Methods, systems, and apparatuses for spinal fusion
A method for implanting an intrafacet implant includes making an incision, advancing an instrument assembly through the incision and to a facet joint. The instrument assembly includes a guide having a lumen extending therethrough. The method includes anchoring the guide at the facet joint, advancing an intrafacet implant to the facet joint through the guide using an inserter, and countersinking the intrafacet implant within the facet joint using the inserter.
1 . A method for implanting an intrafacet implant, comprising:
making an incision;
advancing an instrument assembly through the incision and to a facet joint using an intrafacet approach, the instrument assembly comprising a guide having a lumen extending therethrough;
anchoring the guide at the facet joint;
advancing a cutting tool through the guide to the facet joint through an entry point between a first articular process and a second articular process and forming a pilot hole using the cutting tool, wherein the pilot hole is formed partially within the first articular process and partially within the second articular process, wherein the cutting tool comprises a distal section of the cutting tool configured to form a distal section of the pilot hole partially within the first articular process and partially within the second articular process and a proximal section of the cutting tool configured to form a proximal section of the pilot hole partially within the first articular process and partially within the second articular process such that a cross-sectional area of the proximal section of the pilot hole is larger than a cross-sectional area of the distal section of the pilot hole;
advancing the intrafacet implant to the facet joint through the guide using an inserter; and
driving the intrafacet implant into the pilot hole.
2 . The method of claim 1 , wherein the proximal section of the cutting tool comprises a plurality of saw teeth, and the distal section of the cutting tool comprises a flute drill bit section or twist drill bit section.
3 . The method of claim 1 , wherein the proximal section of the cutting tool comprises a tapered blade, and the distal section of the cutting tool comprises a flute drill bit section or twist drill bit section.
4 . The method of claim 1 , wherein the inserter comprises a distal tip configured to couple with the intrafacet implant and a split extending proximally through the distal tip from a distal end of the inserter to a relief.
5 . The method of claim 1 , wherein the instrument assembly comprises a stylet comprising a distal tip, wherein the stylet is positioned within the guide of the instrument assembly while advancing the instrument assembly through the incision and to the facet joint, the method further comprises penetrating tissue with the distal tip of the stylet.
6 . The method of claim 5 , further comprising removing the stylet prior to advancing the intrafacet implant to the facet joint.
7 . The method of claim 1 , wherein anchoring the guide at the facet joint comprises anchoring a plurality of prongs of the guide at the facet joint.
8 . The method of claim 1 , further comprising rasping the facet joint using a rasp after driving the intrafacet implant into the pilot hole.
9 . The method of claim 1 , wherein the intrafacet implant comprises a body extending from a proximal end to a distal end of the intrafacet implant and a plurality of threads extending from the body from the proximal end to the distal end.
10 . The method of claim 9 , wherein the body of the intrafacet implant comprises a uniform cross-sectional area.
11 . The method of claim 1 , further comprising advancing a rasp to the facet joint and decorticating bone of the facet joint with the rasp, wherein a rasping surface of the rasp is wider than a width of the cutting tool.
12 . The method of claim 11 , wherein the rasping surface is a first rasping surface, the rasp comprising a second rasping surface positioned on an opposite side of the first rasping surface.
13 . The method of claim 1 , wherein driving the intrafacet implant into the pilot hole comprises countersinking the intrafacet implant within the facet joint.
14 . The method of claim 1 , further comprising delivering bone graft material into the facet joint to cover a proximal end of the intrafacet implant.
15 . The method of claim 1 , further comprising delivering bone graft material into an interior of the intrafacet implant after driving the intrafacet implant into the pilot hole.
16 . A method for implanting an intrafacet implant, comprising:
making an incision;
advancing an instrument assembly through the incision and to a facet joint, the instrument assembly comprising a guide having a lumen extending therethrough;
anchoring the guide at the facet joint;
advancing a rasp to the facet joint and decorticating bone of the facet joint with the rasp;
advancing a drill bit to the facet joint and forming a pilot hole for the intrafacet implant after decorticating bone of the facet joint with the rasp;
advancing the intrafacet implant to the facet joint through the guide using an inserter; and
countersinking the intrafacet implant within the facet joint using the inserter;
wherein a rasping surface of the rasp is wider than a width of the drill bit.
17 . The method of claim 16 , wherein the rasping surface is a first rasping surface, the rasp comprising a second rasping surface positioned on an opposite side of the first rasping surface.
18 . The method of claim 16 , wherein the inserter comprises a distal tip configured to couple with the intrafacet implant and a split extending proximally through the distal tip from a distal end of the inserter to a relief.
19 . The method of claim 16 , wherein anchoring the guide at the facet joint comprises anchoring a plurality of prongs of the guide at the facet joint.
20 . The method of claim 16 , wherein the rasp comprises a first rasp, the method further comprising rasping the facet joint using a second rasp after countersinking the intrafacet implant within the facet joint.