The following detailed description relates to a device for distracting the spine. More particularly the description relates to a tool for distracting a facet joint of the spine and an implant for maintaining the distracted position of the joint. More particularly the description relates to an implant that may be used together with a tool to distract a facet joint, the implant remaining in place separated from the tool. In some instances, the implant itself may extract the joint.
Chronic back problems cause pain and disability for a large segment of the population. Adverse spinal conditions may be characteristic of age. In particular, spinal stenosis (including, but not limited to, central, canal, and lateral stenosis) and facet arthropathy may increase with age. Spinal stenosis results in a reduction of foraminal area (i.e. the available space for the passage of nerves and blood vessels), which may compress cervical nerve roots and cause radicular pain. Both neck extension and ipsilateral rotation, in contrast to neck flexion, may further reduce the foraminal area and contribute to pain, nerve root compression, and neural injury.
Cervical disc herniations may be a factor in spinal stenosis and may predominantly present upper extremity radicular symptoms. In this case, treatment may take the form of closed traction. A number of closed traction devices are available that alleviate pain by pulling on the head to increase foraminal height. Cervical disc herniations may also be treated with anterior and posterior surgery. Many of these surgeries are performed through an anterior approach, which requires a spinal fusion. These surgeries may be expensive and beget additional surgeries due to changing the biomechanics of the neck. There is a three percent incidence of re-operation after cervical spine surgery. Moreover, these surgeries may be highly invasive leading to long recovery times.
There is a need in the art for a device and procedure to increase foraminal height to reduce radicular symptoms of patients suffering the effects of spinal stenosis. There is also a need for the device to be adapted to allow for the procedure to be minimally invasive and to avoid modifying the biomechanics of the spine.
In one embodiment, a spinal joint distraction system may include a driver assembly including a tubular shaft having a longitudinal axis and a pair of implant holder arms positioned on a distal end of the tubular shaft, where the arms are configured to hold a spinal implant. In another embodiment, the driver assembly may also include an implant distractor positioned along the longitudinal axis near the distal end of the tubular shaft, an internal actuator positioned within the tubular shaft and adapted to advance the implant distractor, and a distractor knob adapted to control the internal actuator. In another embodiment, the system may also include a delivery device with a tubular shaft, a receiving assembly positioned on a proximal end of the tubular shaft, and a pair of forks extending from a distal end of the tubular shaft, where the may be adapted to penetrate a facet joint and the delivery device may be adapted to slidably receive the driver assembly. In some embodiments, the system may include an implant adapted for holding by the implant holding arms of the driver assembly. In some other embodiments, the system may include a chisel with a shaft portion, a tip at a distal end of the shaft, and a head at a proximal end of the shaft, where the delivery device is adapted to receive the chisel, and the head of the chisel is adapted to be tapped by a driving member to insert the tip of the chisel into a facet joint. In still other embodiments, the system may include an injector with a cannula with a closed distal end and two exit doors positioned on opposite sides of the distal end, a plunger with a seal positioned within the cannula, a stop disc at a proximal end of the cannula, and a handle positioned on a proximal end of the plunger, where the delivery device is further adapted to receive an injector.
In another embodiment, a spinal distraction implant may include an upper member and a lower member, the upper and lower member being generally rectangular and each having a distal edge, a proximal edge, and two parallel lateral edges, the upper and lower member positioned adjacent and substantially parallel to each other and having an inner surface and an outer surface, the distal edges of the upper and lower member connected to each other and the proximal edges adapted to receive an implant distractor, and teeth positioned along the lateral edges of at least one of the upper or lower member and extending outwardly. In another embodiment, the implant may include flanges extending substantially orthogonally from a proximal end of the upper and lower members. In some embodiments, the flanges may include openings for receiving anchors to anchor the implant to a lateral mass of a facet joint.
In another embodiment, a method of distracting a facet joint of the spine may include inserting a delivery device to access the facet joint of a patient, inserting a driver assembly holding an implant into the delivery device, and actuating the driver assembly thereby distracting the implant.
In another embodiment, a spinal distraction implant may include an upper member, a lower member, and a proximal member, the upper and lower members being generally rectangular and each having a distal edge and two parallel lateral edges, the upper and lower members extending generally continuously into each other to form the proximal member, the upper and lower member positioned adjacent and substantially parallel to each other and having an inner surface and an outer surface, the proximal member being generally perpendicular relative to the upper and lower members, at least one of the upper and lower members further including threaded slots adapted to receive threads of an implant distractor and outwardly extending teeth positioned along the lateral edges of at least one of the upper or lower members. In another embodiment, the proximal member may include a penetration for receiving an implant distractor.
In another embodiment, a spinal distraction implant may include a threaded bolt with a proximal end terminating in a head, a proximal non-threaded block positioned along the bolt and abutting the head of the bolt, a distal threaded block positioned a distance away from the proximal threaded block, and a plurality of expansion members positioned between the proximal and the distal threaded blocks. In one embodiment, the plurality of expansion members may be V-shaped members. In another embodiment, the plurality of V-shaped members may be adapted to deformably flatten out and expand laterally when compressed between the distal and proximal blocks. In another embodiment, the plurality of expansion members may be planar plates with slotted holes such that when freely positioned on the bolt, the plates are positioned in a skewed position relative to a longitudinal axis of the bolt. In another embodiment, the planar plates may be adapted to engage one another and thus position themselves perpendicular to the bolt when compressed between the distal and proximal blocks.
In another embodiment, a spinal distraction implant may include a pair of stacked structures separated by a sloping plane, the structures having an engagement surface along the plane including ratchet teeth. In one embodiment, a first structure of the pair of stacked structures increases in thickness in a proximal direction and a second structure of the pair of stacked structures increases in thickness in a distal direction.
In another embodiment, a spinal distraction implant may include a generally tapered shaft in the form of a screw, the shaft defining a longitudinal axis and having a length, the shaft having threads along an outer surface for engaging articular surfaces of a facet joint. In one embodiment, the threads may be notched along the length of the implant creating serrations for cutting into the articular surfaces of a facet joint. In another embodiment, the threads may include leaf springs for preventing backing out of the implant. In another embodiment, the threads may have a T-shaped cross-section. In another embodiment, the implant may include a relatively broad head with a decorticating feature on a distal surface thereof. In another embodiment, the decorticating feature may include tabs projecting distally from the head. In another embodiment, the decorticating feature may include spurs. In another embodiment, the head may be in the form of a floating collar and be free to pivot about the longitudinal axis of the implant in a ball and socket type fashion. In another embodiment, the implant may include a torque limiting mechanism. In another embodiment, the shaft may include a hollow cavity and take the form of a cone, the cone being made from a relatively malleable material, the implant further including an inner core support member for use when inserting the implant and for removal once the implant is in place. In still another embodiment, the generally tapered shaft may be a first tapered shaft and the implant may also include a second generally tapered shaft in the form of a screw where the second generally tapered shaft may be positioned adjacent to the first generally tapered shaft and have communicative threaded serrations such that when one shaft is rotated, the other shaft rotates in the opposite direction. In another embodiment, the implant may include an arm type locking mechanism, the arm being biased in a distal direction such that when implanted the arm provides a biasing force to maintain friction on the threads. In another embodiment, the arm may have engaging teeth. In another embodiment, the implant may include flaps extending from the head of the shaft and including teeth for engaging a lateral mass of a facet joint.
In another embodiment, a spinal distraction implant may include a plate and a orthogonally positioned bumper, the superior aspect of the bumper having a rounded surface for opposing the lateral mass of a superior vertebra, the implant including an anchoring screw for securing the implant to a lateral mass of a facet joint.
In another embodiment, a spinal distraction implant may include a wedge insertable between facet surfaces, the wedge having teeth on at least one of an anterior and inferior surface thereof. In another embodiment, the implant may also include a diagonally placed anchor screw positioned through the implant for advancing into the surface of a facet joint.
In another embodiment, a spinal distraction implant may include an anterior hook, a posterior hook, and a bolt joining the anterior and posterior hook. In another embodiment, the anterior hook may be C-shaped with a lip and the posterior hook may be S-shaped with a lip, the anterior hook adapted to engage the anterior aspect of the inferior facet and the posterior hook adapted to engage the posterior aspect of the posterior facet.
In another embodiment, a spinal distraction implant may include an insert and tabs positioned to extend orthogonally from a proximal end of the insert. In one embodiment, the insert may be rectangular and the tabs may have holes for receiving an anchor.
