Stereotactic frame and localization method

• US 5,387,220 A
• Filed: 06/15/1993
• Issued: 02/07/1995
• Est. Priority Date: 06/15/1993
• Status: Expired due to Fees

• Current Assignee: Perumala Corporation
• Original Assignee: Perumala Corporation
• Inventors: Pisharodi, Maohaven
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): DAWSON, GLENN K
• Application Number:
  US08/077,026
• Time in Patent Office: 602 Days
• Field of Search: 128/898, 606/1, 606/130, 604/116
• US Class Current: 606/130
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins

Abstract

Applicant'"'"'s invention is a stereotactic frame and localization method incorporating localization frames which is operable without the use of head pins or screws. Initially, using the localization frames, natural reference points, lines, and planes are established and aligned in relation to a patient'"'"'s head. These natural references provide cranial landmarks for proper attachment and alignment of the stereotactic frame. This stereotactic frame includes a means for positioning and locking the frame as well a multiplicity of adjustable elements which are adjusted according to the determined values of the variables such that localization of a target point within a patient'"'"'s head is possible.

Claims

1. A method of stereotactic localization of a target point in a patient'"'"'s head comprising the steps of:

a. establishing a first orbitomeatal line on a first side of a patient'"'"'s head, said first orbitomeatal line extending from a first orbital ridge to a center point of a first external auditory meatus;

b. establishing a second orbitomeatal line on a second side of said patient'"'"'s head, said second orbitomeatal line extending from a second orbital ridge to a center point of a second external auditory meatus;

c. establishing an orbitomeatal plane, said orbitomeatal plane formed by connecting said first orbitomeatal line and said second orbitomeatal line;

d. establishing a central axis in said orbitomeatal plane, said central axis formed by connecting said center points of said first external auditory meatus and said second external auditory meatus;

e. establishing a vertical plane perpendicularly intersecting said orbitomeatal plane along said central axis;

f. using said orbitomeatal plane, said vertical plane, and said central axis to form a spherical coordinate system to locate said target point in said patient'"'"'s head.

2. A method of stereotactic localization of a target point in a patient'"'"'s head as recited in claim 1 further comprising taking electronic image slices of said patient'"'"'s head and of said target point, and transferring said target point location into said spherical coordinate system.

3. A method of stereotactic localization of a target point in a patient'"'"'s head as recited in claim 2 comprising the steps of:

a. supporting said patient'"'"'s head in a head frame;

b. attaching a stereotactic frame to said head frame; and

c. using said stereotactic frame to position a needle guide proximate to said target point.

4. A method of stereotactic localization as recited in claim 3 comprising the steps of:

a. removably fastening a fixed mount member of said stereotactic frame to said head frame, said fixed mount member including a rigidly attached bar;

b. locking a snake-like retractor arm of said stereotactic frame in a desired configuration;

c. positioning a first disc, affixed to an end of said snake-like retractor arm, such that said first disc aligns with said patient'"'"'s head, said first disc having a centered opening, a zero degree arm, and a ninety degree arm; and

d. positioning a second disc and a third disc in relation to said patient'"'"'s head wherein said second disc and said third disc are rotatably attached, said second disc and said third disc further secured to a first end of an elongated rod wherein said elongated rod slidably engages said first disc.

5. A method of stereotactic localization as recited in claim 4, wherein positioning said first disc in relation to said patient'"'"'s head comprises the steps of:

a. aligning said 0 degree arm of said first disc with said orbitomeatal plane; and

b. aligning said 90 degree arm of said first disc with said vertical plane.

6. A method of stereotactic localization as recited in claim 4, wherein positioning said first disc in relation to said patient'"'"'s head comprises the steps of:

a. aligning said 0 degree arm of said first disc with said vertical plane; and

b. aligning said 90 degree arm of said first disc with said orbitomeatal plane.

7. A method of stereotactic localization as recited in claim 4, wherein positioning said second disc and said third disc comprises the steps of:

a. sliding said second disc and said third disc towards said first disc such that said second disc is immediately adjacent to said first disc;

b. aligning a radial arm, attached to said third disc, with said orbitomeatal plane;

c. positioning an arc frame, slidably attached to said radial arm, such that a base of said arc frame meets a center point of said third disc; and

d. establishing a radius distance "r" wherein said radius distance "r" is the distance from said center point of said third disc to a closest one of said first auditory meatus and said second auditory meatus, said radius distance "r" being a radius of said arc frame.

