Linked bilateral spinal facet implants and methods of use

• US 7,998,177 B2
• Filed: 09/29/2008
• Issued: 08/16/2011
• Est. Priority Date: 02/17/2004
• Status: Active Grant

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Gmedelaware 2 LLC (Globus Medical, Inc.)
• Inventors: Justin, Daniel F., Hoy, Robert W., Fallin, T. Wade, Chervitz, Alan
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): Harvey; Julianna N
• Application Number:
  US12/240,244
• Publication Number:
  US 20090030460A1
• Time in Patent Office: 1,051 Days
• Field of Search: 606/247, 606/279, 623 1711- 1716
• US Class Current: 606/279
• CPC Class Codes: A61B 17/7049 Connectors, not bearing on the vertebrae, for linking longitudinal elements together A61B17/7055, A61B17/7053, A61B17/7019 take precedence
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7067 Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
• CPC Class Codes: A61B 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 17/8695 Washers surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone
• CPC Class Codes: A61F 2/30771 applied in original prostheses, e.g. holes or grooves
• 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 2002/30125 elliptical or oval
• CPC Class Codes: A61F 2002/30154 square
• CPC Class Codes: A61F 2002/30156 triangular
• CPC Class Codes: A61F 2002/30171 rosette- or star-shaped
• CPC Class Codes: A61F 2002/30179 X-shaped
• CPC Class Codes: A61F 2002/30426 Bayonet coupling
• CPC Class Codes: A61F 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30448 using adhesives
• CPC Class Codes: A61F 2002/30514 using a locking washer
• CPC Class Codes: A61F 2002/30574 with an integral complete or partial collar or flange
• CPC Class Codes: A61F 2002/30576 with extending fixation tabs
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30616 : Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30663 : multiaxial, e.g. biaxial; multipolar, e.g. bipolar or having an intermediate shell articulating between the ball and the socket
• 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 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30934 : Special articulating surfaces
• 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 2220/005 : using adhesives
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0021 : square
• CPC Class Codes: A61F 2230/0023 : triangular
• CPC Class Codes: A61F 2230/005 : Rosette-shaped, e.g. star-shaped
• 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 2310/00203 : containing alumina or aluminium oxide
• CPC Class Codes: A61F 2310/00239 : containing zirconia or zirconium oxide ZrO2
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
• CPC Class Codes: A61F 2310/00928 : Coating or prosthesis-covering structure made of glass or of glass-containing compounds, e.g. of bioglass

Abstract

Superior and/or inferior facets of one or more facet joints may be replaced by superior and/or inferior facet joint prostheses. In one embodiment, a kit of superior or inferior prostheses is provided, in which the prostheses have at least two dimensions that vary among members of the kit independently of each other. Each prosthesis may have a bone engaging surface having a surface that is polyaxially rotatable against a corresponding resection of a vertebra. Each prosthesis may also have an articulating surface shaped such that, after attachment to the spine, the replaced or partially replaced facet joints provide a larger medial-lateral range of motion when the spine is flexed than when the spine is extended. Crosslinks may be used to connect left and right prosthesis together in such a manner that they are stabilized in a position in which they are seated directly against the vertebra.

Claims

1. A method for replacing facets of a mammalian vertebra, the method comprising:

resecting the vertebra to provide first and second resected portions of the vertebra;

attaching a first prosthesis to the first resected portion such that a first articulating surface of the first prosthesis is positioned to articulate against a first facet of an adjacent vertebra;

attaching a second prosthesis to the second resected portion such that a second articulating surface of the second prosthesis is positioned to articulate against a second facet of the adjacent vertebra;

selecting any one of a plurality of displacement values between the first and second prostheses;

positioning a crosslink between adjacent spinous processes of the vertebra; and

attaching the crosslink to the first and second prostheses after attachment of at least one of the prostheses to the vertebra such that the crosslink extends between the first and second prostheses to provide the selected displacement value between the prostheses,

wherein the crosslink is adjustable laterally with respect to the first and second prostheses.

2. The method of claim 1, wherein attaching the crosslink to the prostheses comprises gripping the crosslink with a first gripping mechanism of a first coupling coupled to the first prosthesis at any of a plurality of positions along an axis of the crosslink.

3. The method of claim 2, wherein attaching the crosslink to the prostheses further comprises gripping the crosslink with a second gripping mechanism of a second coupling coupled to the second prosthesis at any of a plurality of positions along the axis.

4. The method of claim 2, wherein attaching the crosslink to the prosthesis further comprises:

positioning flanges on either side of the crosslink; and

gripping the crosslink between the flanges.

5. The method of claim 4, wherein gripping the crosslink between the flanges comprises rotating a first turnbuckle to urge the flanges together.

6. The method of claim 4, further comprising fixing an angular displacement between the prostheses about a first axis at any of a plurality of angular displacement values.

7. The method of claim 6, wherein fixing the angular displacement between the prostheses comprises engaging a semispherical member of the first prosthesis with the flanges to provide a ball-and-socket joint.

