prosthesis according to claim 15

wherein the fixation area is located superior to the artificial facet joint structure to accommodate fixation of the base member to the vertebral body at or near a pedicle.

17. A prosthesis according to claim 15

wherein the fixation area is located superior to the artificial facet joint structure to accommodate fixation of the base member to a pedicle of the vertebral body.

18. A prosthesis according to claim 15

further including an other artificial facet joint structure on the base member superior to the first defined artificial facet joint structure adapted and configured to replace a caudal portion of a natural facet joint on the vertebral body.

19. A prosthesis according to claim 18

wherein the other artificial facet joint structure includes means for replacing a caudal portion of a natural facet joint after removal of at least a portion of the caudal portion of the natural facet joint from the vertebral body.

20. A prosthesis according to claim 18

wherein the other artificial facet joint structure includes means for replacing a caudal portion of a natural facet joint after removal of at least a portion of a mamillary process, or an accessory process, or part of a transverse process, or part of a pedicle from the vertebral body.

21. A method of replacing on a vertebral body, a cephalad portion of a natural facet joint using the prosthesis as defined in claim 15 to provide improved support for the spinal column, the method comprising the steps of

(i) removing the cephalad portion of the natural facet joint from the vertebral body, including removal of an inferior articular process and at least a portion of a lamina from the vertebral body, and

(ii) after step (i), fixing the prosthesis as defined in claim 15 to the vertebral body to replace the removed cephalad portion of the natural facet joint with the artificial facet joint structure.

30. A prosthesis system to replace a cephalad portion and a caudal portion of a natural facet joint on a vertebral body comprising

a first prosthesis as defined in claim 15 to replace a cephalad portion of the natural facet joint,

a second prosthesis as defined in claim 22 or 24 to replace a caudal portion of the natural facet joint, and

the artificial facet joint structure of the first prosthesis being adapted and configured to articulate with the artificial facet joint structure of the second prosthesis to replace the cephalad and caudal portions of the natural facet joint.

22. A prosthesis to replace a caudal portion of a natural facet joint on a vertebral body comprising

a stem member including a fixation area to accommodate fixation of the stem member to the vertebral body at or near a pedicle, and

an artificial facet joint structure carried by the stem member adapted and configured to replace a caudal portion of a natural facet joint.

23. A prosthesis according to claim 22

wherein the fixation area accommodates fixation of the stem member to the vertebral body without fixation of the stem member to a lamina of the vertebral body.

26. A prosthesis according to claim 22 or 24

wherein the artificial facet joint structure includes means for replacing a caudal portion of a natural facet joint after removal of at least a portion of the caudal portion of the natural facet joint from the vertebral body.

27. A prosthesis according to claim 22 or 24

wherein the artificial facet joint structure includes means for replacing a caudal portion of a natural facet joint after removal of at least a portion of a mamillary process, or an accessory process, or part of a transverse process, or part of a pedicle from the vertebral body.

28. A method of replacing, on a vertebral body, a caudal portion of a natural facet joint using the prosthesis as defined in claim 22 or 24 to provide improved support for the spinal column, the method comprising the steps of

(i) removing the caudal portion of the natural facet joint from the vertebral body, and

(ii) after step (i), fixing the prosthesis as defined in claim 22 or 24 to the vertebral body to replace the removed caudal portion of the natural facet joint with the artificial facet joint structure.

24. A prosthesis to replace a caudal portion of a natural facet joint on a vertebral body comprising

a screw member including a fixation area to accommodate fixation of the screw member to the vertebral body at or near a pedicle, and

an artificial facet joint structure carried by the screw member adapted and configured to replace a caudal portion of a natural facet joint.

25. A prosthesis according to claim 24

wherein the fixation area accommodates fixation of the screw member to the vertebral body without fixation of the screw member to a lamina of the vertebral body.

29. A method according to claim 25

wherein the removing step includes removing at least a portion of a mamillary process, or an accessory process, or part of a transverse process, or part of a pedicle from the vertebral body.