Computer-assisted surgical positioning method and system

• US 20040087852A1
• Filed: 12/22/2003
• Published: 05/06/2004
• Est. Priority Date: 02/06/2001
• Status: Abandoned Application

• Current Assignee: Cedara Software, Corp (International Business Machines Corporation)
• Original Assignee: Cedara Software, Corp (International Business Machines Corporation)
• Inventors: Chen, Edward, Sati, Marwan, Croitoru, Haniel, Tate, Peter, Fu, Liqun
• Application Number:
  US10/467,445
• Publication Number:
  US 20040087852A1
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• 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 5/1114 Tracking parts of the body
• CPC Class Codes: A61B 6/4405 the apparatus being movable or portable, e.g. handheld or mounted on a trolley
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/547 involving tracking of position of the device or parts of the device
• CPC Class Codes: A61B 6/583 using calibration phantoms
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• 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: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2002/4632 : using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4668 : for measuring angles

Abstract

A method and apparatus are disclosed for defining a three-dimensional coordinate system in relation to an anatomical structure (64) for use with computer-assisted surgical systems. At least three landmarks (66, 68, 70) associated with the anatomical structure (64) are identified. Landmarks are identified using a digitization device (96) and their location refined using at least one single calibrated X-ray image. Using the landmarks (66, 68, 70), first and second planes are defined, the second plane being orthogonal to the first plane. These planes define a coordinate system, which can be used to ascertain the position trajectory of any object (80) with respect to the anatomical structure. Exposure to imaging radiation and additional surgical procedure is minimized.

Claims

1. A method of defining a coordinate system for computer-assisted surgical systems, the method comprising the steps of:

identifying at least three landmarks associated with an anatomical structure;

determining a location for each of the landmarks;

refining the location for one or more landmarks using imaging; and

defining the coordinate system using the refined location for each of the landmarks.

2. A method of claim 1 wherein the step of determining a location for each of the landmarks includes determining a coordinate position for each of the landmarks for use in the computer-assisted surgical system.

3. A method of claim 2 wherein the step of determining the location of each of the landmarks includes using a location digitizing device.

4. A method of claim 1 wherein the step of refining the location for each of the landmarks includes using a single X-ray image in the plane of the image.

5. A method of claim 4 wherein the X-ray view is an anterior-posterior view.

6. A method of claim 4 wherein the X-ray view is a lateral view.

7. A method of claim 4 wherein more than one X-ray images are used in bi-planar X-ray reconstruction.

8. A method of claim 1 wherein the step of refining the location for each of the landmarks includes using ultrasound imaging.

9. A method of claim 1 wherein the step of defining the coordinate system comprises the steps of:

defining a first plane using the landmarks;

defining a second plane orthogonal to the first plane; and

using the planes for defining the coordinate system.

10. A method of claim 9 wherein the first plane is a frontal plane.

11. A method of claim 9 wherein the second plane is a sagittal plane.

12. A method of claim 9 further including the step of defining a third plane orthogonal to each of the first plane and the second plane.

13. A method of claim 12 wherein the third plane is an axial plane.

14. A method of claim 1 wherein the anatomical structure is a pelvis.

15. A method of claim 14 wherein the landmarks include a left anterior superior iliac spine, a right anterior superior iliac spine, and a centre of a public symphysis.

16. A method of claim 15 wherein the frontal plane is defined using the left anterior superior iliac spine, the right anterior superior iliac spine, and the centre of the pubic symphysis.

17. A method of claim 16 wherein the centre of the pubic symphysis is centred in the anterior posterior plane.

18. A method of claim 1 wherein the step of defining the coordinate system using the refined location for each of the landmarks includes the step of defining at least two vectors using the refined location for each of the landmarks.

19. A method of claim 18 wherein the step of defining at least two vectors includes the steps of:

defining a first vector using at least two landmarks; and

defining a second vector using at least two landmarks, said second vector being non-parallel to the first vector.

20. A method of claim 19 wherein the first vector is defined using the left anterior superior iliac spine and the right anterior superior iliac spine.

21. A method of claim 20 wherein the second vector is defined using the first vector and the centre of the pubic symphysis.

22. A method of claim 19 wherein the first vector and the second vector are used in defining the frontal plane and the sagittal plane.

23. A method of any one of claims 1 to 22 wherein the coordinate system is used for ascertaining the trajectory of an object with reference to the anatomical structure.

24. A method of claim 23 wherein the object is a tracked instrument.

25. A method of claim 24 wherein the object is an acetabular cup positioner.

26. The use of a coordinate system defined in any one of claims 1 to 25, intra-operatively.

27. The use of a coordinate system of claim 26 in surgery.

28. The use of a coordinate systems of claim 27 in total hip replacement surgery.

29. A system for defining a coordinate system for computer-assisted surgical systems, the system comprising:

means for determining a location for each of at least three landmarks associated with an anatomical structure;

means for refining the location for each of the landmarks using imaging; and

means for defining the coordinate system using the refined location for each of the landmarks.

30. A system of claim 29 further including means for defining a first plane using the landmarks;

means for defining a second plane orthogonal to the first plane; and

means for using the planes for defining the coordinate system.

31. A system of claim 30 further including means for ascertaining the trajectory of an object in relation to an anatomical structure for use with computer-assisted surgery.

32. A system of claim 29 wherein means for defining the coordinate system using the refined location for each of the landmarks includes means for defining at least two vectors using the refined location for each of the landmarks.

33. A system of claim 32, wherein means for defining at least two vectors includes the steps of:

defining a first vector using at least two landmarks; and

defining a second vector using at least two landmarks, said second vector being non-parallel to the first vector.

35. A computer-readable medium of claim 32 further including:

a code for defining a first plane using the landmarks;

a code for defining a second plane orthogonal to the first plane; and

a code using the planes for defining the coordinate system.

36. A computer-readable medium of claim 33 further including:

a code for ascertaining the trajectory of an object with reference to the anatomical structure for using the coordinate system.

37. A system according to any one of claims 29 to 33 wherein the means for determining a location for each of the landmarks includes a C-arm device.

34. A computer-readable medium having computer-executable software code stored thereon, comprising:

a code for determining a coordinate position for each of at least three landmarks identified, wherein the landmarks are associated with the anatomical structure;

a code for refining the coordinate position for each of the landmarks; and

a code for defining the coordinate system using the refined coordinate positions for each of the landmarks.