Method and apparatus for preplanning a surgical procedure

• US 20040171924A1
• Filed: 03/05/2004
• Published: 09/02/2004
• Est. Priority Date: 01/30/2003
• Status: Active Grant

• Current Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Original Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Inventors: Trieu, Hai H., Hunter, Mark W., Mire, David A., Dugger, Janice
• Granted Patent: US 7,542,791 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method and system to assist in a selection and planning of procedure and assist in selecting a prosthetic for the procedure. Generally, the system allows for image acquisition of a selected area of the anatomy. A model may be formed of the anatomy from the acquired images. The system may also allow for navigational tracking of the procedure to ensure that the procedure is substantially carried out relative to the selected plan.

Claims

1. A surgical system for a procedure pertaining to an anatomy, comprising:

an imaging device to obtain image data of a selected portion of the anatomy; and

a planning system including a processor to execute operations relating to said image data;

wherein said imaging device is operable to generate image data of the selected portion of the anatomy prior to the procedure; and

wherein said processor is operable to determine a selected dimension in said image data from said imaging device.

2. The surgical system of claim 1, further comprising a user input such that said processor may receive an instruction from a user and execute the instruction to perform a process.

3. The surgical system of claim 2, wherein said user interface includes at least one of a keyboard, a mouse, a pointing device, a touch sensitive display, or combinations thereof.

4. The surgical system of claim 2, wherein said planning system further includes a work station including said user interface;

and

a storage system operable to store a selected dataset including said image data of the selected portion of the anatomy.

5. The surgical system of claim 1, wherein said processor is operable to form a model of the selected portion of the anatomy with said image data obtained by said imaging device.

6. The surgical system of claim 1, wherein said imaging device is selected from a group comprising a fluoroscopic C-arm, a magnetic resonance imaging system and the X-ray system, an ultrasound system, a computed tomography system, and combinations thereof.

7. The surgical system of claim 1, further comprising a display,

wherein said planning system is operable to form a model of the selected portion of the anatomy with said image data and display said model on said display.

8. The surgical system of claim 1, further comprising a navigation system including:

a tracking system; and

a tracking sensor;

wherein said navigation system is operable with said planning system to perform the procedure according to a selected plan described with said planning system.

9. The surgical system of claim 8, wherein said tracking system is at least one of an electromagnetic tracking system, an optical tracking system, an acoustic tracking system, or combinations thereof.

10. The surgical system of claim 1, wherein said planning system is operable to determine at least one of a selection of a procedure, selection of an implant, or planning of the selected procedure.

11. The surgical system of claim 1, further comprising a display;

wherein said image data from said imaging device is displayable on said display as an image;

wherein said image on said display allows at least one of a selection of a procedure, selection of an implant, or planning of the selected procedure.

12. The surgical system of claim 1, further comprising:

a navigation system including a tracking array and a tracking sensor;

wherein said planning system is operable to plan the procedure with said image data;

wherein said navigation system is operable to navigate an instrument for substantially performing the planned procedure.

13. The surgical system of claim 1, further comprising:

a navigation system and a tracking sensor;

wherein said tracking sensor is affixed to an implant;

wherein said planning system is operable to determine an implanted characteristic of said implant;

wherein said navigation system is operable to determine a location of said tracking sensor to navigate a characteristic of said implant to allow implantation of said implant with a selected characteristic.

14. The surgical system of claim 1, further comprising:

an implant kit including a plurality of implants;

wherein said planning system is operable to select at least one of the plurality of the implants to be positioned in the selected portion of the anatomy to achieve a result.

15. The surgical system of claim 14, further comprising a memory system wherein said memory system is operable to save the modeled portion formed from said image data and the planned procedure for retrieval.

16. The surgical system of claim 14, wherein said planning system substantially autonomously selects the at least one of the plurality of the implants.

17. The surgical system of claim 14, wherein said planning system selects at least one of the plurality of the implants for at least one of confirmation or selection by a user.

18. The surgical system of claim 1, further comprising a template program, wherein said template program is executable by said planning system for planning a selected procedure.

