US PATENT 9,833,265 B2

INTEGRATED ELECTROMAGNETIC IMPLANT GUIDANCE SYSTEMS AND METHODS OF USE FOR SACROILIAC JOINT FUSION

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.

CLAIMS

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 include a cooperatively mating electrical connection that forms a segment of the electrical conductor pathway.

33. The method of claim 32, wherein the cooperatively mating electrical connection includes male-female pin contact assembly.

34. The method of claim 1, wherein the body of the joint implant further comprises an electrically insulative coating or being formed of an electrically nonconductive material.

35. The method of claim 1, further comprising employing an electromyograph.

36. The method of claim 1, wherein the first electrode is displaceable relative to the implant body.

37. The method of claim 1, wherein the first electrode is affixed to the implant body such that it is not removable from the implant body after implantation.

38. The method of claim 1, wherein the controller unit is housed within the delivery tool.

39. The method of claim 1, wherein the controller unit is located in an operating suite and electrically coupled to the first electrode via electrical conductors extending through the implant body to electrically couple to the controller unit via a cable extending proximally from the delivery tool to the controller unit.

40. The method of claim 1, wherein a radiopaque marker is positioned near the distal-inferior corner and is configured to assist in surgical navigation.

41. 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 iliumn, and a sacroiliac joint defined between the sacrum and the ilium, the method comprising:

c) converting the energy from the second electrode to an electrical signal; and

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.

42. The method of claim 41, wherein the first and second openings are coaxial with each other.

43. The method of claim 41, wherein the first and second openings are not coaxial with each other.

44. The method of claim 43, wherein the body of the joint implant further includes a keel extending outward from the body, the keel separating the first and second openings.

45. The method of claim 41, wherein the body of the joint implant further comprises a first, a second, and a third side extending the length, and a first, second, and third junction, the first side comprising the first plurality of struts, the second side comprising the second plurality of struts, 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.

46. The method of claim 45, wherein the first plurality of struts zig-zag at least partially along the length of the joint implant.

47. The method of claim 45, wherein the first plurality of struts defines a pattern of openings extending between multiple struts of the first plurality of struts, wherein the pattern of openings comprises a repeating geometric pattern.

48. The method of claim 47, wherein the repeating geometric pattern is polygonal.

49. The method of claim 45, 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.

50. The method of claim 41, wherein a 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.

51. The method of claim 50, wherein the distal-inferior corner generally anatomically mimics a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

52. The method of claim 41, wherein a parameter of the energy emitted from the first electrode is adjustable.

53. The method of claim 52, 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.

54. The method of claim 41, 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.

55. The method of claim 54, wherein the data comprises allothetic sourced state feedback of the first electrode.

56. The method of claim 55, 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.

57. The method of claim 56, wherein a third electrode is located within, near, or on the member.

58. The method of claim 57, wherein a fourth electrode is located within, near, or on a probe, trial, broach, or drill.

59. The method of claim 56, 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.

60. The method of claim 41, further comprising: e) emitting information via a signal.

61. The method of claim 60, wherein the information is a correlate of the relative location of the implant.

62. The method of claim 61, wherein the signal comprises sensory feedback.

63. The method of claim 62, wherein the sensory feedback is an auditory signal with varying amplitude or frequency.

64. The method of claim 62, wherein the sensory feedback is a visual image displayed on a display screen.

65. The method of claim 41, 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.

66. The method of claim 41, wherein the joint implant comprises an amount of curvature along the length of the joint implant.

67. The method of claim 41, wherein the joint implant comprises a plurality of implant segments and each implant segment is individually positioned into the sacroiliac joint.

68. The method of claim 41, wherein the implant and the distal end of the delivery tool include a cooperatively mating electrical connection that forms a segment of the electrical conductor pathway.

69. The method of claim 68, wherein the cooperatively mating electrical connection includes male-female pin contact assembly.

70. The method of claim 41, wherein the body of the joint implant further comprises an electrically insulative coating or being formed of an electrically nonconductive material.

