Instrumentation and method for mounting a surgical navigation reference device to a patient

• US 20050119566A1
• Filed: 10/18/2004
• Published: 06/02/2005
• Est. Priority Date: 04/17/2002
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Sasso, Ricardo
• Granted Patent: US 8,180,429 B2
• Time in Patent Office: Days
• US Class Current: 600/429
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2034/207 Divots for calibration
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery

Abstract

Instrumentation and methods are provided for mounting a surgical navigation reference frame to a patient. In one embodiment, a trocar is positioned within a cannula to form an insertion device adapted for percutaneous introduction into the patient. A bone anchor having a bone engaging portion is inserted through the cannula for anchoring to bone. The bone anchor cooperates with the cannula to form a mounting device adapted for coupling with the surgical navigation reference frame. In a further embodiment, an image-guided surgical procedure is performed at a location remote from the anchoring location. In a specific embodiment, a minimally invasive surgical procedure is performed adjacent the spinal column, with a reference frame anchored to the pelvic bone, and more specifically to the iliac region of the pelvic bone. In another specific embodiment, a minimally invasive surgical procedure is performed adjacent the hip joint, with a first reference frame anchored to the pelvic bone, and more specifically to the iliac region of the pelvic bone, and with a second reference frame anchored to the femur.

Claims

1. A method of mounting a surgical navigation reference device to a patient for performing an image-guided surgical procedure adjacent the patient'"'"'s spinal column, comprising:

providing a bone anchor;

anchoring the bone anchor to bone at a location remote from the patient'"'"'s spinal column;

coupling the reference device to the bone anchor to mount the reference device in a substantially fixed position relative to the patient'"'"'s spinal column; and

performing an image-guided surgical procedure adjacent the patient'"'"'s spinal column.

2. The method of claim 1, wherein the anchoring comprises anchoring the bone anchor to a portion of the patient'"'"'s pelvic bone.

3. The method of claim 2, wherein the portion of the pelvic bone is the iliac region of the pelvic bone.

4. The method of claim 3, wherein the portion of the pelvic bone is the iliac crest.

5. The method of claim 1, further comprising percutaneously inserting the bone anchor into the patient prior to the anchoring.

6. The method of claim 5, wherein the percutaneously inserting comprises:

providing a cannula having a proximal end and a distal end;

providing a trocar having a distal end portion;

positioning the trocar within the cannula with the distal end portion of the trocar extending beyond the distal end of the cannula;

percutaneously introducing the cannula into the patient;

removing the trocar from the cannula; and

inserting a bone engaging portion of the bone anchor through the cannula and into engagement with bone.

7. The method of claim 1, further comprising:

forming a minimally invasive surgical incision at a location remote from the anchoring location; and

performing the image-guided surgical procedure through the minimally invasive surgical incision.

8. The method of claim 7, wherein the minimally invasive surgical incision is formed subsequent to the anchoring.

9. The method of claim 1, wherein the image-guided surgical procedure is a minimally invasive image-guided surgical procedure on a portion of the patient'"'"'s spinal column.

10. A method of mounting a number of surgical navigation reference devices to a patient for performing an image-guided surgical procedure adjacent the patient'"'"'s hip joint, comprising:

providing first and second bone anchors;

anchoring the first bone anchor to a portion of the patient'"'"'s pelvic bone;

coupling a first reference device to the first bone anchor to mount the first reference device in a substantially fixed position relative to the pelvic bone;

anchoring the second bone anchor to a portion of the patient'"'"'s femur;

coupling a second reference device to the second bone anchor to mount the second reference device in a substantially fixed position relative to the femur; and

performing an image-guided surgical procedure adjacent the patient'"'"'s hip joint.

11. The method of claim 10, wherein the portion of the pelvic bone is the iliac region of the pelvic bone.

12. The method of claim 11, wherein the portion of the pelvic bone is the iliac crest.

13. The method of claim 10, wherein the portion of the femur is a distal portion of the femur.

14. The method of claim 10, further comprising percutaneously inserting each of the first and second bone anchors into the patient prior to the anchoring.