In another embodiment, a spinal distraction implant may include a collapsible diamond shaped structure including two opposing threaded corners, and two opposing non-threaded corners including pads. The implant may also include a bolt threaded through the threaded corners of the diamond shaped structure, where actuating the bolt draws the threaded corners together and extends the non-threaded corners.
In another embodiment, a spinal distraction implant may include an upper member, a lower member, a hinge connecting the upper member to the lower member, and a brace member for maintaining the implant in an open position.
In another embodiment, a spinal distraction implant may include a generally cylindrically shaped member including at least two sections separated by a slot, the sections connected together at distal ends to form a tip, the member adapted to receive a screw to cause it to expand, and the outer surface of the sections including teeth for engaging articular surfaces of a facet joint.
In another embodiment, a method of securing a superior verterbra may include applying a force to the superior vertebra to increase the foraminal area between the superior vertebra and an inferior vertebra and placing an angled screw through a superior facet, through a facet capsule, and into an inferior facet.
In another embodiment, a spinal distraction implant may include a collapsible triangular shaped implant including a central shaft and at least two springing leaves connected to the distal end of the shaft, extending proximally along the shaft, and biased in a direction to form an arrow shape, where the implant may be collapsed within a tube and delivered to a site where the tube is removed and the implant is allowed to expand.
In another embodiment, a spinal distraction implant may include a facet spacer plate and screw, wherein the screw may be inserted diagonally through a facet surface to engage the facet spacer plate thereby forcing separation of a facet joint. In another embodiment, the spacer may have a C-shape and the screw may pass through the spacer plate prior to entering the spinal structure.
In another embodiment, a spinal distraction implant may include a first bracket, second bracket, and a bolt extending between the brackets, where the brackets are adapted to separate when the bolt is turned. In another embodiment, the first and second brackets may be adapted to be attached to a lateral mass of a facet joint. In yet another embodiment, the first and second brackets may include a leg adapted to be inserted into a facet joint.
In another embodiment, a spinal distraction implant may include a triangular shaped wedge, an anchor screw positioned diagonally through the wedge, and a malleable flap extending from the wedge including teeth for engaging a lateral mass of a facet joint.
In another embodiment, a spinal distraction implant may include an anchoring plug, an expandable plate, and two external plates, where securing the external plates to a lateral mass of a facet joint and inserting the anchoring plug causes the facet joint to separate.
In another embodiment, a spinal distraction implant may include a delivery system and at least two nitinol hooks, where the hooks may be flattened and inserted with the delivery system and once in place may be allowed to assume their pre-flattened shape.
In another embodiment, a spinal distraction implant may include a hollow screw sleeve having barbs adapted to be ejected from a retracted position and a wedge adapted to be inserted in the hollow screw sleeve to eject the barbs.
In another embodiment, a spinal distraction implant may include a collapsible nut positioned over a bolt, the bolt defining a longitudinal axis, where advancing the bolt may cause the nut to collapse along the longitudinal axis in an accordion shape, thereby expanding laterally.
In another embodiment, a spinal distraction implant may include a collapsible plate positioned over a bolt, the bolt defining a longitudinal axis, where advancing the bolt causes the plate to collapse along the longitudinal axis in an accordion shape, thereby expanding laterally.
In another embodiment, a spinal distraction implant may include a wire surrounding a block in a helical fashion, the wire adapted to contract and expand laterally when pulled taught or released respectively.
In another embodiment, a spinal distraction implant may include an outer housing and an internal spring, where the housing may be biased to be in a laterally broad position when the spring is in a neutral position.
In another embodiment, a spinal distraction implant may include a pair of stacked structures separated by a sloping plane and a fastener positioned at an angle through the pair of structures thereby preventing relative movement along the plane.
In another embodiment, a spinal distraction implant may include a collapsible cylinder with side cutouts, the cylinder made from a resilient elastic material.
In another embodiment, a spinal distraction implant may include a distal tip of a delivery tool, where the tip is adapted to distract a facet joint and detach from the delivery tool.
In another embodiment, a spinal distraction implant may include a housing, a central gear rotatably positioned within the housing, and two plates slidably positioned in the housing and positioned opposite one another adjacent to the central gear and including teeth for engaging the gear, where rotating the gear slidably extends the plates beyond an outer surface of the housing in opposite directions.
In another embodiment, a spinal distraction implant may include a triangularly bent plate with a first and second bracket on each side, the first bracket adapted to receive an anchor screw and the second bracket including teeth for biting into a lateral mass of a facet joint.
In another embodiment, a spinal distraction implant may include a rotatable cone with a longitudinal axis including a shoulder with a ledge defining a cam surface and an anchor screw, where the shoulder is adapted to be inserted into a facet joint and the implant rotated to cause a superior facet to ride upward along the cam surface and distract the joint, wherein the screw may be advanced to secure the implant.
In another embodiment, a spinal distraction implant may include a housing with penetrations for ejection of spikes, internal spikes positioned with the housing and in alignment with the penetrations, and an internal wire routed through the spike positions, where pulling the wire taught forces the spikes from the housing to engage articular surfaces of a facet joint.
In another embodiment, a spinal distraction implant may include a housing, a cavity within the housing, penetrations on lateral surfaces of the housing extending from the cavity through the wall of the housing, spikes positioned to be ejected through the penetrations, the spikes having a beveled inner surface, and a piston having a torpedo shaped distal end positioned within the cavity, where advancing the piston engages the torpedo shaped distal end with the beveled inner surface of the spikes causing them to eject through the penetrations and engage articular surfaces of a facet joint.
In another embodiment, a spinal distraction implant may include two parallel equal length side bars and at least two struts pivotably positioned between the side bars at each end, the struts having textured surfaces on each end thereof, where the struts may be pivoted to lie in plane with and parallel to the side bars and once in position in a facet joint, may be pivoted substantially perpendicular to the side bars to distract the facet joint.
Further aspects of the invention will be brought out in the following portions of the specification, wherein the detailed description is for the purpose of fully disclosing preferred embodiments of the invention without placing limitations thereon.
The invention will be more fully understood by reference to the following drawings which are for illustrative purposes only:
The following description generally relates to devices and methods for treating spinal stenosis. Spinal stenosis reflects a narrowing of one or more areas of the spine often in the upper or lower back. This narrowing can put pressure on the spinal cord or on the nerves that branch out from the compressed areas. Individual vertebrae of the spine are positioned relative to each other and their separation is maintained by discs separating main vertebral bodies and by capsules positioned within facet joints. The discs and capsules are separated from the bone of their respective joints by cartilage. Spinal stenosis is often indicative of degeneration of a disc, a capsule, or the cartilage in a joint, which leads to a compression of the joints and the narrowing mentioned.
As such, the following detailed description includes discussion of a device for distracting a facet joint of the spine to remedy this condition. The device may include a tool and an implant for distracting and maintaining the distracted position of the joint. Several embodiments of an implant are described in addition to several embodiments of a tool. In addition, several embodiments are described where the implant and the tool work together to distract the facet joint and thereafter leave the implant behind to maintain the distraction of the joint. In short, the device may be adapted to access a facet joint by inserting a delivery tool and an implant, forcibly separate the associated articular surfaces with the tool, the implant, or both, and leave the implant in place to maintain the separation of the articular surfaces. This approach may allow for maintaining the distraction of the joint, thereby relieving symptoms associated with spinal stenosis.
The present application hereby incorporates the following U.S. patent applications by reference herein in their entireties: U.S. patent application Ser. No. 11/618,619, which was filed on Dec. 29, 2006 and is entitled Cervical Distraction Device; U.S. Provisional Patent Application No. 61/020,082, which was filed on Jan. 9, 2008 and is entitled Methods and Apparatus for Accessing and Treating the Facet Joint; U.S. Provisional Application No. 61/059,723, which was filed on Jun. 6, 2008 and is entitled Spine Distraction Device; U.S. Provisional Application No. 61/097,103, which was filed on Sep. 15, 2008 and is entitled Cervical Distraction/Implant Delivery Device; and U.S. Provisional Application No. 61/109,776, which was filed on Oct. 30, 2008 and is entitled Facet Joint Implants.
Referring now to
The delivery device 104 may include a receiving assembly 110 at a proximal end, anchoring forks 112 at a distal end, and a generally tubular shaft 114 defining a longitudinal axis and extending between the receiving assembly 110 and the anchoring forks 112. The tubular shaft 114 may have an annular shaped cross-section with an inner radius and an outer radius, where the difference between the two radii defines a thickness of the tubular shaft 114.