71. The method of claim 41, wherein an area directly surrounding the first electrode has an electrically insulative coating or is formed of an electrically nonconductive material so as to reduce certain current shunting.

72. The method of claim 41, further comprising employing an electromyograph.

73. The method of claim 41, wherein the first electrode is displaceable relative to the implant body.

74. The method of claim 73, wherein the first electrode is removable from the implant body.

75. The method of claim 41, wherein the first electrode is affixed to the implant body such that it is not removable from the implant body after implantation.

76. The method of claim 41, wherein the controller unit is housed within the delivery tool.

77. The method of claim 41, wherein the controller unit is located in an operating suite and electrically coupled to the first electrode via electrical conductors extending through the implant body to electrically couple to the controller unit via a cable extending proximally from the delivery tool to the controller unit.

78. The method of claim 41, wherein the delivery tool further comprises an anchor arm configured to be coupled to an implant arm resulting in an arrangement 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.

79. The method of claim 78, wherein the member is at least one of: a) a tool; b) a biocompatible material; c) an anchor; d) an elongated body; e) a nail; f) a rod; g) a pin; h) a threaded screw; i) an expanding body; or j) a cable.

80. The method of claim 78, wherein the delivery tool is configured to guide the delivery of the member though an opening of the joint implant via the anchor arm.

81. The method of claim 78, wherein the delivery tool is configured to guide the delivery of the member adjacent the implant via the anchor arm.

82. The method of claim 41, wherein a radiopaque marker is positioned near a distal-inferior corner and is configured to assist in surgical navigation.

83. 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:

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 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.

84. The method of claim 83, 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.

85. The method of claim 84, wherein the first and second openings are coaxial with each other.

86. The method of claim 84, wherein the first and second openings are not coaxial with each other.

87. The method of claim 84, 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.

88. The method of claim 83, 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.

89. The method of claim 88, wherein the plurality of struts zig-zag at least partially along the length of the joint implant.

90. The method of claim 88, wherein the pattern of openings comprises a repeating geometric pattern.

91. The method of claim 88, 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.

92. The method of claim 83, wherein a 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.

93. The method of claim 92, wherein the distal-inferior corner generally anatomically mimics a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

94. The method of claim 83, wherein an area directly surrounding the first electrode has an electrically insulative coating or is formed of an electrically nonconductive material so as to reduce certain current shunting.

95. The method of claim 83, 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.

96. The method of claim 95, wherein the data comprises allothetic sourced state feedback of the first electrode, and 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.

97. The method of claim 96, 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.

98. The method of claim 83, wherein the delivery tool further comprises an anchor arm configured to be coupled to an implant arm resulting in an arrangement 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.

99. The method of claim 98, wherein the member is at least one of: a) a tool; b) a biocompatible material; c) an anchor; d) an elongated body; e) a nail; f) a rod; g) a pin; h) a threaded screw; i) an expanding body; or j) a cable.

100. The method of claim 98, wherein the delivery tool is configured to guide the delivery of the member though an opening of the joint implant via the anchor arm.

101. The method of claim 98, wherein the delivery tool is configured to guide the delivery of the member adjacent the implant via the anchor arm.

102. The method of claim 83, wherein a radiopaque marker is positioned near a distal-inferior corner and is configured to assist in surgical navigation.

103. 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:

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 a 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.

104. The method of claim 103, wherein the distal-inferior corner generally anatomically mimics a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

105. The method of claim 103, wherein the first electrode is supported and exposed on the distal-inferior corner of the body of the joint implant.

106. 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:

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 a parameter of the energy emitted from the first electrode is adjustable.

107. The method of claim 106, wherein the parameter comprises amperage and a current of the amperage is about 8 milliamperes.

108. The method of claim 107, wherein the first electrode is removable from the implant body.

109. The method of claim 106, wherein a first stimulus intensity is employed for navigation and a second stimulus intensity is employed for final positioning of the implant, the first stimulus intensity is different than the second stimulus intensity, wherein at least one of the first and second stimuli intensities is about 8 milliamperes.

