# US 9,039,743 B2 · Systems and methods for the fusion of the sacral-iliac joint

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- Number: US 9,039,743 B2
- Document ID: US9039743B2
- Status: Granted
- Kind: B2
- Application number: 14/280,436
- Filed: 2014-05-16
- Published: 2014-09-11
- Granted: 2015-05-26
- Earliest claimed: 2004-08-09
- Assignees: SI-Bone Inc.
- Applicants: SI-Bone Inc.
- Inventors: Mark A. Reiley
- Web page: https://patentgrep.com/patent/US9039743B2

## CPC

- A61B 17/1757: {for the spine}
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1659: {Surgical rasps, files, planes, or scrapers}
- A61B 17/1664: {for the hip}
- A61B 17/1671: {for the spine}
- A61B 17/68: Internal fixation devices {, including fasteners and spinal fixators, even if a part thereof projects from the skin (bone staples A61B17/0642)}
- A61B 17/686: {Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw}
- A61B 17/7055: {connected to sacrum, pelvis or skull}
- A61B 17/84: Fasteners therefor {or fasteners being internal fixation devices}
- A61B 17/86: Pins or screws {or threaded wires; nuts therefor (A61B17/72 take precedence)}
- A61B 17/863: {with thread interrupted or changing its form along shank, other than constant taper}
- A61B 17/864: {hollow, e.g. with socket or cannulated}
- A61B 17/866: {Material or manufacture}
- A61B 17/8665: {Nuts}
- A61B 17/8685: {comprising multiple separate parts}
- A61B 17/8695: {Washers (surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028)}
- A61B 17/8897: {Guide wires or guide pins}
- 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)}
- A61B 17/683: {comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut}
- A61B 17/8875: {Screwdrivers, spanners or wrenches}
- A61B 17/8891: {at its periphery}
- A61B 2017/681: {Alignment, compression, or distraction mechanisms}
- A61B 2017/8675: {clamping effect due to tapering, e.g. conical thread}
- A61F 2/0077: {Special surfaces of prostheses, e.g. for improving ingrowth (A61F2/30767 takes precedence)}
- A61F 2/28: Bones
- A61F 2/30767: {Special external or bone-contacting surface, e.g. coating for improving bone ingrowth}
- A61F 2/4465: {having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine}
- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- A61F 2002/30062: {(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive}
- A61F 2002/30156: {triangular}
- A61F 2002/30179: {X-shaped}
- A61F 2002/3023: {wedge-shaped cylinders}
- A61F 2002/30235: {tubular, e.g. sleeves}
- A61F 2002/30405: {made by screwing complementary threads machined on the parts themselves}
- A61F 2002/305: {Snap connection}
- A61F 2002/30576: {with extending fixation tabs}
- A61F 2002/30604: {modular}
- A61F 2002/30622: {Implant for fusing a joint or bone material}
- A61F 2002/30777: {Oblong apertures}
- A61F 2002/30785: {parallel}
- A61F 2002/30787: {inclined obliquely with respect to each other}
- A61F 2002/3082: {Grooves}
- A61F 2002/30841: {Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes}
- A61F 2002/3085: {with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface}
- A61F 2002/4238: {for tarso-metatarsal joints, i.e. TMT joints}
- 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}
- A61F 2210/0004: bioabsorbable
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2230/0023: triangular
- A61F 2230/0058: X-shaped
- A61F 2230/0069: cylindrical
- A61F 2310/00017: Iron- or Fe-based alloys, e.g. stainless steel
- A61F 2310/00023: Titanium or titanium-based alloys, e.g. Ti-Ni alloys
- A61F 2310/00029: Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
- A61F 2310/00131: Tantalum or Ta-based alloys
- A61F 2310/00179: Ceramics or ceramic-like structures
- A61F 2310/00329: Glasses, e.g. bioglass
- A61F 2310/00796: Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
- A61F 2310/0097: Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

The sacral-iliac joint between an iliac and a sacrum is fused either by the creation of a lateral insertion path laterally through the ilium, through the sacral-iliac joint, and into the sacrum, or by the creation of a postero-lateral insertion path entering from a posterior iliac spine of an ilium, angling through the sacral-iliac joint, and terminating in the sacral alae. A bone fixation implant is inserted through the insertion path and anchored in the interior region of the sacrum or sacral alea to fixate the sacral-iliac joint.

## Claims

### Claim 1

A method of forming a bore in the ileum, across the sacroiliac joint, and into the sacrum to receive an implant having a rectilinear cross-sectional profile, the method comprising:
inserting a guide pin into the ileum, across the sacroiliac joint, and into the sacrum;
disposing a drill bit over the guide pin, the drill bit having a longitudinal axis and a cross-sectional profile transverse to the longitudinal axis of the drill bit, the drill bit having a lumen configured to receive the guide pin;
drilling a bore along the guide pin with the drill bit, the bore extending from the ileum, across the sacroiliac joint, and into the sacrum;
removing the drill bit from the guide pin;
disposing a broach over the guide pin, the broach having longitudinal axis and a rectilinear cross-sectional profile transverse to the longitudinal axis of the broach that matches in shape the rectilinear cross-sectional profile of the implant, the broach having a lumen configured to receive the guide pin, wherein the rectilinear cross-sectional profile of the broach is larger than the cross-sectional profile of the drill bit; and
shaping the bore with the broach such that the cross-sectional profile of the bore matches the shape of the rectilinear cross-sectional profile of the implant.

### Claim 2 (depends on 1)

The method of claim 1, wherein the rectilinear cross-sectional profile of the broach is triangular.

### Claim 3 (depends on 1)

The method of claim 1, wherein the rectilinear cross-sectional profile of the broach is square.

### Claim 4 (depends on 1)

The method of claim 1, wherein the rectilinear cross-sectional profile of the broach is rectangular.

### Claim 5 (depends on 1)

The method of claim 1, wherein the step of shaping the bore with the broach comprises tapping the broach into the bore.

### Claim 6 (depends on 1)

The method of claim 1, wherein the cross-sectional profile of the bore is smaller than that of the rectilinear cross-sectional profile of the implant.

### Claim 7

A method of forming a bore in the ileum, across the sacroiliac joint, and into the sacrum to receive an implant having a rectilinear cross-sectional profile, the method comprising:
drilling a bore through the ileum, across the sacroiliac joint, and into the sacrum with a drill bit, the drill bit having a longitudinal axis and a cross-sectional profile transverse to the longitudinal axis of the drill bit; and
shaping the bore with a broach such that the cross-sectional profile of the bore matches the shape of the rectilinear cross-sectional profile of the implant, the broach having longitudinal axis and a rectilinear cross-sectional profile transverse to the longitudinal axis of the broach that matches in shape the rectilinear cross-sectional profile of the implant, wherein the rectilinear cross-sectional profile of the broach is larger than the cross-sectional profile of the drill bit.

### Claim 8 (depends on 7)

The method of claim 7, wherein the rectilinear cross-sectional profile of the broach is triangular.

### Claim 9 (depends on 7)

The method of claim 7, wherein the rectilinear cross-sectional profile of the broach is square.

### Claim 10 (depends on 7)

The method of claim 7, wherein the rectilinear cross-sectional profile of the broach is rectangular.

### Claim 11 (depends on 7)

The method of claim 7, wherein the step of shaping the bore with the broach comprises tapping the broach into the bore.

### Claim 12 (depends on 7)

The method of claim 7, wherein the cross-sectional profile of the bore is smaller than that of the rectilinear cross-sectional profile of the implant.