Set of equipment

Abstract

A method for installing a fusion implant (5) in a sacroiliac joint ("SI joint") (3) without the use of a rotary cutting instrument. The method incorporates a multi-modal abrading device (30) having opposing abrasive surfaces (33) and an open tip (34) including a cutting edge (36). The method includes using the abrasive head (32) to cut bone tissue from the SI joint (3) at an insertion location and simultaneously using the abrasive surface (33) to decorticate cortical bone at the insertion location.

Description

[Technical field]

[0001] (1) (Areas of Focus)

[0002] The present invention relates generally to the field of sacroiliac joint fusion surgery, and more particularly to a unique method for fusing the sacroiliac joint without the use of rotational cutting instruments.

[0003] (2) (Description of Related Art)

[0004] The sacroiliac joint ("SI joint") is located at the interface between the sacrum and ilium in the human pelvic region. The SI joint contains strong ligaments that allow only slight movement between the sacrum and ilium. The sacrum connects to the bottom of the spine, and each ilium connects to the top of the legs and the hip area. Thus, the SI joint connects the upper and lower halves of a human body.

[0005] SI joint dysfunction is a common problem in lower back pain. In fact, more than 25% of lower back pain is due to SI joint dysfunction. Even a properly functioning SI joint can be painful after certain types of spinal surgery. For example, more than 75% of lumbar fusion surgeries result in SI joint pain. Often, SI joint pain or dysfunction is addressed by fusing the SI joint, and there have been many surgeries to achieve this. Previous SI joint fusion surgeries have included the placement of complex implant devices such as bone anchors, fusion devices, and multi-component implants. These surgeries include complex devices such as drills and drill bits, as well as multi-component expanders, braces, and anchor placement devices. As a result, fusion surgeries using these devices are complex, time-consuming, and often produce suboptimal results.

[0006] The instrument set herein seeks to overcome these problems by providing a streamlined system and procedure for placing allograft implants in the SI joint without the use of drills, drill bits, or other rotary cutting instruments.

[0007] Another complication of SI joint fusion is that promoting bone fusion often involves decorticating the cortical bone within the SI joint. This decortication is performed using a broach, rasp, or similar abrasive device. These abrasive devices often get stuck inside the SI joint during the decortication process. When the abrasive device gets stuck, it is not possible to apply counter pressure to the patient to counter the pull-out force required to remove the abrasive device. Such counter pressure applied to the patient can cause injury to the patient or damage to the tissues surrounding the surgical site. A past solution has been to install a separate slap hammer or slide hammer on the abrasive device so that a pull-out force can be applied to the abrasive device without the need to apply counter pressure to the patient or other objects. However, past slide hammer assemblies have been cumbersome to operate, difficult to install on the abrasive device, and difficult to operate. They also complicate the instruments required to perform the SI joint fusion surgery.

[0008] The instrument set herein seeks to overcome these problems by providing a slide hammer integrated with an abrasion device in a single tool, eliminating the need to use a rotary cutting instrument to form implant pilot holes in the bone of the SI joint. Summary of the Invention [Means for solving the problem]

[0009] In a preferred embodiment, the systems and instruments described herein include a working channel, a joint locator, a grinding device, and an implant inserter. The working channel has an insertion end and a working end, and a channel extending therebetween. The working channel provides a working passage for inserting other instruments of the system and for delivering an implant to the SI joint. The insertion end has a pair of arms for providing engagement of the SI joint and retraction of tissue around the insertion end. The insertion end further has a first iliac contour and a first sacral contour, both of which are defined by a contour between the insertion arm and the body of the working channel. The inner surface of the working channel has alignment means including grooves, recesses, channels, indentations, etc. for receiving and engaging ridges, ribs, detents, or other protrusions on a mating instrument aligned with the alignment means. In one embodiment, the working channel further has a channel collar for receiving a mating component of the joint locator, grinding device, or implant inserter for abutting and engaging.

[0010] The joint locator has an insertion end and a handle. The insertion end has a penetrating tip for penetrating soft tissue near the SI joint. The leading edge of the penetrating tip may have a blade or chisel component, in whole or in part, to facilitate this penetration. Alternatively, the penetrating tip may be rounded or blunted to prevent inadvertent penetration of the sacrum or ilium if the joint locator is misaligned during insertion. The insertion end of the joint locator has a second ilium contour and a second sacrum contour. The outer surface of the joint locator has keying means for engaging with the alignment means of the working channel, the keying means having ridges, ribs, detents, or other protrusions on the outer surface of the joint locator that can be engaged with the alignment means.

[0011] The sharpening device has a hammer sleeve at a proximal end, an abrasive head at a distal end, and keying means similar to the joint locator keying means of the joint locator. In a preferred embodiment, the sharpening device further includes a slap hammer assembly or a slide hammer assembly. In one embodiment, the slide hammer assembly has a bottom connected to the shaft and a release means releasably connecting the hammer sleeve to the bottom. The released hammer sleeve is configured to slide along the shaft. To operate the slide hammer assembly, the hammer sleeve is disengaged from the bottom and the slide hammer assembly is placed in a release position. This release position allows the hammer sleeve to slide freely along the shaft. The hammer sleeve is pulled until the inner diaphragm of the hammer sleeve engages the stop end of the shaft, thereby generating an impact that delivers the force of the slide hammer.

[0012] The implant inserter has a handle and an implant insertion end having a pair of tines for holding the implant during the process of inserting the implant into the SI joint. The implant inserter further has an inserter keying means similar to the keying means of the joint locator. [Brief description of the drawings]

[0013] [Figure 1] 1 shows a posterior view of a typical human pelvis.

[0014] [Diagram 2] FIG. 1 is a perspective view of an embodiment of an allograft implant for insertion into the SI joint.

[0015] [Diagram 3] 1 shows an alternative view of an embodiment of an allograft implant.

[0016] [Figure 4] 1 illustrates an embodiment of an instrument in a joint fusion device.

[0017] [Diagram 5] 13 shows an embodiment of a working channel and an embodiment of a joint locator.

[0018] [Figure 6] 13 illustrates an enlarged insertion end of one embodiment of a working channel.

[0019] [Figure 7] 7 illustrates an alternative view of the embodiment shown in FIG. 6.

[0020] [Figure 8] 5 is a close-up view of the insertion end of an embodiment of the joint locator fully inserted into the working channel of FIG. 4.

[0021] [Figure 9] FIG. 9 is an enlarged view of the device in FIG. 8 with the orientation reversed.

