Methods of fusing a sacroiliac joint via a posterior-inferior access region

Patent metadata

Field	Value
Publication number	US-9949835-B2
Application number	US-201715828556-A
Country	US
Kind code	B2
Filing date	Dec 1, 2017
Priority date	Jan 13, 2010
Publication date	Apr 24, 2018
Grant date	Apr 24, 2018

Abstract

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.

First claim

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 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 the distal end of the joint implant is positioned posteriorly of the anterior boundary segment of the articular plane.

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 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.

3. The method of claim 2 , 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.

4. The method of claim 2 , 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.

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 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.

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 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.

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, 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.

8. The method of claim 2 , wherein the implanted position comprises the joint implant being positioned in a caudal portion of the sacroiliac joint.

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

10. The method of claim 2 , 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.

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 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.

18. The method of claim 1 , 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.

19. The method of claim 18 , wherein the bore extends through an anti-migration element of the joint implant.

20. A method of fusing a sacroiliac joint defined between an ilium and a sacrum, 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, 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 articul

Assignees

• Jcbd Llc

Inventors

• Donner Edward Jeffrey

Classifications

• B33Y80/00

  Products made by additive manufacturing · CPC title

• A61B2017/00876

  magnetic · CPC title

• A61F2/4603

  for insertion or extraction of endoprosthetic joints or of accessories thereof · CPC title

• A61B17/1671

  for the spine · CPC title

• A61F2002/30331

  made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit · CPC title