8. A method of stereotactic localization as recited in claim 7 further comprising the steps of:

a. determining a distance "a" from said central axis to said target point in a plane "a" wherein said plane "a" is parallel with said orbitomeatal plane;

b. determining a distance "b" from said central axis to said target point in a plane "b" wherein said plane "b" is parallel with said vertical plane;

c. determining a point "c" on said central axis by projecting a line "c" from said target point to a closest point on said central axis; and

d. determining a distance "d" along said central axis, said distance "d" being a shorter distance from said point "c" to either said first auditory meatus or said second auditory meatus.

9. A method of stereotactic localization as recited in claim 8, wherein determining said distance "a" comprises the steps of:

a. projecting a line "a" from said target point to a closest point "a" on said vertical plane;

b. ascertaining said distance "a" from said target point to said vertical plane along said line "a".

10. A method of stereotactic localization as recited in claim 9 further comprises the step of calculating an angle "ac" between said line "a" and said line "c".

11. A method of stereotactic localization as recited in claim 10 further comprising the steps of:

a. moving said second disc and said third disc away from said first disc by said distance "d";

b. rotating said third disc through said angle "ac" from said orbitomeatal plane;

c. sliding said arc frame along said radial arm by said distance "c"; and

d. inserting a needle guide through said arc frame at a point of insertion wherein said needle guide is perpendicular to said arc frame at said point of insertion, said needle guide passing through said target point at a distance "r" from said arc frame.

12. A method of stereotactic localization as recited in claim 8, wherein determining said distance "b" comprises the steps of:

a. projecting a line "b" from said target point to a closet point "b" on said orbitomeatal plane;

b. ascertaining said distance "b" from said target point to said orbitomeatal plane along said line "b".

13. A method of stereotactic localization as recited in claim 12 further comprises the step of calculating an angle "bc" between said line "b" and said line "c".

14. A method of stereotactic localization as recited in claim 13 further comprising the steps of:

a. moving said second disc and said third disc away from said first disc by said distance "d";

b. rotating said third disc through said angle "bc" from said vertical plane;

c. sliding said arc frame along said radial arm by said distance "c"; and

d. inserting a needle guide through said arc frame at a point of insertion wherein said needle guide is perpendicular to said arc frame at said point of insertion, said needle guide passing through said target point at a distance "r" from said arc frame.

15. A method of stereotactic localization as recited in claim 14 wherein said rigidly attached bar is an edged piston member, further comprising the step of extending said edged piston member to an elongated position for removing said sterotactic frame from the surgery field after locating said target point.

16. A method of stereotactic localization as recited in claim 4, wherein positioning said second disc and said third disc comprises the steps of:

a. sliding said second disc and said third disc towards said first disc such that said second disc is immediately adjacent to said first disc;

b. aligning a radial arm, attached to said third disc, with said vertical plane;

c. positioning an arc frame, slidably attached to said radial arm, such that a base of said arc frame meets a center point of said third disc; and

d. establishing a radius distance "r" wherein said radius distance "r" is the distance from said center point of said third disc to a closest one of said first auditory meatus and said second auditory meatus, said radius distance "r" being the radius of said arc frame.

17. A method of stereotactic localization of a target point in a patient'"'"'s head, said patient'"'"'s head supported by a head frame during surgery, comprising the steps of:

a. positioning a localization frame on a patient'"'"'s head such that a first side member of said localization frame establishes a first orbitomeatal line on a first side of said patient'"'"'s head, said first orbitomeatal line extending from a first orbital ridge to a center point of a first external auditory meatus and a second side member of said localization frame establishes a second orbitomeatal line on a second side of said patient'"'"'s head, said second orbitomeatal line extending from a second orbital ridge to a center point of a second external auditory meatus;

b. establishing an orbitomeatal plane by connecting said first orbitomeatal line and said second orbitomeatal line;

c. establishing a central axis in said orbitomeatal plane by connecting said center points of said first external auditory meatus and said second external auditory meatus;

d. establishing a vertical plane perpendicularly intersecting said orbitomeatal plane along said central axis;

e. attaching a stereotactic frame to said head frame;

f. determining variable values for location of a target point within said patient'"'"'s head; and

g. locating said target point.

18. A method of stereotactic localization of a target point in a patient'"'"'s head, said patient'"'"'s head supported by a head frame during surgery, as recited in claim 17 further comprising the step of using said stereotactic frame to position a needle guide proximate to said target point.

19. A method of stereotactic localization as recited in claim 17 further comprising the steps of:

a. removably fastening a fixed mount member of said stereotactic frame to said head frame for securing said stereotactic frame to said head frame;

b. stationing an edged piston member, said edged piston member attached to said fixed mount member;

c. locking a snake-like retractor arm of said stereotactic frame in a desired configuration;

d. positioning a first disc, affixed to an end of said snake-like retractor arm, such that said first disc aligns with said patient'"'"'s head, said first disc having a centered opening, a zero degree arm, and a ninety degree arm; and

e. positioning a second disc and a third disc in relation to said patient'"'"'s head wherein said second disc and said third disc are rotatably attached, said second disc and said third disc further secured to a first end of an elongated rod wherein said elongated rod slidably engages said first disc.

