US20120071929A1 - Linked Bilateral Spinal Facet Implants and Methods of Use - Google Patents

Linked Bilateral Spinal Facet Implants and Methods of Use Download PDF

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Publication number
US20120071929A1
US20120071929A1 US13/179,765 US201113179765A US2012071929A1 US 20120071929 A1 US20120071929 A1 US 20120071929A1 US 201113179765 A US201113179765 A US 201113179765A US 2012071929 A1 US2012071929 A1 US 2012071929A1
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United States
Prior art keywords
vertebra
inferior
prosthesis
superior
facet
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Abandoned
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US13/179,765
Inventor
Alan Chervitz
Daniel F. Justin
T. Wade Fallin
Robert W. Hoy
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Globus Medical Inc
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GMEDelaware 2 LLC
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Priority to US13/179,765 priority Critical patent/US20120071929A1/en
Assigned to GMEDELAWARE 2 LLC reassignment GMEDELAWARE 2 LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: JUSTIN, DANIEL F, HOY, ROBERT W., FALLIN, T WADE, CHERVITZ, ALAN
Publication of US20120071929A1 publication Critical patent/US20120071929A1/en
Assigned to GLOBUS MEDICAL, INC. reassignment GLOBUS MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: GMEDELAWARE 2 LLC
Abandoned legal-status Critical Current

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Definitions

  • FIG. 1 is a perspective view of a portion of the spine
  • FIG. 9 is a perspective view of an alternative left inferior facet prosthesis
  • FIG. 28A is a side view of embodiments G, H, I, J, K, and L of the fixation element with attached enlarged heads, and a cross-sectional view of each of embodiments G, H, I, J, K, and L;
  • FIG. 32 is a dorsal view of a spinal section showing a top, middle, and bottom vertebra with unilateral facet replacements on the right side of the spine section, both between the top and middle vertebra, and between the middle and bottom vertebra;
  • FIG. 45 is a perspective view of superior and inferior facet prostheses held against a vertebra by flexible fixation elements
  • FIG. 48 is a perspective, cross-sectional view of the embodiment of the superior facet prosthesis and fixation element of FIG. 47 showing the semispherical shape of the resection and the approximately similarly semispherical shape of the apposition side of the superior facet prosthesis, as well as an angled resection and corresponding angled flat on the apposition side of the superior facet prosthesis in combination with the semispherical resection;
  • FIG. 53B is a top view of an inferior facet prosthesis according to one embodiment of the invention.
  • FIG. 53D is a perspective view of a plurality of inferior facet prostheses of a kit
  • FIG. 53E is a perspective view showing how a superior facet prosthesis and an inferior facet prosthesis may fit together;
  • FIG. 53F is a dorsal view of an L5 superior facet prosthesis and an L4 inferior facet prosthesis fit on adjacent vertebrae to articulate against each other;
  • the surgeon aligns the fixation element 200 with anatomic landmarks and simply drives the fixation element 200 through the first resected surface 112 and into the pedicle 11 .
  • the fixation element 200 is driven into the vertebra 100 until a connection feature 213 (e.g., a screw thread) is just above the first superior resection surface 112 .
  • the distal end 220 shown in FIG. 27 has a frusto-conical shape that allows the fixation element 200 to be driven or guided into the vertebra 100 .
  • the distal end 220 could be shaped in the form of a spade tip, trochar tip, or twist drill tip to assist in the guidance of the fixation element 200 in the vertebra 100 .
  • the fixation element 200 may also have a cutting flute (not shown) formed in the distal end 220 to help remove bone tissue and accommodate the guidance of the fixation element 200 in the vertebra 100 .
  • the bone stabilizing portion 210 helps to secure the fixation element 200 to the vertebra 100 .
  • FIG. 34 is a dorsal view illustrating how the inferior facet prosthesis 401 can articulate against the natural superior facet 43 , or the inferior facet prosthesis 402 can articulate against the superior facet prosthesis 303 .
  • the right facet joint between the top vertebra 101 and the middle vertebra 102 is a hemiarthroplasty replacement with the inferior facet replaced by the inferior facet prosthesis 401 .
  • the right facet joint between the middle vertebra 102 and the bottom vertebra 103 is a unilateral replacement with the inferior facet replaced by the inferior facet prosthesis 402 and the superior facet of the bottom vertebra 103 replaced by the superior facet prosthesis 303 .
  • FIG. 43 shows a further step in the assembly of the implant construct described in FIG. 42 .
  • the locking washer 800 is secured over the fixation element 200 and into the bone tissue by the enlarged head 500 .
  • the locking washer 800 can alternatively be used to mechanically secure the inferior facet prosthesis 400 , or the combination of the inferior facet prosthesis 400 and the superior facet prosthesis 300 .
  • the locking washer 800 is placed over the superior facet prosthesis 300 .
  • the locking washer 800 may be placed under the superior facet prosthesis 300 , under the inferior facet prosthesis 400 and the superior facet prosthesis 300 , or between the superior facet prosthesis 300 and the inferior facet prosthesis 400 to stabilize the implant construct.
  • the locking washer 800 also has prongs 830 that pass into the bone tissue of the vertebra 100 to help stabilize the implant construct.
  • the prongs 830 in this embodiment of the locking washer 800 are elongated protrusions that taper to a tissue penetration tip 840 .
  • the prongs have sidewalls 850 that provide a surface to resist torsion once the locking washer 800 penetrates the bone tissue.
  • the prongs 830 may also be simple spikes that are either symmetrical or asymmetrical in cross-section that protrude from the locking washer body 805 .
  • the shape and length of the locking washer prongs 830 are dependent on how the locking washer 800 is used.
  • FIG. 46 is a dorsal view of a bilateral inferior facet prosthesis 1000 .
  • the bilateral inferior facet prosthesis 1000 is a one-piece inferior facet prosthesis that has both a right inferior side 1040 and a left inferior side 1020 connected by a stabilizing bar 1010 . Both the right inferior side 1040 and the left inferior side 1020 are designed to fix to the top vertebra 101 at the respective inferior resection surface 121 ( FIG. 19 ) and at the first resection surface 112 .
  • the bilateral inferior facet prosthesis 1000 allows replacement of both the left and the right inferior facets.
  • the bilateral inferior facet prosthesis 1000 is placed over the left and right fixation elements 200 which extend into the bone of the top vertebra 101 . In the embodiment shown in FIG.
  • the semispherical resection 1146 in the bone bed allows for less transverse process to be resected (vs. a flat bone bed resection).
  • the semipherical resection 1146 in the bone bed also allows for more stable support of the superior facet prosthesis 1100 , than does a flat bone bed resection, as the superior facet prosthesis 1100 is polyaxially supported in such a way as to resist any shear forces applied between the semispherical resection 1146 and the coupling portion 1144 .
  • “polyaxial” refers to a linear or angular force or motion acting with respect to at least two perpendicular axes.
  • the coupling portion 1144 may seat directly against the semispherical resection 1146 .
  • an item that “seats directly against” another is positioned to abut the other item so that surfaces of the two items are in contact with each other.
  • FIG. 51 is a top view of the superior facet prosthesis 1100 , particularly showing the curved shape of the articulating surface 1122 and the semispherical bone engaging surface 1150 of the coupling portion 1144 . Additionally, FIG. 51 more clearly illustrates the angled flat 1156 on the apposition side of the superior facet prosthesis 1100 .
  • the inferior facet angle I.beta. may be defined as the angle of the surface to which the articulating surface 1174 is most nearly parallel. Due to the shape of the inferior facet prostheses 1180 , 1182 , 1184 , 1186 , 1188 , or 1190 , this angle is the same as the inferior resection angle I.alpha., when measured according to the coordinate system of the superior facet prosthesis 1100 of FIG. 51 .
  • one of the articulating surfaces 1122 , 1174 for example, the articulating surface 1122 of the superior facet prosthesis 1100 , has a cephalad end 1250 and a caudal end 1252 .
  • the articulating surface 1122 also has a radius of curvature 1254 about an axis 1256 extending generally from the cephalad end 1250 end to the caudal end 1252 .
  • the radius of curvature 1254 changes along the axis 1256 to provide greater clearance between the articulating surfaces 1122 , 1174 when the spine is under flexion.
  • the changing radius of curvature 1254 provides less clearance between the articulating surfaces 1122 , 1174 when the spine is extended.
  • ends of the flanges 1212 , 1214 that engage the stabilizing bar 1210 are angled towards each other. This angling avoids interference with surrounding bone and avoids interference with the superior facet or the superior facet prosthesis 1100 .
  • the heads of the turnbuckles 1216 , 1218 can vary in size. As shown, the turnbuckle 1216 is larger than the turnbuckle 1218 .
  • the larger head of the turnbuckle 1216 allows the surgeon to exert more torque on the turnbuckle 1216 , thereby allowing a more secure coupling of the flanges 1212 , 1214 to the stabilizing bar 1210 .
  • the smaller head of the turnbuckle 1218 requires less space at the surgical site of the patient than the larger head of the turnbuckle 1216 . Therefore, the surgeon can select a turnbuckle head having the desired size, weighing the benefits of more applied torque of the larger head with the reduced spatial requirements of the smaller head.
  • FIG. 60 is a top view of the bilateral inferior facet prosthesis system 1200 .
  • FIG. 61 is a bottom view of the bilateral inferior facet prosthesis system 1200 .

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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.

