US PATENT 9,949,835 B2

METHODS OF FUSING A SACROILIAC JOINT VIA A POSTERIOR-INFERIOR ACCESS REGION

A method of fusing a sacroiliac joint including implanting a joint implant into the sacroiliac joint such that the joint implant passes through a posterior-inferior access region, the joint implant having an implanted position in the sacroiliac joint such that a portion of the joint implant is positioned within a caudal portion of an articular plane of the sacroiliac joint.

CLAIMS

The invention claimed is:

1. A method of fusing a sacroiliac joint defined between a sacrum and an ilium, the sacroiliac joint comprising an articular plane defined by an articular boundary, and an extra-articular plane outside the articular boundary, the articular boundary defining an anterior boundary segment at an anterior portion of the articular plane, and a posterior boundary segment at a posterior portion of the articular plane and comprising a superior-posterior corner and an inferior-posterior corner, the method comprising:

a) approaching the posterior portion of the articular plane of the sacroiliac joint with a joint implant comprising a body extending a length between a distal end and a proximal end; and

b) implanting the joint implant into the articular plane of the sacroiliac joint through the posterior boundary segment of the articular plane while not entering the articular plane through the extra-articular plane, the joint implant having an implanted position in the articular plane of the sacroiliac joint such that the distal end of the joint implant is positioned posteriorly of the anterior boundary segment of the sacroiliac joint.

21. A method of fusing a sacroiliac joint defined between a sacrum and an ilium, the sacroiliac joint comprising an articular plane defined by an articular boundary, and an extra-articular plane outside the articular boundary, the articular boundary defining an anterior boundary segment at an anterior portion of the articular plane, the articular plane comprising a superior portion and an inferior portion, the method comprising:

a) approaching a posterior aspect of the sacroiliac joint with a joint implant comprising a body extending a length between a distal end and a proximal end; and

b) implanting the joint implant non-transversely into the inferior portion of the articular plane of the sacroiliac joint such that the joint implant has an implanted position within the articular plane that includes the distal end of the joint implant being positioned posteriorly of the anterior boundary segment of the articular plane.

22. The method of claim 21, wherein, in implanting the joint implant non-transversely into the inferior portion of the sacroiliac joint, the joint implant does not enter the articular plane through the extra-articular plane.

23. A method of fusing a sacroiliac joint defined between a sacrum and an ilium, the sacroiliac joint comprising an articular plane defined by an articular boundary, and an extra-articular plane outside the articular boundary, the articular boundary defining an anterior boundary segment at an anterior portion of the articular plane, and a posterior boundary segment at a posterior portion of the articular plane and comprising a superior-posterior corner and an inferior-posterior corner, the method comprising:

a) approaching the posterior portion of the articular plane of the sacroiliac joint with a joint implant comprising a body; and

b) implanting the joint implant into the sacroiliac joint such that the joint implant passes through an access region defined between the superior-posterior corner and the inferior-posterior corner, the joint implant having an implanted position in the sacroiliac joint such that a portion of the joint implant is positioned within a caudal portion of the articular plane.

24. The method of claim 1, wherein the body of the joint implant further comprises a cylindrical volume extending the length.

25. The method of claim 24, wherein the body of the joint implant further comprises a generally planar member coupled with the cylindrical volume and extending the length.

26. The method of claim 25, wherein the cylindrical volume comprises an axial bore and a plurality of apertures arranged along the length extending from an exterior surface of the body into an inner portion of the cylindrical volume, and the generally planar member further comprises a passageway extending between apertures on opposite faces of the generally planar member, wherein a perimeter of the apertures on the opposite faces is substantially larger than a perimeter of each of the plurality of apertures extending into the inner portion of the cylindrical volume.

27. The method of claim 1, wherein the body of the joint implant further comprises a first generally planar member arranged generally perpendicular with a second generally planar member, the first and second generally planar members extending the length.

28. The method of claim 20, 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 defined 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 a height of the implant receiving space defined between the sacrum and the ilium, the height of the implant receiving space extending generally within a joint plane of the sacroiliac joint and being generally perpendicular to the width of the implant receiving space, the length extending generally within the joint plane of the sacroiliac joint when the joint implant is in the implanted position within the sacroiliac joint, the length being generally perpendicular to both the width and the height of the body of the joint implant, and the length being substantially greater than both the width and the height of the body of the joint implant.

29. The method of claim 28, further comprising: c) inserting a guide wire into the sacroiliac joint; and d) advancing a cannulated probe having a distal spatulate portion over the guide wire and into the sacroiliac joint.

30. The method of claim 28, further comprising forming the implant receiving space by removing at least one of bone and cartilage from the sacrum, the ilium, or the sacroiliac joint prior to implanting the joint implant into the sacroiliac joint.

31. The method of claim 30, 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 a joint plane of the sacroiliac joint; and drilling at least one bore into the sacroiliac joint through at least one of the plurality of drill guide holes so as to form the implant receiving space for the subsequent implantation of the joint implant.

