Facet joint implant crosslinking apparatus and method

• US 8,764,801 B2
• Filed: 02/07/2006
• Issued: 07/01/2014
• Est. Priority Date: 03/28/2005
• Status: Active Grant

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Gmedelaware 2 LLC (Globus Medical, Inc.)
• Inventors: Chervitz, Alan, Triplett, Daniel J.
• Primary Examiner(s): Schaper, Michael T
• Application Number:
  US11/350,179
• Publication Number:
  US 20060217718A1
• Time in Patent Office: 3,066 Days
• Field of Search: 606/61, 606/247, 606250-253, 606/258, 623 1711- 1716
• US Class Current: 606/247
• CPC Class Codes: A61B 17/7014 with means for adjusting the distance between two screws or hooks
• CPC Class Codes: A61B 17/7019 Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7034 characterised by a lateral opening
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7043 with a longitudinal element fixed to one or more transverse elements which connect multiple screws or hooks
• CPC Class Codes: A61B 17/7052 of variable angle or length
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• 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 2002/30367 with additional means for preventing said rotation
• CPC Class Codes: A61F 2002/30395 with additional means for preventing or locking said rotation
• CPC Class Codes: A61F 2002/30471 connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/3054 about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
• CPC Class Codes: A61F 2002/30878 with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0091 connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation

Abstract

A crosslink is provided for securing orthopedic implants, such as facet joint replacement implants, together. The crosslink has a pair of implant coupling components, a pair of rod coupling components, a rod, and a pair of fasteners. Each facet joint implant may include a semicylindrical interface received in a resilient member of the corresponding implant coupling component to permit relative cephalad/caudal adjustment between the crosslink and the implants. The resilient members grip the semicylindrical interface of the implant to enable at least temporary attachment of the implant coupling components to the implants independently of the rod. Clocking features on the semicylindrical interfaces and on the interfacing areas of the implant coupling components and rod coupling components may limit assembly of the crosslink to discrete relative orientations and prevent play after assembly. The fasteners secure the rod coupling components to the rod at the desired positions along the rod.

Claims

1. A system comprising:

a first left implant having an opening for receiving a first fastener, the first fastener having a first head portion and first shaft portion, the first shaft portion engageable with a first vertebra, the first left implant comprising a first left articular surface and a left crosslink coupling interface, wherein the first left articular surface is shaped to articulate with a second left articular surface on a second vertebra;

a first right implant having an opening for receiving a second fastener, the second fastener having a second head portion and second shaft portion, the second shaft portion engageable with the first vertebra, the first right implant comprising a first right articular surface shaped to articulate with a second right articular surface on the second vertebra; and

a crosslink attachable to the first left and right implants to secure the first left implant with respect to the first right implant at any of a limited number of discrete relative displacements, the crosslink comprising a rod and a left implant coupling component, wherein the rod attaches to the left implant coupling component, the left implant coupling component having a left implant coupling interface, wherein the left implant coupling interface attaches directly to the left crosslink coupling interface, wherein a left clocking feature including a plurality of ridges facing the crosslink formed between the left implant coupling interface and the left crosslink coupling interface, wherein the left clocking feature limits attachment between the left implant coupling component and the first left implant to the discrete relative displacements,

wherein the left implant coupling component comprises a resilient member, wherein the resilient member comprises the left implant coupling interface, wherein the left implant coupling interface snaps onto the left crosslink coupling interface to secure the first left implant to the first right implant.

2. The system of claim 1, wherein the crosslink comprises a right implant coupling component, wherein the left and right implant coupling components are securable to the first left and right implants, respectively, independently of securing the first left implant to the first right implant.

3. The system of claim 1, wherein the crosslink is adjustably positionable with respect to the first left implant along an axis having a substantially cephalad/caudal orientation.

4. The system of claim 1, wherein the discrete relative displacements are rotationally offset from each other.

5. The system of claim 1, wherein the crosslink is configured such that attachment of the crosslink to the first left and right implants does not place the crosslink in direct contact with the first vertebra.