Description

    REFERENCE TO PENDING PRIOR APPLICATIONS
  • This application is a continuation application of a divisional application provided with the U.S. patent application Ser. No. 12/240,281 filed on Sep. 29, 2008 which claims priority to the following:
  • pending U.S. application Ser. No. 11/734,502, filed Apr. 12, 2007 and entitled LINKED BILATERAL SPINAL FACET SUPERIOR AND INFERIOR IMPLANTS AND METHODS OF USE (Attorney's Docket No. FSI-04 CON), which is a continuation of U.S. application Ser. No. 10/860,495, filed Jun. 2, 2004 and entitled LINKED BILATERAL SPINAL FACET IMPLANTS AND METHODS OF USE (Attorney's Docket No. FSI-04). The foregoing documents are incorporated herein by reference.
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • The present invention relates to surgical devices and methods to guide instruments that prepare the surface of bones and other tissues for implants that replace a damaged, diseased, or otherwise painful spinal facet joint.
  • 2. Description of Related Art
  • Traumatic, inflammatory, metabolic, and degenerative disorders of the spine can produce debilitating pain that can have severe socioeconomic and psychological effects. One of the most common surgical interventions today is arthrodesis, or spine fusion, of one or more motion segments, with approximately 300,000 procedures performed annually in the United States. Clinical success varies considerably, depending upon technique and indications, and consideration must be given to the concomitant risks and complications. For example, Tsantrizos and Nibu have shown that spine fusion decreases function by limiting the range of motion for patients in flexion, extension, rotation, and lateral bending. Furthermore, Khoo and Nagata have shown that spine fusion creates increased stresses and, therefore, accelerated degeneration of adjacent non-fused motion segments. Additionally, pseudoarthrosis, as a result of an incomplete or ineffective fusion, may reduce or even eliminate the desired pain relief for the patient. Finally, the fusion device, whether artificial or biological, may migrate out of the fusion site.
  • Recently, several attempts have been made to recreate the natural biomechanics of the spine by use of an artificial disc. Artificial discs provide for articulation between vertebral bodies to recreate the full range of motion allowed by the elastic properties of the natural intervertebral disc that directly connects two opposed vertebral bodies. However, the artificial discs proposed to date do not fully address the mechanics of motion of the spinal column. In addition to the intervertebral disc, posterior elements called the facet joints help to support axial, torsional and shear loads that act on the spinal column. Furthermore, the facet joints are diarthroidal joints that provide both sliding articulation and load transmission features. The effects of their absence as a result of facetectomy was observed by Goh to produce significant decreases in the stiffness of the spinal column in all planes of motion: flexion and extension, lateral bending, and rotation. Furthermore, contraindications for artificial discs include arthritic facet joints, absent facet joints, severe facet joint tropism or otherwise deformed facet joints, as noted by Lemaire.
  • U.S. Pat. No. Re. 36,758 to Fitz discloses an artificial facet joint where the inferior facet, the mating superior facet, or both, are resurfaced.
  • U.S. Pat. No. 6,132,464 to Martin discloses a spinal facet joint prosthesis that is supported on the posterior arch of the vertebra. Extending from this support structure are inferior and/or superior blades that replace the cartilage at the facet joint. The Martin prosthesis generally preserves existing bony structures and therefore does not address pathologies that affect the bone of the facets in addition to affecting the associated cartilage. Furthermore, the Martin invention requires a mating condition between the prosthesis and the posterior arch (also known as the lamina) that is a thin base of curved bone that carries all four facets and the spinous process. Since the posterior arch is a very complex and highly variable anatomic surface, it would be very difficult to design a prosthesis that provides reproducible positioning to correctly locate the cartilage-replacing blades for the facet joints.
  • Another approach to surgical intervention for spinal facets is provided in WO9848717A1 to Villaret. While Villaret teaches the replacement of spine facets, the replacement is interlocked in a manner to immobilize the joint.
  • It would therefore be an improvement in the art to provide a vertebral facet replacement device and method that provides a relatively high degree of mobility in the joint, while effectively removing the source of arthritic, traumatic, or other disease mediated pain with a minimum of patient discomfort.
  • SUMMARY OF THE INVENTION
  • In order to overcome the shortcomings of the prior art, the present invention provides a vertebral facet replacement device and method that replaces a bony portion of the facets so as to remove the source of arthritic, traumatic, or other disease mediated pain. Facet joint replacement in conjunction with artificial disc replacements represent a holistic solution to recreating a fully functional motion segment that is compromised due to disease or trauma. Together, facet joint and disc replacement can eliminate all sources of pain, return full function and range of motion, and completely restore the natural biomechanics of the spinal column. Additionally, degenerative or traumatized facet joints may be replaced in the absence of disc replacement when the natural intervertebral disc is unaffected by the disease or trauma. Accordingly, in certain embodiments, the present invention provides an artificial vertebral facet that replaces the cartilage and a portion of the bone of a facet. Furthermore, the invention may provide a method for preparing a vertebra for the installation of an artificial vertebral facet, a method for replacing a spinal facet, and possibly, a total vertebral facet joint replacement.
  • The present invention may provide numerous advantages over the prior art. One advantage may be that the quality of attachment of the prosthesis is improved. The present invention may provide a precise press fit into bones, as opposed to relying on prosthetic surfaces mating with highly complex and variable external surfaces of the vertebra, such as the posterior arch or facet. Another advantage may be that the optional porous coating is placed into interior bone spaces where porous coatings have proven to achieve bone ingrowth for excellent long term fixation strength. This ability to achieve bone ingrowth is uncertain for the prior art devices that engage the external bone surfaces of the vertebra. Yet another advantage may lie in the removal of the facet bone structure; where the facet bone is involved in the disease pathology or the trauma that compromised the articular or cartilaginous surface of the facet, resection provides a means for ensuring that all pain associated with the disease or trauma is removed.
  • The above, and other features and advantages of the present invention, will become apparent from the following description, which is to be read in conjunction with the accompanying drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a perspective view of a portion of the spine;
  • FIG. 2 is a lateral view of a facet joint reconstructed in accordance with the present invention;
  • FIG. 3 is a dorsal view of the facet joint shown in FIG. 2;
  • FIG. 4 is a perspective view of the implanted left inferior facet prosthesis shown in FIGS. 2 and 3;
  • FIG. 5 is a perspective view of the left inferior facet prosthesis shown in FIGS. 2 and 3;
  • FIG. 6 is a cranial view of the implanted left superior facet prosthesis shown in FIGS. 2 and 3;
  • FIG. 7 is a perspective view of the left superior facet prosthesis shown in FIGS. 2 and 3;
  • FIG. 8 is a perspective view of an alternative implanted left inferior facet prosthesis;
  • FIG. 9 is a perspective view of an alternative left inferior facet prosthesis;
  • FIG. 10 is a lateral view of an alternative reconstructed facet joint;
  • FIG. 11 is a dorsal view of an alternative reconstructed facet joint;
  • FIG. 12 is a perspective view of the implanted left inferior facet prosthesis shown in FIGS. 10 and 11;
  • FIG. 13 is a perspective view of the alternative left inferior facet prosthesis shown in FIGS. 10 and 11;
  • FIG. 14 is a cranial view of the alternative implanted left superior facet prosthesis shown in FIGS. 10 and 11;
  • FIG. 15 is a perspective view of the alternative left superior facet prosthesis shown in FIGS. 10 and 11;
  • FIG. 16 is a perspective view of an alternative bearing surface for the superior facet prosthesis shown in FIG. 15;
  • FIG. 17 is a dorsal view of a single intact vertebra;
  • FIG. 18 is a lateral view of the same intact vertebra shown in FIG. 17;
  • FIG. 19 is a dorsal view of the same vertebra of FIG. 17 and FIG. 18, with a portion of the superior facet resected and a portion of the inferior facet resected;
  • FIG. 20 is a lateral view of the resected vertebra shown in FIG. 19;
  • FIG. 21 is a dorsal view of the same resected vertebra shown in FIG. 18 and FIG. 19 with a fixation element placed through the first superior resection surface and into the pedicle bone;
  • FIG. 22 is a dorsal view showing the resected vertebra, the fixation element, and a superior facet prosthesis;
  • FIG. 23 is a dorsal view of the vertebra and the implant of FIG. 23 and also showing the addition of an inferior facet prosthesis;
  • FIG. 24 is a dorsal view of the implant and vertebra of FIG. 23 and also showing the addition of an enlarged head that has the shape of a locking nut;
  • FIG. 25 is a perspective view of a vertebra with an assembled implant comprising a fixation element, superior facet prosthesis, and a locking nut;
  • FIG. 26 is a perspective, cross-sectioned view of the same vertebra and implant of FIG. 25 with a cross section aligned with the axis of the fixation element;
  • FIG. 27 is a cranial, cross-sectioned view of the vertebra and implant of FIG. 25, with the section plane positioned as in FIG. 26;
  • FIG. 28 is a side view of embodiments A, B, C, D, E, and F of the fixation element, a cross-sectional view of each of embodiments A, B, C, D, E, and F, and a side view of the enlarged head in the shape of a locking nut;
  • FIG. 28A is a side view of embodiments G, H, I, J, K, and L of the fixation element with attached enlarged heads, and a cross-sectional view of each of embodiments G, H, I, J, K, and L;
  • FIG. 29 is a perspective view of a radially expanding fixation element in its unexpanded state;
  • FIG. 30 is a side view and a bottom view of (i) an expanded radially expanding fixation element and (ii) an unexpanded radially expanding fixation element;
  • FIG. 31 is a perspective cross-sectional view of a vertebra and a facet implant showing a cross-pin torsionally and axially securing the fixation element;
  • FIG. 32 is a dorsal view of a spinal section showing a top, middle, and bottom vertebra with unilateral facet replacements on the right side of the spine section, both between the top and middle vertebra, and between the middle and bottom vertebra;
  • FIG. 33 is a dorsal view of a spine section showing a superior hemiarthroplasty facet replacement between the top and the middle vertebra and unilateral replacement between the middle and the bottom vertebra;
  • FIG. 34 is a dorsal view of a spinal section showing an inferior facet hemiarthroplasty replacement between the top and the middle vertebra and a unilateral replacement on the right side between the middle and the bottom vertebra;
  • FIG. 35 is a dorsal view of a spinal section showing a unilateral replacement between the top and middle vertebrae on the right side, and an inferior facet hemiarthroplasty replacement between the middle and bottom vertebrae on the same side;
  • FIG. 36 is a dorsal view of a spinal section showing a unilateral replacement between the top and middle vertebrae on the right side and a superior facet hemiarthroplasty replacement on the right side between the middle and bottom vertebrae on the same side;
  • FIG. 37 is a spinal section of two vertebrae showing one inferior facet of the top vertebra and the adjoining superior facet of the bottom vertebra replaced by an articulating facet implant;
  • FIG. 38 is a perspective view of a curved superior facet prosthesis;
  • FIG. 39 is a perspective view of a superior facet prosthesis with a bone ingrowthsurface;
  • FIG. 40 is a perspective view of an inferior facet prosthesis;
  • FIG. 41 is a perspective view of an inferior facet prosthesis with a bone ingrowth surface;
  • FIG. 42 is an exploded, perspective view illustrating the addition of a locking washer to the construction of the implant shown in FIG. 25;
  • FIG. 43 is a perspective view illustrating the implant of FIG. 25 with a locking washer fully installed;
  • FIG. 44 is a perspective view of the locking washer shown in FIG. 42;
  • FIG. 45 is a perspective view of superior and inferior facet prostheses held against a vertebra by flexible fixation elements;
  • FIG. 46 is a dorsal view of a bilateral inferior implant;
  • FIG. 47 is perspective view of a vertebra with an alternative embodiment of a superior facet prosthesis fixed to the bone by one embodiment of a fixation element;
  • FIG. 48 is a perspective, cross-sectional view of the embodiment of the superior facet prosthesis and fixation element of FIG. 47 showing the semispherical shape of the resection and the approximately similarly semispherical shape of the apposition side of the superior facet prosthesis, as well as an angled resection and corresponding angled flat on the apposition side of the superior facet prosthesis in combination with the semispherical resection;
  • FIG. 49 is a perspective view of the resected vertebra without the superior facet prosthesis attached to the vertebra, in which the fixation element is installed in the vertebra;
  • FIG. 50 is a perspective view of the resected vertebra with the superior facet prosthesis attached to the vertebra, with the fixation element installed in the vertebra, but without the locking fastener shown in FIG. 47;
  • FIG. 51 is a top view of the superior facet prosthesis showing the semispherical shape of the bone apposition side in combination with the angled flat on the bone apposition side;
  • FIG. 52 is a rear view of the superior facet prosthesis showing the semispherical nut engaging surface on the top of the area that is design to connect to the fixation element and the locking nut, or the inferior prosthesis and the fixation element;
  • FIG. 53A is a rear view and a perspective view of a plurality of superior facet prostheses of a kit;
  • FIG. 53B is a top view of an inferior facet prosthesis according to one embodiment of the invention;
  • FIG. 53C is a side view of the inferior facet prosthesis of FIG. 53B;
  • FIG. 53D is a perspective view of a plurality of inferior facet prostheses of a kit;
  • FIG. 53E is a perspective view showing how a superior facet prosthesis and an inferior facet prosthesis may fit together;
  • FIG. 53F is a dorsal view of an L5 superior facet prosthesis and an L4 inferior facet prosthesis fit on adjacent vertebrae to articulate against each other;
  • FIG. 53G is a posteriolateral view of the implants and vertebrae shown in FIG. 53F;
  • FIG. 53H is a posteriolateral view showing a cross-section along a first plane cut through the articulation of the implants of FIG. 53F;
  • FIG. 53I is a cephalad view showing a cross-section along a second plane cut through the articulation of the implants shown in FIG. 53F;
  • FIG. 54 is a dorsal view of a bilateral inferior facet prosthesis system and a superior facet prosthesis in situ;
  • FIG. 55 is a perspective view of the bilateral inferior facet prosthesis system and the superior facet prosthesis of FIG. 54;
  • FIG. 56 is a lateral view of the bilateral inferior facet prosthesis system and superior facet prosthesis in situ;
  • FIG. 57 is a cranial view of the bilateral inferior implant system in situ;
  • FIG. 58 is a bottom view of the bilateral inferior facet prosthesis system in situ;
  • FIG. 59 is rear view of the bilateral inferior facet prosthesis system in isolation;
  • FIG. 60 is a top view of the bilateral inferior facet prosthesis system in isolation;
  • FIG. 61 is a bottom view of the bilateral inferior facet prosthesis system in isolation;
  • FIG. 62 is a perspective view of the right inferior prosthesis;
  • FIG. 63 is a perspective view of various ball-shaped members of inferior prostheses, the ball-shaped members having differing surface features, particularly circumferential grooves, longitudinal grooves, and knurling;
  • FIG. 64 is an end view of the ball-shaped members of FIG. 63; and
  • FIG. 65 is a dorsal view of the bilateral inferior facet prosthesis system, in which castle nuts are attached to the left and right fixation elements.
  • DETAILED DESCRIPTION OF THE DRAWINGS
  • Referring now to FIG. 1, there is shown a perspective view of a superior vertebra 1 and an inferior vertebra 3, with an intervertebral disc 2 located in between. The superior vertebra 1 has superior facets 43, inferior facets 6, a posterior arch (or lamina) 35 and a spinous process 46. The inferior vertebra 3 has superior facets 7, inferior facets 44, a posterior arch (or lamina) 36 and a spinous process 45. Each of the vertebrae 1, 3 also has a pair of pedicles 11. Referring now to FIG. 2, in a lateral view, the left inferior facet 6 of the superior vertebra 1 shown in FIG. 1 has been resected and an inferior facet prosthesis 4 has been attached to the superior vertebra 1. Similarly, the left superior facet 7 of the inferior vertebra 3 has been resected and a superior facet prosthesis 5 has been attached to the inferior vertebra 3.
  • FIG. 3 illustrates a dorsal view of the elements shown in FIG. 2. It can be appreciated that inferior facet prosthesis 4 replicates the natural anatomy when compared to the contralateral inferior facet 6 of vertebra 1. Similarly, it can be appreciated that superior facet prosthesis 5 replicates the natural anatomy when compared to the contralateral superior facet 7 of vertebra 3. Neither the inferior facet prosthesis 4 nor the superior facet prosthesis 5 rests on the lamina 35. Turning now to FIG. 4, a perspective view of the superior vertebra 1 with implanted inferior facet prosthesis 4 is provided. A bone resection on the left side of the superior vertebra 1, shown as a resection 31, has removed the natural inferior facet 6 at the bony junction between the inferior facet 6 and the lamina 35. In this manner, any bone pain associated with a disease, such as osteoarthritis, or trauma of the left inferior facet 6 will be eliminated as the involved bony tissue has been osteotomized.
  • FIG. 5 illustrates a perspective view of the inferior facet prosthesis 4. A surface 8 replicates the natural articular surface of the replaced inferior facet 6. A post 9 provides a mechanism that can be used to affix the inferior facet prosthesis 4 to the superior vertebra 1. The post 9 is implanted into the interior bone space of the left pedicle 11 on the superior vertebra 1 and may or may not extend into the vertebral body of superior vertebra 1 to provide additional stability.
  • FIG. 6 illustrates a cranial view of the inferior vertebra 3 with the implanted superior facet prosthesis 5. A resection surface 32 represents the bony junction between the natural superior facet 7 and the lamina 36.
  • FIG. 7 illustrates a perspective view of the superior facet prosthesis 5. A surface 38 replicates the natural articular surface of the replaced superior facet 7. The post 37 provides a mechanism usable to affix the superior facet prosthesis 5 to the inferior vertebra 3. The post 37 is implanted into the interior bone space of the left pedicle 11 (FIG. 6) on the inferior vertebra 3 and may or may not extend into the vertebral body of the inferior vertebra 3 to provide additional stability.
  • When the total facet joint is replaced, as shown in FIGS. 2 and 3, then the surface 8 (FIG. 5) articulates against the surface 38 (FIG. 7) to recreate the natural biomechanics of the spine motion segment made up of the superior vertebra 1, the inferior vertebra 3, and the intervertebral disc 2. Neither the inferior facet prosthesis 4 nor the superior facet prosthesis 5 rests on the lamina 35 or the lamina 36, respectively.
  • FIG. 8 illustrates a perspective view of an alternative inferior facet prosthesis 10 that may be implanted into the interior bone space of the lamina 35 of the superior vertebra 1. The interior bone space is accessed from the resection 31.
  • FIG. 9 shows a perspective view of the alternative inferior facet prosthesis 10, including a fin 13 that extends into the interior bone space of the 35. A surface 12 replicates the natural articular surface of the replaced facet.
  • The surfaces of the post 9 (FIG. 5), the post 37 (FIG. 7), and the fin 13 (FIG. 9) may or may not include porous coatings to facilitate bone ingrowth to enhance the long-term fixation of the implant. Furthermore, such porous coatings may or may not include osteoinductive or osteoconductive substances to further enhance bone remodeling into the porous coating. In this application, the term “implant” refers to any natural or man-made, fabricated or unfabricated device or group of devices that may be added to a human spine. An implant may include one or more prostheses, one or more fixation devices, and/or other components.
  • Referring now to FIG. 10, there is shown a lateral view of a superior vertebra 14 and an inferior vertebra 16, with an intervertebral disc 15 located in between. The left inferior facet of the superior vertebra 14 has been resected and an inferior facet prosthesis 18 has been attached to superior vertebra 14 via a screw fastener 17. Similarly, the left superior facet of the inferior vertebra 16 has been resected and a superior facet prosthesis 19 has been attached to vertebra 16 via a screw fastener 17.
  • FIG. 11 illustrates a dorsal view of the elements of FIG. 10. It can be appreciated that inferior facet prosthesis 18 replicates the natural anatomy when compared to the contralateral inferior facet 22 of the superior vertebra 14. Similarly, it can be appreciated that superior facet prosthesis 19 replicates the natural anatomy when compared to the contralateral superior facet 21 of the inferior vertebra 16. Neither the inferior facet prosthesis 18 nor the superior facet prosthesis 19 rests on the lamina of the corresponding vertebra 14 or 16.
  • Turning now to FIG. 12, there is provided a perspective view of the superior vertebra 14 with the implanted inferior facet prosthesis 18. A resection 34 has removed the natural inferior facet at the bony junction between the inferior facet and the adjoining lamina. In this manner, any bone pain associated with a disease, such as osteoarthritis, or trauma of the natural inferior facet 22 will be eliminated inasmuch as the involved bony tissue has been osteotomized.
  • FIG. 13 illustrates a perspective view of the inferior facet prosthesis 18. A surface 23 replicates the natural articular surface of the replaced facet. A flange 25 contacts the pedicle 11 (FIG. 12) and a hole 24 receives the screw fastener 17 to attach the inferior facet prosthesis 18 to the superior vertebra 14.
  • FIG. 14 illustrates a cranial view of the inferior vertebra 16 with the implanted superior facet prosthesis 19. A resection surface 33 represents the bony junction between the natural superior facet 21 (FIG. 11) and the corresponding lamina.
  • FIG. 15 illustrates a perspective view of the superior facet prosthesis 19. A surface 27 replicates the natural articular surface of the replaced facet. A flange 39 contacts the pedicle 11 (FIG. 14) and hole 26 receives a screw fastener 17 to attach the superior facet prosthesis 19 to the inferior vertebra 16.
  • FIG. 16 provides a perspective view of an alternative superior facet prosthesis 40 with a bearing surface 41 that mounts to substrate 42. The bearing surface 41 is a biocompatible polymeric material, such as ultra high molecular weight polyethylene. Alternatively, the bearing surface can be ceramic, such as zirconia or alumina. The substrate is a biocompatible metal alloy, such as an alloy of titanium, cobalt, and/or iron.
  • The bearing surface 41 may be formed separately from the remainder of the superior facet prosthesis 40, so that the bearing surface 41 and the remainder form components that can be assembled as needed. A kit of differently-sized prostheses may include multiple bearing surfaces like the bearing surface 41 that may have different thicknesses, articulating surface shapes, material selections, and the like. Such a kit may also include other differently-sized components designed such that some subset of the components can be selected and assembled together to provide a prosthesis having the desired dimensions. Prosthesis kits will be shown and described in greater detail subsequently.
  • Referring to FIG. 17 and FIG. 18, a single intact vertebra 100 is shown. FIG. 17 is a dorsal view of the vertebra 100. FIG. 18 is a lateral view of the same vertebra 100. Similar to the two vertebrae 1, 3 shown in the portion of the spine illustrated in FIGS. 1 through 3, the vertebra 100 has posterior anatomy comprising left and right superior facets 43 on the superior, or top side in this view of the dorsal vertebra 100, left and right inferior facets 6 on the inferior or bottom side of the posterior vertebra 100, left and right transverse processes 105 extending laterally from the posterior portion of vertebra 100, and left and right pedicles 11. Each of the superior facets 43 has a superior articulating surface 145. The posterior portion of vertebra 100 also has a posterior arch (or lamina) 35, and a spinous process 46 that protrudes from the lamina 35 posteriorly, out of the page in FIG. 17 and to the left in FIG. 18. In FIG. 17, the bony structure of the superior facets 43 and the inferior facets 6 are intact, as it would be presented in a vertebra without significant tissue degeneration or remodeling resulting from facet joint disease. Although the vertebra 100 is shown in FIG. 17 as a generally structurally healthy and intact vertebra, if the vertebra 100 were a diseased vertebra, the vertebra could exhibit signs of facet joint disease.
  • Consequently, structural pathology related to facet joint disease would likely be visible. For example, the left superior facet 43 and the right superior facet 43 of the vertebra 100 are symmetrical in FIG. 17 and FIG. 18. But in the case of a vertebra 100 with only one diseased joint, the facet on the diseased side would likely be showing pathological signs of disease such as tissue degeneration or inflammation resulting in an asymmetrical structural comparison between the two facets.
  • Also, in more extreme cases the facet disease could progress to a state in which the articular process of the facet is eroded or inflamed resulting in anatomic morphology that is unique to the pathology of a particular facet joint of an individual patient. This could present unusual facet morphology that could be different from what is shown in FIGS. 17 and 18.
  • Furthermore, the facet disease could eventually disable the biomechanics of a patient such that the facet joint is essentially non-articulating and immobile. In this case, one superior facet of a first vertebra could essentially be fused to one inferior facet of a second vertebra. Since the structural pathology of the diseased facet is variable, a surgeon may determine that the best bone apposition surface or foundation for securing a facet implant is a resected bone surface.
  • Referring to FIG. 19 and FIG. 20 which are dorsal and lateral views of the same vertebra shown in FIG. 17 and FIG. 18 after a portion of the right superior facet 43 and a portion of the right inferior facet 6 have been resected. The removal of a portion of the superior facet 43 by resection results in a superior facet resection 111. In the resection shown in FIG. 19 and FIG. 20, the superior resection 111 has two resulting faces, a first resection surface 112 and a second resection surface 113. Likewise, the inferior facet resection results in an inferior facet resection surface 121.
  • Tissue removal tools (not shown) such as a bone burr, rasp, reamer, mill, saw, rounger, osteotome or similar tools designed to cut and remove bone tissue can be used to create these resection surfaces. The surgeon uses anatomic landmarks such as the pedicle 11 or transverse process 105 to align the tissue removal tools in such a way as to remove the portion of the facet necessary to provide a superior resection 111 that serves as a bone apposition surface or foundation to eventually support a superior facet prosthesis 300, as shown in FIG. 22. The left superior facet 43 is shown intact in both FIG. 19 and FIG. 20, but a portion of the right superior facet 43 is resected resulting in the first resection surface 112 and the adjacent second resection surface 113 (FIG. 19). The shape of the superior resection 111 will vary in accordance with the structure of the tissue removal tool. In the embodiment shown in FIG. 19 and FIG. 20, the first resection surface 112 and the second resection surface 113 are on approximately perpendicular planes. However, the geometry of the resection surfaces is a function of the patient anatomy, the pathology of the diseased tissue, the technique of the surgeon, and other factors such as the type of tissue removal tools used to prepare the resection. In general, the first resection surface 112 will be formed in such a way that it will serve as a foundation to support the superior facet prosthesis 300 (FIG. 22). The second resection surface 113 or other additional resection surfaces may or may not be present.
  • FIG. 19 and FIG. 20 also show that a portion of the inferior facet 6 is resected by tissue removal instruments resulting in an inferior resection surface 121. Such resection is preferably effected so that resection is confined to the tissue of the inferior facet 6 and does not extend into the tissue of the posterior arch (or lamina) 35. In FIGS. 19 and 20, the left inferior facet 6 is intact, while a portion of the right inferior facet 6 is resected resulting in the inferior resection surface 121 on the right side. The bone surrounding the inferior resection surface 121 is contoured by tissue removal tools in a shape designed to cradle and support an inferior facet prosthesis 400 (FIG. 23) on the medial side such that when the inferior facet prosthesis 400 is loaded on the lateral side it compresses against and is supported by the inferior resection surface 121.
  • Alternatively, the inferior facet 6 can be resected, and inferior facet prosthesis 400 sized and shaped, so that inferior facet prosthesis 400 does not engage the inferior resection surface 121.
  • FIG. 21 is a dorsal view of the vertebra 100 with a fixation element 200 placed through the superior resection 111 and into the bone of the pedicle 11 to receive the superior facet prosthesis 300 (FIG. 22). The fixation element 200 is aligned and placed into the pedicle 11, similar to how other pedicle screws for posterior stabilization involved with vertebrae fusion are placed in the pedicle 11. In one method, a long guide wire (not shown), with a diameter sized to fit freely into a cannulation 211 (as also shown in FIG. 26 and FIG. 27) in the fixation element 200, is placed through the first resection surface 112 and into the bone of the pedicle 11. The alignment of the long guide wire can be confirmed by x-ray. The fixation element 200 is then guided over the guide wire and driven into the vertebra 100 by a driver (not shown) engaged with a drive feature 212 (FIG. 21) on a proximal post 230 of the fixation element 200. The fixation element 200 is driven into the vertebra 100 until a connection feature 213 (e.g., a screw thread) is just above the first resection surface 112. This connection feature 213 is eventually used to secure the superior facet prosthesis 300 to the vertebra 100.
  • In a second method for guiding the fixation element 200 into the pedicle 11, a long guide wire (not shown), with a diameter sized to fit freely into a cannulation in a bone preparation instrument (not shown) such as a tap, drill, broach or reamer, is placed through the first resection surface 112 and into the bone of the pedicle 11. The alignment of the long guide wire can be confirmed by x-ray. The bone preparation instrument is then guided over the guide wire and driven into the bone of the pedicle 11 to prepare a cavity for the fixation element 200. The guide wire and bone preparation instrument are then removed and the fixation element 200 is guided into the prepared cavity in the pedicle 11 by a driver (not shown) engaged with the drive feature 212 on the proximal post 230 of the fixation element 200. Like in the first method, the fixation element 200 is driven into the vertebra until a connection feature 213 (e.g., a screw thread) is just above the first resection surface 112. This connection feature 213 is eventually used to secure the superior facet prosthesis 300 to the vertebra 100.
  • In yet a third method of placing the fixation element 200 in the pedicle, the surgeon aligns the fixation element 200 with anatomic landmarks and simply drives the fixation element 200 through the first resected surface 112 and into the pedicle 11. As with the first and second methods, the fixation element 200 is driven into the vertebra 100 until a connection feature 213 (e.g., a screw thread) is just above the first superior resection surface 112.
  • In FIG. 22, a dorsal view illustrates a superior facet prosthesis 300 placed around the fixation element 200. The superior facet prosthesis 300 has a facet articulating component 320 that articulates against the inferior facet articulating surface of the vertebra above it. The facet articulating component 320 is preferably formed in the general shape of a blade or wing ear. The superior facet prosthesis 300 also has a bone apposition surface 322 that has been placed on the first resection surface 112 and an opening 324 in a flange 323 that surrounds the fixation element 200. The superior facet articulating component 320 has an articulating surface 321 generally adjacent to the flange 323 that is oriented in a direction that faces approximately the same direction that the original anatomic superior articulating surface 145 faced prior to resection.
  • This orientation of the articulating surface 321 allows the superior facet prosthesis 300 to function as either a hemiarthroplasty implant and articulate against a natural anatomic inferior facet 6 or act as a portion of a unilateral prosthesis and articulate against an inferior facet prosthesis 400 on the vertebra superior (cephalad) to it. No portion of superior facet prosthesis 300 rests on the lamina of the vertebra 100. In this application, a “unilateral prosthesis” is a prosthesis in which both facets of only one of the facet joints between adjacent vertebrae are replaced by prostheses. A “hemiarthroplasty” is a type of arthroplasty in which one side of an articulating joint surface is replaced with an artificial implant.
  • FIG. 23 is a dorsal view showing the addition of the inferior facet prosthesis 400 to the construct described in FIG. 22. The inferior facet prosthesis 400 generally has a shape similar to a longitudinal rod that is curved to match the contour of the inferior resection 121 (FIGS. 19 and 20). The inferior facet prosthesis 400 has an opening 410 through its superior end 420 that is shaped to surround the portion of the fixation element 200 that protrudes from the first resection surface 112. In FIG. 23, the inferior facet prosthesis 400 is placed over the superior facet prosthesis 300. However, the order of the placement of the prostheses 300, 400 can be reversed such that the inferior prosthesis 400 is placed on the fixation element 200 first, followed by the superior prosthesis 300. When only the inferior facet 6 or the superior facet 43 is being replaced, only the appropriate (superior or inferior) facet prosthesis 300 or 400 is placed on the fixation element 200 without the other (inferior or superior) facet prosthesis 300 or 400.
  • Because the various components of the implant are modular, many combinations of configurations and implant size, structure and shapes are feasible. For example, in a patient with unusual anatomy, the inferior facet prosthesis 400 may need to be larger than expected to conform to a particularly unusual or exceptionally large morphology of the inferior resection surface 121, and the superior facet prosthesis 300 may need to have an unusual angle to its articulating surface 321 to conform to particular anatomic constraints. If this is the case, the modularity of the system allows for the surgeon to assemble an implant specifically designed to match the patient's anatomic structures during the surgery. This flexibility of a modular implant design allows the implant manufacturer to accommodate a large variation in anatomic structures with a limited selection of implant component sizes, shapes, and material types.
  • The modularity of the implant design also allows different components of the implant to be fabricated from different materials. Traditionally, bone fixation implants such as the fixation element 200 are fabricated from biocompatible metals or alloys that provide sufficient strength and fatigue properties, such as cobalt chrome alloys, titanium and titanium alloys, and stainless steels. However, the fixation element 200 may be fabricated from ceramics, polymers, or biological materials such as allograft bone, composites, or other biocompatible structural materials. Likewise the superior facet prosthesis 300 and the inferior facet prosthesis 400 may be fabricated from metals, alloys, ceramics, polymers, biological materials, composites, or other biocompatible structural materials.
  • In FIG. 24, a dorsal view illustrates the addition of an enlarged head 500 to the fixation element 200. The enlarged head 500 is tightened down to force the prostheses 300, 400 against the bone to stabilize them. The enlarged head 500 shown in FIG. 24 has a hexagonal geometry on its external surface that is shaped to accept a driver (not shown) that is used to force an internal connection feature 520 (e.g., a screw thread) of the enlarged head 500 onto the connection feature 213 of the fixation element 200. In the case of the threaded embodiment of the connection feature 213, the enlarged head 500 is provided with a threaded connection feature 520 and is driven onto the fixation element 200 by turning the enlarged head 500 and allowing the threads to drive all components of the implant between the enlarged head 500 and the first resection surface 112 against the bone at or near the resection surface 112.
  • FIG. 25 is a perspective posterior view of the assembly of the fixation element 200, the superior facet prosthesis 300, and the enlarged head 500. The enlarged head 500 has been placed on the first resection surface 112.
  • FIG. 26 is a perspective, cross-sectioned view of the same construct shown in FIG. 25. The superior facet prosthesis 300, the enlarged head 500, the fixation element 200, and the vertebra 100 have been cut by a cross-sectioning plane 150 placed along an axis that passes through the center of the fixation element 200. The cross-section plane 150 is shown for visualization purposes to illustrate, using a cross-sectioned view, how the vertebra 100, fixation element 200, superior facet prosthesis 300 and the enlarged head 500 engage each other. In actual surgery, it is highly unlikely that a surgeon would make a cut as illustrated by the cross-section 150 shown in FIG. 26.
  • FIG. 27 is a cranial, section view of the vertebra 100 and the implant, wherein the cross-section plane 150 is oriented to face the viewer. In FIG. 27, the fixation element 200 is in the vertebra 100. The embodiment of the fixation element 200 in FIG. 27 comprises a distal end 220 that is shaped to guide the fixation element 200 into bone tissue, a bone stabilizing portion 210 adjacent to the distal end, a shaft portion 240 adjacent to the bone stabilizing portion 210, a connection feature 213 adjacent to the shaft portion 240, and a drive feature 212.
  • The distal end 220 shown in FIG. 27 has a frusto-conical shape that allows the fixation element 200 to be driven or guided into the vertebra 100. The distal end 220 could be shaped in the form of a spade tip, trochar tip, or twist drill tip to assist in the guidance of the fixation element 200 in the vertebra 100. The fixation element 200 may also have a cutting flute (not shown) formed in the distal end 220 to help remove bone tissue and accommodate the guidance of the fixation element 200 in the vertebra 100. The bone stabilizing portion 210 helps to secure the fixation element 200 to the vertebra 100. The bone stabilizing portion 210 can include various features designed to anchor into bone such as threads, ribs, grooves, slots, fins, barbs, splines, bone ingrowth surfaces, roughened surfaces, or any geometric feature that helps to engage the fixation element 200 with the bone tissue to help stabilize the fixation element 200. In FIG. 27, the bone stabilizing portion 210 has a unitary continuous bone thread 231. However, other types of threads such as multiple lead threads, variable pitched thread, non-uniform pitch thread, buttress thread, or other thread forms used on bone screws may be used. Because FIG. 27 is a cross-sectional view, the full length of the cannulation 211 is seen passing from the distal end 220 of the fixation element 200 to the proximal post 230 of the fixation element 200.
