CA2485514A1 - Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces - Google Patents

Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces Download PDF

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Publication number
CA2485514A1
CA2485514A1 CA002485514A CA2485514A CA2485514A1 CA 2485514 A1 CA2485514 A1 CA 2485514A1 CA 002485514 A CA002485514 A CA 002485514A CA 2485514 A CA2485514 A CA 2485514A CA 2485514 A1 CA2485514 A1 CA 2485514A1
Authority
CA
Canada
Prior art keywords
facet joint
vertebral body
prosthesis
artificial
natural
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002485514A
Other languages
French (fr)
Other versions
CA2485514C (en
Inventor
Mark A. Reiley
Robert M. Scribner
James Davidson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
FSI ACQUISITION SUB LLC
Original Assignee
Archus Orthopedics, Inc.
Mark A. Reiley
Robert M. Scribner
James Davidson
Fsi Acquisition Sub, Llc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Archus Orthopedics, Inc., Mark A. Reiley, Robert M. Scribner, James Davidson, Fsi Acquisition Sub, Llc filed Critical Archus Orthopedics, Inc.
Publication of CA2485514A1 publication Critical patent/CA2485514A1/en
Application granted granted Critical
Publication of CA2485514C publication Critical patent/CA2485514C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4405Joints for the spine, e.g. vertebrae, spinal discs for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7064Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/28Bones
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387Dovetail connection
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30777Oblong apertures
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
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    • A61F2310/00634Coating made of zirconium oxide or hydroxides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389The prosthesis being coated or covered with a particular material
    • A61F2310/0097Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389The prosthesis being coated or covered with a particular material
    • A61F2310/00976Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00Surgery
    • Y10S606/907Composed of particular material or coated
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00Surgery
    • Y10S606/907Composed of particular material or coated
    • Y10S606/91Polymer

Abstract

Cephalad and caudal vertebral facet joint prostheses (36 and 38) and methods of use are provided. The prostheses provide an artificial facet joint structure including an artificial articular configuration unlike the preexisting articular configuration. The radii and material stress values of the prostheses are configured to sustain contact stress. The cephalad prosthesis (36) provides for posterior-anterior adjustment. Both prostheses permit lateral adjustment and adjustment to accommodate interpedicle distanc e. Further, the prostheses may be customized to provide a pre-defined lordotic angle and a pre-defined pedicle entry angle.

Claims (78)

