Percutaneous registration apparatus and method for use in computer-assisted surgical navigation

• US 20060009780A1
• Filed: 08/08/2005
• Published: 01/12/2006
• Est. Priority Date: 09/24/1997
• Status: Abandoned Application

• Current Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Original Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Inventors: Sherman, Michael C., Clayton, John B., Melkent, Anthony, Foley, Kevin T.
• Application Number:
  US11/199,418
• Publication Number:
  US 20060009780A1
• Time in Patent Office: Days
• US Class Current: 606/99
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7083 Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• 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 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

An apparatus and procedures for percutaneous placement of surgical implants and instruments such as, for example, screws, rods, wires and plates into various body parts using image guided surgery. An apparatus for use with a surgical navigation system, an attaching device rigidly connected to a body part, such as the spinous process of a vertebrae, with an identification superstructure rigidly but removably connected to the attaching device. This identification superstructure, for example, is a reference arc and fiducial array which accomplishes the function of identifying the location of the superstructure, and, therefore, the body part to which it is fixed, during imaging by CAT scan or MRI, and later during medical procedures.

Claims

1. A method of positioning an implant in an anatomy, including a first implant portion and a second implant portion with a surgical navigation system, comprising:

positioning the first implant portion through an opening in a soft tissue of the anatomy;

tracking a position of the first implant portion;

interconnecting an implant inserter with the second implant portion;

determining a location of the second implant portion; and

moving the second implant portion relative to the first implant portion via determining a location of the second implant portion.

2. The method of claim 1, wherein positioning a first implant portion through an opening in a soft tissue, moving the second implant portion relative to the first implant portion, or combinations thereof includes positioning the first implant portion, the second implant portion, or combinations thereof percutaneously.

3. The method of claim 2, wherein tracking a position of the first implant portion includes;

interconnecting a tracking apparatus with the first implant portion; and

tracking the tracking apparatus interconnected to the first implant portion.

4. The method of claim 3, further comprising:

determining a position of the portion of the first implant portion;

wherein moving the second implant portion relative to the first implant portion includes determining a location of a second implant portion relative to the first implant portion.

5. The method of claim 4, further comprising:

displaying the determined position of the first implant portion and the position of the second implant portion.

6. The method of claim 1, further comprising:

configuring the second implant portion based upon a tracked position of the first implant portion, a determined location of the second implant portion, or combinations thereof.

7. The method of claim 1, further comprising:

interconnecting a reference frame with the anatomy.

8. The method of claim 7, further comprising:

displaying a determined position of the second implant portion on a display relative to a registered image of the anatomy.

9. The method of claim 1, further comprising:

interconnecting a tracking apparatus with the implant inserter; and

tracking the tracking apparatus.

10. The method of claim 1, wherein determining a location of the second implant further includes tracking the tracking apparatus.

11. The method of claim 9, wherein the tracking apparatus includes a sensor.

12. The method of claim 11, further comprising:

selecting a sensor to include at least one of a light emitter, an infrared light emitter, an electromagnet, a magnet, a radiation emitter, or combinations thereof.

13. The method of claim 1, further comprising:

imaging the anatomy while at least one of tracking the position of the first implant, tracking the tracking apparatus, determining a location of a portion of the second implant portion, or combinations thereof.

14. The method of claim 13, wherein imaging the anatomy includes imaging the anatomy with an ultrasound system.

15. The method of claim 1, further comprising:

positioning a third implant portion through an opening in a soft tissue; and

interconnecting the first implant portion and the third implant portion with the second implant portion by moving the second implant portion relative to the first implant portion and the third implant portion.

16. The method of claim 1, wherein said first implant portion is a slot in a screw head;

wherein said second implant portion is a rod;

wherein moving the second implant portion includes aligning the rod with the slot.

17. The method of claim 16, further comprising:

fixing the first implant portion to a vertebrae.

18. The method of claim 1, wherein tracking a position includes tracking with an acoustic tracking system, optical tracking system, electromagnetic tracking system, micropulsed radar, or combinations thereof.

19. A method of performing a spinal procedure in an anatomy with a surgical navigation system, comprising:

positioning a first screw implant in a vertebrae percutaneously through an opening in a soft tissue of the anatomy;

tracking a position of the first screw implant;

orientating the first screw implant in a selected orientation at least in part via tracking the position of the first screw implant;

interconnecting an implant inserter with a rod;

determining a position of a portion of the rod; and

moving the rod relative to the first screw implant via determining a location of the rod to interconnect the screw with rod.

20. The method of claim 19, further comprising:

interconnecting a second tracking apparatus with the implant inserter.

21. The method of claim 19, wherein orientating said first screw implant includes orientating a slot defined by the screw.

22. The method of claim 21, wherein tracking a position of the first screw implant includes interconnecting a screw tracking apparatus with the first screw implant.