[0022] [Figure 10] 13 illustrates an enlarged working end of one embodiment of a working channel.

[0023] [Figure 11] 5 illustrates the articular locator of FIG. 4 partially inserted into the working channel.

[0024] [Figure 12] 5 illustrates the articular locator of FIG. 4 fully inserted into the working channel.

[0025] [Figure 13] 5 illustrates an embodiment of the working channel and abrasive device of FIG. 4.

[0026] [Figure 14] 1 is a close-up view of an embodiment of a polishing head.

[0027] [Figure 15] 1 illustrates an enlarged view of one embodiment of a polishing head.

[0028] [Figure 16] 14 shows the abrasive device of FIG. 13 with an embodiment of the slide hammer disassembled.

[0029] [Figure 17] FIG. 13 is a close-up view of an embodiment of a connection interface of the slide hammer.

[0030] [Figure 18] 1 illustrates an enlarged view of one embodiment of a diaphragm and threaded connector of the slide hammer assembly.

[0031] [Figure 19] 14 shows the abrasive device of FIG. 13 partially inserted into the working channel of FIG. 4.

[0032] [Figure 20] 14 shows the abrasive device of FIG. 13 fully inserted into the working channel of FIG. 4 with the sliding hammer in a locked position.

[0033] [Figure 21] 14 shows the abrasive device of FIG. 13 fully inserted into the working channel of FIG. 4 with the slide hammer in an extended position.

[0034] [Figure 22] 5 illustrates one embodiment of the working channel and insertion device of FIG. 4.

[0035] [Diagram 23] FIG. 23 is a close-up view of the insertion end of the insertion device of FIG.

[0036] [Figure 24] 23 shows the insertion device of FIG. 22 with an embodiment of an allograft implant loaded onto the tines of the insertion end.

[0037] [Diagram 25]23 shows the insertion device of FIG. 22 and the allograft implant partially inserted into the working channel of FIG. 4.

[0038] [Figure 26] 23 shows the insertion device of FIG. 22 and the allograft implant fully inserted into the working channel of FIG. 4.

[0039] [Figure 27] FIG. 13 is a front view of one embodiment of a dissection guide.

[0040] [Figure 28] FIG. 13 illustrates a top view of one embodiment of a dissection guide.

[0041] [Figure 29] FIG. 13 is a right side view of one embodiment of a dissection guide.

[0042] [Diagram 30] 30 is a cross-sectional view AA of the incision guide of FIG. 29.

[0043] [Diagram 31] FIG. 1 illustrates an isometric view of one embodiment of a dissection guide.

[0044] [Diagram 32] FIG. 1 is a side view of one embodiment of an allograft implant.

[0045] [Diagram 33] 33 is a cross-sectional view BB of the allograft implant of FIG. 32.

[0046] [Diagram 34] FIG. 1 is a top view of one embodiment of an allograft implant.

[0047] [Diagram 35] FIG. 1 illustrates a rear view of one embodiment of an allograft implant.

[0048] [Diagram 36] FIG. 1 is a front view of one embodiment of an allograft implant. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0049] With reference to the drawings, a method for fusing the sacroiliac joint ("SI joint") will now be described in terms of the best mode and preferred embodiments. The embodiments disclosed herein are intended to illustrate, but not to limit, the invention. A practitioner of ordinary skill will appreciate that many variations of the following embodiments can be made without undue experimentation.

[0050] The methods and corresponding systems and instruments described herein are primarily used to fuse the SI joint 3 in the human pelvis. With reference to FIGS. 1-3, an allograft implant 5 is placed in the soft tissue of the SI joint 3 between the sacrum 1 and ilium 2 of the pelvis. For reference purposes, the SI joint surface as used herein generally refers to the plane of the SI joint 3 defined by the abutting surfaces of the sacrum 1 and ilium 2. The implant 5 provides a substrate for bone healing throughout the SI joint, thereby fusing the sacrum 1 and ilium 2. In one embodiment, the implant 5 generally includes a nose 6 and at least one pair of opposing sides 7, each having a groove 8 disposed at least partially along the length of each such side 7.

[0051] With reference to FIG. 4, in one embodiment, the system includes a working channel 10, a joint locator 20, an abrasion device 30, and an implant inserter 60. Each of these instruments has a longitudinal axis along the centerline of its length. With reference to FIG. 5, the working channel 10 is a tubular member that provides a working passage for inserting other instruments of the system and for delivering the implant 5 to the SI joint 3. The working channel 10 is a cannula, lumen, sleeve, or another device suitable for providing working access for other instruments to the SI joint 3, as described below. The working channel 10 has an insertion end 11 and a working end 12, and a channel 13 extending therebetween. The channel 13 is a tube or hole having a straight or curved cross section. The insertion end 11 has a pair of arms 14 for providing engagement of the SI joint 3 and retraction of tissue surrounding the insertion end 11. The arms 14 are a probe, prong, or other member protruding from the insertion end 11 of the working channel 10. When arm 14 is inserted into SI joint 3, working channel 10 resists or prevents rotation about its longitudinal axis relative to SI joint 3, as described below. The longitudinal axis generally extends along the length of working channel 10, proximate to the centerline of channel 13.

[0052] The insertion end 11 of the working channel 10 is configured to seat in and against the SI joint 3, specifically against the sacrum 1 and ilium 2. The insertion end 11 has a first iliac contour 15 and a first sacral contour 16, both of which are defined by a contour between the insertion arm 14 and the body of the working channel 10. For example, with reference to FIGS. 6-9, one side of the insertion end 11 has an arm 14 connected to the working channel 10 via a first iliac contour 15, the arm 14 configured to abut the ilium 2 when the arm 14 is inserted into and seated in the SI joint 3. The opposite side of the insertion end 11 has an arm 14 connected to the working channel 10 via a first sacral contour 16, the arm 14 configured to abut the sacrum 1 when the arm 14 is inserted into and seated in the SI joint 3.

[0053] 5 and 10, the inner surface of the working channel 10 has a means for aligning an instrument, the alignment means 17 having grooves, recesses, channels, indentations, etc. for receiving and engaging ridges, ribs, detents, or other protrusions on a mating instrument aligned with the alignment means 17. In one embodiment, the working channel 10 further has a channel collar 18 for receiving a mating component of an articular locator 20, abrasion device 30, or implant inserter 60 in abutting engagement, as described below. In an embodiment of the channel collar 18, the collar further has an alignment means 17.