1. A facet joint prosthesis to replace, on a vertebral body, a portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the portion of the natural facet joint, a fixation region on the component being configured and arranged to receive a fixation element to fix the component to the vertebral body on or near a pedicle, the fixation region being sized to accommodate adjustment of the component on the vertebral body.
2. A facet joint prosthesis according to claim 1 wherein the fixation region is sized to accommodate lateral adjustment of the component on the vertebral body.
3. A facet joint prosthesis according to claim 1 wherein the fixation region is sized to accommodate inferior-superior adjustment of the component on the vertebral body.
4. A facet joint prosthesis according to claim 1 wherein the artificial facet joint structure comprises a generally convex surface.
5. A facet joint prosthesis according to claim 1 wherein the artificial facet joint structure comprises a generally concave surface.
6. A facet joint prosthesis according to claim 1 wherein the artificial facet joint structure comprises a surface adapted to articulate with another facet joint structure.
7. A facet joint prosthesis according to claim 1 wherein the artificial facet joint structure comprises a surface adapted to articulate with another artificial facet joint structure.
8. A facet joint prosthesis according to claim 1 wherein the artificial facet joint structure is adapted to replace a cephalad portion of the natural facet joint.
9. A facet joint prosthesis according to claim 1 wherein the artificial facet joint structure is adapted to replace a caudal portion of the natural facet joint.
10. A facet joint prosthesis according to claim 1 wherein the fixation region is configured and arranged to support the fixation element at a desired pedicle entry angle.
11. A facet joint prosthesis according to claim 1 wherein the fixation region is configured and arranged to support the fixation element at an angle that approximates a desired lardotic angle.
12. A facet joint prosthesis according to claim 1 further including a second fixation region on the component being configured and arranged to fix the component to the vertebral body on or near a spinous process.
13. A facet joint prosthesis to replace, on a vertebral body, a portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the portion of the natural facet joint, the artificial facet joint structure being mounted for movement on the component.
14. A facet joint prosthesis according to claim 13 wherein the artificial facet joint structure is mounted for posterior-anterior movement on the component.
15. A facet joint prosthesis according to claim 13 wherein the artificial facet joint structure comprises a generally convex surface.
16. A facet joint prosthesis according to claim 13 wherein the artificial facet joint structure comprises a generally concave surface.
17. A facet joint prosthesis according to claim 13 wherein the artificial facet joint structure comprises a surface adapted to articulate with another facet joint structure.
18. A facet joint prosthesis according to claim 13 wherein the artificial facet joint structure comprises a surface adapted to articulate with another artificial facet joint structure.
19. A facet joint prosthesis according to claim 13 wherein the artificial facet joint structure is adapted to replace a cephalad portion of the natural facet joint.
20. A facet joint prosthesis according to claim 13 wherein the fixation region is configured and arranged to support the fixation element at a desired pedicle entry angle.
21. A facet joint prosthesis according to claim 13 wherein the fixation region is configured and arranged to support the fixation element at an angle that approximates a desired lardotic angle.
22. A facet joint prosthesis according to claim 13 further including a second fixation region on the component being configured and arranged to fix the component to the vertebral body on or near a spinous process.
23. A prosthesis assembly for replacing the inferior and superior halves of a natural facet joint comprising a cephalad prosthesis comprising a component sized to be fixed to a vertebral body and including a first artificial facet joint structure adapted to replace the inferior half of the natural facet joint, a first fixation region on the component being configured and arranged to receive a fixation element to fix the component to the vertebral body on or near a pedicle, a caudal prosthesis comprising a component sized to be fixed to a vertebral body and including a second artificial facet joint structure adapted to replace the superior half of the natural facet joint, a second fixation region on the component being configured and arranged to receive a fixation element to fix the component to the vertebral body on or near a pedicle, the first and second artificial facet joint structures articulating to form, respectively, the superior and inferior halves of an artificial facet joint, and at least one of the first and second fixation regions being sized to accommodate adjustment of the respective component on the respective vertebral body.
24. A prosthesis assembly according to claim wherein the at least one fixation region is sized to accommodate lateral adjustment of the respective component on the respective vertebral body.
25. A prosthesis assembly according to claim wherein the at least one fixation region is sized to accommodate inferior-superior adjustment of the respective component on the respective vertebral body.
26. A prosthesis assembly according to claim wherein the first artificial facet joint structure comprises a generally convex surface, and wherein the second artificial facet joint structure comprises a generally concave surface articulating with the generally convex surface.
27. A prosthesis assembly according to claim wherein the first artificial facet joint structure comprises a generally concave surface, and wherein the second artificial facet joint structure comprises a generally convex surface articulating with the generally concave surface.
28. A prosthesis assembly according to claim wherein the first and second artificial facet joint structures comprise articulating metal surfaces having a contact stress less than about 25,000 psi.