The receiving assembly 110 of the delivery device 104 may have a generally conical outer surface defining a generally hollow volume or solid mass. The conical outer surface may have a longitudinal axis that coincides with that of the tubular shaft 114. The conical outer surface may be defined by a first radius at a proximal end and a second radius at a distal end. Where the tubular shaft 114 and the receiving assembly 110 are manufactured as one piece, the second radius may match the outer radius of the tubular shaft. Alternatively, the distal end of the receiving assembly 110 may be adapted for a press fit over the proximal end of the tubular shaft 114. The receiving assembly 110 may also include a longitudinally extending bore 116 having an inner radius matching that of the tubular shaft 114 or may have a conically shaped inner surface leading to the tubular shaft 114. The receiving assembly 110 may also include a relatively thin annular ring 118 offset from its distal end by two relatively thin extension elements 120. The space between the proximal end of the conical portion of the receiving assembly 110 and the distal end of the annular ring 118 may define an access opening 122.
In another embodiment as shown in
As shown in more detail in
Referring again to
In another embodiment, the chisel 108 may include a longitudinal lumen 131 as shown in
As shown in
Referring again to
In still another embodiment, a decorticator 106 may take the form of a relatively sharp pick, as shown in
Referring now to
Referring now to
Referring now to
With continued reference to
Referring now to
The implant distractor 150 is shown in
Referring again to
In one embodiment, when the driver assembly 142 is inserted, it may carry the internal actuator 152, the implant distractor 150, as well as the implant 154 with it. However, to properly position the driver assembly 142 and the implant 154, some force may be required via a mallet or other member driving member. In this embodiment, the internal actuator 152 may be slightly isolated from the driver assembly 142, so as to avoid advancing the internal actuator 152, and thus the implant distractor 150, when forcing the driver assembly 142 into the joint. This isolation may help to avoid inadvertently advancing the internal actuator 152 and the implant distractor 150, thus avoiding inadvertent distraction prior to proper placement. The isolation of the internal actuator 152 from the driver assembly may take the form of a loosely fitting threaded engagement between the driver assembly 142 and the internal actuator 152. Alternatively, this isolation may be in the form of a clip between the two features.
For a detailed discussion of an implant 154 according to certain embodiments, reference is now made to
As can be understood from
With continued reference to
As shown, the upper 168 and lower 170 members may also each include teeth 186 projecting outwardly (e.g. a direction opposite the position of the other upper or lower member) from the outer surfaces 180 of the upper 168 and lower 170 members. As shown in
As shown in
As shown in
The receiving feature 160 may take several forms including a rectangular notch in the lateral edge 176 of the upper 168 and lower 170 member or a U-shaped notch. The receiving feature 160 may be adapted to receive an engagement feature 158 positioned on the arm 148 of the driver assembly 142. The receiving feature 160 may be any shaped recess and may be adapted to be engaged by the engagement feature 158 so as to prevent or limit relative longitudinal motion between the arms 148 and the implant 154, when the implant 154 is in the neutral position. However, when in an expanded or distracted position, the receiving features 160 may be such that they are lifted free of the engagement feature 158 of the arms 148, thus allowing relative longitudinal motion between the driver assembly 142 and the implant 154.
The driver assembly 142 and implant 154 described with respect to
As shown in
The above description has included some references to use to allow for a better understanding of the structure. Below is a more detailed discussion of that use including the devices and techniques for distracting and retaining a facet joint in a distracted and forwardly translated condition. The implantation procedure may be performed under conscious sedation in order to obtain intra-operative patient symptom feedback.
Initially an incision may be made in the patients back. Tools known in the art may be used to create this incision and to open an access path through the tissues of the back to access the spine. Once an access path is created, the chisel 108 described above may be inserted into the delivery device 104 and the two of them may be inserted through the incision and the distal tip 130 may be positioned adjacent the target facet joint. It is noted that visualization may be provided by first inserting a scope down the delivery device 104 rather than the chisel 108. Additionally, an incision in the facet joint capsule may be made prior to beginning the procedure, and thus prior to insertion of the chisel 108. Once the distal tip of the delivery device 130 is properly positioned adjacent the facet joint and any other preparation steps are completed, the chisel 108 may be inserted. Once the chisel 108 and delivery device 104 are properly positioned, the head 132 of the chisel 108 may be tapped with a driving device 140 such as a hammer or other instrument to advance the distal tip 130 of the chisel 108 and the forks 112 of the delivery device 104 into the facet joint. Once the delivery device 104 is properly positioned, the chisel 108 may be removed. At this point, the implant 154 may be placed in the driver assembly 142 and the implant 154 and driver assembly 142 may be slidably advanced through the delivery device 104. The forks 112 of the delivery device 104 may be holding the facet joint slightly distracted. As such, the implant 154, in its flat and parallel position, may slide relatively easily into the facet joint. To the extent that it does not, the proximal end of the driver assembly 142 may be tapped to properly advance and position the implant 154. Once properly positioned, the distractor knob 144 on the driver assembly may be rotated or otherwise actuated to activate the internal actuator 152. The internal actuator 152 advances the implant distractor 150 into the implant 154 and thus distracts the implant 154. It is noted here that the distraction of the implant 154 may cause the upper 168 and lower 170 member of the implant 154 to clear the engagement features 158 of the holder arms 148 thus allowing the driver assembly 142 to be freely removed from the delivery device 104 leaving the implant 154 and the implant distractor 150 behind. The injector 202 may then be advanced through the delivery device 104 and positioned to allow the doors 208 to open in a direction approximately perpendicular to the forks 112 of the delivery device 104. The handle 214 may be depressed thus advancing the plunger 210 and ejecting the bone paste or other anchoring material. The injector 202 may then be removed. The delivery device 104 may also be removed and the incision closed.
Those skilled in the art will understand and appreciate that several modifications or variations from the above the identified embodiments may be made while still falling within the scope and spirit of the present disclosure. For example, several alternative actuation mechanisms at the proximal end of the tool for actuating the distracting elements of the tool may be available. Additionally, several alternative implants may be available. For example, as shown in
As shown in
As can be understood from
The distraction and separation of the facet joint via the expanded implant (see
Another implant embodiment is depicted in
In the present embodiment, the protrusions 298 may be tab like and cut relatively deeply into the lateral mass. In addition as shown in
In the case of a screw implant, the torque limiting mechanism 314 may be a necked down portion of the device creating a calibrated weakened portion intended to fail when a specified torque is exceeded.
In this embodiment, the implant 312 may also include a number of anit migration features to prevent backout. These features may include directional teeth, roughened surfaces, keels, spikes, or other features known in the art. As with other implants, the geometry of the implant may cause distraction of the joint and lead to a more pronounced forward translation of the joint as the opposing facet surfaces separate.
Yet another embodiment is show in
The surfaces of this implant 338 may include teeth, spikes, cleats, surface roughening, and/or keels 342 to help prevent migration or backout. In another configuration of this embodiment, as shown in
In the second embodiment, as shown, a directional facet screw 436 may be advanced through the inferior facet surface until it engages with a facet spacer/plate 440 that is inserted in between the facet surfaces within the facet capsule. As the screw 436 makes contact with the facet spacer/plate 440, the flat surface of the spacer/plate 440 may push up against the opposing superior facet surface causes distraction and forward translation. This separation of the facet surfaces results in increased foraminal area and reduced nerve root compression.
In a third embodiment, the spacer/plate 440 may have a shape to allow the screw 436 to pass through a first end and the other end to be placed in the facet joint. In this embodiment, the C-shaped spacer 440 may be positioned in the joint, thereby slightly distracting the joint. The screw may then penetrate a first end of the spacer 440 thereby anchoring the spacer 440 in the joint. The screw may then be advanced through the inferior facet surface until it engages with the spacer/plate 440. As the screw 436 makes contact with the facet spacer/plate 440, the flat surface of the spacer/plate 440 may push up against the opposing superior facet surface causes distraction and forward translation. In some embodiments, the screw may penetrate the spacer and aid in fixing the joint.
In similar fashion, the embodiment shown in
Similarly, as shown in
Similarly, as shown in
Another variation of this embodiment is shown in
In another embodiment, a kit is provided. As shown in
Those of skill in the art will understand and appreciate that the implant embodiments depicted herein may be made of several types of biocompatible materials including stainless steel, titanium, ceramics, nitinol, polymers, and other materials known in the art.