19. The surgical system of claim 18, wherein said template program allows said planning system to select at least one of a size, a geometry, a type or combinations thereof of the implant.

20. The surgical system of claim 18, wherein said template program allows a user to select at least one of a size, a shape, a type, or combinations thereof.

21. The surgical system of claim 1, wherein said planning system includes a tracking system;

wherein said planning system is operable to plan at least one of a selection of an implant, a volume to be removed, a geometry to be removed, or combinations thereof;

wherein said tracking system allows for tracking of at least one of the removal of the selected volume, the selected shape, or the selected geometry.

22. The surgical system of claim 1, further comprising an implant including at least one of a spinal implant, a knee implant, a hip implant, a shoulder implant, a wrist implant, a hand implant, an arm implant, or combinations thereof.

23. A surgical system operable to obtain image data for a procedure pertaining to a selected portion of an anatomy, comprising:

a planning system including a processor to execute operations relating to the image data;

wherein the image data relates to the selected portion of the anatomy prior to the procedure;

wherein said planning system is operable to determine a selected dimension of the selected portion of the anatomy from the image data.

24. The surgical system of claim 23, further comprising:

an implant including at least one of an implant dimension, type, geometry, or combinations thereof;

wherein said planning system is operable to select the implant including the at least one of an implant dimension, type, geometry, or combinations thereof, and placement to substantially fit the anatomical dimension.

25. The surgical system of claim 24, further comprising:

a tracking system to track the implant during placement of the implant to confirm placement of the implant per the plan.

26. The surgical system of claim 23, further comprising a user input such that said processor may receive an instruction from a user and execute the instruction to perform a process.

27. The surgical system of claim 23, wherein said planning system further includes a work station including said user interface;

and

a storage system operable to store a selected dataset including said image of the selected portion of the anatomy.

28. The surgical system of claim 27, wherein said planning system further includes an implant storage system, wherein said implant storage system includes a data set of a plurality of implants;

wherein said planning system is operable to compare said data set of said implants to said image data from a selected portion of the anatomy to select at least one of the plurality of the implants for implantation.

29. The surgical system of claim 23, further comprising:

an imaging system operable to collect image data regarding the selected portion of the anatomy;

wherein said processor is operable to form a model of the selected portion of the anatomy with the image data obtained by said imaging device.

30. The surgical system of claim 29, wherein said imaging device is selected from a group comprising a fluoroscopic C-arm, a magnetic resonance imaging system and the X-ray system, an ultrasound system, a computed tomography system, and combinations thereof.

31. The surgical system of claim 30, further comprising a display:

wherein said planning system is operable to form a model of the selected portion of the anatomy with said image data and display said model on said display.

32. The surgical system of claim 23, further comprising a navigation system including:

a tracking system; and

a tracking sensor;

wherein said navigation system is operable with said planning system to perform the procedure according to a selected plan described with said planning system.

33. The surgical system of claim 32, wherein said tracking system is at least one of an electromagnetic tracking system, an optical tracking system, an acoustic tracking system, or combinations thereof.

34. The surgical system of claim 23, wherein said planning system is operable to determine at least one of a selection of a procedure, selection of an implant, planning of the selected procedure, or combinations thereof.

35. The surgical system of claim 23, further comprising a display;

wherein the image data is displayable on said display;

wherein the image data on said display allows at least one of a selection of a procedure, selection of an implant, planning of the selected procedure, or combinations thereof.

36. The surgical system of claim 23, further comprising:

a navigation system including a tracking array and a tracking sensor;

wherein said planning system is operable to plan the procedure with the image data;

wherein said navigation system is operable to navigate an instrument for substantially performing the planned procedure.

37. The surgical system of claim 23, further comprising:

a navigation system and a tracking sensor;

wherein said tracking sensor is affixed to an implant;

wherein said navigation system is operable to determine a location of said tracking sensor to navigate a characteristic of said implant to allow implantation of said implant with the selected implanted characteristic.

38. The surgical system of claim 23, further comprising:

an implant kit including a plurality of implants;

wherein said planning system is operable to select at least one of the plurality of the implants to be positioned in the selected portion of the anatomy to achieve a result.

