Methods and instruments for use in vertebral treatment

Abstract

Embodiments of the invention include instruments, implants, and methods for surgically treating facet joints of vertebrae. An instrument may be advanced into one or more facet joints to one or both separate vertebrae and remove tissue from one or more articular processes. A stop on the instrument may be used to terminate advancement of the instrument by contacting a vertebra, and one or more implants may be placed into one or more facet joints.

1 - 20 . (canceled) 
     
     
         21 . A first instrument comprising:
 a shaft comprising a proximal end and an opposite distal end;   a handle coupled to the proximal end; and   a core comprising opposite proximal and distal walls, the proximal wall being coupled to the distal end, the distal wall defining an implant interface, the core comprising opposite top and bottom walls each extending from the proximal wall to the distal wall, the core comprising a pusher stop extending outwardly from the top wall.   
     
     
         22 . The first instrument recited in  claim 21 , wherein the pusher stop extends substantially perpendicularly from the top wall. 
     
     
         23 . The first instrument recited in  claim 21 , wherein the pusher stop comprises opposite proximal and distal faces and a connecting wall extending from the proximal face to the distal face, the proximal face extending parallel to the distal face. 
     
     
         24 . The first instrument recited in  claim 21 , wherein the pusher stop comprises opposite proximal and distal faces and a connecting wall extending from the proximal face to the distal face, the distal face extending parallel to the distal wall. 
     
     
         25 . The first instrument recited in  claim 21 , wherein the pusher stop comprises opposite proximal and distal faces and a connecting wall extending from the proximal face to the distal face, the connecting wall including opposite first and second ends each extending from the top wall, the connecting wall being arcuate between the first end and the second end. 
     
     
         26 . The first instrument recited in  claim 21 , wherein the pusher stop comprises opposite proximal and distal faces, the distal face being a first distance from the distal wall, the proximal face being a second distance from the proximal wall, the second distance being greater than the first distance. 
     
     
         27 . The first instrument recited in  claim 21 , wherein the core comprises opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the pusher stop being positioned equidistant between the side walls. 
     
     
         28 . The first instrument recited in  claim 21 , wherein the implant interface includes teeth. 
     
     
         29 . The first instrument recited in  claim 21 , wherein the implant interface includes teeth, the teeth being pyramid shaped. 
     
     
         30 . The first instrument recited in  claim 21 , wherein the implant interface includes teeth, the teeth extending continuously from the top wall to the bottom wall. 
     
     
         31 . The first instrument recited in  claim 21 , wherein the implant interface includes teeth, the core comprising opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the teeth extending continuously from the first side wall to the second side wall. 
     
     
         32 . The first instrument recited in  claim 21 , wherein the implant interface includes teeth, the core comprising opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the teeth extending continuously from the first side wall to the second side wall and continuously from the top wall to the bottom wall. 
     
     
         33 . The first instrument recited in  claim 21 , wherein the implant interface includes teeth, the core comprising opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the side walls each defining a portion of at least one of the teeth. 
     
     
         34 . The first instrument recited in  claim 21 , wherein the shaft has a maximum diameter greater than a maximum diameter of the distal wall. 
     
     
         35 . The first instrument recited in  claim 21 , wherein the core comprises opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the core having a width defined by a distance from the first side wall to the second side wall, the shaft having a diameter greater than the width. 
     
     
         36 . The first instrument recited in  claim 21 , wherein the shaft extends along a longitudinal axis from the proximal end to the distal end, the distal wall extending at an acute angle relative to the longitudinal axis. 
     
     
         37 . The first instrument recited in  claim 21 , wherein the proximal wall has a first height defined by a first distance from the top wall to the bottom wall and the distal wall has a second height defined by a second distance from the top wall to the bottom wall, the second height being less than the first height. 
     
     
         38 . The first instrument recited in  claim 21 , wherein the pusher stop has a first height defined by a distance from the top wall to a top portion of the pusher stop, the distal wall having a second height defined by a distance from the top wall to the bottom wall, the second height being less than the first height. 
     
     
         39 . A first instrument comprising:
 a shaft extending along a longitudinal axis between a proximal end and an opposite distal end;   a handle coupled to the proximal end; and   a core comprising opposite proximal and distal walls, the proximal wall being coupled directly to the distal end, the distal wall extending at an acute angle relative to the longitudinal axis, the distal wall defining an implant interface, the implant interface including teeth, the core comprising opposite top and bottom walls each extending from the proximal wall to the distal wall, the core comprising opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the core comprising a pusher stop extending outwardly from the top wall such that the pusher stop extends substantially perpendicular to the top wall,   wherein the shaft has a maximum diameter greater than a maximum diameter of the distal wall,   wherein the pusher stop comprises opposite proximal and distal faces and a connecting wall extending from the proximal face to the distal face, the distal face extending parallel to the distal wall.   
     
     
         40 . A first instrument comprising:
 a shaft extending along a longitudinal axis between a proximal end and an opposite distal end;   a handle coupled to the proximal end; and   a core comprising opposite proximal and distal walls, the proximal wall being coupled directly to the distal end, the distal wall extending at an acute angle relative to the longitudinal axis, the distal wall defining an implant interface, the implant interface including teeth, the core comprising opposite top and bottom walls each extending from the proximal wall to the distal wall, the core comprising opposite first and second side walls each extending from the proximal wall to the distal wall and from the top wall to the bottom wall, the core comprising a pusher stop extending outwardly from the top wall such that the pusher stop extends substantially perpendicular to the top wall, the pusher stop being positioned equidistant between the side walls,   wherein the pusher stop comprises opposite proximal and distal faces, the distal face being a first distance from the distal wall, the proximal face being a second distance from the proximal wall, the second distance being greater than the first distance, and   wherein the core has a width defined by a distance from the first side wall to the second side wall, the shaft having a diameter greater than the width.