Surgical Spinal Correction

• US 20160235480A1
• Filed: 10/09/2014
• Published: 08/18/2016
• Est. Priority Date: 10/09/2013
• Status: Active Grant

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Nuvasive Incorporated
• Inventors: Isaacs, Robert, Scholl, Thomas, Peterson, Mark
• Granted Patent: US 10,561,465 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/7002 Longitudinal elements, e.g. rods
• 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 17/7086 Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 17/8863 Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• 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 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• 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 2034/254 being adapted depending on the stage of the surgical procedure
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/0086 using infrared radiation
• CPC Class Codes: A61B 5/4566 Evaluating the spine A61B5/4561 takes precedence
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

A method is provided for planning, performing, and assessing of surgical correction to the spine during a spinal surgical procedure. This method is implemented by a control unit through a GUI to digitize screw locations, digitize anatomical reference points, accept one or more correction inputs, and generate one or more rod solution outputs shaped to engage the screws at locations distinct from the originally digitized locations.

Claims

1. A system for intraoperative planning and assessment of spinal deformity correction during a surgical spinal procedure, the system comprising:

a spatial tracking system comprising an IR sensor and an IR tracking array, said IR tracking array being arranged along a proximal end of a surgical pointer tool capable of digitizing the location of an implanted surgical device and relaying to the spatial tracking system via the IR sensor;

a control unit in communication with the spatial tracking system, said control unit being configured to;

(a) receive the digitized location data of a plurality of implanted screws;

(b) receive the digitized location data of at least one anatomical reference point;

(c) generate at least one virtual anatomic reference line based on the digitized location data of said at least one anatomical reference point;

(d) accept one or more spine correction inputs; and

(e) generating at least one rod solution output shaped to engage the screws at locations distinct from the digitized location.

2. The system of claim 1, wherein the spine correction input is a spinal correction in the coronal plane.

3. The system of claim 2, wherein the virtual anatomic reference line is the central sacral vertical line (CSVL).

4. The system of claim 3, wherein the at least one anatomical reference point comprises at least two points that correlate to the CSVL.

5. The system of claim 4, wherein the at least two points are the left iliac crest, the right iliac crest, and the midpoint of the sacrum.

6. The system of claim 3, wherein the at least one anatomical reference point comprises two points that lie along the CSVL.

7. The system of claim 6, wherein the at least one anatomical reference point comprises a superior point and an inferior point on the sacrum.

8. The system of claim 3, wherein the spine correction input comprises aligning all of the digitized screw locations relative to the CSVL in the coronal plane.

9. The system of claim 3, wherein the rod solution output is a vertically straight rod along at least a portion of the length.

10. The system of claim 1, wherein the control unit is further configured to generate at least one measurement value based on at least one anatomically-based reference point.

11. The system of claim 1, wherein the control unit is configured to generate at least one measurement value based on at least two anatomically-based reference lines.

12. The system of claim 11, wherein the measurement is an offset distance between said two reference lines.

13. The system of claim 12, wherein said two reference lines are the central sacral vertical line (CSVL) and the C7 plumb line (C7PL).

14. The system of claim 13, wherein the control unit is further configured to assess intraoperative spinal balance based on a relationship between said CSVL and C7PL and communicate that assessment to a user.

15. The system of claim 14, wherein said relationship is based on the coronal offset distance between the CSVL and C7PL.

16. The system of claim 15, wherein said visual communication is a color in which a first color designates an offset distance indicating a balanced spine within the coronal plane and a second color designates an offset distance indicating an unbalanced spine within the coronal plane.

17. The system of claim 10, wherein the measurement value comprises an intraoperative lumbar lordosis angle and a planned pelvic incidence angle.

18. The system of claim 17, wherein the control unit is further configured to assess intraoperative spinal balance based on a relationship between an intraoperative lumbar lordosis angle measurement and a planned pelvic incidence angle.

19. The system of claim 18, wherein the lumbar lordosis angle and pelvic incidence angle are measured at least once during the operation.

20. The system of claim 19, wherein the relationship is based on the variance between the intraoperative lumbar lordosis angle and the planned pelvic incidence angle.

21. The system of claim 20, wherein said communication is a color in which a first color designates a variance indicating a balanced spine within the sagittal plane and a second color designates an variance distance indicating an unbalanced spine within the sagittal plane.