110. A method of fusing a sacroiliac joint comprising a sacrum and an ilium of a patient, the method comprising:

delivering a joint implant into the sacroiliac joint,

the joint implant comprising a first electrode and a body having a length a distal end, and a proximal end opposite the distal end, the joint implant releasably coupled with a distal end of a delivery tool, the first electrode supported on the body and electrically coupled with a controller unit,

the controller unit configured to cause the first electrode to emit a predetermined amount of energy; and

receiving information associated with a relative location of the joint implant within the sacroiliac joint via the first electrode and a second electrode in or on the patient and electrically coupled with a processing unit,

wherein the second electrode is an intramuscular electrode and the second electrode is deliverable in one of a quadriceps femoris, tibialis anterior, gastrocnemius, or abductor hallucis muscle of the patient.

111. The method of claim 110, 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.

112. The method of claim 111, wherein the first and second openings are coaxial with each other.

113. The method of claim 111, 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.

114. The method of claim 111, wherein the distal end of the joint implant comprises a distal opening configured to receive tissue of the patient into the inner portion via the distal opening such that when the joint implant is advanced into the patient the distal opening allows for self-harvesting of the tissue into the inner portion.

115. The method of claim 114, wherein a perimeter of the distal opening comprises an at least first perimeter side and second perimeter side, the first perimeter side arranged at an angle to the second perimeter side and the first perimeter side connected to the second perimeter side at a perimeter corner, and the body of the joint implant further comprises a first side extending the length and comprising the first plurality of struts, a second side extending the length and comprising the second plurality of struts, and a first junction extending the length and separating the first and second sides, wherein the first junction while extending the length generally terminates at the perimeter corner.

116. The method of claim 110, wherein the joint implant is delivered non-transversely into the sacroiliac joint.

117. The method of claim 110, 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.

118. The method of claim 117, 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.

119. The method of claim 110, wherein a 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.

120. The method of claim 119, wherein the distal-inferior corner generally anatomically mimics a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

121. The method of claim 110, wherein an area directly surrounding the first electrode has an electrically insulative coating or is formed of an electrically nonconductive material so as to reduce certain current shunting.

122. The method of claim 110, wherein the delivery tool further comprises an anchor arm configured to be coupled to an implant arm resulting in an arrangement 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.

123. The method of claim 122, wherein the member is at least one of: a) a tool; b) a biocompatible material; c) an anchor; d) an elongated body; e) a nail; f) a rod; g) a pin; h) a threaded screw; i) an expanding body; or j) a cable.

124. The method of claim 122, wherein the delivery tool is configured to guide the delivery of the member though an opening of the joint implant via the anchor arm.

125. The method of claim 122, wherein the delivery tool is configured to guide the delivery of the member adjacent the implant via the anchor arm.

126. The method of claim 110, wherein a radiopaque marker is positioned near a distal-inferior corner and is configured to assist in surgical navigation.

127. A method of fusing a sacroiliac joint comprising a sacrum and an ilium of a patient, the method comprising:

delivering a joint implant into the sacroiliac joint,

the joint implant comprising a first electrode and a body having a length, a distal end, and a proximal end opposite the distal end, the joint implant releasably coupled with a distal end of a delivery tool, the first electrode supported on the body and electrically coupled with a controller unit,

the controller unit configured to cause the first electrode to emit a predetermined amount of energy; and

wherein a 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.

128. The method of claim 127, 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.

129. The method of claim 128, wherein the first and second openings are coaxial with each other.

130. The method of claim 128, 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.

131. The method of claim 127, wherein the joint implant is delivered non-transversely into the sacroiliac joint.

132. The method of claim 127, 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.

133. The method of claim 127, wherein an area directly surrounding the first electrode has an electrically insulative coating or is formed of an electrically nonconductive material so as to reduce certain current shunting.

134. The method of claim 127, wherein the delivery tool further comprises an anchor arm configured to be coupled to an implant arm resulting in an arrangement 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.

135. The method of claim 134, wherein the member is at least one of: a) a tool; b) a biocompatible material; c) an anchor; d) an elongated body; e) a nail; f) a rod; g) a pin; h) a threaded screw; i) an expanding body; or j) a cable.