39. The surgical system of claim 38, wherein said plurality of implants include a plurality of implants of a hip implant, a knee implant, a shoulder implant, a spinal implant, and combinations thereof.

40. The surgical system of claim 38, further comprising a memory system wherein said memory systems operable to save the modeled portion formed from said image data and the planned procedure for retrieval.

41. A method of performing a procedure to position a prosthesis in a selected portion of an anatomy, comprising:

acquiring an image of the selected portion of the anatomy;

forming a model of the selected portion of the anatomy;

measuring a dimension of the model; and

selecting the prosthesis based upon the measurement.

42. The method of claim 41, wherein acquiring an image of the selected portion of the anatomy includes obtaining an image from at least one of a magnetic resonance imaging apparatus, a computed tomography apparatus, an X-ray apparatus, a fluoroscopic system, an ultrasound, or combinations thereof.

43. The method of claim 41, wherein acquiring an image includes acquiring a plurality of images of the selected portion of the anatomy.

44. The method of claim 41, wherein forming a model includes forming a multidimensional model of the selected portion of the anatomy based upon the acquired images;

wherein the model is placed in a coordinate space to substantially accurately measure the selected portion of the anatomy on the model.

45. The method of claim 41, wherein forming a model includes:

forming a substantially three dimensional model of the selected portion of the anatomy; and

manipulating said model formed of the selected portion of the anatomy.

46. The method of claim 41, wherein measuring a dimension of the model includes measuring at least one of a length, a width, a depth, a volume, a geometry, or combinations thereof.

47. The method of claim 46, wherein selecting the prosthesis includes selecting a prosthesis to substantially mimic at least one of said dimensions measured.

48. The method of claim 41, wherein selecting the prosthesis includes selecting a prosthetic for at least one of a femoral head, an intramedullary stem, a vertebral disc, a vertebral nucleus, a humeral head, a glenoid, a distal femoral implant, a proximal tibial implant, or combinations thereof.

49. The method of claim 41, further comprising:

determining an abnormality of the selected portion of the anatomy from said formed model; and

determining a procedure to perform relative to the selected portion of the anatomy to alleviate the determined abnormality.

50. The method of claim 49, wherein selecting the prosthesis includes selecting a procedure to substantially alleviate the abnormalities;

and

wherein the prosthesis is operable to interact with the selected portion of the anatomy to alleviate at least a portion of the abnormality.

51. The method of claim 41, further comprising:

planning a procedure; and

performing a procedure relative to the selected portion of the anatomy including;

navigating an instrument relative to the selected portion of the anatomy to remove a portion of the anatomy per the planned procedure; and

performing the removal with a navigation system to substantially achieve the planned procedure.

52. The method of claim 41, further comprising:

implanting the prosthesis; and

confirming the selected placement of the prosthesis.

53. The method of claim 41, further comprising:

planning the procedure to achieve a selected characteristic of the implant at least in part based upon the measurement; and

implanting the prosthesis with navigation to substantially ensure that the plan achieves the selected characteristic.

54. The method of claim 53, wherein the characteristic includes at least one of a size, a geometry, a material characteristic, a curing time period, a dynamic movement of the anatomy, or combinations thereof.

55. The method of claim 54, further comprising:

navigating a curing element relative to the implant to cure the implant according to a selected plan to achieve the characteristic.

56. The method of claim 55, wherein navigating the curing element includes navigating a radiating probe, a curing dispenser probe, and combinations thereof.

57. The method of claim 41, further comprising:

positioning a tracking sensor relative to the prosthesis to allow tracking of the prosthesis to achieve a selected characteristic of the prosthesis during at least one of implantation and post-implantation of the prosthesis.

58. A method of planning a procedure to implant a prosthetic into a portion of an anatomy, comprising:

selecting the portion of the anatomy;

forming a model of the selected portion of the anatomy manipulateable with a workstation;

selecting a procedure to be performed on the selected portion of the anatomy; and

selecting the prosthetic to be implanted during the procedure.

59. The method of claim 58, further comprising:

acquiring an image of the selected portion of the anatomy;

wherein said model is formed with said acquired image.

