US PATENT 10,058,430 B2
METHODS OF FUSING A SACROILIAC JOINT WITH AN ADDITIVELY MANUFACTURED SACROILIAC JOINT IMPLANT
A system for fixating a dysfunctional sacroiliac joint for SI joint fusion, the system including a sacroiliac joint implant 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.
CLAIMS:
The invention claimed is:
1. A method of fusing a sacroiliac joint defined between a sacrum and an ilium, the method comprising:
delivering a joint implant into the sacroiliac joint, the joint implant comprising:
a body extending a length between a proximal end and a distal end,
an exterior portion,
an interior portion defining a hollow space therein,
a proximal opening that extends into the interior portion,
a first side surface extending the length,
a second side surface extending the length,
the first side surface comprising a first plurality of voids along the length, each of the first plurality of voids defining a passageway extending from the exterior portion to the interior portion through a first width of the first side surface, the first plurality of voids arranged along the length in a repeating pattern of a first group of voids, each of the first plurality of voids being generally triangular in shape,
the second side surface comprising a second plurality of voids along the length, each of the second plurality of voids defining a passageway from the exterior portion to the interior portion through a second width of the second side surface, the second plurality of voids arranged along the length in a repeating pattern of a second group of voids, each of the second plurality of voids being generally triangular in shape.
2. The method of claim 1, wherein the first group of voids comprises two voids arranged in a first mirror image of each other, and the second group of voids comprises two voids arranged in a second mirror image of each other.
3. The method of claim 1, wherein the first side surface further comprises a first leading void positioned distal to the first plurality of voids, the first leading void defining a passageway extending from the exterior portion to the interior portion through the first width of the first surface, and the second side surface further comprises a second leading void positioned distal to the second plurality of voids, the second leading void defining a passageway extending from the exterior portion to the interior portion through the second width of the second surface.
4. The method of claim 1, wherein the first group of voids comprises at least two voids, the first group repeating three times along the length, the second group of voids comprises at least two voids, the second group repeating three times along the length.
5. The method of claim 1, wherein the first and second side surfaces are generally planar.
6. The method of claim 5, wherein the first and second side surfaces are generally parallel to each other.
7. The method of claim 1, wherein the joint implant is delivered non-transversely into the sacroiliac joint.
8. The method of claim 1, wherein the body further comprises a third side surface extending the length and coupled between the first and second side surfaces, the third side surface comprising a third void defining a passageway extending from the exterior portion to the interior portion through a third width of the third side surface, the third void configured to permit the passage of biocompatible material therethrough.
9. The method of claim 1, wherein the first side surface comprises two longitudinal boundaries that taper inward at the distal end, the second side surfaces comprises two longitudinal boundaries that taper inward at the distal end.
10. A method of fusing a sacroiliac joint defined between a sacrum and an ilium, the method comprising:
delivering a joint implant into the sacroiliac joint, the joint implant comprising:
a body extending a length between a proximal end and a distal end,
an exterior surface,
an interior surface opposite the exterior surface and defining a lumen therein,
a wall thickness extending between the exterior surface and the interior surface,
a proximal opening extending into the lumen,
a first plurality of voids along the length and extending through the wall thickness from the exterior surface to the interior surface,
a second plurality of voids along the length and extending through the wall thickness from the exterior surface to the interior surface, and
a third plurality of voids along the length and extending through the wall thickness from the exterior surface to the interior surface,
the first, second, and third plurality of voids arranged along the length in a matching pattern of groups of voids, wherein each void of the first, second, and third plurality of voids defines a shape having at least two corners.
11. The method of claim 10, wherein the each void of the first, second, and third plurality of voids is generally triangular in shape.
12. The method of claim 10, wherein the first plurality of voids are defined on a first side surface of the body, the second plurality of voids are defined on a second side surface of the body, and the third plurality of voids are defined on the second side surface of the body.
13. A method of fusing a sacroiliac joint of a patient, the sacroiliac joint defined between a sacrum and an ilium, the method comprising:
delivering a joint implant into the sacroiliac joint, the joint implant comprising:
a fenestrated core extending a length between a proximal end and a distal end,
at least three wall portions extending the length,
a hollow interior portion defined between the at least three wall portions, and
a proximal opening that extends into the interior portion,
each of the at least three wall portions comprising a plurality of fenestrations arranged along the length and extending into the inner portion of the fenestrated core so as to promote bony ingrowth through the plurality of fenestrations, each of the plurality of fenestrations being generally triangular in shape, the at least three wall portions tapering at the distal end.
14. The method of claim 13, wherein the joint implant is delivered non-transversely into the sacroiliac joint.
15. The method of claim 1, wherein the body comprises a distal opening configured to receive tissue of the patient into the interior portion when the joint implant is delivered into the sacroiliac joint so as to permit self-harvesting of the tissue into the interior portion.
16. The method of claim 15, wherein at least a portion of the distal opening is positioned at a tapered portion of the distal end of the body.
17. The method of claim 15, wherein the distal opening comprises a perimeter including at least a first perimeter side, a second perimeter side, and a third perimeter side, the first and second perimeter sides coupling to the third perimeter side at a distal terminus of the distal opening and extending proximally therefrom.
18. The method of claim 17, wherein the perimeter includes a fourth perimeter side opposite the third perimeter side, and positioned proximally therefrom.
19. The method of claim 13, wherein the at least three wall portions comprises a first wall portion, a second wall portion, and a third wall portion, the first wall portion defined on a first planar member of the fenestrated core, the second and third wall portions defined on a second planar member of the fenestrated core.
20. The method of claim 19, wherein the fenestrated core further comprises a third planar member extending away from the second planar member and separating the second and third wall portions.
21. The method of claim 13, further comprising: packing the fenestrated core with biological material configured to promote bone growth through the plurality of fenestrations prior to delivering the joint implant into the sacroiliac joint.
22. The method of claim 9, wherein a first void of the first plurality of voids comprises a first side which is generally parallel to at least one of the two longitudinal boundaries of the first side surface.
23. The method of claim 22, wherein a second void of the first plurality of voids that is positioned adjacent and proximal to the first void comprises a second side that is generally perpendicular to the at least one of the two longitudinal boundaries of the first side surface, the first void further comprising a third side, the second void further comprising a fourth side, the third and fourth sides being generally parallel to each other and being at a diagonal relative to the at least one of the two longitudinal boundaries.
24. The method of claim 1, wherein the body further comprises a bore extending non-parallel to the length through the first side surface, and the second side surface, the bore having a bore perimeter which is non-triangular.
25. The method of claim 24, further comprising: delivering an anchor through the bore.
26. The method of claim 1, further comprising: delivering an elongate body into engagement with the sacroiliac joint, wherein at least one of the elongate body and the joint implant is delivered non-transversely into the sacroiliac joint, and wherein a delivery trajectory of the elongate body and a delivery trajectory of the joint implant are non-parallel to one another.
27. The method of claim 10, further comprising: delivering an elongate body into engagement with the sacroiliac joint, wherein at least one of the elongate body or joint implant is delivered non-transversely into the sacroiliac joint and wherein a delivery trajectory of the elongate body and a delivery trajectory of the joint implant are substantially non-parallel to one another.