136. The method of claim 134, wherein the delivery tool is configured to guide the delivery of the member though an opening of the joint implant via the anchor arm.

137. The method of claim 134, wherein the delivery tool is configured to guide the delivery of the member adjacent the implant via the anchor arm.

138. The method of claim 127, wherein a radiopaque marker is positioned near a distal-inferior corner and is configured to assist in surgical navigation.

139. A method of fusing a sacroiliac joint comprising a sacrum and an ilium of a patient, the method comprising:

delivering a joint implant into the sacroiliac joint,

the controller unit configured to cause the first electrode to emit a predetermined amount of energy; and

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

140. The method of claim 139, 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.

141. The method of claim 140, wherein the plurality of struts zig-zag at least partially along the length of the joint implant.

142. The method of claim 140, 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.

143. The method of claim 140, wherein the joint implant comprises an amount of curvature along the length of the joint implant.

144. The method of claim 140, wherein the joint implant comprises a plurality of implant segments and each implant segment is individually positioned into the sacroiliac joint.

145. The method of claim 139, 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.

146. The method of claim 145, wherein the first and second openings are coaxial with each other.

147. The method of claim 145, 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.

148. The method of claim 139, wherein the joint implant is delivered non-transversely into the sacroiliac joint.

149. The method of claim 139, 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.

150. The method of claim 139, wherein an area directly surrounding the first electrode has an electrically insulative coating or is formed of an electrically nonconductive material so as to reduce certain current shunting.

151. The method of claim 139, wherein the delivery tool further comprises an anchor arm configured to be coupled to an implant arm resulting in an arrangement 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.

152. The method of claim 151, wherein the member is at least one of: a) a tool; b) a biocompatible material; c) an anchor; d) an elongated body; e) a nail; f) a rod; g) a pin; h) a threaded screw; i) an expanding body; or j) a cable.

153. The method of claim 151, wherein the delivery tool is configured to guide the delivery of the member though an opening of the joint implant via the anchor arm.

154. The method of claim 151, wherein the delivery tool is configured to guide the delivery of the member adjacent the implant via the anchor arm.

155. The method of claim 139, wherein a radiopaque marker is positioned near the distal-inferior corner and is configured to assist in surgical navigation.

156. A method of fusing a sacroiliac joint comprising a sacrum and an ilium of a patient, the method comprising:

delivering a joint implant into the sacroiliac joint,

the controller unit configured to cause the first electrode to emit a predetermined amount of energy; and

further comprising delivering a first elongate pin into the sacroiliac joint in a first position near a border of the sacroiliac joint such that a length of the elongate pin generally follows and is aligned with the border.

157. The method of claim 156, wherein the first elongate pin is delivered via a sacroiliac joint line near an inferior end of a posterior inferior access region of an articular region of the sacroiliac joint so as to border a portion of a greater sciatic notch.

158. The method of claim 157, wherein the first elongate pin provides an inferior barrier.

159. The method of claim 157, further comprising delivering a second elongate pin into the sacroiliac joint in a second position in a transition zone between the articular region and an extra-articular region of the sacroiliac joint, the second pin positioned superior to the first pin.

160. The method of claim 159, wherein the second pin is delivered via a superior end of the posterior inferior access region of the articular region of the sacroiliac joint.

161. The method of claim 160, wherein a region between the first and second pins demarcate inferior and superior boundaries, respectively, for treatment.

162. The method of claim 160, wherein the certain proximity is when the joint implant contacts the first elongate pin.

163. The method of claim 156, further comprising introducing a contrast material into the sacroiliac joint so as to highlight the border under x-ray.

164. The method of claim 163, wherein the step of introducing the contrast material further comprises highlighting the border via a computer guided surgical system.

165. The method of claim 156, wherein the first elongate pin is configured as an electrode.

166. The method of claim 165, wherein the information comprises sensory feedback when the joint implant comes into a certain proximity to the first elongate pin.

US9833265B2

SI-TECHNOLOGY