Methods of using a robotic spine system

• US 10,265,128 B2
• Filed: 07/25/2016
• Issued: 04/23/2019
• Est. Priority Date: 03/20/2002
• Status: Expired due to Term

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): Eckman, Michelle C
• Application Number:
  US15/218,608
• Publication Number:
  US 20160331481A1
• Time in Patent Office: 1,002 Days
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/14 Surgical saws A61B17/1637 takes precedence; tooth saws A61C3/12 ; Accessories therefor
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8802 Equipment for handling bone cement or other fluid fillers
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 17/885 Tools for expanding or compacting bones or discs or cavities therein A61B17/8805, A61B17/7097 take precedence
• CPC Class Codes: A61B 17/8852 capable of being assembled or enlarged, or changing shape, inside the bone or disc
• CPC Class Codes: A61B 17/8855 inflatable, e.g. kyphoplasty balloons
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/3916 : Bone tissue
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/32 : operating autonomously
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0071 : by measuring fluorescence emission
• CPC Class Codes: A61B 6/032 : Transmission computed tomography [CT]
• CPC Class Codes: A61B 90/03 : Automatic limiting or abutting means, e.g. for safety
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30133 : kidney-shaped or bean-shaped

Abstract

A method of using a robotic guidance system for performing surgery on a spine is provided. The method includes utilizing a computerized tomographic scan image of a location on a spinal column of a patient, such that the computerized tomographic scan image is connected to a computer and visible on a monitor connected to the computer. The method also includes attaching a coupling component to the spinal column of the patient, coupling a marker to the coupling component, and imaging, with a fluoroscope, the view of the spinal column of the patient, wherein the fluoroscope image is transmitted to the computer and visible on the monitor and the at marker is clearly visible in the fluoroscope image. The method also includes positioning a cannula, with a robotic mechanism, to a first position relative to a vertebra in the spinal column of the patient, drilling a passage through the cannula into bone of the vertebra in the spinal column of the patient, inserting a guidewire through the cannula into the passage in the bone of the vertebra in the spinal column of the patient, and positioning a screw into the bone of the vertebra in the spinal column of the patient.

Claims

1. A robotic guidance system for performing surgery on a spine, the robotic guidance system comprising:

at least one computer configured to receive at least one computerized tomographic scan image of a spinal column of a patient on whom a surgical procedure is to be performed;

at least one monitor connected to the at least one computer, wherein the at least one monitor is configured to display, from the at least one computer, the at least one computerized tomographic scan image of the spinal column of the patient on whom the surgical procedure is to be performed;

at least one coupling component configured to couple to the spinal column of the patient;

at least one marker configured to be positionable relative to the at least one coupling component, wherein the at least one marker is configured to be clearly visible in at least one fluoroscope image of the spinal column of the patient on whom the surgical procedure is to be performed, and wherein at least one fluoroscope image is transmitted to the at least one computer and visible on the at least one monitor connected to the at least one computer;

a robotic mechanism connected to the at least one computer and configured to move through various programmed motions for the performance of the surgical procedure on the spinal column of the patient; and

a cannula coupled to the robotic mechanism, the robotic mechanism being configured to position the cannula relative to at least one vertebrae in the spinal column of the patient;

wherein the robotic mechanism is connected to a base configured to be on a floor next to the patient when surgery is performed.

2. The robotic guidance system according to claim 1, wherein the cannula is at least one portion of a tissue retractor assembly.

3. The robotic guidance system according to claim 1, further comprising at least one tissue retractor configured to be positioned through the cannula.

4. The robotic guidance system according to claim 1, further comprising at least one surgical instrument configured to be utilized through the cannula.

5. The robotic guidance system according to claim 1, further comprising at least one prosthetic implant configured to be positioned in a bone of the at least one vertebrae in the spinal column of the patient.

6. The robotic guidance system according to claim 1, further comprising a drill configured to create at least one passage into bone of the at least one vertebrae in the spinal column of the patient.

