Device for immobilizing a primary instrument and method therefor

• US 10,300,268 B2
• Filed: 12/15/2014
• Issued: 05/28/2019
• Est. Priority Date: 04/07/2000
• Status: Expired due to Fees

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic), Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic), Medtronic Incorporated (Medtronic Plc)
• Inventors: Skakoon, James, Wharen, Robert, Solar, Matthew, Parmer, Kari, Mazzocchi, Rudy A., David, John, Murdock, Frank, Hatcher, David, Miller, Thomas I., Parmer, Timothy, Truwit, Charles
• Primary Examiner(s): Yabut, Diane
• Assistant Examiner(s): Ton, Martin T
• Application Number:
  US14/570,718
• Publication Number:
  US 20150100064A1
• Time in Patent Office: 1,625 Days
• Field of Search: 606129, 606130, 606108, 600372, 600373, 600377, 600378, 604174, 604178, 607116
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00911 for fields applied by a magnetic resonance imaging system
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole

Abstract

Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Claims

1. A method for securing an instrument relative to a burr hole, comprising:

positioning a base relative to the burr hole with a base positioning device, the base defining a central opening and an outer perimeter having a pair of attachment portions extending therefrom;

securing the base to a surface surrounding the burr hole with a pair of bone screws detachably retained to the base positioning device, each screw received in an aperture in one of the attachment portions;

engaging the bone screws with a screwdriver to secure the base to the surface surrounding the burr hole and to release the bone screws from the base positioning device upon tightening the bone screws to the base;

positioning a stabilizer relative to the base and the instrument, the stabilizer having a body defining a slot extending through the body and inward from an outer circumference of the body;

moving a clamping device moveable within the slot from an open position where the slot is at least substantially unobstructed by the clamping device to allow the instrument to pass into the slot to a closed position to secure the instrument relative to the base;

positioning the instrument into a radially extending slot formed in an upper surface of the base; and

attaching a cover to the base by attaching fingers extending from a perimeter of the cover to receptacles formed in the base such that the cover secures the instrument in the radially extending slot and in an opening formed in a cylindrically extending portion of the cover.

2. The method of claim 1, further comprising using a tool to move the clamping device relative to the slot to secure the instrument relative to the base.

3. The method of claim 2, wherein using the tool further includes engaging the tool into a recess formed in the stabilizer to move the clamping device.

4. The method of claim 1, wherein positioning the stabilizer relative to the base and the instrument includes using a tool to move the stabilizer relative to the base.

5. The method of claim 4, wherein using the tool to position the stabilizer further includes engaging the tool within a recess of the stabilizer to position the stabilizer relative to the base.

6. The method of claim 1, wherein positioning the stabilizer relative to the base includes positioning the stabilizer in a central opening defined by the base.

7. The method of claim 6, further comprising rotating the stabilizer relative to the base to a desired circumferential orientation of the slot relative to the base before positioning the stabilizer within the central opening.

8. The method of claim 1, wherein attaching the cover to the base includes receiving the cylindrical portion of the cover in a central opening defined by the base, and removably attaching the fingers extending from the perimeter of the cover to the receptacles formed in the base in a snap-fit manner.

9. The method of claim 1, further comprising attaching the cover to the base to substantially cover the burr hole, a portion of the instrument, and a central opening defined by the base.

10. The method of claim 1, wherein the instrument is a deep brain stimulator electrode and the method further comprises positioning the electrode in the radially extending slot formed in the upper surface of the base between an outer perimeter and a central opening of the base.

11. The method of claim 10, further comprising:

laterally bending the electrode into the radially extending slot; and

attaching the cover to the base to secure the laterally bent electrode in the radially extending slot.

12. The method of claim 1, wherein positioning the base relative to the burr hole includes removably coupling the base positioning device to the base to facilitate positioning the base about the burr hole;

and

removing the base positioning device from the base prior to positioning the stabilizer relative to the base.

13. The method of claim 1, further comprising providing a guide assembly for introducing and guiding the instrument through the burr hole and the base and relative to a brain of a patient.

14. The method of claim 1, wherein moving the clamping device within the slot includes rotatably moving the clamping device within the slot about an axis perpendicular to a plane of the body.

15. The method of claim 1, wherein attaching the cover to the base includes positioning a first and a second pair of spaced apart fingers extending from the cover into a corresponding first and second pair of receptacles in the base to snap fit the cover to the base.

16. The method of claim 1, wherein the clamping device locks into a substantially closed position upon moving the clamping device to the closed position and is opened by pressing a tool into an aperture positioned in the stabilizer.