  • The drive feature 212 in the embodiment shown in FIG. 27 is an internal hex. However, any shape of drive feature 212 that transmits the loads necessary to drive the fixation element 200 into the vertebra 100 can be formed on the proximal post 230 of the fixation element 200. The depth of the drive feature 212 formed in the proximal post 230 of the fixation element 200 is seen in the cross-sectional view of FIG. 27. The drive feature 212 may be an internal drive feature such as the hex socket shown in this embodiment, or an external drive feature with geometry on the periphery of the proximal post 230 of the fixation element 200 that engages with a corresponding internal drive feature on a driver tool (not shown). In this embodiment the depth of the drive feature 212 is slightly longer than its cross-section is wide. This depth can be adjusted based on the material properties of the fixation element 200 and the drive tool (not shown).
  • The fixation element 200 is fabricated from biocompatible base materials that provide the necessary structural rigidity and strength. Examples of base materials that may be used in the construction of the fixation element 200 include titanium, titanium alloys, cobalt-chrome alloys, stainless steel alloys, zirconium alloys, other biocompatible metal materials, biocompatible ceramics, biocompatible composites, and biocompatible polymers. The fixation element 200 may also have surface materials formed on the base material that provide material properties specific to a particular portion of the fixation element 200. For example, the bone stabilization portion 210 could be coated with materials that allow for improved bone ingrowth into the implant surface such as a hydroxylapatite, bioceramic, Bioglass.RTM., or other calcium phosphate derived material. The tribological bearing properties of the material in the areas that the fixation element 200 interfaces with other artificial elements may be improved by applying surface hardening techniques to the material of the fixation element 200 in these areas. Surface hardening techniques known in the materials science and materials engineering arts such as anodizing, ion implantation, and other techniques could be applied to these isolated areas.
  • As mentioned previously, the connection feature 213 is formed on the portion of the fixation element 200 that protrudes from the first resection surface 112. This connection feature 213 is designed to connect the enlarged head 500 to the fixation element 200. In the embodiment of the connection feature 213 shown in FIG. 21, threads 260 are on the external surface of this proximal section of the fixation element 200. These threads 260 engage with the threads of the internal connection feature 520 (FIG. 27) of the enlarged head 500. Although the connection feature 213 in this embodiment is threaded, other mechanical locking features (not shown) capable of locking the fixation element 200 and the enlarged head 500 together, such as press fit, taper fit, bonding fit by cement or glue, interference fit, expansion fit and mechanical interlocking fit such as a bayonet connection, can be used as the connection feature 213. A corresponding construction may then be used as connection feature 520 of the enlarged head 500.
  • Also shown in FIG. 27 is a cross-sectional view of the superior facet prosthesis 300. This embodiment of the superior facet prosthesis 300 has a flange 323 that has an opening 324 that receives the fixation element 200. In the assembled and implanted configuration of this embodiment, the flange 323 is positioned such that its bone apposition surface 322 makes contact with the first resection surface 112. Although not shown in this embodiment, other embodiments of the superior facet prosthesis 300 have structures (e.g., spikes) that protrude into the first resection surface 112 to help resist torsion and other anatomic loads. Protruding from the flange 323 at a given angle .alpha., and a given distance X from the opening 324, is the articulating component 320. The articulating surface 321 of the facet articulating component 320 replicates the natural articular surface of the replaced facet. Once the surgeon assesses the anatomy of the superior facet 43 that is being replaced, a particular superior facet prosthesis 300 is selected that has the angle .alpha. and the distance X that best fits the anatomy of the level of vertebra, the left or right side, and the size of the patient's anatomy being replaced. Thus a kit containing various sizes and shapes of superior facet prostheses 300 is provided to the surgeon and the surgeon selects the superior facet prosthesis 300 that best suits the situation.
  • After the fixation element 200 and the superior facet prosthesis 300 are selected and placed, they are locked to the vertebra 100 by the enlarged head 500. As shown in FIG. 24, the enlarged head 500 in this embodiment has an internal connection feature 520 and a hexagonal shaped external drive feature 510 that is used to drive the enlarged head 500 over the fixation element 200 and against the superior facet prosthesis 300. The specific shape of the external drive feature 510 is dependent on the mating shape of the driver (not shown).
  • Referring to FIG. 28, side and cross-sectional views illustrate six different embodiments of fixation elements, which are labeled A, B, C, D, E, and F. The figure shows a side view of each fixation element embodiment and a cross-sectional view of each embodiment to the right of the respective side view. To the left of the six embodiments is a representative enlarged head 500. Embodiment A is the threaded fixation element 200 embodiment shown in FIGS. 26 and 27 and described above. Embodiments B through E are various designs of fixation elements with non-circular cross-sections. Embodiment B is a four rib cruciate design with four longitudinal fins 285 configured to resist torsion when the fixation element 200 is in the vertebra 100. Embodiment C is an oval shaped cross-section design that is wider in the first direction 286 than the second direction 287 to resist torsion. If the width in the first direction 286 is equal to the width in the second direction 287, the cross-section shape becomes more of a circle and bone stabilization portion 210 becomes more of a press-fit peg. Embodiment D is a square cross-section design with four approximately perpendicular sides 288. The corners 289 of the sides 288 help to resist torsion. Embodiment E is a triangular cross-section design with three sides 291 to resist torsion. Embodiment F is an anchor-like design that is driven into the vertebra, with the wire arches or barbs 290 being compressed against the host bone and applying a radial expansion force so as to lock the structure to the bone.
  • Referring to FIG. 28A, side and cross-sectional views illustrate six more different embodiments of fixation elements, which are labeled G, H, I, J, K, and L. FIG. 28A shows a side view of each fixation element embodiment and a cross-sectional view of each embodiment to the right of the respective side view. Each embodiment has an attached or integrally formed enlarged head 500′. Embodiment G is similar to the threaded fixation element 200 embodiment shown in FIGS. 10, 11, 12 and 24 and described above. Embodiments H through K are various designs of fixation elements with non-circular cross-sections. Embodiment H is a four rib cruciate design with four longitudinal fins 285 configured to resist torsion when the fixation element is in the vertebra 100. Embodiment I is an oval shaped cross-section design that is wider in a first direction 286 than in a second direction 287 to resist torsion. If the width in the first direction 286 is equal to the width in the second direction 287, the cross-section shape becomes more of a circle and the bone stabilization portion 210 becomes more of a press-fit peg. Embodiment J is a square cross-section design with four approximately perpendicular sides 288. The corners 289 of the sides 288 help to resist torsion. Embodiment K is a triangular cross-section design with three sides 291 to resist torsion.
  • Embodiment L is an anchor-like design that is similar to Embodiment F in FIG. 28, but with an attached or integrally formed enlarged head 500′. As embodiment L is driven into the vertebra, wire arches or barbs 290 are compressed and apply radial expansion force against the wall of the prepared bone and into the pedicle 11, resulting in a locking anchor.
  • FIG. 29 is a perspective view of a radially expanding fixation element 600. The radially expanding fixation element 600 comprises two main elements, an expansion sleeve 620 and a central element 610 that is inside of the expansion sleeve 620. The radially expanding fixation element 600 is placed into the vertebra 100 and then the central element 610 is drawn outward relative to the expansion sleeve 620 resulting in radial expansion of the fixation element 600. This is shown in FIG. 30.
  • Referring to FIG. 30, side and bottom views illustrate the fixation element 600 of FIG. 29. As a proximal post 630 of the central element 610 is pulled axially along its longitudinal axis, and the expansion sleeve is held axially in the bone by compression fit, talons 621 on the expansion sleeve 620 are radially expanded outward by a mandrel 660 on the central element 610. The talons or fingers 621 provide both torsional and axial stability to the radially expanding fixation element 600. This provides a secure fixation element for fixation of the remaining implant components. Furthermore, expansion of the fixation element 600 may cause the fixation element 600 to center itself within the pedicle 11.
  • FIG. 31 is a perspective, cross-sectional view of a cross-pin element 700 engaged with the fixation element 200 to help secure the fixation element 200 both torsionally and axially. The cross-pin element 700 is columnar in shape having a distal end 710, a midsection 730 (with a length along its longitudinal axis that is longer than its transverse cross-sectional width), and a proximal post 720. The distal end 710 is shaped to penetrate through bone tissue and into a cross hole 280 formed in the fixation element 200. Instrumentation (not shown) is used to align the cross-pin element 700 with the cross-hole 280 via fixation of the instrumentation to the drive feature 212 or the cannulation 211 on the fixation element 200 and alignment of the direction of insertion of the cross-pin element 700 with the cross-hole 280. Once the cross-pin element 700 is in place in the bone and through the fixation element 200, the torsional and axial stability of the fixation element 200 is improved.
  • The various embodiments of the fixation element 200 described above and shown in FIG. 28 through FIG. 31 function in conjunction with the enlarged head 500 to hold the inferior facet prosthesis 400 and/or the superior facet prosthesis 300 to their respective resection surfaces 112, 113, and/or 121. Various combinations of this modular implant will be described below and shown in FIGS. 32 through 37. Although these figures illustrate the use of the fixation element 200 and the enlarged head 500 as the mechanism for securing the prostheses 300, 400 to the vertebra 100, other clamping devices such as the screw fastener 17 (FIG. 10) may be used to mount the prostheses 300, 400 to the bone. For example, the screw prostheses 17 shown in FIGS. 10 through 12 may pass through either the opening 324 (FIG. 22) in the superior facet prosthesis 300 or the opening 410 (FIG. 23) in the inferior facet prosthesis 400 or through both of these openings 324, 410. The head of the screw fastener 17 acts as the securing mechanism by pressing the inferior facet prosthesis 400 and the superior facet prosthesis 300 against their respective resection surfaces 112, 113, and/or 121.
  • FIGS. 32 through 37 demonstrate different combinations of assemblies of facet replacement prostheses. The basic components of the prosthesis are the fixation element 200, the superior facet prosthesis 300, the inferior facet prosthesis 400, and the enlarged head 500. However, as described above, a screw fastener 17 can replace the fixation element 200 and the enlarged head 500.
  • Referring to FIG. 32, a dorsal view illustrates three sequential layers of vertebrae. A top vertebra 101 is above a middle vertebra 102, and the middle vertebra 102 is above a bottom vertebra 103. Portions of some of the facets on the right side of the vertebrae are replaced by prostheses. With regard to the facet joint between the top vertebra 101 and the middle vertebra 102, an inferior facet prosthesis 401 is articulating against a superior facet prosthesis 302 to form an artificial unilateral joint. The inferior facet of the middle vertebra 102 is replaced by an inferior facet prosthesis 402 and the superior facet of the bottom vertebra 103 is replaced by superior facet prosthesis 303. Thus, a second unilateral prosthetic joint is formed that is also on the right side and is located at the level between the middle vertebra 102 and the bottom vertebra 103. FIG. 32 demonstrates the difference in shape of the inferior facet prosthesis 401 that is implanted around the fixation element 201 without a superior facet prosthesis 300 and an inferior facet prosthesis 402 that is implanted around a fixation element 202 and over a superior facet prosthesis 302. The opening 410 (not visible) of the inferior facet prosthesis 401 on the top vertebra 101 in this assembly is offset more laterally than the opening 410 (not visible) in the inferior facet prosthesis 402 for the middle vertebra 102. This is because the fixation element 201 is implanted more laterally on the top vertebra 101 to preserve more of the superior facet since it is not replaced by a prosthesis at this level.
  • Referring to FIG. 33, a dorsal view illustrates the top vertebra 101 in intact form, without resection of the facets. Portions of both the superior and inferior facets on the right side of the middle vertebra 102 are replaced by a superior facet prosthesis 302 and an inferior facet prosthesis 402. Only the right superior facet of the bottom vertebra 103 is replaced (i.e., by a superior facet prosthesis 303) in FIG. 33. Thus, a hemiarthroplasty replacement has been performed on the right facet joint between the top vertebra 101 and the middle vertebra 102 and a unilateral replacement has been performed between the middle vertebra 102 and the bottom vertebra 103. The assembly shown in FIG. 33 demonstrates how the superior facet prosthesis 302 can articulate against the natural inferior facet 6 and the superior facet prosthesis 303 can articulate against the inferior facet prosthesis 402.
  • FIG. 34 is a dorsal view illustrating how the inferior facet prosthesis 401 can articulate against the natural superior facet 43, or the inferior facet prosthesis 402 can articulate against the superior facet prosthesis 303. The right facet joint between the top vertebra 101 and the middle vertebra 102 is a hemiarthroplasty replacement with the inferior facet replaced by the inferior facet prosthesis 401. The right facet joint between the middle vertebra 102 and the bottom vertebra 103 is a unilateral replacement with the inferior facet replaced by the inferior facet prosthesis 402 and the superior facet of the bottom vertebra 103 replaced by the superior facet prosthesis 303.
  • Referring to FIG. 35, a dorsal view shows another example of how the superior facet prosthesis 303 can articulate against the natural inferior facet 6 or the superior facet prosthesis 302 can articulate against the inferior facet prosthesis 401. In this assembly of the implant, the right side between the top vertebra 101 and the middle vertebra 102 is a unilateral replacement and the right side between the middle vertebra 102 and the bottom vertebra 103 is a hemiarthroplasty replacement.
  • Referring to FIG. 36, a dorsal view shows another example of how the inferior facet prosthesis 402 can articulate against the natural superior facet 43, or the inferior facet prosthesis 401 can articulate against the superior facet prosthesis 302. The right facet joint between the top vertebra 101 and the middle vertebra 102 is a unilateral replacement with the inferior facet of the top vertebra 101 replaced by the inferior facet prosthesis 401 and the superior facet of the middle vertebra 102 replaced by the superior facet prosthesis 302. The right facet joint between the middle vertebra 102 and the bottom vertebra 103 is a hemiarthroplasty replacement with the inferior facet replaced by the inferior facet prosthesis 402.
  • Referring to FIG. 37, a dorsal view illustrates only one level, that between the middle vertebra 102 and the bottom vertebra 103, being replaced on the right side. The right facet joint between the middle vertebra 102 and the bottom vertebra 103 is a unilateral replacement with the inferior facet of the middle vertebra 102 replaced by the inferior facet prosthesis 402 and the superior facet of the bottom vertebra 103 replaced by the superior facet prosthesis 303.
  • FIG. 38 and FIG. 39 show two embodiments of the superior facet prosthesis. In FIG. 38, a perspective view illustrates an embodiment in which a curved superior facet prosthesis 305 with a curved articulating component 330 has a curved articulating surface 331. This curved articulating surface 331 allows for a more distributed contact load between an inferior facet prosthesis, such as the inferior facet prosthesis 400 of FIG. 23, and the curved articulating surface 331. This allows slightly more flexibility in the position that the surgeon places the curved superior facet prosthesis 305 than the superior facet prosthesis 300 previously described. The articulating surface 321 of the superior facet prosthesis 300 previously described is relatively flat. The articulating surface 331 of the curved superior facet prosthesis 305 is curved. Since the bearing portion of the inferior facet prosthesis 400 is columnar, the two prosthesis can be aligned on a slight mismatch and make more of an anatomic contact if the articulated surface is curved as in FIG. 38.
  • Referring to FIG. 39 a perspective view illustrates a bone ingrowth feature 390 on a superior facet prosthesis 306. The bone ingrowth feature 390 can be any surface that allows bone to grow into the implant between the first resection surface 112 of the vertebra 100 and the apposition surface 322 of the implant. Examples of bone ingrowth features 390 include porous coating of beads or meshes, electrochemically etched shapes and porous pads pressed onto the implant surface made from tantalum, titanium, cobalt chrome alloys and/or other biocompatible material such as hydroxylapatite or calcium phosphate ceramics.
  • Referring to FIG. 40, a perspective view shows the inferior facet prosthesis 400, which is formed in the general shape of a finger or talon. More particularly, the inferior facet prosthesis 400 is formed with a flange 420 on its superior side shaped to fit between the enlarged head 500 and either the superior facet prosthesis 300 or the first resection surface 112. The flange 420 has an opening 410 that is dimensioned to allow the inferior facet prosthesis 400 to fit over the proximal post 230 of the fixation element 200 and around the shaft portion 240 of the fixation element 200. The inferior facet prosthesis 400 also has an inferior portion 450 on the opposite side of the flange 420 that has a bone apposition side 440 that is shaped to contact the surface of the inferior facet resection surface 121 (FIG. 19) and a joint articulation side 430 that is shaped to articulate against a natural or prosthetic superior facet.
  • Referring to FIG. 41, a perspective view shows an inferior facet prosthesis 460 also formed in the general shape of a finger or talon. The inferior facet prosthesis 460 is formed with a superior end 420 having an opening 410 that is dimensioned and shaped to accept the fixation element 200. The inferior facet prosthesis 460 is generally columnar in shape, having a curved length designed to conform to the prepared anatomy of the vertebra 100. The inferior facet prosthesis 460 of FIG. 41 has an inferior portion 470, which is shown opposite the superior end 420, and slightly medially offset from the superior end 420. This medial offset of the opening 410 relative to the inferior portion 470 allows the inferior facet prosthesis 400 to be anchored to the bone by the fixation element 200 and secured to the bone by the enlarged head 500, or the superior facet prosthesis 300 in combination with the enlarged head 500, at an anatomical position that allows optimal bone fixation. The inferior facet prosthesis 460 of FIG. 41 has a bone ingrowth surface 441 and a joint articulating side 430 on its inferior end 470. In this embodiment, the bone ingrowth surface 441 is a textured structure that permits bone cells to grow into the implant surface. The shape of the bone ingrowth surface 441 can be a uniform textured surface as shown in FIG. 41, or can be a non-uniform randomized structure such as a open cell foam structure, a porous beaded structure, a wire mesh structure, an electrochemical etched structure, or other bone ingrowth structures known in the design of orthopedic implants. The bone ingrowth surface 441 is shaped to mate with the inferior resected bone surface 121 shown in FIG. 19 and FIG. 20.
  • FIG. 42 shows an exploded, perspective view of the vertebra 100 with the superior facet prosthesis 300 installed. An additional locking washer 800 is used to assist in stabilizing the attachment of the superior facet prosthesis 300 to the first resection surface 112. The construction of the implant assembly shown in FIG. 42 is similar to that of the assembly shown in FIG. 25 with the addition of the locking washer 800 that is placed over and around the proximal post 230 of the fixation element 200.
  • Referring to FIG. 43, a perspective view shows the same implant of FIG. 42 with the enlarged head 500 locked onto the fixation element 200 and pushing the locking washer 800 against the superior facet prosthesis 300 and into the bone tissue. This added bone penetration of the locking washer 800 helps to fix the superior prosthesis 300 such that the entire assembly is more mechanically stable with respect to the vertebra 100.
  • FIG. 43 shows a further step in the assembly of the implant construct described in FIG. 42. In FIG. 43, the locking washer 800 is secured over the fixation element 200 and into the bone tissue by the enlarged head 500. Although this embodiment of the locking washer 800 is only shown with the superior facet prosthesis 300, the locking washer 800 can alternatively be used to mechanically secure the inferior facet prosthesis 400, or the combination of the inferior facet prosthesis 400 and the superior facet prosthesis 300. In the embodiment of the locking washer 800 shown in FIG. 42 and FIG. 43, the locking washer 800 is placed over the superior facet prosthesis 300. However, the locking washer 800 may be placed under the superior facet prosthesis 300, under the inferior facet prosthesis 400 and the superior facet prosthesis 300, or between the superior facet prosthesis 300 and the inferior facet prosthesis 400 to stabilize the implant construct.
  • FIG. 44 shows a perspective view of the locking washer 800. The locking washer 800 has a body 805 with an opening 810 that is dimensioned to fit over the proximal post 230 of the fixation element 200. The locking washer 800 also has an anti-rotation feature 820 that mates with either the superior facet prosthesis 300 or the inferior facet prosthesis 400 or a combination of both the inferior facet prosthesis 400 and the superior facet prosthesis 400. The anti-rotation feature 820 shown in this embodiment is a flat surface, however, any feature that would rotationally constrain the locking washer 800 to the other components of the implant (such as a tab, groove, taper or other geometric shape) can be formed on the locking washer 800 as an anti-rotation feature. The locking washer 800 also has prongs 830 that pass into the bone tissue of the vertebra 100 to help stabilize the implant construct. The prongs 830 in this embodiment of the locking washer 800 are elongated protrusions that taper to a tissue penetration tip 840. The prongs have sidewalls 850 that provide a surface to resist torsion once the locking washer 800 penetrates the bone tissue. The prongs 830 may also be simple spikes that are either symmetrical or asymmetrical in cross-section that protrude from the locking washer body 805. The shape and length of the locking washer prongs 830 are dependent on how the locking washer 800 is used. The prongs 830 of the locking washer 800 that holds only one of the inferior facet prosthesis 400 or the superior facet prosthesis 300 to the vertebra 100 may be shorter than prongs of a locking washer that holds both the inferior facet prosthesis 400 and the superior facet prosthesis 300 to the vertebra 100.
  • FIG. 45 shows a perspective view of the superior facet prosthesis 300 and inferior facet prosthesis 400 held to the vertebra 100 by an adjunctive flexible fixation element 900 and a secondary flexible fixation element 910. These flexible fixation elements 900 and/or 910 may be made from such constructs as suture, braided cable, wire, ribbon, and/or other constructs that have longer lengths than cross-sections and withstand larger loads in tension than in compression. The flexible fixation elements 900 and/or 910 may be manufactured from biocompatible metals, alloys such as cobalt chrome alloys, titanium alloys, stainless steel alloys, polymers, bioabsorbable materials, composites, or other materials that are biocompatible and can be formed into a flexible element structure 900 and/or 910 such as those shown in FIG. 45. The adjunctive flexible element 900 shown in FIG. 45 is shown attached to and securing the elongated head 500. A flexible element attachment portion 580 (e.g., including an opening) mates the flexible element 900 to the elongated head. However, the adjunctive flexible fixation element 900 may alternatively or additionally be attached to the fixation element 200, the superior facet prosthesis 300, the inferior facet prosthesis 400 or any combination of the above listed elements. A flexible fixation attachment portion 480 (e.g., including an opening) in the inferior facet prosthesis 400 allows the secondary flexible fixation element 910 to secure the inferior facet prostheses 400 to the vertebra 100. The flexible fixation elements 900 and/or 910 may be secured to the vertebra 100 by physically wrapping them around anatomic features such as the posterior arch 35, the spinous process 46, transverse process 105, or a combination of these anatomic features. The flexible element 900 and the secondary flexible element 910 may also be secured to the vertebra 100 by bone anchors such as anchors designed to anchor flexible fixation elements (such as suture, not shown) to bone. Suture anchors such as threaded suture anchors, barbed suture anchors, toggle suture anchors or any other means of anchoring a flexible fixation element to bone may be used to anchor the flexible fixation element 900 and/or the secondary flexible fixation element 910 to the vertebra 100.
  • FIG. 46 is a dorsal view of a bilateral inferior facet prosthesis 1000. The bilateral inferior facet prosthesis 1000 is a one-piece inferior facet prosthesis that has both a right inferior side 1040 and a left inferior side 1020 connected by a stabilizing bar 1010. Both the right inferior side 1040 and the left inferior side 1020 are designed to fix to the top vertebra 101 at the respective inferior resection surface 121 (FIG. 19) and at the first resection surface 112. The bilateral inferior facet prosthesis 1000 allows replacement of both the left and the right inferior facets. In this embodiment, the bilateral inferior facet prosthesis 1000 is placed over the left and right fixation elements 200 which extend into the bone of the top vertebra 101. In the embodiment shown in FIG. 46, the right inferior side 1040 is articulating against the right superior facet prosthesis 300 attached to the bottom vertebra 102. Also in this embodiment, the left inferior side 1020 is articulating against the left natural superior facet 43 of the bottom vertebra 102. The stabilizing bar 1010 of the bilateral inferior prosthesis 1000 is designed to stabilize the left side 1020 and the right side 1040 so that they are secure.
  • FIG. 47 illustrates a perspective view of a superior facet prosthesis 1100 coupled to the vertebra 3. The superior facet prosthesis 1100 has a bone apposition surface (not shown) that has been placed on a first resection surface 1112 and an opening (not shown) in a flange 1116 that surrounds a fixation element 1110, and coupled thereto by a locking fastener such as a castle nut 1114 or the like. The superior facet prosthesis 1100 has a superior facet articulating component 1120 with an articulating surface 1122 generally adjacent to the flange 1116. The articulating surface 1122 is oriented in a direction that faces approximately the same direction that the original anatomic superior articulating surface faced prior to resection. This orientation of the articulating surface 1122 allows the superior facet prosthesis 1100 to function as either a hemiarthroplasty implant by articulating against a natural anatomic inferior facet 6 or as a unilateral prosthesis by articulating against an inferior facet prosthesis on the vertebra superior (cephalad) to it, such as the inferior facet prosthesis 4 shown in FIG. 5, the inferior facet prostheses 10 shown in FIGS. 8 and 9, and the inferior facet prosthesis 400 shown in FIG. 40, as well as those described below.
  • The facet articulating component 1120 is preferably formed in the general shape of a blade or wing ear, wherein the articulating surface 1122 has a concave shape. In the embodiment shown, the articulating surface 1122 curves from an orientation generally perpendicular to the flange 1116 towards an orientation generally parallel to the flange 1116 from a distal end 1124 thereof to a proximal end 1126 thereof.
  • The concave shape of the articulating surface 1122 provides more tolerance for a miss-match with the natural anatomic inferior facet 6 or with the inferior facet prosthesis 4 on the vertebra superior to it. Functionally, the clearance between the concave shape of the articulating surface 1122 and the adjacent inferior facet 6 or inferior facet prosthesis 4 increases as the patient bends forward (flexion) and decreases as the patient bends backward (extension). Thus in flexion the patient has more facet movement allowing for more torsion (twisting) and lateral bending (side to side movement) than in a neutral stance. As the patient extends, the articulating members are more constrained in torsion and lateral bending. This mimics the natural anatomic constraints of the spinal facets.
  • FIG. 48 is a perspective view of the same construct shown in FIG. 47, but with the implants and the vertebra 3 cut by a cross-sectioning plane 1130 placed along an axis that passes through the center of the fixation element 1110. The cross-section plane 1130 shown cutting through the vertebra 3 and the implant of FIG. 47 is shown for visualization purposes to illustrate, using a cross-sectioned view, how the vertebra 3, fixation element 1110, and superior facet prosthesis 1100 engage each other.
  • The fixation element 1110 provides a mechanism that affixes the superior facet prosthesis 1100 to vertebra 3. Fixation element 1110 is implanted into the interior bone space of the left pedicle 11 (FIG. 6) on the vertebra 3 and may or may not extend into the vertebral body of vertebra 3 to provide additional stability. The fixation element 1110 can take the form of a screw (as shown), or any of the devices shown in FIGS. 28-30. The fixation element 1110 has a drive feature 1140, which is an internal hex in the embodiment shown in FIG. 48. However, any shape of drive feature that transmits the loads necessary to drive the fixation element 1110 into the vertebra 3 can be formed on a proximal post 1142 of the fixation element 1110.
  • The depth of the drive feature 1140 formed in the proximal post 1142 of the fixation element 1110 is seen in the cross-sectional view of FIG. 48. The drive feature 1140 may be an internal drive feature such as the hex socket shown in this embodiment, or an external drive feature with geometry on the periphery of the proximal post 1142 of the fixation element 1110 that engages with a corresponding internal drive feature on a driver tool (not shown). The flange 1116 of the superior facet prosthesis 1100 is secured to the fixation element 1110 by the castle nut 1114 or the like.
  • The flange 1116 of the superior facet prosthesis 1100 includes a coupling portion 1144 having a generally semispherical bone engaging surface 1150 on the apposition side of the superior facet prosthesis 1100 that engages a corresponding semispherical resection 1146 in the bone bed of the pedicle of vertebra 3. The term “semispherical” relates to a surface that includes some sectorial portion of a sphere, which may be less than a hemisphere. A semispherical surface may be concave or convex. A surface that is semispherical or generally semispherical may have some deviations from a precise semispherical shape.
  • The semispherical resection 1146 may be said to be “inversely shaped” with respect to the coupling portion because the semispherical resection 1146 has a generally concave surface that matches the generally convex surface of the coupling portion 1144. Although the coupling portion 1144 and the semispherical resection 1146 are semispherical in the embodiment of FIGS. 47 and 48, in alternative embodiments, they may have a variety of other matched shapes, including three-dimensional parabolas, ellipsoids, and other regularly or irregularly curved or flat-sided shapes. Furthermore, although the coupling portion 1144 is convex and the semispherical resection 1146 is concave in the embodiment of FIGS. 47 and 48, in alternative embodiments, the shapes may be reversed so that a coupling portion is concave and a resection is convex.
  • In the embodiment of FIGS. 47 and 48, the coupling portion 1144 is integrally formed with the articulating surface 1122 of the superior facet articulating component 1120. The coupling portion 1144 may be said to be “attached to” the articulating surface 1122 because in this application, the term “attached” is used broadly to include parts that are integrally formed with each other as well as parts that are formed separately and subsequently coupled together.
  • The semispherical resection 1146 in the bone bed allows for less transverse process to be resected (vs. a flat bone bed resection). The semipherical resection 1146 in the bone bed also allows for more stable support of the superior facet prosthesis 1100, than does a flat bone bed resection, as the superior facet prosthesis 1100 is polyaxially supported in such a way as to resist any shear forces applied between the semispherical resection 1146 and the coupling portion 1144. In this application, “polyaxial” refers to a linear or angular force or motion acting with respect to at least two perpendicular axes. The coupling portion 1144 may seat directly against the semispherical resection 1146. In this application, an item that “seats directly against” another is positioned to abut the other item so that surfaces of the two items are in contact with each other.
  • The coupling portion 1144 has a fixation element receiving aperture 1148 that can be made slightly larger than a circumferential diameter of the fixation element 1110 taken in a direction perpendicular to a longitudinal axis thereof to provide accurate polyaxial seating of the implant 1100 in relation to the resected bone bed and fixation element 1110, as well as to provide increased tolerance for miss-match. An implant engaging end 1154 of the castle nut 1114 (or other fastener) also has a semispherical shape for engaging a semispherical nut engaging side of the coupling portion 1144 of the superior facet prosthesis 1100 at the final position of the superior facet prosthesis 1100.
  • The semispherical shape of the coupling portion 1144 enables the coupling portion 1144 to move polyaxially against the semispherical resection 1146. Movement “against” the semispherical resection refers to movement in which the coupling portion 1144 remains substantially continuously in contact with the semispherical resection 1146 so as to slide against the semispherical resection 1146. Accordingly, during installation, a surgeon can position the coupling portion 1144 against the semispherical resection 1146 and then pivot the coupling portion 1144 along three perpendicular axes, without removing the coupling portion 1144 from the semispherical resection 1146. The coupling portion 1144 simply rotates against the semispherical resection 1146.
  • The phrase “polyaxial motion” refers to any combination of translation and/or rotation along at least two perpendicular axes. Since the coupling portion 1144 is pivotable with respect to the semispherical resection 1146 along three perpendicular axes, the coupling portion 1144 is “tri-axially pivotable” with respect to the semispherical resection 1146.
  • When the superior facet prosthesis 1100 has been rotated to the proper orientation, the articulating surface 1122 is positioned for proper articulation against the corresponding inferior facet or inferior facet prosthesis. The orientation of the coupling portion 1144 may then be fixed with respect to the semispherical resection 1146 by tightening the castle nut 1114 (or another fastener) on the fixation element 1110, thereby firmly gripping the coupling portion 1144 against the semispherical resection 1146. Accordingly, the coupling portion 1144 is “selectively polyaxially movable” with respect to the semispherical resection 1146 because the coupling portion 1144 is movable with respect to the semispherical resection 1146 along multiple perpendicular axes until the surgeon decides to fix its disposition.
  • In alternative embodiments (not shown) of the invention, tri-axial pivotal movement need not be provided. Rather, a coupling portion and a corresponding resection surface may have a cylindrical, flat-sided, splined, or other shape designed to enable relative translation in addition to or in place of rotation. In place of the fixation element receiving aperture 1148, an elongated fixation element receiving aperture may be used to accommodate relative translation between the coupling portion and a fixation element. Alternatively, a coupling portion and a resection surface may be shaped to provide relative pivotal motion along only one or two axes.
  • In an alternative embodiment the implant engaging end 1154 of the castle nut 1114 (or other fastener) can be deformable such that the implant engaging end 1154 conforms under pressure to the adjacent surface of the coupling portion 1144 regardless of the angle of the surface with respect to the axis of the castle nut 1114. The deformable end can be formed of a plastic such as polyethylene attached to the metal body of the castle nut 1114, but is preferably formed of a substance that hardens over time, such as a fast-curing and biocompatible resin or a material that is heated prior to insertion into the patient and hardens upon cooling to the patient's body temperature. The material that hardens over time provides more stability than the deformable material, though both provide acceptable results.
  • FIG. 48 also shows an angled resection 1112 and corresponding angled flat 1156 on the apposition side of the superior facet prosthesis 1100 in combination with the semispherical resection 1148.
  • The surfaces of the apposition side of the coupling portion 1144 and flat 1156, as well as fixation element 1110, may or may not include porous coatings to facilitate bone ingrowth to enhance the long-term fixation of the implant. Furthermore, such porous coatings may or may not include osteoinductive or osteoconductive substances to further enhance the bone remodeling into the porous coating.
  • FIG. 49 shows a perspective view of the vertebra 3 with a fixation element 1110 portion implant placed through the semispherical resection 1146 in the resection surface 1112 and into the bone of the pedicle 11. The fixation element 1110 is aligned and placed into the pedicle 11 in a manner similar to that of other pedicle screws for posterior stabilization vertebrae fusion procedures.
  • In FIG. 50, a perspective view illustrates the superior facet prosthesis 1100 in place around the fixation element 1110. The castle nut 1114 has not yet been installed. As shown, the coupling portion 1144 has a semispherical nut engaging surface 1152.
  • FIG. 51 is a top view of the superior facet prosthesis 1100, particularly showing the curved shape of the articulating surface 1122 and the semispherical bone engaging surface 1150 of the coupling portion 1144. Additionally, FIG. 51 more clearly illustrates the angled flat 1156 on the apposition side of the superior facet prosthesis 1100.
