Augmented reality guidance for spinal surgery and spinal procedures using stereoscopic optical see-through head mounted displays and inertial measurement units

• US 10,602,114 B2
• Filed: 10/10/2019
• Issued: 03/24/2020
• 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:
  US16/598,697
• Publication Number:
  US 20200053335A1
• Time in Patent Office: 166 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;

at least one computing system, wherein the at least one computing system is configured to receive preoperative, intraoperative or preoperative and intraoperative image information of a physical spine of a patient; and

at least one marker configured to be attached to the patient,

wherein the at least one computing system is configured to generate at least one graphical representation, wherein the at least one graphical representation is a three-dimensional (3D) virtual representation of a surgical guide, a surgical technique, a physical instrument, a physical device, an anatomical model, patient anatomic data derived from the image information of the physical spine or combinations thereof,

wherein the at least one computing system is configured to register at least one image information in a common coordinate system, wherein the at least one image information comprises the preoperative, intraoperative or preoperative and intraoperative image information,

wherein the at least one computing system is configured to register the physical spine of the patient using the at least one marker in the common coordinate system,

wherein the at least one computing system is configured to register the at least one graphical representation in the common coordinate system,

wherein the at least one computing system is configured to generate a 3D stereoscopic view displayed by the optical see-through head mounted display based on the at least one graphical representation,

wherein the at least one computing system is configured to track movement from a first position to a second position of the physical spine during surgery in the common coordinate system,

wherein the at least one computing system is configured to determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using at least one inertial measurement unit,

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

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

wherein the at least one computing system is configured to superimpose the 3D stereoscopic view on a target portion of the physical spine, and

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

2. The system of claim 1, wherein the at least one computing system is configured to receive or generate at least one 2D image, 3D image, or 2D and 3D image of the spine of the patient and wherein the at least one computing system is configured to generate a 3D stereoscopic view based on the at least one 2D image, 3D image, or 2D and 3D image of the spine or a combination thereof.

3. The system of claim 1, wherein the at least one graphical representation is a graphical representation of a tracked physical instrument, a tracked physical device or a tracked physical instrument and a tracked physical device.

4. The system of claim 1, wherein the at least one graphical representation is a virtual pin, a virtual screw, a virtual nail, a virtual plate, a virtual template of the physical instrument, a virtual template of the physical device, a virtual trajectory for the physical instrument, a virtual trajectory for the physical device, or any combinations of the foregoing.

5. 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 at least one marker in real time and wherein the at least one marker is attached to a bone of the patient, or wherein the computing system is configured to track in real time the location, orientation or location and orientation of the physical instrument, the physical device, the physical spine, the surgeon, the optical see-through head mounted display, or any combinations of the foregoing.

6. The system of claim 1, wherein the computing system is configured to determine in real time the location, orientation or location and orientation of the optical see-through head mounted display.

7. The system of claim 1, wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient, the computing system configured to generate the at least one graphical representation, the computing system configured to register the image information of the spine in the common coordinate system, the computing system configured to register the physical spine of the patient using the at least one marker in the common coordinate system, the computing system configured to register the at least one graphical representation in the common coordinate system, the computing system configured to generate the 3D stereoscopic view displayed by the optical see-through head mounted display based on the at least one graphical representation, 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 determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using the at least one inertial measurement unit, the computing system configured to adjust in real time the 3D stereoscopic view displayed by the optical see-through head mounted display based on the location, orientation, or location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the 3D stereoscopic view based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the 3D stereoscopic view on the target portion of the physical spine, and wherein one or more of the at least one computing system are the same.

8. The system of claim 1, wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient, the computing system configured to generate the at least one graphical representation, the computing system configured to register the image information of the spine in the common coordinate system, the computing system configured to register the physical spine of the patient using the at least one marker in the common coordinate system, the computing system configured to register the at least one graphical representation in the common coordinate system, the computing system configured to generate the 3D stereoscopic view displayed by the optical see-through head mounted display based on the at least one graphical representation, 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 determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using the at least one inertial measurement unit, the computing system configured to adjust in real time the 3D stereoscopic view displayed by the optical see-through head mounted display based on the location, orientation, or location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the 3D stereoscopic view based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the 3D stereoscopic view on the target portion of the physical spine, and wherein one or more of the at least one computing system are different.

9. The system of claim 1, wherein the at least one computing system is configured to provide for adjustment of transparency, color, contrast or combinations thereof of the 3D stereoscopic view displayed by the optical see-through head mounted display superimposed on the target portion of the physical spine.