6. The system of claim 1, wherein the crosslink is configured such that attachment of the crosslink to the first left and right implants does not require resection of a spinous process of the first vertebra.

7. The system of claim 1, wherein the crosslink further comprises a right implant coupling component, wherein the left and right implant coupling components are securable to the first left and right implants, respectively, wherein the rod is attachable to the left and right implant coupling components to secure the left and right implant coupling components together at any of a plurality of displacements of the right implant coupling component with respect to the left implant coupling component.

8. The system of claim 7, wherein the crosslink further comprises a left rod coupling component attachable directly to the rod and the left implant coupling component, wherein at least one of the left implant coupling component and the left rod coupling component comprises a clocking feature configured to limit attachment between the left rod coupling component and the left implant coupling component to the discrete relative displacements.

9. A system comprising:

a first left implant attachable to a first vertebra, the first left implant comprising a first left articular surface;

a second left implant attachable to a second vertebra, the second left implant comprising a second left articular surface, wherein the first left articular surface is shaped to articulate with the second left articular surface on the second left implant;

a first right implant attachable to the first vertebra, the first right implant comprising a first right articular surface;

a second right implant attachable to the second vertebra, the second right implant comprising a second right articular surface, wherein the first right articular surface is shaped to articulate with the second right articular surface on the second right implant; and

a crosslink attachable to the first left and right implants, the crosslink comprising a left resilient member that engages the first left implant and a right resilient member that engages the first right implant, the left and right resilient members adjustably arranged on a rod of the crosslink, wherein, when the crosslink is attached to the first left and right implants, the first left implant and first right implant are adjustably positionable relative to each other in a medial/lateral direction,

a clocking feature positioned between the first left implant and the crosslink, the clocking feature including a plurality of ridges facing the crosslink, wherein the clocking feature restricts rotation between the first left implant and the crosslink,

wherein each of the left and right resilient members comprises an implant coupling interface that engages a corresponding crosslink coupling interface on a corresponding one of the first left and right implants,

wherein each crosslink coupling interface comprises a semicylindrical protrusion and the implant coupling interface comprises a semicylindrical cavity that is expandable to receive the semicylindrical protrusion.

10. The system of claim 9, wherein each of the left and right resilient members comprises a monolithic clip having a stationary arm and a bendable arm, wherein the bendable arm is configured to bend relative to the stationary arm to permit each resilient member to receive and grip a corresponding crosslink coupling interface on a corresponding one of the first left and right implants.

11. The system of claim 9, further comprising a fastener configured to be actuated independently of engaging each of the left and right resilient members into engagement to substantially prevent disengagement of each resilient member.

12. A system comprising:

a first left implant having an opening for receiving a first fastener, the first fastener having a first head portion and first shaft portion, the first shaft portion engageable with a first vertebra, the first left implant comprising a first left articular surface and a left crosslink coupling interface, wherein the first left articular surface is shaped to articulate with a second left articular surface on a second vertebra;

a first right implant having an opening for receiving a second fastener, the second fastener having a second head portion and second shaft portion, the second shaft portion engageable with the first vertebra, the first right implant comprising a first right articular surface and a right crosslink coupling interface, wherein the first right articular surface is shaped to articulate with a second right articular surface on the second vertebra;

a crosslink comprising a rod, a left implant coupling component attachable to a first end of the rod, and a right implant coupling component attachable to a second end of the rod opposite the first end, wherein the left implant coupling component comprises a left implant coupling interface, wherein the right implant coupling component comprises a right implant coupling interface, wherein the left and right implant coupling interfaces interlock with the left and right crosslink coupling interfaces, respectively, independently of attaching the rod to the left and right implant coupling components and independently of securing the first left implant to the first right implant; and

a clocking feature including a plurality of ridges facing the crosslink formed between the left implant coupling interface and the left crosslink coupling interface, wherein the clocking feature restricts relative rotation between the left implant coupling interface and the left crosslink coupling interface,

wherein the left implant coupling component comprises a resilient member, wherein the resilient member comprises the left implant coupling interface, wherein the left implant coupling interface snaps onto the left crosslink coupling interface to secure the first left implant to the first right implant.