  • FIG. 52 is an illustration of a rear view of the superior facet prosthesis 1100. In this context, “rear” means as viewed from along the axis of the fixation element receiving aperture 1148. FIG. 52 particularly shows the curved shape of the articulating surface 1122 and the semispherical nut engaging surface 1152 of the coupling portion 1144.
  • FIG. 53A shows a kit including a plurality of differently configured superior facet prostheses 1100, 1162, 1164, 1166, 1168. View A is a rear view of the superior facet prostheses 1100, 1162, 1164, 1166, 1168, while View B illustrates a perspective view of the laterally adjacent prosthesis 1100, 1162, 1164, 1166, 1168 rotated 90.degree. As shown, the superior facet prostheses 1100, 1162, 1164, 1166, 1168 have differing physical dimensions.
  • Referring again to FIG. 51, which shows a single superior facet prosthesis 1100, some of the physical dimensions that change between the differently sizes superior facet prostheses 1100, 1162, 1164, 1166, 1168 in the kit (FIG. 53A) are a resection angle (.alpha.), an x offset (X.sub.1), a y offset (Y.sub.1), a facet angle (.beta.), and a facet articulation radius (R). Exemplary values for the foregoing will be provided below. Although the exemplary values relate primarily to L5 superior and L4 inferior, they may apply to other combinations of vertebrae in the lower back and/or the sacrum. One or more of these variables can change between the different superior facet prosthesis sizes.
  • P1 is the most medial and anterior point on the articulating surface 1122. The superior pedicle axis 1170 is the axis that is colinear with the longitudinal axis of the fixation element 1110 that is positioned through the pedicle 11 nearest to the resected superior facet (not shown). The superior pedicle axis 1170 extends through a saddle point S1, which is offset as shown, by an offset 1176, which may be about 2 mm, from the fixation element receiving aperture 1148. The superior pedicle axis 1170 is parallel with the direction of the y offset (Y.sub.1). The direction of the x offset (X.sub.1) is perpendicular to the direction of the y offset (Y.sub.1). The direction of the x offset (X.sub.1) is generally, but not precisely, lateral to medial with respect to the central axis of the patient's spine.
  • P4 is the most posterior point on the articulating surface 1122. As shown, P4 is displaced from the saddle point S1 by an x offset (X.sub.4) and a y offset (Y.sub.4). The direction of the X.sub.4 offset is parallel to that of the X.sub.1 offset, and the direction of the Y.sub.4 offset is parallel to that of the Y.sub.1 offset.
  • The resection angle (.alpha.) for the superior facet prostheses 1100 can range from 50 to 85.degree. However, the optimal range of the resection angle (.alpha.) for the majority of patients will range from 30.degree. to 70.degree. Thus, by way of example, a family containing nine sets of superior facet prostheses 1100 can be provided with the resection angles (a) varying in increments of 5.degree. Sets of superior facet prostheses 1100 would be provided with resection angles (a) at 30.degree., 35.degree., 40.degree., 45.degree., 50.degree., 55.degree., 60.degree., 65.degree. and 70.degree.
  • The x offset (X.sub.1) for the superior facet prosthesis 1100 can range from 5 mm to 30 mm. However, for the majority of patients, the x offset (X.sub.1) will range from 10 mm to 20 mm. Therefore a family of superior facet prostheses 1100 can be provided with the x offset (X.sub.1) varying in increments of 5 mm. Thus, sets of superior facet prostheses 1100 would be provided with x offset (X.sub.1) at 10 mm, 12 mm, 14 mm, 16 mm, 18 mm, and 20 mm to provide superior facet prostheses 1100 that cover the statistical range for the majority of the population of patients needing superior facet prostheses 1100.
  • The y offset (Y.sub.1) for the superior facet prosthesis 1100 can range from 2 mm to 20 mm. However, for the majority of patients, the y offset (Y.sub.1) will range from 5 mm to 15 mm. Therefore a family of superior facet prostheses 1100 can be provided with the y offset (Y.sub.1) varying in increments of 2 mm. Thus, sets of superior facet prostheses 1100 would be provided with y offset (Y.sub.1) at 5 mm, 7 mm, 9 mm, 11 mm, 13 mm, and 15 mm to provide superior facet prostheses 1100 that cover the statistical range for the majority of the population of patients needing superior facet prostheses 1100.
  • The x offset (X.sub.4) for the superior facet prosthesis 1100 can range from about 5 mm to about 25 mm. However, for the majority of patients, X.sub.4 will range from about 8 mm to about 20 mm. A family of superior facet prostheses may be provided with X.sub.4 values varying in increments of 2 mm. Thus, sets of superior facet prostheses 1100 would be provided with X.sub.4 values of 8 mm, 10 mm, 12 mm, 14 mm, 16 mm, 18 mm, and 20 mm to provide superior facet prostheses 1100 that cover the statistical range for the majority of the population of patients needing superior facet prostheses 1100.
  • The y offset (Y.sub.4) for the superior facet prosthesis 1100 can range from about −5 to about 15 mm. However, for the majority of patients, Y.sub.4 will range from about −2 mm to about 10 mm. A family of superior facet prostheses may be provided with Y.sub.4 values varying in increments of 2 mm. Thus, sets of superior facet prostheses 1100 would be provided with Y.sub.4 values of −2 mm, 0 mm, 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm to provide superior facet prostheses 1100 that cover the statistical range for the majority of the population of patients needing superior facet prostheses 1100.
  • The facet angle (.beta.) for the superior facet prosthesis 1100 can range from 50.degree. to 120.degree. However, for the majority of patients, the facet angle (.beta.) will range from 60.degree. to 100.degree. Therefore a family of superior facet prostheses 1100 can be provided with the facet angle (.beta.) varying in increments of 5.degree. Thus, sets of superior facet prostheses 1100 would be provided with the angle (.beta.) at 60.degree., 65.degree., 70.degree., 75.degree., 80.degree., 85.degree., 90.degree., 95.degree., and 100.degree. to provide superior facet prostheses 1100 that cover the statistical range for the majority of the population of patients needing superior facet prostheses 1100.
  • Once the surgeon assesses the anatomy of the superior facet that is being replaced, a particular superior facet prosthesis 1100 is selected that has the curvature and overall angle of the articulating surface 1122, with respect to the flange 1116 that best fits the anatomy of the level of vertebra, the left or right side, and the size of the patient's anatomy being replaced. Thus a kit containing various sizes and shapes of superior facet prostheses 1100 is provided to the surgeon and the surgeon selects the superior facet prosthesis 1100 that best suits the situation.
  • According to one example, such a kit may contain nine prostheses, which may be dimensioned to provide a variety of combinations of values for .alpha., X.sub.1, Y.sub.1, .beta., X.sub.4, Y.sub.4, and R, within the ranges listed above. If desired, one or more of the above-listed variables may remain constant over the entire kit. For example, R may have a constant value, such as 11.5 mm, for all members of the kit.
  • The prostheses 1100, 1162, 1164, 1166, 1168 of the kit of FIG. 53A are not simply scaled up or down, but are varied according to a number of carefully selected parameters to cover the vast majority of morphologies occurring in the L5 vertebra. In a similar manner, a plurality of inferior facet prostheses adapted to replace inferior facets can be provided either as a separate kit, or in combination with the kit of FIG. 53A. Such a kit will be shown and described in connection with FIG. 53D.
  • FIGS. 53B and 53C illustrate top and side views, respectively, of an exemplary inferior facet prosthesis 1172. The inferior facet prosthesis 1172 has an x offset (X), a y offset (Y), and a z offset (Z), which are illustrated in FIGS. 53B and 53C. As shown, the offsets X, Y, and Z run between a saddle point S1 of the inferior facet prosthesis 1172 and a center point C1 of the articulation surface 1174. The saddle point S1 of FIGS. 53B and 53C is defined in a manner similar to that of the superior facet prosthesis 1100 of FIG. 51.
  • As shown in FIGS. 53B and 53C, the inferior facet prosthesis 1172 has a semispherical coupling portion similar to the coupling portion 1144 of the superior facet prosthesis 1100 introduced in the description of FIG. 47. Accordingly, the inferior facet prosthesis 1172 provides the same type of tri-axial pivotal motion during installation as the coupling portion 1144, as described previously. The coupling portion of the inferior facet prosthesis 1172 may also be nested in the coupling portion 1144 of the superior facet prosthesis 1100, or vice versa, to enable independent polyaxial adjustment of the prostheses 1100, 1170 when positioned in engagement with a single semispherical resection 1146.
  • Referring to FIG. 53D, a perspective view illustrates a kit of inferior facet prostheses 1180, 1182, 1184, 1186, 1188, 1190. Again, the physical dimensions can vary between the various inferior facet prostheses 1180 in the kit of FIG. 53D. These dimensions may include an inferior resection angle (I.alpha.), an inferior x offset (X), an inferior y offset (Y), an inferior facet angle (I.beta.), an inferior facet articulation radius (IR), and an inferior z offset (Z, from the center of fixation to the center of the articulation radius).
  • The inferior resection angle I.alpha. is the angle of the flat resection to be made in the vertebra, for example, the vertebra 101 illustrated in some of the preceding drawings, to serve as a backing for the articulating surface of the selected inferior facet prosthesis 1180, 1182, 1184, 1186, 1188, or 1190. When measured according to the coordinate system established for the superior facet prosthesis 1100, as illustrated in FIG. 51, the inferior resection angle I.alpha. may be approximately the same as the facet angle .beta. for the superior prosthesis 1100 because the articulation surfaces 1122, 1174 are to be positioned generally parallel to each other. Due to the clearance between the articulating surfaces 1122, 1174 and the generally concave and convex shapes thereof, as long as the selected inferior facet prosthesis 1180, 1182, 1184, 1186, 1188, or 1190 is placed so that the articulating surfaces 1122, 1174 are generally parallel to each other, proper articulation may be expected to occur. Thus, the inferior facet prosthesis 1180, 1182, 1184, 1186, 1188, or 1190 may be dimensioned such that I.alpha. is nearly the same as .beta., and the orientation of the articulating surface 1174 may be adjusted as needed to permit the inferior facet prosthesis 1180, 1182, 1184, 1186, 1188, or 1190 to be attached to the corresponding vertebra 101. Accordingly, I.alpha. need not be determined based on measurement of the vertebra 101, but may instead be inferred based on the selection of the superior facet prosthesis 1100, 1162, 1164, 1166, or 1168 and adjusted during installation.
  • The inferior facet angle I.beta. may be defined as the angle of the surface to which the articulating surface 1174 is most nearly parallel. Due to the shape of the inferior facet prostheses 1180, 1182, 1184, 1186, 1188, or 1190, this angle is the same as the inferior resection angle I.alpha., when measured according to the coordinate system of the superior facet prosthesis 1100 of FIG. 51.
  • The inferior pedicle axis 1170 is the axis that is collinear with the longitudinal axis of the fixation element 1110 that is positioned through the pedicle 11 nearest to the resected inferior facet (not shown). This axis is parallel with the direction of the inferior y offset (Y). The direction of the inferior x offset (X) is perpendicular to the direction of the inferior y offset (Y). The direction of the inferior x offset (X) is generally lateral to medial with respect to the central axis of the patient's spine. The direction of the inferior y offset (Y) is generally anterior to posterior. The direction of the inferior z offset (Z) is generally cephalad to caudal.
  • The inferior x offset (X) for the inferior facet prosthesis 1180 can range from 0 mm to 20 mm. However, for the majority of patients, the inferior x offset (X) will range from 2 mm to 16 mm. Therefore a family of inferior facet prostheses 1180 can be provided with the inferior x offset (X) varying in increments of 2 mm. Thus, sets of inferior facet prostheses 1180 would be provided with inferior x offset (X) at 2 mm, 4 mm, 6 mm, 8 mm, 10 mm, 12 mm, 14 mm, and 16 mm to provide inferior facet prostheses 1180 that cover the statistical range for the majority of the population of patients needing inferior facet prostheses 1180.
  • The inferior y offset (Y) for the inferior facet prosthesis 1180 can range from −15 mm to 5 mm. However, for the majority of patients, the inferior y offset (Y) will range from −12 mm to 4 mm. Therefore a family of inferior facet prostheses 1180 can be provided with the inferior y offset (Y) varying in increments of 2 mm. Thus, sets of inferior facet prostheses 1180 would be provided with inferior y offset (Y) at −12 mm, −10 mm, −8 mm, −6 mm, −4 mm, −2 mm, 0 mm, 2 mm, and 4 mm to provide inferior facet prostheses 1180 that cover the statistical range for the majority of the population of patients needing inferior facet prostheses 1180.
  • The inferior facet articulation radius (IR) for the inferior facet prosthesis 1180 can range from 5 mm to 30 mm. However, for the majority of patients, the inferior facet articulation radius (IR) will range from 10 mm to 15 mm. A family of incremented inferior prostheses may be provided to cover the aforementioned range. Alternatively, the inferior facet articulation radius (IR) may be set at a given value, for example, 12 mm, and such a value may be used in substantially all cases.
  • The inferior z offset (Z) for the inferior facet prosthesis 1180 can range from 20 mm to 40 mm. However, for the majority of patients, the inferior z offset (Z) will range from 25 mm to 31 mm. Therefore a family of inferior facet prostheses 1180 can be provided with the inferior z offset (Z) varying in increments of 1 mm. Thus, sets of inferior facet prostheses 1180 would be provided with inferior z offset (Z) at 25 mm, 26 mm, 27 mm, 28 mm, 29 mm, 30 mm, and 31 mm to provide inferior facet prostheses 1180 that cover the statistical range for the majority of the population of patients needing inferior facet prostheses 1180. If desired, a kit having ten inferior facet prostheses may be assembled. Like the prostheses 1100, 1162, 1164, 1166, 1168 of the kit of FIG. 53A, the prostheses 1180, 1182, 1184, 1186, 1188, 1190 of FIG. 53D are not simply scaled up or down, but are varied according to a number of carefully selected parameters to cover the vast majority of morphologies occurring in the L4 vertebra and/or other vertebrae.
  • The parameters of the prostheses 1100, 1162, 1164, 1166, 1168 of FIG. 53A and/or the prostheses 1180, 1182, 1184, 1186, 1188, 1190 of FIG. 53D may include at least two dimensions that vary among the members of the kit independently of each other. Dimensions that vary independently of each other need not change according to any established relationship between the dimensions, but instead, one may change while the other remains the same between any two prostheses of the kit.
  • FIG. 53E is a perspective view illustrating how a superior facet prosthesis 1100 and an inferior facet prosthesis 1180 fit together. The surgeon selects an inferior facet prosthesis that, in addition to most adequately meeting the anatomy of the patient, has an articulating surface adapted for articulating with the articulating surface of the superior facet prosthesis selected.
  • FIG. 53F is a dorsal view of a superior facet prosthesis 1100 and an inferior facet prosthesis 1204 attached to the L5 and L4 lumbar vertebrae 102, 101. In FIG. 53F, the superior facet prosthesis 1100 is attached to the left side of the L5 vertebra 102 and the inferior facet prosthesis 1204 is attached to the left L4 vertebra 101. The two prostheses 1100, 1204 are positioned on respective bone resections and oriented such that they articulate together through the range of motion naturally exhibited between the L4 and L5 vertebrae 1100, 1204. This range of motion includes flexion-extension, lateral left and right bending, torsion along a sagittal axis and combinations and coupling of all these ranges of motion.
  • FIG. 53F shows the prostheses 1100, 1204 and vertebrae 101, 102 in a natural position. The articulation surface 1174 of the inferior prosthesis 1204 and the articulation surface 1122 of the superior prosthesis 1100 are in contact in the neutral position. However, the prostheses 1100, 1204 are shaped to allow anatomic contact and articulation between the inferior facet articulation surface 1174 and the superior facet articulation surface 1122 throughout various anatomic ranges of motion.
  • Also shown in FIG. 53F are two planes labeled “Plane 1” and “Plane 2” that that intersect along an axis (not shown) that passes through the contact areas of the superior facet articulation surface 1122 and the inferior facet articulation surface 1174. Plane 1 is parallel to the page of FIG. 53F, and Plane 2 is perpendicular to the page.
  • FIG. 53G is a posteriolaterial view of the same inferior and superior facet prostheses 1100, 1204 with the planes shown in FIG. 53F. In FIG. 53G, Plane 2 is oriented parallel to the page and plane 1 is oriented perpendicular to the page. FIG. 53G illustrates the saddle point (S1) of the vertebra 102 to which the superior facet prosthesis 1100 is coupled, and the saddle point (S2) of the vertebra 101 to which the inferior facet prosthesis 1204 is coupled. The saddle points S1, S2 are displaced from each other along an x offset (IX) parallel to the axis at which Plane 1 and Plane 2 intersect, a y offset (IY) extending perpendicular to Plane 2, or out of the page with respect to FIG. 53G, and a z offset (IZ) extending perpendicular to Plane 1. The offsets IX, IY, and IZ may be used for implant sizing and/or selection, as will be discussed subsequently.
  • FIG. 53H is a posteriolateral view showing a cross-section along Plane 2. This cross-section view cuts through the articulation surfaces 1122, 1174 of the prostheses 1100, 1204, thereby showing the convex shape of the inferior articulation surface 1174 against the concave shape of the superior articulation surface 1122.
  • FIG. 53H also illustrates the cephalad and caudal ends 1250, 1252 of the articulation surface 1122 of the superior facet prosthesis 1100. The articulation surface 1122 has a radius of curvature 1254 generally about an axis 1256. However, since the radius of curvature 1254 changes along the articulating surface 1122, the axis 1256 may be the center of curvature for only a portion of the articulation surface 1122. The radius of curvature 1254 is shown extending from the axis 1256 to the articulation surface 1122 in FIG. 53H. Furthermore, FIG. 53H illustrates a longitudinal axis 1258 of the spine in general. The axis 1256 is angled from the axis 1258 by an offset angle 1259. Since the axis 1256 and the axis 1258 may not both be precisely parallel to Plane 2, the offset angle 1259 may have a component that extends out of the page with respect to the view of FIG. 53H.
  • FIG. 53I is a cephalad view showing a cross-section along Plane 1. This cross-section cuts through the articulation surfaces 1122, 1174 of the prostheses showing the convex shape of the inferior articulation surface 1174 against the concave shape of the superior articulation surface 1122. Each of the articulating surfaces 1122, 1174 has a curved shape. The articulating surfaces 1122, 1174 of the superior and inferior prostheses 1100, 1204, respectively, are shaped and relatively positioned to articulate against each other such that a medial-lateral range of relative motion between the first and second vertebrae 101, 102 increases significantly with flexion (i.e., forward bending) of the spine.
  • A “significant” increase in the medial-lateral range of motion refers to a difference in the range of motion that approximates the natural motion of the spine to a degree sufficient to be noticeable by the patient. More precisely, a “significant” increase may refer to the existence of at least one additional millimeter of clearance between articulating surfaces of a facet joint under flexion, as compared to the same facet joint under extension. Furthermore, a “significant” increase in the medial-lateral range of motion may refer to the existence of two additional millimeters of clearance between the articulating surfaces.
  • As shown in FIG. 53H, one of the articulating surfaces 1122, 1174, for example, the articulating surface 1122 of the superior facet prosthesis 1100, has a cephalad end 1250 and a caudal end 1252. The articulating surface 1122 also has a radius of curvature 1254 about an axis 1256 extending generally from the cephalad end 1250 end to the caudal end 1252. The radius of curvature 1254 changes along the axis 1256 to provide greater clearance between the articulating surfaces 1122, 1174 when the spine is under flexion. Similarly, the changing radius of curvature 1254 provides less clearance between the articulating surfaces 1122, 1174 when the spine is extended.
  • In this embodiment, the articulating surface 1122 is shaped such that, when the superior facet prosthesis 1100 is coupled to the vertebra, the axis 1256 is significantly anteriorly inclined at the cephalad end 1250 to provide greater clearance between the articulating surfaces 1122, 1174 when the spine is under flexion. In addition to or in the alternative to variation of the radius of curvature 1254 from the cephalad end 1250 to the caudal end 1252, the radius of curvature 1254 could vary along a medial-lateral direction of the articulating surface.
  • More precisely, with brief reference to FIG. 51 again, the radius of curvature may be larger toward a medial end 1260 and a lateral end 1262 of the articulating surface 1122 than at a central portion 1264 thereof. The radius of curvature could also be substantially infinite toward the medial and lateral ends, such that the articulating surface of the superior prosthesis has a curved region 1268 proximate the central portion 1264, a first tangent flat 1270 disposed medially of and tangent to the curved region 1268, and a second tangent flat 1272 disposed laterally of and tangent to the curved region 1268.
  • If desired, the inferior facet prosthesis may have an articulating surface with a three-dimensionally curved, generally elliptical shape. A three-dimensionally curved, generally elliptical shape may have the appearance of a stretched spheroid or the like. Accordingly, a three-dimensionally curved, generally elliptical shape has a first cross section having a generally elliptical shape and a second cross section perpendicular to the first cross section, having a semicircular shape. Alternatively, an inferior facet prosthesis may have an articulating surface with a generally cylindrical or semispherical shape, as illustrated in connection with FIGS. 40, 53B, and 53C, for example.
  • According to one alternative embodiment, the articulating surface of the superior facet prosthesis may have a uniform, substantially unchanging radius of curvature. The relative medial-lateral motion between the vertebra and the adjacent vertebra may still increase significantly with flexion of the spine due to the curvature of the inferior facet prosthesis. The radius of curvature of the articulating surface of the inferior facet prosthesis may change along an axis thereof, either along the cephalad-caudal direction or along the medial-lateral direction, to provide greater clearance between the articulating surfaces when the spine is under flexion. According to yet another alternative, the variation in motion in the medial-lateral direction may be obtained, not through a variable radius of curvature, but rather, through the relative positioning of the superior and inferior facet prostheses.
  • Returning to FIGS. 53F, 53G, 53H, and 531, the materials used to construct the articulating surfaces of the prostheses 1100, 1174 may be selected from a group consisting of a polymeric material, a polymeric bearing material attached to a metal substrate, a ceramic bearing material, a metal bearing material, and combinations thereof. A variety of surface coatings, treatments, and the like may be used to enhance the performance and/or longevity of the prostheses 1100, 1174.
  • The superior facet prosthesis 1100 may be shaped such that, when the superior facet prosthesis 1100 is coupled to the vertebra 102, the axis 1256 is significantly anteriorly inclined from a longitudinal axis (not shown) of the spine to provide greater clearance between the articulating surfaces 1122, 1174 when the spine is under flexion. In this application, “significantly anteriorly inclined” refers to the presence of a deliberate offset, from the longitudinal axis of the spine, that has a meaningful effect on the facet joint of which the corresponding prosthesis is a part. The offset angle 1259 between the axis 1256 and the longitudinal axis 1258 of the spine may range from about −2.5.degree. to about 14.5.degree. More precisely, the offset angle 1259 may range from about 5.degree. to about 10.degree. Yet more precisely, the offset angle 1259 may be about 7.25.degree.
  • Referring briefly again to FIG. 51 and FIG. 53G, one method of selecting inferior and superior facet prosthesis will be described. The appropriate prosthesis of the kit of superior facet prostheses may be selected by, for example, forming a semicircular resection centered at a position along the pedicle axis 1170 of the vertebra 102, at a known displacement from the saddle point S1. Certain offsets, such as X.sub.1 and X.sub.2, as shown in FIG. 51, may be measured with between the saddle point S1 and the most medial and anterior point P1.
  • Based on X.sub.1 and X.sub.2, values of the resection angle .alpha. and the facet angle .beta. may be obtained. The values of .alpha. and .beta. may be used to select the appropriate superior facet prosthesis of the kit by, for example, looking up the values of .alpha. and .beta. on a lookup table or the like. The remaining dimensions of the selected superior facet prosthesis may thus be determined based on the combination of .alpha. and .beta.
  • The appropriate prosthesis of the kit of inferior facet prostheses may also be selected by making a limited number of measurements. More precisely, a semicircular resection may be formed at a position centered along the pedicle axis of the vertebra 101, at a known displacement from the saddle point S2. One or more of the offsets IX, IY, and IZ may be measured between the resections of the saddle points S1 and S2.
  • Based on the values of IX, IY, and/or IZ obtained, the values of I.alpha. and Z (as illustrated in FIG. 53C) are determined. The values of I.alpha. and Z may be used to select the appropriate inferior facet prosthesis of the kit by, for example, looking up the values of I.alpha. and Z on a lookup table or the like. The remaining dimensions of the selected inferior facet prosthesis may thus be determined based on the combination of I.alpha. and Z.
  • The above-described selection method is beneficial because a relatively small number of linear measurements may be made to determine which set of prostheses is most appropriate for a given patient. Ease of measurement is important because the measurements must generally be performed during surgery. Accordingly, easier, more rapid measurements enable surgery to be more rapidly and safely carried out. In alternative embodiments, different measurement schemes may be carried out, and may include different linear measurements, angular measurements, and the like. In this application, measuring the “relative positions” of bony landmarks may include measurement of linear displacements, angular displacements, or any combination thereof.
  • In alternative embodiments, a kit of superior and/or inferior prosthesis need not have multiple one-piece prostheses, but may instead have multiple components designed to be assembled together to provide a prosthesis having the necessary parameters. For example, each of a plurality of semispherical bone contacting portions may be connectable to any of a plurality of articulating surfaces, via a plurality of connecting members. Selecting a prosthesis may then entail selecting a bone contacting portion, an articulating surface, and a connecting member. The bone contacting portion, articulating surface, and connecting member may then be coupled together via set screws, adhesives, interference fits, or the like.
  • If desired, the manner in which the various components are attached together may also be adjustable to enable further adjustability of the dimensions of a selected prosthesis. Such a kit of components may also include additional components such as bearing surfaces, as described in connection with FIG. 16. As yet another alternative, a single prosthesis may be adjustably deformed, for example, through the use of a lever-operated manual press, a hydraulic press, or the like, to provide the desired dimensions prior to attachment to a patient's vertebra.
  • After a semispherical resection 1146 has been formed in a vertebra and the corresponding prosthesis has been selected, a flat resection, such as the first resection surface 1112 of FIG. 48, may be formed. The flat resection may be contiguous with the semispherical resection 1146, or may be separated from the semispherical resection 1146 by an expanse of unresected bone. The determination of which prosthesis to use may also indicate to the surgeon the proper placement of the flat resection to properly receive the selected prosthesis. After the flat resection has been formed, the selected prosthesis may be attached to the vertebra. The procedure may be the same as or similar to that described above for installation of the inferior and superior facet prostheses.
  • FIG. 54 is a dorsal view of a bilateral inferior facet prosthesis system 1200 in situ. The bilateral inferior facet prosthesis system 1200 is a multi-piece inferior and superior facet prosthesis that has both a right inferior facet prosthesis 1202 and a left inferior facet prosthesis 1204 connected by a crosslink, which may take the form of a stabilizing bar 1210. Both the right inferior facet prosthesis 1202 and the left inferior facet prosthesis 1204 are designed to be affixed to the top vertebra 101 at the respective inferior facet resection surfaces 121 (FIG. 19).
  • The bilateral inferior facet prostheses 1202, 1204 allow replacement of both the left and the right inferior facets. In this embodiment, the inferior prostheses are placed over left and right fixation elements 1232, 1234 that extend into the top vertebra 101. In the embodiment shown in FIG. 54, the right inferior side is articulating against a right superior facet prosthesis 1100 attached to the first resection surface 1112 (FIG. 49) of the bottom vertebra 102. Also in this embodiment, the left inferior facet prosthesis 1204 is articulating against the left natural superior facet of the bottom vertebra 102.
  • The stabilizing bar 1210 of the bilateral inferior prosthesis system 1200 is designed to stabilize the left inferior facet prosthesis 1204 and the right inferior facet prosthesis 1202 so that they are secure. The stabilizing bar 1210 also allows the left and right inferior facet prostheses 1204, 1202 to support each other rather than requiring stabilizing members to be coupled to the spine lamina or the resected inferior facet tissue. Further, the stabilizing bar 1210 can compress the left and right inferior facet prostheses 1202, 1204 against the resected bone to improve bony ingrowth and apposition.
  • As also shown in FIG. 54, the stabilizing bar 1210 is coupled to the left and right inferior prostheses 1202, 1204 by a gripping mechanism. The gripping mechanism may include any of a variety of structures, including clips, clamps, adhesive-bonds, threaded fasteners, and the like. In the embodiment of FIG. 54, the gripping mechanism includes fore and aft flanges 1212, 1214 that engage the stabilizing bar 1210 to form a groove-and-rod joint. The fore and aft flanges 1212, 1214 are compressed together with threaded turnbuckles 1216, 1218 to pinch the stabilizing bar 1210 there between.
  • The pinching action of the flanges 1212, 1214 allows the distance between the left and right inferior prostheses 1202, 1204 to be adjusted to best suit the anatomy of the patient. During surgery, the surgeon would use a tool (not shown) to compress the left and right inferior prostheses 1202, 1204 to the desired positions and then tighten the turnbuckles 1216, 1218 to secure the stabilizing bar 1210.
  • FIG. 55 is a perspective view of the bilateral inferior facet prosthesis system 1200. The right inferior facet prosthesis 1202 includes a convex articulating surface 1220 that engages an articulating surface 1122 of the superior facet prosthesis 1100. In one embodiment, the articulating surface 1122 of the superior facet prosthesis 1100 has a concave shape (FIGS. 47, 51).
  • In this application, the term “convex” relates to a surface that bulges outward with a three-dimensional curvature. Accordingly, a convex surface is not just a sectorial portion of a cylinder, but rather, has some outward curvature along two perpendicular directions. A convex surface may be “semispherical,” or in other words, may include some sectorial portion of a sphere, which may be less than a hemisphere. However, a convex surface need not be semispherical, but may instead have contouring that provides a portion of an oval, elliptical, parabolic, and/or irregular cross sectional shape. A convex surface also need not be curved in whole or in part, but may instead have one or more planar portions.
  • In this application, “concave” refers to a surface with a central portion that is recessed with respect to at least two peripheral portions positioned on either side of the central portion. A concave surface may be formed by planar regions, curves, or combinations thereof. The central portion may be recessed along only one dimension, as with a surface defined by an interior section of a cylindrical wall. Alternatively, the central portion may be recessed along two perpendicular dimensions, so that the central portion is recessed with respect to at least four peripheral portions arranged around the central portion. Accordingly, the surface may include a semispherical section, a three-dimensional parabolic or ellipsoidal section, or any other three-dimensionally curved shape.
  • As another alternative, the central portion of a concave surface may be recessed along one direction and distended with respect to a perpendicular direction, so that the concave surface takes on a shape similar to that of the rounded groove of a pulley that is designed to receive a rope. Like a convex surface, a concave surface need not be curved in whole or in part, but may instead have one or more planar portions.
  • FIG. 56 is a lateral view of the bilateral inferior facet prosthesis system 1200 and superior facet prosthesis 1100. The right inferior prosthesis 1202 includes a member 1230 upon which the flanges 1212, 1214 clamp. In the embodiment shown, the member 1230 is a ball-shaped member 1230 upon which the flanges 1212, 1214 clamp to form a ball-and-socket joint. The ball-and-socket joint and groove-and-rod joint provide multiple degrees of freedom for variable positioning of the left and right inferior prostheses 1202, 1204. More precisely, the ball-and socket joint enables tri-axial rotation, i.e., rotation about three perpendicular axes, until the flanges 1212, 1214 are pressed about the member 1230 to resist further relative rotation.
  • The ball-and-socket joint enables relative motion between the inferior prostheses 1202, 1204 along the anterior/posterior directions and along the cephalad/caudal directions. The groove-and-rod joint enables relative motion between the inferior prostheses 1202, 1204 along the lateral/medial directions. However, when the turnbuckles 1216, 1218 are tightened, the displacement between the ball-shaped members 1230 of the inferior prostheses 1202, 1204 becomes fixed, and the ball-shaped members 1230 are no longer freely pivotable with respect to the flanges 1212, 1214. Thus, the relative positions and orientations of the inferior prostheses 1202, 1204 may be fixed by tightening the turnbuckles 1216, 1218.
  • An alternative embodiment replaces the ball shaped member 1230 with a member (not shown) of differing shape and flanges adapted to engage the alternative member. Other potential shapes that allow a range of adjustability and movement between the left and right inferior prostheses 1202, 1204 and the flanges 1212, 1214 prior to clamping include, but are not limited to, columnar and annular shapes.
  • The ball-shaped member 1230 shown in FIG. 56 has several divots formed thereon. Upon compression of the flanges 1212, 1214, the flanges deform into the divots to provide enhanced coupling and resistance to slippage therebetween. An alternative embodiment of the ball-shaped member 1230 has circumferential or axial splines (FIG. 63) formed thereon, which “bite” into the flanges 1212, 1214. Other alternative surface features of the ball-shaped member 1230 include knurling, nubs, grooves, facets, and combinations of any of the above.
  • Similarly, the stabilizing bar 1210 can have surface features to enhance coupling to the flanges 1212, 1214. Exemplary surface features include longitudinal splines, knurling, divots, nubs, and grooves. Splines prevent rotation of the stabilizing bar 1210 with respect to the flanges 1212, 1214. Knurling advantageously prevents both rotation and translation of the stabilizing bar 1210 with respect to the flanges 1212, 1214.
  • The flanges 1212, 1214 can be formed of a material softer than that of the stabilizing bar 1210 and the ball-shaped members 1230 to further enhance coupling. Illustrative materials for the stabilizing bar 1210 and ball-shaped members 1230 are Cobalt-Chrome (Co—Cr) alloys, Titanium (Ti) and stainless steel alloys. However, other biocompatible materials such as rigid polymers including PEEK and PEAK can be formed into the shapes of the stabilization bar 1210, and/or the ball-shaped members 1230. In one alternative embodiment, the flanges 1212, 1214 are formed integrally with or rigidly attached to the left and right inferior prostheses 1202, 1204.
  • Referring again to FIG. 54, ends of the flanges 1212, 1214 that engage the stabilizing bar 1210 are angled towards each other. This angling avoids interference with surrounding bone and avoids interference with the superior facet or the superior facet prosthesis 1100.
  • With continued reference to FIG. 54, it is seen that the heads of the turnbuckles 1216, 1218 can vary in size. As shown, the turnbuckle 1216 is larger than the turnbuckle 1218. The larger head of the turnbuckle 1216 allows the surgeon to exert more torque on the turnbuckle 1216, thereby allowing a more secure coupling of the flanges 1212, 1214 to the stabilizing bar 1210. The smaller head of the turnbuckle 1218 requires less space at the surgical site of the patient than the larger head of the turnbuckle 1216. Therefore, the surgeon can select a turnbuckle head having the desired size, weighing the benefits of more applied torque of the larger head with the reduced spatial requirements of the smaller head.
  • An alternative embodiment replaces the stabilizing bar 1210 with a flexible link, such as a cable of a biocompatible material. Yet another alternative embodiment includes a stabilizing bar having threaded ends. Instead of pinching flanges, the threaded ends of the stabilizing bar extend through flanges of the left and right inferior prostheses 1202, 1204. Threaded fasteners engage the threaded ends of the stabilizing bar. The threaded fasteners are then tightened to provide the desired positioning of the left and right inferior prostheses 1202, 1204. In another variation, the stabilizing bar is rotated such that the threads of the stabilizing bar engage fixed threaded portions of the flanges.
  • FIG. 57 is a cranial view of the bilateral inferior facet prosthesis system 1200.
  • FIG. 58 is a bottom in situ view of the bilateral inferior facet prosthesis system 1200 in situ.
  • FIG. 59 is rear view of the bilateral inferior facet prosthesis system 1200 in isolation.
  • FIG. 60 is a top view of the bilateral inferior facet prosthesis system 1200.
  • FIG. 61 is a bottom view of the bilateral inferior facet prosthesis system 1200.
  • FIG. 62 is a perspective view of the right inferior prosthesis 1204.
  • FIGS. 63 and 64 are perspective and end views, respectively, of various ball-shaped members 1240, 1242, 1244 that may be included in the inferior prostheses 1202, 1204 in place of the members 1230, the ball-shaped members 1240, 1242, 1244 having differing surface features, particularly circumferential grooves 1302, longitudinal grooves 1304, and knurling 1306.
  • FIG. 65 is a dorsal view of the bilateral inferior facet prosthesis system 1200, in which castle nuts 1320 are attached to the left and right fixation elements 1232, 1234 and to the fixation member 1110.
  • While various embodiments have been described above, it should be understood that they have been presented by way of example only, and not by way of limitation. Thus, the breadth and scope of the invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents.