17. The method of claim 1, wherein the instrument is a deep brain stimulator electrode and the method further includes positioning the deep brain stimulator electrode in a brain of a patient and securing the electrode relative to the base with the clamping device and the cover.

18. A method for securing an instrument relative to a burr hole, comprising:

positioning a base relative to the burr hole with a base positioning device, the base defining a central opening and an outer perimeter having a pair of attachment portions extending therefrom;

detachably positioning a pair of bone screws with the base positioning device, the bone screws configured to be received in the attachment portions extending from the outer perimeter of the base;

securing the base to a surface surrounding the burr hole by engaging the bone screws with a screwdriver and driving the screws into the attachment portions to release the bone screws from the base positioning device upon tightening the bone screws to the base;

positioning a stabilizer relative to the base and the instrument where the stabilizer includes a body defining a slot extending through the body and inward from an outer circumference of the body;

moving a clamping device moveable within the slot from an opened position to a closed position to secure the instrument within the slot and relative to the base; and

attaching a cover to the base to at least substantially cover the central opening and the burr hole.

19. The method of claim 18, further comprising using a tool to move the clamping device to secure the instrument relative to the slot and the base.

20. The method of claim 19, wherein using the tool further includes engaging an end of the tool into an aperture formed in the stabilizer to move the clamping device.

21. The method of claim 18, further comprising using a tool to rotationally position the stabilizer relative to the base.

22. The method of claim 21, wherein using the tool includes engaging the tool to an aperture formed in the stabilizer.

23. The method of claim 18, further comprising laterally bending the instrument into a radially extending slot formed in an upper surface of the base between the outer perimeter and the central opening;

wherein attaching the cover to the base includes attaching fingers extending from a perimeter of the cover to receptacles formed in the base in a snap-fit manner such that the cover secures the laterally bent instrument in the radially extending slot and an opening formed in a cylindrically extending portion of the cover.

24. The method of claim 18, wherein positioning the stabilizer relative to the base and the instrument includes positioning the stabilizer relative to the instrument and in the central opening of the base such that the instrument is slidably received within the slot and the clamping device from the outer perimeter of the stabilizer.

25. The method of claim 18, wherein positioning the base relative to the burr hole includes removably coupling the base positioning device to the base to facilitate positioning the base about the burr hole;

and

removing the base positioning device from the base prior to positioning the stabilizer within the central opening of the base.

26. The method of claim 18, wherein moving the clamping device within the slot includes rotatably moving the clamping device within the slot about an axis perpendicular to a plane of the body.

27. The method of claim 18, wherein the clamping device locks into a substantially closed position upon moving the clamping device to the closed position and is opened by pressing a tool into an aperture positioned in the stabilizer.

28. The method of claim 18, wherein the base positioning device includes a pair of opposed wings retaining the pair of bone screws such that upon engaging the bone screws with the screwdriver and driving the screws into the attachment portions, the wings release the bone screws from the base positioning device so that the bone screws fasten the base relative to the burr hole.

29. A method for securing an instrument relative to a burr hole comprising:

positioning a base relative to the burr hole with a base positioning device, the base defining a central opening and an outer perimeter having a pair of attachment portions extending therefrom;

securing the base to a surface surrounding the burr hole with a pair of bone screws detachably retained to the base positioning device, each screw received in an aperture in one of the attachment portions;

engaging the bone screws with a screwdriver to secure the base to the surface surrounding the burr hole and to release the bone screws from the base positioning device upon tightening the bone screws to the base;

positioning a stabilizer relative to the base and the instrument, the stabilizer having a body defining a slot extending through the body and inward from an outer circumference of the body;

moving a clamping device moveable within the slot with a tool from an open position where the slot is at least substantially unobstructed by the clamping device to allow the instrument to pass into the slot to a closed position where the clamping device substantially obstructs the slot so as to secure the instrument relative to the base; and

attaching a cover to the base to at least substantially cover the central opening and the burr hole.

30. The method of claim 29, further comprising removably coupling the base positioning device to the base.

31. The method of claim 29, wherein attaching the cover to the base includes attaching the cover to the base by positioning opposed pairs of projections extending from the cover into corresponding opposed pairs of receptacles formed in the base and aligning an opening in a sidewall of the cover with the instrument.

32. The method of claim 29, wherein moving the clamping device within the slot includes rotatably moving the clamping device within the slot about an axis perpendicular to a plane of the body.

33. The method of claim 29, wherein the clamping device locks into a substantially closed position upon moving the clamping device to the closed position and is opened by pressing a tool into an aperture positioned in the stabilizer.

34. The method of claim 29, wherein the instrument is a deep brain simulator electrode and the method further includes positioning the deep brain stimulator electrode in a brain of a patient and securing the electrode relative to the base with the clamping device and the cover.