Linked bilateral spinal facet implants and methods of use

• US 7,998,178 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:
  US12/240,281
• Publication Number:
  US 20090024168A1
• 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 comprising:

securing a left coupling portion to a left side of a first vertebra;

securing a right coupling portion to a right side of the first vertebra;

positioning a left articular surface to replace a left natural articular surface of the first vertebra;

positioning a right articular surface to replace a right natural articular surface of the first vertebra;

securing a crosslink to one of the left and right coupling portions; and

actuating a first locking mechanism from a posterior approach to secure the crosslink to the other of the left and right coupling portions

wherein the crosslink is adjustable laterally with respect to the left and right coupling portions,

wherein the left articular surface and the right articular surface are configured to articulate with respect to a facet of an adjacent vertebral body.

2. The method of claim 1, wherein securing the left coupling portion to the left side comprises implanting a left fixation member in a left pedicle of the first vertebra;

wherein securing the right coupling portion to the right side comprises implanting a right fixation member in a right pedicle of the first vertebra.

3. The method of claim 1, wherein the left coupling portion and the left articular surface are both incorporated into a unitarily formed left prosthesis, wherein the right coupling portion and the right articular surface are both incorporated into a unitarily formed right prosthesis.

4. The method of claim 1, wherein actuating the first locking mechanism to secure the crosslink to the other of the left and right coupling portions comprises providing any of a plurality of relative positions of the left and right articular surfaces.

5. The method of claim 1, wherein actuating the first locking mechanism to secure the crosslink to the other of the left and right coupling portions comprises providing any of a plurality of relative orientations of the left and right articular surfaces.

6. The method of claim 1, wherein the crosslink comprises a rod, wherein actuating the first locking mechanism to secure the crosslink to the other of the left and right coupling portions comprises gripping the crosslink.

7. The method of claim 1, wherein actuating the first locking mechanism to secure the crosslink to the other of the left and right coupling portions comprises securing the crosslink in a position in which the crosslink does not contact the first vertebra.

8. The method of claim 1, wherein securing the crosslink to one of the left and right coupling portions comprises actuating a second locking mechanism from a posterior approach.

9. The method of claim 1, further comprising polyaxially adjustably coupling the crosslink to one of the left and right coupling portions.

10. The system of claim 1, wherein positioning the left articular surface to replace the left natural articular surface comprises positioning the left articular surface to replace an inferior left natural articular surface of the first vertebra;

wherein positioning the right articular surface to replace the right natural articular surface comprises positioning the right articular surface to replace an inferior right natural articular surface of the first vertebra.

11. A method comprising:

securing a left coupling portion to a left side of a first vertebra;

securing a right coupling portion to a right side of the first vertebra;

positioning a left articular surface to replace a left natural articular surface of the first vertebra;

positioning a right articular surface to replace a right natural articular surface of the first vertebra such that the right articular surface is displaced from the left articular surface;

coupling a crosslink to one of the left and right coupling portions; and

polyaxially adjustably coupling the crosslink to the other of the left and right coupling portions

wherein the crosslink is adjustable laterally with respect to the left and right coupling portions

wherein the left articular surface and the right articular surface are configured to articulate with respect to a facet of an adjacent vertebral body.

12. The method of claim 11, wherein securing the left coupling portion to the left side comprises implanting a left fixation member in a left pedicle of the first vertebra;

wherein securing the right coupling portion to the right side comprises implanting a right fixation member in a right pedicle of the first vertebra.

13. The method of claim 11, wherein the left coupling portion and the left articular surface are both incorporated into a unitarily formed left prosthesis, wherein the right coupling portion and the right articular surface are both incorporated into a unitarily formed right prosthesis.

14. The method of claim 11, wherein polyaxially adjustably coupling the crosslink to the other of the left and right coupling portions comprises utilizing a ball-and-socket joint to control motion of the crosslink relative to the other of the left and right coupling portions.

15. The method of claim 11, wherein coupling the crosslink to one of the left and right coupling portions comprises coupling the crosslink in a position in which the crosslink does not contact the first vertebra.

16. The method of claim 11, wherein coupling the crosslink to one of the left and right coupling portions comprises polyaxially adjustably coupling the crosslink to the one of the left and right coupling portions.