Augmented reality guidance for spinal surgery and spinal procedures

• US 10,194,131 B2
• Filed: 05/07/2018
• Issued: 01/29/2019
• Est. Priority Date: 12/30/2014
• Status: Active Grant

• Current Assignee: Onpoint Medical, Inc.
• Original Assignee: Onpoint Medical, Inc.
• Inventors: Casas, Carlos Quiles
• Primary Examiner(s): Nasri, Maryam A
• Application Number:
  US15/972,649
• Publication Number:
  US 20180262743A1
• Time in Patent Office: 267 Days
• CPC Class Codes: A61B 1/00 Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes examination of body cavities or body tracts using ultrasonic, sonic or infrasonic waves A61B8/12; endoscopic instruments for taking cell samples or for biopsy A61B10/04; for surgical purposes A61B17/00; endoscopic surgical cutting instruments A61B17/32; surgical instruments using a laser beam being directed along or through a flexible conduit A61B18/22; Illuminating arrangements therefor for the eyes A61B3/00
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2090/371 with simultaneous use of two cameras
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: G02B 2027/0134 of stereoscopic type
• CPC Class Codes: G02B 2027/0138 comprising image capture systems, e.g. camera
• CPC Class Codes: G02B 2027/014 comprising information/image processing systems
• CPC Class Codes: G02B 27/0172 characterised by optical features
• CPC Class Codes: G06F 2203/04804 Transparency, e.g. transparent or translucent windows
• CPC Class Codes: G06F 3/011 Arrangements for interaction with the human body, e.g. for user immersion in virtual reality blind teaching G09B21/00
• CPC Class Codes: G06F 3/017 Gesture based interaction, e.g. based on a set of recognized hand gestures interaction based on gestures traced on a digitiser G06F3/04883
• CPC Class Codes: G06F 3/0304 Detection arrangements using opto-electronic means constructional details of pointing devices not related to the detection arrangement using opto-electronic means G06F3/033; optical digitisers G06F3/042
• CPC Class Codes: G06F 3/04845 for image manipulation, e.g. dragging, rotation, expansion or change of colour
• CPC Class Codes: G06T 19/006 Mixed reality object pose determination, tracking or camera calibration for mixed reality G06T7/00
• CPC Class Codes: G06T 2210/41 Medical
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass
• CPC Class Codes: H04N 13/111 Transformation of image signals corresponding to virtual viewpoints, e.g. spatial image interpolation
• CPC Class Codes: H04N 13/156 Mixing image signals
• CPC Class Codes: H04N 13/239 : using two 2D image sensors having a relative position equal to or related to the interocular distance H04N13/243 takes precedence
• CPC Class Codes: H04N 13/279 : the virtual viewpoint locations being selected by the viewers or determined by tracking
• CPC Class Codes: H04N 13/296 : Synchronisation thereof; Control thereof
• CPC Class Codes: H04N 13/366 : using viewer tracking

Abstract

Embodiments disclose a real-time surgery method and apparatus for displaying a stereoscopic augmented view of a patient from a static or dynamic viewpoint of the surgeon, which employs real-time three-dimensional surface reconstruction for preoperative and intraoperative image registration. Stereoscopic cameras provide real-time images of the scene including the patient. A stereoscopic video display is used by the surgeon, who sees a graphical representation of the preoperative or intraoperative images blended with the video images in a stereoscopic manner through a see through display.

Claims

1. A system comprising:

a stereoscopic optical see-through head mounted display;

a computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information of the physical spine of a patient and to generate a three-dimensional (3D) image of the spine of the patient,

one or more markers configured to be attached to a bony structure within a target portion of the physical spine of the patient,

wherein the computing system is configured to register the image information of the physical spine in a common coordinate system,

wherein the computing system is configured to register the one or more markers in the common coordinate system,

wherein the computing system is configured to generate a 3D stereoscopic display by the optical see-through head mounted display based on the 3D image of the spine,

wherein the computing system is configured to track movement from a first position to a second position of the physical spine during surgery,

wherein the computing system is configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system,

wherein the computing system is configured to adjust in real time the 3D stereoscopic display based on the location and orientation of the optical see-through head mounted display,

wherein the computing system is configured to adjust in real time the 3D stereoscopic display based on the tracked movement from the first position to the second position of the physical spine,

wherein the computing system is configured to superimpose the 3D stereoscopic display on the target portion of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and

wherein the first and second positions of the physical spine of the patient are different.

2. The system of claim 1, wherein the computing system is configured to reconstruct one or more preoperative, intraoperative or preoperative and intraoperative two-dimensional (2D) images into three-dimensional images using 2D to 3D reconstruction.

3. The system of claim 1, wherein the computing system is configured to track movement from the first position to the second position of the physical spine by tracking the position of the one or more markers in real time.

4. The system of claim 1, wherein the computing system is configured to compare tracking data of instruments and/or devices to the tracked position of the physical spine during surgery in real time.

5. The system of claim 1, wherein the computing system is configured to track the location and/or orientation of one or more of the instruments, devices, the physical spine, the surgeon, or the optical see-through head mounted display in real time.

