Patient-specific sacroiliac guides and associated methods

• US 9,603,613 B2
• Filed: 08/01/2016
• Issued: 03/28/2017
• Est. Priority Date: 08/31/2011
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Schoenefeld, Ryan John, Gutierrez, Robert C., Mellinger, Philip
• Primary Examiner(s): Sevilla, Christian
• Assistant Examiner(s): GIBSON, ERIC SHANE
• Application Number:
  US15/224,764
• Publication Number:
  US 20160338714A1
• Time in Patent Office: 239 Days
• Field of Search: 606/86.A, 606 86 R- 89, 606/96, 606/104, 606/246, 606250-278, 623 1711- 1716
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7055 connected to sacrum, pelvis or skull
• CPC Class Codes: A61B 2017/0042 with special provisions for gripping
• CPC Class Codes: A61B 2017/567 Joint mechanisms or joint supports in addition to the natural joints and outside the joint gaps
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/92 coded with colour

Abstract

A patient-specific alignment guide includes a patient-specific portion and a guiding element having a through opening. The patient-specific portion has a patient-specific surface preoperatively configured to mate as a negative of a portion of an iliac crest of a pelvis of a specific patient and mate to the iliac crest only in one position. The guiding element has a preoperatively configured orientation and location relative to the patient-specific portion for preparing a bore in the bone of the patient to direct a bone screw at the preoperatively configured orientation and location for sacroiliac fixation.

Claims

1. A method for lumbopelvic fixation comprising:

providing a convertible patient-specific alignment guide for a patient'"'"'s pelvis, the convertible patient-specific alignment guide including first and second patient-specific portions coupled by a bridge;

intraoperatively selecting one of unilateral fixation, iliac fixation, sacral fixation and bilateral sacroiliac fixation procedure for the patient; and

reconfiguring the convertible patient-specific alignment guide to a corresponding patient-specific alignment guide for the selected fixation procedure.

2. The method of claim 1, further comprising:

selecting a unilateral fixation procedure for a first side of the pelvis;

removing the bridge and the second patient-specific portion;

registering a patient-specific surface of the first patient-specific portion on a first iliac crest of the patient; and

drilling a bone bore for a bone screw through a guiding element of the first patient-specific portion into the first iliac crest.

3. The method of claim 2, further comprising:

removing the first patient-specific portion; and

resecting a portion of the iliac crest around the bone bore for seating a bone screw assembly.

4. The method of claim 1, further comprising:

selecting a bilateral fixation procedure for the pelvis;

registering a first patient-specific surface of the first patient-specific portion on a first iliac crest of the patient;

registering a second patient-specific surface of the second patient specific portion on a second iliac crest of the patient; and

drilling first and second bone bores for first and second bone screws through corresponding first and second guiding elements coupled to the corresponding first and second patient-specific portions and into the first and second iliac crests.

5. The method of claim 4, further comprising:

removing the convertible alignment guide; and

resecting first and second portions of the corresponding first and second iliac crests around the corresponding first and second bone bores for seating corresponding first and second bone screw assemblies.

6. A method for lumbopelvic fixation comprising:

providing a convertible patient-specific alignment guide for a pelvis of a patient, the convertible patient-specific alignment guide including first and second modular portions coupled to each other;

selecting one of unilateral fixation, iliac fixation, sacral fixation and bilateral sacroiliac fixation procedure for the patient; and

configuring the convertible patient-specific alignment guide to arrange the first and second modular portions to correspond to the selected fixation procedure.

7. The method of claim 6, wherein:

the first and second modular portions comprise;

an iliac guiding element; and

a sacral guiding element; and

selecting one of unilateral fixation, iliac fixation, sacral fixation and bilateral sacroiliac

fixation procedure for the patient comprises;

selecting unilateral fixation; and

selecting one or both of the iliac guiding element and the sacral guiding element for fixation to the pelvis.

8. The method of claim 7, wherein configuring the convertible patient-specific alignment guide to arrange the first and second modular portions to correspond to the selected fixation procedure includes:

selecting one of the iliac guiding element and the sacral guiding element; and

uncoupling the selected one of the iliac guiding element and the sacral guiding element from the convertible patient-specific alignment guide.

9. The method of claim 8, further comprising:

registering a first patient-specific surface of the selected one of the iliac guiding element and the sacral guiding element on the pelvis of the patient;

drilling a bone bore for a bone screw through the selected one of the iliac guiding element and the sacral guiding element into the pelvis;

removing the selected one of the iliac guiding element and the sacral guiding element; and

resecting a portion of the pelvis around the bone bore before seating a bone screw assembly.

10. The method of claim 7, wherein configuring the convertible patient-specific alignment guide to arrange the first and second modular portions to correspond to the selected fixation procedure includes:

detaching an arm connecting the iliac guiding element and the sacral guiding element.

11. The method of claim 6, wherein:

the first and second modular portions comprise;

a first patient-specific iliac guiding element; and

a second patient-specific iliac guiding element; and

selecting one of unilateral fixation, iliac fixation, sacral fixation and bilateral sacroiliac fixation procedure for the patient comprises;

selecting bilateral fixation;

selecting both of the first and second patient-specific iliac guiding elements for fixation to the pelvis.

12. The method of claim 11, wherein the first patient-specific iliac guiding element and the second patient-specific iliac guiding element include a first sacral guiding element and a second sacral guiding element, respectively.

13. The method of claim 12, wherein configuring the convertible patient-specific alignment guide to arrange the first and second modular portions to correspond to the selected fixation procedure includes:

detaching a first arm and a second arm connecting the first sacral guiding element and the second sacral guiding element to the first patient-specific iliac guiding element and the second patient-specific iliac guiding element, respectively.

14. The method of claim 13, wherein configuring the convertible patient-specific alignment guide to arrange the first and second modular portions to correspond to the selected fixation procedure includes:

detaching the first arm and the second arm from a bridge connecting the first and second patient-specific iliac guiding elements.

15. The method of claim 12, further comprising uncoupling one or both of the first sacral guiding element from the first patient-specific iliac guiding element and the second sacral guiding element from the second patient-specific iliac guiding element.

16. The method of claim 15, further comprising:

registering a first patient-specific surface of the first patient-specific iliac guiding element on a first iliac crest of the patient;

registering a second patient-specific surface of the second patient-specific iliac guiding element on a second iliac crest of the patient;

drilling first and second bone bores for first and second bone screws through corresponding first and second guiding elements coupled to the corresponding first and second patient-specific iliac guiding elements and into the first and second iliac crests;

removing the convertible alignment guide; and

resecting first and second portions of the corresponding first and second iliac crests around the corresponding first and second bone bores for seating corresponding first and second bone screw assemblies.

17. A method for lumbopelvic fixation comprising:

evaluating a convertible patient-specific alignment guide for a pelvis of a patient, the convertible patient-specific alignment guide including an iliac guiding element and a sacral guiding element coupled to each other;

selecting between performing one or both of an iliac fixation procedure and a sacral fixation procedure for the patient; and

reconfiguring the convertible patient-specific alignment guide to a corresponding patient-specific alignment guide for the selected fixation procedure.

18. The method of claim 17, wherein reconfiguring the convertible patient-specific alignment guide comprises uncoupling an arm connecting the iliac guiding element and the sacral guiding element.

19. The method of claim 17, wherein reconfiguring the convertible patient-specific alignment guide comprises uncoupling a drill guide from a patient-specific base.

20. The method of claim 17, wherein reconfiguring the convertible patient-specific alignment guide comprises uncoupling a bridge from the convertible patient-specific alignment guide.