10. The system of claim 1, wherein the at least one computing system is configured to track the location and/or orientation of the physical instrument, the physical device or combinations thereof in the common coordinate system, and wherein the at least one computing system is configured to generate a 3D stereoscopic view of the graphical representation of the tracked physical instrument, the tracked physical device or combinations thereof by the optical see-through head mounted display superimposed on the target portion of the physical spine.

11. The system of claim 1, wherein the 3D stereoscopic view displayed by the optical see-through head mounted display is based on preoperative, intraoperative or preoperative and intraoperative image information of individual vertebrae registered in the common coordinate system.

12. The system of claim 1, wherein the 3D stereoscopic view is a 3D stereoscopic view of a 3D image of one or more individualized vertebrae, or a 3D stereoscopic view of a virtual pin, a virtual screw, a virtual nail, a virtual plate, or a virtual trajectory for the instrument or device or a combination thereof.

13. The system of claim 1, wherein the computing system is configured to detect changes in rotation of the physical spine and to adjust the 3D stereoscopic view based on the detected changes in rotation of the physical spine.

14. The system of claim 1, comprising at least one of a passive optical marker, an active optical marker, an inertial measurement unit, a magnetic tracking device, an electromagnetic tracking device, an ultrasonic tracking device, a mechanical tracking device, a tracking device using inertial measurement units, or 3D scanners configured to track the physical instrument, the physical device, the patient'"'"'s spine, the surgeon, or the optical see-through head mounted display or combinations thereof.

15. 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 or a lateralization of at least one vertebrae.

16. The system of claim 1, wherein the target portion of the physical spine comprises a portion of the physical spine that is exposed during surgery.

17. The system of claim 1, wherein the patient anatomic data derived from the image information of the physical spine is a 2D image of the spine, a 3D image of the spine, or a combination thereof, and wherein the 2D image of the spine or the 3D image of the spine is generated using CT data, MRI data, ultrasound data, x-ray data or combinations thereof.

18. A system comprising:

a stereoscopic optical see-through head mounted display;

at least one computing system configured to receive preoperative, intraoperative, or preoperative and intraoperative image information of at least two individual vertebrae of a physical spine of a patient; and

at least one marker configured to be attached to the patient,

wherein the at least one computing system is configured to generate at least one graphical representation, wherein the at least one graphical representation is a three-dimensional virtual representation of a surgical guide, a surgical technique, a physical instrument, a physical device, an anatomical model, patient anatomic data derived from the image information of the physical spine or combinations thereof;

wherein the at least one computing system is configured to register at least one image information in a common coordinate system, wherein the at least one image information comprises the preoperative, intraoperative or preoperative and intraoperative image information,

wherein the at least one computing system is configured to register the physical spine of the patient using the at least one marker in the common coordinate system,

wherein the at least one computing system is configured to register the at least one graphical representation in the common coordinate system,

wherein the at least one computing system is configured to generate a 3D stereoscopic view displayed by the optical see-through head mounted display based on the least one graphical representation,

wherein the at least one 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 at least one marker,

wherein the at least one computing system is configured to determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using at least one inertial measurement unit,

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

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

wherein the at least one computing system is configured to superimpose the 3D stereoscopic view on corresponding individual vertebrae of the physical spine, and

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

19. The system of claim 18, wherein the at least one computing system is configured to receive or generate at least two 2D images or 3D images, or at least one 2D and at least one 3D image of individualized vertebrae and to generate one or more 3D stereoscopic views by the optical see-through head mounted display based on the at least two 2D images or 3D images, or the at least one 2D and at least one 3D images of the individualized vertebrae.

20. The system of claim 18, wherein the at least one graphical representation is a graphical representation of a tracked physical instrument, a tracked physical device or a tracked physical instrument and a tracked physical device.

21. The system of claim 18, wherein the at least one graphical representation is a virtual pin, a virtual screw, a virtual nail, a virtual plate, a virtual template of the physical instrument, a virtual template of the physical device, a virtual trajectory for the physical instrument, a virtual trajectory for the physical device or any combinations of the foregoing.

22. The system of claim 18, wherein the at least one computing system is configured to detect changes in the sagittal position of the physical spine and to adjust the 3D stereoscopic view based on the detected changes in sagittal position.

23. The system of claim 18, wherein the at least one computing system is configured to detect changes in rotation or lateralization of the physical spine and to adjust the stereoscopic view based on the detected changes in rotation or lateralization of the physical spine.

24. The system of claim 18, wherein the location, orientation, or location and orientation of the stereoscopic view displayed by the optical see-through head mounted display is based on the location, orientation, or location and orientation of at least one of the individual vertebrae of the physical spine.

