Facet joint fusion devices and methods

• US 20060004367A1
• Filed: 06/16/2005
• Published: 01/05/2006
• Est. Priority Date: 06/17/2004
• Status: Active Grant

• Current Assignee: Todd F. Alamin, Uriel Hiram Chee
• Original Assignee: Todd F. Alamin, Uriel Hiram Chee
• Inventors: Chee, Uriel Hiram, Alamin, Todd F.
• Granted Patent: US 7,935,136 B2
• Time in Patent Office: Days
• US Class Current: 606/74
• CPC Class Codes: A61B 17/7053 with parts attached to bones or to each other by flexible wires, straps, sutures or cables
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence

Abstract

A method for promoting fusion of and/or stabilizing a facet joint between two adjacent vertebrae comprises clamping the two adjacent vertebrae across the facet joint to apply a compressive force across the joint. Apparatus for promoting fusion of and/or stabilizing a facet joint comprises at least one cinchable tether and at least one locking member coupled with the tether for locking the cinched tether to maintain compressive force across the facet joint. The tether is adapted to extend through at least one hole through each of two adjacent vertebrae, across the facet joint.

Claims

1. A method for promoting fusion of a facet joint between two adjacent vertebrae, the method comprising clamping the two adjacent vertebrae across the facet joint to apply a compressive force across the joint.

2. A method as in claim 1, further comprising forming at least one hole through the two vertebrae across the facet joint, wherein clamping comprises advancing a tether through the hole across the joint.

3. A method as in claim 2, further comprising forming two holes through the two vertebrae across the facet joint, wherein a separate tether is advanced through each of the two holes.

4. A method as in claim 2, further comprising forming two holes through the two vertebrae across the facet joint, wherein the tether is advanced through both holes.

5. A method as in claim 2, wherein clamping further comprises cinching the tether.

6. A method as in claim 5, wherein the at least one hole extends through a first of the two vertebrae along a first axis and through a second of the two vertebrae along a second axis, and wherein advancing the tether through the hole causes the vertebrae to translate relative to each other

7. A method as in claim 5, further comprising, before the cinching step, contacting at least a first bone surface contacting member slidably coupled with the tether with the first vertebra.

8. A method as in claim 7, further comprising contacting a second bone surface contacting member slidably coupled with the tether with the second vertebra.

9. A method as in claim 5, further comprising, before the cinching step, contacting a curved bone surface contacting member slidably coupled with the tether with the first and second vertebrae.

10. A method as in claim 5, further comprising locking the cinched tether to maintain the compressive force across the facet joint.

11. A method as in claim 10, wherein two ends of the cinched tether overlap, and wherein locking the cinched tether comprises locking the two ends together.

12. A method as in claim 11, wherein locking the two ends together comprises crimping at least one crimping member coupled with the two ends.

13. A method as in claim 11, wherein locking the two ends together comprises locking two locking members together, wherein each locking member is coupled with one of the two ends.

14. A method as in claim 1, wherein clamping comprises circumscribing the joint with a tether disposed over the vertebrae.

15. A method as in claim 14, further comprising cinching the tether to apply the compressive force.

16. A method as in claim 14, further comprising contouring external surfaces of the vertebrae to enhance engagement of the tether with the surfaces.

17. A method as in claim 1, wherein clamping comprises engaging a clamping device with external surfaces of the vertebrae across the joint.

18. A method as in claim 1, wherein clamping comprises releasing a shape-memory or spring-loaded clamping device from constraint to clamp the vertebrae and apply the compressive force.

19. A method as in claim 1, further comprising preparing at least one opposing surface of the two vertebrae, within the facet joint, by removing cartilage from the surface.

20. A method as in claim 1, further comprising inserting at least one material into the facet joint to promote joint fusion.

21. A method as in claim 20, wherein the material is selected from the group consisting of autologous bone, bone allograft, bone adhesive, bone morphogenic protein and bone growth promoting materials.

22. A method as in claim 1, wherein clamping is performed percutaneously.

23. A method as in claim 1, wherein clamping is performed as part of an open surgical procedure.

24. A method for applying force across a facet joint between two vertebrae, the method comprising:

forming at least a first hole through the two vertebrae, across the facet joint;

advancing a first tether through the first hole across the joint; and

cinching the tether.

25. A method as in claim 24, further comprising contacting at least a first bone surface contacting member slidably coupled with the tether with a first of the two vertebrae.

26. A method as in claim 25, further comprising contacting a second bone surface contacting member slidably coupled with the tether with a second of the two vertebrae.

27. A method as in claim 24, further comprising locking the cinched tether to maintain the force across the facet joint.

28. A method as in claim 24, further comprising contacting two washers slidably disposed over the tether with surfaces of the two vertebrae outside the facet joint.

29. A method as in claim 24, further comprising:

forming at least a second hole through the two vertebrae across the joint;

advancing a second tether through the second hole across the joint; and

cinching the second tether.

30. A method as in claim 24, further comprising preparing at least one opposing surface of the two vertebrae, within the facet joint, by removing at least one of cartilage and bone from the surface.

31. A method as in claim 24, further comprising inserting at least one material into the facet joint to promote joint fusion.

32. A method as in claim 31, wherein the material is selected from the group consisting of autologous bone, bone allograft, bone adhesive, bone morphogenic proteins and bone growth promoting materials.

33. A method for stabilizing a facet joint between two adjacent vertebrae, the method comprising clamping the two adjacent vertebrae across the facet joint to apply a compressive force across the joint.

34. A method as in claim 33, further comprising forming at least one hole through the two vertebrae across the facet joint, wherein clamping comprises advancing a tether through the hole across the joint.

35. A method as in claim 34, wherein clamping further comprises cinching the tether.

36. A method as in claim 35, wherein the at least one hole extends through a first of the two vertebrae along a first axis and through a second of the two vertebrae along a second axis, and wherein advancing the tether through the hole causes the vertebrae to translate relative to each other.

37. A method as in claim 35, further comprising forming two holes through the two vertebrae across the facet joint, wherein a separate tether is advanced through each of the two holes.

38. A method as in claim 35, further comprising forming two holes through the two vertebrae across the facet joint, wherein the tether is advanced through both holes.

39. A method as in claim 35, further comprising, before the cinching step, contacting at least a first bone surface contacting member slidably coupled with the tether with a first of the two vertebrae.

40. A method as in claim 39, further comprising contacting a second bone surface contacting member slidably coupled with the tether with a second of the two vertebrae.

41. A method as in claim 35, further comprising locking the cinched tether to maintain the compressive force across the facet joint.

42. A method as in claim 33, wherein clamping comprises circumscribing the joint with a tether disposed over the vertebrae.

43. A method as in claim 33, wherein clamping comprises engaging a clamping device with external surfaces of the vertebrae across the joint.

44. A method as in claim 33, wherein clamping comprises releasing a shape-memory or spring-loaded clamping device from constraint to clamp the vertebrae and apply the compressive force.

45-101. -101. (canceled)