METHODS OF USING A ROBOTIC SPINE SYSTEM

• US 20160331481A1
• Filed: 07/25/2016
• Published: 11/17/2016
• Est. Priority Date: 03/20/2002
• Status: Active Grant

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Granted Patent: US 10,265,128 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/14 Surgical saws A61B17/1637 takes precedence; tooth saws A61C3/12 ; Accessories therefor
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8802 Equipment for handling bone cement or other fluid fillers
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 17/885 Tools for expanding or compacting bones or discs or cavities therein A61B17/8805, A61B17/7097 take precedence
• CPC Class Codes: A61B 17/8852 capable of being assembled or enlarged, or changing shape, inside the bone or disc
• CPC Class Codes: A61B 17/8855 inflatable, e.g. kyphoplasty balloons
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/3916 : Bone tissue
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/32 : operating autonomously
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0071 : by measuring fluorescence emission
• CPC Class Codes: A61B 6/032 : Transmission computed tomography [CT]
• CPC Class Codes: A61B 90/03 : Automatic limiting or abutting means, e.g. for safety
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30133 : kidney-shaped or bean-shaped

Abstract

A method of using a robotic guidance system for performing surgery on a spine is provided. The method includes utilizing a computerized tomographic scan image of a location on a spinal column of a patient, such that the computerized tomographic scan image is connected to a computer and visible on a monitor connected to the computer. The method also includes attaching a coupling component to the spinal column of the patient, coupling a marker to the coupling component, and imaging, with a fluoroscope, the view of the spinal column of the patient, wherein the fluoroscope image is transmitted to the computer and visible on the monitor and the at marker is clearly visible in the fluoroscope image. The method also includes positioning a cannula, with a robotic mechanism, to a first position relative to a vertebra in the spinal column of the patient, drilling a passage through the cannula into bone of the vertebra in the spinal column of the patient, inserting a guidewire through the cannula into the passage in the bone of the vertebra in the spinal column of the patient, and positioning a screw into the bone of the vertebra in the spinal column of the patient.

Claims

1. A method of using a robotic guidance system for performing surgery on a spine, the method comprising:

utilizing at least one computerized tomographic scan image of a location on a spinal column of a patient on whom a surgical procedure is to be performed, wherein the at least one computerized tomographic scan image is connected to at least one computer and visible on at least one monitor connected to the at least one computer;

attaching at least one coupling component to the spinal column of the patient;

coupling at least one marker to the at least one coupling component;

imaging, with a fluoroscope, at least one view of the spinal column of the patient on whom the surgical procedure is to be performed, wherein the at least one fluoroscope image is transmitted to the at least one computer and visible on the at least one monitor connected to the at least one computer, and wherein the at least one marker is clearly visible in the at least one fluoroscope image;

positioning a cannula, with a robotic mechanism, to a first position relative to a vertebra in the spinal column of the patient;

drilling a passage through the cannula into bone of the vertebra in the spinal column of the patient;

inserting a guidewire through the cannula into the passage in the bone of the vertebra in the spinal column of the patient; and

positioning a screw into the bone of the vertebra in the spinal column of the patient, wherein the screw is configured to secure body tissue.

2. The method according to claim 1, wherein at least one of

drilling a passage further comprises drilling a passage, with a manual effort, through the cannula positioned with the robotic mechanism into bone of the vertebra in the spinal column of the patient,

inserting a guidewire further comprises inserting a guidewire, with a manual effort, through the cannula positioned with the robotic mechanism into the passage in the bone of the vertebra in the spinal column of the patient, and

positioning a screw further comprises positioning a screw, with a manual effort, into the bone of the vertebra in the spinal column of the patient, wherein the screw is configured to secure body tissue.

3. The method according to claim 1, further comprising:

positioning the cannula, with the robotic mechanism, to a second position different from the first position relative to the vertebra in the spinal column of the patient;

drilling a second passage through the cannula positioned in the second position into bone of the vertebra in the spinal column of the patient;

inserting a second guidewire through the cannula positioned in the second position into the second passage in the bone of the vertebra in the spinal column of the patient; and

positioning a second screw, in the second position, into the bone of the vertebra in the spinal column of the patient, wherein the second screw is configured to secure body tissue.