The above description has included some references to use to allow for a better understanding of the structure. Below is a more detailed discussion of that use including the devices and techniques for distracting and retaining a facet joint in a distracted and forwardly translated condition. The implantation procedure may be performed under conscious sedation in order to obtain intra-operative patient symptom feedback. Before the facet joint can be distracted, however, the joint, which is difficult to access, must be accessed pursuant, for example, to a method and apparatus disclosed in U.S. provisional application Ser. No. 61/020,082, filed Jan. 9, 2008, which is commonly owned with the present application and hereby incorporated by reference. Pursuant to the disclosure in that application, the access system may include one or more cannulas made of steel, titanium, or plastic. The initial facet joint access cannula may have a sharp spatula tip on the distal end. The spatula tip may have a flat configuration to enable access into the flat facet joint. Once the spatula tip achieves access into the flatly oriented facet joint, subsequent stylets and working instruments may be passed down this access channel to complete a distraction procedure. Alternatively the chisel and delivery device described above may be used to access the joint. The distraction procedure may then begin.
The percutaneous distraction system may be introduced down the working cannula of the above-identified access system using a handle or delivery tool that would allow the surgeon to generate distraction by applying energy to the handle for a distraction device at the proximal end of the device.
A distraction device may be inserted down the working cannula, for example of the access system described previously, which is docked in a facet joint. Once the distal end of the distraction device is positioned at the anterior aspect of the joint, the surgeon applies energy to the distraction device to create separation and distraction of the facet joint. This separation occurs in both the vertical and horizontal planes of the joint resulting in vertical distraction and forward/anterior translation of the superior vertebrae relative to the inferior vertebrae. The facet joint distraction and forward translation will cause an increase in foraminal area and may reduce nerve root compression and associated symptoms.
Although the present invention has been described with a certain degree of particularity, it is understood the disclosure has been made by way of example, and changes in detail or structure may be made without departing from the spirit of the invention as defined in the appended claims.
This application is a continuation application of Ser. No. 14/687,218, filed Apr. 15, 2015, entitled “FACET JOINT IMPLANTS AND DELIVERY TOOLS,” which issued Dec. 11, 2018 as U.S. Pat. No. 10,149,673, which is a continuation application of Ser. No. 13/614,281, filed Sep. 13, 2012, entitled “FACET JOINT IMPLANTS AND DELIVERY TOOLS,” which issued Apr. 21, 2015 as U.S. Pat. No. 9,011,492, which is a divisional application of Ser. No. 12/317,682, filed Dec. 23, 2008, entitled “FACET JOINT IMPLANTS AND DELIVERY TOOLS,” now U.S. Pat. No. 8,267,966, which claims priority to U.S. Provisional Patent Application No. 61,109,776, entitled “FACET JOINT IMPLANTS,” filed on Oct. 30, 2008 and U.S. Provisional Patent Application No. 61/059,726, entitled “SPINE DISTRACTION DEVICE,” filed on Jun. 6, 2008. The full disclosures of the above-listed patent applications are hereby incorporated by reference herein.
Number | Name | Date | Kind |
---|---|---|---|
1934962 | Barry | Nov 1933 | A |
2708376 | Booth | May 1955 | A |
2984241 | Carlson | May 1961 | A |
3486505 | Morrison | Dec 1969 | A |
4479491 | Martin | Oct 1984 | A |
4530355 | Griggs | Jul 1985 | A |
4604995 | Stephens et al. | Aug 1986 | A |
4772287 | Ray et al. | Sep 1988 | A |
4877020 | Vich | Oct 1989 | A |
4878915 | Brantigan | Nov 1989 | A |
5015247 | Michelson | May 1991 | A |
5026373 | Ray et al. | Jun 1991 | A |
5100405 | McLaren | Mar 1992 | A |
5135528 | Winston | Aug 1992 | A |
5192327 | Brantigan | Mar 1993 | A |
5236460 | Barber | Aug 1993 | A |
5443514 | Steffee | Aug 1995 | A |
5484437 | Michelson | Jan 1996 | A |
5489307 | Kuslich et al. | Feb 1996 | A |
5505732 | Michelson | Apr 1996 | A |
5527312 | Ray | Jun 1996 | A |
5549679 | Kuslich et al. | Aug 1996 | A |
5554191 | Lahille et al. | Sep 1996 | A |
5571191 | Fitz | Nov 1996 | A |
5584832 | Schlapfer et al. | Dec 1996 | A |
5593409 | Michelson | Jan 1997 | A |
5632747 | Scarborough et al. | May 1997 | A |
5649945 | Ray et al. | Jul 1997 | A |
5653763 | Errico et al. | Aug 1997 | A |
5665122 | Kambin | Sep 1997 | A |
5674295 | Ray et al. | Oct 1997 | A |
5720748 | Kuslich et al. | Feb 1998 | A |
5741253 | Michelson | Apr 1998 | A |
5772661 | Michelson | Jun 1998 | A |
5792044 | Foley et al. | Aug 1998 | A |
5797909 | Michelson | Aug 1998 | A |
5836948 | Zucherman et al. | Nov 1998 | A |
5879353 | Terry | Mar 1999 | A |
5885299 | Winslow et al. | Mar 1999 | A |
5891147 | Moskovitz | Apr 1999 | A |
5895426 | Scarborough et al. | Apr 1999 | A |
5899908 | Kuslich et al. | May 1999 | A |
5928238 | Scarborough et al. | Jul 1999 | A |
5953820 | Vasudeva | Sep 1999 | A |
5961522 | Mehdizadeh | Oct 1999 | A |
5976146 | Ogawa et al. | Nov 1999 | A |
6008433 | Stone | Dec 1999 | A |
6033405 | Winslow et al. | Mar 2000 | A |
6045580 | Scarborough et al. | Apr 2000 | A |
6063088 | Winslow | May 2000 | A |
RE36758 | Fitz | Jun 2000 | E |
6080155 | Michelson | Jun 2000 | A |
6090143 | Meriwether et al. | Jul 2000 | A |
6096038 | Michelson | Aug 2000 | A |
6099531 | Bonutti | Aug 2000 | A |
6102950 | Vaccaro | Aug 2000 | A |
6113602 | Sand | Sep 2000 | A |
6149650 | Michelson | Nov 2000 | A |
RE37005 | Michelson et al. | Dec 2000 | E |
6159245 | Meriwether et al. | Dec 2000 | A |
6176882 | Biedermann et al. | Jan 2001 | B1 |
6179873 | Zientek | Jan 2001 | B1 |
6190388 | Michelson et al. | Feb 2001 | B1 |
6190414 | Young et al. | Feb 2001 | B1 |
6193757 | Foley et al. | Feb 2001 | B1 |
