Facet arthroplasty devices 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 . (Copied from claim 1 of U.S. Pat. No. 7,090,698) A method for replacing a spine joint, comprising the steps of: replacing an intervertebral disc adjacent to a vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; resecting at least a portion of a bone of a facet of the vertebra; attaching a prosthetic facet to the remaining bone of the vertebra such that no portion of the prosthetic facet contacts a posterior arch of the vertebra; wherein said prosthetic facet is adapted to articulate with another facet; with the artificial disc and the prosthetic facet cooperating so as to restore the natural biomechanics of a spinal motion segment comprising the vertebra, the prosthetic facet, and the artificial disc.  
     
     
         2 . (Copied from claim 2 of U.S. Pat. No. 7,090,698) A method for replacing a spine joint, comprising the steps of: replacing an intervertebral disc between a first vertebra and a second vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; resecting at least a portion of a bone of a first facet on the first vertebra; attaching a first prosthetic facet to the remaining bone of the first vertebra such that no portion of the prosthetic facet contacts a posterior arch of the first vertebra; resecting at least a portion of the bone of a second facet on the second vertebra; and attaching a second prosthetic facet to the remaining bone of the second vertebra such that no portion of the prosthetic facet contacts the posterior arch of the vertebra; wherein the first prosthetic facet is adapted to articulate with the second prosthetic facet; with the artificial disc and the prosthetic facet cooperating so as to restore the natural biomechanics of a spinal motion segment comprising the first vertebra, the second vertebra, the artificial disc, the first prosthetic facet, and the second prosthetic facet.  
     
     
         3 . (Copied from claim 3 of U.S. Pat. No. 7,090,698) A method for replacing a spine joint, comprising the steps of: replacing an intervertebral disc adjacent to a vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; resecting a pair of facets on the vertebra; and attaching a prosthesis to the vertebra so that a pair of bearing surfaces on the prosthesis are positioned in place of the resected facets, wherein the prosthesis is configured so that no portion of the prosthesis is supported by the lamina of the vertebra; with the artificial disc and the prosthesis cooperating so as to restore natural biomechanics of a spinal motion segment comprising the vertebra, the artificial disc, and the prosthesis.  
     
     
         4 . (Copied from claim 4 of U.S. Pat. No. 7,090,698) A method for replacing a mammalian spine joint, comprising the steps of: replacing an intervertebral disc between a superior vertebra and an inferior vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; resecting at least a bony portion of the inferior facets of the superior vertebra; attaching a first prosthesis that replaces the inferior facets of the superior vertebra; resecting at least a bony portion of the superior facets of the inferior vertebra; and attaching a second prosthesis that replaces the superior facets of the inferior vertebra; wherein no portion of the first prosthesis is supported by the lamina of the superior vertebra, and further wherein no portion of the second prosthesis is supported by the lamina of the inferior vertebra; with the artificial disc and the first prosthesis and the second prosthesis cooperating so as to restore the natural biomechanics of a spinal motion segment comprising the superior vertebra, the inferior vertebra, the artificial disc, the first prosthesis, and the second prosthesis.  
     
     
         5 . (Copied from claim 5 of U.S. Pat. No. 7,090,698) A method for replacing a mammalian spine joint, comprising the steps of: replacing an intervertebral disc adjacent to an intermediate vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; resecting at least a bony portion of the inferior facets of a most superior vertebra; attaching a first prosthesis that replaces the inferior facets of the most superior vertebra; resecting at least a bony portion of the superior facets of a most inferior vertebra; attaching a second prosthesis that replaces the superior facets of the most inferior vertebra; resecting at least a bony portion of all of the facets of at least one intermediate vertebra located between the most superior vertebra and the most inferior vertebra; wherein, for each of the at least one intermediate vertebra, a prosthesis is attached to replace all facets of the intermediate vertebra; with the artificial disc and the prostheses cooperating so as to restore the natural biomechanics of a spinal motion segment comprising the intermediate vertebra, the artificial disc, and the prosthesis attached to replace all facets of the intermediate vertebra.  
     
