Sacro-iliac joint implant system and method

Abstract

A sacro-iliac implant includes a body having a proximal portion and a distal tip. The proximal portion includes an inner surface and a uniform diameter. The inner surface includes a first mating surface engageable with a first instrument surface and a second mating surface engageable with a second instrument surface. Systems, constructs, instruments and methods are disclosed.

1 - 20 . (canceled) 
     
     
         21 . A method for treating a sacro-iliac joint between a sacrum and an ilium, the method comprising:
 providing an implant, the implant comprising a body including a proximal portion and a distal tip, an outer surface of the body including a thread having a trailing edge disposed perpendicular to the outer surface and a leading edge disposed transverse to the outer surface, the body having a maximum length defined by a distance from an end surface of the proximal portion to an end surface of the distal tip, the thread extending the maximum length such that the body is fully threaded, the body defining a longitudinal cavity and a plurality of lateral openings in communication therewith, the lateral openings extending through the thread, the distal tip comprising an aperture that is in communication with the longitudinal cavity, the proximal portion including an inner surface and a uniform diameter, the inner surface including a first mating surface engageable with a first instrument surface and a second mating surface engageable with a second instrument surface, the first mating surface including a threaded inner surface of the proximal portion and the second mating surface defining a hexalobular cross section of the proximal portion, the second mating surface defining a hexalobular cavity positioned between the first mating surface and the distal tip, wherein the longitudinal cavity has a diameter from the aperture to the hexalobular cavity that is greater than a diameter of the hexalobular cavity;   reaming a surgical pathway through the ilium, across the sacro-iliac joint and into the sacrum; and   delivering the implant along the surgical pathway such that the implant extends through the ilium and into the sacrum to treat the sacro-iliac joint.   
     
     
         22 . A method as recited in  claim 21 , wherein the surgical pathway is reamed from a posterior approach. 
     
     
         23 . A method as recited in  claim 21 , wherein delivering the implant comprises driving the implant through the ilium and into the sacrum until at least one surface of the implant is flush with the ilium and the implant is docked with the sacrum. 
     
     
         24 . A method as recited in  claim 21 , wherein delivering the implant comprises driving the implant through the ilium and into the sacrum until the end surface of the proximal portion is disposed in substantially flush alignment with an outer surface of the ilium. 
     
     
         25 . A method as recited in  claim 21 , further comprising creating an incision using a posterior iliac spine as a landmark and inserting a reamer through the incision such that the reamer can ream the surgical pathway. 
     
     
         26 . A method as recited in  claim 21 , wherein the surgical pathway extends through a thickness of the ilium defined by opposite first and second outer surfaces of the ilium. 
     
     
         27 . A method as recited in  claim 21 , further comprising inserting a graft into the implant, wherein inserting the graft comprises packing the graft within the implant. 
     
     
         28 . A method as recited in  claim 21 , further comprising inserting a graft into the implant, where the graft is bone graft material, and inserting the graft comprises inserting the bone graft material into the longitudinal cavity. 
     
     
         29 . A method as recited in  claim 21 , further comprising inserting a graft into the implant, where the graft is bone graft material, and inserting the graft comprises inserting the bone graft material into the longitudinal cavity such that the graft exits the longitudinal cavity through the lateral openings. 
     
     
         30 . A method as recited in  claim 21 , wherein the implant is advanced along the surgical pathway to the ilium along a guidewire. 
     
     
         31 . A method for treating a sacro-iliac joint between a sacrum and an ilium, the method comprising:
 providing an implant, the implant comprising a body including a proximal portion and a distal tip, an outer surface of the body including a thread having a trailing edge disposed perpendicular to the outer surface and a leading edge disposed transverse to the outer surface, the body having a maximum length defined by a distance from an end surface of the proximal portion to an end surface of the distal tip, the thread extending the maximum length such that the body is fully threaded, the body defining a longitudinal cavity and a plurality of lateral openings in communication therewith, the lateral openings extending through the thread, the distal tip comprising an aperture that is in communication with the longitudinal cavity, the proximal portion including an inner surface and a uniform diameter, the inner surface including a first mating surface engageable with a first instrument surface and a second mating surface engageable with a second instrument surface, the first mating surface including a threaded inner surface of the proximal portion and the second mating surface defining a hexalobular cross section of the proximal portion, the second mating surface defining a hexalobular cavity positioned between the first mating surface and the distal tip, wherein the longitudinal cavity has a diameter from the aperture to the hexalobular cavity that is greater than a diameter of the hexalobular cavity;   reaming a surgical pathway through the ilium, across the sacro-iliac joint and into the sacrum;   inserting a graft comprising an agent into the implant; and   delivering the implant along the surgical pathway such that the implant extends through the ilium and into the sacrum and the graft releases the agent to treat the sacro-iliac joint.   
     
     
         32 . A method as recited in  claim 31 , wherein the agent comprises bone growth promoting material. 
     
     
         33 . A method as recited in  claim 31 , wherein reaming the surgical pathway comprises reaming through a thickness of the ilium. 
     
     
         34 . A method as recited in  claim 31 , wherein delivering the implant comprises driving the implant through the ilium and into the sacrum until a surface of the implant is flush with the ilium and the implant is docked with the sacrum. 
     
     
         35 . A method as recited in  claim 31 , wherein delivering the implant comprises driving the implant through the ilium and into the sacrum until the end surface of the proximal portion is disposed in substantially flush alignment with an outer surface of the ilium. 
     
     
         36 . A method as recited in  claim 31 , further comprising creating an incision using a posterior iliac spine as a landmark and inserting a reamer through the incision such that the reamer can ream the surgical pathway. 
     
     
         37 . A method as recited in  claim 31 , wherein the surgical pathway is reamed from a posterior approach. 
     
     
         38 . A method as recited in  claim 31 , wherein the graft is bone graft material. 
     
     
         39 . A method as recited in  claim 31 , wherein inserting the graft comprises inserting the graft into the longitudinal cavity such that the graft exits the longitudinal cavity through the lateral openings. 
     
     
         40 . A method for treating a sacro-iliac joint between a sacrum and an ilium, the method comprising:
 providing an implant, the implant comprising a body including a proximal portion and a distal tip, an outer surface of the body including a thread having a trailing edge disposed perpendicular to the outer surface and a leading edge disposed transverse to the outer surface, the body having a maximum length defined by a distance from an end surface of the proximal portion to an end surface of the distal tip, the thread extending the maximum length such that the body is fully threaded, the body defining a longitudinal cavity and a plurality of lateral openings in communication therewith, the lateral openings extending through the thread, the distal tip comprising an aperture that is in communication with the longitudinal cavity, the proximal portion including an inner surface and a uniform diameter, the inner surface including a first mating surface engageable with a first instrument surface and a second mating surface engageable with a second instrument surface, the first mating surface including a threaded inner surface of the proximal portion and the second mating surface defining a hexalobular cross section of the proximal portion, the second mating surface defining a hexalobular cavity positioned between the first mating surface and the distal tip, wherein the longitudinal cavity has a diameter from the aperture to the hexalobular cavity that is greater than a diameter of the hexalobular cavity;   creating an incision using a posterior iliac spine as a landmark, the posterior superior iliac spine defining a vertical axis;   reaming through the ilium, across the sacro-iliac joint and into the sacrum using a reamer to enlarge the surgical pathway; and   delivering the implant along a surgical pathway such that the implant extends through the ilium and into the sacrum, the implant being advanced along the surgical pathway until a surface the implant is disposed in substantially flush alignment with an outer surface of the ilium.