Claims (16)

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 the left and right coupling portions; and
wherein the crosslink is adjustable laterally with respect to the left and right coupling portions.
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 the left and right coupling portions; and
wherein the crosslink is adjustable laterally with respect to left and right coupling portions.
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.
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US12/240,281 US7998178B2 (en) 2004-02-17 2008-09-29 Linked bilateral spinal facet implants and methods of use
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US10/860,487 Active 2029-02-21 US8926700B2 (en) 2003-12-10 2004-06-02 Spinal facet joint implant
US10/860,543 Active 2031-12-13 US8419770B2 (en) 2003-12-10 2004-06-02 Spinal facet implants with mating articulating bearing surface and methods of use
US10/860,778 Active 2027-03-26 US7588590B2 (en) 2003-12-10 2004-06-02 Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
US11/734,502 Active 2025-10-22 US8579941B2 (en) 2003-12-10 2007-04-12 Linked bilateral spinal facet implants and methods of use
US12/240,244 Expired - Fee Related US7998177B2 (en) 2004-02-17 2008-09-29 Linked bilateral spinal facet implants and methods of use
US12/240,320 Active 2026-12-13 US8906063B2 (en) 2004-02-17 2008-09-29 Spinal facet joint implant
US12/240,047 Expired - Fee Related US7914560B2 (en) 2004-02-17 2008-09-29 Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
US12/240,070 Abandoned US20090024167A1 (en) 2004-02-17 2008-09-29 Spinal facet implants with mating articulating bearing surface and methods of use
US12/240,281 Active 2025-03-08 US7998178B2 (en) 2004-02-17 2008-09-29 Linked bilateral spinal facet implants and methods of use
US13/032,223 Expired - Fee Related US8709046B2 (en) 2004-02-17 2011-02-22 Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
US13/181,829 Active US8449579B2 (en) 2004-02-17 2011-09-16 Linked bilateral spinal facet implants and methods of use
US13/179,765 Abandoned US20120071929A1 (en) 2004-02-17 2011-09-16 Linked Bilateral Spinal Facet Implants and Methods of Use
US13/596,830 Expired - Lifetime US8911475B2 (en) 2004-02-17 2012-08-28 Spinal facet implants with mating articulating bearing surface and methods of use
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US14/047,086 Expired - Fee Related US9358132B2 (en) 2003-12-10 2013-10-07 Linked bilateral spinal facet implants and methods of use
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US10/860,543 Active 2031-12-13 US8419770B2 (en) 2003-12-10 2004-06-02 Spinal facet implants with mating articulating bearing surface and methods of use
US10/860,778 Active 2027-03-26 US7588590B2 (en) 2003-12-10 2004-06-02 Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
US11/734,502 Active 2025-10-22 US8579941B2 (en) 2003-12-10 2007-04-12 Linked bilateral spinal facet implants and methods of use
US12/240,244 Expired - Fee Related US7998177B2 (en) 2004-02-17 2008-09-29 Linked bilateral spinal facet implants and methods of use
US12/240,320 Active 2026-12-13 US8906063B2 (en) 2004-02-17 2008-09-29 Spinal facet joint implant
US12/240,047 Expired - Fee Related US7914560B2 (en) 2004-02-17 2008-09-29 Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
US12/240,070 Abandoned US20090024167A1 (en) 2004-02-17 2008-09-29 Spinal facet implants with mating articulating bearing surface and methods of use
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US13/032,223 Expired - Fee Related US8709046B2 (en) 2004-02-17 2011-02-22 Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
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US13/886,964 Active US9339394B2 (en) 2004-02-17 2013-05-03 Linked bilateral spinal facet implants and methods of use
US14/047,086 Expired - Fee Related US9358132B2 (en) 2003-12-10 2013-10-07 Linked bilateral spinal facet implants and methods of use
US15/152,585 Abandoned US20170007419A1 (en) 2004-02-17 2016-05-12 Linked Bilateral Spinal Facet Implants and Methods of Use
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20110054537A1 (en) * 2009-08-28 2011-03-03 Zimmer Spine Austin, Inc. Fusion method and pedicle access tool

Families Citing this family (250)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2897259B1 (en) 2006-02-15 2008-05-09 Ldr Medical Soc Par Actions Si INTERSOMATIC TRANSFORAMINAL CAGE WITH INTERBREBAL FUSION GRAFT AND CAGE IMPLANTATION INSTRUMENT
US7691145B2 (en) 1999-10-22 2010-04-06 Facet Solutions, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US7674293B2 (en) 2004-04-22 2010-03-09 Facet Solutions, Inc. Crossbar spinal prosthesis having a modular design and related implantation methods
US8187303B2 (en) 2004-04-22 2012-05-29 Gmedelaware 2 Llc Anti-rotation fixation element for spinal prostheses
US20050261770A1 (en) * 2004-04-22 2005-11-24 Kuiper Mark K Crossbar spinal prosthesis having a modular design and related implantation methods
US20050027361A1 (en) * 1999-10-22 2005-02-03 Reiley Mark A. Facet arthroplasty devices and methods
FR2824261B1 (en) 2001-05-04 2004-05-28 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS AND IMPLEMENTATION METHOD AND TOOLS
FR2827156B1 (en) 2001-07-13 2003-11-14 Ldr Medical VERTEBRAL CAGE DEVICE WITH MODULAR FASTENING
AU2003239118B2 (en) 2002-02-20 2007-09-20 Stephen Ritland Pedicle screw connector apparatus and method
CA2484923C (en) 2002-05-08 2011-02-22 Stephen Ritland Dynamic fixation device and method of use
US6793678B2 (en) 2002-06-27 2004-09-21 Depuy Acromed, Inc. Prosthetic intervertebral motion disc having dampening
FR2846550B1 (en) 2002-11-05 2006-01-13 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US7282064B2 (en) * 2003-02-11 2007-10-16 Spinefrontier Lls Apparatus and method for connecting spinal vertebrae
US7608104B2 (en) 2003-05-14 2009-10-27 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US9254137B2 (en) 2003-08-29 2016-02-09 Lanterna Medical Technologies Ltd Facet implant
US7905907B2 (en) 2003-10-21 2011-03-15 Theken Spine, Llc Internal structure stabilization system for spanning three or more structures
US7967826B2 (en) 2003-10-21 2011-06-28 Theken Spine, Llc Connector transfer tool for internal structure stabilization systems
US7753937B2 (en) 2003-12-10 2010-07-13 Facet Solutions Inc. Linked bilateral spinal facet implants and methods of use
US20050159746A1 (en) * 2004-01-21 2005-07-21 Dieter Grob Cervical facet resurfacing implant
ES2363154T3 (en) 2004-02-04 2011-07-22 Ldr Medical INTERVERTEBRAL DISK PROSTHESIS.
FR2865629B1 (en) 2004-02-04 2007-01-26 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US7846183B2 (en) 2004-02-06 2010-12-07 Spinal Elements, Inc. Vertebral facet joint prosthesis and method of fixation
US7993373B2 (en) * 2005-02-22 2011-08-09 Hoy Robert W Polyaxial orthopedic fastening apparatus
US9451990B2 (en) * 2004-02-17 2016-09-27 Globus Medical, Inc. Facet joint replacement instruments and methods
US8353933B2 (en) * 2007-04-17 2013-01-15 Gmedelaware 2 Llc Facet joint replacement
US8562649B2 (en) 2004-02-17 2013-10-22 Gmedelaware 2 Llc System and method for multiple level facet joint arthroplasty and fusion
US8097020B2 (en) * 2004-02-27 2012-01-17 Custom Spine, Inc. Pedicle dynamic facet arthroplasty system and method
US7214227B2 (en) * 2004-03-22 2007-05-08 Innovative Spinal Technologies Closure member for a medical implant device
US7051451B2 (en) * 2004-04-22 2006-05-30 Archus Orthopedics, Inc. Facet joint prosthesis measurement and implant tools
US7406775B2 (en) * 2004-04-22 2008-08-05 Archus Orthopedics, Inc. Implantable orthopedic device component selection instrument and methods
FR2869528B1 (en) 2004-04-28 2007-02-02 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US8764801B2 (en) * 2005-03-28 2014-07-01 Gmedelaware 2 Llc Facet joint implant crosslinking apparatus and method
US7588578B2 (en) 2004-06-02 2009-09-15 Facet Solutions, Inc Surgical measurement systems and methods
US9504583B2 (en) 2004-06-10 2016-11-29 Spinal Elements, Inc. Implant and method for facet immobilization
US8114158B2 (en) 2004-08-03 2012-02-14 Kspine, Inc. Facet device and method
US8425570B2 (en) 2004-08-09 2013-04-23 Si-Bone Inc. Apparatus, systems, and methods for achieving anterior lumbar interbody fusion
US8414648B2 (en) 2004-08-09 2013-04-09 Si-Bone Inc. Apparatus, systems, and methods for achieving trans-iliac lumbar fusion
US8388667B2 (en) 2004-08-09 2013-03-05 Si-Bone, Inc. Systems and methods for the fixation or fusion of bone using compressive implants
US9949843B2 (en) 2004-08-09 2018-04-24 Si-Bone Inc. Apparatus, systems, and methods for the fixation or fusion of bone
US9662158B2 (en) 2004-08-09 2017-05-30 Si-Bone Inc. Systems and methods for the fixation or fusion of bone at or near a sacroiliac joint
US20070156241A1 (en) 2004-08-09 2007-07-05 Reiley Mark A Systems and methods for the fixation or fusion of bone
US20180228621A1 (en) 2004-08-09 2018-08-16 Mark A. Reiley Apparatus, systems, and methods for the fixation or fusion of bone
US20060036251A1 (en) 2004-08-09 2006-02-16 Reiley Mark A Systems and methods for the fixation or fusion of bone
US7846184B2 (en) * 2004-08-13 2010-12-07 Sasso Ricardo C Replacement facet joint and method
US8491634B2 (en) * 2004-08-13 2013-07-23 Ricardo C. Sasso Replacement facet joint and method
JP2008510518A (en) 2004-08-18 2008-04-10 アーカス・オーソペディクス・インコーポレーテッド Adjoint level articulating device, spinal stabilization system and method
US8951290B2 (en) 2004-08-27 2015-02-10 Blackstone Medical, Inc. Multi-axial connection system
US20060058788A1 (en) * 2004-08-27 2006-03-16 Hammer Michael A Multi-axial connection system
US7766940B2 (en) * 2004-12-30 2010-08-03 Depuy Spine, Inc. Posterior stabilization system
US7896906B2 (en) 2004-12-30 2011-03-01 Depuy Spine, Inc. Artificial facet joint
US20060084976A1 (en) * 2004-09-30 2006-04-20 Depuy Spine, Inc. Posterior stabilization systems and methods
US8092496B2 (en) * 2004-09-30 2012-01-10 Depuy Spine, Inc. Methods and devices for posterior stabilization
US20060085075A1 (en) * 2004-10-04 2006-04-20 Archus Orthopedics, Inc. Polymeric joint complex and methods of use
US8267969B2 (en) 2004-10-20 2012-09-18 Exactech, Inc. Screw systems and methods for use in stabilization of bone structures
US8025680B2 (en) * 2004-10-20 2011-09-27 Exactech, Inc. Systems and methods for posterior dynamic stabilization of the spine
US7935134B2 (en) 2004-10-20 2011-05-03 Exactech, Inc. Systems and methods for stabilization of bone structures
US8162985B2 (en) 2004-10-20 2012-04-24 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for posterior dynamic stabilization of the spine
US8226690B2 (en) * 2005-07-22 2012-07-24 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for stabilization of bone structures
CA2585135A1 (en) * 2004-10-25 2006-05-26 Archus Orthopedics, Inc. Spinal prosthesis having a modular design
US20070016297A1 (en) * 2004-11-18 2007-01-18 University Of South Florida Prostheses for Spine Facets
US20060111779A1 (en) * 2004-11-22 2006-05-25 Orthopedic Development Corporation, A Florida Corporation Minimally invasive facet joint fusion
US7837713B2 (en) * 2004-11-22 2010-11-23 Minsurg International, Inc. Methods and surgical kits for minimally-invasive facet joint fusion
US8021392B2 (en) 2004-11-22 2011-09-20 Minsurg International, Inc. Methods and surgical kits for minimally-invasive facet joint fusion
EP1814474B1 (en) 2004-11-24 2011-09-14 Samy Abdou Devices for inter-vertebral orthopedic device placement
US7776090B2 (en) * 2004-12-13 2010-08-17 Warsaw Orthopedic, Inc. Inter-cervical facet implant and method
FR2879436B1 (en) 2004-12-22 2007-03-09 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US8496686B2 (en) * 2005-03-22 2013-07-30 Gmedelaware 2 Llc Minimally invasive spine restoration systems, devices, methods and kits
US20060247634A1 (en) * 2005-05-02 2006-11-02 Warner Kenneth D Spinous Process Spacer Implant and Technique
US8523865B2 (en) 2005-07-22 2013-09-03 Exactech, Inc. Tissue splitter
US20070055373A1 (en) * 2005-09-08 2007-03-08 Zimmer Spine, Inc. Facet replacement/spacing and flexible spinal stabilization
FR2891135B1 (en) 2005-09-23 2008-09-12 Ldr Medical Sarl INTERVERTEBRAL DISC PROSTHESIS
FR2893838B1 (en) 2005-11-30 2008-08-08 Ldr Medical Soc Par Actions Si PROSTHESIS OF INTERVERTEBRAL DISC AND INSTRUMENTATION OF INSERTION OF THE PROSTHESIS BETWEEN VERTEBRATES
FR2894128B1 (en) * 2005-12-07 2008-08-22 Alain Tornier DEVICE FOR LATERAL STABILIZATION OF THE RACHIS
ES2411706T3 (en) * 2005-12-13 2013-07-08 Facet-Link Inc. Facet joint prosthesis
DE202005019487U1 (en) * 2005-12-13 2007-04-26 Deru Gmbh Facet joint prosthesis
US8430911B2 (en) * 2005-12-14 2013-04-30 Spinefrontier Inc Spinous process fixation implant
WO2007126428A2 (en) 2005-12-20 2007-11-08 Archus Orthopedics, Inc. Arthroplasty revision system and method
EP1983938A4 (en) * 2006-02-02 2012-07-25 Trinity Orthopedics Percutaneous facet joint fusion system and method
US8262696B2 (en) * 2006-02-24 2012-09-11 Medical Design, LLC Multilevel facet/laminar fixation system
US8246684B2 (en) * 2006-04-20 2012-08-21 RE-Spine LLC. Intervertebral disc and facet joint prosthesis
US20080015691A1 (en) * 2006-06-15 2008-01-17 Depuy Products, Inc. Orthopaedic implants having bioresorbable posts
US20080027543A1 (en) * 2006-06-28 2008-01-31 Sdgi Holdings, Inc. Prosthesis and method for replacing degenerative vertebral portions
US7799055B2 (en) * 2006-07-07 2010-09-21 Warsaw Orthopedic, Inc. Minimal spacing spinal stabilization device and method
US20080039847A1 (en) * 2006-08-09 2008-02-14 Mark Piper Implant and system for stabilization of the spine
US8702755B2 (en) 2006-08-11 2014-04-22 Gmedelaware 2 Llc Angled washer polyaxial connection for dynamic spine prosthesis
US20080119845A1 (en) * 2006-09-25 2008-05-22 Archus Orthopedics, Inc. Facet replacement device removal and revision systems and methods
US8096996B2 (en) 2007-03-20 2012-01-17 Exactech, Inc. Rod reducer
US8740941B2 (en) * 2006-11-10 2014-06-03 Lanx, Inc. Pedicle based spinal stabilization with adjacent vertebral body support
EP2097120B1 (en) * 2006-11-15 2011-08-03 Impliant Ltd. Pedicle screw surface treatment for improving bone-implant interface
WO2008070863A2 (en) 2006-12-07 2008-06-12 Interventional Spine, Inc. Intervertebral implant
US20140180338A1 (en) * 2007-01-10 2014-06-26 Globus Medical, Inc System and Method for Bone Anchorage
US8075596B2 (en) * 2007-01-12 2011-12-13 Warsaw Orthopedic, Inc. Spinal prosthesis systems
US8034081B2 (en) 2007-02-06 2011-10-11 CollabComl, LLC Interspinous dynamic stabilization implant and method of implanting
US8465546B2 (en) 2007-02-16 2013-06-18 Ldr Medical Intervertebral disc prosthesis insertion assemblies
EP2129304B1 (en) 2007-02-22 2014-09-03 Spinal Elements, Inc. Vertebral articular process drill
US8992533B2 (en) 2007-02-22 2015-03-31 Spinal Elements, Inc. Vertebral facet joint drill and method of use
US7951173B2 (en) 2007-05-16 2011-05-31 Ortho Innovations, Llc Pedicle screw implant system
US7942909B2 (en) 2009-08-13 2011-05-17 Ortho Innovations, Llc Thread-thru polyaxial pedicle screw system
US8197518B2 (en) 2007-05-16 2012-06-12 Ortho Innovations, Llc Thread-thru polyaxial pedicle screw system
US7947065B2 (en) 2008-11-14 2011-05-24 Ortho Innovations, Llc Locking polyaxial ball and socket fastener
US7942911B2 (en) 2007-05-16 2011-05-17 Ortho Innovations, Llc Polyaxial bone screw
US7942910B2 (en) 2007-05-16 2011-05-17 Ortho Innovations, Llc Polyaxial bone screw
FR2916956B1 (en) 2007-06-08 2012-12-14 Ldr Medical INTERSOMATIC CAGE, INTERVERTEBRAL PROSTHESIS, ANCHORING DEVICE AND IMPLANTATION INSTRUMENTATION
US8900307B2 (en) 2007-06-26 2014-12-02 DePuy Synthes Products, LLC Highly lordosed fusion cage
US8460341B2 (en) * 2007-06-27 2013-06-11 Spinefrontier Inc Dynamic facet replacement system
WO2009006455A1 (en) * 2007-06-29 2009-01-08 Nuvasive, Inc. Facet joint implant and related methods
DK2923664T3 (en) * 2007-10-17 2019-04-23 Aro Medical Aps Torsion stabilization systems and apparatus
US7947063B2 (en) * 2007-11-08 2011-05-24 Spine21 Ltd. Posterior-medial facet support assembly
WO2009067486A2 (en) * 2007-11-19 2009-05-28 David Lee Method and apparatus for spinal facet joint fusion using irregularly shaped cortical bone implants
US20090164020A1 (en) * 2007-11-28 2009-06-25 Pioneer Surgical Technology, Inc. Device for Securing an Implant to Tissue
WO2009076107A1 (en) 2007-12-13 2009-06-18 Trinity Orthopedics, Llc Spinal transverse connector
EP2237748B1 (en) 2008-01-17 2012-09-05 Synthes GmbH An expandable intervertebral implant
JP2011514208A (en) * 2008-03-06 2011-05-06 ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング Intervertebral joint interference screw
CA2720580A1 (en) 2008-04-05 2009-10-08 Synthes Usa, Llc Expandable intervertebral implant
US8100949B2 (en) * 2008-06-03 2012-01-24 Warsaw Orthopedic, Inc. Transverse rod connectors with osteoconductive material
ES2523801T3 (en) 2008-09-03 2014-12-01 Simpirica Spine, Inc. Apparatus for coupling a prosthesis to a segment of the spine
BRPI0920176A2 (en) * 2008-10-16 2015-12-29 Kinetic Spine Technologies Inc veneer prosthesis system
US9636121B2 (en) * 2008-11-11 2017-05-02 Harbinger Medical Group, Llc Facet distraction device, facet joint implant, and associated methods
US8828058B2 (en) 2008-11-11 2014-09-09 Kspine, Inc. Growth directed vertebral fixation system with distractible connector(s) and apical control
US8075603B2 (en) 2008-11-14 2011-12-13 Ortho Innovations, Llc Locking polyaxial ball and socket fastener
WO2010065277A1 (en) * 2008-11-25 2010-06-10 Synthes Usa, Llc Visco-elastic facet joint implant
US8700072B2 (en) 2008-12-23 2014-04-15 At&T Mobility Ii Llc Scalable message fidelity
US8357183B2 (en) 2009-03-26 2013-01-22 Kspine, Inc. Semi-constrained anchoring system
US9526620B2 (en) 2009-03-30 2016-12-27 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US20100262244A1 (en) * 2009-04-14 2010-10-14 Warsaw Orthopedic, Inc. Metal Coated Implant
US9168071B2 (en) 2009-09-15 2015-10-27 K2M, Inc. Growth modulation system
JP5699353B2 (en) 2009-09-17 2015-04-08 エルディーアール ホールディング コーポレイション Intervertebral implant with expandable bone fixation member
US8764806B2 (en) 2009-12-07 2014-07-01 Samy Abdou Devices and methods for minimally invasive spinal stabilization and instrumentation
US9393129B2 (en) 2009-12-10 2016-07-19 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US9480511B2 (en) 2009-12-17 2016-11-01 Engage Medical Holdings, Llc Blade fixation for ankle fusion and arthroplasty
RU2573945C2 (en) 2009-12-31 2016-01-27 Лдр Медикал Fastening device, intervertebral implant and device for implantation
US8142477B2 (en) * 2010-01-21 2012-03-27 Warsaw Orthopedic, Inc. Retaining system
US20110313465A1 (en) * 2010-06-16 2011-12-22 Interventional Spine, Inc. Method and apparatus for spinal stabilization
US9282979B2 (en) 2010-06-24 2016-03-15 DePuy Synthes Products, Inc. Instruments and methods for non-parallel disc space preparation
US8979860B2 (en) 2010-06-24 2015-03-17 DePuy Synthes Products. LLC Enhanced cage insertion device
JP5850930B2 (en) 2010-06-29 2016-02-03 ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング Isolated intervertebral implant
WO2012006216A1 (en) * 2010-07-08 2012-01-12 X-Spine Systems, Inc. Spinal stabilization system utilizing screw and external facet and/or lamina fixation
US8986355B2 (en) 2010-07-09 2015-03-24 DePuy Synthes Products, LLC Facet fusion implant
WO2012030712A1 (en) 2010-08-30 2012-03-08 Zimmer Spine, Inc. Polyaxial pedicle screw
EP2618786B1 (en) 2010-09-21 2015-10-14 Spinewelding AG Device for repairing a human or animal joint
US8679160B2 (en) * 2010-09-28 2014-03-25 Facet-Link Inc. Lamina implant set
US9402732B2 (en) 2010-10-11 2016-08-02 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
US8425611B2 (en) 2010-10-26 2013-04-23 Warsaw Orthopedic, Inc. Expandable orthopedic implant system and method
WO2012083205A1 (en) 2010-12-16 2012-06-21 Medicinelodge, Inc. Dba Imds Co-Innovation Arthroplasty systems and methods
US9271765B2 (en) 2011-02-24 2016-03-01 Spinal Elements, Inc. Vertebral facet joint fusion implant and method for fusion
USD724733S1 (en) 2011-02-24 2015-03-17 Spinal Elements, Inc. Interbody bone implant
US8740949B2 (en) 2011-02-24 2014-06-03 Spinal Elements, Inc. Methods and apparatus for stabilizing bone
US8337530B2 (en) * 2011-03-09 2012-12-25 Zimmer Spine, Inc. Polyaxial pedicle screw with increased angulation
US8790375B2 (en) * 2011-03-18 2014-07-29 Raed M. Ali, M.D., Inc. Transpedicular access to intervertebral spaces and related spinal fusion systems and methods
US9265620B2 (en) 2011-03-18 2016-02-23 Raed M. Ali, M.D., Inc. Devices and methods for transpedicular stabilization of the spine
AU2012261983B2 (en) 2011-06-03 2015-10-08 K2M, Inc. Spinal correction system actuators
EP2729081A4 (en) * 2011-07-07 2015-09-09 Samy Abdou Devices and methods to prevent or limit spondlylolisthesis and other aberrant movements of the vertebral bones
US9277946B2 (en) 2011-09-06 2016-03-08 Amendia, Inc. Spinal fusion system
US8845728B1 (en) 2011-09-23 2014-09-30 Samy Abdou Spinal fixation devices and methods of use
WO2013059763A1 (en) 2011-10-21 2013-04-25 Custom Spine, Inc. Facet screw system and method
USD739935S1 (en) 2011-10-26 2015-09-29 Spinal Elements, Inc. Interbody bone implant
US9254130B2 (en) 2011-11-01 2016-02-09 Hyun Bae Blade anchor systems for bone fusion
US9468468B2 (en) 2011-11-16 2016-10-18 K2M, Inc. Transverse connector for spinal stabilization system
WO2014172632A2 (en) 2011-11-16 2014-10-23 Kspine, Inc. Spinal correction and secondary stabilization
US9451987B2 (en) 2011-11-16 2016-09-27 K2M, Inc. System and method for spinal correction
US9468469B2 (en) 2011-11-16 2016-10-18 K2M, Inc. Transverse coupler adjuster spinal correction systems and methods
US8920472B2 (en) 2011-11-16 2014-12-30 Kspine, Inc. Spinal correction and secondary stabilization
US9717603B2 (en) 2012-02-17 2017-08-01 Timothy T. DAVIS Implantable facet fusion devices
US20130226240A1 (en) 2012-02-22 2013-08-29 Samy Abdou Spinous process fixation devices and methods of use
FR2987256B1 (en) 2012-02-24 2014-08-08 Ldr Medical ANCHORING DEVICE FOR INTERVERTEBRAL IMPLANT, INTERVERTEBRAL IMPLANT AND IMPLANTATION INSTRUMENTATION
US10363140B2 (en) 2012-03-09 2019-07-30 Si-Bone Inc. Systems, device, and methods for joint fusion
JP6091529B2 (en) 2012-03-09 2017-03-08 エスアイ−ボーン・インコーポレイテッドSi−Bone, Inc. Integrated implant
US10238382B2 (en) 2012-03-26 2019-03-26 Engage Medical Holdings, Llc Blade anchor for foot and ankle
BR112014027319A2 (en) 2012-05-04 2017-06-27 Si Bone Inc fenestrated implant
CN104379065B (en) * 2012-05-25 2018-07-13 阿西斯特医疗系统有限公司 Flow measuring system and method
EP2877127B1 (en) 2012-07-26 2019-08-21 Synthes GmbH Expandable implant
US9198767B2 (en) 2012-08-28 2015-12-01 Samy Abdou Devices and methods for spinal stabilization and instrumentation
US20140067069A1 (en) 2012-08-30 2014-03-06 Interventional Spine, Inc. Artificial disc
CN104602629A (en) 2012-08-31 2015-05-06 新南创新公司 Bone stabilization device and methods of use
US9301782B2 (en) 2012-09-04 2016-04-05 Zimmer, Inc. External fixation
US9924969B2 (en) 2012-09-04 2018-03-27 Zimmer, Inc. External fixation
US9320617B2 (en) 2012-10-22 2016-04-26 Cogent Spine, LLC Devices and methods for spinal stabilization and instrumentation
US9717601B2 (en) 2013-02-28 2017-08-01 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US9522070B2 (en) 2013-03-07 2016-12-20 Interventional Spine, Inc. Intervertebral implant
EP2967909A4 (en) 2013-03-14 2016-10-05 Raed M Ali M D Inc Lateral interbody fusion devices, systems and methods
US9421044B2 (en) 2013-03-14 2016-08-23 Spinal Elements, Inc. Apparatus for bone stabilization and distraction and methods of use
US9820784B2 (en) 2013-03-14 2017-11-21 Spinal Elements, Inc. Apparatus for spinal fixation and methods of use
USD765853S1 (en) 2013-03-14 2016-09-06 Spinal Elements, Inc. Flexible elongate member with a portion configured to receive a bone anchor
US9700435B2 (en) 2013-03-14 2017-07-11 Warsaw Orthopedic, Inc. Surgical delivery system and method
US10687962B2 (en) 2013-03-14 2020-06-23 Raed M. Ali, M.D., Inc. Interbody fusion devices, systems and methods
US9510872B2 (en) * 2013-03-15 2016-12-06 Jcbd, Llc Spinal stabilization system
WO2014145902A1 (en) * 2013-03-15 2014-09-18 Si-Bone Inc. Implants for spinal fixation or fusion
US9453526B2 (en) 2013-04-30 2016-09-27 Degen Medical, Inc. Bottom-loading anchor assembly
FR3005569B1 (en) 2013-05-16 2021-09-03 Ldr Medical VERTEBRAL IMPLANT, VERTEBRAL IMPLANT FIXATION DEVICE AND IMPLANTATION INSTRUMENTATION
EP2892453B1 (en) 2013-08-30 2019-05-08 NewSouth Innovations Pty Limited Spine stabilization device
US9468471B2 (en) 2013-09-17 2016-10-18 K2M, Inc. Transverse coupler adjuster spinal correction systems and methods
US9456855B2 (en) 2013-09-27 2016-10-04 Spinal Elements, Inc. Method of placing an implant between bone portions
US9839450B2 (en) 2013-09-27 2017-12-12 Spinal Elements, Inc. Device and method for reinforcement of a facet
US11147688B2 (en) 2013-10-15 2021-10-19 Si-Bone Inc. Implant placement
US9839448B2 (en) 2013-10-15 2017-12-12 Si-Bone Inc. Implant placement
US20150164498A1 (en) * 2013-12-11 2015-06-18 Arthrex, Inc. Suture washer
CN103704264B (en) * 2014-01-09 2016-04-20 南通思锐生物科技有限公司 A kind of disinfectant detergent
FR3016793B1 (en) 2014-01-30 2021-05-07 Ldr Medical ANCHORING DEVICE FOR SPINAL IMPLANT, SPINAL IMPLANT AND IMPLANTATION INSTRUMENTATION
US20150230833A1 (en) * 2014-02-17 2015-08-20 Gmedelaware 2 Llc Spinal Facet Implant with Spherical Implant Apposition Surface and Bone Bed and Methods of Use
GB2525664B (en) * 2014-05-01 2020-12-09 Bamford Excavators Ltd An air inlet system comprising a mass air flow sensor
FR3020756B1 (en) 2014-05-06 2022-03-11 Ldr Medical VERTEBRAL IMPLANT, VERTEBRAL IMPLANT FIXATION DEVICE AND IMPLANT INSTRUMENTATION
WO2015184012A2 (en) * 2014-05-27 2015-12-03 Providence Medical Technology, Inc. Lateral mass fixation implant
US9962187B2 (en) 2014-08-11 2018-05-08 Zimmer, Inc. External fixation
US11478275B2 (en) 2014-09-17 2022-10-25 Spinal Elements, Inc. Flexible fastening band connector
US9662157B2 (en) 2014-09-18 2017-05-30 Si-Bone Inc. Matrix implant
US10166033B2 (en) 2014-09-18 2019-01-01 Si-Bone Inc. Implants for bone fixation or fusion
CA2964912A1 (en) * 2014-10-17 2016-04-21 Azenium Ip Limited A dental implant
EP3229714B1 (en) 2014-12-09 2022-03-02 Heflin, John, A. Spine alignment system
CA2972788A1 (en) 2015-01-27 2016-08-04 Spinal Elements, Inc. Facet joint implant
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US10376206B2 (en) 2015-04-01 2019-08-13 Si-Bone Inc. Neuromonitoring systems and methods for bone fixation or fusion procedures
WO2016172607A1 (en) 2015-04-24 2016-10-27 Articular Spine Fix, Inc. Vertebral fixation devices, systems, and methods
WO2016205128A2 (en) 2015-06-17 2016-12-22 Nathan Erickson Ankle fixation system
US9913727B2 (en) 2015-07-02 2018-03-13 Medos International Sarl Expandable implant
US9968378B1 (en) * 2015-07-22 2018-05-15 University Of South Florida Adaptation sphere saddle
US10857003B1 (en) 2015-10-14 2020-12-08 Samy Abdou Devices and methods for vertebral stabilization
WO2017147140A1 (en) * 2016-02-22 2017-08-31 Conventus Orthopaedics, Inc. Apparatus and methods for spine and sacroiliac joint repair
AU2017241894B2 (en) 2016-03-29 2022-01-27 Facet Dynamics, Inc. Facet joint replacement device and methods of use
JP6995789B2 (en) 2016-06-28 2022-01-17 イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー Expandable and angle adjustable intervertebral cage
CN109688980B (en) 2016-06-28 2022-06-10 Eit 新兴移植技术股份有限公司 Expandable and angularly adjustable intervertebral cage with articulation joint
US10390955B2 (en) 2016-09-22 2019-08-27 Engage Medical Holdings, Llc Bone implants
US10744000B1 (en) 2016-10-25 2020-08-18 Samy Abdou Devices and methods for vertebral bone realignment
US10973648B1 (en) 2016-10-25 2021-04-13 Samy Abdou Devices and methods for vertebral bone realignment
US10537436B2 (en) 2016-11-01 2020-01-21 DePuy Synthes Products, Inc. Curved expandable cage
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US10456272B2 (en) 2017-03-03 2019-10-29 Engage Uni Llc Unicompartmental knee arthroplasty
US11540928B2 (en) 2017-03-03 2023-01-03 Engage Uni Llc Unicompartmental knee arthroplasty
US10398563B2 (en) 2017-05-08 2019-09-03 Medos International Sarl Expandable cage
US11344424B2 (en) 2017-06-14 2022-05-31 Medos International Sarl Expandable intervertebral implant and related methods
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
DE102017212293A1 (en) * 2017-07-18 2019-01-24 Henkel Ag & Co. Kgaa Improved antiperspirant sticks
WO2019067584A1 (en) 2017-09-26 2019-04-04 Si-Bone Inc. Systems and methods for decorticating the sacroiliac joint
US11179248B2 (en) 2018-10-02 2021-11-23 Samy Abdou Devices and methods for spinal implantation
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
US11369419B2 (en) 2019-02-14 2022-06-28 Si-Bone Inc. Implants for spinal fixation and or fusion
WO2020168269A1 (en) 2019-02-14 2020-08-20 Si-Bone Inc. Implants for spinal fixation and or fusion
WO2020229143A2 (en) * 2019-05-14 2020-11-19 Loci Orthopaedics Limited A set of tools for installing an implant
US11457959B2 (en) 2019-05-22 2022-10-04 Spinal Elements, Inc. Bone tie and bone tie inserter
WO2020236229A1 (en) 2019-05-22 2020-11-26 Spinal Elements, Inc. Bone tie and bone tie inserter
WO2021108590A1 (en) 2019-11-27 2021-06-03 Si-Bone, Inc. Bone stabilizing implants and methods of placement across si joints
WO2021119126A1 (en) 2019-12-09 2021-06-17 Si-Bone Inc. Sacro-iliac joint stabilizing implants and methods of implantation
US11304733B2 (en) 2020-02-14 2022-04-19 Spinal Elements, Inc. Bone tie methods
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
CN112402001B (en) * 2020-09-11 2022-03-08 南昌大学第二附属医院 Universal centrum resetting device for orthopedic spine operation
EP4259015A4 (en) 2020-12-09 2024-09-11 Si Bone Inc Sacro-iliac joint stabilizing implants and methods of implantation
US11850160B2 (en) 2021-03-26 2023-12-26 Medos International Sarl Expandable lordotic intervertebral fusion cage
US11752009B2 (en) 2021-04-06 2023-09-12 Medos International Sarl Expandable intervertebral fusion cage
IT202100013841A1 (en) * 2021-05-27 2022-11-27 Mt Ortho S R L Intraosseous tap with triangular section for biomedical applications and fixing kit comprising said tap
JP7260118B1 (en) * 2021-12-22 2023-04-18 学校法人東京女子医科大学 drill stopper
US12090064B2 (en) 2022-03-01 2024-09-17 Medos International Sarl Stabilization members for expandable intervertebral implants, and related systems and methods