6200322 | Branch | Mar 2001 | B1 |
6210412 | Michelson | Apr 2001 | B1 |
RE37161 | Michelson et al. | May 2001 | E |
6224595 | Michelson | May 2001 | B1 |
6224607 | Michelson | May 2001 | B1 |
6224630 | Bao et al. | May 2001 | B1 |
6245108 | Biscup | Jun 2001 | B1 |
6248110 | Reiley et al. | Jun 2001 | B1 |
D444878 | Walter | Jul 2001 | S |
D445188 | Walter | Jul 2001 | S |
6264656 | Michelson | Jul 2001 | B1 |
6267763 | Castro | Jul 2001 | B1 |
6270498 | Michelson | Aug 2001 | B1 |
6283966 | Boufburg | Sep 2001 | B1 |
6315795 | Scarborough et al. | Nov 2001 | B1 |
6325827 | Lin | Dec 2001 | B1 |
6371984 | Van Dyke et al. | Apr 2002 | B1 |
6371988 | Pafford et al. | Apr 2002 | B1 |
6402784 | Wardlaw | Jun 2002 | B1 |
6423063 | Bonutti | Jul 2002 | B1 |
6423083 | Reiley et al. | Jul 2002 | B2 |
6425919 | Lambrecht | Jul 2002 | B1 |
6436098 | Michelson | Aug 2002 | B1 |
6436142 | Paes et al. | Aug 2002 | B1 |
6443988 | Felt et al. | Sep 2002 | B2 |
6451023 | Salazar et al. | Sep 2002 | B1 |
6454807 | Jackson | Sep 2002 | B1 |
6478796 | Zucherman et al. | Nov 2002 | B2 |
6500206 | Bryan | Dec 2002 | B1 |
6514256 | Zucherman et al. | Feb 2003 | B2 |
6530955 | Boyle et al. | Mar 2003 | B2 |
6558390 | Cragg | May 2003 | B2 |
6565574 | Michelson | May 2003 | B2 |
6565605 | Fallin et al. | May 2003 | B2 |
6569186 | Winters et al. | May 2003 | B1 |
6575919 | Reiley et al. | Jun 2003 | B1 |
6575979 | Cragg | Jun 2003 | B1 |
6579319 | Goble et al. | Jun 2003 | B2 |
6582432 | Michelson | Jun 2003 | B1 |
6582467 | Teitelbaum et al. | Jun 2003 | B1 |
6607530 | Carl et al. | Aug 2003 | B1 |
6610091 | Reiley | Aug 2003 | B1 |
6626905 | Schmiel et al. | Sep 2003 | B1 |
6632235 | Weikel et al. | Oct 2003 | B2 |
6635060 | Hanson et al. | Oct 2003 | B2 |
6641582 | Hanson et al. | Nov 2003 | B1 |
6648893 | Dudasik | Nov 2003 | B2 |
6652584 | Michelson | Nov 2003 | B2 |
6663647 | Reiley et al. | Dec 2003 | B2 |
6666866 | Martz et al. | Dec 2003 | B2 |
6679886 | Weikel et al. | Jan 2004 | B2 |
6682535 | Hoogland | Jan 2004 | B2 |
6685742 | Jackson | Feb 2004 | B1 |
6709458 | Michelson | Mar 2004 | B2 |
6712853 | Kuslich | Mar 2004 | B2 |
6719773 | Boucher et al. | Apr 2004 | B1 |
6719794 | Gerber et al. | Apr 2004 | B2 |
6723095 | Hammerslag | Apr 2004 | B2 |
6733534 | Sherman | May 2004 | B2 |
6740093 | Hochschuler et al. | May 2004 | B2 |
6751875 | Jones | Jun 2004 | B2 |
6770074 | Michelson | Aug 2004 | B2 |
6793679 | Michelson | Sep 2004 | B2 |
6805715 | Reuter et al. | Oct 2004 | B2 |
6808537 | Michelson | Oct 2004 | B2 |
6823871 | Schmieding | Nov 2004 | B2 |
6840941 | Rogers et al. | Jan 2005 | B2 |
6851430 | Tsou | Feb 2005 | B2 |
6875213 | Michelson | Apr 2005 | B2 |
6899719 | Reiley et al. | May 2005 | B2 |
6921403 | Cragg et al. | Jul 2005 | B2 |
6923813 | Phillips et al. | Aug 2005 | B2 |
6958077 | Suddaby | Oct 2005 | B2 |
6962606 | Michelson | Nov 2005 | B2 |
6964686 | Gordon | Nov 2005 | B2 |
6966930 | Arnin et al. | Nov 2005 | B2 |
6972035 | Michelson | Dec 2005 | B2 |
6974478 | Reiley et al. | Dec 2005 | B2 |
6979333 | Hammerslag | Dec 2005 | B2 |
6986772 | Michelson | Jan 2006 | B2 |
7001385 | Bonutti | Feb 2006 | B2 |
7008453 | Michelson | Mar 2006 | B1 |
7033362 | McGahan et al. | Apr 2006 | B2 |
7033392 | Schmiel et al. | Apr 2006 | B2 |
7033394 | Michelson | Apr 2006 | B2 |
7066961 | Michelson | Jun 2006 | B2 |
D524443 | Blain | Jul 2006 | S |
7083623 | Michelson | Aug 2006 | B2 |
7090698 | Fallin et al. | Aug 2006 | B2 |
7096972 | Orozco, Jr. | Aug 2006 | B2 |
7101398 | Dooris et al. | Sep 2006 | B2 |
7115128 | Michelson | Oct 2006 | B2 |
7118598 | Michelson | Oct 2006 | B2 |
7128760 | Michelson | Oct 2006 | B2 |
7156877 | Lotz et al. | Jan 2007 | B2 |
7166110 | Yundt | Jan 2007 | B2 |
7175023 | Martin | Feb 2007 | B2 |
7179263 | Zdeblick et al. | Feb 2007 | B2 |
7207991 | Michelson | Apr 2007 | B2 |
D541940 | Blain | May 2007 | S |
7220280 | Kast et al. | May 2007 | B2 |
7255703 | Mujwid et al. | Aug 2007 | B2 |
7261739 | Ralph et al. | Aug 2007 | B2 |
7264622 | Michelson | Sep 2007 | B2 |
7273498 | Bianchi et al. | Sep 2007 | B2 |
7288093 | Michelson | Oct 2007 | B2 |
7291149 | Michelson | Nov 2007 | B1 |
7300440 | Zdeblick et al. | Nov 2007 | B2 |
7326211 | Padget et al. | Feb 2008 | B2 |
7326214 | Michelson | Feb 2008 | B2 |
7371238 | Soboleski et al. | May 2008 | B2 |
7399303 | Michelson | Jul 2008 | B2 |
7410501 | Michelson | Aug 2008 | B2 |
7431722 | Michelson | Oct 2008 | B1 |
7445636 | Michelson | Nov 2008 | B2 |
7452359 | Michelson | Nov 2008 | B1 |
7452369 | Barry | Nov 2008 | B2 |
7465304 | Haufe et al. | Dec 2008 | B1 |
7476226 | Weikel et al. | Jan 2009 | B2 |
7476251 | Zucherman et al. | Jan 2009 | B2 |
7479160 | Branch et al. | Jan 2009 | B2 |
7491205 | Michelson | Feb 2009 | B1 |
7491240 | Carver et al. | Feb 2009 | B1 |
7500992 | Li | Mar 2009 | B2 |
7517358 | Peterson | Apr 2009 | B2 |
7524333 | Lambrecht et al. | Apr 2009 | B2 |
7569054 | Michelson | Aug 2009 | B2 |
7569057 | Liu et al. | Aug 2009 | B2 |
7580743 | Bourlion et al. | Aug 2009 | B2 |
7591851 | Winslow et al. | Sep 2009 | B2 |
7601170 | Winslow et al. | Oct 2009 | B2 |
7608077 | Cragg et al. | Oct 2009 | B2 |
7608107 | Michelson | Oct 2009 | B2 |
7615079 | Flickinger et al. | Nov 2009 | B2 |
7618451 | Berez et al. | Nov 2009 | B2 |
7632291 | Stephens et al. | Dec 2009 | B2 |
7641664 | Pagano | Jan 2010 | B2 |
7648509 | Stark | Jan 2010 | B2 |
7648523 | Mirkovic et al. | Jan 2010 | B2 |
7655027 | Michelson | Feb 2010 | B2 |
7655043 | Peterman et al. | Feb 2010 | B2 |
7662173 | Cragg et al. | Feb 2010 | B2 |
D611147 | Hanson et al. | Mar 2010 | S |
7682378 | Truckai et al. | Mar 2010 | B2 |
7686805 | Michelson | Mar 2010 | B2 |
7686807 | Padget et al. | Mar 2010 | B2 |
7699878 | Pavlov et al. | Apr 2010 | B2 |
D615653 | Horton | May 2010 | S |
7708761 | Petersen | May 2010 | B2 |
7722619 | Michelson | May 2010 | B2 |
D619719 | Pannu | Jul 2010 | S |
D620113 | Courtney et al. | Jul 2010 | S |
7763024 | Bertagnoli et al. | Jul 2010 | B2 |
7763050 | Winslow et al. | Jul 2010 | B2 |
7776090 | Winslow et al. | Aug 2010 | B2 |
