Fenestrated bone screws and methods of bone fastening and stabilization

A method for stabilization across a bone joint in the spine, comprising:

• providing a screw comprising:
• an elongate shank defining an internal longitudinal passage therethrough the shank, and having an external threaded surface, and a tapered distal end defining a tip aperture in communication with the internal longitudinal passage, the external threaded surface defining at least one substantially longitudinal groove and at least one shank aperture in communication with the internal longitudinal passage and the substantially longitudinal groove;
• and
• a head configured for engagement with a portion of an insertion tool and positioned at a proximal end of the elongate shank, the head defining a head aperture in communication with the internal longitudinal passage;
• positioning a lumen within the internal longitudinal passage, wherein when the lumen is positioned within the internal passage the lumen substantially prevents communication between the internal longitudinal passage and the at least one shank aperture;
• accessing a desired motion segment;
• inserting a guide wire along a selected trajectory to cross a bone joint of the desired motion segment;
• placing the screw over the guide wire and driving it across the bone joint;
• removing the guide wire;
• and
• injecting bone fusion material into the internal passageway and removing the lumen to enable the bone fusion material to secrete from the at least one shank aperture.

A system for bone fixation, comprising:

• a bone screw comprising:
• an elongate shank defining an internal longitudinal passage, and having an external threaded surface, and a tapered distal end defining a tip aperture in communication with the internal longitudinal passage, the external threaded surface defining at least one substantially longitudinal groove and at least one shank aperture in communication with the internal longitudinal passage and the substantially longitudinal groove;
• and
• a head positioned at a proximal end of the elongate shank, the head defining a head aperture in communication with the internal longitudinal passage;
• and
• an insertion tool comprising:
• an elongate tube having a tube distal end configured to mate with a portion of the head of the screw;
• a lumen positionable within the internal longitudinal passage of the bone screw, wherein when the lumen is positioned within the internal passage the lumen substantially prevents communication between the internal longitudinal passage and the at least one shank aperture;
• and
• a drive rod disposed within the tube having a rod distal end configured to mate with and drive the screw, the drive rod defining a longitudinal drive rod passageway, wherein the rod is selectively removable from the elongate tube.