Assemblies of one or more implant structures make possible the achievement of diverse interventions involving the fusion and/or stabilization of the SI-joint and/or lumbar and sacral vertebra in a non-invasive manner, with minimal incision, and without the necessitating the removing the intervertebral disc. The representative lumbar spine interventions, which can be performed on adults or children, include, but are not limited to, SI-joint fusion or fixation; lumbar interbody fusion; translaminar lumbar fusion; lumbar facet fusion; trans-iliac lumbar fusion; and the stabilization of a spondylolisthesis.

A surgical fastener manipulation tool in accordance with embodiment of the present invention is useful by a surgeon to place fasteners such as threaded screws. The surgical fastener manipulation tool selectively engages a mating structure of fastener for securing the fastener thereto. Thus, advantageously, the surgical fastener manipulation tool can be used for placing such fasteners and/or can be used for extracting (i.e., removing) such fasteners. The ability to extract a fastener (e.g., a threaded bone screw) with the same tool used for placing it is highly beneficial due to time savings during a surgical procedure and is advantageous with respect to prior art fastener manipulation tool configurations that require placement and extraction tools to be differently configured.

A method for forming and abrading an implant void in a sacroiliac joint (“SI Joint”) without the use of a rotary cutting instrument. The method incorporates a multimodal abrading device having abrading surfaces on opposing sides and an open tip comprising a cutting edge. The method includes the step of using the abrading head to cut bone tissue from the SI Joint at an insertion point while simultaneously using the abrading surfaces to decorticate the cortical bone at the insertion point.

A fusion device assembly for fusion of a joint, including a first screw portion, including a first distal end, a first proximal end, a first radially outward facing surface including a first diameter, and a first hole, a second screw portion, including a second distal end, a second proximal end, a second radially outward facing surface including a second diameter, and a second hole, and a section, including a first end connected to the first proximal end, a second end connected to the second distal end, a third radially outward facing surface including a third diameter, the third diameter being less than the first diameter and the second diameter, and a third hole, wherein the first hole, the second hole, and the third hole are in fluid communication.

A tissue fixation implant that includes leading fixation and trailing fixation members, each fixation member having a proximal head and an elongate shank with a distal tip, and each fixation member adapted to at least partially contact the other fixation member at one or more points along their respective lengths. The tissue fixation implant includes a proximal inter-engagement feature for fixedly engaging each of the two fixation members relative to one another when engaged within tissue, including bone tissue, soft tissue, and combinations of these, and has an interior chamber suitable for receiving osteogenic material to enhance new bone growth and fusion of the fixation implant within bone.

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.

A parallel spacer for parallel spacing of a plurality of guiding elements during surgery is provided. The parallel spacer includes a parallel spacer body defining a first guide aperture extending through the parallel spacer body, the first guide aperture being sized to receive a first guiding element in a first orientation with respect to the parallel spacer body and hold the guiding element at the first orientation. The body further defines a second guide aperture extending through the parallel spacer body, sized to receive an access needle. The parallel spacer further includes a first external positioning protrusion, with the first guide aperture extending through the first external positioning protrusion, and a second external positioning protrusion, with the second guide aperture extending therethrough. The second guide aperture is open from a proximal end of the parallel spacer body to a distal end of the second external positioning protrusion.

Implants for the fusion or fixation of two bone segments are described. For example, the implants can be used for the fusion or fixation of the sacroiliac joint. The implants can include fenestrations, have a rectilinear overall cross-sectional area, and have a curvature. Some implants can also be used to rescue failed implants.

Bone implants, including methods of use and assembly. The bone implants, which are optionally composite implants, generally include a distal anchoring region and a growth region that is proximal to the distal anchoring region. The distal anchoring region can have one or more distal surface features that adapt the distal anchoring region for anchoring into iliac bone. The growth region can have one or more growth features that adapt the growth region to facilitate at least one of bony on-growth, in-growth, or through-growth. The implants may be positioned along a posterior sacral alar-iliac (“SAI”) trajectory. The implants may be coupled to one or more bone stabilizing constructs, such as rod elements thereof.

Prostheses are described for stabilizing dysfunctional sacroiliac (SI) joints. The prostheses are sized and configured to be press-fit into surgically created pilot SI joint openings in dysfunctional SI joint structures. The prostheses have an integral structure with opposed elongated sections connected by a bridge section. The elongated sections, in some instances, have an unequal length.