32. The method of claim 30, 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 a joint plane of the sacroiliac joint; and drilling at least one bore within the sacroiliac joint so as to remove an amount of the cartilage from within the sacroiliac joint.

33. The method of claim 30, wherein the step of forming the implant receiving space comprises: positioning a broach jig up to the sacroiliac joint, the broach jig comprising a broach guide hole configured to guide a broach into the sacroiliac joint; and advancing a distal end of a broach into the sacroiliac joint.

34. The method of claim 28, wherein, in implanting the joint implant into the sacroiliac joint, the bottom surface of the body of the joint implant is generally parallel to an inferior sacroiliac joint border.

35. The method of claim 28, wherein the distal end tapers to a terminal end.

36. The method of claim 28, wherein the body comprises a passageway extending between an opening on the sacral face and an opening on the iliac face.

37. The method of claim 36, further comprising inserting biocompatible material within the passageway.

38. The method of claim 20, 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.

39. The method of claim 20, wherein the body of the joint implant further comprises an anti-migration element coupled to the proximal end.

40. The method of claim 39, wherein the anti-migration element comprises an enlarged terminal portion.

41. The method of claim 20, wherein the body of the joint implant further comprises a first planar member, a second planar member parallel with the first planar member, a third planar member, and a fourth planar member parallel with the third planar member, the first and second planar members being perpendicular to the third and fourth planar members, the first, the second, the third, and the fourth planar members extending the length.

42. The method of claim 20, wherein the body of the joint implant further comprises a bore extending therethrough, and the method further comprises: c) inserting a mechanical fastener through the bore and into the sacrum or the ilium.

43. The method of claim 42, wherein the bore extends through an anti-migration element of the joint implant.

44. The method of claim 20, wherein the body of the joint implant further comprises a cylindrical volume extending the length.

45. The method of claim 44, wherein the body of the joint implant further comprises a generally planar member coupled with the cylindrical volume and extending the length.

46. The method of claim 45, wherein the cylindrical volume comprises an axial bore and a plurality of apertures arranged along the length extending from an exterior surface of the body into an inner portion of the cylindrical volume, and the generally planar member further comprises a passageway extending between apertures on opposite faces of the generally planar member, wherein a perimeter of the apertures on the opposite faces is substantially larger than a perimeter of each of the plurality of apertures extending into the inner portion of the cylindrical volume.

47. The method of claim 20, wherein the body of the joint implant further comprises a first generally planar member arranged generally perpendicular with a second generally planar member, the first and second generally planar members extending the length.

48. The method of claim 21, 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 defined 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 a height of the implant receiving space defined between the sacrum and the ilium, the height of the implant receiving space extending generally within a joint plane of the sacroiliac joint and being generally perpendicular to the width of the implant receiving space, the length extending generally within the joint plane of the sacroiliac joint when the joint implant is in the implanted position within the sacroiliac joint, the length being generally perpendicular to both the width and the height of the body of the joint implant, and the length being substantially greater than both the width and the height of the body of the joint implant.

49. The method of claim 48, further comprising: c) inserting a guide wire into the sacroiliac joint; and d) advancing a cannulated probe having a distal spatulate portion over the guide wire and into the sacroiliac joint.

50. The method of claim 48, further comprising forming the implant receiving space by removing at least one of bone and cartilage from the sacrum, the ilium, or the sacroiliac joint prior to implanting the joint implant into the sacroiliac joint.

51. The method of claim 50, 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 a joint plane of the sacroiliac joint; and drilling at least one bore into the sacroiliac joint through at least one of the plurality of drill guide holes so as to form the implant receiving space for the subsequent implantation of the joint implant.

52. The method of claim 50, 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 a joint plane of the sacroiliac joint; and drilling at least one bore within the sacroiliac joint so as to remove an amount of the cartilage from within the sacroiliac joint.

53. The method of claim 50, wherein the step of forming the implant receiving space comprises: positioning a broach jig up to the sacroiliac joint, the broach jig comprising a broach guide hole configured to guide a broach into the sacroiliac joint; and advancing a distal end of a broach into the sacroiliac joint.

54. The method of claim 48, wherein, in implanting the joint implant into the sacroiliac joint, the bottom surface of the body of the joint implant is generally parallel to an inferior sacroiliac joint border.

55. The method of claim 48, wherein the distal end tapers to a terminal end.

56. The method of claim 48, wherein the body comprises a passageway extending between an opening on the sacral face and an opening on the iliac face.

57. The method of claim 56, further comprising inserting biocompatible material within the passageway.

58. The method of claim 21, 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.

59. The method of claim 21, wherein the body of the joint implant further comprises an anti-migration element coupled to the proximal end.

60. The method of claim 59, wherein the anti-migration element comprises an enlarged terminal portion.

61. The method of claim 21, wherein the body of the joint implant further comprises a first planar member, a second planar member parallel with the first planar member, a third planar member, and a fourth planar member parallel with the third planar member, the first and second planar members being perpendicular to the third and fourth planar members, the first, the second, the third, and the fourth planar members extending the length.

