Minimally invasive approaches, methods and apparatuses to accomplish sacroiliac fusion

Abstract

The present disclosure presents novel methods, procedures associated steps, and apparatuses to accomplish SI joint fusion in a minimally invasive manner. The preferred embodiment of the invention incorporates improved methods, procedures and apparatuses to facilitate a SI joint fusion providing a generally safer, more minimally invasive SI joint stabilization. In the method associated with the preferred embodiment of the invention, in one aspect, a path or a plurality of paths through an ilium to the sacrum is established, wherein a stabilizer device allows the securement of the sacrum to the ilium. In another aspect, a path or a plurality of paths to the SI joint is established, where bone fusion material allows fusion of the articular surface of the ilium and the articular surface of the sacrum of an SI joint.

What is claimed is: 
     
         1 . An orthopedic method for stabilizing a hip, the method comprising:
 determining a first path traversing a first sacroiliac joint between a first ilium and a first side of a sacrum, and traversing a second sacroiliac joint located between a second ilium and a second side of the sacrum;   drilling through the first ilium, the sacrum, and the second ilium—coincident with the first path;   determining a second path generally oblique to the first path and in a direction parallel to the first sacroiliac joint;   creating a second pathway along the second path;   decorticating the first sacroiliac joint through the second path;   filling the first sacroiliac joint with a bone grafting material; and   placing a device configured to stabilize the first sacroiliac joint and the second sacroiliac joint through the opening and beyond the midline of the sacrum,   wherein the device applies a compressive force across the first sacroiliac joint and the second sacroiliac joint.   
     
     
         2 . The method of  claim 1 , further comprising determining a third path generally oblique to the first path and in a direction parallel to the second sacroiliac joint;
 creating a third pathway along the third path;   decorticating the first sacroiliac joint through the third pathway; and   filling the second sacroiliac joint with a bone grafting material.   
     
     
         3 . The method in  claim 1 , further comprising expanding the first sacroiliac joint after creating the second pathway along the second path. 
     
     
         4 . The method of  claim 1 , further comprising inserting a trephine needle along the first path;
 confirming the trajectory of the trephine needle;   and inserting a guidewire beyond the midline of the sacrum prior to the step of placing a device.   
     
     
         5 . The method of  claim 1 , wherein placing a device further comprises inserting a first end of a first component of a device into the first pathway through the first ilium. 
     
     
         6 . The method of  claim 5 , further comprising advancing a first threaded head coincident with the second end of the first component of the device into the first ilium;
 engaging a floating screw with an end of a shaft; and   advancing the floating screw into the second ilium.   
     
     
         7 . The method of  claim 6 , further comprising advancing an end screw through a recess of the floating screw, thereby affixing the end screw to the device. 
     
     
         8 . The method of  claim 7 , further comprising inserting a first locking pin which engages with the end screw, the floating screw, and the device;
 wherein the first locking pin rotationally constrains the assembly of the end screw, the floating screw, and the device.   
     
     
         9 . The method of  claim 5 , further comprising inserting a first component of a bilateral device into the first pathway, through the first ilium;
 inserting a second component of a bilateral device into the first pathway, through the second ilium; and   rotating the first component in relation to the second component,   wherein the rotation of the first component in relation to the second component axially engages the first component with the second component.   
     
     
         10 . The method of  claim 5 , further comprising affixing a first screw to the first end of the device;
 and affixing a second screw to the second end of the device.   
     
     
         11 . The method of  claim 10 , further comprising inserting a first locking pin into the first screw; and
 inserting a second locking pin in the second screw,   wherein the insertion of the locking pins into the screws lock the screws to the device.   
     
     
         12 . The method of  claim 5 , further comprising affixing a first surface anchor to the first end of the device with an end screw. 
     
     
         13 . The method of  claim 12 , further comprising inserting a first locking pin, which engages with the end screw, the surface anchor, and the device;
 thereby rotationally constraining the assembly of the end screw, the floating screw, and the device.