[0054] Referring to FIG. 5, the joint locator 20 has an insertion end 21 and a handle 22, or working end. The insertion end 21 has a penetrating tip 23 for penetrating soft tissue near the SI joint 3. This soft tissue is between the surface of the patient's skin and the SI joint 3, such as muscle tissue, as well as soft tissue inside the SI joint 3, such as cartilage and ligaments. The penetrating tip 23 is configured to penetrate these types of soft tissue. For example, one embodiment of the penetrating tip 23 has a blade or chisel component for cutting the soft tissue. The leading edge of the penetrating tip 23 may have such a blade or chisel component, in whole or in part. In another embodiment of the penetrating tip 23, the penetrating tip 23 is rounded or blunted to prevent inadvertent penetration of the sacrum 1, ilium 2, or other bony structures of the pelvic region if the joint locator 20 is misaligned during insertion and penetration. In this embodiment, the penetrating tip 23 tends to peel or tear the soft tissue, rather than slicing or cutting it.

[0055] 8 and 9, the insertion end 21 of the joint locator 20 has a second ilium contour 24 and a second sacrum contour 25. For example, one side of the insertion end 21 of the joint locator 20 has a second ilium contour 24 configured to abut against the ilium 2 when the piercing tip 23 is inserted into the SI joint 3, as described below. The other side of the insertion end 21 of the joint locator 20 has a second sacrum contour 25 configured to abut against the sacrum 1 when the piercing tip 23 is inserted into the SI joint 3.

[0056] The outer surface of the articular locator 20 has a means for keying with the alignment means 17 of the working channel 10, and the keying means 27 has ridges, ribs, detents, or other protrusions on the outer surface of the articular locator 20 that can engage with the alignment means 17 to resist or prevent relative rotation between the articular locator 20 and the working channel 10.

[0057] 5, 11 and 12, the joint locator 20 has a channel 26 for receiving the K-wire 4. The channel 26 is a cannula, lumen, or other bore-like feature that can receive the K-wire 4 in a pass-through manner, preferably along the longitudinal axis or centerline of the joint locator 20. In one embodiment of the joint locator 20, the handle 22 further has a stop 28 for abutting the channel collar 18 of the working channel 10.

[0058] 13, an abrading device 30 has a hammer sleeve 31 at a proximal end and an abrading head 32 at a distal end. The abrading head 32 is a rasp, broach, or other abrasive tool used to abrade, polish, or otherwise decorticate the cortical bone in the SI joint 3. In one embodiment shown in FIGS. 14 and 15, the abrading head 32 is a generally rectangular member having abrasive surfaces 33 on a first pair of opposing sides of the head 32, an open tip 34 for insertion into the SI joint 3, a second pair of opposing sides 35 between the abrasive surfaces 33, and a second pair of opposing sides 35 having one or more side openings. Each abrasive surface 33 has one or more teeth, barbs, blades, ridges, slots, broaches, or other members or features capable of abrading the cortical bone of the SI joint 3. The opening tip 34 has a cutting edge 36 around all or a portion of a leading edge of the opening tip 34, where the cutting edge 36 is configured to cut bone tissue inside an SI joint 3, such as the sacrum 1 or ilium 2. The abrasive surface 33 and the sides 35 form a box-shaped abrasive head 32 with a gap therein. The openings in the sides 35 allow lateral access to the gap. For example, as the cutting edge 36 cuts bone tissue inside the SI joint 3, the removed bone tissue may fall into the gap and exit the abrasive head 32 through the openings in the sides 35.

[0059] In one embodiment, each side of the first pair of opposing sides is a substantially planar member having a distal edge that terminates in an open tip 34, with the interface between the open tip 34 and the distal edge having a substantially straight cutting edge 36. Each side of the second pair of opposing sides may include a curved distal portion that terminates in the open tip 34, with the interface between the open tip 34 and the curved distal portion having a curved cutting edge 36. The curved distal portion of each side of the second pair of opposing sides 35 may further have a taper toward its opposing side of the second pair of opposing sides 35.

[0060] 19, the sharpening device 30 further includes keying means 37 similar to the keying means 27 of the joint locator 20 described above. The keying means 37 mates with the alignment means 17 in the working channel 10 to resist or prevent relative rotation between the sharpening device 30 and the working channel 10 about the respective longitudinal axes of each member. The sharpening device 30 further includes an abrasive stop 38 for abutting the channel collar 18 of the working channel 10. In one embodiment, the sharpening device 30 further includes a K-wire channel for receiving a K-wire 4. The K-wire channel preferably includes a cannula, lumen, or other bore-like feature along the longitudinal axis of the sharpening device 30 that can receive the K-wire 4 in a pass-through manner.

[0061] 16, 17, and 18, the abrasive device 30 further includes a slap hammer assembly, or slide hammer assembly 40. In one embodiment, the slide hammer assembly 40 includes a bottom portion 51 connected to the shaft 44, and a release means for releasably connecting the hammer sleeve 31 to the bottom portion 51. The released hammer sleeve 31 is configured for sliding engagement along the shaft 44. The release means is any means for releasably connecting the hammer sleeve 31 to the bottom portion 51, thereby allowing the slide hammer assembly to move between a released position and a locked position. The release means can be a mating threaded connection, a quick disconnect attachment, a depressible tab, a latch, a clasp, a clip, a clamp, or other equivalent connection structure.

[0062] In one embodiment shown in Figures 16, 17, and 18, the release means is a mating threaded connection. This embodiment includes a collar 41 on the abrasive device 30, a sliding hammer shaft 44, and a hammer sleeve 31. The collar 41 has an internal thread 42 and an external thread 43. The shaft 44 has a threaded end 45 and a stop end 46. The hammer sleeve 31 has a hollow cylindrical bore with a threaded connector 48, and an internal diaphragm 47 with a diaphragm opening 49 (see Figure 18). The diaphragm opening 49 is sized to allow a sliding path for all portions of the shaft 44 except the stop end 46. The stop end 46 is sized too large to fit through the diaphragm opening 49.

[0063] To assemble the sliding hammer assembly 40 of this embodiment, the threaded end 45 of the shaft 44 is inserted into the bore of the hammer sleeve 31 through the inner diaphragm 47 of the hammer sleeve 31, and the threaded end 45 is threaded and mated with the internal threads 42 of the collar 41. The threaded connector 48 of the hammer sleeve 31 is then mated with the external threads 43 of the collar 41 to facilitate a secure connection. The stop end 46 is located inside the bore of the hammer sleeve 31 on the side of the diaphragm 47 opposite the location of the threaded connector 48. In this configuration, shown in FIG. 20, the sliding hammer assembly 40 is in its locked position.

