Methods and surgical kits for minimally-invasive facet joint fusion
First Claim
1. A method comprising:
- creating an incision;
locating a facet joint with a distal end of a pin wherein said facet joint is formed between two opposing facet joint bones and said pin comprises said distal end and a proximal end;
sliding a substantially hollow spatula over said pin wherein said spatula comprises a proximal end, a distal end and a body wherein said distal end comprises a planar wedge, and said body comprises a longitudinal marking that can indicate the orientation of said planar wedge and one or more transverse guide markings near the proximal end of said spatula;
adjusting the rotation of said planar wedge until said planar wedge enters said facet joint;
sliding a substantially hollow drill guide over said spatula wherein said drill guide comprises a proximal end, a distal end, a longitudinal axis extending from the proximal end to the distal end and a handle wherein said handle is nearer to the proximal end of the drill guide than to the distal end, said distal end comprises two opposed teeth that can be inserted into said facet joint and a marking on said proximal end that can be aligned with said longitudinal marking on said spatula thereby allowing the orientation of said opposed teeth to be in approximately the same plane defined by said planar wedge;
inserting said drill guide into said incision until said proximal end of the drill guide aligns with said first transverse guide mark on said spatula;
aligning said longitudinal marking on said spatula with said marking on said drill guide thereby aligning said opposed teeth in approximately the same plane defined by said planar wedge;
further inserting said drill guide into said incision and using said one or more transverse guide markings to indicate the depth of the insertion of said teeth of said drill guide into said facet joint;
removing said spatula from within said drill guide;
inserting a drill bit into said drill guide, wherein the drill bit comprises a longitudinal drill bit axis, and wherein the drill bit axis is concentric with the longitudinal axis;
drilling a hole into said facet joint by simultaneously drilling the two opposing facet joint bones;
removing said drill bit;
inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near its proximal end, wherein said raised portion prevents over-insertion of said bone plug; and
removing said drill guide.
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Accused Products
Abstract
Disclosed herein are methods and surgical kits that can be used to fuse facet joints via a minimally invasive procedure (including an arthroscopic or percutaneous procedure). An exemplary method includes creating an incision; locating a facet joint with a distal end of a pin; sliding a substantially hollow drill guide over said pin wherein said drill guide comprises a proximal end, a distal end; removing said pin from within said drill guide; inserting a drill bit into said drill guide; drilling a hole into a bone of said facet joint; removing said drill bit; inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near is proximal end, wherein said raised portion prevents over-insertion of said bone plug; and removing said drill guide.
189 Citations
21 Claims
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1. A method comprising:
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creating an incision; locating a facet joint with a distal end of a pin wherein said facet joint is formed between two opposing facet joint bones and said pin comprises said distal end and a proximal end; sliding a substantially hollow spatula over said pin wherein said spatula comprises a proximal end, a distal end and a body wherein said distal end comprises a planar wedge, and said body comprises a longitudinal marking that can indicate the orientation of said planar wedge and one or more transverse guide markings near the proximal end of said spatula; adjusting the rotation of said planar wedge until said planar wedge enters said facet joint; sliding a substantially hollow drill guide over said spatula wherein said drill guide comprises a proximal end, a distal end, a longitudinal axis extending from the proximal end to the distal end and a handle wherein said handle is nearer to the proximal end of the drill guide than to the distal end, said distal end comprises two opposed teeth that can be inserted into said facet joint and a marking on said proximal end that can be aligned with said longitudinal marking on said spatula thereby allowing the orientation of said opposed teeth to be in approximately the same plane defined by said planar wedge; inserting said drill guide into said incision until said proximal end of the drill guide aligns with said first transverse guide mark on said spatula; aligning said longitudinal marking on said spatula with said marking on said drill guide thereby aligning said opposed teeth in approximately the same plane defined by said planar wedge; further inserting said drill guide into said incision and using said one or more transverse guide markings to indicate the depth of the insertion of said teeth of said drill guide into said facet joint; removing said spatula from within said drill guide; inserting a drill bit into said drill guide, wherein the drill bit comprises a longitudinal drill bit axis, and wherein the drill bit axis is concentric with the longitudinal axis; drilling a hole into said facet joint by simultaneously drilling the two opposing facet joint bones; removing said drill bit; inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near its proximal end, wherein said raised portion prevents over-insertion of said bone plug; and removing said drill guide. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method comprising:
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creating an incision; locating a facet joint with a distal end of a pin wherein said facet joint is formed between two opposing facet joint bones and said pin comprises said distal end and a proximal end; sliding a substantially hollow spatula over said pin wherein said spatula comprises a proximal end, a distal end and a body wherein said distal end comprises a planar wedge, and said body comprises a longitudinal marking that can indicate the orientation of said planar wedge, and one or more transverse guide markings near the proximal end of said spatula; adjusting the rotation of said planar wedge until said planar wedge enters said facet joint; sliding a substantially hollow drill guide over said spatula wherein said drill guide comprises a proximal end, a distal end wherein said distal end comprises opposed teeth with a length longer than about 3 mm that can be inserted into said facet joint, a longitudinal axis extending from the proximal end to the distal end, a handle wherein said handle is nearer to the proximal end of the drill guide than to the distal end, and a marking on said proximal end that can be aligned with said longitudinal marking on said spatula thereby allowing the orientation of said opposed teeth to be in approximately the same plane defined by said planar wedge, and; inserting said drill guide into said incision until said proximal end of the drill guide aligns with said first transverse guide mark on said spatula; aligning said longitudinal marking on said spatula with said marking on said drill guide thereby aligning said opposed teeth in approximately the same plane defined by said planar wedge; further inserting said drill guide into said incision until said proximal end of the drill guide aligns with said second transverse guide mark on said spatula, thereby indicating that said distal end of said drill guide is at the entry level of said facet joint or closely approaching it; further aligning said longitudinal marking on said spatula with said marking on said drill guide thereby assuring said opposed teeth are in approximately the same plane defined by said planar wedge; further inserting said drill guide into said incision and using said one or more transverse guide markings to indicate the depth of the insertion of said teeth of said drill guide into said facet joint; removing said spatula from within said drill guide; inserting a drill bit into said drill guide, wherein the drill bit comprises a longitudinal drill bit axis, wherein the drill bit axis is concentric to the longitudinal axis; drilling a hole into said facet joint by simultaneously drilling the two opposing facet joint bones; removing said drill bit; inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near its proximal end, wherein said raised portion prevents over-insertion of said bone plug; removing said drill guide; and closing said incision wherein said pin has also been removed prior to said closing of said incision. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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Specification