D623748 | Horton et al. | Sep 2010 | S |
D623749 | Horton et al. | Sep 2010 | S |
7789898 | Peterman | Sep 2010 | B2 |
7824431 | McCormack | Nov 2010 | B2 |
7837713 | Peterson | Nov 2010 | B2 |
7846183 | Blain | Dec 2010 | B2 |
7846184 | Sasso et al. | Dec 2010 | B2 |
7850733 | Baynham et al. | Dec 2010 | B2 |
7862589 | Thramann | Jan 2011 | B2 |
7867277 | Tohmeh | Jan 2011 | B1 |
D631967 | Horton | Feb 2011 | S |
7887565 | Michelson | Feb 2011 | B2 |
7892261 | Bonutti | Feb 2011 | B2 |
7892286 | Michelson | Feb 2011 | B2 |
7896803 | Schara et al. | Mar 2011 | B2 |
7896903 | Link | Mar 2011 | B2 |
7901439 | Horton | Mar 2011 | B2 |
7914530 | Michelson | Mar 2011 | B2 |
7918891 | Curran et al. | Apr 2011 | B1 |
7922729 | Michelson | Apr 2011 | B2 |
7922766 | Grob et al. | Apr 2011 | B2 |
7935136 | Alamin et al. | May 2011 | B2 |
7938857 | Krueger et al. | May 2011 | B2 |
7942903 | Moskowitz et al. | May 2011 | B2 |
7988712 | Hale et al. | Aug 2011 | B2 |
7988714 | Puekert et al. | Aug 2011 | B2 |
7998174 | Malandain et al. | Aug 2011 | B2 |
8007534 | Michelson | Aug 2011 | B2 |
8029540 | Winslow et al. | Oct 2011 | B2 |
8043334 | Fisher et al. | Oct 2011 | B2 |
8052728 | Hestad | Nov 2011 | B2 |
8062303 | Berry et al. | Nov 2011 | B2 |
8066705 | Michelson | Nov 2011 | B2 |
D650481 | Gottlieb et al. | Dec 2011 | S |
8097034 | Michelson | Jan 2012 | B2 |
8100944 | Lauryssen et al. | Jan 2012 | B2 |
D653757 | Binder | Feb 2012 | S |
8114158 | Carl et al. | Feb 2012 | B2 |
8118838 | Winslow et al. | Feb 2012 | B2 |
8128660 | Mitchel et al. | Mar 2012 | B2 |
8133261 | Fisher et al. | Mar 2012 | B2 |
8142503 | Malone | Mar 2012 | B2 |
8147553 | Vresilovic et al. | Apr 2012 | B2 |
8162981 | Vestgaarden | Apr 2012 | B2 |
8172877 | Winslow et al. | May 2012 | B2 |
8177872 | Nelson et al. | May 2012 | B2 |
8197513 | Fisher et al. | Jun 2012 | B2 |
8206418 | Triplett et al. | Jun 2012 | B2 |
8267966 | McCormack et al. | Sep 2012 | B2 |
D674900 | Janice et al. | Jan 2013 | S |
8348979 | McCormack | Jan 2013 | B2 |
8361152 | McCormack et al. | Jan 2013 | B2 |
8366748 | Kleiner | Feb 2013 | B2 |
8382767 | Wassinger et al. | Feb 2013 | B2 |
D677791 | Danacioglu et al. | Mar 2013 | S |
8394107 | Fanger et al. | Mar 2013 | B2 |
8394129 | Morgenstern et al. | Mar 2013 | B2 |
D681205 | Farris et al. | Apr 2013 | S |
8425558 | McCormack et al. | Apr 2013 | B2 |
8512347 | McCormack et al. | Aug 2013 | B2 |
8523908 | Malone | Sep 2013 | B2 |
8529609 | Helgerson et al. | Sep 2013 | B2 |
8623054 | McCormack et al. | Jan 2014 | B2 |
8668722 | Pavlov et al. | Mar 2014 | B2 |
8753345 | Mccormack et al. | Jun 2014 | B2 |
8753347 | McCormack et al. | Jun 2014 | B2 |
8764755 | Michelson | Jul 2014 | B2 |
8828062 | McCormack et al. | Sep 2014 | B2 |
8834530 | McCormack | Sep 2014 | B2 |
8845727 | Gottlieb et al. | Sep 2014 | B2 |
8870882 | Kleiner | Oct 2014 | B2 |
D723690 | McCormack et al. | Mar 2015 | S |
D723691 | McCormack et al. | Mar 2015 | S |
8998905 | Marik et al. | Apr 2015 | B2 |
9005288 | Mccormack et al. | Apr 2015 | B2 |
9011492 | McCormack et al. | Apr 2015 | B2 |
D732667 | McCormack et al. | Jun 2015 | S |
9186193 | Kleiner et al. | Nov 2015 | B2 |
D745156 | McCormack et al. | Dec 2015 | S |
9211198 | Michelson | Dec 2015 | B2 |
9220608 | McKay | Dec 2015 | B2 |
D750249 | Grimberg, Jr. et al. | Feb 2016 | S |
9271765 | Blain | Mar 2016 | B2 |
9333086 | McCormack et al. | May 2016 | B2 |
9358127 | Duffield et al. | Jun 2016 | B2 |
9381049 | McCormack et al. | Jul 2016 | B2 |
9427264 | Kleiner et al. | Aug 2016 | B2 |
9504583 | Blain | Nov 2016 | B2 |
9622791 | Mccormack et al. | Apr 2017 | B2 |
9622873 | Mccormack | Apr 2017 | B2 |
9622874 | Mccormack et al. | Apr 2017 | B2 |
9629665 | Mccormack et al. | Apr 2017 | B2 |
9717403 | Kleiner et al. | Aug 2017 | B2 |
9937053 | Melkent et al. | Apr 2018 | B2 |
10039649 | Mccormack et al. | Aug 2018 | B2 |
10149673 | Mccormack et al. | Dec 2018 | B2 |
10172721 | Mccormack et al. | Jan 2019 | B2 |
D841165 | Mccormack et al. | Feb 2019 | S |
D841167 | Ricca et al. | Feb 2019 | S |
10201375 | Mccormack et al. | Feb 2019 | B2 |
10206787 | Voellmicke | Feb 2019 | B2 |
10219910 | Mccormack | Mar 2019 | B2 |
10226285 | Mccormack et al. | Mar 2019 | B2 |
10238501 | Mccormack et al. | Mar 2019 | B2 |
10327913 | Palmatier et al. | Jun 2019 | B2 |
10456175 | McCormack et al. | Oct 2019 | B2 |
10568666 | McCormack et al. | Feb 2020 | B2 |
10588672 | McCormack | Mar 2020 | B2 |
D884895 | McCormack et al. | May 2020 | S |
D887552 | Tanaka et al. | Jun 2020 | S |
10682243 | Phan et al. | Jun 2020 | B2 |
D911525 | Tanaka et al. | Feb 2021 | S |
RE48501 | McCormack et al. | Apr 2021 | E |
20010004710 | Felt et al. | Jun 2001 | A1 |
20010047208 | Michelson | Nov 2001 | A1 |
20010053914 | Landry et al. | Dec 2001 | A1 |
20020026195 | Layne et al. | Feb 2002 | A1 |
20020068941 | Hanson et al. | Jun 2002 | A1 |
20020107519 | Dixon et al. | Aug 2002 | A1 |
20020143343 | Castro | Oct 2002 | A1 |
20020147496 | Belef et al. | Oct 2002 | A1 |
20020147497 | Belef et al. | Oct 2002 | A1 |
20020165612 | Gerber et al. | Nov 2002 | A1 |
20020169471 | Ferdinand | Nov 2002 | A1 |
20020177866 | Weikel et al. | Nov 2002 | A1 |
20030023312 | Thalgott | Jan 2003 | A1 |
20030028251 | Mathews | Feb 2003 | A1 |
20030032962 | McGahan et al. | Feb 2003 | A1 |
20030033017 | Lotz et al. | Feb 2003 | A1 |
20030105526 | Bryant et al. | Jun 2003 | A1 |
20030109928 | Pasquet et al. | Jun 2003 | A1 |
20030139816 | Michelson | Jul 2003 | A1 |
20030144737 | Sherman | Jul 2003 | A1 |
20030149438 | Nichols et al. | Aug 2003 | A1 |
20030158553 | Michelson | Aug 2003 | A1 |
20030225416 | Bonvallet et al. | Dec 2003 | A1 |
20040059337 | Hanson et al. | Mar 2004 | A1 |
20040073217 | Michelson | Apr 2004 | A1 |
20040087948 | Suddaby | May 2004 | A1 |
20040087956 | Weikel et al. | May 2004 | A1 |
20040106999 | Mathews | Jun 2004 | A1 |
20040133277 | Michelson | Jul 2004 | A1 |
20040133280 | Trieu | Jul 2004 | A1 |
20040162562 | Martz | Aug 2004 | A1 |
20040215344 | Hochshculer et al. | Oct 2004 | A1 |
20050010294 | Michelson | Jan 2005 | A1 |