[0064] To operate the slide hammer assembly 40, the threaded connector 48 is disengaged from the external threads 43 of the collar 41, placing the slide hammer assembly 40 in its released position shown in FIG. 21. This released position allows the hammer sleeve 31 to slide freely along the shaft 44. The hammer sleeve 31 is pulled until the inner diaphragm 47 of the hammer sleeve 31 engages the stop end 46 of the shaft 44, thereby generating an impact that delivers the force of the slide hammer. Thus, the slide hammer assembly has a released position that allows operation of the slide hammer assembly, and a locked position that prohibits operation of the slide hammer assembly.

[0065] 22-26, implant inserter 60 has a handle 61 and an implant insertion end 62. Implant insertion end 62 has a pair of tines 63 for holding implant 5 during the process of inserting implant 5 into SI joint 3. Each tine 63 is supported by a tine shaft 66 that terminates in a shoulder 67. The tine shaft 66 provides flexibility so that implant 5 can be removably held between tines 63 and shoulder 67 abuts implant 5 (see FIG. 24). For example, in one embodiment, the width of implant 5 between opposing grooves 8 is slightly greater than the space between each tine 63 such that when implant 5 is seated in implant insertion end 62, each tine 63 is slightly pushed apart by groove 8. This creates a slight amount of friction between tines 63 and grooves 8, thereby releasably holding implant 5 in implant insertion end 62.

[0066] The implant inserter 60 further includes an inserter keying means 65 similar to the keying means 27 of the joint locator 20. The inserter keying means 65 mates with the alignment means 17 in the working channel 10 to resist or prevent relative rotation between the implant inserter 60 and the working channel 10 about the longitudinal axis of each member. In one embodiment, the implant inserter 60 further includes a channel 64 for receiving a K-wire 4 (see FIG. 23). The channel 64 includes a cannula, lumen, or other hole-like feature that can receive the K-wire 4 in a pass-through manner. In one embodiment of the implant inserter 60, the handle 61 further includes an insertion stop 68 for abutting the channel collar 18 of the working channel 10.

[0067] In one embodiment of the method for installing the implant 5, the procedure for installing the implant 5 in the SI joint 3 begins by locating an insertion location in the SI joint 3, where the implant 5 will be installed. For example, the free end of the K-wire 4 is inserted into the SI joint 3 at the insertion location where the implant 5 will be installed, thereby defining the intended location of the implant gap. The implant gap is a place or groove between the sacrum 1 and the ilium 2 for seating the implant 5, as described below. The K-wire 4 is preferably inserted from a posterior approach. It is preferred, but not required, that the implant 5 be placed below the portion of the posterior superior iliac spine that projects into the SI joint 3. One or more alternative locations are also suitable for fusing the SI joint 3. The K-wire 4 is inserted into the SI joint 3 at each location where the implant 5 will be inserted.

[0068] In one embodiment, with reference to Figures 27-31, an initial incision is made using an incision guide 70 having a channel 71 for removably receiving a K-wire 4. The incision guide 10 further has a guide slot 72 for receiving a blade, scalpel, or similar cutting instrument (not shown). The guide slot 72 is oriented at an angle relative to the channel 71 such that as the scalpel extends through the guide slot 72, the tip of the scalpel is positioned on the patient's skin in the proper location for making the initial incision in the patient. This location is above the SI joint 3 and is where the allograft implant 5 will be introduced into the soft tissue above the SI joint 3 and ultimately into the SI joint 3 itself. In one embodiment, the guide slot 72 is oriented at an angle A of about 70° to about 75° relative to the horizontal H (see Figure 30). In this orientation, the channel 71 is perpendicular to the horizontal.

[0069] In this embodiment, the K-wire 4 is inserted into the SI joint 3 as described above. The dissection guide 70 is placed over the K-wire 4 such that the K-wire 4 is slidably received in the channel 71. In one embodiment, a scalpel is inserted into the guide slot 72 and held in a fixed relationship relative to the channel 71 such that the cutting tip of the scalpel is positioned in close proximity to the K-wire 4. The dissection guide 70 is then advanced towards the SI joint 3, with the cutting tip of the scalpel making the incision as the dissection guide 70 advances. Once the initial incision is sufficiently made, the dissection guide 70 is lifted and removed from the K-wire 4 and the procedure proceeds using other instruments to insert the implant 5 into the SI joint 3.

[0070] The joint locator 20 is then fully inserted into the working channel 10 (see FIG. 12). In mating the joint locator 20 inside the working channel 10, the keying means 27 of the joint locator 20 is oriented to engage with the alignment means 17 of the working channel 10. This engagement allows the first iliac contour 15 of the working channel to be positioned in mating alignment with the second iliac contour 24 of the joint locator 20, and the first sacral contour 16 of the working channel 10 to be positioned in mating alignment with the second sacral contour 25 of the joint locator 20 (see FIGS. 8 and 9). Each of the first and second iliac contours 15, 24 is configured to seat in a mating arrangement against the ilium 2 when the insertion end 11 is positioned medial to the SI joint 3, and each of the first and second sacral contours 16, 25 is configured to seat in a corresponding mating arrangement against the sacrum 1 when the insertion end 11 is positioned medial to the SI joint 3. Stop 28 abuts channel collar 18 of working channel 10 to prevent excessive penetration of penetrating tip 23 into SI joint 3 , thereby avoiding damage to the soft tissue and nerves anterior to SI joint 3 .

[0071] The free end of the K-wire is inserted into the K-wire channel 26 of the combined joint locator 20 / working channel 10, and the combined device is advanced toward the SI joint 3, guided by the K-wire 4. As the combined joint locator 20 / working channel 10 advances, the penetrating tip 23 cuts or peels away the soft tissue above and inside the SI joint 3. If necessary, the combined joint locator 20 / working channel 10 is advanced by a strike from the mallet against the proximal end of the handle 22 to deliver the appropriate axial force. The impact from the mallet causes an axial force that is transmitted through the handle 22 to the stop 28, where the axial force is imparted to the channel collar 18 and working channel 10. Thus, the impact force from the mallet is shared between the working channel insertion end 11 and the joint locator insertion end 21.