6. The system of claim 5, wherein the tracking of the one or more of the instruments, devices, the spine, the surgeon, or the optical see-through head mounted display is performed using one or more of attached passive optical markers, active optical markers, magnetic tracking, electromagnetic tracking, ultrasonic tracking, mechanical tracking, tracking using inertial measurement units and 3D scanners.

7. The system of claim 1, wherein the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient and to generate the 3D image of the spine of the patient is the same or different than one or more of the computing systems configured to register the image information of the spine in the common coordinate system, the computing system configured to register the one or more markers in the common coordinate system, the computing system configured to track movement from the first position to the second position of the physical spine during surgery, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to superimpose the 3D stereoscopic display displayed by the optical see-through head mounted display with the physical spine of the patient, and the computing system configured to adjust in real time the 3D stereoscopic display displayed by the optical see-through head mounted display.

8. The system of claim 1, wherein the computing system configured to register the image information of the spine in the common coordinate system is the same or different than one or more of the computing systems configured to receive the preoperative, the intraoperative or the preoperative and intraoperative image information from the patient and to generate the 3D image of the spine of the patient, the computing system configured to register the one or more markers in the common coordinate system, the computing system configured to track movement from the first position to the second position of the physical spine during surgery, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to superimpose the 3D stereoscopic display displayed by the optical see-through head mounted display with the physical spine, and the computing system configured to adjust in real time the 3D stereoscopic display displayed by the optical see-through head mounted display.

9. The system of claim 1, wherein the computing system configured to register the one or more markers in the common coordinate system is the same or different than one or more of the computing system configured to receive the preoperative, the intraoperative or the preoperative and intraoperative image information from the patient and to generate the 3D image of the spine of the patient, the computing systems configured to register the image information of the spine in the common coordinate system, the computing system configured to track movement from the first position to the second position of the physical spine during surgery, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to superimpose the 3D stereoscopic display displayed by the optical see-through head mounted display with the physical spine, and the computing system configured to adjust in real time the 3D stereoscopic display displayed by the optical see-through head mounted display.

10. The system of claim 1, wherein the computing system configured to track movement from the first position to the second position of the physical spine during surgery is the same or different than one or more of the computing systems configured to receive the preoperative, the intraoperative or the preoperative and intraoperative image information from the patient and to generate the 3D image of the spine of the patient, the computing system configured to register the image information of the patient'"'"'s spine in the common coordinate system, the computing system configured to register the one or more markers in the common coordinate system, the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, the computing system configured to superimpose the 3D stereoscopic display displayed by the optical see-through head mounted display with the physical spine, and the computing system configured to adjust in real time the 3D stereoscopic display displayed by the optical see-through head mounted display.

11. The system of claim 1, wherein the computing system configured to track the location and orientation of the optical head see-through mounted display in the common coordinate system is the same or different than one or more of the computing systems configured to receive the preoperative, the intraoperative or the preoperative and intraoperative image information from the patient and to generate the 3D image of the spine of the patient, the computing system configured to register the image information of the spine in the common coordinate system, the computing system configured to register the one or more markers in the common coordinate system, the computing system configured to track movement from the first position to the second position of the physical spine during surgery, the computing system configured to superimpose the 3D stereoscopic display displayed by the optical see-through head mounted display with the physical spine, and the computing system configured to adjust in real time the 3D stereoscopic display displayed by the optical see-through head mounted display.

12. The system of claim 1, wherein the computing system configured to adjust in real time the 3D stereoscopic display displayed by the optical see-through head mounted display is the same or different than one or more of the computing systems configured to receive the preoperative, the intraoperative or the preoperative and intraoperative image information from the patient and to generate the 3D image of the spine of the patient, the computing system configured to register the image information of the spine in the common coordinate system, the computing system configured to register the one or more markers in the common coordinate system, the computing system configured to track movement from the first position to the second position of the physical spine during surgery, and the computing system configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system, and the computing system configured to superimpose the 3D stereoscopic display displayed by the optical see-through head mounted display with the physical spine.

13. The system of claim 1, wherein the image information of the spine is registered with one or more structures of the physical spine using a navigation system.

14. The system of claim 1, wherein the computing system is configured to provide for adjustment of transparency, color and contrast of the 3D stereoscopic display displayed by the optical see-through head mounted display superimposed on the physical spine.

15. The system of claim 1, wherein the computing system is configured to display one or more virtual graphical representations of tracked instruments or devices by the optical see-through head mounted display superimposed on the physical spine.

16. The system of claim 1, wherein the 3D stereoscopic display of the spine displayed by the optical see-through head mounted display includes 3D images of individually rendered vertebrae registered in the common coordinate system superimposed with individual vertebra of the physical spine.

17. The system of claim 16, wherein the computing system is configured to track pose changes of the individual vertebrae in the common coordinate system and wherein the pose changes are translated into display of a different second 3D stereoscopic display at a location and orientation that corresponds to the location and orientation of the individual vertebrae of the spine after the pose changes.