20050015097 | Mujwid et al. | Jan 2005 | A1 |
20050015149 | Michelson | Jan 2005 | A1 |
20050027358 | Suddaby | Feb 2005 | A1 |
20050033432 | Gordon et al. | Feb 2005 | A1 |
20050038511 | Martz | Feb 2005 | A1 |
20050049705 | Hale et al. | Mar 2005 | A1 |
20050055096 | Serhan et al. | Mar 2005 | A1 |
20050065518 | Michelson | Mar 2005 | A1 |
20050065519 | Michelson | Mar 2005 | A1 |
20050065608 | Michelson | Mar 2005 | A1 |
20050065609 | Wardlaw | Mar 2005 | A1 |
20050080422 | Otte et al. | Apr 2005 | A1 |
20050090829 | Martz et al. | Apr 2005 | A1 |
20050090901 | Studer | Apr 2005 | A1 |
20050119680 | Dykes | Jun 2005 | A1 |
20050124993 | Chappuis | Jun 2005 | A1 |
20050149192 | Zucherman et al. | Jul 2005 | A1 |
20050159650 | Raymond et al. | Jul 2005 | A1 |
20050159746 | Grob et al. | Jul 2005 | A1 |
20050177240 | Blain | Aug 2005 | A1 |
20050182417 | Pagano | Aug 2005 | A1 |
20050209698 | Gordon et al. | Sep 2005 | A1 |
20050216018 | Sennett | Sep 2005 | A1 |
20050234455 | Binder et al. | Oct 2005 | A1 |
20050240188 | Chow et al. | Oct 2005 | A1 |
20050251146 | Martz et al. | Nov 2005 | A1 |
20050251257 | Mitchell et al. | Nov 2005 | A1 |
20050267480 | Suddaby | Dec 2005 | A1 |
20060004367 | Alamin et al. | Jan 2006 | A1 |
20060015184 | Winterbottom et al. | Jan 2006 | A1 |
20060036243 | Sasso et al. | Feb 2006 | A1 |
20060036247 | Michelson | Feb 2006 | A1 |
20060036323 | Carl et al. | Feb 2006 | A1 |
20060041311 | McLeer | Feb 2006 | A1 |
20060058793 | Michelson | Mar 2006 | A1 |
20060058878 | Michelson | Mar 2006 | A1 |
20060069442 | Michelson | Mar 2006 | A1 |
20060079905 | Beyar et al. | Apr 2006 | A1 |
20060079962 | Michelson | Apr 2006 | A1 |
20060085068 | Barry | Apr 2006 | A1 |
20060085074 | Raiszadeh | Apr 2006 | A1 |
20060095028 | Bleich | May 2006 | A1 |
20060095036 | Ham Merslag | May 2006 | A1 |
20060111779 | Peterson | May 2006 | A1 |
20060111780 | Petersen | May 2006 | A1 |
20060111781 | Petersen | May 2006 | A1 |
20060142762 | Michelson | Jun 2006 | A1 |
20060149279 | Mathews | Jul 2006 | A1 |
20060149289 | Winslow et al. | Jul 2006 | A1 |
20060184172 | Michelson | Aug 2006 | A1 |
20060189991 | Bickley | Aug 2006 | A1 |
20060190081 | Kraus et al. | Aug 2006 | A1 |
20060195109 | McGahan et al. | Aug 2006 | A1 |
20060200137 | Soboleski et al. | Sep 2006 | A1 |
20060200138 | Michelson | Sep 2006 | A1 |
20060200139 | Michelson | Sep 2006 | A1 |
20060206118 | Kim et al. | Sep 2006 | A1 |
20060217812 | Lambrecht et al. | Sep 2006 | A1 |
20060229627 | Hunt et al. | Oct 2006 | A1 |
20060235391 | Sutterlin, III | Oct 2006 | A1 |
20060241597 | Mitchell et al. | Oct 2006 | A1 |
20060241626 | McGahan et al. | Oct 2006 | A1 |
20060241758 | Peterman et al. | Oct 2006 | A1 |
20060247632 | Winslow et al. | Nov 2006 | A1 |
20060247633 | Winslow et al. | Nov 2006 | A1 |
20060247650 | Yerby et al. | Nov 2006 | A1 |
20060259142 | Dooris et al. | Nov 2006 | A1 |
20060271195 | Thramann | Nov 2006 | A1 |
20060276790 | Dawson et al. | Dec 2006 | A1 |
20060276801 | Yerby et al. | Dec 2006 | A1 |
20060276897 | Winslow et al. | Dec 2006 | A1 |
20060293663 | Walkenhorst et al. | Dec 2006 | A1 |
20070016195 | Winslow et al. | Jan 2007 | A1 |
20070016196 | Winslow et al. | Jan 2007 | A1 |
20070016218 | Winslow et al. | Jan 2007 | A1 |
20070032871 | Michelson | Feb 2007 | A1 |
20070043362 | Malandain et al. | Feb 2007 | A1 |
20070050031 | Khosrowshahi | Mar 2007 | A1 |
20070055245 | Sasso et al. | Mar 2007 | A1 |
20070055263 | Way et al. | Mar 2007 | A1 |
20070073402 | Vresilovic et al. | Mar 2007 | A1 |
20070083265 | Malone | Apr 2007 | A1 |
20070123863 | Winslow et al. | May 2007 | A1 |
20070123888 | Bleich et al. | May 2007 | A1 |
20070135814 | Farris | Jun 2007 | A1 |
20070135921 | Park | Jun 2007 | A1 |
20070149976 | Hale et al. | Jun 2007 | A1 |
20070149983 | Link | Jun 2007 | A1 |
20070150061 | Trieu | Jun 2007 | A1 |
20070161991 | Altarac et al. | Jul 2007 | A1 |
20070162138 | Heinz | Jul 2007 | A1 |
20070179617 | Brown et al. | Aug 2007 | A1 |
20070179619 | Grob et al. | Aug 2007 | A1 |
20070191861 | Allard et al. | Aug 2007 | A1 |
20070225721 | Thelen et al. | Sep 2007 | A1 |
20070225812 | Gill | Sep 2007 | A1 |
20070244483 | Winslow et al. | Oct 2007 | A9 |
20070250167 | Bray et al. | Oct 2007 | A1 |
20070276491 | Ahrens | Nov 2007 | A1 |
20070282441 | Stream et al. | Dec 2007 | A1 |
20070288014 | Shadduck et al. | Dec 2007 | A1 |
20070293949 | Salerni et al. | Dec 2007 | A1 |
20070299451 | Tulkis | Dec 2007 | A1 |
20080015581 | Eckman | Jan 2008 | A1 |
20080021457 | Anderson et al. | Jan 2008 | A1 |
20080021464 | Morin et al. | Jan 2008 | A1 |
20080058954 | Trieu | Mar 2008 | A1 |
20080065219 | Dye | Mar 2008 | A1 |
20080097436 | Culbert et al. | Apr 2008 | A1 |
20080108996 | Padget et al. | May 2008 | A1 |
20080140207 | Olmos et al. | Jun 2008 | A1 |
20080154377 | Voellmicke | Jun 2008 | A1 |
20080161810 | Melkent | Jul 2008 | A1 |
20080161929 | McCormack et al. | Jul 2008 | A1 |
20080167657 | Greenhaigh | Jul 2008 | A1 |
20080177311 | Winslow et al. | Jul 2008 | A1 |
20080216846 | Levin | Sep 2008 | A1 |
20080234677 | Dahners et al. | Sep 2008 | A1 |
20080234758 | Fisher et al. | Sep 2008 | A1 |
20080249571 | Sasso et al. | Oct 2008 | A1 |
20080255564 | Michelson | Oct 2008 | A1 |
20080255618 | Fisher et al. | Oct 2008 | A1 |
20080255622 | Mickiewicz et al. | Oct 2008 | A1 |
20080255666 | Fisher et al. | Oct 2008 | A1 |
20080255667 | Horton | Oct 2008 | A1 |
20080275455 | Berry et al. | Nov 2008 | A1 |
20080287955 | Michelson | Nov 2008 | A1 |
20080300685 | Carls et al. | Dec 2008 | A1 |
20080306537 | Culbert | Dec 2008 | A1 |
20080312744 | Vresilovic et al. | Dec 2008 | A1 |
20090131986 | Lee et al. | May 2009 | A1 |
20090138053 | Assell et al. | May 2009 | A1 |
20090177215 | Stack et al. | Jul 2009 | A1 |
20090177237 | Zucherman et al. | Jul 2009 | A1 |
20090234397 | Petersen | Sep 2009 | A1 |
20090248076 | Reynolds et al. | Oct 2009 | A1 |
20090263461 | McKay | Oct 2009 | A1 |
20090270929 | Suddaby et al. | Oct 2009 | A1 |
20090275994 | Phan et al. | Nov 2009 | A1 |
