METHOD FOR RESURFACING A LUMBAR ARTICULAR FACET

• US 20070149976A1
• Filed: 03/09/2007
• Published: 06/28/2007
• Est. Priority Date: 08/29/2003
• Status: Active Grant

• Current Assignee: Lanterna Medical Technologies Limited
• Original Assignee: Gerraspine AG
• Inventors: Grob, Dieter, Hale, Horace
• Granted Patent: US 7,988,712 B2
• Time in Patent Office: Days
• US Class Current: 606/85
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 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: 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 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30405 made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30769 madreporic
• CPC Class Codes: A61F 2002/3082 Grooves
• CPC Class Codes: A61F 2002/30841 Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30878 with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• 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 2310/00161 Carbon; Graphite
• CPC Class Codes: A61F 2310/00203 containing alumina or aluminium oxide
• CPC Class Codes: A61F 2310/00239 containing zirconia or zirconium oxide ZrO2

Abstract

Methods for treating spinal pathologies, and more specifically methods for treating articulating surfaces of facet joints. The methods involve providing artificial articulating surfaces for facet joint articular facets. In addition, various types of rasps may be used to prepare the articulating surfaces prior to placement of the artificial articulating surfaces.

Claims

1. A method for providing articulating surfaces for facet joint articular facets comprising:

creating a space between an inferior articular facet and a superior articular facet;

using an inferior facet rasp to prepare an articulating surface of the inferior articular facet for placement of an inferior implant;

using a superior facet rasp to prepare an articulating surface of the superior articular facet for placement of a superior implant;

placing the inferior implant on the inferior articular facet such that the articulating surface of the inferior implant is positioned on the articulating surface of the inferior articular facet; and

placing the superior implant on the superior articular facet such that the articulating surface of the superior implant is positioned on the articulating surface of the superior articular facet.

2. The method of claim 1 wherein the articulating surface of the inferior implant and the articulating surface of the superior implant are positioned to articulate with one another.

3. The method of claim 1 further comprising performing each of the steps of claim 1 on a contralateral side of the facet joint.

4. The method of claim 1 wherein the inferior facet rasp and the superior facet rasp are the same rasp.

5. The method of claim 1 wherein a curette is used to begin the step of creating the space.

6. The method of claim 1 wherein the created space is sufficient for using at least one of the inferior facet rasp or the superior facet rasp on the articulating surface of an articular facet.

7. The method of claim 1 wherein the created space ranges from about 2 mm to about 15 mm.

8. The method of claim 1 wherein multiple rasps of increasing thickness are used to prepare the articulating surfaces of the inferior and superior articular facets.

9. The method of claim 1 wherein preparing the articulating surfaces of the inferior and superior articular facets causes the created space to be increased to accommodate the superior implant and the inferior implant.

10. The method of claim 1 wherein the articulating surfaces of the inferior and superior articular facets are prepared such that the shape of the prepared articulating surface of the superior articular facet resembles the superior implant and the shape of the prepared articulating surface of the inferior articular facet resembles the inferior implant.

11. The method of claim 1 wherein preparing the articulating surfaces of the inferior and superior articular facets creates a bleeding bone bed to facilitate bone ingrowth at the articulating surfaces of the inferior and superior articular facets.

12. The method of claim 1 wherein at least one of the inferior facet rasp or the superior facet rasp is configured to cut when moving in a first direction, but not when moving in a direction opposite of the first direction.

13. The method of claim 1 further comprising securing the inferior implant to the inferior articular facet with a translaminar fixation mechanism.

14. The method of claim 13 wherein securing the inferior implant to the inferior articular facet with the translaminar fixation mechanism comprises using an aiming device to position the translaminar fixation mechanism.

15. The method of claim 13 further comprising drilling a translaminar hole for the translaminar fixation mechanism.

16. A method for providing articulating surfaces for facet joint articular facets comprising:

placing an inferior implant on an articulating surface of an inferior articular facet;

securing the inferior implant to the inferior articular facet with a fixation mechanism that passes through a lamina on a vertabra that comprises the inferior articular facet; and

placing an superior implant on an articulating surface of a superior articular facet such that an articulating surface of the superior implant is capable of articulating with an articulating surface of the inferior implant.

17. The method of claim 16 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.

18. The method of claim 16 further comprising drilling a translaminar hole through which the fixation mechanism is passed.

19. The method of claim 16 wherein the articulating surface of the inferior implant and the articulating surface of the superior implant are positioned to articulate with one another.

20. The method of claim 16 further comprising performing each of the steps of claim 16 on a contralateral side of the facet joint.

21. The method of claim 16 further comprising creating a space between the inferior articular facet and the superior articular facet prior to placement of the inferior implant and the superior implant.

22. The method of claim 16 further comprising using at least one rasp to prepare at least one of the articulating surfaces of the superior articular facet or the inferior articular facet prior to the placement of the inferior implant or the superior implant.

23. The method of claim 22 wherein multiple rasps of increasing thickness are used to prepare at least one of the articulating surfaces of the superior articular facet or the inferior articular facet prior to the placement of the inferior implant or the superior implant.

24. The method of claim 22 wherein the at least one rasp is configured to cut when moving in a first direction, but not when moving in a direction opposite of the first direction.

25. A method for providing articulating surfaces for facet joint articular facets comprising:

creating a space of from about 4 mm to about 15 mm between a superior articular facet of a selected vertebra and an inferior articular facet of a vertebra immediately above the selected vertebra;

placing an inferior implant having a fixation surface and a generally convex articulating surface in the created space;

fixing the inferior implant on the inferior articular facet such that the fixation surface of the inferior implant interacts with an articulating surface of the inferior articular facet;

placing a superior implant having a fixation surface and a generally curved articulating surface in the created space; and

fixing the superior implant on the superior articular facet such that the fixation surface of the superior implant interacts with an articulating surface of the superior articular facet;

wherein the articulating surface of the superior implant and the articulating surface of the inferior implant are positioned to articulate with one another following the fixation of the superior implant to the superior articular facet and fixation of the inferior implant to the inferior articular facet.

26. The method of claim 25 further comprising performing each of the steps of claim 25 on a contralateral side of the facet joint.

27. The method of claim 25 wherein a curette is used to begin the step of creating the space.

28. The method of claim 25 further comprising using an inferior facet rasp to prepare the articulating surface of the inferior articular facet for the inferior implant and using a superior facet rasp to prepare the articulating surface of the superior articular facet for the superior implant.

29. The method of claim 28 wherein the inferior facet rasp and the superior facet rasp are the same rasp.

30. The method of claim 28 wherein multiple rasps of increasing thickness are used to prepare the articulating surfaces of the inferior and superior articular facets.

31. The method of claim 28 wherein preparing the articulating surfaces of the inferior and superior articular facets causes the created space to be increased to accommodate the superior implant and the inferior implant.

32. The method of claim 29 wherein preparing the articulating surfaces of the inferior and superior articular facets creates a bleeding bone bed to facilitate bone ingrowth at the articulating surfaces of the inferior and superior articular facets.

33. The method of claim 28 wherein at least one of the inferior facet rasp or the superior facet rasp is configured to cut when moving in a first direction, but not when moving in a direction opposite of the first direction.

34. The method of claim 25 the step of fixing the inferior implant on the inferior articular facet comprises using a translaminar fixation mechanism.

35. The method of claim 34 further comprising using an aiming device to position the translaminar fixation mechanism.