Integrated electromagnetic implant guidance systems and methods of use for sacroiliac joint fusion

Patent metadata

Field	Value
Publication number	US-9833265-B2
Application number	US-201615178291-A
Country	US
Kind code	B2
Filing date	Jun 9, 2016
Priority date	Jan 13, 2010
Publication date	Dec 5, 2017
Grant date	Dec 5, 2017

Abstract

A system for fixating a dysfunctional sacroiliac joint for SI joint fusion, the system including a sacroiliac joint implant, a sacroiliac joint screw or rod and a delivery tool configured for approaching a sacroiliac joint. The system may include an implant having a porous 3D matrix structure and may be manufactured by laser or electron beam additive manufacturing. The delivery tool may include a radiolucent material. The SI fusion system may further include custom sacroiliac joint implants, anchors, alignment tools or targeting arms manufactured for a particular patient. Pre-surgical imaging studies, including 3D rendering, and their interpretation may assist in planning desired trajectories, anchor dimensions and implant dimensions and may provide details specific to the manufacture of particular sacroiliac joint tools or implants and their implantation into the sacroiliac joint. The system may be configured for use with surgical robots and may include an integrated nerve monitoring and stimulation system.

First claim

What is claimed is:

1. A method of surgical tracking and navigating a joint implant in a sacroiliac joint region of a patient, the sacroiliac joint region comprising a sacrum, an ilium, and a sacroiliac joint defined between the sacrum and the ilium, the method comprising:
a) causing a first electrode supported on the joint implant to emit a predetermined amount of energy, the joint implant releasably coupled to a distal end of a delivery tool and electrically coupled with a controller unit, the joint implant comprising a body having a length, a distal end, and a proximal end opposite the distal end;
b) receiving energy with a second electrode, the energy being a result of the predetermined amount of energy emitted by the first electrode, the second electrode electrically coupled with a processing unit;
c) converting the energy from the second electrode to an electrical signal; and
d) processing the electrical signal so as to determine a relative location of the joint implant within the sacroiliac joint,
wherein the first electrode is supported and exposed on a distal region of the body of the joint implant, and

wherein the first electrode is supported and exposed on a distal-inferior corner of the body of the joint implant.

2. The method of claim 1 , wherein the body of the joint implant further comprises an inner portion, a first, a second, and a third side extending the length, and a first, second, and third junction, each of the first, second, and third sides comprising a plurality of struts defining a pattern of openings extending between multiple struts of the plurality of struts, the openings extending into the inner portion, the first junction separating the first and second sides, the second junction separating the second and third sides, and the third junction separating the third and first sides.

3. The method of claim 2 , wherein the plurality of struts zig-zag at least partially along the length of the joint implant.

4. The method of claim 2 , wherein the pattern of openings comprises a repeating geometric pattern.

5. The method of claim 4 , wherein the repeating geometric pattern is polygonal.

6. The method of claim 2 , wherein a sequence of a plurality of struts comprises an alternating arrangement such that a first strut in the sequence comprises a first strut width defined perpendicular to a longitudinal axis of the first strut, a second strut in the sequence comprises a second strut width defined perpendicular to a longitudinal axis of the second strut, and a third strut in the sequence comprises a third strut width defined perpendicular to a longitudinal axis of the third strut, and wherein the first and third strut width are different than the second strut width.

7. The method of claim 2 , wherein the joint implant comprises an amount of curvature along the length of the joint implant.

8. The method of claim 2 , wherein the joint implant comprises a plurality of implant segments and each implant segment is individually positioned into the sacroiliac joint.

9. The method of claim 2 , wherein a cross section transverse to the length of the implant is substantially non-circular such that it comprises at least three prominent apices and wherein each apex is comprised of a first, second, and third longitudinal strut each extending generally uninterrupted between the distal and proximal ends of the joint implant.

10. The method of claim 1 , wherein the second electrode is a surface electrode and is positioned within or on skin of the patient.

11. The method of claim 1 , wherein the body of the joint implant further comprises an inner portion, a first plurality of struts defining first openings extending between multiple struts of the first plurality of struts, and a second plurality of struts defining second openings extending between multiple struts of the second plurality of struts, the first and second openings extending into the inner portion.

12. The method of claim 1 , wherein the first openings and second openings are coaxial with each other.

13. The method of claim 1 , wherein the first and second openings are not coaxial with each other.

14. The method of claim 13 , wherein the body of the joint implant further includes a keel extending outward from the body, the keel separating the first and second openings.

15. The method of claim 1 , wherein the second electrode is an intramuscular electrode and the second electrode is positioned in one of a quadriceps femoris, tibialis anterior, gastrocnemius, or abductor hallucis muscle of the patient.

16. The method of claim 1 , wherein the distal-inferior corner generally anatomically mimics a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

17. The method of claim 1 , wherein a parameter of the energy emitted from the first electrode is adjustable.

18. The method of claim 17 , wherein the parameter comprises amperage and a current of the amperage is about 8 milliamperes.

19. The method of claim 17 , wherein a first measure of the parameter of the energy is employed for navigation and a second measure of the parameter of the energy is employed for final positioning of the implant, the first measure is different than the second measure.

20. The method of claim 1 , further comprising: e) transmitting real-time functional guidance data to a surgical robot during the sacroiliac joint fusion procedure via at least one signal comprising a modulated parameter, the data being a result of signal conditioning and processing, the data comprising localization data being a correlate of the relative location of the implant.

21. The method of claim 20 , wherein the data comprises allothetic sourced state feedback of the first electrode.

22. The method of claim 21 , wherein the delivery tool further comprises an anchor arm configured to be coupled to an implant arm resulting in an arrangement providing an idiothetic relational mapping source such that a member is deliverable to a sacroiliac joint region via the anchor arm into a position relative to a location of the joint implant.

23. The method of claim 22 , wherein a third electrode is located within, near, or on the member.

24. The method of claim 23 , wherein a fourth electrode is located within, near, or on a probe, trial, broach, or drill.

25. The method of claim 22 , wherein the delivery tool comprises multiple preselected trajectories for guidance of the member relative to the joint implant, the preselected trajectories being a result of imaging studies of the patient.

26. The method of claim 1 , further comprising: e) emitting information via a signal.

27. The method of claim 26 , wherein the information is a correlate of the relative location of the implant.

28. The method of claim 27 , wherein the signal comprises sensory feedback.

29. The method of claim 28 , wherein the sensory feedback is an auditory signal with varying amplitude or frequency.

30. The method of claim 28 , wherein the sensory feedback is a visual image displayed on a display screen.

31. The method of claim 1 , wherein the distal-inferior corner of the joint implant generally anatomically mimics a curvature of a boundary defining at least one of the sacrum or the ilium.

32. The method of claim 1 , wherein the implant and the distal end of the delivery tool inclu

Assignees

• Jcbd Llc

Inventors

• Donner Edward Jeffrey
• Donner Christopher Thomas

Classifications

• A61F2002/30179

  X-shaped · CPC title

• A61F2/46

  Special tools for implanting artificial joints · CPC title

• A61F2/44

  for the spine, e.g. vertebrae, spinal discs · CPC title

• A61F2/4455

  for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442) · CPC title

• A61F2310/00359

  Bone or bony tissue · CPC title