SURGICAL NAVIGATIONAL AND NEUROMONITORING INSTRUMENT

• US 20080183189A1
• Filed: 01/25/2007
• Published: 07/31/2008
• Est. Priority Date: 01/25/2007
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Clayton, John B., Mire, David, Verard, Laurent, Teichman, Robert, Ryterski, Eric, Adcox, W. Keith
• Granted Patent: US 7,987,001 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00734 battery operated
• 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 2034/256 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 34/20 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: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes

Abstract

The invention relates to a surgical instrument capable of applying an electrostimulation to a neural structure. The surgical instrument also has a tracking system associated therewith to provide navigational tracking during a surgical procedure.

Claims

1. A surgical tool capable of applying electrostimulation comprising:

an instrument having a handle portion and a body member extending from the handle portion, the body member having an electrically conductive portion connected to an energy source and capable of applying electrostimulation energy provided by the energy source; and

a tracking system associated with the instrument and operative to provide information regarding a position of the instrument.

2. The surgical tool of claim 1 wherein the handle portion includes an electrical lead connectable to the energy source, wherein the energy source is remote from the instrument.

3. The surgical tool of claim 1 wherein the energy source includes a battery pack disposed within the handle portion.

4. The surgical tool of claim 1 wherein the body member includes an electrically insulated outer surface area, and wherein the electrically conductive portion extends from the handle portion and internal to the insulated outer surface.

5. The surgical tool of claim 1 wherein the tracking system includes a set of reflectors connected to the instrument and operative to reflect energy that can be detected and analyzed by a navigation system to determine a real-time position of the instrument.

6. The surgical tool of claim 5 wherein the set of reflectors are connected to an outer surface of the handle portion.

7. The surgical tool of claim 1 wherein the tracking system includes a set of emitters connected to the instrument and operative to provide detectable energy that can be analyzed by a navigational system to determine a real-time position of the instrument.

8. The surgical tool of claim 7 wherein the set of emitters are powered by electrical energy provided to the instrument by the energy source.

9. The surgical tool of claim 1 wherein the instrument is capable of applying bi-polar electrostimulation.

10. The surgical tool of claim 1 wherein the instrument is a surgical probe.

11. The surgical tool of claim 1 wherein the instrument is a surgical tap.

12. The surgical tool of claim 1 wherein the instrument is a screwdriver.

13. The surgical tool of claim 1 wherein the instrument is a retractor.

14. The surgical tool of claim 1 wherein the instrument is capable of applying uni-polar electrostimulation.

15. The surgical tool of claim 1 wherein the electrically conductive portion has a distal end configured to removably couple to an electrically conductive implant.

16. The surgical tool of claim 15 wherein the electrically conductive implant includes a pedicle screw.

17. The surgical tool of claim 15 wherein the electrically conductive implant includes an artificial disc.

18. The surgical tool of claim 15 wherein the electrically conductive implant includes a nucleus replacement.

19. A surgical tool assembly comprising:

an instrument having a handle, an insulating sheath, and a conductive member connected to the handle and internal to the insulating sheath, wherein a portion of the conductive member projects distally from the insulating sheath;

an energy source operable with the instrument and designed to provide electrical energy to the conductive member for application of electrostimulation to a neural structure when the neural structure is in contact with the portion of the conductive member and electrical energy is provided to the conductive member; and

a tracking system associated with the instrument and operative to provide information regarding a position of the instrument.

20. The surgical tool assembly of claim 19 wherein the energy source is a battery.

21. The surgical tool assembly of claim 20 wherein the battery is housed within the handle.

22. The surgical tool assembly of claim 19 wherein the insulating sheath includes a non-conductive coating on the conductive member.

23. The surgical tool assembly of claim 19 wherein the instrument is one of a probe, a retractor, a screwdriver, and a tap.

24. The surgical tool assembly of claim 19 wherein the instrument is capable of applying bipolar or unipolar electrostimulation to the neural structure.

25. The surgical tool assembly of claim 19 wherein the tracking system includes active, passive, or a combination of active and passive tracking elements.

26. A surgical method comprising:

inserting a surgical instrument through tissue to a vertebral structure;

tracking a position of the surgical instrument relative to the vertebral structure on a user interface;

delivering an electrical stimulus to the vertebral structure using the surgical instrument; and

monitoring neurological response to the electrical stimulus.

27. The surgical method of claim 26 wherein delivering the electrical stimulus includes actuation of an electrical circuit in a handle of the instrument that includes a battery.

28. The surgical method of claim 26 wherein the instrument is one of a probe, a retractor, a screwdriver, and a tap.

29. The surgical method of claim 26 wherein the surgical instrument includes a tracking system operative to provide feedback to a surgical navigational system linked to the user interface regarding a position of the instrument.

30. A neuromonitoring instrument capable of applying electrostimuation to a neural structure, the instrument comprising:

a handle and a stylet extending from a distal end of the handle; and

a navigational sensor associated with at least one of the handle and the stylet, the navigation sensor operative to provide feedback regarding a position of the instrument.

31. The neuromonitoring probe of claim 30 further comprising a cannula of insulating material extending from the distal end of the handle and wherein the stylet is disposed within a lumen of the cannula.

32. The neuromonitoring probe of claim 31 wherein the navigational sensor is secured to an outer surface of the cannula.

33. The neuromonitoring probe of claim 32 wherein the navigational sensor is a reflector.

34. The neuromonitoring probe of claim 30 wherein the handle houses an energy source that provides energy to the stylet for the application of electrostimulation to a neural structure.

35. The neuromonitoring probe of claim 34 wherein the energy source is a battery.

36. The neuromonitoring probe of claim 30 wherein the stylet includes a pointed distal end capable of forming a hole in a pedicle.