[0072] The combined joint locator 20 / working channel 10 is advanced until the respective first and second iliac contours 15, 24 abut the ilium 2 and the respective first and second sacral contours 16, 25 abut the sacrum 1. In this position, the arms 14 of the working channel 10 are positioned inside the SI joint 3 to maintain proper alignment of the working channel 10, and thus the alignment means 17, thereby ensuring proper alignment of the abrasion device 30 and implant inserter 60 later in the procedure. In some embodiments, insertion of the arms 14 into the SI joint 3 retracts the joint, thus separating the sacrum 1 and ilium 2. This retraction establishes a uniform width of the SI joint 3 spacing prior to the use of other instruments. Thus, the instruments described herein work with any size patient, as the arms 14 set the width of the SI joint 3 at a consistent distance, regardless of the size or scale of the sacrum 1 or ilium 2.

[0073] In an alternative embodiment of the installation method, the K-wire 4 is omitted from the procedure. Instead, the combined joint locator 20 / working channel 10 is advanced through the patient's incision, and this advancement continues as described above until the insertion ends 11, 21 are inserted into the SI joint 3 as described above.

[0074] Once the combined joint locator 20 / working channel 10 device is properly seated on the SI joint 3, the joint locator 20 is removed from the working channel 10. The surrounding soft tissue remains retracted or dilated by the working channel 10 and respective arms 14, thereby allowing direct access to the SI joint 3 area. The abrading device 30 is then inserted into the working channel 10, with the keying means 37 engaging the alignment means 17 to facilitate proper alignment of the abrading head 32 relative to the SI joint 3. The abrading head 32 advances through the working channel 10 until the abrading head 32 contacts the SI joint 3. The abrading head 32 is forced (using a mallet if necessary) into the SI joint 3, with the cutting edge 36 cutting the bone tissue and any soft tissue such as ligaments or cartilage. The abrading stop 38 abuts against the channel collar 18 of the working channel 10 to prevent excessive penetration of the abrading head 32 into the SI joint 3, thereby avoiding damage to the soft tissue and nerves anterior to the SI joint 3. During this process, the cutting edge 36 cuts the relevant bone portions of the sacrum 1 and ilium 2, and the abrasive surface 33 simultaneously operates in conjunction with the cutting edge 36 to decorticate the cortical bone medial to the SI joint 3, thereby forming a decorticated implant gap at the insertion location of the SI joint 3. The decorticated implant gap has a generally rectangular cross-sectional shape such that the decorticated implant gap is adapted to receive a fusion implant 5 having a generally rectangular cross-sectional shape for mating with the decorticated implant gap. Thus, the use of the abrasive head 32 allows for the installation of the implant 5 without the need to use a drill or other rotary cutting instrument to form a pilot hole for the implant 5. As used herein, a rotary cutting instrument is any device capable of cutting material by turning, rotating, or other angular motion about the axis of the device, whether power-driven or manually-driven. This is a significant improvement of the inventive instrument set over prior art methods and instrument sets for SI joint 3 fusion.

[0075] The abrasive device 30 is then operated in and out of the working channel 10 such that the abrasive surface 33 abrades or decorticates the respective surfaces of the sacrum 1 and ilium 2 medial to the SI joint 3. Again, the abrasive stop 38 abuts against the channel collar 18 to prevent excessive penetration of the abrasive head 32. During this process, the abrasive head 32 may become stuck in the SI joint 3 and become difficult to remove. In these cases, the slide hammer assembly 40 may be effective and thus remove the abrasive head 32 by the impact force of the slide hammer assembly 40 as described above. The operation of the slide hammer assembly 40 offers many advantages over previous systems because once the abrasive head 32 becomes stuck in the SI joint 3, no back pressure can be applied to the patient to counter the pulling force required to remove the abrasive head 32 from the SI joint 3. The slide hammer assembly 40 allows for the removal of the stuck abrasive head 32 in a safe manner without applying back pressure to the patient.

[0076] As the abrasive head 32 operates in and out of the SI joint 3, the abrasive surface 33 abrades the cortical bone of the sacrum 1 and ilium 2 medial to the SI joint 3. The cortical bone is abraded until bleeding begins, thereby promoting the healing process of the patient's cortical bone. This degree of abrasion and corresponding healing promotes fusion of the SI joint 3.

[0077] Once the SI joint 3 has been properly abraded, the abrasive device 30 is removed from the working channel 10. Thus, the present method of fusing the SI joint 3 includes a step for forming a gap for the fusion implant 5 in the SI joint 3 without the use of a rotary cutting instrument. At this point in the procedure, the K-wire 4 may be removed from the working channel 10 to allow for proper advancement of the implant 5 through the working channel 10 and proper placement of the implant 5 in the SI joint 5. Alternatively, the K-wire 4 may be removed from the working channel 10 at any time after the working channel 10 is properly seated in the SI joint 3, as described above.

[0078] The allograft implant 5 is placed on the tines 63 of the implant inserter 60 such that each tine 63 seats in a mating groove 8 on the side surface 7 of the implant 5 and the shoulder 67 abuts the implant 5 (see FIG. 24). The implant inserter 60 is then inserted into the working channel 10 such that the keying means 65 engages the alignment means 17 to ensure proper orientation of the implant inserter 60 and thus the implant 5. The implant inserter 60 is used to deliver the implant 5 through the working channel 10 to the polished area of ​​the SI joint 3. If necessary, the implant inserter 60 is struck with a mallet to force the implant 5 into the polished area of ​​the SI joint 3, with the shoulder 67 transmitting the force of the impact to the implant 5. In these cases, the insertion stop 68 abuts the channel collar 18 of the working channel 10 to prevent excessive penetration of the implant 5 into the SI joint 3, thereby ensuring that the implant 5 is properly positioned inside the SI joint 3.

[0079] Once the implant 5 is fully inserted into the SI joint 3, the implant inserter 60 is removed from the working channel 10 leaving the implant 5 seated in the abraded area of ​​the SI joint 3. In most cases, the frictional force between the implant 5 and the inside of the SI joint 3 is greater than the frictional force between the respective tines 63 and the grooves 8. In these cases, removal of the implant inserter 60 is accomplished by applying a removal force to the implant inserter 60 that is greater than the frictional force between the tines 63 and the grooves 8. The tines 63 slide out of the grooves 8 as the implant inserter 60 is retracted from the working channel 10. In other cases, the frictional force between the implant 5 and the inside of the SI joint 3 is less than the frictional force between the respective tines 63 and the grooves 8. In these cases, removal of the implant inserter 60 is accomplished by inserting a K-wire 4 or similar device into the K-wire channel 64 and advancing the K-wire 4 until the distal end of the K-wire abuts the implant 5 between the tines 63. The K-wire 4 is used to hold the implant 5 in place inside the SI joint 3 as a removal force is applied to the implant inserter 60. The tines 63 are thereby removed from the grooves 8 as the K-wire 4 holds the implant 5 in its installed position. As the tines 63 are withdrawn from the grooves 8, the implant inserter 60 disengages from the implant 5 and the implant inserter 60 and K-wire 4 are removed from the working channel 10. The working channel 10 is then removed from the surgical site, contracting the SI joint 3, thereby exerting a compressive force on the implant 5. This compressive force is created by the ligaments of the SI joint 3 which hold the joint together by compressing the joint. The surgical site is then sterilized and closed for healing.