60. The method of claim 59, further comprising:

placing said model in a coordinate system; and

measuring said model with said coordinate system to obtain measurements of the selected portion of the anatomy.

61. The method of claim 60, wherein selecting the prosthetic includes selecting a prosthetic based upon said measuring.

62. The method of claim 60, wherein said measuring includes measuring at least one of a height, width, volume, depth, or combinations thereof.

63. The method of claim 61, wherein forming a model includes:

acquiring an image of the selected area of the anatomy with at least one of a MRI, an ultrasound, a fluoroscope, and X-ray device, a CT scanner, or combinations thereof;

processing the image to form a multi-dimensional digital image of the selected portion of the anatomy;

providing the multi-dimensional digital image to be analyzed.

64. The method of claim 63, wherein selecting a procedure includes:

analyzing said multi-dimensional digital image;

verifying a preliminary procedure decision; and

planning a procedure substantially with said multi-dimensional digital image.

65. The method of claim 63, further comprising:

saving the planned procedure;

providing the saved planned procedure to a work station; and

navigating an instrument with said plan to perform the selected procedure.

66. The method 63, further comprising:

implanting the selected prosthetic including navigating the prosthetic to the planned location;

wherein selecting the prosthetic includes substantially matching an obtained measurement with a prosthetic to achieve the planned procedure.

67. A method of performing a procedure to position a prosthesis in a selected portion of an anatomy, comprising:

acquiring image data of the selected portion of the anatomy;

measuring an anatomical dimension of the selected portion of the anatomy; and

selecting the prosthesis based upon the measurement.

68. The method of claim 67, further comprising:

determining an implant dimension of an implant;

substantially matching the implant dimension with the anatomical dimension; and

selecting the implant.

69. The method of claim 67, wherein the substantially matching of the implant dimension with the anatomical dimension is performed with a processor.

70. The method of claim 69, further comprising:

storing a plurality of matching the implant dimension with the anatomical dimension;

forming a correlation between the anatomical dimension and the implant dimension; and

selecting an implant by at least referring to the correlation of the anatomical dimension and the implant dimension.

71. The method of claim 67, wherein acquiring image data of the selected portion of the anatomy includes obtaining image data from at least one of a magnetic resonance imaging apparatus, a computed tomography apparatus, an X-ray apparatus, a fluoroscopic system, an ultrasound, or combinations thereof.

72. The method of claim 67, further comprising forming a model includes forming a multidimensional model of the selected portion of the anatomy based upon the acquired image data;

wherein the model is placed in a coordinate space to substantially accurately measure the selected portion of the anatomy on the model.

73. The method of claim 67, further comprising:

forming a substantially three dimensional model of the selected portion of the anatomy; and

manipulating said model formed of the selected portion of the anatomy.

74. The method of claim 67, wherein measuring the anatomical dimension includes measuring at least one of a length, a width, a depth, a volume, a geometry, or combinations thereof.

75. The method of claim 74, wherein selecting the prosthesis includes selecting a prosthesis to substantially mimic at least one of the anatomical dimension measured.

76. The method of claim 67, wherein selecting the prosthesis includes selecting a prosthetic for at least one of a femoral head, an intramedullary stem, a vertebral disc, a vertebral nucleus, a humeral head, a glenoid, a distal femoral implant, a proximal tibial implant, or combinations thereof.

77. The method of claim 67, further comprising:

determining an abnormality of the selected portion of the anatomy; and

determining a procedure to perform relative to the selected portion of the anatomy to alleviate the determined abnormality.

78. The method of claim 77, wherein selecting the prosthesis includes selecting a procedure to substantially alleviate the abnormalities;

and

wherein the prosthesis is operable to interact with the selected portion of the anatomy to alleviate at least a portion of the abnormality.

79. The method of claim 67, further comprising:

planning a procedure; and

performing a procedure relative to the selected portion of the anatomy including;

navigating an instrument relative to the selected portion of the anatomy to remove a portion of the anatomy per the planned procedure; and

performing the removal with a navigation system to substantially achieve the planned procedure.

