US10314710B2

US PATENT 10,314,710 B2

METHODS OF FUSING A SACROILIAC JOINT

One implementation of the present disclosure may include a method of sacroiliac joint fusion involving a joint implant and a delivery tool. The joint implant includes at least one integral anchor configured to move relative to a body of the implant when being brought into anchoring engagement with bone defining a sacroiliac joint space in which the body of the implant is located. In certain embodiments, the anchor extends distally and laterally relative to a body of the implant or the anchor rotates relative to the body of the implant via a center axle when being brought into anchoring engagement with the bone. The delivery tool may be configured to support the implant and to cause the displacement of the at least one anchor relative to the implant body so as to cause the at least one anchor to be brought into anchoring engagement with the bone.

CLAIMS

What is claimed is:

1. A method of implanting an implant in a sacroiliac joint defined between a sacrum and an ilium, the method comprising:

positioning the implant in the sacroiliac joint such that a first lateral side of the implant faces and contacts a sacrum surface of the sacroiliac joint and a second lateral side of the implant faces and contacts an ilium surface of the sacroiliac joint, the first and second lateral sides being opposite the implant from each other;

acting at a proximal end of the implant to cause an anchor to transition from a recessed condition to a deployed condition, the deployed condition being when a bone engagement portion of the anchor extends from an outer surface of the implant into bone defining at least a portion of the sacroiliac joint, the recessed condition being when the bone engagement portion does not extend from the outer surface of the implant; and

using the implanted implant as an attachment point for structural components of a spinal support system.

2. The method of claim 1, wherein the anchor is configured to displace within a passage extending distal-lateral from a proximal opening of the passage when the anchor transitions from the recessed condition to the deployed condition.

3. The method of claim 2, wherein the displacement includes sliding.

4. The method of claim 3, wherein the anchor is a nail.

5. The method of claim 3, wherein the anchor has blade-like configuration and the passage has a slot-like configuration.

6. The method of claim 3, wherein acting at the proximal end of the implant to cause the anchor to transition from the recessed condition to the deployed condition includes pushing or impacting on a proximal end of the anchor.

7. The method of claim 6, further comprising selectively releasably coupling the proximal end of the implant to a distal end of an insertion tool and then employing the insertion tool to deliver the implant into and position the implant in the sacroiliac joint.

8. The method of claim 7, further comprising displacing a member of the insertion tool relative to the rest of the insertion tool and against the proximal end of the implant to cause the anchor to transition from the recessed condition to the deployed condition.

9. The method of claim 8, wherein the displacing of the member of the insertion tool is sliding displacement.

10. The method of claim 1, wherein the anchor is configured to displace within a passage extending generally distal from a proximal opening of the passage when the anchor transitions from the recessed condition to the deployed condition.

11. The method of claim 1, wherein the anchor is configured to displace within a passage extending generally lateral from a proximal opening of the passage when the anchor transitions from the recessed condition to the deployed condition.

12. The method of claim 11, wherein the displacement includes rotation.

13. The method of claim 12, wherein the anchor is a screw.

14. The method of claim 13, wherein the passage has a bore-like configuration.

15. The method of claim 13, wherein acting at the proximal end of the implant to cause the anchor to transition from the recessed condition to the deployed condition includes applying a rotational force to a proximal end of the anchor.

16. The method of claim 15, further comprising selectively releasably coupling the proximal end of the implant to a distal end of an insertion tool and then employing the insertion tool to deliver the implant into and position the implant in the sacroiliac joint.

17. The method of claim 1, wherein the first and second lateral sides are offset from each other by a thickness of the implant that is less than a width of at least one of the first or second lateral sides.

18. The method of claim 1, wherein the first and second lateral sides are generally planar.

19. The method of claim 18, further comprising selectively releasably coupling the proximal end of the implant to a distal end of an insertion tool and then employing the insertion tool to deliver the implant into and position the implant in the sacroiliac joint.

20. The method of claim 1, wherein when in the deployed condition the bone engagement portion of the anchor extends from at least one of the first or second lateral sides.

21. The method of claim 1, wherein the anchor is pivotally supported about a pivot axis in the implant, and the anchor is configured to pivot about the pivot axis when the anchor transitions from the recessed condition to the deployed condition.

22. The method of claim 21, wherein the pivot axis extends proximal-distal between the proximal end of the implant and a distal end of the implant.

23. The method of claim 21, wherein the bone engagement portion of the anchor includes a blade-like edge extending generally parallel to the pivot axis.

24. The method of claim 21, wherein the bone engagement portion of the anchor terminates in a tip extending radially outwardly from the pivot axis.

25. The method of claim 21, wherein acting at the proximal end of the implant to cause the anchor to transition from the recessed condition to the deployed condition includes applying at the proximal end of the implant a torque to the anchor.

26. The method of claim 1, wherein the spinal support system is configured to support across a patient hip structure.

27. The method of claim 1, wherein the spinal support system is configured to support along a patient spinal column.

28. The method of claim 1, wherein the implant enters the sacroiliac joint via a caudal access into the sacroiliac joint.

