Multiple facet joint replacement
View Patent ↗A prosthesis for the replacement of multiple diseased or traumatized spinal facets comprises a portion that replaces at least a bony portion of the facets to be replaced and where the prosthesis attaches to the vertebra in a manner that does not require attachment to, or abutment against, the lamina. Multiple configurations of the prosthesis provide for replacement of the two inferior facets, the two superior facets, a superior and inferior facet, or all four facets. A method of installing the prosthesis is provided that is comprised of the steps of resecting at least a portion of the facets that carry the diseased or traumatized spinal facets and attaching the prosthesis in a manner that does not require attachment or abutment against the lamina.
1. A surgical method comprising:
resecting at least a portion of a left inferior facet;
resecting at least a portion of a right inferior facet;
inserting a left inferior facet prosthetic component into the resected left inferior facet via a fastener;
inserting a right inferior facet prosthetic component into the resected right inferior facet via a fastener, wherein the left inferior facet prosthetic component and the right inferior prosthetic component are connected via a bridge having first and second parallel flanges extending posteriorly from the bridge, wherein the bridge is configured to extend along a natural spinous process formed between the left inferior facet and the right inferior facet without removing or attaching to the natural spinous process, the bridge having a curvature that matches a corresponding lamina and does not contact the lamina, and wherein the first flange extends along a first side of the spinous process and the second flange extends along an opposite side of the spinous process;
resecting at least a portion of a left superior facet;
resecting at least a portion of a right superior facet;
inserting a left superior facet prosthetic component into the resected left superior facet via a fastener; and
inserting a right superior facet prosthetic component into the resected right superior facet via a fastener.
2. The surgical method of claim 1 , wherein the bridge is curved.
3. The surgical method of claim 1 , wherein the left inferior facet prosthetic component does not contact a lamina.
4. The surgical method of claim 1 , wherein the right inferior facet prosthetic component does not contact a lamina.
5. The surgical method of claim 1 , wherein the left inferior facet prosthetic component and the right inferior prosthetic component are part of a single body.
6. The surgical method of claim 1 , wherein left superior facet prosthetic component and the right superior facet prosthetic component are part of a single body.
7. The surgical method of claim 6 , wherein the single body comprises a pair of flanges.
8. The surgical method of claim 7 , wherein each of the flanges abuts against a pedicle of a vertebra.
9. A surgical method comprising:
resecting at least a portion of a left inferior facet;
resecting at least a portion of a right inferior facet;
inserting a left inferior facet prosthetic component into the resected left inferior facet via a fastener; and
inserting a right inferior facet prosthetic component into the resected right inferior facet via a fastener, wherein the left inferior facet prosthetic component and the right inferior prosthetic component are connected via a bridge having first and second parallel flanges extending posteriorly from the bridge, wherein the bridge is configured to extend along a natural spinous process formed between the left inferior facet and the right inferior facet without removing or attaching to the natural spinous process, the bridge having a curvature that matches a corresponding lamina and does not contact the lamina, and wherein the first flange extends along a first side of the spinous process and the second flange extends along an opposite side of the spinous process.
10. The surgical method of claim 9 , wherein the left inferior facet prosthetic component and the right inferior prosthetic component are part of a single body.
11. The surgical method of claim 9 , wherein the bridge is curved.
12. The surgical method of claim 9 , wherein neither the left inferior facet prosthetic component nor the right inferior facet prosthetic component contacts a lamina.
13. The surgical method of claim 9 , wherein the bridge does not contact any portion of a vertebra.
14. A surgical method comprising:
resecting at least a portion of a left superior facet;
resecting at least a portion of a right superior facet;
inserting a left superior facet prosthetic component into the resected left superior facet via a fastener; and
inserting a right superior facet prosthetic component into the resected right superior facet via a fastener, wherein the left superior facet prosthetic component and the right superior prosthetic component are connected via a bridge having first and second parallel flanges extending posteriorly from the bridge, wherein the bridge is configured to extend along a natural spinous process formed between the left superior facet and the right superior facet without removing or attaching to the natural spinous process, the bridge having a curvature that matches a corresponding lamina and does not contact the lamina, and wherein the first flange extends along a first side of the spinous process and the second flange extends along an opposite side of the spinous process.
15. The surgical method of claim 14 , wherein the left superior facet prosthetic component and the right superior prosthetic component are part of a single body.
16. The surgical method of claim 14 , wherein the bridge is curved.
17. The surgical method of claim 14 , wherein the left superior facet prosthetic component and the right superior facet prosthetic component are connected to a pedicle.
18. The surgical method of claim 14 , wherein the bridge does not contact any portion of a vertebra.