80. The method of claim 67, further comprising:

implanting the prosthesis; and

confirming the selected placement of the prosthesis.

81. A surgical system for a procedure pertaining to an anatomy, comprising:

an imaging device to obtain image data of a selected portion of a spine of the anatomy;

a planning system including a processor to execute operations relating to said image data;

wherein said imaging device is operable to generate image data of the selected portion of the anatomy prior to the procedure; and

wherein said processor is operable to determine a selected dimension in said image data from said imaging device; and

an implant operable to be positioned relative to the selected portion of the spine based on the selected dimension.

82. The surgical system of claim 81 further comprising:

a confirmation system to compare at least one of an implanted status and position of said implant to a selected planned status or positioned determined with said planning system.

83. The surgical system of claim 82, wherein said confirmation system includes a virtual digital subtraction system;

wherein said imaging device is operable to obtain image data of the selected portion of the spine after said implant is positioned relative to said selected portion of the spine and compare the after image data to the image data used by said planning system to plan the procedure.

84. The surgical system of claim 82, wherein said confirmation system is operable to compare image data of the selected portion of the spine in at least one of two dimensions, three dimensions, a coronal plane, an axial plane, a sagittal plane, or combinations thereof.

85. The surgical system of claim 81, wherein said planning system is operable to plan an alignment of said implant relative to the selected portion of the spine during an operative procedure.

86. The surgical system of claim 85, wherein said alignment is along at least one of a coronal plane, a sagittal plane, an axial plane or combinations thereof.

87. The surgical system of claim 82, further comprising:

a tracking system operable to track a position of said implant with at least one of an electromagnetic sensor, an acoustic sensor, an optical sensor or combinations thereof.

88. The surgical system of claim 81, wherein said implant includes a radio-opaque portion operable to be imaged with said image device.

98. The method of claim 84, further comprising:

selecting a characteristic of the prosthesis;

implanting the prosthesis into the anatomy; and

manipulating the prosthesis to achieve the selected characteristic.

99. The method of claim 98, wherein the characteristic includes at least one of a specific location of a dimension, a specific location of a rigidity, a specific location of a curing time, or combinations thereof.

100. The method of claim 99, further comprising:

confirming the presence of the selected characteristic.

101. The method of claim 99, further comprising:

navigating the implant relative to the anatomy to position the selected characteristic in a selected area of the anatomy.

102. The method of claim 99, further comprising:

navigating a curing probe relative to the implant to cure a selected portion of the implant to allow the positioning of the selected characteristic at a selected position relative to the anatomy.

89. A method of performing a procedure to position a prosthesis in a selected portion of a spinal region, comprising:

acquiring image data of the selected portion of the spinal region;

measuring an anatomical dimension of the selected portion of the anatomy with said acquired image data; and

selecting the prosthesis based upon the measurement.

90. The method of claim 89, further comprising:

aligning the prosthesis relative to the selected portion of the spinal region with said acquired image data.

91. The method of claim 90, wherein aligning the prosthesis includes aligning the prosthesis in at least one of a sagittal plane, a coronal plane, an axial plane, or combinations thereof.

92. The method of claim 90, wherein aligning the prosthesis includes:

navigating the prosthesis relative to the spinal region with said image data by tracking the prosthesis with a tracking sensor.

93. The method of claim 92, wherein said tracking sensor includes at least one of an optical sensor, an electromagnetic sensor, an acoustic sensor, or combinations thereof.

94. The method of claim 90, further comprising:

providing a template program to be executed by a processor;

wherein said template program is operable to measure the anatomical dimension.

95. The method of claim 94, wherein said template program includes a computer aided drafting program operable to create a shape according to instructions from a user and determine dimensions of the shape.

96. The method of claim 90, further comprising:

confirming a characteristic of the prosthesis after implanting the prosthesis.

97. The method of claim 95, wherein said confirming the position may be performed with a tracking sensor, and imaging device, radio-opaque portions in the prosthesis, and combinations thereof.

103. The method of claim 89, further comprising:

confirming that the prosthesis includes a selected characteristic relative to a selected portion of the anatomy.