Device for Immobilizing a Primary Instrument and Method Therefor

• US 20110022059A1
• Filed: 10/07/2010
• Published: 01/27/2011
• Est. Priority Date: 04/07/2000
• Status: Active Grant

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic), Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic), Medtronic Incorporated (Medtronic Plc)
• Inventors: Wharen, Robert, Skakoon, James G., Parmer, Kari, Solar, Matthew S., Parmer, Timothy Alan, Truwit, Charles L., Hatcher, David, Murdock, Frank, David, John, Miller, Thomas I., Mazzocchi, Rudy A.
• Granted Patent: US 8,911,452 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00911 for fields applied by a magnetic resonance imaging system
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• 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: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole

Abstract

Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Claims

1. A method for securing a deep brain stimulator electrode relative to a burr hole, comprising:

positioning a base relative to the burr hole;

providing a stabilizer with a pair of opposed movable sidewalls defining a slot extending through the stabilizer and radially inward from an outer perimeter of the stabilizer, the opposed sidewalls biased to a closed configuration;

engaging the stabilizer with a tool to open the slot to an open configuration for receiving the electrode therein;

positioning the stabilizer relative to the base and the deep brain stimulator electrode such that the electrode is slidably received within the slot in the open configuration from the outer perimeter thereof while the opposed sidewalls are facing each other;

removing the tool from the stabilizer to close the slot to a closed configuration while maintaining the electrode within the slot as the opposed sidewalls move from the open configuration to the closed configuration while facing each other to engage the electrode and secure the electrode relative to the base; and

attaching a cover to the base.

2. The method of claim 1, wherein engaging the stabilizer with a tool includes inserting a tool into an aperture in the stabilizer to open the slot to an open configuration for receiving the electrode therein.

3. The method of claim 1, wherein positioning the stabilizer relative to the base includes positioning the stabilizer in a central opening defined by the base.

4. The method of claim 3, further comprising opening the stabilizer slot to the open configuration before receiving the electrode within the stabilizer;

wherein positioning the stabilizer relative to the base includes receiving the electrode within the slot in the open configuration before positioning the stabilizer within the central opening.

5. The method of claim 3, further comprising positioning the stabilizer relative to a circumferentially extending lip within a central opening of the base.

6. The method of claim 3, further comprising rotating the stabilizer relative to the base to a desired circumferential orientation of the slot relative to the base before positioning the stabilizer within the central opening.

7. The method of claim 1, wherein attaching a cover to the base includes receiving a cylindrical portion of the cover in a central opening defined by the base, and removably attaching fingers extending from a perimeter of the cover to receptacles formed in the base in a snap-fit manner.

8. The method of claim 7, further comprising attaching the cover to the base to substantially cover the burr hole, a portion of the electrode, and a central opening defined by the base.

9. The method of claim 7, further comprising prying the cover from the base via a groove positioned in an upper surface of the base adjacent the cover.

10. The method of claim 1, wherein positioning a base relative to the burr hole further comprises:

providing the base with a pair of attachment portions extending from an outer perimeter of the base, the attachment portions including apertures for receiving bone screws;

providing a screwdriver configured to engage the bone screws; and

engaging the bone screws with the screwdriver to secure the base to a skull of a patient.

11. The method of claim 1, further comprising positioning the electrode in a radially extending slot formed in an upper surface of the base between an outer perimeter and a central opening of the base.

12. The method of claim 11, further comprising:

laterally bending the electrode into the radially extending slot; and

attaching the cover to the base to secure the laterally bent electrode in the radially extending slot.

13. The method of claim 1, wherein positioning a base relative to the burr hole includes removably coupling a base positioning device to the base to facilitate positioning the base about the burr hole;

and

removing the base positioning device from the base prior to positioning the stabilizer relative to the base.

14. The method of claim 13, further comprising:

detachably capturing a pair of bone screws with the base positioning device, the bone screws configured to be received in attachment portions extending from a perimeter of the base;

securing the base to a skull of a patient about the burr hole by engaging the bone screws with a screwdriver and driving the screws through the attachment portions; and

releasing the bone screws from the base positioning device upon tightening the bone screws to the base.

15. The method of claim 1, further comprising providing a guide assembly for introducing and guiding the deep brain stimulator electrode through the burr hole and the base and relative to a brain of the patient.