20. A method of stereotactic localization as recited in claim 19, wherein positioning said first disc in relation to said patient'"'"'s head comprises the steps of:

a. aligning said 0 degree arm of said first disc with said orbitomeatal plane; and

b. aligning said 90 degree arm of said first disc with said vertical plane.

21. A method of stereotactic localization as recited in claim 19, wherein positioning said first disc in relation to said patient'"'"'s head comprises the steps of:

a. aligning said 0 degree arm of said first disc with said vertical plane; and

b. aligning said 90 degree arm of said first disc with said orbitomeatal plane.

22. A method of stereotactic localization as recited in claim 19, wherein positioning said second disc and said third disc comprises the steps of:

a. sliding said second disc and said third disc towards said first disc such that said second disc is immediately adjacent to said first disc;

b. aligning a radial arm, attached to said third disc, with said orbitomeatal plane;

c. positioning an arc frame, slidably attached to said radial arm, such that a base of said arc frame meets a center point of said third disc; and

d. establishing a radius distance "r" wherein said radius distance "r" is the distance from said center point of said third disc to a closest one of said first auditory meatus and said second auditory meatus, said radius distance "r" being the radius of said arc frame.

23. A method of stereotactic localization as recited in claim 19, wherein positioning said second disc and said third disc comprises the steps of:

a. sliding said second disc and said third disc towards said first disc such that said second disc is immediately adjacent to said first disc;

b. aligning a radial arm, attached to said third disc, with said vertical plane;

c. positioning an arc frame, slidably attached to said radial arm, such that a base of said arc frame meets a center point of said third disc; and

d. establishing a radius distance "r" wherein said radius distance "r" is the distance from said center point of said third disc to a closest one of said first auditory meatus and said second auditory meatus, said radius distance "r" being the radius of said arc frame.

24. A method of stereotactic localization as recited in claim 19 further comprising the step of extending said edged piston member to an elongated position for removing said stereotactic frame from the surgery field after locating said target point.

25. A method of stereotactic localization as recited in claim 17 wherein determining said variable values comprises the steps of:

a. determining a distance "a" from said central axis to said target point in a plane "a" wherein said plane "a" is parallel with said orbitomeatal plane;

b. determining a distance "b" from said central axis to said target point in a plane "b" wherein said plane "b" is parallel to said vertical plane;

c. determining a point "c" on said central axis by projecting a line "c" from said target point to a closest point on said central axis; and

d. determining a distance "d" along said central axis, said distance "d" being a shorter distance from said point "c" to either said first auditory meatus or said second auditory meatus.

26. A method of stereotactic localization as recited in claim 25, wherein determining said distance "a" comprises the steps of:

a. projecting a line "a" from said target point to a closest point "a" on said vertical plane; and

b. ascertaining said distance "a" from said target point to said vertical plane along said line "a".

27. A method of stereotactic localization as recited in claim 26 wherein determining said variable values further comprises the step of calculating an angle "ac" between said line "a" and said line "c".

28. A method of stereotactic localization as recited in claim 27, wherein locating said target point comprises the steps of:

a. moving said second disc and said third disc away from said first disc by said distance "d";

b. rotating said third disc through said angle "ac" from said orbitomeatal plane;

c. sliding said arc frame along said radial arm by said distance "c"; and

d. inserting a needle guide through said arc frame at a point of insertion wherein said needle guide is perpendicular to said arc frame at said point of insertion, said needle guide passing through said target point at a distance "r" from said arc frame.

29. A method of stereotactic localization as recited in claim 25, wherein determining said distance "b" comprises the steps of:

a. projecting a line "b" from said target point to a closest point "b" on said orbitomeatal plane; and

b. ascertaining said distance "b" from said target point to said orbitomeatal plane along said line "b".

30. A method of stereotactic localization as recited in claim 29 wherein determining said variable values further comprises the steps of calculating an angle "bc" between said line "b" and said line "c".

31. A method of stereotactic localization as recited in claim 30, wherein locating said target point comprises the steps of:

a. moving said second disc and said third disc away from said first disc by said distance "d";

b. rotating said third disc through said angle "bc" from said vertical plane;

c. sliding said arc frame along said radial arm by said distance "c"; and

d. inserting a needle guide through said arc frame at a point of insertion wherein said needle guide is perpendicular to said arc frame at said point of insertion, said needle guide passing through said target point at a distance "r" from said arc frame.