29. The method of claim 1, wherein the implant enters the sacroiliac joint via a cranial access into the sacroiliac joint.

30. The method of claim 1, wherein the implant enters the sacroiliac joint via an extra-articular access into the sacroiliac joint.

31. The method of claim 1, wherein the implant enters the sacroiliac joint via crossing a sacroiliac joint inferior boundary.

32. The method of claim 31, wherein the implant enters the sacroiliac joint via a patient entry point near a coccyx and a sacrotuberous ligament.

33. The method of claim 1, wherein the implant comprises a coupling element at the proximal end of the implant.

34. The method of claim 33, wherein the coupling element comprises a fastener portion at a distal end thereof and a coupling portion at a proximal end thereof, the fastener portion threadably received in the proximal end of the implant.

35. The method of claim 33, further comprising joining a spanning member to the coupling element.

36. The method of claim 35, wherein the spanning member comprises a rod.

37. The method of claim 35, wherein joining the spanning member to the coupling element comprises engaging a spirally threaded body with the coupling element such that the spanning member is sandwiched between the spirally threaded body and the coupling element.

38. The method of claim 35, further comprising implanting a device into at least one of a bone and a joint proximate the sacroiliac joint.

39. The method of claim 38, further comprising joining the spanning member to the device.

40. The method of claim 38, wherein the bone comprises at least one of the sacrum and the ilium.

41. The method of claim 38, wherein the bone comprises a vertebra.

42. The method of claim 38, wherein the joint proximate the sacroiliac joint comprises another sacroiliac joint spaced apart from the sacroiliac joint by the sacrum.

43. The method of claim 35, wherein the spanning member comprises a plate.

44. The method of claim 43, wherein the plate comprises at least one aperture through which a fastener portion of the coupling element is passable.

45. The method of claim 43, wherein the plate comprises at least one aperture through which a screw is passable and the method further comprising delivering the screw through the at least one aperture generally anteriorly and via an S1 pedicle location.

46. The method of claim 45, wherein the plate comprises a second aperture of the at least one aperture through which a second screw is passable and the method further comprising delivering the screw through the second aperture and into the sacrum, across the sacroiliac joint, and terminating in or through the ilium.

47. The method of claim 33, further comprising joining the coupling element to the proximal end of the implant.

48. The method of claim 33, wherein the coupling element comprises a coupling portion configured to join with a spanning member.

49. The method of claim 48, wherein the coupling portion comprises a cup coupled to the implant and having a pass-through element in which at least part of a spanning member is receivable therethrough.

50. The method of claim 49, wherein the cup is pivotally coupled to the implant.

51. The method of claim 49, wherein the cup is a generally cylindrical body.

52. The method of claim 49, wherein a locking body is engageable with the cup allowing the spanning member to be selectively placed in fixed relation to the cup.

53. The method of claim 1, wherein the implant is coupled to a spanning member in a multi-piece arrangement.

54. The method of claim 53, wherein the implant and spanning member are assembled during a surgery at the sacroiliac joint.

55. The method of claim 54, further comprising coupling the spanning member to the proximal end of the implant.

56. The method of claim 53, wherein the multi-piece arrangement is provided from a manufacturer with the spanning member being an extension of a proximal region of the implant.

57. The method of claim 53, wherein the spanning member comprises a rod.

58. The method of claim 53, wherein the spanning member comprises a plate.

59. The method of claim 58, wherein the plate comprises at least one aperture through which a fastener is passable.

60. The method of claim 59, further comprising delivering the fastener through the at least one aperture and into an S1 body of the sacrum.

61. The method of claim 59, further comprising delivering the fastener through the at least one aperture and into an S2 body of the sacrum, through the sacroiliac joint, and further into the ilium.

62. The method of claim 59, wherein the at least one aperture comprises a first and second aperture through which a first and second fastener, respectively, are passable, and the method further comprising delivering the first fastener through the first aperture and into an S1 body of the sacrum, and delivering the second fastener through the second aperture and into an S2 body of the sacrum, through the sacroiliac joint, and further into the ilium.

63. The method of claim 1, wherein the implant and a spanning member are coupled to each other and form of an integral, unitary construction.

64. The method of claim 63, wherein the spanning member comprises a rod.

65. The method of claim 63, wherein the spanning member comprises a plate.

66. The method of claim 65, wherein the plate comprises at least one aperture through which a fastener is passable.

67. The method of claim 66, further comprising delivering the fastener through the at least one aperture and into an S1 body of the sacrum.

68. The method of claim 66, further comprising delivering the fastener through the at least one aperture and into an S2 body of the sacrum, through the sacroiliac joint, and further into the ilium.

69. The method of claim 66, wherein the at least one aperture comprises a first and second aperture through which a first and second fastener, respectively, are passable, and the method further comprising delivering the first fastener through the first aperture and into an S1 body of the sacrum, and delivering the second fastener through the second aperture and into an S2 body of the sacrum, through the sacroiliac joint, and further into the ilium.