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US-12622730-B2 - Method of placing an implant between bone portions

US12622730B2US 12622730 B2US12622730 B2US 12622730B2US-12622730-B2

Abstract

Devices and methods for placing an implant between two bone portions are disclosed. In some embodiments, a method comprises disposing a portion of a flexible member through a first bone portion, through an aperture in a trial implant, and through a second bone portion. The trial implant can be withdrawn to enable an implant to be coupled to the flexible member. The method includes applying tension to the flexible member to urge the implant into the space between two bone portions. In some embodiments, the two bone portions are facets.

Inventors

  • Jason Blain
  • Gregory Martin
  • Charles C. Newton
  • Hyun Bae

Assignees

  • SPINAL ELEMENTS, INC.

Dates

Publication Date
20260512
Application Date
20221103

Claims (20)

  1. 1 . A method comprising: inserting a trial implant between articular processes of a facet joint; forming a lumen through the articular processes of the facet joint; inserting a portion of a flexible member through the lumen and the trial implant; withdrawing the trial implant and the flexible member from between the articular processes of the facet joint; coupling an implant with the flexible member, wherein the implant comprises an allograft; and advancing the implant between the articular processes of the facet joint.
  2. 2 . The method of claim 1 , further comprising preparing the articular processes of the facet joint.
  3. 3 . The method of claim 1 , wherein forming the lumen comprises forming a curved lumen.
  4. 4 . The method of claim 1 , wherein forming the lumen comprises utilizing a curved drill.
  5. 5 . The method of claim 1 , wherein coupling the implant with the flexible member comprises passing the flexible member through a slot extending from an edge of the implant.
  6. 6 . The method of claim 1 , wherein advancing the implant between the articular processes comprises applying tension to ends of the flexible member.
  7. 7 . The method of claim 1 , wherein forming the lumen comprises extending a lumen-forming arm through an aperture in the trial implant.
  8. 8 . The method of claim 1 , further comprising inserting a portion of a fastening band through the lumen and the implant.
  9. 9 . A method comprising: inserting a trial implant of a trial member into a facet joint space of a facet joint; forming a lumen through a portion of the facet joint; inserting a portion of a flexible member through the lumen and the trial implant; withdrawing the trial implant and the flexible member from the facet joint space; and disassembling the trial member to disengage the trial implant from the flexible member.
  10. 10 . The method of claim 9 , further comprising preparing the facet joint.
  11. 11 . The method of claim 9 , wherein forming the lumen comprises utilizing a curved drill.
  12. 12 . The method of claim 9 , further comprising coupling an implant with the flexible member.
  13. 13 . The method of claim 12 , further comprising advancing the implant into the facet joint space.
  14. 14 . The method of claim 13 , further comprising inserting a fastening band through the lumen and the implant.
  15. 15 . The method of claim 13 , wherein advancing the implant into the facet joint space comprises pulling ends of the flexible member.
  16. 16 . A method comprising: inserting a trial implant between a first bone portion and a second bone portion; forming a first lumen with a drill bit through the first bone portion; extending the drill bit through an aperture of the trial implant; forming a second lumen with the drill bit through the second bone portion; and inserting a flexible member through the first lumen in the first bone portion, through the trial implant, and through the second lumen in the second bone portion, wherein the flexible member is removed after insertion of a band through the first lumen in the first bone portion and through the second lumen in the second bone portion.
  17. 17 . The method of claim 16 , further comprising preparing the first bone portion and the second bone portion.
  18. 18 . The method of claim 16 , wherein forming the first lumen comprises forming a curved lumen.
  19. 19 . The method of claim 16 , further comprising withdrawing the trial implant and the flexible member from between the first bone portion and the second bone portion.
  20. 20 . The method of claim 16 , further comprising advancing an implant between the first bone portion and the second bone portion.