25. The system of claim 18, wherein the at least one computing system is configured to track position changes of the at least two 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 view corresponding to the second position, displayed by the optical see-through head mounted display at a location and orientation that is based on the location and orientation of the individual vertebrae of the physical spine after the position change.

26. The system of claim 18, comprising at least two markers configured to be attached to at least two bony structures of the at least two individual vertebrae,

wherein the at least one computing system is configured to register the at least two markers in the common coordinate system,

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

wherein the at least one computing system is configured to adjust in real time the 3D stereoscopic view based on the tracked movement from the first position to the second position of the individual vertebrae of the physical spine.

27. The system of claim 18, wherein the image information from the patient is from a preoperative CT or MRI 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 a 3D stereoscopic view of the at least one graphical representation by the optical see-through head mounted display based on the CT or MRI image information, and wherein the at least one computing system is configured to adjust the 3D stereoscopic view of the at least one graphical representation based on the prone position of the physical spine during surgery to superimpose the 3D stereoscopic view of the at least one graphical representation on corresponding individual vertebrae of the physical spine by the optical see-through head mounted display.

28. The system of claim 18, wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient, the computing system configured to generate the at least one graphical representation, the computing system configured to register the image information of the spine in the common coordinate system, the computing system configured to register the physical spine of the patient using the at least one marker in the common coordinate system, the computing system configured to register the at least one graphical representation in the common coordinate system, the computing system configured to generate the 3D stereoscopic view displayed by the optical see-through head mounted display based on the at least one graphical representation, 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 determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using the at least one inertial measurement unit, the computing system configured to adjust in real time the 3D stereoscopic view displayed by the optical see-through head mounted display based on the location, orientation, or location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the 3D stereoscopic view based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the 3D stereoscopic view on corresponding individual vertebrae of the physical spine, and wherein one or more of the at least one computing system are the same.

29. The system of claim 18, wherein the at least one computing system comprises the computing system configured to receive preoperative, intraoperative or preoperative and intraoperative image information from the patient, the computing system configured to generate the at least one graphical representation, the computing system configured to register the image information of the spine in the common coordinate system, the computing system configured to register the physical spine of the patient using the at least one marker in the common coordinate system, the computing system configured to register the at least one graphical representation in the common coordinate system, the computing system configured to generate the 3D stereoscopic view displayed by the optical see-through head mounted display based on the at least one graphical representation, 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 determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using the at least one inertial measurement unit, the computing system configured to adjust in real time the 3D stereoscopic view displayed by the optical see-through head mounted display based on the location, orientation, or location and orientation of the optical see-through head mounted display, the computing system configured to adjust in real time the 3D stereoscopic view based on the tracked movement from the first position to the second position of the physical spine, the computing system configured to superimpose the 3D stereoscopic view on corresponding individual vertebrae of the physical spine, and wherein one or more of the at least one computing system are different.

30. A system comprising:

a stereoscopic optical see-through head mounted display;

at least one computing system, wherein the at least one computing system is configured to receive preoperative, intraoperative or preoperative and intraoperative image information of a physical spine of a patient; and

at least one marker configured to be attached to the patient,

wherein the at least one computing system is configured to generate at least one graphical representation, wherein the at least one graphical representation is a three-dimensional (3D) virtual representation of a pin, a screw, a nail, a plate, a template of the physical instrument, a template of the physical device, a surgical guide for a physical instrument, a surgical guide for a physical device, a trajectory for a physical instrument, a trajectory for a physical device, a physical instrument, a physical device, an anatomical model, patient anatomic data derived from the image information of the physical spine or combinations thereof,

wherein the at least one computing system is configured to register at least one image information in a common coordinate system, wherein the at least one image information comprises the preoperative, intraoperative or preoperative and intraoperative image information,

wherein the at least one computing system is configured to register the physical spine of the patient using the at least one marker in the common coordinate system,

wherein the at least one computing system is configured to register the at least one graphical representation in the common coordinate system,

wherein the at least one computing system is configured to generate a 3D stereoscopic view displayed by the optical see-through head mounted display based on the at least one graphical representation,

wherein the at least one computing system is configured to track movement from a first position to a second position of the physical spine during surgery in the common coordinate system,

wherein the at least one computing system is configured to determine the location, orientation, or location and orientation of the optical see-through head mounted display in the common coordinate system using at least one inertial measurement unit,

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

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

wherein the at least one computing system is configured to superimpose the 3D stereoscopic view on a target portion of the physical spine, and

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