Systems for and methods of preparing a sacroiliac joint for fusion
A method of surgically preparing a sacroiliac joint comprising: a) approaching a sacroiliac joint space with a joint preparation tool comprising a cutting element including an exterior having an asymmetric cutting band such that the first side includes a first surface having a first texture and the second side includes a second surface having a second texture, the first and second textures being different such that the first texture is substantially smoother than the second texture; and b) delivering at least a portion of the cutting element non-transversely into the sacroiliac joint space for decortication, the cutting element being oriented in the sacroiliac joint space such that the first surface opposes the generally softer sacrum and the second surface opposes the generally harder ilium in order to more aggressively prepare the surface of the ilium while not over-preparing the sacrum to provide a robust biologic environment for intra-articular fusion.
1. A method of surgically preparing a sacroiliac joint having a sacrum, an ilium, and a sacroiliac joint space defined therebetween for a surgical fusion procedure, the method comprising:
a) approaching the sacroiliac joint space with a joint preparation tool comprising: a proximal end, a distal end, a cutting element supported at the distal end, and a shaft extending proximally from the cutting element, the cutting element comprising a length extending between a proximal cutting element end and a distal cutting element end, a first surface extending the length, and a second surface opposite the first surface extending the length;
b) delivering at least a portion of the cutting element non-transversely into the sacroiliac joint space, the cutting element being oriented in the sacroiliac joint space such that the first surface opposes the sacrum and the second surface opposes the ilium;
c) delivering an anchor into the sacrum, the sacroiliac joint space, and the ilium along a delivery trajectory provided by an anchoring arm assembly; and
d) removing the cutting element from the sacroiliac joint space.
2. The method of claim 1 , wherein the delivery trajectory is fixed and non-adjustable.
3. The method of claim 1 , wherein the anchoring arm assembly comprises a tubular guide, and at least one guide collar for supporting the tubular guide in an orientation that provides the delivery trajectory for the anchor.
4. The method of claim 1 , wherein, upon being delivered into the sacrum and the ilium, the anchor is positioned cranial to the cutting element.
5. The method of claim 1 , wherein, upon being delivered into the sacrum and the ilium, the anchor is positioned caudal to the cutting element.
6. The method of claim 1 , wherein, upon being delivered into the sacrum and the ilium, the anchor is positioned distal to the cutting element.
7. The method of claim 1 , wherein delivering the at least a portion of the cutting element non-transversely into the sacroiliac joint space at least partially forms an implant receiving space, and wherein the method further comprises: delivering a joint implant into the implant receiving space.
8. The method of claim 7 , wherein the joint implant comprises a distal end, a proximal end, at least two planar members extending between the distal and proximal ends, and a window positioned between the at least two planar members, the window positioned intermediate the distal and proximal ends.
9. The method of claim 8 , wherein upon delivery of the joint implant into the implant receiving space, the window is positioned within the sacroiliac joint space and the at least two planar members bridge across the sacroiliac joint space.
10. The method of claim 1 , wherein the cutting element comprises a box-chisel, a drill bit, a rasp, or a saw blade.
11. The method of claim 1 , further comprising attaching the anchoring arm assembly to the joint preparation tool.
12. The method of claim 1 , wherein removing the cutting element from the sacroiliac joint space occurs subsequent to step c).
13. A method of surgically preparing a sacroiliac joint having a sacrum, an ilium, and a sacroiliac joint space defined therebetween for a surgical fusion procedure, the method comprising:
a) aligning a trajectory of an anchor for delivery into the sacrum and the ilium, the trajectory being provided by an anchor arm assembly which is coupled to a joint preparation tool, the joint preparation tool comprising: a proximal end, a distal end, a cutting element supported at the distal end, and a shaft extending proximally from the cutting element, the cutting element configured to remove tissue from at least one of the sacrum, the ilium, or the sacroiliac joint space, the cutting element comprising a longitudinal axis extending between a proximal cutting element end and a distal cutting element end, a first surface extending along the longitudinal axis, and a second surface opposite the first surface extending along the longitudinal axis; and
b) removing the tissue from at least one of the sacrum, the ilium, or the sacroiliac joint space with the cutting element.
14. The method of claim 13 , wherein step b) further comprises inserting the cutting element non-transversely into the sacroiliac joint space.
15. The method of claim 14 , wherein the cutting element is inserted non-transversely into the sacroiliac joint space such that the first surface opposes the sacrum and the second surface opposes the ilium.
16. The method of claim 14 , wherein the trajectory of the anchor is along a trajectory axis that intersects the longitudinal axis distal to the cutting element.
17. The method of claim 14 , further comprising delivering the anchor into the sacrum and the ilium.
18. The method of claim 17 , wherein the anchor is positioned distal to the cutting element.
19. The method of claim 17 , wherein the anchor is positioned caudal to the cutting element.
20. The method of claim 17 , wherein the anchor is positioned cranial to the cutting element.
21. The method of claim 13 , further comprising positioning a cannula adjacent the sacroiliac joint space; and passing at least a portion of the joint preparation tool through the cannula.
22. A method of surgically preparing a sacroiliac joint having a sacrum, an ilium, and a sacroiliac joint space defined therebetween for a surgical fusion procedure, the method comprising:
a) approaching the sacroiliac joint space with a joint preparation tool comprising: a proximal end, a distal end, a cutting element supported at the distal end, and a shaft extending proximally from the cutting element, the cutting element comprising a length extending between a proximal cutting element end and a distal cutting element end, a first surface extending the length, and a second surface opposite the first surface extending the length;
b) delivering at least a portion of the cutting element non-transversely into the sacroiliac joint space along a cutting axis, the cutting element being oriented in the sacroiliac joint space such that the first surface opposes the sacrum and the second surface opposes the ilium; and
c) delivering an anchor into at least one of the sacrum and the ilium along an anchor axis via guidance by an anchoring arm assembly, the anchoring arm assembly being adjustable so as to provide multiple trajectories for the anchor axis relative to the cutting axis, wherein the anchor axis and the cutting axis converge at a common axis for the multiple trajectories.
23. The method of claim 22 , wherein the anchor is delivered through the sacroiliac joint space.
24. The method of claim 22 , further comprising removing the cutting element from the sacroiliac joint space.
25. The method of claim 22 , further comprising positioning a cannula adjacent the sacroiliac joint space; and passing at least a portion of the joint preparation tool through the cannula.
26. The method of claim 22 , wherein the anchor axis and the cutting axis converge at a coincident point on the common axis for the multiple trajectories.
27. The method of claim 22 , wherein the anchor arm assembly is coupled to the joint preparation tool.