Methods and apparatus for accessing and treating the facet joint

• US 9,005,288 B2
• Filed: 01/08/2009
• Issued: 04/14/2015
• Est. Priority Date: 01/09/2008
• Status: Active Grant

• Current Assignee: Providence Medical Technology, Inc.
• Original Assignee: Providence Medical Technology, Inc.
• Inventors: McCormack, Bruce M., Maier, Nathan
• Primary Examiner(s): Prone, Christopher D
• Application Number:
  US12/350,609
• Publication Number:
  US 20090177205A1
• Time in Patent Office: 2,287 Days
• Field of Search: 606247-249, 606/57, 606/86.A, 606/90, 606/99, 606/246, 606/914, 623/17.11
• US Class Current: 623/17.11
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/7074 Tools specially adapted for spinal fixation operations other than for bone removal or filler handling A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• 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 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2310/00359 Bone or bony tissue

Abstract

Methods and systems are disclosed for accessing and treating the interior of the facet joint for vertebral distraction and immobilization. The systems include a number of tools that facilitate access to the facet joint, distraction of the articulating decortication of the articulating surfaces, and delivery of implants and agents into the facet joint for fusion.

Claims

1. A surgical system for facet joint immobilization, the facet joint comprising first and second articulating subchondral surfaces forming a facet cavity enclosed by a facet capsule, the surgical system comprising:

a facet access tool configured to pierce through the facet capsule and into the facet cavity to generate a minimally invasive slit-shaped aperture in the facet capsule, the facet access tool comprising;

a blade sized and shaped to pierce through the facet capsule; and

a shaft attached to the blade and including a distal beveled surface sized and shaped to allow the blade to access the facet joint;

a distraction apparatus, comprising;

an elongate tube;

an upper pivoting member mounted to the tube via a hinge; and

a lower pivoting member mounted to the tube via the hinge,

wherein distal tips of the pivoting members are configured to be delivered through the minimally invasive slit-shaped aperture in the facet capsule and into the facet cavity, and wherein proximal ends of the pivoting members are configured to be manually pressed inward toward the elongate tube to cause the distraction apparatus to expand at the distal tips to distract the first and second articulating subchondral surfaces of the facet joint a predetermined distance;

a decortication apparatus slidably received within the tube of the distraction apparatus and configured to be articulated outward from the distal tips and reciprocated back and forth within the tube to decorticate at least one of the first and second articulating subchondral surfaces; and

an introducer consisting of;

only one, single, elongate shaft configured for insertion through the tube of the distraction apparatus, the shaft comprising;

a proximal end; and

a distal end opposite the proximal end; and

a single tip extending distally outward from the distal end of the single elongate shaft,

wherein the introducer is configured to be delivered through the minimally invasive slit-shaped aperture in the facet capsule and into the facet cavity to deliver an implant between the first and second articulating subchondral surfaces of the facet joint to immobilize the joint at said predetermined distance.

2. The surgical system as recited in claim 1, wherein the decortication apparatus comprises:

a flat, flexible, spatula-shaped rasp configured to decorticate at least one of the articulating surfaces; and

a shaft attached to the rasp and having a distal, beveled surface.

3. The surgical system as recited in claim 1, wherein the implant comprises bone allograft.

4. The surgical system as recited in claim 1, further comprising a delivery system configured to deliver an agent to the facet joint.