29. A prosthesis assembly according to claim wherein the contact stress is less than about 12,000 psi.
30. A prosthesis assembly according to claim wherein at least one of the first and second artificial facet joint structures comprises an articulating polymer surface having a contact stress less than about 10,000 psi.
31. A prosthesis assembly according to claim wherein the contact stress is less than about 5,000 psi.
32. A prosthesis assembly according to claim wherein at least one of the first and second fixation regions is configured and arranged to support the respective fixation element at a desired pedicle entry angle.
33. A facet joint prosthesis according to claim 23 wherein at least one of the first and second fixation regions is configured and arranged to support the respective fixation element at an angle that approximates a desired lardotic angle.
34. A prosthesis assembly according to claim wherein the cephalad prosthesis further includes an auxiliary fixation region on the respective component configured and arranged to fix the respective component to the respective vertebral body on or near a spinous process.
35. A prosthesis assembly according to claim wherein the first artificial facet joint structure is mounted for movement on the cephalad prosthesis.
36. A prosthesis assembly for replacing the inferior and superior halves of a natural facet joint comprising a cephalad prosthesis comprising a component sized to be fixed to a vertebral body and including a first artificial facet joint structure adapted to replace the inferior half of the natural facet joint, a caudal prosthesis comprising a component sized to be fixed to a vertebral body and including a second artificial facet joint structure adapted to replace the superior half of the natural facet joint, the first and second artificial facet joint structures articulating to form, respectively, the superior and inferior halves of an artificial facet joint, and the first and second artificial facet joint structures comprise articulating metal surfaces having a contact stress less than about 25,000 psi.
37. A prosthesis assembly according to claim wherein the contact stress is less than about 12,000 psi.
38. A prosthesis assembly for replacing the inferior and superior halves of a natural facet joint comprising a cephalad prosthesis comprising a component sized to be fixed to a vertebral body and including a first artificial facet joint structure adapted to replace the inferior half of the natural facet joint, a caudal prosthesis comprising a component sized to be fixed to a vertebral body and including a second artificial facet joint structure adapted to replace the superior half of the natural facet joint, the first and second artificial facet joint structures articulating to form, respectively, the superior and inferior halves of an artificial facet joint, and at least one of the first and second artificial facet joint structures comprises an articulating polymer surface having a contact stress less than about 10,000 psi.
39. A prosthesis assembly according to claim wherein the contact stress is less than about 5,000 psi.
40. A facet joint prosthesis to replace, on a vertebral body, a portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the portion of the natural facet joint, a fixation element on the component being configured and arranged to engage a portion of the lamina to fix the component to the vertebral body.
41. A facet joint prosthesis according to claim 40 wherein the fixation element comprises a hook.
42. A facet joint prosthesis to replace, on a vertebral body, a portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the portion of the natural facet joint, a fixation region on the component being configured and arranged to receive a fixation element to fix the component to the vertebral body on or near a pedicle, the fixation region being configured and arranged to support the fixation element at a desired pedicle entry angle.
43. A facet joint prosthesis according to claim 42 wherein the component includes laterally spaced first and second fixation regions each being configured and arranged to support a fixation element at a desired pedicle entry angle.
44. A facet joint prosthesis according to claim 43 wherein the desired pedicle entry angle for the first fixation region differs from the desired pedicle entry region for the second fixation region.
45. A facet joint prosthesis according to claim 42 wherein the fixation region is configured and arranged to support the fixation element at an angle that approximates a desired lardotic angle.
46. A facet joint prosthesis to replace, on a vertebral body, a portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the portion of the natural facet joint, a fixation region on the component being configured and arranged to receive a fixation element to fix the component to the vertebral body on or near a pedicle, the fixation region being configured and arranged to support the fixation element at an angle that approximates a desired lardotic angle.
47. A method of replacing, on a vertebral body, a portion of a natural facet joint using the prosthesis as defined in claim 1, the method comprising the steps of (i) removing at least a portion of the natural facet joint from the vertebral body, and (ii) fixing the prosthesis as defined in claim 1 to the vertebral body to replace the removed portion of the natural facet joint with the artificial facet joint structure.
48. A method of replacing, on a vertebral body, a portion of a natural facet joint using the prosthesis as defined in claim 13, the method comprising the steps of (i) removing at least a portion of the natural facet joint from the vertebral body, and (ii) fixing the prosthesis as defined in claim 13 to the vertebral body to replace the removed portion of the natural facet joint with the artificial facet joint structure.
