Sacro-iliac joint stabilizing implants and methods of implantation
Sacro-iliac joint stabilizing implants adapted for implanting across a SI joint from a dorsal approach. Methods of, and delivery tools adapted for implanting sacro-iliac joint stabilizing implants across a SI joint from a dorsal approach.
1. A method of positioning a sacro-iliac (“SI”) joint stabilizing implant across an SI joint from a dorsal approach, comprising:
advancing an elongate sacrum pin from a dorsal starting point into a sacrum of a subject such that a distal end of the sacrum pin is in the sacrum and a proximal end of the sacrum pin is disposed outside of the subject;
advancing an elongate ilium pin from a dorsal starting point into an ilium of the subject such that a distal end of the ilium pin is in the ilium and a proximal end of the ilium pin is disposed outside of the subject;
advancing a distal opening of an ilium lumen that is in an ilium portion of an SI joint stabilizing implant over the ilium pin and advancing a distal opening of a sacrum lumen that is in a sacrum portion of the SI joint stabilizing implant over the sacrum pin,
wherein the distal opening of the ilium lumen extends further distally than the distal opening of the sacrum lumen;
advancing the implant distally over and relative to the sacrum pin and the ilium pin until the implant is across the SI joint with the ilium portion in the ilium and the sacrum portion in the sacrum,
wherein the distal opening of the ilium portion is advanced further distally than the distal opening of the sacrum portion; and
removing the ilium pin and the sacrum pin from the subject, leaving the implant positioned across the SI joint.
2. The method of claim 1 , wherein advancing the ilium pin comprises advancing the ilium pin into the ilium between lateral and medial cortical walls of the ilium.
3. The method of claim 1 , wherein advancing the sacrum pin occurs in time prior to advancing the ilium pin.
4. The method of claim 1 , wherein advancing the sacrum pin comprises preventing a distal end of the sacrum pin from extending beyond the alar line.
5. The method of claim 1 , wherein advancing the ilium pin comprises preventing a distal end of the ilium pin from extending beyond the alar line.
6. The method of claim 1 , further comprising securing an impactor to a proximal end of the implant.
7. The method of claim 6 , further comprising extending an impactor ilium lumen over the ilium pin and extending an impactor sacrum lumen over the sacrum pin.
8. The method of claim 7 , wherein securing the impactor to the proximal end of the implant comprises engaging an impactor threaded elongate member with an internally threaded channel in the implant.
9. The method of claim 7 , wherein advancing the implant distally over and relative to the sacrum pin and the ilium pin comprises applying a distally directed force on the impactor.
10. The method of claim 1 , further comprising bringing a distal end of an impactor adjacent to a proximal end of the implant, wherein the distal end of the impactor has a shape that is complimentary to a proximal end of the implant.
11. The method of claim 1 , wherein bringing a distal end of an impactor adjacent to a proximal end of the implant comprises causing an ilium side of the impactor to be further distally than a sacrum side of the impactor.
12. The method of claim 1 , further comprising, prior to advancing the distal openings over the ilium pin and sacrum pin, advancing a broach over and distally relative to the ilium pin and the sacrum pin, and advancing the broach into tissue across the SI joint.
13. The method of claim 12 , further comprising securing an impactor to a proximal end of the broach, and wherein advancing the broach comprises applying a distally directed force on the impactor.