Inter-cervical facet implant with locking screw and method

• US 7,763,050 B2
• Filed: 03/30/2005
• Issued: 07/27/2010
• Est. Priority Date: 12/13/2004
• Status: Expired due to Fees

• Current Assignee: Kyphon SARL (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Flynn, John J., Mitchell, Steven T., Zucherman, James F., Winslow, Charles J., Hsu, Ken Y., Yerby, Scott A.
• Primary Examiner(s): Barrett; Thomas C
• Assistant Examiner(s): WOODALL, NICHOLAS W
• Application Number:
  US11/093,557
• Publication Number:
  US 20060149239A1
• Time in Patent Office: 1,945 Days
• Field of Search: 606/61, 606/69, 606/70, 606/71
• US Class Current: 606/247
• CPC Class Codes: A61B 17/562 Implants for placement in joint gaps without restricting joint motion, e.g. to reduce arthritic pain
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7022 Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables A61B17/702 takes precedence
• CPC Class Codes: A61B 17/7028 the flexible part being a coil spring
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7071 Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
• CPC Class Codes: A61B 17/8042 the additional component being a cover over the screw head
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone
• 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

Abstract

Systems and method in accordance with the embodiments of the present invention can include an implant for positioning within a cervical facet joint for distracting the cervical spine, thereby increasing the area of the canals and openings through which the spinal cord and nerves must pass, and decreasing pressure on the spinal cord and/or nerve roots. The implant can be inserted laterally or posteriorly.

Claims

1. A facet joint implant that addresses spinal stenosis and other ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer sized to fit between adjacent superior and inferior facets, the inter-facet joint spacer having an upper surface adapted to support the inferior facet and a lower surface adapted to support the superior facet;

an anchoring plate having a connecting portion pivotably attached to the spacer, the connecting portion configured to freely pivot the anchoring plate relative to the spacer,

the inter-facet joint spacer being sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer;

a bone screw;

a locking screw;

the anchoring plate receives the bone screw and the locking screw; and

wherein the locking screw is adapted to self-cut into a vertebra and to block the bone screw, the locking screw and the bone screw adapted to anchor the anchoring plate to the vertebra,

wherein the locking screw is positioned medially, relative to the bone screw in the patient.

2. The implant of claim 1 wherein the locking screw has a head that blocks the bone screw from at least one of a backward displacement and a rotational displacement.

3. The implant of claim 1 wherein the locking screw further comprises a chisel-point end, wherein the chisel point end self-cuts the locking screw into the vertebra.

4. The implant of claim 1 wherein the locking screw and the bone screw are adapted to prevent at least one of a backward displacement and a rotational displacement of the implant.

5. The implant of claim 1 wherein said connecting portion is comprised of a flexible material.

6. The facet joint implant of claim 1, wherein the inter-facet joint spacer, the connecting portion, and the anchoring plate form an hour-glass shape, with the connecting portion forming the isthmus.

7. The facet joint implant of claim 1, wherein the inter-facet joint spacer and the connecting portion are P-shaped.

9. The implant in claim 1 wherein the anchoring plate has a first bore that receives the bone screw and a second bore that receives the locking screw.

8. A facet joint implant that addresses spinal stenosis and other ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer freely pivotably connected to an anchoring plate at a connecting portion, the inter-facet joint spacer having an upper surface adapted to support an inferior facet and a lower surface adapted to support a superior facet, the inter-facet joint spacer being sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer;

a bone screw;

a locking screw;

the anchoring plate receives the bone screw and the locking screw; and

wherein the locking screw is adapted to self-cut into a vertebra and to block the bone screw, the locking screw and the bone screw adapted to anchor the anchoring plate to the vertebra,

wherein said connection is a hinge.

10. A facet joint implant that addresses spinal stenosis and other ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer flexibly connected to an anchoring plate at a connecting portion, the inter-facet joint spacer having an upper surface adapted to support an inferior facet and a lower surface adapted to support a superior facet, the inter-facet joint spacer being sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer;

only one bone screw;

only one locking screw;

the anchoring plate receives the bone screw and the locking screw; and

wherein the locking screw is adapted to self-cut into a vertebra and to block the bone screw, the locking screw and the bone screw adapted to anchor the anchoring plate to the vertebra,

wherein the anchoring plate has a first bore that receives the bone screw and a second bore that receives the locking screw, and

wherein when the implant is adapted to be implanted from the right side of a patient and the second bore is positioned to the left of the first bore when the implant is viewed from a posterior perspective.

