Method and apparatus for spinal facet joint fusion using irregularly shaped cortical bone implants

Abstract

A method and apparatus for spinal fusion at the facet joint using an irregularly shaped implant where the orientation of the implant can be preselected before implantation.

1 . A method of mounting an implant in a facet joint C1-C2 through L5-S1, the method comprising the steps of:
 (a) cutting an arthroscopic type portal in the tissue of a patient outside a diseased or damaged facet joint;   (b) using a positioning selection tool to select an orientation of a plug to be implanted, the selected orientation including a plurality of prongs defining an orientation of the plug to be implanted;   (c) placing an implantation guide in operative connection with the positioning selection tool;   (d) while maintaining at least two distinct prongs of the selected orientation removing the positioning selection tool from operative connection with the implantation guide;   (e) placing a cutting tool in operative connection with the implantation guide, and using operative connection between the cutting tool and implantation guide to form a shaped hole between two opposed bones forming the facet joint, the shaped hole having at least the two distinct prongs of orientation specified in step “d”; and   (f) inserting a preshaped plug into the hole, the plug having a shape substantially the same as the hole.   
     
     
         2 . The method of  claim 1 , wherein in step “f” the plug comprises:
 (i) a substantially solid body having a longitudinal axis; 
 (ii) a plurality ofopposed arms, the arms being symmetrically disposed around the longitudinal axis; and 
 (iii) the body being formed from a material selected from the group consisting of synthetic cortical bone, a harvested synthetic cortical and compacted iliac crest graft and a cadaveric allograft. 
 
     
     
         3 . The method of  claim 2 , wherein there are four arms. 
     
     
         4 . The method of  claim 3 , wherein the four arms form an “X”. 
     
     
         5 . The method of  claim 2 , wherein the arms include tips which are rounded. 
     
     
         6 . The method of  claim 5 , wherein between each pair of arms is a valley which valley is rounded. 
     
     
         7 . The method of  claim 2  wherein the body is formed from synthetic cortical bone. 
     
     
         8 . The method of  claim 2  wherein the body is formed from a harvested and compacted iliac crest graft. 
     
     
         9 . The method of  claim 2  wherein the body is formed from a cadaveric allograft.