Facet arthroplasty devices and methods

• US 6,949,123 B2
• Filed: 09/09/2003
• Issued: 09/27/2005
• Est. Priority Date: 10/22/1999
• Status: Expired due to Term

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Archus Orthopedics, Inc. (Globus Medical, Inc.)
• Inventors: Reiley, Mark A
• Primary Examiner(s): Isabella, David J.
• Application Number:
  US10/657,844
• Publication Number:
  US 20040049272A1
• Time in Patent Office: 749 Days
• Field of Search: 606 60- 74, 623 1711- 16
• 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

A prosthesis assembly replaces all or a portion of a caudal portion of a left natural facet joint (i.e., a left superior articular process) and all or a portion of a caudal portion of a right natural facet joint (i.e., a right superior articular process) on a vertebral body. The prosthesis assembly has a left prosthesis body accommodating fixation to the vertebral body at or near a left pedicle and without support by a lamina. An artificial left facet joint structure is carried by the left prosthesis body and is adapted and configured to replace all or a portion of a caudal portion of the left natural facet joint. The prosthesis assembly also has a right prosthesis body accommodating fixation to the vertebral body at or near a right pedicle and without support by a lamina. An artificial right facet joint structure is carried by the right prosthesis body and is adapted and configured to replace all or a portion of a caudal portion of the left natural facet joint.

Claims

1. A prosthesis assembly to replace all or a portion of a caudal portion of a left natural facet joint and all or a portion of a caudal portion of a right natural facet joint on a vertebral body, the prosthesis assembly comprising:

a left prosthesis body accommodating fixation to the vertebral body at or near a left pedicle and without support by a lamina,

an artificial left facet joint structure carried by the left prosthesis body adapted and configured to replace all or a portion of a caudal portion of the left natural facet joint,

a right prosthesis body accommodating fixation to the vertebral body at or near a right pedicle and without support by a lamina, and

an artificial right facet joint structure carried by the right prosthesis body adapted and configured to replace all or a portion of a caudal portion of the right natural facet joint.

2. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints.

3. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least some of a lamina from the vertebral body.

4. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least part of a mamillary process from the vertebral body.

5. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least part of a transverse process from the vertebral body.

6. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least part of a pedicle from the vertebral body.

7. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least some of the natural articular process from the vertebral body.

8. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least some of the natural articular process and of at least some of a lamina from the vertebral body.

9. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least some of the natural articular process and of at least some of a mamillary process from the vertebral body.

10. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints after removal of at least some of the natural articular process and of at least part of a transverse process from the vertebral body.

11. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the natural left and right facet joints after removal of at least some of the natural articular process and of at least part of a pedicle from the vertebral body.

12. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints, and wherein at least one of the prosthesis bodies is adapted and configured to replace at least some of a lamina of the vertebral body.

13. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints, and wherein at least one of the prosthesis bodies is adapted and configured to replace at least some of a mamillary process of the vertebral body.

14. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to replace a natural articular process of a caudal portion of the respective one of the left and right natural facet joints, and wherein at least one of the prosthesis bodies is adapted and configured to replace at least some of a pedicle of the vertebral body.

15. A prosthesis assembly according to claim 1 wherein at least one of the prosthesis bodies is adapted and configured to replace at least some of a lamina of the vertebral body.

16. A prosthesis assembly according to claim 1 wherein at least one of the prosthesis bodies is adapted and configured to replace at least some of a mamillary process of the vertebral body.

17. A prosthesis assembly according to claim 1 wherein at least one of the prosthesis bodies is adapted and configured to replace at least some of a pedicle of the vertebral body.

18. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is adapted and configured to articulate with a cephalad portion of the respective one of the left and right facet joints of an adjoining vertebral body.

19. A prosthesis assembly according to claim 1 wherein at least one of the artificial left and right facet joint structures is made of at least one selected prosthetic material.

