Method of utilizing a cerebral instrument guide frame

• US 5,474,564 A
• Filed: 04/01/1994
• Issued: 12/12/1995
• Est. Priority Date: 11/01/1991
• Status: Expired due to Fees

• Current Assignee: David A. Clayman, Tai Q. Nguyen
• Original Assignee: David A. Clayman, Tai Q. Nguyen
• Inventors: Nguyen, Tai Q., Clayman, David A.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/221,901
• Time in Patent Office: 620 Days
• Field of Search: 606/130, 128/653.1, 128/898, 378/20, 378/205, 609/117
• US Class Current: 606/130
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• 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

A cerebral instrument guide includes first and second arcs with aligned openings adjacent their ends, the openings defining a common axis about which the arcs are pivotal. The rods are mounted for movement along the common axis into contact with a human patient'"'"'s auditory meati. A nasal bridge fixation element mounted on the first arc, as well as orbit pads, engage the bridge of a patient'"'"'s nose, and his/her bony orbits. The appropriate angle to which the arcs should be pivoted with respect to each other is calculated by a computer program, as is the position to which a tubular instrument guide, slidable along the second arc and a projection from it intersecting the mid point of the common axis, is to be positioned to mark the burr hole on the patient'"'"'s skull for performing a neurological procedure, such as a ventriculostomy. A needle is passed through the tubular instrument guide to mark the burr hole site. The cerebral instrument guide frame may be left in place, or removed, while a stereotactic instrument placement guide is used (after the burr hole is formed) to properly position the neurological instrument (e.g. catheter) used to perform the neurological procedure.

Claims

1. A method of performing a neurological procedure on a human patient utilizing imaging equipment, a cerebral instrument guide frame, and an operating room, comprising the steps of substantially sequentially:

(a) effecting coordinate multiplanar tomographic diagnostic imaging of the patient'"'"'s head with the imaging equipment while the patient'"'"'s head is free of frame attachments, to obtain data necessary for performing a neurological procedure;

(b) moving the patient to the operating room;

(c) in the operating room, utilizing the data from the diagnostic imaging of step (a), fixing the cerebral instrument guide frame on the patient'"'"'s head; and

(d) substantially immediately after step (c), in the operating room, without transporting the patient back to the imaging equipment to effect a second imaging, performing the neurological procedure on the patient, utilizing the cerebral instrument guide frame to guide one or more medical instruments.

2. A method as recited claim 1 wherein during the practice of step (a) there is non-zero angle of inclination between imaging equipment and the patient and while there is an incremental advance between images;

and wherein step (a) is practiced by the sub-steps of;

(a1) during coordinate multiplanar tomographic imaging of the patient'"'"'s body, determining the coordinates of a first point on or within the patient'"'"'s body;

(a2) during coordinate multiplanar tomographic imaging of the patient'"'"'s body, determining the coordinates of a second point on or within the patient'"'"'s body;

(a3) determining the non-zero angle of inclination of the imaging equipment with respect to the patient and the incremental advance between images; and

(a4) utilizing the coordinates of the first and second points, the non-zero angle of inclination, and the incremental advance, by vector parameterization calculating the distance between the first and the second points and the loci of points along a line containing the first and second points.

3. A method as recited in claim 2 wherein step (a4) is practiced by calculating the straight line distance between the first and second points and the loci of points along a straight line containing those points.

4. A method as recited in claim 2 wherein steps (a1) and (a2) are practiced by CT scanning.

5. A method as recited in claim 2 wherein the neurological procedure of step (d) is selected from the group consisting essentially of ventriculostomy, biopsy, radioactive seed placement, and lesion generation.

6. A method as recited in claim 1 wherein the neurological procedure of step (d) is selected from the group consisting essentially of ventriculostomy, biopsy, radioactive seed placement, and lesion generation.