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020123806A1 (en) * 1999-10-22 2002-09-05 Total Facet Technologies, Inc. Facet arthroplasty devices and methods

Family Cites Families (616)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US598291A (en) * 1898-02-01 hoube
US512900A (en) * 1894-01-16 Ornament for picture
US2067868A (en) * 1935-05-09 1937-01-12 Singer Mfg Co Sewing machine lighting device
US2677369A (en) 1952-03-26 1954-05-04 Fred L Knowles Apparatus for treatment of the spinal column
US3247000A (en) 1961-10-16 1966-04-19 Carborundum Co Refractory bodies and method of making same
US3298372A (en) * 1963-12-17 1967-01-17 Feinberg Maurice Surgical hydrocephalus shunt sleeve for placement in a vertebra
US3426364A (en) * 1966-08-25 1969-02-11 Colorado State Univ Research F Prosthetic appliance for replacing one or more natural vertebrae
US3486505A (en) 1967-05-22 1969-12-30 Gordon M Morrison Orthopedic surgical instrument
US3508954A (en) 1967-10-05 1970-04-28 Texaco Inc Silicon carbide structures
US3648691A (en) 1970-02-24 1972-03-14 Univ Colorado State Res Found Method of applying vertebral appliance
DE2016067B2 (en) 1970-04-03 1977-05-12 Ausscheidung aus: 20 65 923 Bardocz, Arpad, Dr., 8000 München MODULAR SYSTEM FOR MOUNTING OPTICAL EQUIPMENT
CA992255A (en) 1971-01-25 1976-07-06 Cutter Laboratories Prosthesis for spinal repair
US3857642A (en) 1973-02-26 1974-12-31 Ingersoll Rand Co Flexible or universal coupling means
US3875595A (en) 1974-04-15 1975-04-08 Edward C Froning Intervertebral disc prosthesis and instruments for locating same
US4003376A (en) 1975-08-25 1977-01-18 Bio-Dynamics, Inc. Apparatus for straightening the spinal column
DE2655353A1 (en) 1976-12-07 1978-06-08 Lemfoerder Metallwaren Ag ELASTIC CONNECTION OF AN AXIAL JOINT WITH THE CONNECTING ROD OF A MOTOR VEHICLE STEERING SYSTEM
GB1565178A (en) 1977-02-24 1980-04-16 Interfix Ltd Bone screw
ES253459Y (en) * 1978-11-10 1982-04-16 EXTERNAL CLINICAL FIXER, OF HIGH STABILITY, TO REDUCE FRACTURES.
US4361141A (en) * 1979-07-27 1982-11-30 Zimmer Usa, Inc. Scoliosis transverse traction assembly
US4289123A (en) 1980-03-31 1981-09-15 Dunn Harold K Orthopedic appliance
CA1146301A (en) 1980-06-13 1983-05-17 J. David Kuntz Intervertebral disc prosthesis
US4369769A (en) * 1980-06-13 1983-01-25 Edwards Charles C Spinal fixation device and method
US4408927A (en) * 1981-08-17 1983-10-11 Gearhart Industries, Inc. Threaded joint toggle-locked with a helical spring
US4501269A (en) * 1981-12-11 1985-02-26 Washington State University Research Foundation, Inc. Process for fusing bone joints
US4479491A (en) 1982-07-26 1984-10-30 Martin Felix M Intervertebral stabilization implant
US4483334A (en) 1983-04-11 1984-11-20 Murray William M External fixation device
FR2545350B1 (en) 1983-05-04 1985-08-23 Cotrel Yves DEVICE FOR SHRINKAGE OF THE RACHIS
US4536894A (en) * 1983-08-04 1985-08-27 Galante Jorge O Hip prosthesis with flared porous bony ingrowth pads
US4554914A (en) 1983-10-04 1985-11-26 Kapp John P Prosthetic vertebral body
US4611581A (en) 1983-12-16 1986-09-16 Acromed Corporation Apparatus for straightening spinal columns
US4696290A (en) 1983-12-16 1987-09-29 Acromed Corporation Apparatus for straightening spinal columns
US4604995A (en) 1984-03-30 1986-08-12 Stephens David C Spinal stabilizer
EP0176728B1 (en) * 1984-09-04 1989-07-26 Humboldt-Universität zu Berlin Intervertebral-disc prosthesis
FR2575059B1 (en) * 1984-12-21 1988-11-10 Daher Youssef SHORING DEVICE FOR USE IN A VERTEBRAL PROSTHESIS
US4599086A (en) 1985-06-07 1986-07-08 Doty James R Spine stabilization device and method
US4743260A (en) 1985-06-10 1988-05-10 Burton Charles V Method for a flexible stabilization system for a vertebral column
US4653481A (en) 1985-07-24 1987-03-31 Howland Robert S Advanced spine fixation system and method
SE458417B (en) 1985-08-15 1989-04-03 Sven Olerud FIXING INSTRUMENTS PROVIDED FOR USE IN SPINE OPERATIONS
DE3614101C1 (en) 1986-04-25 1987-10-22 Juergen Prof Dr Med Harms Pedicle screw
DE3620549A1 (en) 1986-06-19 1987-12-23 S & G Implants Gmbh IMPLANT FOR FIXING NEXT SPINE BONES OF THE SPINE
AT387711B (en) 1986-07-15 1989-03-10 David Thomas BONE FIXATION PLATE
GB8620937D0 (en) 1986-08-29 1986-10-08 Shepperd J A N Spinal implant
US4805602A (en) * 1986-11-03 1989-02-21 Danninger Medical Technology Transpedicular screw and rod system
CA1283501C (en) 1987-02-12 1991-04-30 Thomas P. Hedman Artificial spinal disc
US4790303A (en) 1987-03-11 1988-12-13 Acromed Corporation Apparatus and method for securing bone graft
SU1468543A1 (en) 1987-04-09 1989-03-30 Харьковский Научно-Исследовательский Институт Ортопедии И Травматологии Им.Проф.М.И.Ситенко Method of treatment of patients having arthrosis of arc-process vertebrae of the spine
US4863477A (en) 1987-05-12 1989-09-05 Monson Gary L Synthetic intervertebral disc prosthesis
CH672589A5 (en) * 1987-07-09 1989-12-15 Sulzer Ag
CH672588A5 (en) 1987-07-09 1989-12-15 Sulzer Ag
US4772287A (en) 1987-08-20 1988-09-20 Cedar Surgical, Inc. Prosthetic disc and method of implanting
SU1517953A1 (en) 1987-11-16 1989-10-30 Запорожский Областной Отдел Здравоохранения Apparatus for perosseous osteosynthesis
FR2623085B1 (en) 1987-11-16 1992-08-14 Breard Francis SURGICAL IMPLANT TO LIMIT THE RELATIVE MOVEMENT OF VERTEBRES
US5147404A (en) 1987-12-07 1992-09-15 Downey Ernest L Vertebra prosthesis
FR2625097B1 (en) 1987-12-23 1990-05-18 Cote Sarl INTER-SPINOUS PROSTHESIS COMPOSED OF SEMI-ELASTIC MATERIAL COMPRISING A TRANSFILING EYE AT ITS END AND INTER-SPINOUS PADS
US4911718A (en) 1988-06-10 1990-03-27 University Of Medicine & Dentistry Of N.J. Functional and biocompatible intervertebral disc spacer
US5772661A (en) 1988-06-13 1998-06-30 Michelson; Gary Karlin Methods and instrumentation for the surgical correction of human thoracic and lumbar spinal disease from the antero-lateral aspect of the spine
AU7139994A (en) 1988-06-13 1995-01-03 Karlin Technology, Inc. Apparatus and method of inserting spinal implants
CA1333209C (en) 1988-06-28 1994-11-29 Gary Karlin Michelson Artificial spinal fusion implants
DE3823737A1 (en) 1988-07-13 1990-01-18 Lutz Biedermann CORRECTION AND HOLDING DEVICE, ESPECIALLY FOR THE SPINE
US4892545A (en) 1988-07-14 1990-01-09 Ohio Medical Instrument Company, Inc. Vertebral lock
US5545229A (en) 1988-08-18 1996-08-13 University Of Medicine And Dentistry Of Nj Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness
GB8825909D0 (en) 1988-11-04 1988-12-07 Showell A W Sugicraft Ltd Pedicle engaging means
GB2254394B (en) * 1988-12-21 1993-03-17 Bristol Myers Squibb Co Coupler assembly
FR2642645B1 (en) 1989-02-03 1992-08-14 Breard Francis FLEXIBLE INTERVERTEBRAL STABILIZER AND METHOD AND APPARATUS FOR CONTROLLING ITS VOLTAGE BEFORE PLACEMENT ON THE RACHIS
USRE36221E (en) 1989-02-03 1999-06-01 Breard; Francis Henri Flexible inter-vertebral stabilizer as well as process and apparatus for determining or verifying its tension before installation on the spinal column
CA1318469C (en) 1989-02-15 1993-06-01 Acromed Corporation Artificial disc
SE8901315L (en) 1989-04-11 1990-10-12 Bjoern Albrektsson Joint prosthesis
US5062845A (en) 1989-05-10 1991-11-05 Spine-Tech, Inc. Method of making an intervertebral reamer
US5458638A (en) * 1989-07-06 1995-10-17 Spine-Tech, Inc. Non-threaded spinal implant
CH678803A5 (en) 1989-07-12 1991-11-15 Sulzer Ag
DE8912648U1 (en) 1989-10-23 1990-11-22 Mecron Medizinische Produkte Gmbh, 1000 Berlin Vertebral body implant
JPH066810Y2 (en) 1989-11-29 1994-02-23 旭光学工業株式会社 Vertebral body fixation plate
US5236460A (en) 1990-02-12 1993-08-17 Midas Rex Pneumatic Tools, Inc. Vertebral body prosthesis
DE59100448D1 (en) 1990-04-20 1993-11-11 Sulzer Ag Implant, in particular intervertebral prosthesis.
US5129900B1 (en) 1990-07-24 1998-12-29 Acromed Corp Spinal column retaining method and apparatus
SE9002569D0 (en) 1990-08-03 1990-08-03 Sven Olerud SPINAL KNUT
US5092893A (en) * 1990-09-04 1992-03-03 Smith Thomas E Human orthopedic vertebra implant
FR2666981B1 (en) 1990-09-21 1993-06-25 Commarmond Jacques SYNTHETIC LIGAMENT VERTEBRAL.
US5127912A (en) 1990-10-05 1992-07-07 R. Charles Ray Sacral implant system
DE69111021T2 (en) 1990-10-31 1996-01-04 Gendler El Flexible membrane made from organic bone matrix for repairing and restoring bones.
US5047055A (en) 1990-12-21 1991-09-10 Pfizer Hospital Products Group, Inc. Hydrogel intervertebral disc nucleus
US5192326A (en) 1990-12-21 1993-03-09 Pfizer Hospital Products Group, Inc. Hydrogel bead intervertebral disc nucleus
FR2672202B1 (en) 1991-02-05 1993-07-30 Safir BONE SURGICAL IMPLANT, ESPECIALLY FOR INTERVERTEBRAL STABILIZER.
JP3007903B2 (en) 1991-03-29 2000-02-14 京セラ株式会社 Artificial disc
FR2676354B1 (en) * 1991-05-17 1997-11-07 Vignaud Jean Louis LOCKABLE CONNECTION DEVICE OF SPINAL OSTEOSYNTHESIS ANCHORING ELEMENTS.
FR2676911B1 (en) 1991-05-30 1998-03-06 Psi Ste Civile Particuliere INTERVERTEBRAL STABILIZATION DEVICE WITH SHOCK ABSORBERS.
US5258098A (en) * 1991-06-17 1993-11-02 Cycam, Inc. Method of production of a surface adapted to promote adhesion
US5318567A (en) 1991-07-02 1994-06-07 Olivier Vichard Screw-on plate for treatment of fractures of the odontoid apophysis
US5545228A (en) * 1991-08-15 1996-08-13 Smith & Nephew Richards Inc. Offset bone bolt
US5603713A (en) * 1991-09-24 1997-02-18 Aust; Gilbert M. Anterior lumbar/cervical bicortical compression plate
FR2681520B1 (en) 1991-09-24 1993-12-24 Henry Graf DEVICE FOR MEASURING THE AMPLITUDES OF TWO VERTEBRES IN THREE ORTHOGONAL PLANS.
US5313962A (en) 1991-10-18 1994-05-24 Obenchain Theodore G Method of performing laparoscopic lumbar discectomy
US5263953A (en) 1991-12-31 1993-11-23 Spine-Tech, Inc. Apparatus and system for fusing bone joints
US5258031A (en) 1992-01-06 1993-11-02 Danek Medical Intervertebral disk arthroplasty
US5534031A (en) 1992-01-28 1996-07-09 Asahi Kogaku Kogyo Kabushiki Kaisha Prosthesis for spanning a space formed upon removal of an intervertebral disk
FR2686915B1 (en) * 1992-01-31 1998-10-16 Gtm Batimen Travaux Publ DEVICE FOR THE TENSIONING OF TENSIONS IN COMPOSITE MATERIAL.
US5261910A (en) 1992-02-19 1993-11-16 Acromed Corporation Apparatus for maintaining spinal elements in a desired spatial relationship
DE9202745U1 (en) 1992-03-02 1992-04-30 Howmedica Gmbh, 2314 Schoenkirchen Device for bracing vertebrae of the human spine
US5282861A (en) * 1992-03-11 1994-02-01 Ultramet Open cell tantalum structures for cancellous bone implants and cell and tissue receptors
DE4208115A1 (en) 1992-03-13 1993-09-16 Link Waldemar Gmbh Co DISC ENDOPROTHESIS
DE4208116C2 (en) 1992-03-13 1995-08-03 Link Waldemar Gmbh Co Intervertebral disc prosthesis
US5171279A (en) 1992-03-17 1992-12-15 Danek Medical Method for subcutaneous suprafascial pedicular internal fixation
NL9200612A (en) 1992-04-01 1993-11-01 Acromed Bv Device for correcting the shape and / or fixing the vertebral column of man.
FR2689750B1 (en) * 1992-04-10 1997-01-31 Eurosurgical BONE ANCHORING ELEMENT AND SPINAL OSTEOSYNTHESIS DEVICE INCORPORATING SUCH ELEMENTS.
ATE141149T1 (en) 1992-04-21 1996-08-15 Sulzer Medizinaltechnik Ag ARTIFICIAL DISC BODY
US5306309A (en) * 1992-05-04 1994-04-26 Calcitek, Inc. Spinal disk implant and implantation kit
US5304178A (en) 1992-05-29 1994-04-19 Acromed Corporation Sublaminar wire
ES2100348T3 (en) 1992-06-25 1997-06-16 Synthes Ag OSTEOSYNTHETIC FIXING DEVICE.
FR2692952B1 (en) 1992-06-25 1996-04-05 Psi IMPROVED SHOCK ABSORBER WITH MOVEMENT LIMIT.
FR2693364B1 (en) * 1992-07-07 1995-06-30 Erpios Snc INTERVERTEBRAL PROSTHESIS FOR STABILIZING ROTATORY AND FLEXIBLE-EXTENSION CONSTRAINTS.
GB9217578D0 (en) * 1992-08-19 1992-09-30 Surgicarft Ltd Surgical implants,etc
US5246458A (en) 1992-10-07 1993-09-21 Graham Donald V Artificial disk
US5562735A (en) 1992-11-09 1996-10-08 Hospital For Joint Diseases Spinal stabilization system and improved method
US5611354A (en) * 1992-11-12 1997-03-18 Alleyne; Neville Cardiac protection device
AU5600294A (en) 1992-11-12 1994-06-08 Neville Alleyne Cardiac protection device
US5814046A (en) 1992-11-13 1998-09-29 Sofamor S.N.C. Pedicular screw and posterior spinal instrumentation
US5306275A (en) * 1992-12-31 1994-04-26 Bryan Donald W Lumbar spine fixation apparatus and method
US5456722A (en) 1993-01-06 1995-10-10 Smith & Nephew Richards Inc. Load bearing polymeric cable
US5496318A (en) * 1993-01-08 1996-03-05 Advanced Spine Fixation Systems, Inc. Interspinous segmental spine fixation device
US5676701A (en) 1993-01-14 1997-10-14 Smith & Nephew, Inc. Low wear artificial spinal disc
ES2161725T3 (en) 1993-02-09 2001-12-16 Depuy Acromed Inc INTERVERTEBRAL DISC.
FR2701650B1 (en) 1993-02-17 1995-05-24 Psi Double shock absorber for intervertebral stabilization.
US5549607A (en) 1993-02-19 1996-08-27 Alphatec Manufacturing, Inc, Apparatus for spinal fixation system
FR2702362B3 (en) * 1993-02-24 1995-04-14 Soprane Sa Fixator for osteosynthesis of the lumbosacral spine.
US5439464A (en) 1993-03-09 1995-08-08 Shapiro Partners Limited Method and instruments for performing arthroscopic spinal surgery
US5531745A (en) 1993-03-11 1996-07-02 Danek Medical, Inc. System for stabilizing the spine and reducing spondylolisthesis
US5470333A (en) 1993-03-11 1995-11-28 Danek Medical, Inc. System for stabilizing the cervical and the lumbar region of the spine
WO1994021186A1 (en) 1993-03-15 1994-09-29 Synthes Ag, Chur Hook with bolt for treating spinal deformities
DE4308750A1 (en) 1993-03-19 1994-09-22 Esselte Meto Int Gmbh Article security element
US5415661A (en) 1993-03-24 1995-05-16 University Of Miami Implantable spinal assist device
US5534028A (en) 1993-04-20 1996-07-09 Howmedica, Inc. Hydrogel intervertebral disc nucleus with diminished lateral bulging
US5304179A (en) * 1993-06-17 1994-04-19 Amei Technologies Inc. System and method for installing a spinal fixation system at variable angles
FR2707480B1 (en) 1993-06-28 1995-10-20 Bisserie Michel Intervertebral disc prosthesis.
US5584831A (en) * 1993-07-09 1996-12-17 September 28, Inc. Spinal fixation device and method
US5360430A (en) 1993-07-29 1994-11-01 Lin Chih I Intervertebral locking device
US5437669A (en) 1993-08-12 1995-08-01 Amei Technologies Inc. Spinal fixation systems with bifurcated connectors
FR2709248B1 (en) 1993-08-27 1995-09-29 Martin Jean Raymond Ancillary equipment for placing a spinal instrumentation.
FR2709245B1 (en) 1993-08-27 1995-09-29 Fairant Paulette Dynamic internal vertebral orthosis.
FR2709247B1 (en) 1993-08-27 1995-09-29 Martin Jean Raymond Device for anchoring spinal instrumentation on a vertebra.
FR2722393B1 (en) 1993-08-27 1996-08-23 Martin Jean Raymond ANCILLARY MATERIAL FOR CORRECTING A VERTEBRAL DEFORMATION
FR2709246B1 (en) 1993-08-27 1995-09-29 Martin Jean Raymond Dynamic implanted spinal orthosis.
US5458641A (en) 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis
CN1156255C (en) * 1993-10-01 2004-07-07 美商-艾克罗米德公司 Spinal implant
FR2712481B1 (en) 1993-11-18 1996-01-12 Graf Henry Improvements to flexible inter-vertebral stabilizers.
DE4340398C2 (en) 1993-11-26 1997-06-19 Jeffrey D Dr Fairley Device for the passive connection of two bones in one plane, movable in one plane
US5507813A (en) 1993-12-09 1996-04-16 Osteotech, Inc. Shaped materials derived from elongate bone particles
US5476463A (en) 1994-01-12 1995-12-19 Acromed Corporation Spinal column retaining apparatus
US5514180A (en) 1994-01-14 1996-05-07 Heggeness; Michael H. Prosthetic intervertebral devices
US5458642A (en) 1994-01-18 1995-10-17 Beer; John C. Synthetic intervertebral disc
US6716216B1 (en) 1998-08-14 2004-04-06 Kyphon Inc. Systems and methods for treating vertebral bodies
NL9400210A (en) 1994-02-10 1995-09-01 Acromed Bv Implantation device for limiting movements between two vertebrae.
US5507745A (en) 1994-02-18 1996-04-16 Sofamor, S.N.C. Occipito-cervical osteosynthesis instrumentation
EP0669109B1 (en) 1994-02-28 1999-05-26 Sulzer Orthopädie AG Stabilizer for adjacent vertebrae
US5653762A (en) 1994-03-18 1997-08-05 Pisharodi; Madhavan Method of stabilizing adjacent vertebrae with rotating, lockable, middle-expanded intervertebral disk stabilizer
US5571189A (en) 1994-05-20 1996-11-05 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
SE9402130D0 (en) * 1994-06-17 1994-06-17 Sven Olerud Device and method for plate fixation of legs
FR2721501B1 (en) 1994-06-24 1996-08-23 Fairant Paulette Prostheses of the vertebral articular facets.
US5545166A (en) 1994-07-14 1996-08-13 Advanced Spine Fixation Systems, Incorporated Spinal segmental reduction derotational fixation system
US5681310A (en) 1994-07-20 1997-10-28 Yuan; Hansen A. Vertebral auxiliary fixation device having holding capability
FR2722980B1 (en) 1994-07-26 1996-09-27 Samani Jacques INTERTEPINOUS VERTEBRAL IMPLANT
US5527312A (en) 1994-08-19 1996-06-18 Salut, Ltd. Facet screw anchor
US5556687A (en) 1994-10-14 1996-09-17 Acromed Corporation Composite structure suitable for use as a bone plate and method for making said structure
DE69532856T2 (en) 1994-10-17 2005-04-21 Raymedica Inc Spinal disc-GRAFT
US5562736A (en) 1994-10-17 1996-10-08 Raymedica, Inc. Method for surgical implantation of a prosthetic spinal disc nucleus
US5824093A (en) 1994-10-17 1998-10-20 Raymedica, Inc. Prosthetic spinal disc nucleus
US6176861B1 (en) * 1994-10-25 2001-01-23 Sdgi Holdings, Inc. Modular spinal system
US6004322A (en) 1994-10-25 1999-12-21 Sdgi Holdings, Inc. Modular pedicle screw system
US5674296A (en) * 1994-11-14 1997-10-07 Spinal Dynamics Corporation Human spinal disc prosthesis
US5474551A (en) 1994-11-18 1995-12-12 Smith & Nephew Richards, Inc. Universal coupler for spinal fixation
WO1996018363A1 (en) * 1994-12-08 1996-06-20 Vanderbilt University Low profile intraosseous anterior spinal fusion system and method
JP3732228B2 (en) 1994-12-09 2006-01-05 ソファモーア・デインク・グループ・インコーポレーテッド Adjustable vertebral body replacement
US5620443A (en) 1995-01-25 1997-04-15 Danek Medical, Inc. Anterior screw-rod connector
US5571191A (en) * 1995-03-16 1996-11-05 Fitz; William R. Artificial facet joint
US6206922B1 (en) * 1995-03-27 2001-03-27 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US5688272A (en) 1995-03-30 1997-11-18 Danek Medical, Inc. Top-tightening transverse connector for a spinal fixation system
US5582612A (en) 1995-05-01 1996-12-10 Lin; Chih-I Vertebral fixing and retrieving device having centrally two fixation
US6264655B1 (en) 1995-06-07 2001-07-24 Madhavan Pisharodi Cervical disk and spinal stabilizer
NZ272994A (en) 1995-09-12 2001-06-29 C G Surgical Ltd Spinal prosthesis device which stabilises lamina after laminoplasty
US5702392A (en) 1995-09-25 1997-12-30 Wu; Shing-Sheng Coupling plate for spinal correction and a correction device of using the same
US5888222A (en) * 1995-10-16 1999-03-30 Sdgi Holding, Inc. Intervertebral spacers
EP0915687A4 (en) * 1995-12-08 1999-11-10 Robert S Bray Jr Anterior stabilization device
US5645597A (en) 1995-12-29 1997-07-08 Krapiva; Pavel I. Disc replacement method and apparatus
US5683465A (en) 1996-03-18 1997-11-04 Shinn; Gary Lee Artificial intervertebral disk prosthesis
ES2213174T3 (en) 1996-03-27 2004-08-16 Lubos Rehak DEVICE FOR CORRECTION OF MALFORMATIONS OF THE VERTEBRAL COLUMN.
US5690629A (en) 1996-04-24 1997-11-25 Acromed Corporation Apparatus for maintaining vertebrae of a spinal column in a desired spatial relationship
FR2748387B1 (en) * 1996-05-13 1998-10-30 Stryker France Sa BONE FIXATION DEVICE, IN PARTICULAR TO THE SACRUM, IN OSTEOSYNTHESIS OF THE SPINE
US5713900A (en) 1996-05-31 1998-02-03 Acromed Corporation Apparatus for retaining bone portions in a desired spatial relationship
US5755796A (en) 1996-06-06 1998-05-26 Ibo; Ivo Prosthesis of the cervical intervertebralis disk
US5849004A (en) * 1996-07-17 1998-12-15 Bramlet; Dale G. Surgical anchor
US6835207B2 (en) 1996-07-22 2004-12-28 Fred Zacouto Skeletal implant
US6019759A (en) 1996-07-29 2000-02-01 Rogozinski; Chaim Multi-Directional fasteners or attachment devices for spinal implant elements
FR2751864B1 (en) 1996-08-01 1999-04-30 Graf Henry DEVICE FOR MECHANICALLY CONNECTING AND ASSISTING VERTEBRES BETWEEN THEM
US6066325A (en) 1996-08-27 2000-05-23 Fusion Medical Technologies, Inc. Fragmented polymeric compositions and methods for their use
US5666243A (en) 1996-09-03 1997-09-09 Seagate Technology, Inc. Spring loaded stacked actuator assembly
US6063088A (en) 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
US6190414B1 (en) * 1996-10-31 2001-02-20 Surgical Dynamics Inc. Apparatus for fusion of adjacent bone structures
US5895428A (en) * 1996-11-01 1999-04-20 Berry; Don Load bearing spinal joint implant
US5728098A (en) * 1996-11-07 1998-03-17 Sdgi Holdings, Inc. Multi-angle bone screw assembly using shape-memory technology
FR2755844B1 (en) 1996-11-15 1999-01-29 Stryker France Sa OSTEOSYNTHESIS SYSTEM WITH ELASTIC DEFORMATION FOR SPINE
ATE234046T1 (en) 1996-12-12 2003-03-15 Synthes Ag DEVICE FOR CONNECTING A LONG SUPPORT TO A PEDICLE SCREW
JPH10179622A (en) 1996-12-20 1998-07-07 Mizuho Ika Kogyo Kk Vertebral implant
US6068630A (en) 1997-01-02 2000-05-30 St. Francis Medical Technologies, Inc. Spine distraction implant
US6796983B1 (en) 1997-01-02 2004-09-28 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US20020143331A1 (en) 1998-10-20 2002-10-03 Zucherman James F. Inter-spinous process implant and method with deformable spacer
US6451019B1 (en) 1998-10-20 2002-09-17 St. Francis Medical Technologies, Inc. Supplemental spine fixation device and method
US5836948A (en) 1997-01-02 1998-11-17 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US6514256B2 (en) * 1997-01-02 2003-02-04 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US5860977A (en) 1997-01-02 1999-01-19 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US7201751B2 (en) 1997-01-02 2007-04-10 St. Francis Medical Technologies, Inc. Supplemental spine fixation device
US6156038A (en) 1997-01-02 2000-12-05 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US6695842B2 (en) 1997-10-27 2004-02-24 St. Francis Medical Technologies, Inc. Interspinous process distraction system and method with positionable wing and method
US7101375B2 (en) 1997-01-02 2006-09-05 St. Francis Medical Technologies, Inc. Spine distraction implant
US7306628B2 (en) 2002-10-29 2007-12-11 St. Francis Medical Technologies Interspinous process apparatus and method with a selectably expandable spacer
US7618451B2 (en) 2001-05-25 2009-11-17 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools facilitating increased accuracy, speed and simplicity in performing total and partial joint arthroplasty
