Devices, systems and methods to alter spinal alignment

Abstract

Disclosed are systems, devices, methods and surgical procedures for altering and/or correcting the alignment of adjacent bones, including bones of the spine.

What is claimed is: 
     
         1 . A surgical method for altering an alignment between an upper vertebra and an adjacent lower vertebra of a diseased or damaged spine, comprising:
 removing at least a portion of an intervertebral disc from between the upper vertebra and the adjacent lower vertebra to create a disc space, wherein an upper endplate of the adjacent lower vertebra has an upper surface;   removing a first wedge of bony material from a medial portion of the upper endplate to create a medial modified vertebral surface having a first osteotomy angle;   removing at least a portion of a medial pedicle of the adjacent lower vertebra to create a medial resected pedicle surface which extends along the medial pedicle;   removing a second wedge of bony material from a lateral portion of the upper endplate to create a lateral modified vertebral surface having a second osteotomy angle, the first osteotomy angle being different than the second osteotomy angle; and   inserting a first lower portion of a first arthroplasty device at least partially into the disc space, the first lower portion of the first arthroplasty device including a first upward facing articulation surface, a first lower surface adapted to engage with the medial modified vertebral surface and a first bridge portion adapted to engage with the medial resected pedicle surface.   
     
     
         2 . The surgical method of  claim 2 , wherein at least a portion of one of the medial and lateral modified vertebral surfaces comprises a cancellous bone interior surface of the adjacent lower vertebra. 
     
     
         3 . The surgical method of  claim 1 , wherein the medial modified vertebral surface is coplanar with the medial resected pedicle surface. 
     
     
         4 . The surgical method of  claim 1 , further comprising:
 inserting a first upper portion of the first arthroplasty device at least partially into the disc space, the first upper portion of the first arthroplasty device including a first downwardly facing articulation surface which articulates with the first upward facing articulation surface of the first lower portion to allow the upper vertebra and adjacent lower vertebra to articulate relative to each other, the first upper portion further including a first upper surface adapted to engage with the upper vertebra.   
     
     
         5 . The surgical method of  claim 4 , wherein the first lower portion and first upper portion of the first arthroplasty device are inserted into the disc space concurrently. 
     
     
         6 . The surgical method of  claim 4 , further comprising:
 inserting a second lower portion of a second arthroplasty device at least partially into the disc space, the second lower portion of the second arthroplasty device including a second upward facing articulation surface, a second lower surface adapted to engage with the lateral modified vertebral surface and a second bridge portion adapted to engage with a lateral resected pedicle surface.   
     
     
         7 . The surgical method of  claim 6 , further comprising
 inserting a second upper portion of the second arthroplasty device at least partially into the disc space, the second upper portion of the second arthroplasty device including a second downwardly facing articulation surface which articulates with the second upward facing articulation surface of the second lower portion to allow the upper vertebra and adjacent lower vertebra to articulate relative to each other, the second upper portion further including a second upper surface adapted to engage with the upper vertebra.   
     
     
         8 . The surgical method of  claim 7 , wherein the first arthroplasty device has a first height and the second arthroplasty device has a second height and the first height equals the second height. 
     
     
         9 . The surgical method of  claim 1 , further comprising attaching the first lower portion of the first arthroplasty device to the adjacent lower vertebra with a first bone fastener. The surgical method of  claim 9 , wherein the first bone fastener passes through a cortical bone wall of the medial pedicle. 
     
     
         11 . The surgical method of  claim 9 , wherein the first bone fastener extends through the resected pedicle surface bone fastener passes through the medial resected pedicle surface. 
     
     
         12 . The surgical method of  claim 9 , further comprising attaching the second lower portion of the second arthroplasty device to the adjacent lower vertebra with a second bone fastener. 
     
     
         13 . The surgical method of  claim 9 , wherein the first arthroplasty device is positioned at a first toe-in angle relative to the adjacent lower vertebra and the second arthroplasty device is positioned at a second toe-in angle relative to the adjacent lower vertebra, and the first and second toe-in angles are the same angle. 
     
     
         14 . The surgical method of  claim 9 , wherein the first arthroplasty device is positioned at a first toe-in angle relative to the adjacent lower vertebra and the second arthroplasty device is positioned at a second toe-in angle relative to the adjacent lower vertebra, and the first and second toe-in angles are different angles. 
     
     
         15 . The surgical method of  claim 7 , wherein the first and second arthroplasty devices are spaced apart from each other within the disc space. 
     
     
         16 . A surgical method for altering a kinematic motion of a spine, comprising:
 removing at least a portion of an intervertebral disc from between an upper vertebra and an adjacent lower vertebra of the spine to create a disc space having an endplate of the adjacent lower vertebra positioned at a lower portion thereof;   removing a first endplate portion from a medial half of the endplate and at least a portion of a medial pedicle to create a medial modified support surface at a first osteotomy angle;   removing a second endplate portion from a lateral half of the endplate and at least a portion of a lateral pedicle to create a to create a lateral modified support surface at a second osteotomy angle;   inserting a first arthroplasty device at least partially into the disc space, the first arthroplasty device having a first upper surface for engaging with an endplate of the upper vertebrae and a first lower surface adapted to engage the medial modified support surface;   inserting a second arthroplasty device at least partially into the disc space, the second arthroplasty device having a second upper surface for engaging with an endplate of the upper vertebrae and a second lower surface adapted to engage the lateral modified support surface, the first and second arthroplasty devices being of a similar shape and size;   wherein the first osteotomy angle is different from the second osteotomy angle.   
     
     
         17 . The surgical method of  claim 16 , wherein at least a portion of one of the medial and lateral modified support surfaces comprises a cancellous bone surface of the adjacent lower vertebra. 
     
     
         18 . The surgical method of  claim 17 , wherein the first and second arthroplasty devices are spaced apart from each other within the disc space. 
     
     
         19 . The surgical method of  claim 17 , wherein the step of removing a first endplate portion from a medial half of the endplate and at least a portion of a medial pedicle to create a medial modified support surface at a first osteotomy angle are performed concurrently. 
     
     
         20 . The surgical method of  claim 16 , wherein the first arthroplasty device has a first height and the second arthroplasty device has a second height and the first height equals the second height.