     
         6 . (Copied from claim 6 of U.S. Pat. No. 7,090,698) A method for replacing a spine joint, wherein the natural vertebra comprises a natural vertebral body, a pair of natural pedicles extending from the natural vertebral body, a natural lamina extending from the two natural pedicles, a pair of natural superior facets extending from the two natural pedicles and the natural lamina, a pair of natural inferior facets extending from the natural lamina, a natural spinous process extending from the natural lamina, and a pair of natural transverse processes extending from the two natural pedicles, said method comprising the steps of: replacing an intervertebral disc adjacent to the natural vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; making a resection at the most dorsal aspect of the two natural pedicles; and attaching a prosthesis to the resected vertebra, the prosthesis comprising two prosthetic mounts, a prosthetic lamina extending from the two prosthetic mounts, a pair of prosthetic superior facets extending from said two prosthetic mounts and the prosthetic lamina, and a pair of prosthetic inferior facets extending from the prosthetic lamina; with the artificial disc and the prosthesis cooperating so as to restore the natural biomechanics of a spinal motion segment comprising the natural vertebra, the artificial disc, and the prosthesis.  
     
     
         7 . (Copied from claim 7 of U.S. Pat. No. 7,090,698) A method according to  claim 6  wherein the prosthesis further comprises a prosthetic spinous process extending from the prosthetic lamina.  
     
     
         8 . (Copied from claim 8 of U.S. Pat. No. 7,090,698) A method according to  claim 6  wherein the prosthesis further comprises a pair of prosthetic transverse processes extending from the two prosthetic mounts.  
     
     
         9 . (Copied from claim 9 of U.S. Pat. No. 7,090,698) A method according to  claim 6  wherein the prosthesis further comprises a prosthetic spinous process extending from the prosthetic lamina and a pair of prosthetic transverse processes extending from the two prosthetic mounts and the prosthetic lamina.  
     
     
         10 . (Copied from claim 10 of U.S. Pat. No. 7,090,698) A method for replacing a spine joint, wherein the natural vertebra comprises a natural vertebral body, a pair of natural pedicles extending from the natural vertebral body, a natural lamina extending from the two natural pedicles, a pair of natural superior facets extending from the two natural pedicles and the natural lamina, a pair of natural inferior facets extending from the natural lamina, a natural spinous process extending from the natural lamina, and a pair of natural transverse processes extending from the natural pedicles, said method comprising the steps of: replacing an intervertebral disc adjacent to the natural vertebra with an artificial disc comprising opposing end plates and articulating structure therebetween; making a resection at the junction of the natural vertebral body and the two natural pedicles; and attaching a prosthesis to the resected vertebra, the prosthesis comprising two prosthetic pedicles, a prosthetic lamina extending from the prosthetic pedicles, a pair of prosthetic superior facets extending from the two prosthetic pedicles and the prosthetic lamina, and a pair of prosthetic inferior facets extending from the prosthetic lamina; with the artificial disc and the prosthesis cooperating so as to restore the natural biomechanics of a spinal motion segment comprising the natural vertebra, the artificial disc, and the prosthesis.  
     
     
         11 . (Copied from claim 11 of U.S. Pat. No. 7,090,698) A method according to  claim 10  wherein the prosthesis further comprises a prosthetic spinous process extending from the prosthetic lamina.  
     
     
         12 . (Copied from claim 12 of U.S. Pat. No. 7,090,698) A method according to  claim 10  wherein the prosthesis further comprises a pair of prosthetic transverse processes extending from the two prosthetic pedicles.  
     
     
         13 . (Copied from claim 13 of U.S. Pat. No. 7,090,698) A method according to  claim 10  wherein the prosthesis further comprises a prosthetic spinous process extending from the prosthetic lamina and two prosthetic transverse processes extending from the two prosthetic pedicles and the prosthetic lamina.