7. The robotic guidance system according to claim 6, further comprising at least one elongate member configured to be inserted into the at least one passage in the bone of the at least one vertebrae in the spinal column of the patient, wherein the elongate member is positionable through the cannula.

8. The robotic guidance system according to claim 7, wherein the elongate member has an external thread.

9. The robotic guidance system according to claim 8, wherein the elongate member is configured to be screwed into a passage in bone of the vertebrae.

10. The robotic guidance system according to claim 6, further comprising at least one screw configured to be positioned into the at least one passage in the bone of the at least one vertebrae in the spinal column of the patient, wherein the at least one screw is configured to secure body tissue.

11. The robotic guidance system according to claim 1, wherein the cannula is configured to facilitate the insertion of one or more surgical instruments to a location on the body of the patient.

12. The robotic guidance system according to claim 11, wherein the location on the body of the patient comprises an opening formed in a vertebrae of the patient'"'"'s spinal column.

13. The robotic guidance system according to claim 12, wherein the robotic mechanism is configured to be used to form the opening in the vertebrae of the patient'"'"'s spinal column.

14. The robotic guidance system according to claim 1, wherein the marker is radiopaque.

15. The robotic guidance system as set forth in claim 1, further comprising:

a drill configured to create at least one passage into bone of the at least one vertebrae in the spinal column of the patient;

at least one elongate member configured to be inserted into the at least one passage in the bone of the at least one vertebrae in the spinal column of the patient, wherein the elongate member is positionable through the cannula; and

at least one screw configured to be positioned into the at least one passage in the bone of the at least one vertebrae in the spinal column of the patient, wherein the at least one screw is configured to secure body tissue.

16. The robotic guidance system according to claim 1, wherein the programmed motions are configured such that the robotic mechanism positions the cannula at one or more desired locations relative to the spinal column of the patient as the robotic mechanism moves through the programmed motions.

17. The robotic guidance system according to claim 16, wherein the desired locations are related to the surgical procedure.

18. The robotic guidance system according to claim 16, wherein the desired locations are configured to facilitate inserting a surgical instrument through the cannula into a defined working space of the patient during the surgical procedure.

19. A robotic guidance system for performing surgery on a spine, the robotic guidance system comprising:

at least one computer configured to receive at least one computerized tomographic scan image of a spinal column of a patient on whom a surgical procedure is to be performed;

at least one monitor connected to the at least one computer, wherein the at least one monitor is configured to display, from the at least one computer, the at least one computerized tomographic scan image of the spinal column of the patient on whom the surgical procedure is to be performed;

at least one coupling component configured to couple to the spinal column of the patient;

at least one marker configured to be positionable relative to the at least one coupling component, wherein the at least one marker is configured to be clearly visible in at least one fluoroscope image of the spinal column of the patient on whom the surgical procedure is to be performed, and wherein at least one fluoroscope image is transmitted to the at least one computer and visible on the at least one monitor connected to the at least one computer;

a robotic mechanism connected to the at least one computer and configured to move through programmed motions for the performance of the surgical procedure on the spinal column of the patient; and

a cannula coupled to the robotic mechanism, the robotic mechanism being configured to position the cannula relative to the spinal column of the patient;

wherein the cannula is configured such that at least one surgical instrument is configured to be inserted through the cannula into the patient during the surgical procedure;

wherein the robotic mechanism is connected to a base configured to be on a floor next to the patient when surgery is performed.

20. The robotic guidance system according to claim 19, wherein the cannula is at least one portion of a tissue retractor assembly.

21. The robotic guidance system according to claim 19, further comprising at least one tissue retractor configured to be positioned through the cannula.

22. The robotic guidance system according to claim 19, further comprising at least one prosthetic implant configured to be positioned in the spinal column of the patient.

23. The robotic guidance system according to claim 19, further comprising the at least one surgical instrument.

24. The robotic guidance system according to claim 19, wherein the marker is radiopaque.