Simulated bone or tissue manipulation

• US 10,641,844 B2
• Filed: 02/28/2018
• Issued: 05/05/2020
• Est. Priority Date: 08/11/2006
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Frigg, Robert, Weikel, Stuart, Schwer, Stefan, Flexner, Geoffrey, Hamel, Ross Jonathan
• Primary Examiner(s): Hoffa, Angela M
• Assistant Examiner(s): Bor, Helene
• Application Number:
  US15/908,764
• Publication Number:
  US 20180203079A1
• Time in Patent Office: 797 Days
• 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 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/3912 Body cavities
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• 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: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/52 Devices using data or image processing specially adapted for radiation diagnosis
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/52 Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves image processing per se G06T
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61C 19/04 : Measuring instruments specially adapted for dentistry A61C5/44 takes precedence; testing vitality of teeth A61B5/0534; radiation diagnosis specially adapted for dentistry A61B6/51
• CPC Class Codes: G01R 33/285 : Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
• CPC Class Codes: G01R 33/5608 : Data processing and visualization specially adapted for MR, e.g. for feature analysis and pattern recognition on the basis of measured MR data, segmentation of measured MR data, edge contour detection on the basis of measured MR data, for enhancing measured MR data in terms of signal-to-noise ratio by means of noise filtering or apodization, for enhancing measured MR data in terms of resolution by means for deblurring, windowing, zero filling, or generation of gray-scaled images, colour-coded images or images displaying vectors instead of pixels image data processing or generation, in general G06T
• CPC Class Codes: G16H 50/50 : for simulation or modelling of medical disorders

Abstract

The present invention is directed to a system and method for performing tissue, preferably bone tissue manipulation. The system and method may include implanting markers on opposite sides of a bone, fractured bone or tissue to facilitate bone or tissue manipulation, preferably in-situ closed fracture reduction. The markers are preferably configured to be detected by one or more devices, such as, for example, a detection device so that the detection device can determine the relative relationship of the markers. The markers may also be capable of transmitting and receiving signals. An image may be captured of the bone or tissue and the attached markers. From the captured image, the orientation of each marker relative to the bone fragment may be determined. Next, the captured image may be manipulated in a virtual or simulated environment until a desired restored orientation has been achieved. The orientation of the markers in the desired restored orientation may then be determined. The desired relationship between markers may then be programmed into, for example, the detection device. Next, actual physical reduction and/or manipulation of the bone may begin. During the manipulation procedure, the orientation of the markers may be continuously monitored and when the markers substantially align with the virtual or simulated orientation of the markers in the desired restored orientation, an indicator signal is transmitted.

Claims

1. A method for performing tissue manipulation, comprising the steps of:

implanting first and second markers on first and second portions of tissue, respectively;

capturing an image of the first and second portions of tissue with the first and second markers attached thereto;

merging the image with orientation data transmitted from the first and second markers;

manipulating the image of the first and second portions of tissue in a simulated environment to a planned orientation;

determining positions of the first and second markers in the planned orientation;

programming a detection device with the planned orientation;

determining, with the detection device, a current marker orientation, the detection device generating an indicator signal when the first and second markers are in the planned orientation;

manipulating the first and second portions of tissue, until the indicator signal is generated by the detection device indicating the planned orientation has been substantially achieved; and

after the planned orientation is achieved, implanting a fixation device to fix the first and second portions of tissue in the planned orientation.

2. The method of claim 1, wherein the detection device is one of a computer console, x-ray machine, computed tomography scan and a receiver.

3. The method of claim 1, wherein the first portion of tissue is a vertebra.

4. The method of claim 1, wherein the first and second markers wirelessly communicate with the detection device to determine marker orientation.

5. The method of claim 1, wherein the first and second markers are configured to communicate with one another.

6. The method of claim 5, wherein the communication between the first and second markers is continuous during the tissue manipulation.

7. The method of claim 1, further comprising:

displaying the indicator signal on a display.

8. The method of claim 1, wherein the image is merged with the orientation data via the detection device.

9. The method of claim 1, wherein the image and the orientation data are merged by one of overlapping and calibrating the image with the orientation data via the detection device so that the orientation of the first and second markers is reflected relative to each other at the time the image was captured.