US PATENT 8,979,928 B2 Sacroiliac joint fixation fusion system
A sacroiliac joint fixation fusion system that provides a method of fixation and fusion of the sacroiliac joint and a sacroiliac joint implant which upon placement within the articular region of the sacroiliac joint facilitates stability and fusion of the sacroiliac joint.
CLAIMS
I claim:
1. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the second perpendicular flange further includes an anti-migration element at a proximal end of the second perpendicular flange, the anti-migration element including a tapering of the proximal end of the second perpendicular flange in order to resist movement of the implant within the articular surfaces.
2. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein a proximal end of the first connecting member further includes an outward flaring portion that is configured to resist movement of the implant within the articular surfaces.
3. The sacroiliac joint implant as in claim 2, wherein the at least one passage includes a first passage that extends generally distally from the proximal end and extends through the outward flaring portion.
4. The sacroiliac joint implant as in claim 3, wherein the at least one passage includes a second passage that extends between respective openings on opposite sides of the first connecting member, the second passage being positioned distal of the outward flaring portion.
5. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the at least one passage includes a passage length that is more than about one fourth of the length of the implant.
6. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the at least one passage includes a passage length that is between about one fourth to about two thirds of the length of the implant.
7. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the at least one passage includes a passage height that is more than about one fourth of a height of the first connecting member.
8. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the at least one passage includes a passage height that is between about one fourth to about two thirds of a height of the first connecting member.
9. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the at least one passage includes a passage length that is about one fourth to about two thirds of the length of the implant and the at least one passage includes a passage height that is about one fourth to about two thirds of a height of the first connecting member.
10. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a third perpendicular flange that is opposite of and parallel to the first perpendicular flange, the third perpendicular flange extending the length of the implant, the second perpendicular flange being substantially centered between the first perpendicular flange and the third perpendicular flange; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, and a second connecting member coupled to and extending substantially perpendicularly between the second perpendicular flange and the third perpendicular flange, the second connecting member extending the length of the implant and comprising a second distal edge that slopes from the distal most tip to a distal end of the third perpendicular flange.
11. The sacroiliac joint implant as in claim 10, further comprising at least one second passage that extends transversely through the second connecting member between the distal end and a proximal end, the at least one second passage dimensioned to allow the elongate member to be received within the at least one second passage to anchor the implant to the articular surfaces.
12. The sacroiliac joint implant as in claim 11, wherein the at least one second passage communicates between respective openings on opposite sides of the second connecting member.
13. The sacroiliac joint implant as in claim 12, wherein the opposite sides of the second connecting member are substantially parallel along at least a portion of the length.
14. The sacroiliac joint implant as in any of claims 1-2, or 5-10, in which the implant is curved along the length of the implant.
15. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the implant comprising: a distal end, a proximal end opposite the distal end, an axial bore extending distally from the proximal end, and a length extending between the distal end and the proximal end; a first perpendicular flange extending the length of the implant and including a first planar top surface; a second perpendicular flange opposite of and substantially parallel to the first perpendicular flange, the second perpendicular flange extending the length of the implant and including a second planar top surface; a first connecting member coupled to and extending substantially perpendicularly between the first perpendicular flange and the second perpendicular flange, the first connecting member extending at least the length of the implant and comprising: a distal edge that slopes from a distal most tip to a distal end of the first perpendicular flange; and at least one passage that extends transversely through the first connecting member between the distal end and the proximal end, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the implant is curved along the length of the implant and defines a radius along the length of the implant, a ratio of the radius to the length of the implant being between about one third to about one.
16. The sacroiliac joint implant as in any of claims 1-2, 5-10, or 15, in which the at least one passage extends transversely to the extension of the axial bore.
17. The sacroiliac joint implant as in any of claims 1-2, 5-10, or 15, in which the first planar top surface is an uninterrupted planar surface.
18. The sacroiliac joint implant as in any of claims 1-2, 5-10, or 15, in which the first connecting member is generally rectangular.
19. The sacroiliac joint implant as in any of claims 1-2, 5-10, or 15, in which the first and the second perpendicular flange include a tapered edge along the length of the implant.
20. The sacroiliac joint implant as in any of claims 1-2, 5-10, or 15, in which the first and the second perpendicular flange and the first connecting member define an I-beam shape.
21. The sacroiliac joint implant as in any of claims 1-2, 5-10, or 15, in which the distal edge extends distally beyond the length of the implant.
22. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the articular surfaces comprising a cranial portion and a caudal portion, the implant comprising: a distal end, a proximal end opposite the distal end, and a length extending between the distal end and the proximal end; a first arcuate edge extending the length of the implant; a second arcuate edge opposite the first arcuate edge and extending the length of the implant, wherein the first arcuate edge defines a first curvature along the length of the implant that matches a second curvature that is defined by the second arcuate edge along the length of the implant; a first planar connecting member extending a first distance between the first arcuate edge and the second arcuate edge and extending the length of the implant, the first planar connecting member including opposite planar surfaces disposed a second distance apart at the distal end and a third distance apart at the proximal end, the first arcuate edge extending the second distance between the opposite planar surfaces at the distal end, the first arcuate edge extending the third distance between the opposite planar surfaces at the proximal end; at least one passage extending transversely through the first planar connecting member, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces, wherein the first curvature defines a radial path along the length of the implant of between about 2 centimeters and about 6 centimeters.
23. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the articular surfaces comprising a cranial portion and a caudal portion, the implant comprising: a distal end, a proximal end opposite the distal end, and a length extending between the distal end and the proximal end; a first arcuate edge extending the length of the implant; a second arcuate edge opposite the first arcuate edge and extending the length of the implant, wherein the first arcuate edge defines a first curvature along the length of the implant that matches a second curvature that is defined by the second arcuate edge along the length of the implant, wherein the first curvature defines a radius along the length of the implant, a ratio of the radius to the length of the implant being between about one third to about one; a first planar connecting member extending a first distance between the first arcuate edge and the second arcuate edge and extending the length of the implant, the first planar connecting member including opposite planar surfaces disposed a second distance apart at the distal end and a third distance apart at the proximal end, the first arcuate edge extending the second distance between the opposite planar surfaces at the distal end, the first arcuate edge extending the third distance between the opposite planar surfaces at the proximal end; at least one passage extending transversely through the first planar connecting member, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces.
24. A sacroiliac joint implant for non-transverse placement between articular surfaces of a sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the articular surfaces comprising a cranial portion and a caudal portion, the implant comprising: a distal end, a proximal end opposite the distal end, and a length extending between the distal end and the proximal end; a first arcuate edge extending the length of the implant; a second arcuate edge opposite the first arcuate edge and extending the length of the implant; a first planar connecting member extending a first distance between the first arcuate edge and the second arcuate edge and extending the length of the implant, the first planar connecting member including opposite planar surfaces disposed a second distance apart at the distal end and a third distance apart at the proximal end, the first arcuate edge extending the second distance between the opposite planar surfaces at the distal end, the first arcuate edge extending the third distance between the opposite planar surfaces at the proximal end; at least one passage extending transversely through the first planar connecting member, the at least one passage dimensioned to allow an elongate member to be received within the at least one passage to anchor the implant to the articular surfaces; a third arcuate edge extending the length of the implant; a fourth arcuate edge opposite the third arcuate edge and extending the length of the implant; and a second planar connecting member extending a sixth distance between the third arcuate edge and the fourth arcuate edge and extending the length of the implant, the second planar connecting member including opposite planar surfaces disposed a seventh distance apart, the first arcuate edge and the second arcuate edge extending the sixth distance between the opposite planar surfaces of the planar connecting member, the second planar connecting member coupled to the first planar connecting member and being in substantially orthogonal relation to the first planar connecting member.
25. The sacroiliac joint implant as in claim 24, wherein the first distance is greater than the sixth distance.
26. The sacroiliac joint implant as in claim 24, wherein the first distance is at least double the sixth distance.
27. The sacroiliac joint implant as in claim 24, wherein the first arcuate edge defines a first curvature along the length of the implant that matches a second curvature that is defined by the second arcuate edge along the length of the implant.
28. The sacroiliac joint implant as in any of claims 22-23 or 24, in which the first curvature and the second curvature are consistent along the length of the implant.
29. The sacroiliac joint implant as in any of claims 22-23 or 24, in which the first distance is greater than the second distance.
30. The sacroiliac joint implant as in any of claims 22-23 or 24, in which the second distance and the third distance are substantially equal.
31. The sacroiliac joint implant as in any of claims 22-23 or 24, in which the third distance is greater than the second distance.
32. The sacroiliac joint implant as in any of claims 22-23 or 24, in which the second arcuate edge extends a fourth distance between the opposite planar surfaces at the distal end and extends a fifth distance between the opposite planar surfaces at the proximal end.
33. The sacroiliac joint implant as in claim 32, wherein the second distance is substantially equal to the fourth distance, the third distance is substantially equal to the fifth distance, and the third and the fifth distances are greater than the second and the fourth distances.
34. The sacroiliac joint implant as in claim 32, wherein the second and the third distances are greater than the fourth and the fifth distances such that the first planar connecting member defines a wedge-shape that tapers between the first arcuate edge and the second arcuate edge.
35. The sacroiliac joint implant as in any of claims 1-2, 5-10, 15, 22-23, or 24, in which the at least one passage comprises a pair of openings, each of the pair of openings including a closed perimeter and being positioned on opposite sides of the implant.
36. A system for treating a patient body having a sacroiliac joint, a spine, and a pelvis by delivery of an implant non-transversely between articular surfaces of the sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the system comprising: a) the sacroiliac joint implant as in any of claims 1-2, 5-10, 15, 22-23, or 24; and b) a first coupling element connected to the proximal end of the sacroiliac joint implant, the first coupling element comprising a first coupling portion configured to join with an at least one spanning member; wherein the first coupling portion is configured to fix a location of the at least one spanning member allowing for coupling of either: i) the spine to the pelvis such that the sacroiliac joint implant is operably coupled with at least one spine fixation element via the at least one spanning member; ii) the sacroiliac joint implant to a second sacroiliac joint implant such that the sacroiliac joint implant is operably coupled with the second sacroiliac joint implant via the at least one spanning member; or iii) the sacroiliac joint implant to a second, coupling element disposed into either of the sacrum or ilium such that the sacroiliac joint implant is operably coupled with the second coupling element via the at least one spanning member.
37. A system for treating a patient body having a sacroiliac joint, a spine, and a pelvis by delivery of an implant non-transversely between articular surfaces of the sacroiliac joint to dispose a sacrum and an ilium in substantially immobilized relation, the system comprising: a) the sacroiliac joint implant as in any of claims 1-2, 5-10, 15, 22-23, or 24; and b) an alignment tool comprising an alignment guide and a distal portion configured to fixedly mate with the proximal end of the sacroiliac joint implant, wherein the alignment tool comprises a fixed or adjustably fixed configuration such that the alignment guide is configured to align the elongate member to pass through the at least one passage.