13. The system of claim 12, wherein the rod attaches to the left and right implant coupling components to secure the left and right implant coupling components together at any of a plurality of displacements of the right implant coupling component with respect to the left implant coupling component.

14. The system of claim 13, wherein the crosslink further comprises a left rod coupling component attachable directly to the rod and the left implant coupling component.

15. The system of claim 14, wherein the left rod coupling component is attachable at a variety of relative orientations with respect to the left implant coupling component and at a variety of relative orientations with respect to the rod.

16. A system comprising:

a first left implant having an opening for receiving a first fastener, the first fastener having a first head portion and first shaft portion, the first shaft portion engageable with a first vertebra, the first left implant comprising an implant stem, a first left articular surface, and a left crosslink coupling interface, wherein the first left articular surface is shaped to articulate with a second left articular surface on a second vertebra;

a first right implant having an opening for receiving a second fastener, the second fastener having a second head portion and second shaft portion, the second shaft portion engageable with the first vertebra, the first right implant comprising a first right articular surface shaped to articulate with a second right articular surface on the second vertebra; and

a crosslink attachable to secure the first left implant to the first right implant, the crosslink comprising a rod and a left implant coupling component, wherein the rod attaches to the left implant coupling component, the left implant coupling component comprising a left implant coupling interface, wherein the left implant coupling interface attaches directly to the left crosslink coupling interface, wherein a left clocking feature is formed between the left implant coupling interface and the left crosslink coupling interface, wherein the crosslink is adjustably positionable with respect to the first left implant along a first axis having a substantially cephalad/caudal orientation, wherein the first axis is displaced from a second axis defined by the implant stem in at least one of an angular displacement and a linear displacement; and

wherein the left a clocking feature includes a plurality of ridges facing the crosslink wherein the left clocking feature restricts relative rotation between the left implant coupling interface and the left crosslink coupling interface,

wherein the left crosslink coupling interface comprises a shape that is generally elongated along the first axis to permit attachment of the left implant coupling interface at any of a plurality of positions along the left crosslink coupling interface,

wherein the left crosslink coupling interface comprises a semicylindrical protrusion and the left implant coupling interface comprises a semicylindrical cavity sized to receive the semicylindrical protrusion.

17. A method comprising:

positioning a first left articular surface of a first left implant to articulate with a second left articular surface on a second vertebra, the first left implant comprising an opening for receiving a first fastener and a left crosslink coupling interface;

attaching the first left implant to the first vertebra using the first fastener, the first fastener having a first head portion and first shaft portion, the first shaft portion engaging the first vertebra;

positioning a first right articular surface of a first right implant to articulate with a second right articular surface on the second vertebra;

attaching the first right implant to the first vertebra using a second fastener, the second fastener having a second head portion and second shaft portion, the second shaft portion engaging the second vertebra; and

attaching a crosslink to the first left and right implants to secure the first left implant with respect to the first right implant at any of a limited number of discrete relative displacements, the crosslink comprising a rod and a left implant coupling component, the left implant coupling interface comprising a left implant coupling interface, and wherein a left clocking feature includes a plurality of ridges facing the crosslink, wherein the left clocking feature restricts relative rotation between the left implant coupling interface and the left crosslink coupling interface;

wherein the left clocking feature is formed between the left implant coupling interface and the left crosslink coupling interface, wherein the left clocking feature limits attachment between the left implant coupling component and the first left implant to the discrete relative displacements;

wherein attaching the crosslink to the first left and right implants comprises attaching the rod to the left implant coupling component and attaching the left implant coupling interface directly to the left crosslink coupling interface,

wherein the left implant coupling component comprises a resilient member, wherein the resilient member comprises the left implant coupling interface, wherein attaching the crosslink to the first left and right implants comprises snapping the left implant coupling interface into engagement with the left crosslink coupling interface.