23. The method of claim 22, wherein interconnecting the screw tracking apparatus includes selecting a sensor.

24. The method of claim 23, wherein selecting the sensor includes selecting a light emitting diode, a light reflector, an infrared emitter, a magnet, an electromagnet, an acoustic emitter, an infrared reflector, or combinations thereof.

25. The method of claim 22, wherein interconnecting the screw tracking apparatus with the first screw implant includes positioning the screw tracking apparatus percutaneously.

26. The method of claim 22, wherein tracking the tracking apparatus includes at least triangulating a position of the tracking apparatus with the surgical navigational system.

27. The method of claim 26, wherein the surgical navigation system includes an acoustic tracking system, or electromagnetic tracking system, an optical tracking system, a micropulsed radar, or combinations thereof.

28. The method of claim 19, wherein orientating the first screw implant includes selecting an orientation of a head of the screw relative to a portion of the anatomy.

29. The method of claim 21, wherein orientating the first screw implant includes orientating the slot relative to the anatomy.

30. The method of claim 29, further comprising:

positioning a second screw implant in a vertebrae percutaneously; and

orientating the second screw implant;

wherein orientating the second screw implant includes orientating second screw implant relative to the first screw implant.

31. The method of claim 30, wherein moving the rod relative to the first screw implant includes moving the rod relative to both the first screw implant and the second screw implant.

32. The method of claim 31, further comprising:

manipulating the rod to achieve an interconnection of the first screw implant and the second screw implant.

33. The method of claim 19, wherein interconnecting the implant inserter with the rod includes interconnecting the implant inserter near a first end of the rod, a second end of the rod, a portion intermediate between the first end and the second end, or combinations thereof.

34. The method of claim 19, wherein interconnecting an implant inserter with a rod includes rigidly interconnecting an implant inserter with the rod.

35. The method of claim 34, further comprising:

interconnecting a tracking apparatus with the implant inserter that includes rigidly interconnecting the tracking apparatus with the implant inserter.

36. The method of claim 19, wherein interconnecting an implant inserter with a rod includes releasably interconnecting the implant inserter with the rod.

37. The method of claim 19, further comprising:

interconnecting a tracking apparatus with the implant inserter that includes positioning an emitter on the tracking apparatus.

38. The method of claim 37, wherein interconnecting a sensor with the tracking apparatus includes selecting at least one of a light emitting a diode, a light reflecting portion, an infrared light emitting portion, an infrared light reflecting portion, an acoustic emitter, an electromagnet, a magnet, or combinations thereof.

39. The method of claim 19, further comprising:

imaging a portion of the anatomy.

40. The method of claim 39, wherein imaging a portion of the anatomy includes obtaining an MRI scan, a CT scan, an x-ray image, an ultrasound image, or combinations thereof.

41. The method of claim 19, further comprising:

displaying an image of the anatomy; and

displaying a position of the portion of the screw on the display relative to the image of the anatomy, and displaying a determined position of the rod relative to the image of the anatomy.

42. The method of claim 41, wherein moving the rod relative to the screw includes displaying on the display the portion of the rod relative to the position of the head of the screw.

43. The method of claim 42, further comprising:

manipulating the rod to achieve a selected interconnection of the rod and the screw implant.

44. The method of claim 43, wherein manipulating the rod includes bending the rod.

45. The method of claim 44, further comprising:

positioning a second screw implant in a vertebrae percutaneously; and

moving the rod relative to the screw implant and the second screw implant.

46. The method of claim 19, wherein moving the rod relative to the screw includes moving the rod substantially percutaneously.

47. The method of claim 46, wherein moving the rod substantially percutaneously includes inserting the rod through a substantially single opening in a soft tissue of the anatomy and moving the rod based upon a tracked position of the rod.

48. The method of claim 47, wherein tracking a position of the portion of the screw and determining a position of a portion of the rod is substantially percutaneous.

49. The method of claim 19, wherein tracking the position of the first screw implant includes tracking a position of a slot defined by the screw.

50. The method of claim 49, wherein moving the rod relative to the first screw implant includes moving the rod percutaneously through the slot.

51. The method of claim 50, further comprising:

positioning a second screw implant in a vertebrae percutaneously through an opening in a soft tissue of the anatomy;

tracking a position of the second screw implant; and

orientating the second screw implant in a selected orientation at least in part via tracking the position of the second screw implant.

52. The method of claim 51, wherein orientating the second screw implant includes aligning a second slot defined by the second screw implant with a first slot defined by the first screw implant at least in part by tracking the position of the first screw implant, tracking the position of the first screw implant, or combinations thereof;

wherein moving the rod includes moving the rod through the first slot and the second slot;

53. The method of claim 52, further comprising:

fixing the rod to the first screw implant and the second screw implant.