62. The method of claim 21, wherein the body of the joint implant further comprises a bore extending therethrough, and the method further comprises: c) inserting a mechanical fastener through the bore and into the sacrum or the ilium.

63. The method of claim 62, wherein the bore extends through an anti-migration element of the joint implant.

64. The method of claim 21, wherein the body of the joint implant further comprises a cylindrical volume extending the length.

65. The method of claim 64, wherein the body of the joint implant further comprises a generally planar member coupled with the cylindrical volume and extending the length.

66. The method of claim 65, wherein the cylindrical volume comprises an axial bore and a plurality of apertures arranged along the length extending from an exterior surface of the body into an inner portion of the cylindrical volume, and the generally planar member further comprises a passageway extending between apertures on opposite faces of the generally planar member, wherein a perimeter of the apertures on the opposite faces is substantially larger than a perimeter of each of the plurality of apertures extending into the inner portion of the cylindrical volume.

67. The method of claim 21, wherein the body of the joint implant further comprises a first generally planar member arranged generally perpendicular with a second generally planar member, the first and second generally planar members extending the length.

68. The method of claim 23, 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 defined 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 a height of the implant receiving space defined between the sacrum and the ilium, the height of the implant receiving space extending generally within a joint plane of the sacroiliac joint and being generally perpendicular to the width of the implant receiving space, the length extending generally within the joint plane of the sacroiliac joint when the joint implant is in the implanted position within the sacroiliac joint, the length being generally perpendicular to both the width and the height of the body of the joint implant, and the length being substantially greater than both the width and the height of the body of the joint implant.

69. The method of claim 68, further comprising: c) inserting a guide wire into the sacroiliac joint; and d) advancing a cannulated probe having a distal spatulate portion over the guide wire and into the sacroiliac joint.

70. The method of claim 68, further comprising forming the implant receiving space by removing at least one of bone and cartilage from the sacrum, the ilium, or the sacroiliac joint prior to implanting the joint implant into the sacroiliac joint.

71. The method of claim 70, 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 a joint plane of the sacroiliac joint; and drilling at least one bore into the sacroiliac joint through at least one of the plurality of drill guide holes so as to form the implant receiving space for the subsequent implantation of the joint implant.

72. The method of claim 70, 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 a joint plane of the sacroiliac joint; and drilling at least one bore within the sacroiliac joint so as to remove an amount of the cartilage from within the sacroiliac joint.

73. The method of claim 70, wherein the step of forming the implant receiving space comprises: positioning a broach jig up to the sacroiliac joint, the broach jig comprising a broach guide hole configured to guide a broach into the sacroiliac joint; and advancing a distal end of a broach into the sacroiliac joint.

74. The method of claim 68, wherein, in implanting the joint implant into the sacroiliac joint, the bottom surface of the body of the joint implant is generally parallel to an inferior sacroiliac joint border.

75. The method of claim 68, wherein the distal end tapers to a terminal end.

76. The method of claim 68, wherein the body comprises a passageway extending between an opening on the sacral face and an opening on the iliac face.

77. The method of claim 76, further comprising inserting biocompatible material within the passageway.

78. The method of claim 23, 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.

79. The method of claim 23, wherein the body of the joint implant further comprises an anti-migration element coupled to the proximal end.

80. The method of claim 79, wherein the anti-migration element comprises an enlarged terminal portion.

81. The method of claim 23, wherein the body of the joint implant further comprises a first planar member, a second planar member parallel with the first planar member, a third planar member, and a fourth planar member parallel with the third planar member, the first and second planar members being perpendicular to the third and fourth planar members, the first, the second, the third, and the fourth planar members extending the length.

82. The method of claim 23, wherein the body of the joint implant further comprises a bore extending therethrough, and the method further comprises: c) inserting a mechanical fastener through the bore and into the sacrum or the ilium.

83. The method of claim 82, wherein the bore extends through an anti-migration element of the joint implant.

84. The method of claim 23, wherein the body of the joint implant further comprises a cylindrical volume extending the length.

85. The method of claim 84, wherein the body of the joint implant further comprises a generally planar member coupled with the cylindrical volume and extending the length.

86. The method of claim 85, wherein the cylindrical volume comprises an axial bore and a plurality of apertures arranged along the length extending from an exterior surface of the body into an inner portion of the cylindrical volume, and the generally planar member further comprises a passageway extending between apertures on opposite faces of the generally planar member, wherein a perimeter of the apertures on the opposite faces is substantially larger than a perimeter of each of the plurality of apertures extending into the inner portion of the cylindrical volume.

87. The method of claim 23, wherein the body of the joint implant further comprises a first generally planar member arranged generally perpendicular with a second generally planar member, the first and second generally planar members extending the length.

US9949835B2

SI-TECHNOLOGY