# US 9,872,776 B2 · Polyaxial adjustment of facet joint prostheses

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- Number: US 9,872,776 B2
- Document ID: US9872776B2
- Status: Granted
- Kind: B2
- Application number: 14/709,535
- Filed: 2015-05-12
- Published: 2015-08-27
- Granted: 2018-01-23
- Earliest claimed: 2003-12-15
- Assignees: Globus Medical, Inc.
- Applicants: Globus Medical, Inc.
- Inventors: Mark A Reiley; David T. Stinson; Robert M. Scribner; Leonard J. Tokish
- Web page: https://patentgrep.com/patent/US9872776B2

## CPC

- A61F 2/4405: {for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes (devices implanted between spinous or transverse processes A61B17/7062)}
- A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor}
- A61F 2/4637: {for connecting or disconnecting two parts of a prosthesis}
- A61B 17/86: Pins or screws {or threaded wires; nuts therefor (A61B17/72 take precedence)}
- A61F 2002/30365: {with additional means for limiting said rotation}
- A61F 2002/30367: {with additional means for preventing said rotation}
- A61F 2002/30373: {with additional means for preventing said translation}
- A61F 2002/30375: {with an intermediate bushing or sleeve between the moving parts}
- A61F 2002/30433: {using additional screws, bolts, dowels, rivets or washers e.g. connecting screws}
- A61F 2002/30507: {using a threaded locking member, e.g. a locking screw or a set screw}
- A61F 2002/30538: {for adjusting angular orientation}
- A61F 2002/3055: {for adjusting length}
- A61F 2002/30553: {for adjusting a position by translation along an axis}
- A61F 2002/30604: {modular}
- A61F 2002/30616: {Sets comprising a plurality of prosthetic parts of different sizes or orientations}
- A61F 2002/30649: {Ball-and-socket joints}
- A61F 2002/448: {comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants}
- A61F 2002/4631: {the prosthesis being specially adapted for being cemented}
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2220/0033: made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
- A61F 2220/0041: using additional screws, bolts, dowels or rivets, e.g. connecting screws
- A61F 2250/0006: for adjusting angular orientation
- A61F 2250/0007: for adjusting length
- A61F 2250/0008: for adjusting a position by translation along an axis or two perpendicular axes
- A61F 2310/00017: Iron- or Fe-based alloys, e.g. stainless steel
- A61F 2310/00023: Titanium or titanium-based alloys, e.g. Ti-Ni alloys
- A61F 2310/00029: Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
- A61F 2310/00047: Aluminium or Al-based alloys
- A61F 2310/00131: Tantalum or Ta-based alloys
- A61F 2310/00179: Ceramics or ceramic-like structures
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Prostheses, systems, and methods are provided for replacement of natural facet joints between adjacent vertebrae using polyaxial attachment mechanisms for securing the prostheses to the vertebrae. A cephalad prosthesis attached to a superior adjacent vertebra replaces the inferior half of a natural facet joint. A caudal prosthesis attached to an inferior adjacent vertebra replaces the superior half of a natural facet joint. Both the cephalad and caudal prostheses are configured with artificial facet joint structures that include articulating surfaces that cooperate and form an artificial articular configuration. The polyaxial attachment mechanism permits adjustment of the position of the artificial facet joint structure along more than one axis at or after the time the cephalad or caudal prosthesis is attached to a vertebra.

## Claims

### Claim 1

A method of replacing a facet joint between adjacent vertebrae, the method comprising:
attaching a first spinal prosthetic member to a first spinal structure, the first spinal prosthetic member comprising a first joint element including a first support arm attachable to a first fixation element, wherein the first fixation element comprises a spherical head and wherein the first support arm is attachable to the first fixation element via a fixing element having a concave surface that rests on top of the spherical head of the first fixation element; and
attaching a second spinal prosthetic member to a second spinal structure, the second spinal prosthetic member comprising a second joint element including a bearing surface and a support structure attachable to a second fixation element via a connection element, wherein the second fixation element has a first longitudinal axis and the support structure has a second longitudinal axis extending through a center of the bearing surface, wherein the support structure is offset from the second fixation element such that the second longitudinal axis does not intersect the first longitudinal axis when the support structure is secured to the second fixation element, wherein the second longitudinal axis is substantially parallel to the first longitudinal axis when the support structure is secured to the second fixation element; and
allowing articulation between the first joint element of the first spinal prosthetic member and the second joint element of the second spinal prosthetic member to form an articulating assembly.

### Claim 2 (depends on 1)

The method according to claim 1, wherein the support structure of the second spinal prosthetic member is attached to the second fixation element with a second support arm having a third longitudinal axis.

### Claim 3 (depends on 2)

The method according to claim 2, further comprising rotating the second support arm about the third longitudinal axis to adjust the orientation of the bearing surface.

### Claim 4 (depends on 2)

The method according to claim 2, further comprising moving the second support arm along the third longitudinal axis with respect to the second fixation element to longitudinally adjust the bearing surface.

### Claim 5 (depends on 1)

The method according to claim 1, wherein at least one of the first joint element or the second joint element is pivotable about a pivot.

### Claim 6 (depends on 5)

The method according to claim 5, wherein at least one of the first joint element or the second joint element is fixable at a plurality of angles about the pivot.

### Claim 7 (depends on 1)

The method according to claim 1, further comprising rotating the support structure relative to the second fixation element to adjust a relative orientation of the bearing surface.

### Claim 8 (depends on 1)

The method according to claim 1, further comprising moving the first support arm along its longitudinal axis with respect to the first fixation element.

### Claim 9 (depends on 1)

The method according to claim 1, further comprising locking a position of the second fixation element relative to the connection element.

### Claim 10 (depends on 1)

The method according to claim 1, wherein at least one of the spinal prosthetic members has more than one attachment point for attaching thereto at least one of the first or second fixation elements, and at least one of the first joint element or the second joint element is translatable from one attachment point to another.

### Claim 11 (depends on 1)

The method according to claim 1, wherein the first spinal prosthetic member is a cephalad prosthesis attached to a superior adjacent vertebra configured to replace the inferior half of a natural facet joint, and the second spinal prosthetic member is a caudal prosthesis attached to an inferior adjacent vertebra configured to replace the superior half of the natural facet joint.