Description

INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS This application is a continuation of U.S. patent application Ser. No. 16/221,903, filed on Dec. 17, 2018, which is a divisional of U.S. patent application Ser. No. 15/245,664, filed on Aug. 24, 2016, which is a divisional of U.S. patent application Ser. No. 14/491,820, filed on Sep. 19, 2014, which claims priority under 35 U.S.C. § 119 (e) to U.S. Provisional Patent Application No. 61/883,911, filed Sep. 27, 2013, the disclosures of each are incorporated by reference herein in their entirety. This application incorporates by reference U.S. Pat. No. 8,740,949 (U.S. application Ser. No. 13/033,791, filed Feb. 24, 2011); U.S. Patent Publication 2012/0221049 (U.S. application Ser. No. 13/403,698, filed Feb. 23, 2012), U.S. Pat. No. 7,846,183 (application Ser. No. 10/865,073, filed Jun. 10, 2004), U.S. Pat. No. 8,652,137 (U.S. application Ser. No. 12/035,366, filed Feb. 21, 2008), U.S. Publication 2011/0040301 (application Ser. No. 12/859,009, filed Aug. 18, 2010), in their entirety. BACKGROUND Some embodiments described herein relate generally to methods and devices for facilitating the insertion of an implant between bone portions. Some embodiments described herein relate generally to methods and implants for fusing bone, for example, fusing vertebrae by securing the articular processes of the vertebrae. Other embodiments described herein relate to augmentation and restoration of vertebral facet joints affected by degeneration and the surgical method and devices for implanting these devices in the spine Traumatic, inflammatory, and degenerative disorders of the spine can lead to severe pain and loss of mobility. One source of back and spine pain is related to degeneration of the facets of the spine or facet arthritis. Bony contact or grinding of degenerated facet joint surfaces can play a role in some pain syndromes. While many technological advances have focused on the intervertebral disc and artificial replacement or repair of the intervertebral disc, little advancement in facet repair has been made. Facet joint and disc degeneration frequently occur together. Thus, a need exists to address the clinical concerns raised by degenerative facet joints. The current standard of care to address the degenerative problems with the facet joints is to fuse the two adjacent vertebrae. By performing this surgical procedure, the relative motion between the two adjacent vertebrae is stopped, thus stopping motion of the facets and any potential pain generated as a result thereof. Procedures to fuse two adjacent vertebrae often involve fixation and/or stabilization of the two adjacent vertebrae until the two adjacent vertebrae fuse. Commonly owned U.S. Patent Publications 2012/0221049 (U.S. application Ser. No. 13/403,698, filed Feb. 23, 2012) and U.S. Pat. No. 8,740,949 (U.S. application Ser. No. 13/033,791, filed Feb. 24, 2011) describe methods for stabilizing two bone portions by extending a flexible fastening band through a lumen in two bone portions. The flexible fastening band can be advanced through a fastener until the two bone portions are stabilized. In one embodiment, the first bone portion is the articular process of a first vertebrae and the second bone portion is an articular process of a second vertebra. As described in these applications, in certain embodiments it is useful to dispose prosthesis (e.g., an allograft, metallic implant, etc.) between the first and second bone portions before stabilizing the two bone portions. Commonly owned U.S. Pat. No. 7,846,183 (U.S. application Ser. No. 10/865,073, filed Jun. 10, 2004) describes a method in which the facet joint is restored by inserting a prosthesis between bone portions, such as a facet joint. Such a procedure can alleviate the bone on bone contact that is common in degenerative facet joints and often the source of pain generation, while allowing relative motion between the facets to continue post-operatively. Injuries and/or surgical procedure on and/or effecting other bones can also result in the desire to fixate and/or stabilize a bone until the bone, or bone portions, can fuse, for example, to stabilize a sternum after heart surgery, to stabilize a rib after a break, etc. Current procedures to fixate and/or stabilize adjacent vertebrae and/or other bones can be slow and/or complex. Accordingly, a need exists for an apparatus and a procedure to quickly and/or easily stabilize and/or fixate a bone. SUMMARY In some embodiments, a method of placing an implant between a first bone portion and a second bone portion is provided. The method can include the step of forming a lumen in a first bone portion. The method can include the step of forming a lumen in a second bone portion. The method can include the step of inserting a trial implant between the first bone portion and the second bone portion. The method can include the step of inserting a portion of a flexible member through the lumen in the first b