US6039761A (en) 1997-02-12 2000-03-21 Li Medical Technologies, Inc. Intervertebral spacer and tool and method for emplacement thereof
US5752957A (en) * 1997-02-12 1998-05-19 Third Millennium Engineering, Llc Polyaxial mechanism for use with orthopaedic implant devices
US5916267A (en) 1997-04-07 1999-06-29 Arthit Sitiso Anterior spinal implant system for vertebral body prosthesis
JP2992878B2 (en) 1997-04-09 1999-12-20 茂夫 佐野 Artificial facet joint
US6110178A (en) 1997-04-25 2000-08-29 Sulzer Orthopadie Ag Apparatus for the production of endochondral or osteochondral bores
IES80150B2 (en) 1997-04-30 1998-06-03 Eskina Developments Limited Spinal osteosynthesis device for mechanically interconnecting two adjacent vertebrae in particular lumbar vertebrae
NZ513470A (en) 1997-06-09 2003-01-31 Kyphon Inc Device for deployment into an interior body using expandable bodies attached to first and second catheter tubes
US5893889A (en) 1997-06-20 1999-04-13 Harrington; Michael Artificial disc
GB9713330D0 (en) 1997-06-25 1997-08-27 Bridport Gundry Plc Surgical implant
EP0999795A1 (en) 1997-07-31 2000-05-17 Plus Endoprothetik Ag Device for stiffening and/or correcting a vertebral column or such like
US6146421A (en) 1997-08-04 2000-11-14 Gordon, Maya, Roberts And Thomas, Number 1, Llc Multiple axis intervertebral prosthesis
CA2298652A1 (en) 1997-08-04 1999-02-11 Dennis P. Gordon Multiple axis intervertebral prosthesis
US5824094A (en) 1997-10-17 1998-10-20 Acromed Corporation Spinal disc
KR100779258B1 (en) * 1997-10-27 2007-11-27 세인트 프랜시스 메디컬 테크놀로지스, 인코포레이티드 Spine distraction implant
FR2770767B1 (en) 1997-11-10 2000-03-10 Dimso Sa IMPLANT FOR VERTEBRA
FR2771280B1 (en) 1997-11-26 2001-01-26 Albert P Alby RESILIENT VERTEBRAL CONNECTION DEVICE
US5986169A (en) 1997-12-31 1999-11-16 Biorthex Inc. Porous nickel-titanium alloy article
DE19801219A1 (en) * 1998-01-15 1999-07-22 Holger K Dr Essiger Bone nail
FR2774581B1 (en) 1998-02-10 2000-08-11 Dimso Sa INTEREPINOUS STABILIZER TO BE ATTACHED TO SPINOUS APOPHYSIS OF TWO VERTEBRES
FR2775183B1 (en) 1998-02-20 2000-08-04 Jean Taylor INTER-SPINOUS PROSTHESIS
US6179838B1 (en) * 1998-02-24 2001-01-30 Daniel Fiz Bone fixation arrangements and method
US5989291A (en) 1998-02-26 1999-11-23 Third Millennium Engineering, Llc Intervertebral spacer device
US6314325B1 (en) 1998-04-07 2001-11-06 William R. Fitz Nerve hyperpolarization method and apparatus for pain relief
US6014588A (en) 1998-04-07 2000-01-11 Fitz; William R. Facet joint pain relief method and apparatus
US6019792A (en) 1998-04-23 2000-02-01 Cauthen Research Group, Inc. Articulating spinal implant
WO1999060957A1 (en) 1998-05-27 1999-12-02 Nuvasive, Inc. Methods and apparatus for separating and stabilizing adjacent vertebrae
US6132465A (en) 1998-06-04 2000-10-17 Raymedica, Inc. Tapered prosthetic spinal disc nucleus
WO1999065412A1 (en) 1998-06-18 1999-12-23 Pioneer Laboratories, Inc. Spinal fixation system
US6228085B1 (en) * 1998-07-14 2001-05-08 Theken Surgical Llc Bone fixation system
DE19832303C2 (en) 1998-07-17 2000-05-18 Storz Karl Gmbh & Co Kg screwdriver
US6063121A (en) 1998-07-29 2000-05-16 Xavier; Ravi Vertebral body prosthesis
ATE320223T1 (en) * 1998-09-11 2006-04-15 Synthes Ag ANGLE ADJUSTABLE FIXATION SYSTEM FOR THE SPINE
US6652527B2 (en) 1998-10-20 2003-11-25 St. Francis Medical Technologies, Inc. Supplemental spine fixation device and method
US7029473B2 (en) 1998-10-20 2006-04-18 St. Francis Medical Technologies, Inc. Deflectable spacer for use as an interspinous process implant and method
US6652534B2 (en) 1998-10-20 2003-11-25 St. Francis Medical Technologies, Inc. Apparatus and method for determining implant size
US6113637A (en) 1998-10-22 2000-09-05 Sofamor Danek Holdings, Inc. Artificial intervertebral joint permitting translational and rotational motion
US6151934A (en) 1998-10-23 2000-11-28 Emhart Inc. Lock assembly with over-torque defense system
US6039763A (en) * 1998-10-27 2000-03-21 Disc Replacement Technologies, Inc. Articulating spinal disc prosthesis
US6312443B1 (en) 1998-12-23 2001-11-06 Nuvasive, Inc. Expandable cannula
KR100324698B1 (en) * 1999-01-30 2002-02-27 구자교 Spine fixing device
US6086590A (en) * 1999-02-02 2000-07-11 Pioneer Laboratories, Inc. Cable connector for orthopaedic rod
US6113639A (en) 1999-03-23 2000-09-05 Raymedica, Inc. Trial implant and trial implant kit for evaluating an intradiscal space
US6206882B1 (en) 1999-03-30 2001-03-27 Surgical Dynamics Inc. Plating system for the spine
JP2003523784A (en) 1999-04-05 2003-08-12 サージカル ダイナミックス インコーポレイテッド Artificial spinal ligament
AU4246000A (en) 1999-04-16 2000-11-02 Nuvasive, Inc. Articulation systems for positioning minimally invasive surgical tools
US6478805B1 (en) 1999-04-16 2002-11-12 Nuvasive, Inc. System for removing cut tissue from the inner bore of a surgical instrument
US6299613B1 (en) 1999-04-23 2001-10-09 Sdgi Holdings, Inc. Method for the correction of spinal deformities through vertebral body tethering without fusion
US6419704B1 (en) 1999-10-08 2002-07-16 Bret Ferree Artificial intervertebral disc replacement methods and apparatus
CN2386790Y (en) 1999-08-31 2000-07-12 四川华神川大生物材料有限责任公司 Artificial vertebral lamina
US6280442B1 (en) * 1999-09-01 2001-08-28 Sdgi Holdings, Inc. Multi-axial bone screw assembly
US6312469B1 (en) 1999-09-13 2001-11-06 Medtronic Inc. Lamina prosthesis for delivery of medical treatment
FR2799640B1 (en) 1999-10-15 2002-01-25 Spine Next Sa IMPLANT INTERVETEBRAL
US6974478B2 (en) 1999-10-22 2005-12-13 Archus Orthopedics, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US7691145B2 (en) 1999-10-22 2010-04-06 Facet Solutions, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
ATE467400T1 (en) * 1999-10-22 2010-05-15 Fsi Acquisition Sub Llc FACET ARTHROPLASTY DEVICES
US8187303B2 (en) 2004-04-22 2012-05-29 Gmedelaware 2 Llc Anti-rotation fixation element for spinal prostheses
US7674293B2 (en) 2004-04-22 2010-03-09 Facet Solutions, Inc. Crossbar spinal prosthesis having a modular design and related implantation methods
US20050261770A1 (en) 2004-04-22 2005-11-24 Kuiper Mark K Crossbar spinal prosthesis having a modular design and related implantation methods
US20050027361A1 (en) 1999-10-22 2005-02-03 Reiley Mark A. Facet arthroplasty devices and methods
US6461359B1 (en) 1999-11-10 2002-10-08 Clifford Tribus Spine stabilization device
WO2001039678A1 (en) 1999-12-01 2001-06-07 Henry Graf Intervertebral stabilising device
FR2803188A1 (en) 1999-12-29 2001-07-06 Henry Graf DEVICE AND INTERVERTEBRAL STABILIZATION ASSEMBLY
US6485518B1 (en) * 1999-12-10 2002-11-26 Nuvasive Facet screw and bone allograft intervertebral support and fusion system
MXPA02004117A (en) 1999-12-20 2002-10-17 Synthes Ag Device for the stabilisation of two adjacent verterbral bodies of the spine.
US7066957B2 (en) 1999-12-29 2006-06-27 Sdgi Holdings, Inc. Device and assembly for intervertebral stabilization
DE10004712C1 (en) 2000-02-03 2001-08-09 Aesculap Ag & Co Kg Bone plate for bone fracture or fixing adjacent vertebrae has intermediate section between plate-shaped regions secured to fracture sections or vertebrae provided with transverse slits
US6610062B2 (en) * 2000-02-16 2003-08-26 Ebi, L.P. Method and system for spinal fixation
US20020133155A1 (en) * 2000-02-25 2002-09-19 Ferree Bret A. Cross-coupled vertebral stabilizers incorporating spinal motion restriction
JP2003524505A (en) 2000-02-28 2003-08-19 エスディージーアイ・ホールディングス・インコーポレーテッド Articulating spinal implant
US6293949B1 (en) 2000-03-01 2001-09-25 Sdgi Holdings, Inc. Superelastic spinal stabilization system and method
US6338734B1 (en) * 2000-03-14 2002-01-15 Biomet, Inc. Method and apparatus for trochanter fixation
JP4222706B2 (en) * 2000-03-22 2009-02-12 オリンパス株式会社 Medical instrument holding device
US6402750B1 (en) 2000-04-04 2002-06-11 Spinlabs, Llc Devices and methods for the treatment of spinal disorders
US7462195B1 (en) 2000-04-19 2008-12-09 Warsaw Orthopedic, Inc. Artificial lumbar interbody spinal implant having an asymmetrical leading end
US6964667B2 (en) 2000-06-23 2005-11-15 Sdgi Holdings, Inc. Formed in place fixation system with thermal acceleration
AU2001225881A1 (en) 2000-06-23 2002-01-08 University Of Southern California Percutaneous vertebral fusion system
US6875212B2 (en) * 2000-06-23 2005-04-05 Vertelink Corporation Curable media for implantable medical device
EP1294297B1 (en) 2000-06-30 2010-08-11 Warsaw Orthopedic, Inc. Intervertebral linking device
FR2811540B1 (en) 2000-07-12 2003-04-25 Spine Next Sa IMPORTING INTERVERTEBRAL IMPLANT
KR20030029621A (en) 2000-07-14 2003-04-14 카이폰 인코포레이티드 Systems and methods for treating vertebral bodies
FR2812186B1 (en) * 2000-07-25 2003-02-28 Spine Next Sa FLEXIBLE CONNECTION PIECE FOR SPINAL STABILIZATION
FR2812185B1 (en) 2000-07-25 2003-02-28 Spine Next Sa SEMI-RIGID CONNECTION PIECE FOR RACHIS STABILIZATION
US7056321B2 (en) 2000-08-01 2006-06-06 Endius, Incorporated Method of securing vertebrae
US6458131B1 (en) 2000-08-07 2002-10-01 Salut, Ltd. Apparatus and method for reducing spinal deformity
US6447546B1 (en) 2000-08-11 2002-09-10 Dale G. Bramlet Apparatus and method for fusing opposing spinal vertebrae
US7166107B2 (en) * 2000-09-11 2007-01-23 D. Greg Anderson Percutaneous technique and implant for expanding the spinal canal
CA2323252C (en) 2000-10-12 2007-12-11 Biorthex Inc. Artificial disc
US20080177310A1 (en) 2000-10-20 2008-07-24 Archus Orthopedics, Inc. Facet arthroplasty devices and methods
WO2002034120A2 (en) 2000-10-27 2002-05-02 Blackstone Medical, Inc. Facet fixation devices
WO2002036024A1 (en) 2000-11-03 2002-05-10 Hôpital Sainte-Justine Adjustable surgical templates
US6551320B2 (en) * 2000-11-08 2003-04-22 The Cleveland Clinic Foundation Method and apparatus for correcting spinal deformity
WO2002038062A2 (en) * 2000-11-13 2002-05-16 Boehm Frank H Jr Device and method for lumbar interbody fusion
US20050080486A1 (en) 2000-11-29 2005-04-14 Fallin T. Wade Facet joint replacement
US6579319B2 (en) * 2000-11-29 2003-06-17 Medicinelodge, Inc. Facet joint replacement
FR2817461B1 (en) 2000-12-01 2003-08-15 Henry Graf INTERVERTEBRAL STABILIZATION DEVICE
US6419703B1 (en) 2001-03-01 2002-07-16 T. Wade Fallin Prosthesis for the replacement of a posterior element of a vertebra
US6565605B2 (en) 2000-12-13 2003-05-20 Medicinelodge, Inc. Multiple facet joint replacement
US6413259B1 (en) 2000-12-14 2002-07-02 Blackstone Medical, Inc Bone plate assembly including a screw retaining member
US6565564B2 (en) * 2000-12-14 2003-05-20 Synthes U.S.A. Multi-pin clamp and rod attachment
US20020169507A1 (en) 2000-12-14 2002-11-14 David Malone Interbody spine fusion cage
FR2818530B1 (en) 2000-12-22 2003-10-31 Spine Next Sa INTERVERTEBRAL IMPLANT WITH DEFORMABLE SHIM
HRP20000906B1 (en) * 2000-12-28 2009-05-31 Mara-Institut D.O.O. Flat soffit, doubly prestressed, composite, roof-ceiling construction for large span industrial buildings
US7178421B2 (en) * 2001-01-04 2007-02-20 Syron Engineering & Manufacturing, Llc Dual spherical ball clamp
US6989032B2 (en) 2001-07-16 2006-01-24 Spinecore, Inc. Artificial intervertebral disc
US6863689B2 (en) 2001-07-16 2005-03-08 Spinecore, Inc. Intervertebral spacer having a flexible wire mesh vertebral body contact element
US6863688B2 (en) 2001-02-15 2005-03-08 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves
US6740117B2 (en) 2001-02-15 2004-05-25 Spinecore, Inc. Intervertebral spacer device having a radially thinning slotted belleville spring
US6451021B1 (en) 2001-02-15 2002-09-17 Third Millennium Engineering, Llc Polyaxial pedicle screw having a rotating locking element
US20020111687A1 (en) * 2001-02-15 2002-08-15 Ralph James D. Intervertebral spacer device utilizing a belleville washer having radially extending grooves
US6887274B2 (en) 2001-02-15 2005-05-03 Spinecore, Inc. Intervertebral spacer device utilizing a belleville washer having radially spaced concentric grooves
US7115132B2 (en) 2001-07-16 2006-10-03 Spinecore, Inc. Static trials and related instruments and methods for use in implanting an artificial intervertebral disc
US7169182B2 (en) 2001-07-16 2007-01-30 Spinecore, Inc. Implanting an artificial intervertebral disc
US6607559B2 (en) 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
US7235081B2 (en) 2001-07-16 2007-06-26 Spinecore, Inc. Wedge plate inserter/impactor and related methods for use in implanting an artificial intervertebral disc
US6669730B2 (en) 2001-02-15 2003-12-30 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially extending grooves
US7223291B2 (en) 2001-07-16 2007-05-29 Spinecore, Inc. Intervertebral spacer device having engagement hole pairs for manipulation using a surgical tool
US20020111682A1 (en) 2001-02-15 2002-08-15 Ralph James D. Intervertebral spacer device having a radially thinning belleville spring
US6764515B2 (en) 2001-02-15 2004-07-20 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer and a rotational mounting
US7563285B2 (en) 2001-07-16 2009-07-21 Spinecore, Inc. Artificial intervertebral disc utilizing a ball joint coupling
US6673113B2 (en) 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
WO2002065954A1 (en) 2001-02-16 2002-08-29 Queen's University At Kingston Method and device for treating scoliosis
US6652585B2 (en) 2001-02-28 2003-11-25 Sdgi Holdings, Inc. Flexible spine stabilization system
US7229441B2 (en) 2001-02-28 2007-06-12 Warsaw Orthopedic, Inc. Flexible systems for spinal stabilization and fixation
US7090698B2 (en) 2001-03-02 2006-08-15 Facet Solutions Method and apparatus for spine joint replacement
FR2822051B1 (en) 2001-03-13 2004-02-27 Spine Next Sa INTERVERTEBRAL IMPLANT WITH SELF-LOCKING ATTACHMENT
US6764489B2 (en) * 2001-03-27 2004-07-20 Novasive, Inc Hinged anterior thoracic/lumbar plate
US6582433B2 (en) 2001-04-09 2003-06-24 St. Francis Medical Technologies, Inc. Spine fixation device and method
US7122037B2 (en) * 2001-05-17 2006-10-17 Inion Ltd. Bone fracture fastener and material for production thereof
US6475219B1 (en) 2001-06-07 2002-11-05 Alexis P. Shelokov Anterior vertebral protection method and device
GB0114783D0 (en) 2001-06-16 2001-08-08 Sengupta Dilip K A assembly for the stabilisation of vertebral bodies of the spine
DE10129490A1 (en) 2001-06-21 2003-01-02 Helmut Mueckter Implantable screw for stabilization of joint or bone fracture, has flexible shaft which interconnects proximal head portion and distal insertion portion of elongated screw body
ATE243028T1 (en) 2001-07-11 2003-07-15 Applied Pharma Res GRANULES CONTAINING FAT-SOLUBLE SUBSTANCES AND METHOD FOR THE PRODUCTION THEREOF
US6471725B1 (en) 2001-07-16 2002-10-29 Third Millenium Engineering, Llc Porous intervertebral distraction spacers
US20030014115A1 (en) * 2001-07-16 2003-01-16 Ralph James D. Insertion tool for use with intervertebral spacers
US6478801B1 (en) 2001-07-16 2002-11-12 Third Millennium Engineering, Llc Insertion tool for use with tapered trial intervertebral distraction spacers
US7160327B2 (en) * 2001-07-16 2007-01-09 Spinecore, Inc. Axially compressible artificial intervertebral disc having limited rotation using a captured ball and socket joint with a solid ball and compression locking post
US6554864B2 (en) 2001-07-16 2003-04-29 Spinecore, Inc Surgical method of treating scoliosis
DE60231718D1 (en) 2001-07-16 2009-05-07 Spinecore Inc ARTIFICIAL BELT WASH WITH A FORCE RESTORING ELEMENT IN THE FORM OF A WAVE WASHER
US6436102B1 (en) 2001-07-16 2002-08-20 Third Millennium Engineering, Llc Method of distracting vertebral bones
US6562047B2 (en) 2001-07-16 2003-05-13 Spine Core, Inc. Vertebral bone distraction instruments
US6527806B2 (en) 2001-07-16 2003-03-04 Third Millennium Engineering, Llc Intervertebral spacer device having a spiral wave washer force restoring element
US7118599B2 (en) 2001-07-16 2006-10-10 Spinecore, Inc. Artificial intervertebral disc
US8366775B2 (en) 2001-07-16 2013-02-05 Spinecore, Inc. Intervertebral spacer device having an angled perimeter for manipulation using a surgical tool
US6468310B1 (en) 2001-07-16 2002-10-22 Third Millennium Engineering, Llc Intervertebral spacer device having a wave washer force restoring element
US6428544B1 (en) 2001-07-16 2002-08-06 Third Millennium Engineering, Llc Insertion tool for use with trial intervertebral distraction spacers
US6805716B2 (en) 2001-07-16 2004-10-19 Spine Core, Inc. Orthopedic device set for reorienting vertebral bones for the treatment of scoliosis
US7491241B2 (en) 2001-07-16 2009-02-17 Spinecore, Inc. Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US6447548B1 (en) 2001-07-16 2002-09-10 Third Millennium Engineering, Llc Method of surgically treating scoliosis
FR2827499B1 (en) 2001-07-20 2004-05-07 Henry Graf INTERVERTEBRAL LINK DEVICE
EP1427341A1 (en) 2001-07-20 2004-06-16 Spinal Concepts Inc. Spinal stabilization system and method
DE10135771B4 (en) * 2001-07-23 2006-02-16 Aesculap Ag & Co. Kg Facet joint implant
FR2827503B1 (en) * 2001-07-23 2003-10-24 Macara Frederique MODULAR RECONSTRUCTION COTYLE
US20030028251A1 (en) 2001-07-30 2003-02-06 Mathews Hallett H. Methods and devices for interbody spinal stabilization
JP4755781B2 (en) 2001-08-01 2011-08-24 昭和医科工業株式会社 Jointing member for osteosynthesis
FR2828398B1 (en) 2001-08-08 2003-09-19 Jean Taylor VERTEBRA STABILIZATION ASSEMBLY
WO2003032801A2 (en) 2001-10-18 2003-04-24 Third Millennium Engineering Llc Artificial intervertebral disc having a spider spring force restoring element
US6783527B2 (en) 2001-10-30 2004-08-31 Sdgi Holdings, Inc. Flexible spinal stabilization system and method
US20060079892A1 (en) * 2001-10-31 2006-04-13 Suranjan Roychowdhury Adjustable tandem connectors for corrective devices for the spinal column and other bones and joints
US7094242B2 (en) 2001-10-31 2006-08-22 K2M, Inc. Polyaxial drill guide
FR2832054B1 (en) 2001-11-15 2004-09-10 Rene Louis POSTERIOR VERTEBRAL JOINT PROSTHESIS
FR2832917B1 (en) 2001-11-30 2004-09-24 Spine Next Sa ELASTICALLY DEFORMABLE INTERVERTEBRAL IMPLANT
US7485134B2 (en) 2001-12-07 2009-02-03 Simonson Rush E Vertebral implants adapted for posterior insertion
US6733534B2 (en) 2002-01-29 2004-05-11 Sdgi Holdings, Inc. System and method for spine spacing
US7335201B2 (en) 2003-09-26 2008-02-26 Zimmer Spine, Inc. Polyaxial bone screw with torqueless fastening
DE50214375D1 (en) 2002-02-09 2010-05-27 Zeiss Carl Smt Ag FACETED MIRROR WITH SEVERAL MIRROR FACETS
FR2835735B1 (en) 2002-02-11 2004-11-12 Fixano VERTEBRAL ARTHRODESIS MATERIAL
US6626909B2 (en) 2002-02-27 2003-09-30 Kingsley Richard Chin Apparatus and method for spine fixation
US6669729B2 (en) 2002-03-08 2003-12-30 Kingsley Richard Chin Apparatus and method for the replacement of posterior vertebral elements
FR2837094B1 (en) 2002-03-15 2004-11-26 Fixano INTERVERTEBRAL IMPLANT
DE60334897D1 (en) * 2002-03-30 2010-12-23 Infinity Orthopaedics Co Ltd Medical Intervertebral Device
US6966910B2 (en) 2002-04-05 2005-11-22 Stephen Ritland Dynamic fixation device and method of use
US8038713B2 (en) 2002-04-23 2011-10-18 Spinecore, Inc. Two-component artificial disc replacements
US20080027548A9 (en) * 2002-04-12 2008-01-31 Ferree Bret A Spacerless artificial disc replacements
US6706068B2 (en) 2002-04-23 2004-03-16 Bret A. Ferree Artificial disc replacements with natural kinematics
US20040027449A1 (en) * 2002-05-07 2004-02-12 Turner Arthur Monroe Laser printing apparatus using a pivoting scanning mirror
JP2003325536A (en) 2002-05-09 2003-11-18 Showa Ika Kohgyo Co Ltd Implant screw
US7291171B2 (en) 2002-05-10 2007-11-06 Ferree Bret A Artificial disc replacement (ADR) using elastic tether member
DE50300788D1 (en) 2002-05-21 2005-08-25 Spinelab Gmbh Wabern Elastic stabilization system for spinal columns
US20030220643A1 (en) 2002-05-24 2003-11-27 Ferree Bret A. Devices to prevent spinal extension
WO2003105673A2 (en) 2002-06-17 2003-12-24 Trimedyne, Inc. Devices and methods for minimally invasive treatment of degenerated spinal discs
US7066210B2 (en) * 2002-07-15 2006-06-27 Bj Services Company Compression pipe repairing and reinforcing methods
AU2003261286B2 (en) 2002-07-19 2009-10-29 Interventional Spine, Inc. Method and apparatus for spinal fixation
US20040030402A1 (en) * 2002-08-08 2004-02-12 Uri Arnin Elastomeric covers for orthopedic implants
DE10236691B4 (en) * 2002-08-09 2005-12-01 Biedermann Motech Gmbh Dynamic stabilization device for bones, in particular for vertebrae
AU2003265597A1 (en) 2002-08-23 2004-03-11 Paul C. Mcafee Metal-backed uhmpe rod sleeve system preserving spinal motion
FR2844179B1 (en) 2002-09-10 2004-12-03 Jean Taylor POSTERIOR VERTEBRAL SUPPORT KIT
WO2004026170A2 (en) 2002-09-20 2004-04-01 Impliant Ltd. Mechanically attached elastomeric cover for prosthesis
JP2006501977A (en) * 2002-10-07 2006-01-19 コンフォーミス・インコーポレイテッド Minimally invasive joint implant with a three-dimensional profile that conforms to the joint surface
US20040122427A1 (en) 2002-10-10 2004-06-24 Holmes David C. Apparatus and method for restoring biomechanical function to a motion segment unit of the spine
FR2845587B1 (en) 2002-10-14 2005-01-21 Scient X DYNAMIC DEVICE FOR INTERVERTEBRAL CONNECTION WITH MULTIDIRECTIONALLY CONTROLLED DEBATMENT
US7267688B2 (en) 2002-10-22 2007-09-11 Ferree Bret A Biaxial artificial disc replacement
WO2004039291A1 (en) 2002-10-29 2004-05-13 Spinecore, Inc. Instrumentation, methods, and features for use in implanting an artificial intervertebral disc
US7549999B2 (en) 2003-05-22 2009-06-23 Kyphon Sarl Interspinous process distraction implant and method of implantation
US20050075634A1 (en) 2002-10-29 2005-04-07 Zucherman James F. Interspinous process implant with radiolucent spacer and lead-in tissue expander
US20040147928A1 (en) 2002-10-30 2004-07-29 Landry Michael E. Spinal stabilization system using flexible members
US7153281B2 (en) 2002-10-30 2006-12-26 Mekanika, Inc Apparatus and method for measuring instability of a motion segment unit of a spine
US7223269B2 (en) 2002-12-02 2007-05-29 Chappuis James L Facet fusion system
US7101398B2 (en) 2002-12-31 2006-09-05 Depuy Acromed, Inc. Prosthetic facet joint ligament
US20050055096A1 (en) * 2002-12-31 2005-03-10 Depuy Spine, Inc. Functional spinal unit prosthetic
GB0301085D0 (en) 2003-01-17 2003-02-19 Krishna Manoj Articulating spinal disc prosthesis
US7282064B2 (en) 2003-02-11 2007-10-16 Spinefrontier Lls Apparatus and method for connecting spinal vertebrae