[0080] As the polished cortical bone heals, the bone fuses with the allograft implant 5, eventually causing the sacrum 1 and ilium 2 to grow together at the location of the implant 5, thereby fusing the SI joint 3.

[0081] In any of the foregoing embodiments, one or more of the instruments may comprise a disposable material, such as medical grade plastic, certain metals, or other disposable materials.

[0082] 32-36, the implant 5 generally has two opposing surfaces 81. When the implant 5 is inserted into the SI joint 3, one opposing surface 81 is positioned against the sacrum 2 and the other opposing surface 81 is positioned against the ilium 3. Each of the opposing surfaces 81 has one or more anti-migration features 82, such as teeth or ridges, that resist movement of the implant inside the SI joint 3.

[0083] In one embodiment, the implant 5 includes a body 83 having a proximal end 86, a distal end 87, and a length disposed therebetween, the distal end having a rounded tip 6. The body 83 further has two sides 7, each side 7 having a groove 8 beginning at the proximal end 86 of the body 83 and continuing along each of the two sides 7 for at least a portion of its length, the distance between the two sides 7 defining a width W of the body.

[0084] The implant 5 further has a central implant opening 85 that allows fusion of the SI joint 3 to occur through the implant 5. The implant opening 85 is disposed between each of the opposing sides 81, with the implant opening 85 providing a passageway through the body 83 between the two opposing sides 81. The portions of the body 83 located between the implant opening 85 and each side 7 define walls 84.

[0085] When viewed in cross section (see FIG. 33), the area of ​​the grafting opening 85 is about 35% to about 40% of the first cross-sectional area of ​​the body, which is the area of ​​the entire implant 5 as shown by the shaded area in FIG. 33. The area of ​​the opening 85 is about 60% of the total area of ​​each opposing surface 81 that contacts the bone, whether the sacrum 1 or the ilium 2. These ratios provide a strength vs. contact area relationship that optimizes the performance of the implant 5 as a promoter of SI joint 3 fusion. At these ratios, the implant 5 provides sufficient strength to avoid being crushed within the SI joint 3, while providing a grafting opening 85 large enough to pass across the implant 5 and promote SI joint 3 fusion.

[0086] In one embodiment, the implantation opening 85 has a proximal portion 88 and a distal portion 89 positioned adjacent to the groove 8, and the proximal portion 88 has a width W1 that is smaller than the width W2 of the distal portion 89 such that the wall 84 maintains a minimum thickness in the range of about 17% to about 20% of the width W of the body 83.

[0087] In the aforementioned embodiment, it is preferred, but not required, that the graft opening 85 is unobstructed by internal or intermediate supports. Such internal or intermediate supports are sometimes used in allograft implants to provide structural support to the implant. However, these internal or intermediate supports prevent bone fusion from occurring through the opening. Thus, the graft opening 85 may provide an open passageway through the body 83 between the opposing faces 81. The open passageway may be straight or curved. The proximal end 86 of the body 83 may further have a taper 90 that reduces the second cross-sectional area of ​​the body 83.