11. A facet joint implant that addresses spinal stenosis and other ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer flexibly connected to an anchoring plate at a connecting portion, the inter-facet joint spacer having an upper surface adapted to support an inferior facet and a lower surface adapted to support a superior facet, the inter-facet joint spacer being sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer;

only one bone screw;

only one locking screw;

the anchoring plate receives the bone screw and the locking screw; and

wherein the locking screw is adapted to self-cut into a vertebra and to block the bone screw, the locking screw and the bone screw adapted to anchor the anchoring plate to the vertebra,

wherein the anchoring plate has a first bore that receives the bone screw and a second bore that receives the locking screw, and

wherein when the implant is adapted to be implanted from the left side of a patient and the second bore is positioned to the right of the first bore when the implant is viewed from a posterior perspective.

12. A facet joint implant that addresses spinal stenosis and other ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer;

an anchoring plate pivotably coupled to the spacer at a connecting portion, the anchoring plate configured to freely pivot relative to the spacer from a first insertion position to a second insertion position, wherein the first position is configured to introduce the spacer into the joint and the second position is configured to conform the plate to a vertebral bone surface at an angle to the joint, the plate having a first bore and a second bore, the inter-facet joint spacer being sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer;

a bone screw;

a locking screw;

the first bore receives and guides the bone screw into a vertebra to anchor the implant;

the second bore receives the locking screw; and

the locking screw includes a head that prevents displacement of the bone screw, and a chisel end adapted to self-cut the locking screw into the vertebra;

wherein the locking screw is positioned medially relative to the bone screw in a patient.

13. The implant of claim 12, wherein the anchoring plate in the first insertion position is oriented about 180 degrees relative to the inter-facet joint spacer, and wherein the anchoring plate in the second insertion position is oriented less than 180 degrees relative to the inter-facet joint plate.

14. A facet joint implant for treating ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer having an upper surface configured to support an inferior facet of an upper vertebra and a lower surface configured to support a superior facet of a lower vertebra;

an anchoring plate freely pivotably connected to the inter-facet joint spacer at a connecting portion, the anchoring plate having first and second screw receiving portions;

wherein the inter-facet joint spacer being sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer, the connecting portion being offset relative to the inter-facet joint spacer;

only one bone screw configured to attach the anchoring plate to a vertebra through the first screw receiving portion;

a locking screw configured to attach the anchoring plate to a vertebra through the second screw receiving portion, the locking screw being configured to self-cut into a vertebra and to restrict removal of the bone screw, the locking screw and the bone screw being configured to cooperatively anchor the anchoring plate to the vertebra in a manner that the locking screw restricts rotation of the anchoring plate about the bone screw.

15. The implant of claim 14, wherein the inter-facet joint spacer is formed of only one plate.

16. The implant of claim 15, wherein the upper surface of the single plate has a convex shape and the lower surface has a concave shape.

17. The implant of claim 14, wherein the inter-facet joint spacer includes a distal end and a proximal end, the proximal end being freely pivotably connected to the anchoring plate, the distal end having a thickness less than a thickness of the proximal end.

18. The implant of claim 14, wherein the locking screw includes a head configured to restrict removal the bone screw from at least one of a backward displacement and a rotational displacement when the bone screw and the locking screw are located through the first and second screw receiving portions.

19. The implant of claim 14, wherein the locking screw further comprises a chisel-point end configured to self-cut the locking screw into the vertebra.

20. The implant of claim 14, wherein the locking screw is positioned medially, relative to the bone screw in the patient.

21. The implant of claim 14, wherein the locking screw and the bone screw are adapted to prevent at least one of a backward displacement and a rotational displacement of the implant.

22. The implant of claim 14, wherein the anchoring plate and the inter-facet joint spacer are flexibly connected at a connection feature comprised of a flexible material.

23. The implant of claim 14, wherein the anchoring plate and the inter-facet joint spacer are flexibly connected at a hinge.

24. The implant in claim 14, wherein the first and second screw receiving portions are first and second bores respectively sized to receive the bone screw and the locking screw.

25. The implant of claim 24, wherein when the implant is adapted to be implanted from the right side of a patient and the second bore is positioned to the left of the first bore when the implant is viewed from a posterior perspective.

26. The implant of claim 24, wherein when the implant is adapted to be implanted from the left side of a patient and the second bore is positioned to the right of the first bore when the implant is viewed from a posterior perspective.

27. The implant of claim 14, wherein the first and second screw receiving portions are first and second screw-receiving bores and are the only screw-receiving bores in the anchoring plate, the screw-receiving bores having different diameters and being spaced adjacent to each other so that a portion of the locking screw overlaps a portion of the bone screw.

