Method and implant system for sacroiliac joint fixation and fusion

Abstract

An improved method of fusing the sacroiliac joint and tools for accomplishing the same is disclosed. In one embodiment, the present invention is a method that uses an intra-articular joint fusion device for connecting the sacrum and ilium that includes creating a first incision in the patient's skin proximal to the patient's sacroiliac joint, inserting a surgical channel tool into the incision from the patient's posterior, creating a void in the sacroiliac joint, inserting a fusion implant into the void, the fusion implant having at least one fixation element for engagement with bone tissue in the articular surfaces of the sacrum and the ilium, and driving the fusion implant into the void such that the at least one fixation element engages with bone tissue in an articular surface of at least one of the sacrum and ilium, and the fusion implant fixes relative positions of the sacrum and ilium.

1 - 31 . (canceled) 
     
     
         32 . A method for repairing a sacroiliac joint of a patient, comprising:
 a. creating a first incision in the patient's skin proximal to the patient's sacroiliac joint;   b. inserting a working channel having at least one tang on a distal end thereof into said first incision and spreading said sacroiliac joint with an inserted end of said first working channel;   c. creating a void in said sacroiliac joint; and   d. inserting a fusion implant into said void, said fusion implant having at least one protrusion for engagement with bone tissue in an articular surface of at least one of the sacrum and the ilium of said sacroiliac joint.   
     
     
         33 . (canceled) 
     
     
         34 . (canceled) 
     
     
         35 . The method of  claim 32 , further comprising driving said fusion implant into said void with an impactor, wherein driving said fusion implant engages said at least one protrusion with said bone tissue. 
     
     
         36 . The method of  claim 32 , wherein said fusion implant has a central body and said at least one protrusion extends laterally from said central body. 
     
     
         37 . (canceled) 
     
     
         38 . (canceled) 
     
     
         39 . (canceled) 
     
     
         40 . The method of  claim 32 , wherein said fusion implant contacts the patient's ilium and the patient's sacrum and compresses said joint, thereby securing said implant in said joint. 
     
     
         41 . The method of  claim 40 , wherein said fusion implant is configured to substantially fix and fuse the patient's ilium to the patient's sacrum, thereby substantially immobilizing the patient's sacroiliac joint. 
     
     
         42 . (canceled) 
     
     
         43 . The method of  claim 41 , wherein said fusion implant comprises a cavity for holding a fusion-promoting material. 
     
     
         44 . The method of  claim 43 , wherein said cavity comprises at least one hole therein for allowing the growth of bone tissue into said cavity. 
     
     
         45 . (canceled) 
     
     
         46 . (canceled) 
     
     
         47 . The method of  claim 32 , wherein the inserting said fusion implant comprises:
 a. attaching said fusion implant to an inserter having a slot-engagement protrusion; and   b. inserting said inserter into a hollow barrel of said working channel with said slot-engagement protrusion aligned with a guidance slot within said hollow barrel and advancing said inserter until said guidance slot arrests the penetration of said inserter and said fusion implant into said sacroiliac joint at a pre-determined depth.   
     
     
         48 . (canceled) 
     
     
         49 . A method for repairing a sacroiliac joint of a patient using an intra-articular joint fusion device for connecting the sacrum and ilium, comprising:
 a. creating a first incision in the patient's skin proximal to the patient's sacroiliac joint;   b. inserting a working channel of a surgical channel tool into said incision from the posterior of the patient, wherein said working channel includes an insertion control mechanism for controlling the advancement of surgical tools into said working channel;   c. creating a void in said sacroiliac joint;   d. inserting a fusion implant into said void using an inserter tool, said fusion implant having at least one protrusion for engagement with bone tissue in an articular surface of at least one of the sacrum and the ilium of said sacroiliac joint; and   e. driving said fusion implant into said void such that said at least one protrusion engages with said bone tissue.   
     
     
         50 . (canceled) 
     
     
         51 . The method of  claim 49 , wherein said at least one protrusion comprises a helical anchor having a sharp end for piercing said bone tissue in an articular surface of at least one of said sacrum and said ilium. 
     
     
         52 . (canceled) 
     
     
         53 . The method of  claim 49 , wherein said at least one protrusion comprises a fluke having a sharp portion for piercing said bone tissue in said articular surface of said at least one of said sacrum and said ilium. 
     
     
         54 . (canceled) 
     
     
         55 . (canceled) 
     
     
         56 . (canceled) 
     
     
         57 . (canceled) 
     
     
         58 . (canceled) 
     
     
         59 . The method of  claim 49 , wherein said fusion implant comprises a body having a cavity therein and perforations on an exterior thereof that expose said cavity to an exterior of said body, and a hole in a proximal end of said body for accessing the interior of said cavity. 
     