15. The method of claim 14, wherein the percutaneously inserting comprises:

providing a cannula having a proximal end and a distal end;

providing a trocar having a distal end portion;

positioning the trocar within the cannula with the distal end portion of the trocar extending beyond the distal end of the cannula;

percutaneously introducing the cannula into the patient;

removing the trocar from the cannula; and

inserting a bone engaging portion of a respective one of the first and second bone anchors through the cannula and into engagement with bone.

16. The method of claim 10, further comprising:

forming a minimally invasive surgical incision at a location remote from each of the anchoring locations; and

performing the image-guided surgical procedure through the minimally invasive surgical incision.

17. The method of claim 16, wherein the minimally invasive surgical incision is formed subsequent to the anchoring.

18. The method of claim 10, wherein the image-guided surgical procedure is a minimally invasive image-guided surgical procedure on the patient'"'"'s hip joint.

19. The method of claim 18, wherein the minimally invasive image-guided surgical procedure is a total hip replacement procedure.

20. A method of percutaneously mounting a surgical navigation reference device to a patient for performing an image-guided surgical procedure, comprising:

providing a cannula having a proximal end and a distal end, a trocar having a distal end portion, and a bone anchor having a bone engaging portion;

positioning the trocar within the cannula with the distal end portion of the trocar extending beyond the distal end of the cannula;

percutaneously introducing the cannula into the patient;

removing the trocar from the cannula;

inserting the bone engaging portion of the bone anchor through the cannula;

anchoring the bone engaging portion of the bone anchor to bone; and

coupling the surgical navigation reference device to the bone anchor.

21. The method of claim 20, further comprising securely engaging the distal end of the cannula against the bone to substantially prevent displacement of the cannula relative to the bone.

22. The method of claim 21, wherein the coupling comprises securely engaging the bone anchor with the cannula and connecting the surgical navigation reference device to the cannula.

23. The method of claim 20, wherein the bone engaging portion of the bone anchor is threaded and wherein the anchoring comprises threading the bone engaging portion of the bone anchor into the bone.

24. The method of claim 23, wherein the bone engaging portion of the bone anchor is self-tapping, and wherein the threading comprises cutting threads along an opening in the bone.

25. The method of claim 23, wherein the bone engaging portion of the bone anchor is self-drilling and self-tapping, and wherein the threading comprises forming a threaded opening in the bone.

26. The method of claim 20, further comprising performing a percutaneous image-guided surgical procedure on the patient.

27. The method of claim 20, further comprising;

forming a minimally invasive surgical incision at a location remote from the anchoring location; and

performing an image-guided surgical procedure on the patient through the minimally invasive surgical incision.

28. The method of claim 27, wherein the surgical incision is formed subsequent to the anchoring.

29. The method of claim 20, wherein the anchoring comprises anchoring the bone engaging portion of the bone anchor to bone at a location remote from the patient'"'"'s spinal column;

and

further comprising performing a minimally invasive image-guided surgical procedure on a portion of the patient'"'"'s spinal column.

30. The method of claim 29, wherein the anchoring comprises anchoring the bone engaging portion of the bone anchor to a portion of the patient'"'"'s pelvic bone.

31. The method of claim 30, wherein the portion of the pelvic bone is the iliac crest.

32. The method of claim 20, wherein the anchoring comprises anchoring the bone engaging portion of the bone anchor to a portion of the patient'"'"'s pelvic bone;

and

further comprising performing a minimally invasive image-guided surgical procedure on the patient'"'"'s hip joint.

33. The method of claim 32, wherein the portion of the patient'"'"'s pelvic bone is the iliac crest.

34. The method of claim 32, further comprising percutaneously mounting another of the surgical navigation reference device to the patient'"'"'s femur.

35-43. -43. (canceled)