Method for resurfacing a lumbar articular facet

Abstract

Methods for treating spinal pathologies, and more specifically methods for treating articulating surfaces of facet joints. The methods involve providing artificial articulating surfaces for facet joint articular facets. In addition, various types of rasps may be used to prepare the articulating surfaces prior to placement of the artificial articulating surfaces.

1 . A method for providing articulating surfaces for facet joint articular facets comprising:
 placing the inferior implant on the inferior articular facet such that the articulating surface of the inferior implant is positioned on the articulating surface of the inferior articular facet;   securing the inferior implant to the inferior articular facet and to bone on the side of the spinous process of the vertebra opposite the inferior implant via a lamina adjacent to the inferior articular facet; and   placing the superior implant on the superior articular facet such that the articulating surface of the superior implant is positioned on the articulating surface of the superior articular facet.   
     
     
         2 . The method of  claim 1  wherein the articulating surface of the inferior implant and the articulating surface of the superior implant are positioned to articulate with one another. 
     
     
         3 . The method of  claim 1  further comprising performing each of the steps of  claim 1  on a contralateral side of the facet joint. 
     
     
         4 . The method of  claim 1  further comprising creating a space between an inferior articular facet and a superior articular facet. 
     
     
         5 . The method of  claim 1  wherein the created space is sufficient for using at least one of the inferior facet rasp or the superior facet rasp on the articulating surface of an articular facet. 
     
     
         6 . The method of  claim 1  wherein at least one rasp is used to prepare the articulating surface of at least one of the inferior articular facet or the superior articular facet. 
     
     
         7 . The method of  claim 6  wherein preparing the articulating surfaces of the inferior and superior articular facets creates a bleeding bone bed to facilitate bone ingrowth at the articulating surfaces of the inferior and superior articular facets. 
     
     
         8 . The method of  claim 6  wherein at least one rasp is configured to cut when moving in a first direction, but not when moving in a direction opposite of the first direction. 
     
     
         9 . The method of  claim 1  wherein the inferior implant is secured to the inferior articular facet with a translaminar fixation mechanism. 
     
     
         10 . The method of  claim 1  further comprising using an aiming device to position the translaminar fixation mechanism. 
     
     
         11 . The method of  claim 10  further comprising drilling a translaminar hole for the translaminar fixation mechanism. 
     
     
         12 . A method for providing articulating surfaces for facet joint articular facets comprising:
 placing an inferior implant on an articulating surface of an inferior articular facet;   securing the inferior implant to the inferior articular facet with a fixation mechanism that passes through a lamina on a vertabra that comprises the inferior articular facet; and   placing an superior implant on an articulating surface of a superior articular facet such that an articulating surface of the superior implant is capable of articulating with an articulating surface of the inferior implant.   
     
     
         13 . The method of  claim 12  wherein securing the inferior implant to the inferior articular facet with a translaminar fixation mechanism comprises using an aiming device to position the translaminar fixation mechanism. 
     
     
         14 . The method of  claim 12  further comprising drilling a translaminar hole through which the fixation mechanism is passed. 
     
     
         15 . The method of  claim 12  wherein the articulating surface of the inferior implant and the articulating surface of the superior implant are positioned to articulate with one another. 
     
     
         16 . The method of  claim 12  further comprising performing each of the steps of  claim 16  on a contralateral side of the facet joint. 
     
     
         17 . The method of  claim 12  further comprising creating a space between the inferior articular facet and the superior articular facet prior to placement of the inferior implant and the superior implant. 
     
     
         18 . The method of  claim 12  further comprising using at least one rasp to prepare at least one of the articulating surfaces of the superior articular facet or the inferior articular facet prior to the placement of the inferior implant or the superior implant. 
     
     
         19 . The method of  claim 18  wherein multiple rasps of increasing thickness are used to prepare at least one of the articulating surfaces of the superior articular facet or the inferior articular facet prior to the placement of the inferior implant or the superior implant. 
     
     
         20 . The method of  claim 18  wherein the at least one rasp is configured to cut when moving in a first direction, but not when moving in a direction opposite of the first direction.