49. A method for replacing the inferior and superior halves of a natural facet joint comprising the steps of removing the inferior and superior halves of the natural facet joint, fixing a cephalad prosthesis to a vertebral body that includes a first artificial facet joint structure to replace the inferior half of the natural facet joint, fixing a caudal prosthesis to a vertebral body that includes a second artificial facet joint structure to replace the superior half of the natural facet joint, the first and second artificial facet joint structures articulating to form, respectively, the superior and inferior halves of an artificial facet joint, and selecting for the first and second artificial facet joint structures articulating metal surfaces having a contact stress less than about 25,000 psi.
50. A method according to claim 49 wherein the contact stress is less than about 12,000 psi.
51. A method for replacing the inferior and superior halves of a natural facet joint comprising the steps of removing the inferior and superior halves of the natural facet joint, fixing a cephalad prosthesis to a vertebral body that includes a first artificial facet joint structure to replace the inferior half of the natural facet joint, fixing a caudal prosthesis to a vertebral body that includes a second artificial facet joint structure to replace the superior half of the natural facet joint, the first and second artificial facet joint structures articulating to form, respectively, the superior and inferior halves of an artificial facet joint, and selecting for the first and second artificial facet joint structures at least one articulating polymer surface having a contact stress less than about 10,000 psi.
52. A method according to claim 51 wherein the contact stress is less than about 5,000 psi.
53. A method of replacing, on a vertebral body, a portion of a natural facet joint using the prosthesis as defined in claim 40, the method comprising the steps of (i) removing at least a portion of the natural facet joint from the vertebral body, and (ii) fixing the prosthesis as defined in claim 40 to the vertebral body to replace the removed portion of the natural facet joint with the artificial facet joint structure.
54. A method of replacing, on a vertebral body, a portion of a natural facet joint using the prosthesis as defined in claim 42, the method comprising the steps of (i) removing at least a portion of the natural facet joint from the vertebral body, and (ii) fixing the prosthesis as defined in claim 42 to the vertebral body to replace the removed portion of the natural facet joint with the artificial facet joint structure.
55. A method of replacing, on a vertebral body, a portion of a natural facet joint using the prosthesis as defined in claim 46, the method comprising the steps of (i) removing at least a portion of the natural facet joint from the vertebral body, and (ii) fixing the prosthesis as defined in claim 1 to the vertebral body to replace the removed portion of the natural facet joint with the artificial facet joint structure.
56. A facet joint prosthesis to replace, on a vertebral body, a cephalad portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the cephalad portion of the natural facet joint after removal of the cephalad portion of the natural facet joint from the vertebral body.
57. A facet joint prosthesis to replace, on a vertebral body, a cephalad portion of a natural facet joint having a preexisting articular configuration, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the cephalad portion of the natural facet joint after removal of the cephalad portion of the natural facet joint from the vertebral body, the artificial facet joint structure comprising an artificial articular configuration unlike the preexisting natural articular configuration.
58. A prosthesis according to claim 56 or 57 wherein the component is sized to be fixed to the vertebral body on or near a pedicle.
59. A prosthesis according to claim 56 or 57 wherein the component is sized to be fixed to the vertebral body on or near a lamina.
60. A prosthesis according to claim 56 or 57 wherein the component is sized to be fixed to the vertebral body on or near a spinous process.
61. A prosthesis according to claim 56 or 57 wherein the artificial facet joint structure is removable from the component.
62. A prosthesis according to claim 56 or 57 wherein the artificial facet joint structure includes a bony in-growth surface.
63. A method of replacing, on a vertebral body, a cephalad portion of a natural facet joint, the method comprising the steps of removing the cephalad portion of the natural facet joint from the vertebral body, and fixing a component to the vertebral body that includes an artificial facet joint structure adapted to replace the removed cephalad portion of the natural facet joint.
64. A method of replacing on a vertebral body a cephalad portion of a natural facet joint having a prexisting articular configuration, the method comprising the steps of removing the cephalad portion of the natural facet joint from the vertebral body, and fixing a component to the vertebral body that includes an artificial facet joint structure adapted to replace the removed cephalad portion of the natural facet joint, the artificial facet joint structure including an artificial articular configuration unlike the preexisting articular configuration of the removed cephalad portion of the natural facet joint.
65. A facet joint prosthesis to replace, on a vertebral body, a caudal portion of a natural facet joint, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the caudal portion of the natural facet joint after removal of the caudal portion of the natural facet joint from the vertebral body.
66. A facet joint prosthesis to replace, on a vertebral body, a caudal portion of a natural facet joint having a preexisting articular configuration, the prosthesis comprising a component sized to be fixed to the vertebral body and including an artificial facet joint structure adapted to replace the caudal portion of the natural facet joint after removal of the caudal portion of the natural facet joint from the vertebral body, the artificial facet joint structure comprising an artificial articular configuration unlike the preexisting natural articular configuration.
67. A prosthesis according to claim 65 or 66 wherein the component is sized to be fixed to the vertebral body on or near a pedicle.