20. A prosthesis according to claim 1 wherein the selected prosthetic material includes polyethylene, rubber, tantalum, titanium, chrome cobalt, surgical steel, bony in-growth material, ceramic, artificial bone, or a combination thereof.

21. A prosthesis assembly according to claim 1 wherein a connecting member joins the left and right prosthesis bodies without support by a lamina.

22. A prosthesis assembly according to claim 1 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body.

23. A prosthesis assembly according to claim 1 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body, and wherein the respective one of the artificial left and right facet joint structures is carried by the fastening element.

24. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures is fixed to the fastening element.

25. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures is fixed to the fastening element by an adhesive or cement.

26. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures is fixed to the fastening element by mechanical attachment.

27. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures is removably carried by the fastening element.

28. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures is removably attached to the fastening element by frictional engagement.

29. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures is removably attached to the fastening element by a Morse taper.

30. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures comprises an insert fitted to the fastening element.

31. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures comprises an insert fitted by frictional engagement to the fastening element.

32. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures comprises an insert fitted by a Morse taper to the fastening element.

33. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures comprises a removable insert fitted to the fastening element.

34. A prosthesis assembly according to claim 23 wherein the respective one of the artificial facet joint structures pivots with respect to the fastening element.

35. A prosthesis assembly according to claim 22 wherein the fastening element is fixed to the vertebral body by an adhesive or cement.

36. A prosthesis assembly according to claim 22 wherein the fastening element includes a bony in-growth material.

37. A prosthesis assembly according to claim 22 wherein the fastening element includes a screw installed within the vertebral body at or near a pedicle.

38. A prosthesis assembly according to claim 22 wherein the fastening element includes a stem installed within the vertebral body at or near a pedicle.

39. A prosthesis assembly according to claim 22 wherein the fastening element including means for resisting rotation after installation in the vertebral body.

40. A prosthesis assembly according to claim 1 wherein at least one of the prosthesis bodies is fixed to the vertebral body by an adhesive or cement.

41. A prosthesis assembly according to claim 1 wherein at least one of the prosthesis bodies includes a bony in-growth material.

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

(i) removing all or a portion of the caudal portions of the left and right natural facet joints from the vertebral body, and

(ii) fixing the prosthesis assembly as defined in claim 1 to the vertebral body to replace both removed caudal portions of the left and right natural facet joints with the artificial facet joint structure.

43. A method according to claim 42 further including a step of removing at least some of the lamina from the vertebral body.

44. A method according to claim 42 further including a step of removing at least part of a mamillary process from the vertebral body.

45. A method according to claim 42 further including a step of removing at least part of a transverse process from the vertebral body.

46. A method according to claim 42 further including a step of removing at least part of a pedicle from the vertebral body.

47. A prosthesis assembly according to claim 21 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body, and the fastening element is fixed to the vertebral body by an adhesive or cement.

48. A prosthesis assembly according to claim 21 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body, and the fastening element includes a bony in-growth material.

49. A prosthesis assembly according to claim 21 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body, and the fastening element includes a screw installed within the vertebral body at or near a pedicle.

50. A prosthesis assembly according to claim 21 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body, and the fastening element includes a stem installed within the vertebral body at or near a pedicle.

51. A prosthesis assembly according to claim 21 wherein at least one of the left and right prosthesis bodies includes a fastening element installed within the vertebral body at or near a pedicle to fix the respective prosthesis body to the vertebral body, and the fastening element includes means for resisting rotation after installation in the vertebral body.

52. A prosthesis assembly according to claim 23 wherein the fastening element is fixed to the vertebral body by an adhesive or cement.

53. A prosthesis assembly according to claim 23 wherein the fastening element includes a bony in-growth material.

54. A prosthesis assembly according to claim 23 wherein the fastening element includes a screw installed within the vertebral body at or near a pedicle.

55. A prosthesis assembly according to claim 23 wherein the fastening element includes a stem installed within the vertebral body at or near a pedicle.

56. A prosthesis assembly according to claim 23 wherein the fastening element including means for resisting rotation after installation in the vertebral body.