8. The method of claim 7, wherein the semispherical member has surface features selected from a group consisting of divots, splines, knurling, longitudinal grooves, circumferential grooves, facets, nubs, and combinations thereof, wherein engaging the semispherical member comprises urging the surface features against the flanges to resist relative rotation between the first coupling and the semispherical member.

9. The method of claim 1, wherein attaching the crosslink to the prostheses comprises compressing the prostheses against the vertebra.

10. A method for replacing facets of a mammalian vertebra, the method comprising:

resecting the vertebra to provide first and second resected portions of the vertebra;

attaching a first inferior prosthesis to the first resected portion such that a first articulating surface of the first inferior prosthesis is positioned to articulate against a first superior facet of an adjacent vertebra;

attaching a second inferior prosthesis to the second resected portion such that a second articulating surface of the second inferior prosthesis is positioned to articulate against a second superior face of the adjacent vertebra;

selecting any one of a plurality of displacement values between the first and second inferior prosthesis; and

attaching a crosslink to the first and second inferior prosthesis such that the crosslink extends between the first and second inferior prostheses to provide the selected displacement value between the inferior prostheses,

wherein the crosslink is positioned between adjacent spinous processes of the vertebra and is adjustable laterally with respect to the first and second prostheses.

11. The method of claim 10, wherein attaching the crosslink to the inferior prostheses comprises gripping the crosslink with a first gripping mechanism of a first coupling coupled to the first inferior prosthesis at any of a plurality of positions along an axis of the crosslink.

12. The method of claim 11, wherein attaching the crosslink to the inferior prostheses further comprises gripping the crosslink with a second gripping mechanism of a second coupling coupled to the second inferior prostheses at any of a plurality of positions along the axis.

13. The method of claim 11, wherein attaching the crosslink to the inferior prosthesis further comprises:

positioning flanges on either sides of the crosslink; and

gripping the crosslink between the flanges.

14. The method of claim 13, wherein gripping the crosslink between the flanges comprises rotating a first turnbuckle to urge the flanges together.

15. The method of claim 13, further comprising fixing an angular displacement between the inferior prostheses about a first axis at any of a plurality of angular displacement values.

16. The method of claim 15, wherein fixing the angular displacement between the inferior prostheses comprises engaging a semispherical member of the first inferior prosthesis with the flanges to provide a ball-and-socket joint.

17. The method of claim 16, wherein the semispherical member has surface features selected from a group consisting of divots, splines, knurling, longitudinal grooves, circumferential grooves, facets, nubs, and combinations thereof, wherein engaging the semispherical member comprises urging the surface features against the flanges to resist relative rotation between the first coupling and the semispherical member.

18. The method of claim 10, wherein attaching the crosslink to the inferior prostheses comprises compressing the inferior prostheses against the vertebra.

19. A method for replacing facets of a mammalian vertebra the method comprising:

resecting the vertebra to provide first and second resected portions of the vertebra;

attaching a first prosthesis to the first resected portion such that a first articulating surface of the first prosthesis is positioned to articulate against a first facet of an adjacent vertebra;

attaching a second prosthesis to the second resected portion such that a second articulating surface of the second prosthesis is positioned to articulate against a second facet of the adjacent vertebra;

selecting any one of a plurality of angular displacement values between the first and second prosthesis about a first axis; and

attaching a crosslink to the first and second prostheses such that the crosslink extends between the prostheses to fix an orientation of the first prosthesis with respect to the second prosthesis to provide the selected angular displacement value,

wherein the crosslink is positioned between adjacent spinous processes and is adjustable laterally with respect to the first and second prostheses.

20. The method of claim 19, wherein attaching the crosslink to the prostheses comprises gripping the crosslink with a first gripping mechanism of a first coupling coupled to the first prosthesis at any of a plurality of positions along an axis of the crosslink.

21. The method of claim 19, wherein attaching the crosslink to the prostheses further comprises gripping the crosslink with a second gripping mechanism of a second coupling coupled to the second prostheses at any of a plurality of positions along the axis.

22. The method of claim 19, wherein attaching the crosslink to the inferior prosthesis further comprises:

positioning flanges on either sides of the crosslink; and

gripping the crosslink between the flanges.

23. The method of claim 22, wherein gripping the crosslink between the flanges comprises rotating a first turnbuckle to urge the flanges together.

24. The method of claim 22, further comprising fixing an angular displacement between the inferior prostheses about a second axis perpendicular to the first axis, at any of a plurality of angular displacement values.

25. The method of claim 24, wherein fixing the angular displacement between the prostheses comprises engaging a semispherical member of the first prosthesis with the flanges to provide a ball-and-socket joint.

26. The method of claim 25, wherein the semispherical member has surface features selected from a group consisting of divots, splines, knurling, longitudinal grooves, circumferential grooves, facets, nubs, and combinations thereof, wherein engaging the semispherical member comprises urging the surface features against the flanges to resist relative rotation between the first coupling and the semispherical member.

27. The method of claim 19, wherein attaching the crosslink to the prostheses comprises compressing the prostheses against the vertebra.