Method And Apparatus For Performing A Navigated Procedure

• US 20080269602A1
• Filed: 04/28/2008
• Published: 10/30/2008
• Est. Priority Date: 04/24/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Solar, Matthew S., Miller, Thomas I., Freas, Mark S., Waynik, Jeffrey M., Csavoy, Andrew N., Sootsman, Keith
• Granted Patent: US 8,301,226 B2
• Time in Patent Office: Days
• US Class Current: 600/426
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• 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 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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
• CPC Class Codes: A61B 90/18 Retaining sheets, e.g. immobilising masks made from a thermoplastic material

Abstract

A system can be used to navigate or guide an instrument or device into an anatomy of a patient. The navigation can occur with the use of image data acquired of the patient. The image data can be registered to the patient space for navigation. Also, one or more coils can be used for tracking or localization.

Claims

1. A surgical navigation system, comprising:

a head support portion operable to support at least a head of a patient;

a first coil positioned within the head support portion and operable to generate a first field encompassing a volume relative to the patient;

an alignment device including a base operable to be connected directly to the head of the patient;

a second coil integrated into the base of the alignment device, wherein the second coil is operable to sense the first field produced by the first coil; and

an instrument including a third coil;

wherein the second coil integrated into the base is operable to cooperate with the third coil to determine a position of the instrument.

2. The surgical navigation system of claim 1, further comprising:

a patient support that includes a bed portion operable to support at least a substantial portion of a torso of the patient and the head support portion.

3. The surgical navigation system of claim 1, wherein the first coil includes at least three electromagnetic coils operable to form the first field.

4. The surgical navigation system of claim 3, wherein the second coil integrated into the base is operable to generate the second field operable to encompass at least a portion of the head of the patient;

wherein the third coil is operable to sense the second field.

5. The surgical navigation system of claim 4, further comprising:

a processor operable to instruct the first coil to generate the first field and the second coil to generate the second field substantially independently;

wherein the first field and the second field are not simultaneously formed.

6. The surgical navigation system of claim 4, wherein the third coil is operable to sense the first field, the second field, or combinations thereof;

wherein the third coil is operable to determine the location of a first instrument portion independently moveable relative to the base, a location of a second instrument portion moveable relative to a third instrument portion, or combinations thereof.

7. The surgical navigation system of claim 1, further comprising:

an imaging device operable to obtain image data of the patient.

8. The surgical navigation system of claim 7, further comprising:

a display device operable to display the image data of the patient;

the display device further operable to display a graphical representation of at least the alignment device, the instrument, or combinations thereof relative to the image data.

9. The surgical navigation system of claim 8, further comprising:

a data processor operable to process data to determine a tracked location of the alignment device, the instrument, or combinations thereof for display on the display device.

10. The surgical navigation system of claim 1, further comprising:

a fourth coil integrated into the base, wherein a position of the second coil and the fourth coil are operable to be independently determined to at least check an integrity of the first field, the base, the alignment device, the instrument, or combinations thereof.

11. A method of tracking an instrument with a navigation system, comprising:

generating a first navigation field relative to a patient;

navigating an alignment device with the first navigation field;

fixing the alignment device to the patient;

generating a second navigation field relative to the patient; and

navigating an instrument relative to the patient with the second navigation field.

12. The method of claim 11, further comprising:

providing the alignment device including a base; and

providing a first coil integrated into the base;

wherein fixing the alignment device to the patient includes fixing the base to the patient;

wherein navigating the alignment device includes sensing the first navigation field with the first coil integrated into the base.

13. The method of claim 12, wherein forming the second navigation field includes forming the second navigation field with the first coil.

14. The method of claim 13, further comprising:

ceasing generation of the first navigation field prior to generating the second navigation field.

15. The method of claim 14, further comprising:

providing the instrument including guide tube;

providing a second coil on the guide tube;

navigating the guide tube at least by sensing the second navigation field; and

providing the instrument further including a second moveable portion with a third coil;

wherein navigating the instrument includes tracking the location of the guide tube, the second moveable portion, the third coil or combinations thereof in the second navigation field.