20100082065 | Butler et al. | Apr 2010 | A1 |
20100086185 | Weiss | Apr 2010 | A1 |
20100093829 | Gorman | Apr 2010 | A1 |
20100111829 | Drapeau et al. | May 2010 | A1 |
20100114318 | Gittings et al. | May 2010 | A1 |
20100145391 | Kleiner | Jun 2010 | A1 |
20100145459 | Mcdonough et al. | Jun 2010 | A1 |
20100211104 | Moumene et al. | Aug 2010 | A1 |
20100286783 | Lechmann et al. | Nov 2010 | A1 |
20110004247 | Lechmann et al. | Jan 2011 | A1 |
20110022089 | Assell et al. | Jan 2011 | A1 |
20110054613 | Hansen | Mar 2011 | A1 |
20110077686 | Mishra et al. | Mar 2011 | A1 |
20110082548 | Assell et al. | Apr 2011 | A1 |
20110144755 | Baynham et al. | Jun 2011 | A1 |
20110184470 | Gorek et al. | Jul 2011 | A1 |
20110190821 | Chin et al. | Aug 2011 | A1 |
20110245930 | Alley et al. | Oct 2011 | A1 |
20110295327 | Moskowitz et al. | Dec 2011 | A1 |
20110307061 | Assell et al. | Dec 2011 | A1 |
20120010659 | Angert et al. | Jan 2012 | A1 |
20120010662 | O'Neil et al. | Jan 2012 | A1 |
20120010669 | O'Neil et al. | Jan 2012 | A1 |
20120065613 | Pepper et al. | Mar 2012 | A1 |
20120130496 | Duffield et al. | May 2012 | A1 |
20120143334 | Boyce et al. | Jun 2012 | A1 |
20120179259 | Mcdonough et al. | Jul 2012 | A1 |
20120215259 | Cannestra | Aug 2012 | A1 |
20120265250 | Ali | Oct 2012 | A1 |
20120283776 | Mishra | Nov 2012 | A1 |
20120323242 | Tsuang et al. | Dec 2012 | A1 |
20130013070 | McCormack et al. | Jan 2013 | A1 |
20130023889 | Blain et al. | Jan 2013 | A1 |
20130110168 | McCormack et al. | May 2013 | A1 |
20130110243 | Patterson et al. | May 2013 | A1 |
20130123922 | McCormack et al. | May 2013 | A1 |
20130144389 | Bonutti | Jun 2013 | A1 |
20130226239 | Altarac et al. | Aug 2013 | A1 |
20130238095 | Pavento et al. | Sep 2013 | A1 |
20130253649 | Davis | Sep 2013 | A1 |
20130274763 | Drapeau et al. | Oct 2013 | A1 |
20130310839 | McCormack et al. | Nov 2013 | A1 |
20130310943 | McCormack et al. | Nov 2013 | A1 |
20130317548 | Malone | Nov 2013 | A1 |
20130338720 | Kleiner | Dec 2013 | A1 |
20140012318 | Goel | Jan 2014 | A1 |
20140114415 | Tyber | Apr 2014 | A1 |
20140135930 | Georges | May 2014 | A1 |
20140172103 | O'neil et al. | Jun 2014 | A1 |
20140228959 | Niemiec et al. | Aug 2014 | A1 |
20140296916 | Mccormack et al. | Oct 2014 | A1 |
20150025635 | Laubert | Jan 2015 | A1 |
20150100129 | Waugh et al. | Apr 2015 | A1 |
20150201977 | Mccormack et al. | Jul 2015 | A1 |
20150297357 | McCormack et al. | Oct 2015 | A1 |
20150328005 | Padovani et al. | Nov 2015 | A1 |
20150328010 | Martynova et al. | Nov 2015 | A1 |
20150342648 | Mccormack et al. | Dec 2015 | A1 |
20150342649 | Mccormack et al. | Dec 2015 | A1 |
20160008040 | Mccormack et al. | Jan 2016 | A1 |
20160242754 | Mccormack et al. | Aug 2016 | A1 |
20160250035 | De Villiers et al. | Sep 2016 | A1 |
20160317316 | Mccormack et al. | Nov 2016 | A1 |
20170027713 | Kleiner | Feb 2017 | A1 |
20170135733 | Donner et al. | May 2017 | A1 |
20170189199 | Maier et al. | Jul 2017 | A1 |
20170281360 | Seifert | Oct 2017 | A1 |
20170348027 | Mccormack et al. | Dec 2017 | A1 |
20170354444 | Mccormack et al. | Dec 2017 | A1 |
20170360571 | Mesiwala | Dec 2017 | A1 |
20180161077 | Mccormack et al. | Jun 2018 | A1 |
20180303631 | Phan et al. | Oct 2018 | A1 |
20190209151 | Mccormack et al. | Jul 2019 | A1 |
20190239932 | Mccormack et al. | Aug 2019 | A1 |
20190240041 | Mccormack et al. | Aug 2019 | A1 |
20190247099 | McCormack et al. | Aug 2019 | A1 |
20190307571 | McCormack et al. | Oct 2019 | A1 |
20190307572 | McCormack et al. | Oct 2019 | A1 |
20190350626 | McCormack et al. | Nov 2019 | A1 |
20200085475 | McCormack et al. | Mar 2020 | A1 |
20200155205 | Tanaka et al. | May 2020 | A1 |
20200289285 | Siemionow et al. | Sep 2020 | A1 |
20200375633 | McCormack et al. | Dec 2020 | A1 |
20210022881 | McCormack et al. | Jan 2021 | A1 |
20210059833 | Tanaka et al. | Mar 2021 | A1 |
Number | Date | Country |
---|---|---|
G9304368.6 | May 2003 | DE |
2722980 | Feb 1996 | FR |
H11508781 | Aug 1999 | JP |
2004523288 | Aug 2004 | JP |
2008509735 | Apr 2008 | JP |
2008522787 | Jul 2008 | JP |
2012501234 | Jan 2012 | JP |
2014516268 | Jul 2014 | JP |
9641582 | Dec 1996 | WO |
9949818 | Oct 1999 | WO |
00035388 | Jun 2000 | WO |
0053126 | Sep 2000 | WO |
0101895 | Jan 2001 | WO |
0234120 | May 2002 | WO |
2002038062 | May 2002 | WO |
02076335 | Oct 2002 | WO |
02076335 | Oct 2002 | WO |
2006058221 | Jun 2006 | WO |
2006130791 | Dec 2006 | WO |
2007120903 | Oct 2007 | WO |
2008083349 | Jul 2008 | WO |
2008127978 | Oct 2008 | WO |
2008153732 | Dec 2008 | WO |
2009089367 | Jul 2009 | WO |
2009148619 | Dec 2009 | WO |
2010030994 | Mar 2010 | WO |
2010074714 | Jul 2010 | WO |
2010107692 | Sep 2010 | WO |
2011050140 | Apr 2011 | WO |
2013043584 | Mar 2013 | WO |
2014188280 | Nov 2014 | WO |
2016049784 | Apr 2016 | WO |
Entry |
---|
US 7,063,700 B2, 06/2006, Michelson (withdrawn) |
Atul Goel, Facetal distraction as treatment for single- and multilevel cervical spondylotic radiculopathy and myelopathy: a preliminary report, J Neurosurg Spine, Jun. 2011, pp. 689-696. |
Press Release, Interventional Spine, Inc., Interventional Spine, Inc. Introduces the PERPOS Fusion Facet Prep Kit, Oct. 14, 2008, 1 Page. |
Press Release, minSURG Corp., Orthopedic Development Corporation's TruFUSE Procedure Tops 1,750 Patients in First Year, Sep. 24, 2007, 1 Page. |
Press Release, Interventional Spine, Inc., FDA Grants Conditional Approval to Interventional Spine's PercuDyn System IDE Application, Jul. 1, 2008, 1 Page. |
Stein, et al., “Percutaneous Facet Joint Fusion: Preliminary Experience,” Journal of Vascular and Interventional Radiology, Jan.-Feb. 1993, pp. 69-74, vol. 4, No. 1. |
Number | Date | Country | |
---|---|---|---|
20190209151 A1 | Jul 2019 | US |
Number | Date | Country | |
---|---|---|---|
61109776 | Oct 2008 | US | |
61059723 | Jun 2008 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 12317682 | Dec 2008 | US |
Child | 13614281 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 14687218 | Apr 2015 | US |
Child | 16178326 | US | |
Parent | 13614281 | Sep 2012 | US |
Child | 14687218 | US |