System for sacro-iliac stabilization
Configurations are described for conducting minimally invasive medical interventions utilizing elongate instruments and assemblies thereof to stabilize and/or fixate a sacro-iliac joint. In one embodiment, a tool assembly may be advanced from a posterior approach into the SI junction and configured to create a defect defined at least in part by portions of both the sacrum and the ilium, the defect having a three dimensional shape defined in part by at least one noncircular cross sectional shape in a plane substantially perpendicular to the longitudinal axis of the tool assembly. After a defect is created, the tool assembly may be retracted and a prosthesis deployed into the defect.
1. A system for stabilizing an SI joint, comprising:
a. a defect-creating tool assembly configured to be advanced from a posterior approach into an SI junction defined between sacrum and ilium structures of a patient, the tool assembly being configured to create a defect defined at least in part by portions of both the sacrum and the ilium, the defect having a three dimensional shape defined in part by at least one noncircular cross sectional shape in a plane substantially perpendicular to the longitudinal axis of the tool assembly, the noncircular cross sectional shape comprising two lobes connected by a midportion; and
b. a prosthesis having an outer geometry configured to substantially match the noncircular cross sectional shape of the defect created by the tool assembly.
2. The system of claim 1 , wherein the tool assembly comprises one or more coring devices configured to dislodge and remove one or more portions of the sacrum, ilium, or both.
3. The system of claim 1 , further comprising a tool assembly advancing device selected from the group consisting of a hammer, a drill, a solenoid, and a piston.
4. The system of claim 1 , further comprising an image capture device configured to intraoperatively capture images of the tool assembly relative to portions of the sacrum and ilium.
5. The system of claim 4 , wherein the image capture device is selected from the group consisting of a fluoroscope, a CT system, an ultrasound system, a radiography system, and a magnetic resonance imaging system.
6. The system of claim 1 , further comprising a fixation catalyst configured to fit into the defect along with the prosthesis, the catalyst selected from the group consisting of: demineralized bone matrix, autograft bone material, allograft bone material, polymethylmethacrylate, calcium-based bone void filler material, and bone morphogenic protein.
7. The system of claim 6 , wherein a bone morphogenic protein is selected from the group consisting of BMP-1, BMP-7, and OP-1.
8. The system of claim 1 , wherein the at least one noncircular cross sectional shape further comprises one or more leg portions extending away from the noncircular cross sectional shape.
9. The system of claim 8 , wherein one or more of the leg portions comprise a shape selected from the group consisting of a straight leg, an arcuate leg, and a multisegmented leg.
10. The system of claim 1 , wherein the tool assembly is configured to create a defect shape which varies in cross section relative to the longitudinal axis of the tool assembly.
11. The system of claim 10 , wherein the tool assembly is configured to create a defect having a proximal cross sectional shape which is greater in area than a corresponding distal cross sectional shape.
12. The system of claim 1 , wherein the lobes are circular.
13. The system of claim 1 , wherein the prosthesis comprises two lobed portions connected by a midportion.
14. The system of claim 13 , wherein the midportion of the prosthesis is inversely tapered.