4. The method according to claim 3, wherein at least one of

drilling a second passage further comprises drilling a second passage, with a manual effort, through the cannula positioned in the second position with the robotic mechanism into bone of the vertebra in the spinal column of the patient,

inserting a second guidewire further comprises inserting a guidewire, with a manual effort, through the cannula positioned in the second position with the robotic mechanism into the second passage in the bone of the vertebra in the spinal column of the patient, and

positioning a second screw further comprises positioning a screw, with a manual effort, positioned in the second position, into the bone of the vertebra in the spinal column of the patient, wherein the second screw is configured to secure body tissue.

5. The method according to claim 1, further comprising:

positioning the cannula, with the robotic mechanism, to a second position different from the first position relative to at least one of a second position on the same vertebra in the spinal column of the patient, an adjacent vertebra in the spinal column of the patient, and a different vertebral structure in the spinal column of the patient;

drilling a second passage through the cannula positioned in the second position into at least one of bone of the same vertebra, bone of the adjacent vertebra, and the different vertebral structure in the spinal column of the patient;

inserting a second guidewire through the cannula positioned in the second position into the second passage in at least one of the bone of the same vertebra, the bone of the adjacent vertebra, and the different vertebral structure in the spinal column of the patient; and

positioning a second screw, positioned in the second position, into at least one of the bone of the same vertebra, the bone of the adjacent vertebra, and the different vertebral structure, wherein the second screw is configured to secure body tissue.

6. The method according to claim 5, further comprising:

drilling a second passage further comprises drilling a second passage, with a manual effort, through the cannula positioned in the second position with the robotic mechanism into at least one of the bone of the same vertebra, the bone of the adjacent vertebra, and the different vertebral structure in the spinal column of the patient;

inserting a second guidewire further comprises inserting a guidewire, with a manual effort, through the cannula positioned in the second position with the robotic mechanism into the second passage into at least one of the bone of the same vertebra, the bone of the adjacent vertebra, and the different vertebral structure in the spinal column of the patient; and

positioning a second screw further comprises positioning a screw, with a manual effort, through the cannula positioned in the second position with the robotic mechanism into at least one of the bone of the same vertebra, the bone of the adjacent vertebra, and the different vertebral structure in the spinal column of the patient, wherein the second screw is configured to secure body tissue.

7. The method according to claim 1, wherein the cannula is at least one portion of a tissue retractor assembly.

8. The method according to claim 1, further comprising positioning at least one tissue retractor through the cannula positioned by the robotic mechanism.

9. The method according to claim 1, further comprising utilizing at least one surgical instrument positioned through the cannula.

10. The method according to claim 1, wherein the guidewire is configured to have external threads.

11. The method according to claim 10, wherein the guidewire is configured to be screwed into the passage in the bone.

12. The method according to claim 1, wherein the body tissue is at least a portion of one of a bone, ligament, tendon, and muscle.

13. A method of using a robotic guidance system for performing surgery on a spine, the method comprising:

utilizing at least one computerized tomographic scan image of a location on a spinal column of a patient on whom a surgical procedure is to be performed, wherein the at least one computerized tomographic scan image is connected to at least one computer and visible on at least one monitor connected to the at least one computer;

attaching at least one coupling component to the spinal column of the patient;

coupling at least one marker to the at least one coupling component;

imaging, with a fluoroscope, at least one view of the spinal column of the patient on whom the surgical procedure is to be performed, wherein the at least one fluoroscope image is transmitted to the at least one computer and visible on the at least one monitor connected to the at least one computer, and wherein the at least one marker is clearly visible in the at least one fluoroscope image;

positioning a cannula, with a robotic mechanism, to a first position relative to the spinal column of the patient; and

inserting a surgical instrument through the cannula, wherein the surgical instrument is configured for use in the surgical procedure on the spinal column of the patient.

14. The method according to claim 13, wherein inserting a surgical instrument further comprises inserting a surgical instrument, with a manual effort, through the cannula positioned with the robotic mechanism, wherein the surgical instrument is configured for use in the surgical procedure on the spinal column of the patient.

15. The method according to claim 13, further comprising:

positioning the cannula, with the robotic mechanism, to a second position different from the first position relative to the spinal column of the patient; and

inserting a surgical instrument through the cannula positioned in the second position, wherein the surgical instrument is configured for use in the surgical procedure on the spinal column of the patient.

