Facet arthroplasty device and methods

Abstract

Devices and surgical methods treat various types of adult spinal pathologies, such as degenerative spondylolisthesis, spinal stenosis, degenerative lumbar scoliosis, and kypho-scoliosis. Various types of spinal joint replacement prostheses, surgical procedures for performing spinal joint replacements, and surgical instruments are used to perform the surgical procedures.

1 - 31 . (canceled)  
     
     
         32 . A prosthesis for the replacement of at least a portion of the bone of a facet located on a mammalian vertebra, comprising: 
 a surface that articulates with another facet;    a bone contacting surface that contacts one of an exterior surface or a resected surface of said vertebra, said surface that articulates being connected to said bone contacting surface;    a fixation element that attaches said bone contacting surface to said vertebra, said fixation element being adapted for implantation into an interior bone space of a pedicle of said vertebra; and    wherein said prosthesis is configured so that no portion of said prosthesis contacts the lamina of said vertebra.    
     
     
         33 . The device of  claim 32  wherein said fixation element is a screw.  
     
     
         34 . The device of  claim 32  wherein said surface that articulates is connected to said bone contacting surface that contacts one of said exterior surface or said resected surface of said vertebra, wherein said bone contacting surface is porous coated to allow for bone ingrowth.  
     
     
         35 . A prosthesis for the replacement of at least a portion of the bones of opposed and articulating facets located on a mammalian vertebra, comprising: 
 an inferior component adapted to be attached to a first vertebra; and    a superior component adapted to be attached to a second vertebra;    where the first vertebra is adjacent and superior to the second vertebra; and where one of said inferior and superior components includes:    a flange that connects to one of an exterior surface or a resected surface of said vertebra; and    a fixation element that attaches said flange to said vertebra, said fixation element being adapted for implantation into an interior bone space of a pedicle of said vertebra; and    further wherein said prosthesis is configured so that no portion of said prosthesis contacts the lamina of said vertebra.    
     
     
         36 . A prosthesis according to  claim 35  wherein said fixation element is a screw.  
     
     
         37 . A method for replacing a facet of a mammalian vertebra, comprising the steps of: 
 resecting at least a portion of the bone of said facet;    attaching a prosthetic facet to the remaining bone of said vertebra with a fixation element implanted into an interior bone space of a pedicle of said vertebra such that no portion of the prosthetic facet contacts the lamina of said vertebra;    where said prosthetic facet is adapted to articulate with another facet.    
     
     
         38 . A prosthesis according to  claim 37  wherein said fixation element is a screw.  
     
     
         39 . A method for replacing a facet joint of a mammalian spine, comprising the steps of: 
 resecting at least a portion of the bone of a first facet on a first vertebra;    attaching a first prosthetic facet to the remaining bone of said first vertebra with a first fixation element implanted into an interior bone space of a pedicle of said first vertebra such that no portion of said prosthetic facet contacts the lamina of said vertebra;    resecting at least a portion of the bone of a second facet on a second vertebra; and    attaching a second prosthetic facet to the remaining bone of said second vertebra with a second fixation element implanted into an interior bone space of a pedicle of said second vertebra such that no portion of said prosthetic facet contacts the lamina of said vertebra;    where said first prosthetic facet is adapted to articulate with said second prosthetic facet.    
     
     
         40 . A prosthesis according to  claim 39  wherein at least one of said first fixation element and said second fixation element is a screw.  
     
     
         41 . A prosthesis according to  claim 39  wherein said first fixation element and said second fixation element are both screws.  
     
     
         42 . A prosthesis for the replacement of at least a portion of the bone of a facet located on a mammalian vertebra, comprising: 
 a surface that articulates with another facet;    a bone contacting surface that contacts one of an exterior surface or a resected surface of said vertebra, said surface that articulates being connected to said bone contacting surface;    a fixation element that attaches said bone contacting surface to said vertebra; and    wherein said prosthesis is configured so that no portion of said prosthesis contacts the lamina of said vertebra.    
     
     
         43 . The device of  claim 42  wherein said fixation element is a screw.  
     
     
         44 . The device of  claim 42  wherein said flange has a bone side adapted to contact one of said exterior surface or said resected surface of said vertebra, wherein said bone side is porous coated to allow for bone ingrowth.  
     
     
         45 . The device of  claim 42  wherein said surface that articulates is comprised of one of a group consisting of a polymeric bearing material attached to a metal substrate, a ceramic bearing material, and a metal bearing material.  
     
     
         46 . A prosthesis for the replacement of at least a portion of the bones of opposed and articulating facets located on a mammalian vertebra, where said facets are diseased or traumatized, comprising: 
 an inferior component adapted to be attached to a first vertebra and having a first fixation portion adapted to a first articulation portion connected to said first fixation portion;    a superior component adapted to be attached to a second vertebra and having a second fixation portion adapted to be implanted into a second interior bone space and second articulation portion connected to said second fixation portion;    where the first vertebra is adjacent and superior to the second vertebra.    
     
     
         47 . A prosthesis for the replacement of at least a portion of the bones of opposed and articulating facets located on a mammalian vertebra, comprising: 
 an inferior component adapted to be attached to a first vertebra; and    a superior component adapted to be attached to a second vertebra;    where the first vertebra is adjacent and superior to the second vertebra; and    where one of said inferior and superior components includes:    a flange that connects to one of an exterior surface or a resected surface of said vertebra; and    a fixation element that attaches said flange to said vertebra; and    further wherein of said prosthesis is configured so that no portion of said prosthesis contacts the lamina of said vertebra.    
     
     
         48 . A method for replacing a facet of a mammalian vertebra, comprising the steps of: 
 resecting at least a portion of the bone of said facet;    attaching a prosthetic facet to the remaining bone of said vertebra such that no portion of the prosthetic facet contacts the lamina of said vertebra;    where said prosthetic facet is adapted to articulate with another facet.    
     
     
         49 . A method for replacing a facet joint of a mammalian spine, comprising the steps of: 
 resecting at least a portion of the bone of a first facet on a first vertebra;    attaching a first prosthetic facet to the remaining bone of said first vertebra such that no portion of said prosthetic facet contacts the lamina of said vertebra;    resecting at least a portion of the bone of a second facet on a second vertebra; and    attaching a second prosthetic facet to the remaining bone of said second vertebra such that no portion of said prosthetic facet contacts the lamina of said vertebra;    where said first prosthetic facet is adapted to articulate with said second prosthetic facet.