16. The method of claim 12, further comprising:

forming a burr hole in the patient; and

fixing the base at the burr hole.

17. The method of claim 11, wherein navigating an instrument relative to the patient with the second navigation field includes navigating the instrument only with the second navigation field after ceasing generating the first navigation field.

18. The method of claim 17, further comprising:

executing instructions with a processor to cease generating the first navigation field, generating the second navigation field, and tracking the location of the instrument; and

displaying a graphical representation of the instrument being tracked on a display device.

19. The method of claim 18, further comprising:

acquiring image data of the patient; and

superimposing the graphical representation of the instrument on the image data of the patient.

20. The method of claim 11, further comprising:

acquiring image data of the patient;

determining a location for positioning the alignment device relative to the patient;

tracking the alignment device with the first navigational field to navigate the alignment device to the location relative to the patient; and

displaying on a display a graphical representation of the alignment device to illustrate a tracked position of the alignment device relative to the location.

21. The method of claim 11, further comprising:

providing a localizer in a head support of the patient;

wherein forming a first navigation field includes forming the first navigation field with the localizer in the head support of the patient.

22. The method of claim 20, further comprising:

inputting an instruction to the processor to determine timing for forming the first navigation field, the second navigation field, or combinations thereof.

23. The method of claim 11, further comprising:

planning a location of fixation of the alignment device; and

moving the alignment device to the location of fixation;

wherein navigating an instrument includes moving the instrument into the patient at least by guiding the instrument with the alignment device at the location.

24. A method of tracking an instrument with a navigation system, comprising:

generating a first navigation field relative to a patient with a first coil;

navigating an alignment device with the first navigation field by sensing the first navigation field with a second coil;

fixing the alignment device directly to the patient;

ceasing generating the first navigation field;

generating a second navigation field relative to the patient with the second coil after fixing the alignment device directly to the patient and after ceasing generating the first navigation field;

moving an instrument relative to the patient through the alignment device; and

navigating the instrument relative to the patient by sensing the second navigation field with a third coil associated with the instrument.

25. The method of claim 24, further comprising:

executing instructions with a processor to operate the first coil to form the first navigation field, the second coil to generate the second navigation field, and navigating the instrument;

determining a location of the instrument;

acquiring image data of the patient; and

displaying the image data of the patient on a display device and superimposing a graphical representation of a position of the instrument relative to the patient on the display device.

26. The method of claim 25, further comprising:

planning a location of a fixation position of the alignment device prior to forming the first navigation field;

acquiring image data of the patient; and

illustrating a position of the alignment device superimposed on the image data while navigating the alignment device with the first navigation field.

27. The method of claim 26, further comprising:

forming a burr hole in a selected portion of the patient; and

mounting the alignment device to surround the vicinity of the burr hole;

wherein fixing the alignment device directly to the patient includes connecting the alignment device to the patient adjacent to the burr hole.

28. The method of claim 24, further comprising:

executing instructions with a processor operable to receive a signal regarding the first navigation field with the second coil, generating the second navigation field with the second field coil, or combinations thereof.

29. The method of claim 24, wherein moving an instrument includes moving a deep brain stimulation probe through a burr hole in a skull of a patient.

30. The method of claim 24, further comprising:

providing a patient support including a head rest;

providing the first coil within the head rest; and

supporting a patient on the support device.

31. The method of claim 30, wherein generating a first navigation field includes generating the first navigation field to encompass substantially only the head of the patient.

32. The method of claim 31, wherein generating a second navigation field includes generating the second navigation field to encompass substantially only a range of movement of the instrument.

33. The method of claim 24, wherein navigating the instrument includes tracking a location of a guide tube fixed relative to the alignment device;

tracking an axial movement of a first instrument portion through the tube, or combinations thereof.