18. The method of claim 17, wherein the crosslink comprises a right implant coupling component, wherein attaching the crosslink to the first left and right implants comprises securing the left and right implant coupling components to the first left and right implants, respectively, independently of securing the first left implant to the first right implant.

19. The method of claim 17, wherein attaching the crosslink to the first left and right implants comprises adjusting a position of the crosslink with respect to the first left implant along an axis having a substantially cephalad/caudal orientation.

20. The method of claim 17, wherein the discrete relative displacements are rotationally offset from each other.

21. The method of claim 17, wherein attaching the crosslink to the first left and right implants comprises positioning the crosslink to avoid direct contact with the first vertebra.

22. The method of claim 17, wherein attaching the crosslink to the first left and right implants comprises positioning the crosslink to avoid requiring resection of a spinous process of the first vertebra.

23. The method of claim 17, wherein the crosslink further comprises a right implant coupling component, wherein attaching the crosslink to the first left and right implants comprises:

securing the left implant coupling component to the first left implant;

securing the right implant coupling component to the first right implant; and

attaching the rod to the left and right implant coupling components to secure the left and right implant coupling components together at any of a plurality of displacements of the right implant coupling component with respect to the left implant coupling component.

24. The method of claim 23, wherein the crosslink further comprises a left rod coupling component attachable directly to the rod and the left implant coupling component, wherein attaching the crosslink to the first left and right implants further comprises limiting attachment between the left rod coupling component and the left implant coupling component to the discrete relative displacements.

25. A method comprising:

positioning a first left articular surface of a first left implant to articulate with a second left articular surface on a second vertebra;

attaching the first left implant to a first vertebra using a first fastener, the first fastener having a first head portion and first shaft portion, the first shaft portion engaging the first vertebra, the first left implant having an opening for receiving the first fastener;

positioning a first right articular surface of a first right implant to articulate with a second right articular surface on the second vertebra;

attaching the first right implant to the first vertebra using a second fastener, the second fastener having a second head portion and second shaft portion, the second shaft portion engaging the second vertebra the first right implant having an opening for receiving the second fastener; and

securing the first right implant to the first left implant through the use of a crosslink;

wherein a clocking feature is positioned between the first left implant and the crosslink, the clocking feature including a plurality of ridges facing the crosslink, wherein the clocking feature restricts rotation between the first left implant and the crosslink;

wherein securing the first right implant to the first left implant comprises engaging a left resilient member of the crosslink onto the first left implant and engaging a right resilient member of the crosslink onto the first right implant, the left and right resilient members adjustably arranged on a rod of the crosslink,

wherein, after securing the first right implant to the first left implant, the first left implant and first right implant are adjustably positionable relative to each other along at least a medial/lateral axis,

wherein engaging the left resilient member onto the first left implant comprises snapping an implant coupling interface of the left resilient member into direct engagement with a corresponding crosslink coupling interface on the first left implant.

26. The method of claim 25, wherein the crosslink coupling interface comprises a semicylindrical protrusion and the implant coupling interface comprises a semicylindrical cavity, wherein snapping the implant coupling interface into engagement with the corresponding crosslink coupling interface comprises expanding the semicylindrical cavity to receive the semicylindrical protrusion.

27. The method of claim 25, wherein each of the left and right resilient members comprises a monolithic clip having a stationary arm and a bendable arm, wherein engaging each resilient member onto a corresponding one of the first left and right implants comprises bending the bendable arm relative to the stationary arm to permit each resilient member to receive and grip a corresponding crosslink coupling interface on the corresponding implant.

28. The method of claim 25, wherein securing the first right implant to the first left implant further comprises actuating a fastener independently of engaging the resilient member into engagement to substantially prevent disengagement of the resilient member.