     
         60 . The method of  claim 51 , wherein said fusion implant is operable to connect said_sacrum to said ilium in fixed relative positions in the sacroiliac joint. 
     
     
         61 . (canceled) 
     
     
         62 . (canceled) 
     
     
         63 . (canceled) 
     
     
         64 . (canceled) 
     
     
         65 . (canceled) 
     
     
         66 . (canceled) 
     
     
         67 . The method of  claim 49 , wherein the inserting the fusion implant comprises:
 a. attaching said fusion implant to said inserter tool, wherein said inserter tool has an insertion control protrusion; and   b. inserting the inserter tool into a hollow barrel of said working channel and engaging said insertion control protrusion with said insertion control mechanism and advancing the inserter tool until said insertion control protrusion is arrested by the insertion control mechanism at a pre-determined point in the hollow barrel, and said inserter tool is prevented from moving the fusion implant further into said sacroiliac joint.   
     
     
         68 . (canceled) 
     
     
         69 . The method of  claim 49 , wherein driving said fusion implant into said void comprises pushing said fusion implant into said void such that the at least one protrusion contacts said bone tissue. 
     
     
         70 . (canceled) 
     
     
         71 . (canceled) 
     
     
         72 . (canceled) 
     
     
         73 . (canceled) 
     
     
         74 . (canceled) 
     
     
         75 . (canceled) 
     
     
         76 . (canceled) 
     
     
         77 . A method for repairing a sacroiliac joint of a patient using an intra-articular joint fusion device for connecting the sacrum and ilium, comprising:
 a. creating an incision in the patient's skin in a position proximal to the patient's sacroiliac joint to allow access to the posterior portion of the sacroiliac joint;   b. inserting a working channel of a surgical channel tool into said incision from the posterior of the patient, said working channel including at least one tang protruding from a distal end of the working channel and an insertion control mechanism for controlling the advancement of surgical tools into said working channel;   c. creating a void in said sacroiliac joint;   d. inserting a fusion implant using an inserter into said void on a path that is substantially parallel to articular surfaces of the sacroiliac joint, said inserter having an insertion control protrusion for engagement with said insertion control mechanism;   e. advancing the inserter tool until said insertion control protrusion to a pre-determined point in the hollow barrel and placing said fusion implant into said sacroiliac joint, and said inserter tool is prevented from moving the fusion implant further into said sacroiliac joint; and   f. driving said fusion implant into said void such that said fusion implant engages with said bone tissue.   
     
     
         78 . The method of  claim 77 , wherein said fusion implant includes at least one protrusion for engagement with bone tissue in an articular surface of at least one of the sacrum and the ilium of said sacroiliac joint. 
     
     
         79 . The method of  claim 78 , wherein said at least one protrusion comprises a helical anchor having a sharp end for piercing said bone tissue, and said helical anchor first penetrates said articular surface of said at least one of said sacrum and said ilium. 
     
     
         80 . The method of  claim 77 , wherein said fusion implant comprises a cavity for holding a fusion-promoting material. 
     
     
         81 . The method of  claim 80 , wherein said cavity comprises at least one hole therein for allowing the growth of bone tissue into said cavity. 
     
     
         82 . The method of  claim 80 , wherein no further fusion implants are introduced into said sacroiliac joint and said fusion implant is sufficient to fuse the sacroiliac joint. 
     
     
         83 . The method of  claim 77 , wherein said at least one tang secures a position of said working channel in said sacroiliac joint to avoid movement of said working channel during insertion of said fusion implant. 
     
     
         84 . The method of  claim 77 , wherein engagement of said insertion control protrusion with said insertion control mechanism maintains said inserter and said fusion implant in proper orientation for insertion of the fusion implant into said sacroiliac joint. 
     
     
         85 . The method of  claim 32 , wherein the inserting said fusion implant comprises:
 a. attaching said fusion implant to an inserter having a slot-engagement protrusion; and   b. inserting said inserter into a hollow barrel of said working channel with said slot-engagement protrusion aligned with a guidance slot within said hollow barrel, wherein engagement of said slot-engagement protrusion with said guidance slot maintains said inserter and said fusion implant in proper orientation for insertion of the fusion implant into said sacroiliac joint.   
     
     
         86 . The method of  claim 49 , wherein the inserting said fusion implant comprises:
 a. attaching said fusion implant to an inserter having a slot-engagement element; and   b. inserting said inserter into a hollow barrel of said working channel with said slot-engagement protrusion aligned with said insertion control mechanism within said hollow barrel, wherein engagement of said slot-engagement element with said insertion control mechanism maintains said inserter and said fusion implant in proper orientation for insertion of the fusion implant into said sacroiliac joint.