PERCUTANEOUS FACET FIXATION SYSTEM
Percutaneous facet fixation implants. In some embodiments, the implant may comprise fasteners and/or fastener portions configured to be coupled on opposite sides of a facet joint such that a portion of one fastener is configured to be positioned adjacent to one of a superior articular process and an inferior articular process of a facet joint and a portion of another fastener is configured to be positioned adjacent to one of the other of an inferior articular process and a superior articular process of the facet joint so as to engage a surface of the respective articular process. In some embodiments, one or both of the fasteners may be configured to couple with an arm of a facet gun instrument.
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This application is a continuation of U.S. patent application Ser. No. 12/550,017 titled “PERCUTANEOUS FACET FIXATION SYSTEM” filed on Aug. 28, 2009, which application is a continuation of U.S. Pat. No. 7,608,094 issued on Oct. 27, 2009 and also titled “PERCUTANEOUS FACET FIXATION SYSTEM,” which claims priority from U.S. Provisional Patent Application Ser. No. 60/417,543, filed Oct. 10, 2002. Each of the foregoing applications is hereby incorporated herein by reference in its entirety.
FIELD OF THE INVENTIONThis invention relates generally to spine surgery and, in particular, to a percutaneous facet fixation system.
BACKGROUND OF THE INVENTIONFor patients with a high degree of spinal instability (e.g. fractures), or in revision surgery, a combination anterior/posterior fusion is indicated at one or more levels. Fusing both the front and back provides a high degree of stability for the spine and a large surface area for the bone fusion to occur. The disc may be approached either as an anterior lumbar interbody fusion (ALIF), or as a posterior lumbar interbody fusion (PLIF). Both procedures are well known to those of skill in the art.
To further stabilize vertebral segments, posterior instrumentation is often performed in conjunction with an interbody fusion. The most commonly used posterior instrumentation system in use today is pedicle screw fixation. The major disadvantage to this technique is the necessity of major muscle dissection, which can lead to morbidity and scarring.
Facet screw fixation offers the advantage of placing a single screw across each articulating facet joint to immobilize a motion segment, thereby reducing the amount of hardware (and therefore exposure) necessary. Existing techniques, however, still demand relatively open procedures, such that the need remains for a facet fixation system compatible with minimally invasive surgical (MIS) procedures.
SUMMARY OF THE INVENTIONThe present invention is a percutaneous system of facet fixation that is minimally invasive, reproducible, efficient, and effective. Capable of immediate stabilization of a facet joint complex, the instrumentation and methods may be used with C-arm and/or endoscopic visualization.
Reference is now made to the drawings, wherein
A 1.0-inch incision 101 (or thereabouts) is made in midline over the proximal spinous process 104. (For L4-L5 fixation, the incision made over L4 spinous process.) As shown in
Referring to
The upper arm of facet gun is disengaged in
Claims
1. An implant for fusing a facet joint, comprising:
- a first fastener portion; and
- a second fastener portion configured to be connected with the first fastener portion on opposite sides of a facet joint such that a portion of the first fastener portion is configured to be positioned adjacent to one of a superior articular process and an inferior articular process of the facet joint and a portion of the second fastener portion is configured to be positioned adjacent to one of the other of an inferior articular process and a superior articular process of the facet joint so as to engage a surface of the respective articular process, and wherein a surface of at least one of the first and second fastener portions, in an unassembled configuration, is contoured to match a surface of one of the inferior articular process and the superior articular process.
2. The implant of claim 1, wherein the first fastener portion comprises a head.
3. The implant of claim 2, wherein the first fastener portion further comprises a first washer, wherein the head of the first fastener portion is configured to be received in the first washer in an assembled configuration, and wherein a bottom surface of the first washer, in an unassembled configuration, is contoured to match a surface of one of the inferior articular process and the superior articular process.
4. The implant of claim 3, wherein the first washer comprises an unthreaded washer.
5. The implant of claim 3, wherein the first washer comprises a plurality of fixation spikes.
6. The implant of claim 1, wherein the first fastener portion comprises a facet bolt.
7. The implant of claim 6, wherein the second fastener portion comprises a deep locking nut.
8. The implant of claim 1, further comprising a facet bolt.
9. The implant of claim 8, wherein the facet bolt is configured to couple the first fastener portion with the second fastener portion.
10. The implant of claim 1, wherein the second fastener portion comprises a plurality of bone fixation spikes.
11. The implant of claim 1, wherein a surface of each of the first and second fastener portions, in an unassembled configuration, is contoured to match a surface of one of the inferior articular process and the superior articular process.
12. An implant for fusing a facet joint, comprising:
- a first fastener configured to be coupled with a first arm of a facet gun;
- a second fastener configured to be coupled with a second arm of the facet gun; and
- a facet bolt configured to couple with the first and second fasteners, wherein the facet bolt is configured to receive a guidewire therethrough, and wherein the facet bolt is further configured to couple the first and second fasteners on opposite sides of a facet joint such that the first fastener is configured to be positioned adjacent to one of a superior articular process and an inferior articular process of a facet joint and the second fastener is configured to be positioned adjacent to one of the other of an inferior articular process and a superior articular process of the facet joint so as to engage a surface of the respective articular process.
13. The implant of claim 12, wherein the facet bolt comprises a head and a shaft.
14. The implant of claim 12, wherein the first and second fasteners each comprise at least one of a nut and a washer.
15. The implant of claim 12, wherein at least one of the first and second fasteners comprises an integral portion of the facet bolt.
16. The implant of claim 12, wherein a surface of at least one of the first and second fasteners, in an unassembled configuration, is contoured to match a surface of one of the inferior articular process and the superior articular process
17. The implant of claim 16, wherein a surface of each of the first and second fasteners, in an unassembled configuration, is contoured to match a surface of one of the inferior articular process and the superior articular process.
18. The implant of claim 12, further comprising a first washer configured to engage a surface of one of the inferior articular process and the superior articular process on a first surface of the first washer, wherein the first washer is configured to engage at least one of the first and second fasteners on a second surface of the first washer opposite from the first surface.
19. The implant of claim 12, wherein at least one of the first and second fasteners is at least substantially wedge-shaped.
20. The implant of claim 12, wherein both of the first and second fasteners are at least substantially wedge-shaped.
Type: Application
Filed: Nov 4, 2013
Publication Date: Mar 6, 2014
Applicant: US Spine, Inc. (Salt Lake City, UT)
Inventor: Mark H. Falahee (Ann Arbor, MI)
Application Number: 14/071,522