29. A method comprising:

positioning a first left articular surface of a first left implant to articulate with a second left articular surface on a second vertebra, the first left implant comprising a left crosslink coupling interface;

attaching the first left implant to a first vertebra using a first fastener, the first fastener having a first head portion and first shaft portion, the first shaft portion engaging the first vertebra, the first left implant having an opening for receiving the first fastener;

positioning a first right articular surface of a first right implant to articulate with a second right articular surface on the second vertebra, the first right implant comprising a right crosslink coupling interface;

attaching the first right implant to the first vertebra using a second fastener, the second fastener having a second head portion and second shaft portion, the second shaft portion engaging the first vertebra, the first right implant having an opening for receiving the second fastener;

securing a left implant coupling interface of a left implant coupling component of a crosslink with the left crosslink coupling interface of the first left implant;

wherein a clocking feature is positioned between the left implant coupling component and the left crosslink coupling interface, the clocking feature including a plurality of ridges facing the crosslink, wherein the clocking feature restricts rotation between the left implant coupling component and the left crosslink coupling interface;

securing the right implant coupling interface of a right implant coupling component of the crosslink with a right crosslink coupling interface of the first right implant;

securing the first right implant to the first left implant through the use of a first end of a rod of the crosslink to the left implant coupling component; and

securing a second end of the rod to the right implant coupling component, wherein the second end of the rod is opposite the first end of the rod;

wherein securing the rod to the left and right implant coupling components is independent of securing the first left implant to the first right implant,

wherein the left implant coupling component comprises a resilient member, wherein the resilient member comprises the left implant coupling interface, wherein attaching the crosslink to the first left and right implants comprises snapping the left implant coupling interface into engagement with the left crosslink coupling interface.

30. The method of claim 29, wherein securing the rod to the left and right implant coupling components comprises attaching the rod of the crosslink to the left and right implant coupling components at any of a plurality of displacements of the right implant coupling component with respect to the left implant coupling component.

31. The method of claim 30, wherein securing the first right implant to the first left implant further comprises attaching a left rod coupling component directly to the rod and the left implant coupling component.

32. The method of claim 31, wherein attaching a left rod coupling component directly to the rod and the left implant coupling component comprises:

attaching the left rod coupling component to the left implant coupling component at any of a variety of relative orientations; and

attaching the left rod coupling component to the rod at any of a variety of relative orientations.

33. A method comprising:

positioning a first left articular surface of a first left implant to articulate with a second left articular surface on a second vertebra;

attaching the first left implant to the first vertebra, wherein the first left implant further comprises an implant stem and a left crosslink coupling interface;

positioning a first right articular surface of a first right implant to articulate with a second right articular surface on the second vertebra;

attaching the first right implant to the first vertebra using a fastener, the fastener having a head portion and shaft portion, the shaft portion engaging the first vertebra, the first right implant having an opening for receiving the fastener;

adjustably positioning a crosslink with respect to the first left implant along a first axis having a substantially cephalad/caudal orientation, wherein the first axis is displaced from a second axis defined by the implant stem in at least one of an angular displacement and a linear displacement, the crosslink comprising a rod and a left implant coupling component, wherein the rod attaches to the left implant coupling component, the left implant coupling component comprising a left implant coupling interface;

wherein a left clocking feature is formed on at least one of the left implant coupling interface and the left crosslink coupling interface; and

securing the first right implant to the first left implant through the use of the crosslink,

wherein securing the first right implant to the first left implant comprises attaching the left implant coupling interface of the crosslink to the left crosslink coupling interface of the first left implant, wherein the left crosslink coupling interface comprises a shape that is generally elongated along the first axis;

wherein attaching the left implant coupling interface to the left crosslink coupling interface comprises attaching the left implant coupling interface at any of a plurality of positions along the left crosslink coupling interface,

wherein the left crosslink coupling interface comprises a semicylindrical protrusion and the left implant coupling interface comprises a semicylindrical cavity, wherein attaching the left implant coupling interface to the left crosslink coupling interface comprises a receiving the semicylindrical protrusion in the semicylindrical cavity.