16. The method according to claim 15, wherein inserting a surgical instrument further comprises inserting a surgical instrument, with a manual effort, through the cannula positioned in the second position with the robotic mechanism, wherein the surgical instrument is configured for use in the surgical procedure on the spinal column of the patient.

17. The method according to claim 13, wherein the cannula is at least one portion of a tissue retractor assembly.

18. The method according to claim 13, further comprising positioning at least one tissue retractor through the cannula.

19. The method according to claim 13, further comprising positioning at least one prosthetic implant in the spinal column of the patient.

20. A robotic guidance system for performing surgery on a spine, the robotic guidance system comprising:

at least one computer configured to receive at least one computerized tomographic scan image of a spinal column of a patient on whom a surgical procedure is to be performed;

at least one monitor connected to the at least one computer, wherein the at least one monitor is configured to display, from the at least one computer, the at least one computerized tomographic scan image of the spinal column of the patient on whom the surgical procedure is to be performed;

at least one coupling component configured to couple to the spinal column of the patient;

at least one marker configured to couple to the at least one coupling component, wherein the at least one marker is configured to be clearly visible in at least one fluoroscope image of the spinal column of the patient on whom the surgical procedure is to be performed, and wherein at least one fluoroscope image is transmitted to the at least one computer and visible on the at least one monitor connected to the at least one computer;

a robotic mechanism connected to the at least one computer and configured to move through various programmed motions for the performance of the surgical procedure on the spinal column of the patient;

a cannula configured to be positioned, by the robotic mechanism, relative to at least one vertebrae in the spinal column of the patient;

a drill configured to create at least one passage into bone of the at least one vertebrae in the spinal column of the patient, wherein the drill is configured to be positioned through the cannula;

at least one guidewire configured to be inserted into the at least one passage in the bone of the at least one vertebrae in the spinal column of the patient, wherein the guidewire is positionable through the cannula; and

at least one screw configured to be positioned into the at least one passage in the bone of the at least one vertebrae in the spinal column of the patient, wherein the at least one screw is configured to secure body tissue.

21. The robotic guidance system according to claim 20, wherein the cannula is at least one portion of a tissue retractor assembly.

22. The robotic guidance system according to claim 20, further comprising at least one tissue retractor configured to be positioned through the cannula.

23. The robotic guidance system according to claim 20, further comprising at least one surgical instrument configured to be utilized through the cannula.

24. The robotic guidance system according to claim 20, wherein the guidewire is configured to have external threads.

25. The robotic guidance system according to claim 24, wherein the guidewire is configured to be screwed into the passage in the bone.

26. The robotic guidance system according to claim 20, wherein the body tissue is at least a portion of one of a bone, ligament, tendon, and muscle.

27. The robotic guidance system according to claim 20, further comprising at least one prosthetic implant configured to be positioned in the bone of the at least one vertebrae in the spinal column of the patient.

28. A robotic guidance system for performing surgery on a spine, the robotic guidance system comprising:

at least one computer configured to receive at least one computerized tomographic scan image of a spinal column of a patient on whom a surgical procedure is to be performed;

at least one monitor connected to the at least one computer, wherein the at least one monitor is configured to display, from the at least one computer, the at least one computerized tomographic scan image of the spinal column of the patient on whom the surgical procedure is to be performed;

at least one coupling component configured to couple to the spinal column of the patient;

at least one marker configured to couple to the at least one coupling component, wherein the at least one marker is configured to be clearly visible in at least one fluoroscope image of the spinal column of the patient on whom the surgical procedure is to be performed, and wherein at least one fluoroscope image is transmitted to the at least one computer and visible on the at least one monitor connected to the at least one computer;

a robotic mechanism connected to the at least one computer and configured to move through various programmed motions for the performance of the surgical procedure on the spinal column of the patient;

a cannula configured to be positioned, by the robotic mechanism, relative to the spinal column of the patient; and

at least one surgical instrument configured for use in the surgical procedure on the spinal column of the patient, wherein the surgical instrument is positionable through the cannula.

29. The robotic guidance system according to claim 28, wherein the cannula is at least one portion of a tissue retractor assembly.

30. The robotic guidance system according to claim 28, further comprising at least one tissue retractor configured to be positioned through the cannula.

31. The robotic guidance system according to claim 28, further comprising at least one prosthetic implant configured to be positioned in the spinal column of the patient.