Percutaneous facet fixation system
View Patent ↗A percutaneous facet fixation system 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.
1. A method of fusing a facet joint, comprising the steps of:
providing a deep locking nut and a physically separate facet bolt;
positioning the deep locking nut so as to abut the lateral surface of a superior facet forming part of a facet joint;
driving the facet bolt through the facet joint and the deep locking nut, thereby compressing the facet joint.
2. The method of claim 1 , further including the step of:
providing instrumentation configured to hold the deep locking nut in position while driving the facet bolt; and
disengaging and removing the instrumentation once the facet joint is compressed.
3. The method of claim 2 , wherein the deep locking nut is wedge-shaped.
4. The method of claim 2 , wherein the instrumentation including a pair of elongate members, one with a bent distal end to hold the deep locking nut.
5. The method of claim 2 , further including the step of making a midline incision over the proximal spinous process to access the facet joint with the instrumentation.
6. The method of claim 1 , wherein the deep locking nut includes a plurality of fixation spikes.
7. The method of claim 1 , further including the steps of:
providing an unthreaded washer for contacting an inferior facet; and
driving the facet bolt through the washer before the facet bolt engages with the deep locking nut.
8. The method of claim 7 , wherein the washer includes a plurality of fixation spikes.
9. The method of claim 7 , wherein the washer is wedge-shaped.
10. The method of claim 1 , further including the step of compressing the facet joint prior to the step of driving the facet bolt.
11. The method of claim 1 , wherein the step of providing a facet bolt includes the provision of a self-drilling facet bolt.
12. The method of claim 1 , further including the step of locking the facet bolt and the deep locking nut.
13. A method of fusing a facet joint, comprising the steps of:
providing a deep locking nut and a physically separate facet bolt;
providing instrumentation including a bent distal end to hold the deep locking nut and drive the facet bolt through facet joint and the deep locking nut;
positioning the bent distal end of the instrumentation behind the facet joint such that the deep locking nut abuts the lateral surface of a superior facet forming the facet joint;
operating the instrumentation to drive the facet bolt through the facet joint until the bolt locks with the deep locking nut;
disengaging the holder on the bent distal end of the instrumentation from the deep locking nut; and
removing the instrumentation.
14. The method of claim 13 , wherein the deep locking nut includes a plurality of fixation spikes.
15. The method of claim 13 , wherein the deep locking nut is wedge-shaped.
16. The method of claim 13 , further including the steps of:
providing an unthreaded washer for contacting an inferior facet; and
driving the facet bolt through the washer before the facet bolt engages with the deep locking nut.
17. The method of claim 16 , wherein the washer includes a plurality of fixation spikes.
18. The method of claim 16 , wherein the washer is wedge-shaped.
19. The method of claim 13 , wherein the instrumentation includes a user control operative to compress the facet joint prior to driving the facet bolt.
20. The method of claim 13 , further including the step of locking the facet bolt and the deep locking nut.
21. A method of fusing a facet joint, comprising the steps of:
providing a deep locking nut, a facet bolt, and an unthreaded washer;
providing instrumentation including a bent distal end with a holder for the deep locking nut, a handle for compressing a facet joint, and a tool for driving the facet bolt through the washer and into deep locking nut;
positioning the bent distal end of the instrumentation such that the deep locking nut abuts the lateral surface of a superior facet forming the facet joint;
positioning the washer so as to contact an inferior facet forming the facet joint;
operating the handle so as to compress the washer and deep locking nut, thereby compressing the facet joint;
operating the tool to drive the facet bolt through the washer and facet joint until locking with the deep locking nut; and
disengaging the holder on the bent distal end of the instrumentation from the deep locking nut and removing the instrumentation.
22. The method of claim 21 , wherein the deep locking nut includes a plurality of fixation spikes.
23. The method of claim 21 , wherein the deep locking nut is wedge-shaped.
24. The method of claim 21 , wherein the washer includes a plurality of fixation spikes.
25. The method of claim 21 , wherein the washer is wedge-shaped.