FR2851154B1 (en) 2003-02-19 2006-07-07 Sdgi Holding Inc INTER-SPINOUS DEVICE FOR BRAKING THE MOVEMENTS OF TWO SUCCESSIVE VERTEBRATES, AND METHOD FOR MANUFACTURING THE SAME THEREOF
EP1596738A4 (en) 2003-02-25 2010-01-20 Stephen Ritland Adjustable rod and connector device and method of use
AU2004220634B2 (en) 2003-03-06 2009-09-17 Spinecore, Inc. Instrumentation and methods for use in implanting a cervical disc replacement device
US6908484B2 (en) 2003-03-06 2005-06-21 Spinecore, Inc. Cervical disc replacement
US7559946B2 (en) 2003-03-18 2009-07-14 The Cleveland Clinic Foundation Apparatus for insertion into a body lumen
US7588589B2 (en) 2003-03-20 2009-09-15 Medical Designs Llc Posterior spinal reconstruction system
US7112222B2 (en) * 2003-03-31 2006-09-26 Depuy Spine, Inc. Anterior lumbar interbody fusion cage with locking plate
US7029475B2 (en) 2003-05-02 2006-04-18 Yale University Spinal stabilization method
US7615068B2 (en) 2003-05-02 2009-11-10 Applied Spine Technologies, Inc. Mounting mechanisms for pedicle screws and related assemblies
DE10320417A1 (en) 2003-05-07 2004-12-02 Biedermann Motech Gmbh Dynamic anchoring device and dynamic stabilization device for bones, in particular for vertebrae, with such an anchoring device
US20040230201A1 (en) 2003-05-14 2004-11-18 Archus Orthopedics Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US7608104B2 (en) 2003-05-14 2009-10-27 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US20040230304A1 (en) 2003-05-14 2004-11-18 Archus Orthopedics Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
WO2004105577A2 (en) 2003-05-23 2004-12-09 Globus Medical, Inc. Spine stabilization system
US6986771B2 (en) 2003-05-23 2006-01-17 Globus Medical, Inc. Spine stabilization system
US7270665B2 (en) 2003-06-11 2007-09-18 Sdgi Holdings, Inc. Variable offset spinal fixation system
US7074238B2 (en) 2003-07-08 2006-07-11 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
WO2005009302A2 (en) * 2003-07-17 2005-02-03 Lee Casey K Facet joint prosthesis
DE112004001370B8 (en) 2003-07-25 2010-06-10 Impliant Ltd. Elastomeric nucleus replacement
US7153325B2 (en) 2003-08-01 2006-12-26 Ultra-Kinetics, Inc. Prosthetic intervertebral disc and methods for using the same
US7753958B2 (en) 2003-08-05 2010-07-13 Gordon Charles R Expandable intervertebral implant
US7204853B2 (en) 2003-08-05 2007-04-17 Flexuspine, Inc. Artificial functional spinal unit assemblies
US20060229729A1 (en) 2003-08-05 2006-10-12 Gordon Charles R Expandable intervertebral implant for use with instrument
US7909869B2 (en) 2003-08-05 2011-03-22 Flexuspine, Inc. Artificial spinal unit assemblies
US7799082B2 (en) 2003-08-05 2010-09-21 Flexuspine, Inc. Artificial functional spinal unit system and method for use
US7316714B2 (en) * 2003-08-05 2008-01-08 Flexuspine, Inc. Artificial functional spinal unit assemblies
US7377942B2 (en) * 2003-08-06 2008-05-27 Warsaw Orthopedic, Inc. Posterior elements motion restoring device
US9254137B2 (en) 2003-08-29 2016-02-09 Lanterna Medical Technologies Ltd Facet implant
WO2005037149A1 (en) 2003-10-20 2005-04-28 Impliant Ltd. Facet prosthesis
US7591837B2 (en) * 2003-10-28 2009-09-22 Pyramid Spine, Llc Facet triangle spinal fixation device and method of use
ATE363250T1 (en) 2003-11-07 2007-06-15 Impliant Ltd SPINAL PROSTHESIS
EP1686923A1 (en) 2003-11-18 2006-08-09 Quantum Orthopedics Osteoconductive integrated spinal cage and method of making same
US7862586B2 (en) 2003-11-25 2011-01-04 Life Spine, Inc. Spinal stabilization systems
US7553320B2 (en) 2003-12-10 2009-06-30 Warsaw Orthopedic, Inc. Method and apparatus for replacing the function of facet joints
US7753937B2 (en) 2003-12-10 2010-07-13 Facet Solutions Inc. Linked bilateral spinal facet implants and methods of use
US20050131406A1 (en) 2003-12-15 2005-06-16 Archus Orthopedics, Inc. Polyaxial adjustment of facet joint prostheses
US7901459B2 (en) 2004-01-09 2011-03-08 Warsaw Orthopedic, Inc. Split spinal device and method
US7771479B2 (en) 2004-01-09 2010-08-10 Warsaw Orthopedic, Inc. Dual articulating spinal device and method
US7556651B2 (en) 2004-01-09 2009-07-07 Warsaw Orthopedic, Inc. Posterior spinal device and method
US20050171610A1 (en) 2004-01-09 2005-08-04 Sdgi Holdings, Inc. Mobile bearing spinal device and method
US20050154467A1 (en) 2004-01-09 2005-07-14 Sdgi Holdings, Inc. Interconnected spinal device and method
US7875077B2 (en) 2004-01-09 2011-01-25 Warsaw Orthopedic, Inc. Support structure device and method
US7550010B2 (en) * 2004-01-09 2009-06-23 Warsaw Orthopedic, Inc. Spinal arthroplasty device and method
US20050159746A1 (en) 2004-01-21 2005-07-21 Dieter Grob Cervical facet resurfacing implant
US20050165407A1 (en) 2004-01-23 2005-07-28 Diaz Robert L. Disk arthroplasty instrumentation and implants
US7846183B2 (en) 2004-02-06 2010-12-07 Spinal Elements, Inc. Vertebral facet joint prosthesis and method of fixation
EP1761177B1 (en) 2004-02-10 2019-05-15 Spinal Elements, Inc. System for protecting neurovascular structures
US8562649B2 (en) 2004-02-17 2013-10-22 Gmedelaware 2 Llc System and method for multiple level facet joint arthroplasty and fusion
US7993373B2 (en) 2005-02-22 2011-08-09 Hoy Robert W Polyaxial orthopedic fastening apparatus
WO2005079711A1 (en) 2004-02-18 2005-09-01 Boehm Frank H Jr Facet joint prosthesis and method of replacing a facet joint
US7214244B2 (en) 2004-02-19 2007-05-08 Spinecore, Inc. Artificial intervertebral disc having an articulating joint
US20050187537A1 (en) 2004-02-19 2005-08-25 Loeb Marvin P. Angular deflection apparatus for use in confined spaces and method of use
AU2005216112B2 (en) 2004-02-20 2010-07-08 Spinecore, Inc. Artificial intervertebral disc having a universal joint
US7393361B2 (en) 2004-02-20 2008-07-01 Spinecore, Inc. Artificial intervertebral disc having a bored semispherical bearing with a compression locking post and retaining caps
US7819902B2 (en) 2004-02-27 2010-10-26 Custom Spine, Inc. Medialised rod pedicle screw assembly
US8097020B2 (en) 2004-02-27 2012-01-17 Custom Spine, Inc. Pedicle dynamic facet arthroplasty system and method
WO2005084590A1 (en) 2004-03-08 2005-09-15 Impliant Ltd. Spinal prosthesis
US20050203532A1 (en) 2004-03-12 2005-09-15 Sdgi Holdings, Inc. Technique and instrumentation for intervertebral prosthesis implantation using independent landmarks
US20050203533A1 (en) 2004-03-12 2005-09-15 Sdgi Holdings, Inc. Technique and instrumentation for intervertebral prosthesis implantation
US20050209694A1 (en) 2004-03-12 2005-09-22 Loeb Marvin P Artificial spinal joints and method of use
US7226453B2 (en) 2004-03-31 2007-06-05 Depuy Spine, Inc. Instrument for inserting, adjusting and removing pedicle screws and other orthopedic implants
US7282065B2 (en) 2004-04-09 2007-10-16 X-Spine Systems, Inc. Disk augmentation system and method
US7406775B2 (en) 2004-04-22 2008-08-05 Archus Orthopedics, Inc. Implantable orthopedic device component selection instrument and methods
US7051451B2 (en) 2004-04-22 2006-05-30 Archus Orthopedics, Inc. Facet joint prosthesis measurement and implant tools
US20080082171A1 (en) 2004-04-22 2008-04-03 Kuiper Mark K Crossbar spinal prosthesis having a modular design and systems for treating spinal pathologies
US20070093833A1 (en) 2004-05-03 2007-04-26 Kuiper Mark K Crossbar spinal prosthesis having a modular design and related implantation methods
US7338527B2 (en) 2004-05-11 2008-03-04 Geoffrey Blatt Artificial spinal disc, insertion tool, and method of insertion
WO2005117725A2 (en) 2004-05-27 2005-12-15 Depuy Spine, Inc. Tri-joint implant
US7758581B2 (en) 2005-03-28 2010-07-20 Facet Solutions, Inc. Polyaxial reaming apparatus and method
US7588578B2 (en) 2004-06-02 2009-09-15 Facet Solutions, Inc Surgical measurement systems and methods
US8764801B2 (en) 2005-03-28 2014-07-01 Gmedelaware 2 Llc Facet joint implant crosslinking apparatus and method
US7351261B2 (en) * 2004-06-30 2008-04-01 Depuy Spine, Inc. Multi-joint implant
US7261738B2 (en) 2004-06-30 2007-08-28 Depuy Spine, Inc. C-shaped disc prosthesis
US20060036323A1 (en) * 2004-08-03 2006-02-16 Carl Alan L Facet device and method
WO2006017641A2 (en) 2004-08-03 2006-02-16 Vertech Innovations, L.L.C. Spinous process reinforcement device and method
US20060036324A1 (en) * 2004-08-03 2006-02-16 Dan Sachs Adjustable spinal implant device and method
US8491634B2 (en) 2004-08-13 2013-07-23 Ricardo C. Sasso Replacement facet joint and method
US7846184B2 (en) 2004-08-13 2010-12-07 Sasso Ricardo C Replacement facet joint and method
JP2008510518A (en) 2004-08-18 2008-04-10 アーカス・オーソペディクス・インコーポレーテッド Adjoint level articulating device, spinal stabilization system and method
US20060041311A1 (en) * 2004-08-18 2006-02-23 Mcleer Thomas J Devices and methods for treating facet joints
US20060058787A1 (en) 2004-08-24 2006-03-16 Stryker Spine Spinal implant assembly
US7396360B2 (en) 2004-09-29 2008-07-08 The Cleveland Clinic Foundation Minimally invasive method and apparatus for fusing adjacent vertebrae
US7896906B2 (en) 2004-12-30 2011-03-01 Depuy Spine, Inc. Artificial facet joint
US7766940B2 (en) 2004-12-30 2010-08-03 Depuy Spine, Inc. Posterior stabilization system
US20060084976A1 (en) 2004-09-30 2006-04-20 Depuy Spine, Inc. Posterior stabilization systems and methods
US20060079895A1 (en) 2004-09-30 2006-04-13 Mcleer Thomas J Methods and devices for improved bonding of devices to bone
US20060085075A1 (en) 2004-10-04 2006-04-20 Archus Orthopedics, Inc. Polymeric joint complex and methods of use
US20060079903A1 (en) 2004-10-08 2006-04-13 Wong David A Minimally invasive pedicle screw and guide support
US20060085076A1 (en) * 2004-10-15 2006-04-20 Manoj Krishna Posterior spinal arthroplasty-development of a new posteriorly inserted artificial disc and an artificial facet joint
US7452369B2 (en) * 2004-10-18 2008-11-18 Barry Richard J Spine microsurgery techniques, training aids and implants
US8162985B2 (en) 2004-10-20 2012-04-24 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for posterior dynamic stabilization of the spine
US20060265074A1 (en) 2004-10-21 2006-11-23 Manoj Krishna Posterior spinal arthroplasty-development of a new posteriorly inserted artificial disc, a new anteriorly inserted artifical disc and an artificial facet joint
US20070016297A1 (en) * 2004-11-18 2007-01-18 University Of South Florida Prostheses for Spine Facets
US20060111779A1 (en) 2004-11-22 2006-05-25 Orthopedic Development Corporation, A Florida Corporation Minimally invasive facet joint fusion
US20060111780A1 (en) 2004-11-22 2006-05-25 Orthopedic Development Corporation Minimally invasive facet joint hemi-arthroplasty
US8029540B2 (en) 2005-05-10 2011-10-04 Kyphon Sarl Inter-cervical facet implant with implantation tool
US8100944B2 (en) 2004-12-13 2012-01-24 Kyphon Sarl Inter-cervical facet implant and method for preserving the tissues surrounding the facet joint
US8172877B2 (en) 2004-12-13 2012-05-08 Kyphon Sarl Inter-cervical facet implant with surface enhancements
US20070016218A1 (en) * 2005-05-10 2007-01-18 Winslow Charles J Inter-cervical facet implant with implantation tool
US8118838B2 (en) 2004-12-13 2012-02-21 Kyphon Sarl Inter-cervical facet implant with multiple direction articulation joint and method for implanting
US8128660B2 (en) 2004-12-13 2012-03-06 Kyphon Sarl Inter-cervical facet joint implant with locking screw system
US7655044B2 (en) 2004-12-13 2010-02-02 Depuy Spine, Inc. Artificial facet joint device having a compression spring
US7776090B2 (en) 2004-12-13 2010-08-17 Warsaw Orthopedic, Inc. Inter-cervical facet implant and method
US7491238B2 (en) 2004-12-23 2009-02-17 Impliant Ltd. Adjustable spinal prosthesis
US7361196B2 (en) 2005-02-22 2008-04-22 Stryker Spine Apparatus and method for dynamic vertebral stabilization
US7594924B2 (en) 2005-03-03 2009-09-29 Accelerated Innovation, Llc Spinal stabilization using bone anchor seat and cross coupling with improved locking feature
WO2006096273A2 (en) 2005-03-03 2006-09-14 Accelerated Innovation, Llc Methods and apparatus for providing a retainer for a bone stabilization device
US8167913B2 (en) 2005-03-03 2012-05-01 Altus Partners, Llc Spinal stabilization using bone anchor and anchor seat with tangential locking feature
US20060212033A1 (en) 2005-03-03 2006-09-21 Accin Corporation Vertebral stabilization using flexible rods
US7556639B2 (en) 2005-03-03 2009-07-07 Accelerated Innovation, Llc Methods and apparatus for vertebral stabilization using sleeved springs
US7578847B2 (en) 2005-03-03 2009-08-25 Cervical Xpand, Llc Posterior lumbar intervertebral stabilizer
US8496691B2 (en) 2005-03-17 2013-07-30 Spinal Elements, Inc. Side-biased orthopedic fastener retention
US8496686B2 (en) 2005-03-22 2013-07-30 Gmedelaware 2 Llc Minimally invasive spine restoration systems, devices, methods and kits
US7338491B2 (en) 2005-03-22 2008-03-04 Spinefrontier Inc Spinal fixation locking mechanism
JP2008534063A (en) 2005-03-22 2008-08-28 アーカス・オーソペディクス・インコーポレーテッド Minimally invasive spinal recovery system, apparatus, method and kit
US7753957B2 (en) 2005-03-24 2010-07-13 Accelerated Innovation, Llc Ball and Socket intervertebral disc replacement device with keyed surfaces assembly
WO2006102268A2 (en) 2005-03-24 2006-09-28 Accelerated Innovation, Llc Method and apparatus for bone stabilization
RU2400186C2 (en) 2005-04-11 2010-09-27 Имплиант Лтд. Introduction of anterior and posterior spinal prostheses
US20060241758A1 (en) 2005-04-20 2006-10-26 Sdgi Holdings, Inc. Facet spacers
US7361192B2 (en) 2005-04-22 2008-04-22 Doty Keith L Spinal disc prosthesis and methods of use
US20060247769A1 (en) 2005-04-28 2006-11-02 Sdgi Holdings, Inc. Polycrystalline diamond compact surfaces on facet arthroplasty devices
US7811310B2 (en) 2005-05-04 2010-10-12 Spinefrontier, Inc Multistage spinal fixation locking mechanism
US7862589B2 (en) 2005-05-24 2011-01-04 Lanx, Inc. Facet replacement
US20060276787A1 (en) 2005-05-26 2006-12-07 Accin Corporation Pedicle screw, cervical screw and rod
US8777959B2 (en) 2005-05-27 2014-07-15 Spinecore, Inc. Intervertebral disc and insertion methods therefor
US20060276790A1 (en) 2005-06-02 2006-12-07 Zimmer Spine, Inc. Minimally invasive facet joint repair
US20060282080A1 (en) 2005-06-08 2006-12-14 Accin Corporation Vertebral facet stabilizer
US20070035795A1 (en) * 2005-08-04 2007-02-15 Hubbard Jason R Artificial facet joint and a method of making same
US7731753B2 (en) 2005-09-01 2010-06-08 Spinal Kinetics, Inc. Prosthetic intervertebral discs
US20070050032A1 (en) 2005-09-01 2007-03-01 Spinal Kinetics, Inc. Prosthetic intervertebral discs
US7799057B2 (en) 2005-09-02 2010-09-21 Zimmer Spine, Inc. Translaminar facet augmentation and flexible spinal stabilization
US20070055373A1 (en) 2005-09-08 2007-03-08 Zimmer Spine, Inc. Facet replacement/spacing and flexible spinal stabilization
US20070073290A1 (en) 2005-09-13 2007-03-29 Boehm Frank H Jr Insertion of artificial/prosthetic facet joints with ballotable/compressible joint space component
US8163024B2 (en) 2005-09-14 2012-04-24 Premia Spine Ltd. Adjustable spinal prostheses
US8486145B2 (en) 2005-09-19 2013-07-16 Premia Spine Ltd. Flexure limiter for spinal prosthesis
US20080183209A1 (en) 2005-09-23 2008-07-31 Spinal Kinetics, Inc. Spinal Stabilization Device
US20070083200A1 (en) 2005-09-23 2007-04-12 Gittings Darin C Spinal stabilization systems and methods
US8343165B2 (en) 2005-09-26 2013-01-01 Pioneer Surgical Technology, Inc. Apparatus and method for implantation of surgical devices
US7604652B2 (en) 2005-10-11 2009-10-20 Impliant Ltd. Spinal prosthesis
US20070093897A1 (en) 2005-10-21 2007-04-26 Stryker Spine (In France) System and method for fusion cage implantation
US7722651B2 (en) 2005-10-21 2010-05-25 Depuy Spine, Inc. Adjustable bone screw assembly
US7717919B2 (en) 2005-11-04 2010-05-18 Trans1 Inc. Application of therapy aligned to an internal target path
USD524443S1 (en) 2005-11-04 2006-07-04 Quantum Orthopedics, Inc. Interbody fusion device
USD533277S1 (en) 2005-11-04 2006-12-05 Quantum Orthopedics, Inc. Interbody fusion device
US7744630B2 (en) 2005-11-15 2010-06-29 Zimmer Spine, Inc. Facet repair and stabilization
EP2520255B1 (en) 2005-11-21 2016-06-15 Vertegen, Inc. Methods for treating facet joints, uncovertebral joints, costovertebral joints and other joints
US20070118218A1 (en) 2005-11-22 2007-05-24 Hooper David M Facet joint implant and procedure
WO2007067547A2 (en) 2005-12-06 2007-06-14 Globus Medical, Inc. Facet joint prosthesis
FR2894129B1 (en) 2005-12-07 2008-08-22 Alain Tornier DEVICE FOR STABILIZING THE RACHIS
US20070135814A1 (en) 2005-12-12 2007-06-14 Sdgi Holdings, Inc. Facet spacer
DE202005019487U1 (en) 2005-12-13 2007-04-26 Deru Gmbh Facet joint prosthesis
US7695514B2 (en) 2005-12-29 2010-04-13 Depuy Spine, Inc. Facet joint and spinal ligament replacement
US7662183B2 (en) 2006-01-24 2010-02-16 Timothy Haines Dynamic spinal implants incorporating cartilage bearing graft material
US20070179617A1 (en) 2006-01-25 2007-08-02 Spinemedica Corporation Prosthetic wide range motion facets and methods of fabricating same
US7635389B2 (en) 2006-01-30 2009-12-22 Warsaw Orthopedic, Inc. Posterior joint replacement device
US7811326B2 (en) 2006-01-30 2010-10-12 Warsaw Orthopedic Inc. Posterior joint replacement device
US7520888B2 (en) 2006-02-14 2009-04-21 Warsaw Orthopedic, Inc. Treatment of the vertebral column
US20070227547A1 (en) 2006-02-14 2007-10-04 Sdgi Holdings, Inc. Treatment of the vertebral column
US20070213717A1 (en) 2006-02-14 2007-09-13 Sdgi Holdings, Inc. Biological fusion in the vertebral column
US8088148B2 (en) 2006-02-24 2012-01-03 Medical Design, LLC Dynamic/static facet fixation device and method
US7927358B2 (en) 2006-03-07 2011-04-19 Zimmer Spine, Inc. Spinal stabilization device
US8118869B2 (en) 2006-03-08 2012-02-21 Flexuspine, Inc. Dynamic interbody device
WO2007106573A2 (en) 2006-03-15 2007-09-20 Archus Orthopedics, Inc. Facet and disc arthroplasty systems and methods
US20070233262A1 (en) 2006-03-31 2007-10-04 Uri Arnin Articulating spinal prosthesis
WO2007113807A2 (en) 2006-04-05 2007-10-11 Impliant Ltd. Fixation of spinal prosthesis
EP2001372A1 (en) 2006-04-05 2008-12-17 Impliant Ltd. Spinal reamer with cutter elements on track
WO2007121320A2 (en) 2006-04-12 2007-10-25 Spinalmotion, Inc. Posterior spinal device and method
US20070270959A1 (en) 2006-04-18 2007-11-22 Sdgi Holdings, Inc. Arthroplasty device
US20070270952A1 (en) 2006-04-19 2007-11-22 Spinal Kinetics, Inc. Prosthetic intervertebral discs implantable by minimally invasive surgical techniques
US8246684B2 (en) 2006-04-20 2012-08-21 RE-Spine LLC. Intervertebral disc and facet joint prosthesis
US20070250166A1 (en) 2006-04-25 2007-10-25 Sdgi Holdings, Inc. Facet fusion implants and methods of use
US20070270962A1 (en) 2006-04-26 2007-11-22 Impliant Ltd. Tools for spinal prostheses
US20070288009A1 (en) 2006-06-08 2007-12-13 Steven Brown Dynamic spinal stabilization device
US8858600B2 (en) 2006-06-08 2014-10-14 Spinadyne, Inc. Dynamic spinal stabilization device
US7905906B2 (en) 2006-06-08 2011-03-15 Disc Motion Technologies, Inc. System and method for lumbar arthroplasty
US20080027543A1 (en) * 2006-06-28 2008-01-31 Sdgi Holdings, Inc. Prosthesis and method for replacing degenerative vertebral portions
US20080021457A1 (en) * 2006-07-05 2008-01-24 Warsaw Orthopedic Inc. Zygapophysial joint repair system
US8016886B2 (en) 2006-07-18 2011-09-13 Altus Partners, Llc Intervertebral disc replacement device
US8702755B2 (en) 2006-08-11 2014-04-22 Gmedelaware 2 Llc Angled washer polyaxial connection for dynamic spine prosthesis
US20080058954A1 (en) 2006-08-22 2008-03-06 Hai Trieu Methods of treating spinal injuries using injectable flowable compositions comprising organic materials
US20080119845A1 (en) 2006-09-25 2008-05-22 Archus Orthopedics, Inc. Facet replacement device removal and revision systems and methods
US9278007B2 (en) 2006-09-26 2016-03-08 Spinal Kinetics, Inc. Prosthetic intervertebral discs having cast end plates and methods for making and using them
US8403987B2 (en) 2006-09-27 2013-03-26 Spinal Kinetics Inc. Prosthetic intervertebral discs having compressible core elements bounded by fiber-containing membranes
US20080077137A1 (en) 2006-09-27 2008-03-27 Balderston Richard A Posterior stabilization for fixed center of rotation anterior prosthesis of the intervertebral disc
US20080161810A1 (en) 2006-10-18 2008-07-03 Warsaw Orthopedic, Inc. Guide and Cutter for Contouring Facet Joints and Methods of Use
US20080103512A1 (en) 2006-10-23 2008-05-01 G&L Consulting, Llc Clamping system and method for fusing vertebral elements in a spine
US20080177333A1 (en) 2006-10-24 2008-07-24 Warsaw Orthopedic, Inc. Adjustable jacking implant
US20080177311A1 (en) 2006-10-30 2008-07-24 St. Francis Medical Technologies, Inc. Facet joint implant sizing tool
US7828824B2 (en) 2006-12-15 2010-11-09 Depuy Spine, Inc. Facet joint prosthesis
US20080161929A1 (en) 2006-12-29 2008-07-03 Mccormack Bruce Cervical distraction device
US20080161833A1 (en) 2007-01-02 2008-07-03 Ray Charles D Joint prosthesis
AU2008204784A1 (en) 2007-01-10 2008-07-17 Facet Solutions, Inc. Taper-locking fixation system
CA2825442C (en) 2007-02-09 2016-07-05 Diamicron, Inc. Multi-lobe artificial spine joint
US20080200918A1 (en) 2007-02-12 2008-08-21 James Spitler Pedicle screw driver
US8308801B2 (en) 2007-02-12 2012-11-13 Brigham Young University Spinal implant
US7887592B2 (en) 2007-02-14 2011-02-15 Spinal Kinetics, Inc. Prosthetic intervertebral discs assemblies having compressible core elements with enhanced torque transmission
EP2129304B1 (en) 2007-02-22 2014-09-03 Spinal Elements, Inc. Vertebral articular process drill
WO2008143874A1 (en) 2007-05-16 2008-11-27 Stryker Spine Speed multiply screwdriver handle
USD574495S1 (en) 2007-12-03 2008-08-05 Orthopedic Development Corporation Drill guide
USD574957S1 (en) 2008-01-07 2008-08-12 Orthopedic Development Corporation Bone plug
US9619417B2 (en) 2011-06-17 2017-04-11 Alcatel Lucent Method and apparatus for remote delivery of managed USB services via a mobile computing device

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020123806A1 (en) * 1999-10-22 2002-09-05 Total Facet Technologies, Inc. Facet arthroplasty devices and methods

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20110054537A1 (en) * 2009-08-28 2011-03-03 Zimmer Spine Austin, Inc. Fusion method and pedicle access tool
US8814914B2 (en) * 2009-08-28 2014-08-26 Zimmer Spine, Inc. Fusion method and pedicle access tool

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