68. A prosthesis according to claim 65 or 66 wherein the component is sized to be fixed to the vertebral body on or near a lamina.
69. A prosthesis according to claim 65 or 66 wherein the component is sized to be fixed to the vertebral body on or near a spinous process.
70. A prosthesis according to claim 65 or 66 wherein the artificial facet joint structure is removable from the component.
71. A prosthesis according to claim 65 or 66 wherein the artificial facet joint structure includes a bony in-growth surface.
72. A method of replacing, on a vertebral body, a caudal portion of a natural facet joint, the method comprising the steps of removing the caudal portion of the natural facet joint from the vertebral body, and fixing a component to the vertebral body that includes an artificial facet joint structure adapted to replace the removed caudal portion of the natural facet joint.
73. A method of replacing on a vertebral body a caudal portion of a natural facet joint having a prexisting articular configuration, the method comprising the steps of removing the caudal portion of the natural facet joint from the vertebral body, and fixing a component to the vertebral body that includes an artificial facet joint structure adapted to replace the removed caudal portion of the natural facet joint, the artificial facet joint structure including an artificial articular configuration unlike the preexisting articular configuration of the removed caudal portion of the natural facet joint.
74. A prosthesis assembly for replacing a natural facet joint between a first vertebral body and a second vertebral body that is immediately inferior to the first vertebral body, the assembly comprising a first component sized to be fixed to the first vertebral body and including a first artificial facet joint structure adapted to replace a cephalad portion of the natural facet joint on the first vertebral body after removal of the cephalad portion of the natural facet joint from the first vertebral body, ' a second component sized to be fixed to the second vertebral body and including a second artificial facet joint structure adapted to replace the caudad portion of the natural facet joint of the second vertebral body after removal of the caudad portion of the natural facet joint from the second vertebral body, the first and second artificial facet joint structures comprising an artificial facet joint.
75. A prosthesis assembly for replacing a natural facet joint between a first vertebral body and a second vertebral body that is immediately inferior to the first vertebral body, the natural facet joint having a preexisting articular configuration, the assembly comprising a first component sized to be fixed to the first vertebral body and including a first artificial facet joint structure adapted to replace a cephalad portion of the natural facet joint on the first vertebral body after removal of the cephalad portion of the natural facet joint from the first vertebral body, a second component sized to be fixed to the second vertebral body and including a second artificial facet joint structure adapted to replace the caudad portion of the natural facet joint of the second vertebral body after removal of the caudad portion of the natural facet joint from the second vertebral body, the first and second artificial facet joint structures comprising an artificial facet joint having an artificial articular configuration unlike the preexisting articular configuration.
76. A prosthesis assembly according to claim 74 or 75 wherein at least one of the first and second artificial facet joint structures includes a bony in-growth surface.
77. A method of total replacement of a natural facet joint comprising the steps of removing a cephalad portion of the natural facet joint from a first vertebral body, removing a caudal portion of the natural facet joint from a second vertebral body immediately inferior to the first vertebral body, fixing a first component to the first vertebral body, the first component including a first artificial facet joint structure adapted to replace the cephalad portion of the natural facet joint after its removal from the first vertebral body, fixing a second component to the second vertebral body, the second component including a second artificial facet joint structure adapted to replace the caudad portion of the natural facet joint after its removal from the second vertebral body, and articulating the first and second artificial facet joint structures to form an artificial facet joint.
78. A method of total replacement of a natural facet joint having a preexisting articular configuration, comprising the steps of removing a cephalad portion of the natural facet joint from a first vertebral body, removing a caudal portion of the natural facet joint from a second vertebral body immediately inferior to the first vertebral body, fixing a first component to the first vertebral body, the first component including a first artificial facet joint structure adapted to replace the cephalad portion of the natural facet joint after its removal from the first vertebral body, fixing a second component to the second vertebral body, the second component including a second artificial facet joint structure adapted to replace the caudad portion of the natural facet joint after its removal from the second vertebral body, and articulating the first and second artificial facet joint structures to form an artificial facet joint having an artificial articular configuration unlike the preexisting articular configuration.
CA2485514A 2002-05-30 2003-05-30 Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces Expired - Fee Related CA2485514C (en)

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US10/158,563 2002-05-30
PCT/US2003/017094 WO2003101350A1 (en) 2002-05-30 2003-05-30 Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces

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US20080097446A1 (en) 2008-04-24
US6974478B2 (en) 2005-12-13
AU2003238834A1 (en) 2003-12-19
US20080045954A1 (en) 2008-02-21
US20080097440A1 (en) 2008-04-24
WO2003101350A1 (en) 2003-12-11
US20030028250A1 (en) 2003-02-06
US20050267579A1 (en) 2005-12-01
EP1555965A4 (en) 2008-09-24
EP1555965A1 (en) 2005-07-27

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