18. The system of claim 1, wherein the optical see-through head mounted display is configured to display one or more of graphical representations of instruments, surgical guides or techniques, or anatomical models superimposed on the physical spine.

19. The system of claim 1, wherein the movement from the first position to the second position of the physical spine during surgery is a rotation of one or more vertebrae.

20. The system of claim 1, wherein the target portion of the physical spine comprises an exposed portion of the physical spine.

21. The system of claim 1, wherein the intraoperative image information is obtained from the patient using a CT scan.

22. A system comprising:

a stereoscopic optical see-through head mounted display;

a computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from a patient and to generate two or more 3D images of individualized vertebrae; and

one or more markers configured to be attached to a bony structure within a target portion of the physical spine of the patient,

wherein the computing system is configured to register the two or more 3D images of the individualized vertebrae in a common coordinate system,

wherein the computing system is configured to register the one or more markers in the common coordinate system,

wherein the computing system is configured to generate a 3D stereoscopic display by the optical see-through head mounted display based on the two or more 3D images of the individualized vertebrae,

wherein the computing system is configured to track movement from a first position to a second position of the physical spine during surgery by tracking the position of the one or more markers,

wherein the computing system is configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system,

wherein the computing system is configured to adjust in real time the 3D stereoscopic display of the two or more 3D images of the individualized vertebrae based on the location and orientation of the optical see-through head mounted display,

wherein the computing system is configured to adjust in real time the 3D stereoscopic display of the two or more 3D images of the individualized vertebrae based on the tracked movement from the first position to the second position of the physical spine,

wherein the computing system is configured to superimpose the 3D stereoscopic display of the two or more 3D images of the individualized vertebrae on corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and

wherein the first and second positions of the physical spine of the patient are different.

23. The system of claim 22, wherein the computing system is configured to detect changes in the sagittal position of the physical spine and to adjust the display of the two or more 3D images of the individualized vertebrae based on the detected changes in sagittal position.

24. The system of claim 22, wherein the computing system is configured to detect changes in rotation of the physical spine and to adjust the display of the two or more 3D images of the individualized vertebrae based on the detected changes in rotation of the physical spine.

25. The system of claim 22, wherein the location and orientation of the two or more 3D images of the individualized vertebrae displayed by the optical see-through head mounted display matches the location and orientation of the individual vertebrae of the physical spine.

26. The system of claim 22, wherein the computing system is configured to track position changes of the individual vertebrae from the first position to the second position in the common coordinate system and wherein the position changes are translated into a different, second 3D stereoscopic display of 3D images of the individualized vertebrae corresponding to the second position displayed by the optical see-through head mounted display at a location and orientation that matches the location and orientation of the individual vertebrae of the physical spine after the position change.

27. The system of claim 22, wherein the movement from a first position to a second position of the physical spine during surgery is a change in lateralization of the physical spine and wherein the computing system is configured to adjust the 3D stereoscopic display of the two or more 3D images of the individualized vertebrae based on the change in lateralization of the physical spine.

28. The system of claim 22, wherein the image information from the patient is from a preoperative CT scan obtained with the patient in supine position, wherein the position of the physical spine during the surgery is a prone position, wherein the computing system is configured to generate two or more 3D images of individualized vertebrae based on the image information for 3D stereoscopic display by the optical see-through head mounted display, and wherein the computing system is configured to adjust the 3D stereoscopic display of the two or more 3D images of the individualized vertebrae based on the prone position of the physical spine during surgery to superimpose the 3D stereoscopic display of the two or more 3D images of the individualized vertebrae on corresponding individual vertebrae of the physical spine by the optical see-through head mounted display.

29. A system comprising:

a stereoscopic optical see-through head mounted display;

a computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information from a patient and to generate two or more 3D images of two or more individualized vertebrae for stereoscopic display by the optical see-through head mounted display; and

two or more markers configured to be attached to two or more bony structures within a target portion of the physical spine of the patient,

wherein the computing system is configured to register the two or more 3D images of the two or more individualized vertebrae in a common coordinate system,

wherein the computing system is configured to register the two or more markers in the common coordinate system,

wherein the computing system is configured to generate a 3D stereoscopic display by the optical see-through head mounted display based on the two or more 3D images of the two or more individualized vertebrae,

wherein the computing system is configured to track movement from a first position to a second position of two or more individual vertebrae of the physical spine during surgery by tracking the position of the two or more markers,

wherein the computing system is configured to track the location and orientation of the optical see-through head mounted display in the common coordinate system,

wherein the computing system is configured to adjust in real time the 3D stereoscopic display based on the location and orientation of the optical see-through head mounted display,

wherein the computing system is configured to adjust in real time the 3D stereoscopic display of the two or more 3D images of the two or more individualized vertebrae based on the tracked movement from the first position to the second position of the corresponding individual vertebrae of the physical spine,

wherein the computing system is configured to superimpose the 3D stereoscopic display of the two or more 3D images of the two or more individualized vertebrae on the corresponding individual vertebrae of the physical spine visible directly through the stereoscopic optical see-through head mounted display, and

wherein the first and second positions of the physical spine of the patient are different.