US10292720B2

US PATENT 10,292,720 B2

METHODS OF FUSING A SACROILIAC JOINT

A method of fusing a sacroiliac joint including: a) approaching a posterior aspect of a sacroiliac joint space with a joint implant including a body extending a length between a distal end and a proximal end; and b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between a posterior superior iliac spine and a posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

CLAIMS

1.         A method of fusing a sacroiliac joint comprising a sacrum, an ilium, and a sacroiliac joint space defined therebetween, the ilium comprising a posterior superior iliac spine and a posterior inferior iliac spine, the method comprising:

a) approaching a posterior aspect of the sacroiliac joint space with a joint implant comprising a body extending a length between a distal end and a proximal end, the joint implant in an alignment relative to the sacroiliac joint space where the length of the joint implant is generally parallel with a plane defined by the sacroiliac joint space; and

b) delivering the joint implant into the sacroiliac joint space in the alignment such that the joint implant passes through an access region defined between the posterior superior iliac spine and the posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

2.         The method of claim 1, wherein the body defines a generally planar member having a generally rectangular configuration, the body comprises a sacral face extending along the length, an iliac face extending along the length that is opposite the sacral face, a width between the sacral face and the iliac face being about a width of an implant receiving space formed between the sacrum and the ilium, a top surface extending between the sacral face and iliac face and extending along the length, a bottom surface opposite the top surface and extending between the sacral face and iliac face and extending along the length, and a height between the top surface and bottom surface being substantially greater than the width and being about the height of an implant receiving space formed between the sacrum and the ilium, the height of the implant receiving space extending generally within the joint plane of the sacroiliac joint space and being generally perpendicular to the width of the implant receiving space, the length extending generally within the joint plane of the sacroiliac joint space when positioned within the joint plane of the sacroiliac joint space and being generally perpendicular to both the width and the height and being substantially greater than both the width and the height.

3.         The method of claim 2, further comprising: c) inserting a guide wire into the sacroiliac joint space; and d) advancing a cannulated probe having a distal spatulate portion over the guide wire and into the sacroiliac joint space.

4.         The method of claim 2, further comprising forming the implant receiving space prior to delivering the joint implant into the sacroiliac joint space.

5.         The method of claim 4, wherein the step of forming the implant receiving space comprises: aligning a drill jig comprising a plurality of drill guide holes such that at least one of the plurality of drill guide holes is generally coplanar with the joint plane of the sacroiliac joint space; and drilling a plurality of bores into the sacroiliac joint so as to form the implant receiving space for the subsequent delivery of the joint implant.

6.         The method of claim 4, wherein the step of forming the implant receiving space comprises:  aligning a drill jig comprising a plurality of drill guide holes such that the plurality of drill guide holes is generally coplanar with the joint plane of the sacroiliac joint space; and drilling a plurality of bores within the sacroiliac joint space such that each of the plurality of bores removes an amount of cartilage from within the sacroiliac joint space so as to produce the implant receiving space.

7.         The method of claim 4, wherein the step of forming the implant receiving space comprises: positioning a broach jig up to the sacroiliac joint space, the broach jig comprising a broach guide hole configured to guide a broach into the sacroiliac joint space; and advancing a distal end of a broach into the sacroiliac joint space to form the implant receiving space.

8.         The method of claim 2, wherein the joint implant is implanted in a caudal region of the sacroiliac joint space.

9.         The method of claim 8, wherein the caudal region is bounded on an inferior side by an inferior boundary segment and on a superior side by a laterally extending portion of a posterior boundary segment.

10.       The method of claim 2, wherein, in delivering the joint implant into the sacroiliac joint space, the bottom surface of the body of the joint implant is generally parallel to an inferior sacroiliac joint space border.

11.       The method of claim 2, wherein the distal end tapers to a terminal end.

12.       The method of claim 2, wherein the body comprises a passageway extending between an opening on the sacral face and an opening on the iliac face.

13.       The method of claim 12, further comprising inserting biocompatible material within the passageway.

14.       The method of claim 1, wherein the body of the joint implant comprises an end cap having an end cap perimeter selected from at least one of a circle, oval, square or rectangle configuration.

15.       The method of claim 1, wherein the body of the joint implant further comprises an anti-migration element coupled to the proximal end.

16.       The method of claim 15, wherein the anti-migration element comprises an enlarged terminal portion.

17.       The method of claim 1, wherein the joint implant further comprises a first planar member coupled to and extending generally perpendicularly with the body.

18.       The method of claim 1, wherein the joint implant further comprises one or more planar members configured to extend into the sacrum and one or more planar members configured to extend into the ilium when the portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space.