[0088] The foregoing embodiments are merely representative of the SI joint fusion method and are not meant to limit the invention. For example, one skilled in the art will readily appreciate that there are several embodiments and configurations of the abrasive device, slide hammer device, and other devices and instruments described herein that do not substantially alter the nature of the SI joint fusion method. Some steps of the method can be performed in an order other than that described above. Thus, it will be understood that equivalents and substitutions of the specific elements and components described above are part of the invention described herein, with the true scope of the invention being set forth in the following claims. The following items are also disclosed: [Item 1] 1. A method for creating an implant gap in a sacroiliac joint without the use of a rotary cutting instrument, the method comprising: positioning an insertion location in the sacroiliac joint, the insertion location defining an intended location of the implant gap; introducing a working channel into the insertion location, the working channel having an insertion end and a working end connected by a working channel, the insertion end of the working channel further having a first iliac contour, a first sacral contour, and an insertion arm; inserting the insertion arm into the sacroiliac joint at the insertion position such that the first sacral contour seats against the sacrum and the first iliac contour seats against the ilium; Introducing a polishing device into the working channel, the polishing device comprising: a polishing head at a distal end of the polishing device, the polishing head comprising: a first pair of opposing abrasive surfaces, each of the abrasive surfaces having one or more teeth, barbs, blades, ridges, slots, broaches, or other features capable of abrading cortical bone of the sacroiliac joint; an abrading head having an open tip with a cutting edge disposed on a leading edge of the open tip, the cutting edge configured to cut bone tissue of the sacroiliac joint; introducing a slide hammer assembly at a proximal end of the abrading device, the slide hammer assembly having a release position that allows movement of the slide hammer assembly, a locked position that prohibits movement of the slide hammer assembly, and a release means for moving the slide hammer assembly between the locked position and the released position; advancing the abrasive device into the sacroiliac joint such that the opening tip cuts away bone tissue from the sacrum or the ilium and the abrasive surface decorticates the cortical bone within the sacroiliac joint, thereby forming a decorticated implant gap at the insertion location without the use of a rotary cutting instrument; A method comprising: [Item 2] 2. The method of claim 1, wherein when the abrading head gets caught inside the sacroiliac joint, the slide hammer assembly is unlocked via the release means and the slide hammer assembly is used to remove the abrading head from the sacroiliac joint. [Item 3] Introducing the working channel into the insertion location, introducing a joint locator into the working channel, the joint locator having a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 2. The method of claim 1, further comprising: fully inserting the joint locator into the working channel to position the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device. [Item 4] 4. The method of claim 3, wherein inserting the insertion arm into the sacroiliac joint further comprises inserting the combined joint locator and working channel device into the sacroiliac joint at the insertion position such that the first sacral contour and the second sacral contour seat against the sacrum and the first iliac contour and the second iliac contour seat against the ilium. [Item 5] 5. The method of claim 4, further comprising peeling soft tissue above and inside the sacroiliac joint through the piercing tip until the first and second iliac contours abut the ilium and the first and second sacral contours abut the sacrum. [Item 6] Introducing the working channel into the insertion location, introducing a joint locator into the working channel, the joint locator having a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 3. The method of claim 2, further comprising: fully inserting the joint locator into the working channel to position the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device. [Item 7] 7. The method of claim 6, wherein inserting the insertion arm into the sacroiliac joint further comprises inserting the combined joint locator and working channel device into the sacroiliac joint at the insertion position such that the first sacral contour and the second sacral contour seat against the sacrum and the first iliac contour and the second iliac contour seat against the ilium. [Item 8] 8. The method of claim 7, further comprising peeling soft tissue above and inside the sacroiliac joint through the piercing tip until the first and second iliac contours abut the ilium and the first and second sacral contours abut the sacrum. [Item 9] 2. The method of claim 1, wherein forming the decorticated implant gap at the insertion location further comprises forming a generally rectangular cross-sectional shape for the decorticated implant gap such that the decorticated implant gap is adapted to receive a fusion implant having a generally rectangular cross-sectional shape. [Item 10] 10. The method of claim 9, further comprising unlocking the slide hammer assembly via the release means when the abrading head becomes lodged inside the sacroiliac joint, and using the slide hammer assembly to remove the abrading head from the sacroiliac joint. [Item 11] Introducing the working channel into the insertion location, introducing a joint locator into the working channel, the joint locator having a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 10. The method of claim 9, further comprising: fully inserting the joint locator into the working channel to position the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour in mating alignment, thereby defining a combined joint locator and working channel device. [Item 12] 12. The method of claim 11, wherein inserting the insertion arm into the sacroiliac joint further comprises inserting the combined joint locator and working channel device into the sacroiliac joint at the insertion position such that the first sacral contour and the second sacral contour seat against the sacrum and the first iliac contour and the second iliac contour seat against the ilium. [Item 13] Item 13. The method of item 12, further comprising peeling soft tissue above and inside the sacroiliac joint through the piercing tip until the first iliac contour and the second iliac contour abut the ilium and the first sacral contour and the second sacral contour abut the sacrum. [Item 14] Introducing the working channel into the insertion location, introducing a joint locator into the working channel, the joint locator having a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 11. The method of claim 10, further comprising: fully inserting the joint locator into the working channel to position the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device. [Item 15] 15. The method of claim 14, wherein inserting the insertion arm into the sacroiliac joint further comprises inserting the combined joint locator and working channel device into the sacroiliac joint at the insertion position such that the first sacral contour and the second sacral contour seat against the sacrum and the first iliac contour and the second iliac contour seat against the ilium. [Item 16] Item 16. The method of item 15, further comprising peeling soft tissue above and inside the sacroiliac joint through the piercing tip until the first iliac contour and the second iliac contour abut the ilium and the first sacral contour and the second sacral contour abut the sacrum. [Item 17] 1. A method for creating an implant gap in a sacroiliac joint without the use of a rotary cutting instrument, the method comprising: positioning an insertion location in the sacroiliac joint, the insertion location defining an intended location of the implant gap; introducing a working channel into the insertion location, the working channel having an insertion end and a working end, the insertion end of the working channel further having a first iliac contour, a first sacral contour, and an insertion arm; inserting the insertion arm into the sacroiliac joint at the insertion position such that the first sacral contour seats against the sacrum and the first iliac contour seats against the ilium; Introducing a polishing device into the working channel, the polishing device comprising: a polishing head at a distal end of the polishing device, the polishing head comprising: a first pair of opposing abrasive surfaces, each of which is capable of abrading cortical bone of the sacroiliac joint; introducing an abrasive head having an open tip, the open tip having a cutting edge disposed on a leading edge of the open tip, the cutting edge configured to cut bone tissue of the sacroiliac joint; advancing the abrasive device into the sacroiliac joint such that the opening tip cuts away bone tissue from the sacrum or the ilium and the abrasive surface decorticates the cortical bone within the sacroiliac joint, thereby forming a decorticated implant gap at the insertion location without the use of a rotary cutting instrument; 13. A method for forming an implant gap in a sacroiliac joint without the use of a rotary cutting instrument comprising: [Item 18] Introducing the working channel into the insertion location, introducing a joint locator into the working channel, the joint locator having a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 20. The method of claim 17, further comprising: inserting the joint locator into the working channel to position the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device. [Item 19] 20. The method of claim 18, wherein inserting the insertion arm into the sacroiliac joint further comprises inserting the combined joint locator and working channel device into the sacroiliac joint at the insertion position such that the first sacral contour and the second sacral contour seat against the sacrum and the first iliac contour and the second iliac contour seat against the ilium. [Item 20] 1. A method for creating an implant gap in a sacroiliac joint without the use of a rotary cutting instrument, the method comprising: positioning an insertion location in the sacroiliac joint, the insertion location defining an intended location of the implant gap; introducing a working channel to the insertion location, the working channel having an insertion end and a working end, the insertion end further having an insertion arm; inserting the insertion arm into the sacroiliac joint at the insertion position; Introducing a polishing device into the working channel, the polishing device comprising: a polishing head at a distal end of the polishing device, the polishing head comprising: a first pair of opposing abrasive surfaces, each of which is capable of abrading cortical bone of the sacroiliac joint; introducing an abrasive head having an open tip, the open tip having a cutting edge disposed on a leading edge of the open tip, the cutting edge configured to cut bone tissue of the sacroiliac joint; advancing the abrasion device into the sacroiliac joint such that the opening tip cuts away bone tissue from the sacrum or ilium; decorticating the cortical bone within the sacroiliac joint using the abrasive surface; forming a decorticated implant gap at the insertion location without using a rotary cutting tool; A method comprising:

Claims

1. 1. An instrument set for forming an implant gap in a sacroiliac joint without the use of a rotary cutting instrument, the instrument set comprising: a working channel; and an abrasion device; the working channel has an insertion end and a working end connected by a working channel, the insertion end of the working channel further having a first iliac contour, a first sacral contour, and an insertion arm; the first sacral contour is configured to seat against a sacrum and the first iliac contour is configured to seat against an ilium; The polishing device comprises: a polishing head at a distal end of the polishing device, the polishing head comprising: a first pair of opposing abrasive surfaces, each of the abrasive surfaces having one or more teeth, barbs, blades, ridges, slots, broaches, or other features capable of abrading cortical bone of the sacroiliac joint; an abrading head having an open tip having a cutting edge disposed around a periphery of a leading edge of the open tip, the cutting edge having a first portion defined by a straight cutting edge and a second portion defined by a curved cutting edge, the cutting edge configured to cut bone tissue of the sacroiliac joint; a slide hammer assembly at a proximal end of the abrading device, the slide hammer assembly having a release position that allows movement of the slide hammer assembly, a locked position that prevents movement of the slide hammer assembly, and a release means for moving the slide hammer assembly between the locked position and the released position; a set of instruments configured to advance the abrasive device into the sacroiliac joint such that the opening tip separates bone tissue from the sacrum or the ilium and the abrasive surface decorticates the cortical bone within the sacroiliac joint.