28. A facet joint implant for treating ailments of the spine while maintaining mobility of the facet joint, the implant comprising:

an inter-facet joint spacer having an upper surface configured to interface with an inferior facet of an upper vertebra and a lower surface configured to interface with a superior facet of a lower vertebra;

only one anchoring plate freely pivotably connected to the inter-facet joint spacer at a connecting portion and being configured to secure the inter-facet joint spacer in place on a single one of the upper and lower vertebrae, the anchoring plate having a screw receiving portion, wherein the inter-facet joint spacer is sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer, the connecting portion being offset relative to the inter-facet joint spacer;

only one bone screw configured to attach the anchoring plate to said single one of the upper and lower vertebrae through the screw receiving portion;

only one locking screw configured to attach the anchoring plate to said single one of the upper and lower vertebrae through the screw receiving portion, the locking screw being configured to restrict removal of the bone screw, the locking screw and the bone screw being configured to cooperatively anchor the anchoring plate to the vertebra in a manner that the locking screw restricts rotation of the anchoring plate about the bone screw.

29. The implant of claim 28, wherein the inter-facet joint spacer is formed of a single plate.

30. The implant of claim 29, wherein the upper surface of the single plate has a convex shape and the lower surface has a concave shape.

31. The implant of claim 28, wherein the locking screw includes a head configured to restrict removal the bone screw from at least one of a backward displacement and a rotational displacement when the bone screw and the locking screw are located through the screw receiving portion.

32. A method for implanting a facet joint implant into a facet joint, the method comprising the steps of:

accessing a facet joint;

urging an inter-facet joint spacer into the facet joint so that an upper surface of spacer supports an inferior facet of an upper vertebra and a lower surface of the spacer supports a superior facet of a lower vertebra, the inter-facet joint spacer being freely pivotably connected to an anchoring plate at a connecting portion, wherein the inter-facet joint spacer is sized with a first overall width measured laterally across the inter-facet joint spacer, the connecting portion having a second overall width measured laterally across the connecting portion in a direction substantially parallel to the lateral direction of the first width, the second overall width being less than the first overall width such that the connecting portion is narrower than the inter-facet joint spacer;

driving only one bone screw through the anchoring plate freely pivotably connected to the inter-facet joint spacer and into a lateral mass or lamina of a vertebra to anchor the anchoring plate to the bone screw; and

driving only one locking screw through the anchoring plate into a lateral mass or lamina of a vertebra in a manner that both restricts removal of the bone screw and restricts rotation of the anchoring plate about the bone screw.

33. The method of claim 32, wherein the locking screw comprises a chisel end, and wherein driving the locking screw comprises self-cutting a locking screw channel into the vertebra with the chisel end.

34. The method of claim 32, further comprising distracting the facet joint prior to urging the inter-facet joint spacer into the facet joint.

35. The method of claim 32, wherein driving the bone screw further comprises:

guiding the bone screw by a first bore in the anchoring plate; and

driving the bone screw into the lateral mass or lamina through the first bore;

and wherein driving the locking screw comprises;

guiding the locking screw by a second bore in the anchoring plate; and

driving the locking screw into the lateral mass or lamina through the second bore.

36. The method of claim 32 wherein restricting removal of the bone screw comprises causing a head of the locking screw to overlap with and contact a head of the bone screw to prevent the bone screw from at least one of backward or rotational displacement.

37. A method for implanting a facet joint implant into a facet joint, the method comprising the steps of:

accessing a facet joint;

urging an inter-facet joint spacer into the facet joint so that an upper surface of spacer supports an inferior facet of an upper vertebra and a lower surface of the spacer supports a superior facet of a lower vertebra;

driving only one bone screw through the anchoring plate freely pivotably connected at a connection to the inter-facet joint spacer and into a lateral mass or lamina of a vertebra to anchor the anchoring plate to the bone screw; and

driving only one locking screw through the anchoring plate into a lateral mass or lamina of a vertebra in a manner that both restricts removal of the bone screw and restricts rotation of the anchoring plate about the bone screw,

wherein the connection comprises a hinge, the hinge and spacer comprising a P-shape configured to be inserted into the facet joint with most of a facet capsule, a facet capsule ligament, and a synovial membrane left intact, the spacer having at least one edge with a lateral curvature extending medially from the hinge establishing a maximum width of the spacer, the P-shape narrowing to an isthmus at the hinge and the at least one edge being thinned along the lateral curvature; and

the urging step comprising;

orienting the spacer transverse to the facet joint,

introducing the at least one edge through an incision, the incision having a width less than the maximum width of the spacer,

advancing the at least one edge until the spacer is approximately, centrally positioned within the facet capsule, and

rotating the spacer about 90 degrees.