16. A method for securing a deep brain stimulator electrode relative to a burr hole, comprising:

positioning a base relative to the burr hole, the base defining a central opening and an outer perimeter having a pair of attachment portions extending therefrom;

securing the base to a surface surrounding the burr hole with screws received through apertures in the attachment portions;

providing a stabilizer with a pair of opposed movable sidewalls defining a slot extending through the stabilizer and radially inward from an outer perimeter of the stabilizer, the opposed sidewalls biased to a closed configuration;

inserting a tool into an aperture in the stabilizer to open the slot to an open configuration for receiving the electrode therein;

positioning the stabilizer relative to the deep brain stimulator electrode and in the central opening of the base such that the electrode is slidably received within the slot in the open configuration from the outer perimeter thereof while the opposed sidewalls are facing each other;

removing the tool from the stabilizer to biasly close the slot to a closed configuration while maintaining the electrode within the slot as the opposed sidewalls move from the open configuration to the closed configuration while facing each other to engage the electrode and secure the electrode relative to the base; and

removably attaching a cover to the base to at least substantially cover the central opening and the burr hole.

17. The method of claim 16, further comprising laterally bending the electrode into a radially extending slot formed in an upper surface of the base between the outer perimeter and the central opening;

wherein removably attaching a cover to the base includes removably attaching fingers extending from a perimeter of the cover to receptacles formed in the base in a snap-fit manner such that the cover secures the laterally bent electrode in the radially extending slot and an opening formed in a cylindrically extending portion of the cover.

18. The method of claim 16, further comprising engaging the bone screws with a screwdriver to tightly secure the base to the surface surrounding the burr hole.

19. The method of claim 16, wherein positioning the stabilizer relative to the deep brain stimulator electrode and within the central opening of the base includes receiving the electrode within the slot in the open configuration before positioning the stabilizer within the central opening and relative to a circumferentially extending lip positioned about the central opening.

20. The method of claim 16, wherein positioning a base relative to the burr hole includes removably coupling a base positioning device to the base to facilitate positioning the base about the burr hole;

and

removing the base positioning device from the base prior to positioning the stabilizer within the central opening of the base.

21. A method for securing a deep brain stimulator electrode relative to a burr hole, comprising:

providing a base positioning device and a base, the base defining a central opening and an outer perimeter having a pair of attachment portions extending therefrom;

removably coupling the base positioning device to the base;

positioning the base about the burr hole using the base positioning device;

securing the base to a surface surrounding the burr hole with screws received through apertures formed in the attachment portions;

providing a stabilizer with a pair of opposed movable sidewalls defining a slot extending through the stabilizer and radially inward from an outer perimeter of the stabilizer, the opposed sidewalls biased to a closed configuration;

inserting a tool into an aperture in the stabilizer to open the slot to an open configuration for receiving the electrode therein;

positioning the stabilizer relative to the deep brain stimulator electrode and in the central opening of the base such that the electrode is slidably received within the slot in the open configuration from the outer perimeter thereof while the opposed sidewalls are facing each other;

removing the tool from the stabilizer to close the slot to a closed configuration while maintaining the electrode within the slot as each of the opposed sidewalls move from the open configuration to the closed configuration while facing each other to engage the electrode and secure the electrode relative to the base;

laterally bending a portion of the electrode into a radially extending slot formed in an upper surface of the base between the outer perimeter and the central opening; and

removably attaching a cover to the base to at least substantially cover the central opening and the burr hole and secure the laterally bent electrode in the radially extending slot and an opening formed in a cylindrical extending portion of the cover.

22. The method of claim 21, further comprising:

detachably capturing the bone screws with the base positioning device such that the bone screws are aligned with the apertures upon coupling the base positioning device with the base;

engaging the bone screws with a screwdriver to tightly secure the base to the surface surrounding the burr hole; and

releasing the bone screws from the base positioning device upon tightening the bone screws to the base.

23. The method of claim 21, further comprising providing a guide assembly for introducing and guiding the deep brain stimulator electrode through the burr hole and the base and relative to a brain of the patient.

24. The method of claim 21, wherein removably attaching a cover to the base includes removably attaching a cover to the base by positioning opposed pairs of projections extending from the cover into corresponding opposed pairs of receptacles formed in the base.

25. The method of claim 24, further comprising removing the cover from the base by positioning a tool between one of the pairs of spaced apart receptacles in the base to pry the cover from the base.