19.       A method of fusing a sacroiliac joint comprising a sacrum, an ilium, and a sacroiliac joint space defined therebetween, the ilium comprising a posterior superior iliac spine and a posterior inferior iliac spine, the method comprising:

            a) approaching a posterior aspect of the sacroiliac joint space with a joint implant comprising a body extending a length between a distal end portion and a proximal end portion, a sacral bore defined within the proximal end portion on a sacral side of the joint implant, and an iliac bore defined within the proximal end portion on an iliac side of the joint implant; and

            b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between the posterior superior iliac spine and the posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that: a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space; the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space; and, the sacral bore is positioned proximate the sacrum and the iliac bore is positioned proximate the ilium.

20.       The method of claim 19, wherein the sacral and iliac bore are coupled via a planar member.

21.       The method of claim 20, wherein the planar member comprises an end cap having a perimeter defining an oval, square, or rectangle.

22.       The method of claim 19, wherein the joint implant approaches the posterior aspect of the sacroiliac joint space in an alignment relative to the sacroiliac joint space where the length of the joint implant is generally parallel with a plane defined by the sacroiliac joint space, and wherein delivery of the joint implant into the sacroiliac joint space is in the alignment.

23.       The method of claim 19, further comprising preparing an implant receiving space prior to delivery of the joint implant into the sacroiliac joint space.

24.       A method of fusing a sacroiliac joint comprising a sacrum, an ilium, and a sacroiliac joint space defined therebetween, the ilium comprising a posterior superior iliac spine and a posterior inferior iliac spine, the method comprising:

a) approaching a posterior aspect of the sacroiliac joint space with a joint implant comprising a body extending a length between a distal end and a proximal end, a first planar member extending the length, and a second planar member extending the length, the first and second planar members coupled to each other near a midsection thereof; and

b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between the posterior superior iliac spine and the posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

25.       The method of claim 24, wherein the joint implant approaches the posterior aspect of the sacroiliac joint space in an alignment relative to the sacroiliac joint space where the length of the joint implant is generally parallel with a plane defined by the sacroiliac joint space, and wherein delivery of the joint implant into the sacroiliac joint space is in the alignment.

26.       The method of claim 24, wherein the first and second planar members are oriented generally perpendicular to each other.

27.       The method of claim 24, wherein each of the first and second planar members comprises an aperture element comprising an aperture perimeter, the aperture elements extending through opposite faces of the first and second planar members, respectively.

28.       The method of claim 24, further comprising preparing an implant receiving space prior to delivery of the joint implant into the sacroiliac joint space.

29.       A method of fusing a sacroiliac joint comprising a sacrum, an ilium, and a sacroiliac joint space defined therebetween, the ilium comprising a posterior superior iliac spine and a posterior inferior iliac spine, the method comprising:

a) approaching a posterior aspect of the sacroiliac joint space with a joint implant comprising a body extending a length between a distal end and a proximal end, the body comprising an end cap having an end cap perimeter selected from at least one of a circle, oval, square or rectangle configuration; and

b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between the posterior superior iliac spine and the posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

30.       The method of claim 29, wherein the joint implant approaches the posterior aspect of the sacroiliac joint space in an alignment relative to the sacroiliac joint space where the length of the joint implant is generally parallel with a plane defined by the sacroiliac joint space, and wherein delivery of the joint implant into the sacroiliac joint space is in the alignment.

31.       A method of fusing a sacroiliac joint comprising a sacrum, an ilium, and a sacroiliac joint space defined therebetween, the ilium comprising a posterior superior iliac spine and a posterior inferior iliac spine, the method comprising:

a) approaching a posterior aspect of the sacroiliac joint space with a joint implant comprising a body extending a length between a distal end and a proximal end, the body comprising an anti-migration element coupled to the proximal end; and

b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between the posterior superior iliac spine and the posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

32.       The method of claim 31, wherein the joint implant approaches the posterior aspect of the sacroiliac joint space in an alignment relative to the sacroiliac joint space where the length of the joint implant is generally parallel with a plane defined by the sacroiliac joint space, and wherein delivery of the joint implant into the sacroiliac joint space is in the alignment.

33.       A method of fusing a sacroiliac joint comprising a sacrum, an ilium, and a sacroiliac joint space defined therebetween, the ilium comprising a posterior superior iliac spine and a posterior inferior iliac spine, the method comprising:

a) approaching a posterior aspect of the sacroiliac joint space with a joint implant comprising a body extending a length between a distal end and a proximal end, and a first planar member coupled to and extending generally perpendicularly with the body; and

b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between the posterior superior iliac spine and the posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

34.       The method of claim 33, wherein the joint implant approaches the posterior aspect of the sacroiliac joint space in an alignment relative to the sacroiliac joint space where the length of the joint implant is generally parallel with a plane defined by the sacroiliac joint space, and wherein delivery of the joint implant into the sacroiliac joint space is in the alignment.