Apparatus, systems, and methods for achieving trans-iliac lumbar fusion

• US 9,375,323 B2
• Filed: 04/08/2013
• Issued: 06/28/2016
• Est. Priority Date: 08/09/2004
• Status: Active Grant

• Current Assignee: SI-Bone, Incorporated
• Original Assignee: SI-Bone, Incorporated
• Inventors: Reiley, Mark A.
• Primary Examiner(s): Hammond, Ellen C
• Assistant Examiner(s): Negrellirodrigue, Christina
• Application Number:
  US13/858,814
• Publication Number:
  US 20130226301A1
• Time in Patent Office: 1,177 Days
• Field of Search: 606/246, 606/279, 606/95, 606/96, 606/98, 606/99, 606/104, 623 1711- 1716, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/866 Material or manufacture
• CPC Class Codes: A61B 17/8685 comprising multiple separate parts
• CPC Class Codes: A61F 2/0077 Special surfaces of prostheses, e.g. for improving ingrowth A61F2/30767 takes precedence
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• CPC Class Codes: A61F 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30156 triangular
• CPC Class Codes: A61F 2002/30179 X-shaped
• CPC Class Codes: A61F 2002/3023 wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30405 made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/305 Snap connection
• CPC Class Codes: A61F 2002/30576 : with extending fixation tabs
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30622 : Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/3082 : Grooves
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/4238 : for tarso-metatarsal joints, i.e. TMT joints
• CPC Class Codes: A61F 2002/448 : comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0023 : triangular
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: A61F 2310/00329 : Glasses, e.g. bioglass
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
• CPC Class Codes: A61F 2310/0097 : Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics

Abstract

Assemblies of one or more implant structures make possible the achievement of diverse interventions involving the fusion and/or stabilization of lumbar and sacral vertebra in a non-invasive manner, with minimal incision, and without the necessitating the removing the intervertebral disc. The representative lumbar spine interventions, which can be performed on adults or children, include, but are not limited to, lumbar interbody fusion; translaminar lumbar fusion; lumbar facet fusion; trans-iliac lumbar fusion; and the stabilization of a spondylolisthesis.

Claims

1. A method for trans-iliac lumbar fusion, the method comprising:

creating an insertion path from an anterolateral region of a lumbar vertebra L5, in a caudal direction through the intervertebral disc into and through an opposite anterolateral interior region of a sacral vertebra S1, through the sacro-iliac joint, and terminating in the ilium;

providing a bone fixation implant comprising an elongated implant structure; and

inserting the bone fixation implant through the insertion path from the anterolateral region of a lumbar vertebra L5, in a caudal direction through the intervertebral disc into and through the opposite anterolateral interior region of a sacral vertebra S1, through the sacro-iliac joint, and terminating in the ilium.

2. The method of claim 1, wherein the insertion path is created in a non-invasive manner without prior removal of the intervertebral disc.

3. The method of claim 1, wherein the insertion path comprises a bore sized approximately at or approximately about an outer maximum dimension of the bone fixation implant.

4. The method of claim 1, wherein the elongated implant structure enters through the insertion path from a left anterolateral region of the lumbar vertebra L5, in a caudal direction through the intervertebral disc into and through a right anterolateral interior region of the sacral vertebra S1, through the sacro-iliac joint, and terminating in the ilium, and wherein at least a second implant structure enters through an insertion path from a right anterolateral region of the lumbar vertebra L5, in a caudal direction through the intervertebral disc into and through a left anterolateral interior region of the sacral vertebra S1, through the sacro-iliac joint, and terminating in the ilium, the first and second implant structures crossing each other in transit through the intervertebral disc.

5. The method of claim 1, wherein at least a first implant structure enters through an insertion path from a left anterolateral region of a lumbar vertebra L5, in a caudal direction through the intervertebral disc into and through a right anterolateral interior region of a sacral vertebra S1, through the sacro-iliac joint, and terminating in the ilium, and wherein at least a second implant structure enters through an insertion path from a right anterolateral region of a lumbar vertebra L5, in a caudal direction through the intervertebral disc into and through a left anterolateral interior region of a sacral vertebra S1, through the sacro-iliac joint, and terminating in the ilium, the first and second implant structures crossing each other in transit through the intervertebral disc.

6. A method for trans-iliac lumbar fusion, the method comprising:

creating a first insertion path entering from a left posterior region of the iliac spine of the ilium, angling in a cranial direction through the SI-Joint into and through the sacral vertebra S1, and terminating in a right anterolateral region of a lumbar vertebra L5;

creating a second insertion path entering from a right posterior region of the iliac spine of the ilium, angling in a cranial direction through the SI-Joint into and through the sacral vertebra S1, and terminating in a left anterolateral region of a lumbar vertebra L5;

inserting the first implant structure through the first insertion path from the left posterior region of the iliac spine of the ilium, angling in a cranial direction through the SI-Joint into and through the sacral vertebra S1, and terminating in the right anterolateral region of the lumbar vertebra L5;

inserting the second implant structure through the second insertion path from the right posterior region of the iliac spine of the ilium, angling in a cranial direction through the SI-Joint into and through the sacral vertebra S1, and terminating in the left anterolateral region of the lumbar vertebra L5, the first and second implant structures crossing each other in transit through the intervertebral disc.