2. 2. The set of instruments of claim 1, wherein once the abrading head is lodged inside the sacroiliac joint, the slide hammer assembly is unlocked via the release means and the slide hammer assembly is used to remove the abrading head from the sacroiliac joint.

3. Further comprising a joint locator; the joint locator has a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 2. The set of instruments of claim 1, wherein fully inserting the joint locator into the working channel positions the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device.

4. 4. The set of instruments of claim 3, wherein the combined joint locator and working channel device is inserted into the sacroiliac joint such that the first and second sacral contours seat against the sacrum and the first and second iliac contours seat against the ilium.

5. 5. The set of instruments of claim 4, used to peel away soft tissue above and inside the sacroiliac joint through the piercing tips until the first and second iliac contours abut the ilium and the first and second sacral contours abut the sacrum.

6. Further comprising a joint locator; the joint locator has a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 3. The set of instruments of claim 2, wherein the first and second iliac contours and the first and second sacral contours are positioned in mating alignment by fully inserting the joint locator into the working channel, thereby defining a combined joint locator and working channel device.

7. 7. The set of instruments of claim 6, wherein the combined joint locator and working channel device is inserted into the sacroiliac joint such that the first and second sacral contours seat against the sacrum and the first and second iliac contours seat against the ilium.

8. 8. The set of instruments of claim 7, used to peel away soft tissue above and inside the sacroiliac joint through the piercing tips until the first and second iliac contours abut the ilium and the first and second sacral contours abut the sacrum.

9. 10. The set of instruments of claim 1, forming a decorticated implant gap having a generally rectangular cross-sectional shape such that the decorticated implant gap is adapted to receive a fusion implant having a generally rectangular cross-sectional shape.

10. 10. The set of instruments of claim 9, wherein once the abrading head is lodged inside the sacroiliac joint, the slide hammer assembly is unlocked via the release means and the slide hammer assembly is used to remove the abrading head from the sacroiliac joint.

11. Further comprising a joint locator; the joint locator has a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 10. The set of instruments of claim 9, wherein fully inserting the joint locator into the working channel positions the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device.

12. 12. The set of instruments of claim 11, wherein the combined joint locator and working channel device are inserted into the sacroiliac joint such that the first and second sacral contours seat against the sacrum and the first and second iliac contours seat against the ilium.

13. 13. The set of instruments of claim 12, used to peel away soft tissue above and inside the sacroiliac joint through the piercing tips until the first and second iliac contours abut the ilium and the first and second sacral contours abut the sacrum.

14. Further comprising a joint locator; the joint locator has a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; The set of instruments of claim 10, wherein fully inserting the joint locator into the working channel positions the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device.

15. 15. The set of instruments of claim 14, wherein the combined joint locator and working channel device are inserted into the sacroiliac joint such that the first and second sacral contours seat against the sacrum and the first and second iliac contours seat against the ilium.

16. 16. The set of instruments of claim 15, used to peel away soft tissue above and inside the sacroiliac joint through the piercing tips until the first and second iliac contours abut the ilium and the first and second sacral contours abut the sacrum.

17. 1. A set of instruments for forming an implant gap in a sacroiliac joint without the use of a rotary cutting instrument, the set of instruments comprising a working channel and an abrasion device; the working channel has an insertion end and a working end, the insertion end of the working channel further having a first iliac contour, a first sacral contour, and an insertion arm; the first sacral contour is configured to seat against a sacrum and the first iliac contour is configured to seat against an ilium; The polishing device comprises: a polishing head at a distal end of the polishing device, the polishing head comprising: a first pair of opposing abrasive surfaces, each of which is capable of abrading cortical bone of the sacroiliac joint; an abrasive head having an open tip having a cutting edge disposed around a periphery of a leading edge of the open tip, the cutting edge having a first portion defined by a straight cutting edge and a second portion defined by a curved cutting edge, the cutting edge configured to cut bone tissue of the sacroiliac joint; A set of instruments for forming an implant gap in the sacroiliac joint without the use of a rotary cutting instrument, the set of instruments being configured to advance the abrasive device into the sacroiliac joint such that the opening tip separates bone tissue from the sacrum or the ilium and the abrasive surface decorticates the cortical bone in the sacroiliac joint.

18. Further comprising a joint locator; the joint locator has a piercing tip at an insertion end, the piercing tip having a second iliac contour and a second sacral contour; 20. The set of instruments of claim 17, wherein inserting the joint locator into the working channel positions the first and second iliac contours and the first and second sacral contours in mating alignment, thereby defining a combined joint locator and working channel device.

19. 20. The set of instruments of claim 18, wherein the combined joint locator and working channel device are inserted into the sacroiliac joint such that the first and second sacral contours seat against the sacrum and the first and second iliac contours seat against the ilium.

20. 1. A set of instruments for forming an implant gap in a sacroiliac joint without the use of a rotary cutting instrument, the set of instruments comprising a working channel and an abrasion device; the working channel having an insertion end and a working end connected by the working channel, the insertion end further having a first iliac contour, a first sacral contour, and an insertion arm; the first sacral contour is configured to seat against a sacrum and the first iliac contour is configured to seat against an ilium; the insertion arm is inserted into the sacroiliac joint; The polishing device comprises: a polishing head at a distal end of the polishing device, the polishing head comprising: a first pair of opposing abrasive surfaces, each of which is capable of abrading cortical bone of the sacroiliac joint; an abrasive head having an open tip having a cutting edge disposed around a periphery of a leading edge of the open tip, the cutting edge having a first portion defined by a straight cutting edge and a second portion defined by a curved cutting edge, the cutting edge configured to cut bone tissue of the sacroiliac joint; advancing the abrading device into the sacroiliac joint such that the opening tip cuts away bone tissue from the sacrum or ilium; A set of instruments, wherein the abrasive surface is configured to decorticate the cortical bone within the sacroiliac joint.

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